Short Answer Questions in Anaesthesia: How to Manage the Answers PDF
Preview Short Answer Questions in Anaesthesia: How to Manage the Answers
Page i Short Answer Questions in Anaesthesia Page ii © 1997 Greenwich Medical Media 219 The Linen Hall 162-168 Regent Street London W1R 5TB ISBN 1 900151 235 First Published 1997 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the UK Copyright Designs and Patents Act, 1988, this publication may not be reproduced, stored, or transmitted, in any form or by any means, without the prior permission in writing of the publishers, or in the case of reprographic reproduction only in accordance with the terms of the licences issued by the Copyright Licensing Agency in the UK, or in accordance with the terms of the licences issued by the appropriate Reproduction Rights Organization outside the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publishers at the London address printed above. The right of Geoffrey B Rushman to be identified as author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988. The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. A catalogue record for this book is available from the British Library Distributed worldwide by Oxford University Press Production and Design by Derek Virtue, DataNet Printed in Great Britain by Ashford Colour Press Page iii Short Answer Questions in Anaesthesia How to Manage the Answers Geoffrey Rushman Page vii Contents Preface v 1. Advice on answering short answer questions 2 What the words in examination questions mean 2. General anaesthesia What factors show that intubation of the larynx will be difficult enough to indicate 6 fibroptic intubation? How do you manage the physiological consequences of surgical manoeuvres during 7 abdominal laparoscopy? What are the factors that prolong the action of nondepolarising relaxants? 7 What are the "anaesthetic" problems caused by morbid obesity? 8 How would you prevent unplanned awareness during general anaesthesia? 8 How do you detect unplanned awareness during general anaesthesia? 9 What are the advantages and limitations of the laryngeal mask airway? 9 How do you manage total intravenous anaesthesia? 10 Write short notes on ondansetron 10 How do you manage sedoanalgesia? 11 Under what circumstances should general anaesthesia for elective cases be postponed 11 and why? How would you determine the causes of arterial hypotension (80/60 mmHg.) during a 12 prostatectomy, and how would you manage it? Page viii What are the causes and management of hypoventilation immediately following 12 anaesthesia? What causes bradycardia during general anaesthesia and what is the management of 13 this condition? List the causes and briefly note the management of tachycardia (>100 bpm) during 14 general anaesthesia in an adult Why do some patients suffer circulatory collapse at the induction of general 15 anaesthesia and how would you manage it? What signs would lead you to suspect that a patient under general anaesthesia was 16 developing malignant hyperpyrexia? Describe your immediate management What is the pathophysiology of malignant hyperpyrexia? How would you investigate 17 it? You are asked to construct a question sheet for day-case patients to answer on 18 admission to hospital. What questions would you ask? What protocol would you construct to guide surgeons on selecting adult patients for 19 day-case anaesthesia? Describe the anaesthetic arrangements involved in a gynaecological day-case list of 15 20 patients for dilatation and curettage of the uterus Write short notes on rocuronium 21 Give an account of the pharmacology of propofol 22 Compare and contrast halothane and desflurane 22 What are the pharmacological problems presented by a patient taking monoamine- 23 oxidase inhibitors (MAOI) who requires emergency anaesthesia for a bleeding duodenal ulcer? Discuss the pharmacological problems presented List the causes of "suxamethonium apnoea". How would you diagnose and manage it 23 once it had occurred? Describe the Bain system and its functions 23 What are the safety devices involved in delivery of oxygen from a cylinder on an 24 anaesthetic machine to an anaesthetised patient through a Bain system? Compare two types of anaesthetic breathing system used for a healthy spontaneously 24 breathing child weighing 20kg Write short notes on desflurane 25 Describe the circle system for anaesthesia. What are its advantages and limitations? 26 What are the features of an anaesthetic machine which are designed to minimise the 27 risk of delivering hypoxic gas mixtures? Write short notes on dantrolene 27 Write short notes on ketamine 28 List the physical properties of desflurane, and describe the characteristics of a suitable 29 vaporiser How do you estimate bloodloss during various types of surgery? 29 Write short notes on minimum alveolar concentration 30 Write short notes on propofol 30 Write short notes on mivacurium 31 Page ix Write short notes on hyoscine 31 Write short notes on glycopyrronium (glycopyrollate) 32 3. Paediatric anaesthesia How does the physiology of children aged 1 year differ from that of adults? 34 Write short notes on EMLA cream 34 What psychological factors influence your anaesthesia for children aged 2-3 years? 35 What facilities are required for transfer of a 2-month old baby to a paediatric unit? 35 A 6-week old child has projectile vomiting and is presented for laparotomy. Describe 36 the general anaesthetic problems of this case Describe the management of acute epiglottitis in a child of three years 36 Describe the management of acute laryngotracheitis in a child of three years of age, 37 presenting with cyanosis What are the aims of premedication in children? Describe the pharmacology of two 37 such premedicant drugs 4. Neuroanaesthesia How does concomitant head injury influence your anaesthetic management of an 40 operation for a fracture of the hand? What monitoring do you consider necessary for a posterior fossa craniotomy? What 40 are the possible sources of error associated with two of the monitors you mention? Describe the physiological effects of high arterial carbon dioxide tension (10 kpa, 70 41 mmHg.) What factors affect cerebral blood flow? State briefly their importance in relation to 41 anaesthesia within 12 hours of head injury How may cerebral bloodflow be affected by general anaesthesia? 42 5. Obstetric anaesthesia How do obstetric factors affect the management of anaesthesia for the removal of a 44 retained placenta? Write short notes on ranitidine 44 Describe the anaesthetic management of massive intrapartum haemorrhage requiring 45 emergency operation Describe the pathophysiological processes of pre-eclamptic toxaemia of pregnancy 45 You are asked to help with a case of severe pre-eclamptic toxaemia of pregnancy. 46 What is your management? Page x 6. Cardiothoracic anaesthesia Describe the anatomy of the trachea, including its relations 48 Describe the anatomy of the diaphragm, including its relations 48 Describe the arterial blood supply of the myocardium 49 Describe the venous drainage of the myocardium 49 Describe the conducting system of the heart 50 How may abnormalities of cardiac conduction be revealed by the electrocardiogram? 50 Describe the anatomy of the bronchial tree 51 Describe the nerve supply of the larynx 51 Describe the anatomy of the first rib, including its relations 52 7. Trauma and emergency anaesthesia What are the effects of an overdose of a tricyclic antidepressant drug? 54 A child of 12 years has been admitted following a road accident. At emergency 54 laparotomy the surgeon announces that the liver is ruptured. Describe your management of the case up to the end of the operation Write short notes on Hartmann's solution 55 Describe the adverse effects of blood transfusion. How may they be reduced? 55 Describe the alternatives to donor blood transfusion 56 What are the contents of a unit of transfusion blood? Describe briefly the alternatives 56 which can be used in an emergency haemorrhage situation until transfusion blood becomes available Write short notes on Gelatin-based plasma substitutes 57 Describe the features of the Boyle's anaesthetic machine and Bain system which 57 protect the patient from pulmonary barotrauma What physiological changes follow acute hypovolaemia? 58 What is the physiological response to the rapid loss of 1 litre of blood in the adult? 58 Outline the factors responsible for the maintenance of cardiac output 59 What are the causes and effects of hypothermia? 59 Detail the immediate rescusitation (in the first hour) of an unconscious patient 60 admitted to the A & E department after falling off a ladder 8. Acute and nonacute pain management What are the medical effects of opioid drugs? 62 Write short notes on pethidine 62
Description:The list of books you might like
