Download Update 11 - Update in Anaesthesia - WFSA

More documents

Recommendations

Info

84Update in AnaesthesiaSELF ASSESSMENT SECTIONDr Andrew Longmate, Stirling Royal Infirmary, Scotland, UK1. In significant aortic stenosis:A there is an early diastolic murmurB the ECG often shows evidence of left ventricularhypertrophyC can be caused by rheumatic feverD collapse may be the first manifestationE cannot be present if the patient is hypertensive2. With aortic stenosis:A a pulse rate of 40 per minute is good forhaemodynamicsB ketamine is a useful anaesthetic agentC antibiotic prophylaxis is necessary for surgicalprocedures on the bladderD neuromuscular relaxation is contraindicatedE hydralazine is a safe drug to use3. In cardiac tamponade there may be:A hypotensionB distended neck veinsC Kussmaul’s signD pulsus paradoxusE cardiac arrest4. Concerning cardiac tamponade:A may be caused by penetrating traumaB may be secondary to a pericardial effusionC general anaesthesia is required to drain thepericardiumD can follow blunt traumaE ECG complexes may be small5. Constrictive pericarditis:A may be caused by TBB causes abdominal swellingC may lead to hepatomegalyD peripheral oedema may be minimalE may cause peritonitis6. Rheumatic fever:A affects only the heart valvesB occurs after streptococcal infectionC may cause a large joint polyarthritisD does not affect the mitral valveE may cause elevated ST segments on the ECG7. Elevated blood urea may occur:A in renal failureB after bleeding into the gutC in dehydrationD in liver failureE in overhydration8. Concerning tuberculosis:A miliary TB may be associated with a negativemantoux testB the X-ray of miliary TB may mimickstapylococcal pneumoniaC primary TB can cause hilar adenopathy on chestX-rayD the primary complex causes upper lobe cavitationE may present in conjunction with malnutrition9. The Apgar score:A should be measured at 0 and 3 minutesB has a maximum score of 8C includes assessment of respirationD includes assessment of colourE each measure is scored 0-110. The GCS (Glasgow Coma Scale):A has a minimum score of 0B scores pupil sizeC a confused patient would score 13D if reduced in presence of a skull fracture is aworrying signE if 15 in presence of a skull fracture is reassuring11. After head injury:A a lucid interval may occur with an extraduralhaematomaB craniotomy will take preference over surgery forabdominal bleedingC depressed skull fracture always requires operativerepairD wound toilet may be safely accomplished underlocal anaestheticE hypertension and bradycardia may occur with
Update in Anaesthesia 85raised intracranial pressureElow blood pressure and slow pulse12. Features of base of skull fracture include:A Battle’s signB “raccoon” or “panda” eyesC a haemotympanum (blood behind the ear drum)D normal GCSE lowered GCS13. After head injury treatment of raised ICP(intracranial) pressure can include:A 1000ml of 20% mannitolB 20mg of frusemideC intravenous colloid or 0.9% saline solutionD maintenance of nutrition with 5% dextrosesolutionE positioning the patient in slight head up posture14. After head injury treatment of raised ICP(intracranial pressure) can include:A surgical decompression of space occupying lesionB slight hyperventilationC applying atropine to the conjunctiva in order tosee optic discsD using tight bandages round the neck to secure anendotracheal tubeE ketamine infusion15. Instruments can be sterilised:A by thorough cleaning in hot soapy waterB by immersion in chlorhexidine for one hourC by boiling in water for 20 minutesD by autoclaving even if they are still dirtyE by autoclaving if they have been cleanedthoroughly beforehand16. Spinal injury may be associated with:A flaccid paralysisB priapismC urinary retentionD loss of anal tone17. After blunt thoracic trauma:A fractured ribs 9-12 may be associated with liveror spleen injuryB myocardial injury may occur in association with afractured manubriumC pulmonary contusion may be complicated withARDSD flail segment can be diagnosed clinicallyE consider thoracotomy if there is > 1500ml bloodloss from chest drain18. Concerning failed intubation:A never remove cricoid pressure if the stomach isfullB if you cannot intubate or ventilate a surgicalairway is indicatedC don’t worry how long it takes- try, try, try againuntil you are successful at intubatingD the safest plan is to wake the patient up beforeusing an alternative approachE repositioning the patient’s head and neck may beuseful manoevers19. Low serum potassium (hypokalaemia):A may occur in kwashiorkorB can occur after high dose salbutamolC may cause cardiac arrhythmiasD reduces digoxin toxicityE may cause ileus20. High serum potassium (hyperkalaemia):A may cause cardiac arrestB should be treated with 50mls 50% dextrose plus50u of soluble insulinC can be treated with sodium bicarbonateD may be caused by rhabdomyolysisE can occur with spironolactone
Page 1 and 2:
12345678901234567890123456789012123
Page 3 and 4:
Update in Anaesthesia 3the pain of
Page 5 and 6:
Update in Anaesthesia 5Prazosin dil
Page 7 and 8:
Update in Anaesthesia 7Sodium Nitro
Page 9 and 10:
Update in Anaesthesia 9excreted the
Page 11:
Update in Anaesthesia 11PRACTICAL A
Page 14 and 15:
14Update in Anaesthesia(i)(ii)(iii)
Page 16 and 17:
16Update in AnaesthesiaECG MONITORI
Page 18 and 19:
18Update in AnaesthesiaGRAPHICAL RE
Page 20 and 21:
20Update in Anaesthesiasurgery.Drug
Page 22 and 23:
22Update in AnaesthesiaFigure 7: Si
Page 24 and 25:
24Update in AnaesthesiaGentle press
Page 26 and 27:
26Update in Anaesthesiaadministrati
Page 28 and 29:
28Update in AnaesthesiaFigure 15: V
Page 30 and 31:
30Update in AnaesthesiaFailure of c
Page 32 and 33:
32Update in AnaesthesiaFigure 22: M
Page 34 and 35: 34Update in Anaesthesiamore vigorou
Page 36 and 37: 36Update in AnaesthesiaAbnormal Tra
Page 38 and 39: 38Update in Anaesthesiawhichever te
Page 40 and 41: 40Update in AnaesthesiaThe most rel
Page 42 and 43: 42Update in AnaesthesiaMONITORING I
Page 44 and 45: 44Update in Anaesthesialoss. The wo
Page 46 and 47: 46Update in AnaesthesiaANAESTHESIA
Page 48 and 49: 48Update in Anaesthesiasole agent i
Page 50 and 51: 50Update in Anaesthesia7) Control v
Page 52 and 53: 52Update in AnaesthesiaCOMMENTAs so
Page 54 and 55: 54Update in AnaesthesiaTeaching poi
Page 56 and 57: 56Update in AnaesthesiaNERVE BLOCKS
Page 58 and 59: 58Update in AnaesthesiaObturator ne
Page 60 and 61: 60Update in Anaesthesia Allow time
Page 62 and 63: 62Update in Anaesthesiathe psoas ma
Page 64 and 65: 64Update in Anaesthesiato palpate t
Page 66 and 67: 66Update in Anaesthesiabefore and t
Page 68 and 69: 68Update in AnaesthesiaEyes - catar
Page 70 and 71: 70Update in AnaesthesiaFigure 1. Wh
Page 72 and 73: 72Update in AnaesthesiaSummaryThe d
Page 74 and 75: 74Update in AnaesthesiaIt is often
Page 76 and 77: 76Update in AnaesthesiaKidney funct
Page 78 and 79: 78Update in AnaesthesiaVOLATILE ANA
Page 80 and 81: 80Update in AnaesthesiaWhat agents
Page 82 and 83: 82Update in AnaesthesiaTRICHLOROETH
Page 86 and 87: 86Update in AnaesthesiaTECHNIQUES F
Page 88 and 89: 88Update in Anaesthesiapreparations
Page 90 and 91: 90Update in Anaesthesiareducing int
Page 92 and 93: 92Update in Anaesthesiakilling zone
Page 94 and 95: 94Update in AnaesthesiaImplementati
show all

Download Update 11 - Update in Anaesthesia - WFSA

Create successful ePaper yourself

Delete template?

Save as template?