100 secret /book

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100 secret /book by Mind Map: 100 secret /book

1. The newborn heart less complaint cause it's less mature \ less responsive to inotropic support \ myocardial mature complete 6-12 months age

2. Ketamine best inducation agent for patients with :

2.1. elevated intracranial pressure [ICP]

2.2. hypovolemic trauma

2.3. acrive bronchospastic disease

3. Propfol uses:

3.1. Adult patients with docomunted egg allergies

3.2. Should avoided in children with anaphylaxis to egg

4. Local anesthetic agents :

4.1. Esters

4.2. Amides

5. Local anesthetic

5.1. Inuced

5.1.1. CNS toxicity Manifests with excitation Seizures Loss of conscious

5.1.2. Cardiac toxicity Happens after CNS toxicity Hypotension Conduction blockade Dysrhythmias Cardiac arrest

5.2. It's toxicity treated with lipid emulsion therapy /ex: intralipid 20%

6. Adequate oxygenation

6.1. Controlled Postperative pain

6.2. Resolved postperative nausea and vomiting

6.3. Required for postanesthesia unit discharge

7. Glocuse control before,,during and after surgery important for:

7.1. Reduce the risk of wound infection

7.2. Promote rapid wound healing

7.3. Avoid metabolic complications and shorten hospital stay

7.4. Insulin goal:90-180 mg/dl , during most surgicalm operations

8. PONV: postperative nausea and vomiting

9. Chronic exogenous glucocorticoid therapy should not be discontinued abruptly

10. The shoulder primarily supplied by:

10.1. Superiorly : suprascapular nerve

10.2. Both can anesthetize by interscalene block and it's first complications is ipsilateral phrenic nerve block result in:

10.2.1. Hemidiaphragmatic paralysis

10.2.2. Horner syndrome

10.2.3. unilateral recurrent laryngeal nerve paralysis

10.2.4. Pneumothorax \ air in pleural cavity ,chest cavity

10.2.5. inadvertent neuraxial injection\الحقن العصبي غير المقصود

10.2.6. Accidental intravascular injection

10.3. Inferiorly : axillary nerve

11. Regional anesthesia is beneficial for patients with:

11.1. Whom general anesthesia should be avoided

11.2. Whom pain may be difficult to control

11.3. Ex: patients with severe cardiopulmonary disease, PONV , obstructive sleep apnea ,chronic pain, subctance abuse

12. Age-related physiological changes include:

12.1. Left ventricular hypertrophy

12.2. Increased reliance on preload for cardiac output

12.3. Decreased venous compliance

12.4. Increased closing capacity

12.5. Decreased glomerular filtration rate

12.6. Decreased hepatic function

12.7. Increased risk for postoperative delirium

13. Reason to give intravenous fluid is to increase stroke volume

13.1. Use frank-starling law to predict volume responsiveness

14. Patients with reactive airway disease [ex: asthma] require through preoperative preparation incluiding:

14.1. Inhaled β-agonist therapy

14.2. Possibly steroids

15. All that wheezes is not asthma but also consider :

15.1. Mechanical airway obstruction

15.2. Congestive failure

15.3. Allergic reaction

15.4. Pulmonary embolus

15.5. Pneumothorax

15.6. Aspiration

15.7. Endobronchial intubation

16. Congestive failure:heart not able to pump blood around body proprley

17. Mechanical airway obstruction : any solid object work as foreign body and cause airway obstruction

18. Aspiration : to draw in or out using a sucking motion

19. Pulmonary embolus [PE] : is a blood clot that develops in a blood vessel elsewhere in the body [often th leg] travels to an artery in the lung and suddenly forms a blockage of the artery

20. Pneumothorax : when the lung collapsed due to air entering the pleural space

21. TEG: thromboelastography

22. ROTEM: rotational thromboelastometry

23. Agents types:

23.1. Depolarizing agents : Succinylcholine

23.2. Nondepolarizing agents: steroid agents[vecuronium, rocuronium]

23.3. Benzylisoquinolinium agents: [atracurium, cisatracurium]

23.4. Phase 1 : block with depolarizing agents

23.5. Phase 2 : block with nondepolarizing neuromuscular blocking agents

24. The best practice to ensure termination of the relaxant effect from neuromuscular blocking agents are:

24.1. Dose them sparingly

24.2. Allow enough time for normal metabolism to occur

25. It is best practice to administer reversal agents to all patients receiving nondepolarizing neuromuscular blocking agents unless the T4:T1 is greater than 0.9

26. If for some reason a patient is not recovering from neuromuscular blockade , they should remain intubated on supported ventilation until they can demonstrate return of strength

27. Cardiotoxicity because of hyperkalemia should be immediately treated with intravenous calcium chloride or calcium gluconate

28. Nonanion gap metabolic acidosis: hyperchloremia/ eleoctrolyte impalance occurs when there's to kuch blood chloride in the blood

29. Patients who receive high volumes fluid , especially normal saline , often develop hyperchloremia and a nonanion gap metabolic acidosis

30. MAC: minimum alveolar concentration

30.1. Is defined as the minimum alveolar concteration of inhaled anesthetic required to prevent movement in 50% of patients in response to surgical incision

31. The MAC of inhaled anesthetic decreased in cases :

31.1. old age or premature

31.2. Hyponatremia/ sodium level in blood less the normal

31.3. Hypothermia/ the body begins to lose heat faster than it's produced/ cause : prolonged exposures to to very cold temperatures / leads to lower body temperature

31.4. Opioids / illegal and legal drugs

31.5. Barbiturates / affecting the inhibitory neurotransmitters in the brain

31.6. α2 blockers

31.7. Calcium channel blockers

31.8. Acute alcohol intoxication

31.9. Pregnancy

32. The MAC increased by:

32.1. Hyperthermia

32.2. Chronic alcoholism

32.3. Hypernatremia /high sodium levels in blood

32.4. acute intoxication with CNS stimulants (e.g., amphetamine)

33. Nitrous oxide should not be used in:

33.1. Setting of pneumothorax

33.2. Bowel obstruction

33.3. Pneumocephalus

33.4. During middle ear or opthalmological surgeryl / eye surgery

34. Hypoxemia / low oxygen level in blood/ causes :

34.1. Low inspired oxygen

34.2. Alveolar hypoventilation

34.3. V/Q mismatch

34.4. Right-left shunt

34.5. Impaired oxygen diffusion