Anaesthesia Notes Hub
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📚 𝗣𝗿𝗲𝗺𝗶𝘂𝗺 𝗔𝗻𝗮𝗲𝘀𝘁𝗵𝗲𝘀𝗶𝗮 𝗡𝗼𝘁𝗲𝘀 (𝗣𝗗𝗙)

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Which inhalational anaesthetic is LEAST metabolized in the body?
Anonymous Quiz
27%
A️) Halothane
12%
B️) Isoflurane
19%
C️) Sevoflurane
42%
D️) Desflurane
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A patient under general anaesthesia suddenly develops:

📉 Falling EtCO₂ 📉 Hypotension 📉 SpO₂ starts dropping
Anonymous Quiz
16%
A️) Bronchospasm
11%
B️) Circuit Leak
63%
C️) Pulmonary Embolism
10%
D️) Endobronchial Intubation
Anaesthesia Notes Hub
A patient under general anaesthesia suddenly develops:

📉 Falling EtCO₂ 📉 Hypotension 📉 SpO₂ starts dropping
Answer: Pulmonary Embolism

A pulmonary embolism suddenly reduces blood flow to the lungs, leading to a rapid fall in EtCO₂, followed by hypotension and decreasing SpO₂ due to impaired gas exchange.

📌 Clinical Pearl:
A sudden drop in EtCO₂ with hypotension during general anaesthesia should always raise suspicion of pulmonary embolism until proven otherwise.
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A patient under General Anaesthesia suddenly develops:

• EtCO₂: 38 → 60 mmHg • HR: 140/min • Temperature: 39.8°C • Generalized muscle rigidity
Anonymous Quiz
4%
A. Increase tidal volume only
90%
B. Stop volatile agent & administer Dantrolene
1%
C. Give Atropine
5%
D. Start Sodium Bicarbonate immediately
Anaesthesia Notes Hub
A patient under General Anaesthesia suddenly develops:

• EtCO₂: 38 → 60 mmHg • HR: 140/min • Temperature: 39.8°C • Generalized muscle rigidity
Correct Answer: B. Stop the volatile anaesthetic immediately and administer Dantrolene.

Explanation:

• Ye Malignant Hyperthermia ke classic signs hain.

Immediate management:

° Stop all triggering agents (volatile anaesthetics and succinylcholine).

° Administer Dantrolene as soon as possible.

° Hyperventilate with 100% oxygen.

° Start active cooling and treat hyperkalemia/acidosis if present.
4
ABG Results:

• pH: 7.28 • PaCO₂: 58 mmHg • HCO₃⁻: 26 mEq/L
Anonymous Quiz
13%
A. Metabolic Acidosis
75%
B. Respiratory Acidosis
4%
C. Metabolic Alkalosis
9%
D. Respiratory Alkalosis
Anaesthesia Notes Hub
ABG Results:

• pH: 7.28 • PaCO₂: 58 mmHg • HCO₃⁻: 26 mEq/L
Correct Answer: B. Respiratory Acidosis

Why?
• pH ↓ = Acidemia
• PaCO₂ ↑ = Respiratory cause
• HCO₃⁻ normal = Acute (uncompensated) respiratory acidosis

Clinical pearl: Think "CO₂ high = respiratory problem" before looking at compensation.
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A 65-year-old patient under General Anaesthesia suddenly develops:

•BP: 70/40 mmHg •HR: 45/min •SpO₂: 99% •EtCO₂: 35 mmHg
Anonymous Quiz
31%
A. Give Atropine
61%
B. Give Ephedrine
4%
C. Start Chest Compressions
4%
D. Deepen Anaesthesia
Anaesthesia Notes Hub
A 65-year-old patient under General Anaesthesia suddenly develops:

•BP: 70/40 mmHg •HR: 45/min •SpO₂: 99% •EtCO₂: 35 mmHg
Correct Answer B. Ephedrine
(if hypotension with bradycardia after spinal/GA and perfusion is compromised, ephedrine is a common first-line choice in many OT settings; management still depends on the cause and clinical context.)
3
Anaesthesia Notes Hub
What is the most likely type of shock?
Correct Answer: C) Cardiogenic Shock

Explanation:
This hemodynamic pattern strongly suggests pump failure:

🔹 ↓ Cardiac Output → impaired ventricular pumping

🔹 ↑ CVP → elevated right-sided filling pressure/venous congestion

🔹 ↑ SVR → compensatory peripheral vasoconstriction to maintain BP

🔹 ↓ MAP → inadequate forward flow despite compensation

🔹 Basal crepitations → pulmonary congestion, supporting cardiac dysfunction

Cardiogenic shock = ↓ CO + ↑ filling pressures + ↑ SVR.

This pattern helps differentiate it from hypovolemic shock, where filling pressures are usually low, and distributive shock, where SVR is typically reduced.
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