General Anesthesia

Question 1

Dibucaine test is it amuse or ester type of local? And inhibits normal or abnormal pseudo cholinesterase ?

Answer 1

It is Amide

Inhibits normal pseudo cholinesterase

It is a qualitative assessment

Question 2

Increased mixed venous arterial oxygen ddx?

Answer 2

High CO
Sepsis
Left-right shunt
Impaired peripheral O2 uptake (cyanide)
Decrease O2 consumption (hypothermia)

Question 3

Normal Tracheal capillary arteriolar pressure is …. if ETT cuff exerts a pressure greater than that number, …. may develop especially if intimated for > 48 hours.

Answer 3

25-35 mm Hg

Destruction of tracheal rings and tracheomalacia

Question 4

When should therapeutic LMWH stopped before spinal?

Answer 4

24 hours.

Enoxaparin, delteparin, ardeparin are LMWH

Therapeutic dose is 1 mg/kg BID

Question 5

Most common peripheral nerve injury under GA?

Answer 5

Ulnar

Question 6

Why Methoxyflurane was withdrawn from clinical practice?

Answer 6

It caused death and nephrogenic DI from fluoride toxicity .

Sevo dose produce fluoride but it is excreted rapidly through lungs (unlike Metho very slowly excreted).

Question 7

What is the only volatile that very resistant to defluroination and therefore not associated with Nephro toxicity?

Answer 7

Desflurane

Question 8

What is the best ppx against DVT?

Answer 8

Ambulation

Heparin 2 hours before surgery and every 8 hours after reduces DVT risk <10%

Question 9

Eye disease that puts patient great risk for retinal damage if hypotension develops during anesthesia?

Answer 9

Glaucoma

BF to retina decreased by either decrease MAP or increase intra-ocular pressure.