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MRCS med school > Peri-operative care > Flashcards

Peri-operative care Flashcards

1
Q

Risk factors for difficult ventilation

A

OBESE

Obese
Beard
Edentate (no teeth)
Spine (poor neck movement)
Elderly
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2
Q

Effect of acute alcohol on anaesthetic

A

Decreases effects of anaesthetic

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3
Q

Effect of chronic alcohol on anaesthetic

A

Increases effects of anaesthetic

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4
Q

ASA 1

A

Healthy pt

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5
Q

ASA 2

A

Pt with mild systemic disease

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6
Q

ASA 3

A

Pt with severe systemic disease

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7
Q

ASA 4

A

Severe systemic disease that is constant threat to life

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8
Q

ASA 5

A

Moribund pt not expected to survive with or without the operation

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9
Q

ASA 6

A

Declared brain dead pt whose organs are being removed for donation

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10
Q

ASA E

A

Added for emergency operations

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11
Q

Most common blood borne virus

A

Hep B
Hep C
HIV

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12
Q

Rx of Malignant Hyperthermia

A

Dantrolene

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13
Q

Drugs causing malignant hyperthermia

A

Halothane
Suxamethonium
Anti-psychotics

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14
Q

Cyanosed o2 sats

A

80-85 percent

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15
Q

Different types of ventilation

A

NIPPV

IPPV

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16
Q

NIPPV

A

Non-invasive intermittent positive pressure ventilation

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17
Q

NIPPV types

A

BiPAP

CPAP

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18
Q

IPPV involves?

A

Intubation and ventilation

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19
Q

CPAP

A

continuous positive airway pressure

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20
Q

BiPAP

A

Bi-level PAP

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21
Q

CPAP use

A

hypoxia

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22
Q

BiPAP use

A

Resp failure secondary to COPD exacerbation

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23
Q

nasal cannulae normal flow rate

A

2-4l/min

24
Q

nasal cannulae FiO2

A

28-36%

25
Q

normal o2 mask flow rate

A

4 L/min

26
Q

normal o2 mask FiO2

A

35-40%

27
Q

Non-rebreather FiO2

A

up to 85%

28
Q

What group of pts need controlled O2 delivery

A

COPD
CF
Morbidly Obese

29
Q

When to stop warfarin before surgery

A

5 days before

30
Q

Mendelson’s syndrome

A

chemical pneumonitis

31
Q

Smoking effect on anaesthetics

A

risk of bronchospasm

32
Q

Fluid restriction before surgery

A

no fluids within 2 hrs of op

33
Q

Food restriction before surgery

A

no food within 6 hrs of op

34
Q

Oral med restriction before surgery

A

no med within 30 mins

before could have with 30 mls of water

35
Q

Chewing gum restriction before surgery

A

no gum within 2 hrs

36
Q

Effect of trauma on gastric emptying

A

slows it down

37
Q

Prokinetics mech of action

A

speeds gastric emptying (used when risk of aspiration)

38
Q

Prokinetics example

A

Metoclopromide

Erythromycin

39
Q

When should antiacids be given before a surgery

A

immediately before op

40
Q

When should PPIs be given before a surgery

A

90 mins before anaesthesia

41
Q

When should prokinetics be given before a surgery

A

90 mins before anaesthesia

42
Q

When should anti-H2 be given before a surgery

A

90 mins before anaesthesia

43
Q

PE sx

A

Dyspnoea
Pleuritic chest pain
Haemoptosis

44
Q

CVS consequence of PE

A

Pulmonary HTN
Right ventricular failure
Low cardiac output
Cardiac arrest

45
Q

RFs for VTE

A

Patient factors
Associated disease
Operation factors

46
Q

Patient factors for VTE

A 
Age >60 
Immobility/travel
Pregnancy/puerperium 
BMI>30
Unopposed E2
47
Q

Associated disease RFs of VTE

A 
IBD
Nephrotic
Thrombophilia 
Malignancies
MI/CVA
48
Q

Examples of thrombophilia

A

Protein C, S deficiency,

Factor V Leiden

49
Q

Operation RFs for VTE

A

Op >30mins

Joint replacement/abdo op

50
Q

Rapid induction

A

Thiopentone

Suxamethonium

51
Q

Lignocaine dose w, w/o adrenaline

A

3mg/kg

7mg/kg with

52
Q

Bupivacaine dose w, w/o adrenaline

A

2mg/kg

2mg/kg with

53
Q

Prilocaine dose w, w/o adrenaline

A

6mg/kg

9mg/kg with

54
Q

Effect of adrenaline on LA

A

reduces systemic absorption allowing higher dose

55
Q

Dose of adrenaline in LA

A

1 in 200,000

MRCS med school (44 decks)

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