Anaesthesia Flashcards
(179 cards)
1
Q
Predictor for bag an mask
rventilation
A
OBESE
2
Q
Predictors of diff
airway
A
LEMON
3
Q
rule of 3-3-2
A
interincisor gap
hyomental distance
Thypohyoid
4
Q
Patil’s test
A
TMD
6:5 6
5
Q
savva’s test
A
SMD
max .predictive value for a difficult amway
12-5
6
Q
Mallampatti
A
Push
7
Q
nmallampati o
A
Epiglottis visible
8
Q
Cormack and Le hane classification
A
I-
II -
III -
IV-
9
Q
Ideal position for intubation
A
Barking dog/ sniffing
10
Q
ideal position for
obese pts
A
HELP ( head elevated laryngoscopy position)
Ramp
ear . - suprasternal notch
11
Q
Eg for secure aisway
A
ETT
tracheostomy
12
Q
order of increase in dead space in diff
ariway techniques
A
FM >SAD >ETT
except long ETT preterm neonate
13
Q
Why risk of aspiration
A
gastric insufflation of air
14
Q
AMBU=
FiO2
vol
A
Ambulatory manual
breathing unit
100%02
250 N 500 C 1-5L A
15
Q
GUedal’s airway
A
OPA
hard plastic
16
Q
appropriate size of guedel’s awway
A
vertical distance b/w angle of mandible and central incisor or
blw EAM an angle of mouth
17
Q
Nasal trumpet
A
soft silicon
tragus to tip of nose
18
Q
disadv of nasal trumpet
A
/ bleeding pts on ants ‘coagulants
basilar skull #
19
Q
AOC for SAD insertion
A
Propofol
20
Q
tip of CMA →
A
faces esophagus
21
Q
Examples of 2nd gen LMA
A
proseal
supreme
I- gel
22
Q
C/ I to LMA
A
distorted upper away
emergency surgery)
full stomach pts
23
Q
most common size
LMA Claussic
A
M-5
F-4 C- 3 (30.5kg)
man int racuff pressure 60 cms
24
Q
LMA fastrach
A
intubating
plunger
25
Miller Blade
Pediatric intubation
26
most common injured structure during
laryngoscopy
upper central
incIsor
27
maneouvre improving
visualisation of vc
BURP
28
Plan for anticipated difficult arewary
Awake F0B intubation
29
mantiapitated duff airway
A B c D
30
Murphy's eye
types
and opening ETT
Magil - C
Murphys
31
Ad vantage and disadvantageof how volume
high pressure
cuff
N O risk of aspiration
r/o tracheal stenosis
red rubber
32
pressure, volume cuff
size
<25 mm Hg
4-8 m I
2.5 10.5
depth 21-23 cm
F-7/7.5
33
why uncuffed ETT for pediatric
(tell 8 yrs)
P recent post intubation
croup
34
pediatric ETT size for > lyr
age/ 4 +4
age /2 + 12cm
35
ETT size for pretum neonate
2-5/3
3Cmx size
36
surest sign of confirmation of placement of €TT
visualis ation of
vocal colds
37
fold std for placement of
ETT
FOB - carina
38
most common method
of confirmation of placement of ETT
Capnography
39
nasal intubation C/I
in
base of skull#
CS F rhinorr hea
Bleeding tendency
Nasal polyps
40
Why nasal intubation
C/ I in base of
skull#
weak cribri form plate
intracranial migration
41
... ... has no role in confuming
endo bronchial tube
Cap no
42
Pregnant female which ASA
II
43
ASA Iv
sever systemic disease limits activity but not incapacitating
uncontrolled HTM ( DM
chronic smoker
alcohol addict
ESRD on rregular dialysis
11HO CAD TIA stroke MY, stent > 3months
44
Drugs that need to be continued preoperatively
BB NTG CCB Thiazides
statins
*steroids*
POP
anti epileptics anti thyroid
ATT ART
45
stopping aspirin preoperatively
low dose continue
high -3-5d b4
46
stopping clopidogrel preop
7d b4
47
stopping warfarin preop
Target PT IMR < 1.5
or 3-5d b 4
48
stopping heparin preop
UFH- 4-6 hrs
LM WH
proph- 12hrs therapeutic-24 hrs
49
Which antihypertensives
to bestopped on
day of Sx
ACEI
ARB all diuretics except
thiazides
50
stopping insulin n 0HA
day of sx
51
When to stop heebal and Ayurvedic med preop
min 2 weeks by Sx
52
stopping psychiatric meds
continue all except Li MAO#
Li - 48 hrs(24-48)
MAO ⇒ Irreversible- 2-4wks
reversible day of Sx
53
s topping OCP preop
4-6 w eeks
except POP
54
advised duration of
smoking abstinence
4-8 weeks
55
most commonly used premedication
BZD
anti anxiety, sedation, anterograde amnesia
56
BZD of choice for premedication
Midaz
57
most used anti sialogogue
gly copyrrolate
58
use an technique Preoxygenation
Tidal vol respx 3 mins
8_10 vital capacity breathes
increase safe apnea time
59
02 req at rest
250 ml) min
60
96% ischemia detection rate which leads
V5, V4, II
61
Bispectral index
O
0-20
20-40
40-60
60-80
80-100
62
hold std for
monitoring anaesthetic depth
Midale latency auditory evoked potentials
63
Pulse oximetry is based on
Beer Lambert law
64
wavelengths used in
pulse oximetry
660 deoxy
940 oxy
65
False low reading pulse oximetry
meth Itb
methylene blue
indocyanine green
peripheral vasoconstriction
shivering
Badly positioned probe
Nail paints (Blue/ Black/ purple '
66
False high pulse oximetry reading
CO Hb
67
Capno graphy Normal
35-45 mm hg
68
cap no graphy
rebreathing
does not touch
base
69
Curare notch/ cleft
First spontaneous
lescashing effort under muscle relaxant
supplement more
relaxant
70
Shark fin appearance
Partially obstructed ETT
Obstructive lung
disease
COPD
Broncho spasm
upper amway obstruction
71
flat cap no
accidental extubation
disconnection ventilator failure
carctic arrest d
72
source of Co2 in stomach
aerated drinks
Bacterial metabolism
swallowed air
73
Iv inducers
GABA agonist-4
MMDA antagonist -1
74
inhaled inducers
h alothane
sevoflurane
75
AOC inhalational inducers
sevoflurane
76
Barbiturate used for
induction
Thiopentone
77
AOL - ECT
Metho hexitone
78
Eg. of phenecycline
derivative
ketamine
79
site of action of
Thiopentone
RA S
immediate LOC
80
site of action of ketamine
Thalamo cortical jn
hence dissociative
anaesthesia
81
onset of action of Thiopentone
ultrafast 15-20s
I arm brain circulation time
82
duration of action of
thiopentone
<20 mins
redistribution
83
Cns effects of Thiopentone
decrease CBF ICP (Max) CMRO2
anti analgesic
anti epileptic
84
Thiopentone
c| I in
k / C / o AlP and vari gate porphyria
hypovolaemic/
circulatory shock
statUs asthmaticus
85
Aoc for raised ICP Sx
Thiopentone
86
uses of thiopentone
Induction
Barbiturate coma
Nemoanalysis
87
active form of ketamine
Liver- Norketamine
88
ketamine's effect on c Vs
indirect sympathomimetic "HR " BP,,co
89
ketamine effect on RS
max preservation of
respiration
max preservation of
airway reflexes
Max broncho dilation
90
Why avoid ketamine in NSx
" ICP
" CRO2
" IOP
proconvulsant
91
ketamine AO C for
acute shock
asthma
full stomach
PPH
feeld anaesthesia
pediatric pts
cganofic CHD
short and painful
- burns
92
Ketamine c/ I
l HD AA head ingrye caused ICP
open eye sx
NS x
1/0 psychiatric illness
93
Emergence delirium
associated with
ketamine
94
E tomidate ...... derivative
Imida zole
95
max pain on injaction with
Why
Eto midare
propylene glycol
96
Contents of Propofol
EGGS
97
onset and duration
of action of propofol
15-20 secs
10 mins
98
AOC for daycare Sx
Propofol
99
AOC SAD insertion
propofol
100
cardio stable induction agent
Etomid ate
101
cars effects of Propofol
cerebral vasoconstrictor ,,ICP
,,cMROz
anti convulsant
antiemetic
anti prucritic?
No muscle relax?
Max decrease in 10P
102
Proconvulsant inducers
ketamine Etomidate
103
AOC induction cardiac pts
Etomidate
104
Propofol infusion
syndrome
> 4 mg/ kgl hr
for > 48 hrs
105
Mx . propofol infusion
syndrome
hemo dialysis
(PR ECHO
106
MOA NDMR
competitive Antagonism @ nico tinic Ach receptors
107
MOA DMR
pasteal agonist at Ach receptors
108
Suxamethonium I scoline onset a duration
30-605
< 10 minutes
109
dose scoline
1-1-5 my /kg
110
Aoc tracheal intubation
S coline
111
,,plasma cholinesterase
Liner failure
Renal failure
preg
drugs_ Neo stig mine
cyclophosphamide
Echo throophate
112
scoline phase II block
7-10mg/kg
60 mins
113
" drwalton of action - s coline
phase II block
hypothermia
,,enzyme
genetic abn@ or altered enzyme
114
Dibucaine No
scolin e
co-10 40-60 20-40
115
ADR_ scoline
brady cardia
fasciaaulations (-)
myalgia
" ICP "10P
Masseter spasm
Trigger for malignant hyperthermia
histamine release
hyper k+
116
Scolim C/ I
head ingkey malig hypothermia open eye injury, glaucoma heyper kalemia
Myotonica dystrophica pediatric < 8C?) Burns * scinjury, GBS, Tetanus I myopathy chronic dInnervation Stroke massive trauma
117
curium
Benzyl iso quinnolum derivative
doxa dTC
adra cisatra
Ganta miva
118
shortrest on longest curium
Ganta
Doxa
119
Fastest NDMR
Rocuranium
60-90s
120
long duration steroidal derivatives MDMR
Pan
Pipe
121
max ragolytic action
among NDMR
pan
122
MDMR- vago+
histamine -
Rocu ro nium
123
Hist +
vago -
MDMR
Atra
Miva
124
Bile/ urine excretion
ND MR
Rocuranium
125
NDMR " potency of
antibiotics - strep
Amikacin
Amino glycosides
Danteolene
Des> lso> sevo> Halo
Mgso4
forosemide
126
MDMR,,potency of
antiepileptics
Ca20
cholinesterase inhibitors
127
Indication NDMR
intubation
defasciccuelation
maintenance
128
Laudon osine
metabolite of
ateacurium hoffman
elimination
THEORETICAL seizure induction
129
NDMR that can replace
scolere for inthenation
but can cause pain on
inj
Rocu
130
1sT MR used clinically
DTC
max hist amine release
131
most potent
vagolytic MDMR
pan
old- Gallamine
132
only MMDR metabolised
ley pseudo cholineesterase
MIVA
Aoc for day care Sx
133
muscle relaxants that don't need
dings for reversal
scoline
MIva
atra
cisatra
134
MR that need drugs for reversal
cholinestuas inhibitors
anticholinergic
135
sugamma dex
Roc vec reecesal agent
136
most common nerve-muscle
combo tested in NM monitoring
ulnar
Adductor Pollicis
2nd_ facial
orbicullis oculi
137
Gold std of recording N MJ monitori ngresponse
MM G
but m/c AmG
138
use of 1 twitch
supra maxi mal
strength
139
mc need pattern of
stimulation
Train of 4
4→ 2s 2HZ
140
Duration b/w 2 stimulation in a TOF
0-5s
141
duration b/w 2 TOF
10 S
142
continuous stimulation or tetany
50-200 Hz
assess deeper levels of block
143
TOF- R NDMR
0.4
144
TOF R DMR
I- 1.0
I - 0:4
145
intubate on what TOF count
0 / 1
146
TOR- R 0-4 action
0.3-0-7 wait and watch
147
reveesal and extubation on which TO_R
0.7
0.9
148
PTC= O
intense block
149
clinical signs of recovery
sustained head left
sustained leg lift
sustained hand grip
positive tongue depressor
test
Meg inspiratory pressure of
-40to-50 cms. water
150
TIVA AOC for
maintenance
Propofol+ opiod
Remi fentanyl> Alfentanil > tentamyI
151
Pure gases used for
maintenan ce
N20
Xe
152
Fastest onset and recovery
Xenon 0.15
153
slowwest onset and
recovery
Methoxy flurane
154
increasing order of BG PC
Xe
Des
M20
sevo
1so
halo 2-4
155
Fastest volatile agent
Des
156
heast potent inhaled agent
NzO
157
housest MAC) highest potency
Methoxy fleurane
158
Decreasing order of MAC
NO (104)
Xe (70)
Des (6)
sevo (2)
1so (1.1)
159
temperature potency
temperature <42 potency"ses
>42,,ses
160
max MAC @
6 months
161
liffect of electrolyte
on potency
Na decreases potency increases
Ca2 increases potency increases
162
preg, all LA, all
anesthetic except cocaine
MAC decreases
163
Effect of T S H on MAC
No role
164
Metabo li sm sevo iso halo
5 %
0.2%
25 %
165
all inhaled agents are myocardial depressants except
N20
166
Effect of inhaled agents on
RS
"ses HR
,,ses Tidal volume
~ fast and shallow breaths
167
seffect of inhalational
agents C N S
I'ses ICP
,,ses CMRO2 except NzO
muscle relax except N20
trigger malignant hyper exept NzO
168
N20
'
..
-
169
hong term exposun of
M20 causes
peripheral neuropathy
megaloblastic anemia
SACD
tera togens
170
maximum level of agent in OT
M20 - <2 5 ppm
volatile agent w/o M20 - 2 ppm
W N20 0-5 ppm
171
structures parsing through
SOF
3,4,6
V1
172
Fink effect
During recovery from the anesthesia, when nitrous oxide is discontinued – large concentration of nitrous oxide diffuses back to the alveoli from the blood. This is due to low blood solubility of nitrous oxide (N2O) and results in:
Dilution of the inspired oxygen concentration and hypoxia.
Dilution of inspired carbon-dioxide concentration and subsequent decrease in arterial carbon dioxide concentration leading to reduction in respiratory drive.
First 10-15 mins
173
Least potent
NzO
174
Entonox
50%02
50% M20
dental anaesthesia
habour analgesia
175
c/ i N zO
pneumothorax
pulm htm
air embolism
Intraocular
Tympanic
membrane
graft ....
176
why xe ideal
Fastest onset and recoverBGC 0.15
inert analgesic
neuro cardio protective
No metabolism
No malignant
hyperthermia
no pollution
177
halothane preservative
thymol
178
only agent causing
brady
halothane
179
inhalational agent
causing max
bronchochelation
halothane
