anaesthetics 1

Question 1

consequences of untreated pain

Answer 1

increased BP
increased HR
perip MI nausea
inability to cough and clear secretions - pneumonia
inability to move around - DVT, pressure sores

Question 2

WHO pain ladder

Answer 2

paracetoma
NSAIDs
IM opioids
PCA patient controlled analgesia when can’t give oral opiods

Question 3

complications of opiods

Answer 3

nausea and vom
over sedation
hypotension
resp depression - late in spinal/epidural

Question 4

resp depression if RR <10
RR< 8
v drowsy

Answer 4

oxygen 6L/min
Oxygen 6L/min and stop opiod
nagoxon 1ml every min till RR >10

Question 5

peripheral nerve blockade lasts how long

Answer 5

12-48 hours

Question 6

epidural infusion anaesthesia hypotension management

Answer 6

elevation of legs
oxygen
fluids stat
if severe IV ephedrine 3-6mg if low pressure
metaraminol 0.5mg if fast HR

Question 7

Epidural infusion cx

Answer 7

resp Depression 
itch - low dose nagoxon or chlorppheramine
urinary retention - catheter 
motor block
inadequate analgesia

Question 8

post op care

Answer 8

hypotension
resp - low oxygen
GI n/v
CNA - delayed return of consciousness 
urinary - post op oliguria

Question 9

hypovalaemic shock

Answer 9

loss of blood
plasma - burns
fluid - GI obstruction

Question 10

cariogenic shock

Answer 10

post MI - pump failure 
severe arrhthmias 
PE
tension pneumothorax
cardiac tamponade

Question 11

vasogenic shock

Answer 11

anaphylaxis

severe sepsis

Question 12

neurogenic shock

Answer 12

high spinal cord transaction

vaso vagal attack - fainting

Question 13

brain death common causes

Answer 13

head injury
intracranial team
cerberal hypoxia

Question 14

brain death diagnosis

Answer 14

two senior doctors

two sets of tests

Question 15

brain death clinical signs

Answer 15

no pupillary response to light 
absent corneal reflexes
absent caloric reflexes
no motor responses in the distribution of cranial nerves
no cough or gag reflex

Question 16

GA induction

Answer 16

IV propofel GABA agonist

Question 17

muscle relaxant

Answer 17

recronium

to reverse - anticholinersterase neostigmine and atropine

Question 18

endotracheal tube placement

Answer 18

end tidal co2
sats
chest moving
steam on mask

Question 19

CO

Answer 19

SV times HR

Question 20

BP

Answer 20

CO times SVR

Question 21

MAP

Answer 21

DP and [ (SBP-DBP) / 3]
70-110 normla
min 60 to perfused heart kidneys and brian

Question 22

pH is what

Answer 22

logarithmic scale

Question 23

minimum urine output

Answer 23

0.5ml/kg/hour

Question 24

bowel surgery is associated with what

Answer 24

third space fluid loss

Question 25

normal dose of naloxone

Answer 25

40mcg increments titrated to effect and reassess patient

Question 26

warfarin should be stopped how many days before surgery

Answer 26

5 days

Question 27

poor control of blood glucose in the peri op period is assoc w what 3 things

Answer 27

increased risk of wound infection increased cardiovascular complications irreversible brain damage

Question 28

anaphylaxis can cause

Answer 28

bronchoconstriction and airway obstruction

Question 29

dose of adrenaline in cardiac arrest

Answer 29

1mg IV

Question 30

how are morphines analgesic effects measures

Answer 30

mu opiod receptors - its an agonist for these receptors

Question 31

lignocaine

Answer 31

blocks the activity of sodium channels

Question 32

morphone causes

Answer 32

histamine release

Question 33

epidural space contains

Answer 33

adipose tissue venous plexus spinal roots

Question 34

respiratory depression and epidural

Answer 34

not commonly associated

Question 35

bradycardia

Answer 35

atropine 500mcg

Question 36

HDU patient - very ill how to measure BP

Answer 36

intra arterial