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NCERT ECC IMPROVE INTERNATIONAL > Anaesthesia and Analgesia > Flashcards

Anaesthesia and Analgesia Flashcards

1
Q

What are 5 things you should consider when making an GA plan

A

Signalment
Brief History
Current medication
Procedure

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2
Q

What should be done for a clinical exam of a patient before a GA

A 
Temperature 
pulse rate and quality 
heart ausc 
chest ausc 
MM 
CRT 
Weight
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3
Q

What are Dobermanns prone too

A

DCM

Vonn Willebrans disease - coagulation issues

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4
Q

What can ACP cause in boxers

A

vasovagal syncope, hypotension and collapse

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5
Q

What are some complications that can arise for a patient during induction

A

Apnoea
Collapse
Hypoventilation
Regurgitation and aspiration

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6
Q

What are some complications that can arise for a patient during a GA

A 
Hypotension 
Hypoxia 
Hypoventilation 
Regurgitation and aspiration 
Hypothermia 
Hypercapnia
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7
Q

What is the definition of SAP ( Systolic arterial pressure )

A

the pressure during cardiac contraction

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8
Q

What is the definition of MAP (Mean arterial pressure)

A

average pressure in the vessels during one cardiac cycle

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9
Q

What is the definition of DAP (dilated arterial pressure)

A

the pressure during cardiac relaxation

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10
Q

What is Cardiac output (CO)

A

The amount of blood pumped from the left ventricle per minute

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11
Q

What is Stroke Volume (SV)

A

The amount of blood pumped from the left ventricle per beat

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12
Q

What is SVR (systemic vascular resistance

A

The resistance that must be over come to push blood through the circulation and create flow.

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13
Q

What is preload

A

The initial stretching of the cardiac muscle cells prior to contraction

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14
Q

What is afterload

A

The force against which the heart has to contract to eject blood

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15
Q

What is cardiac contractility

A

Myocardial contractility is the ability of the heart muscle

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16
Q

How do you treat hypotension

A
  1. Determine underlying cause (bleed)
  2. Reduce volatile agents
  3. Restore any deficits (bolus?)
  4. Ensure other parameters are normal
  5. vasopressors ( noradrenaline, ephedrine)
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17
Q

When is hypoventilation likely?

A

Due to reduced ventilatory drive (drugs hypothermia CNS depression)
Inability to ventilate properly (open thorax, muscle failure, incorrect tube placement)

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18
Q

What does a normal breathing pattern entail

A

Ribs moving in and out

Negative pressure is produced

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19
Q

What are 5 factors effecting respiration

A

Overweight
Tumours
Environment factors
Species variation (brachy)

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20
Q

What are some abnormalities with a dog with BOAS

A 
Stenotic nares 
Nasal turbulence 
Elongated/thickened soft palate 
Laryngeal collapse 
Fibrotic lungs
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21
Q

What should be avoided in a patient with BOAS

A

Stress
Heat
High doses of sedation

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22
Q

What are some examples of procedures that have respiratory comprised patients under GA

A

BOAS
Bronchoscopy (e.g BAL)
Thoracotomy

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23
Q

What is oxygenation

A

The process of delivering oxygen from the alveoli to the cells of the body.

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24
Q

How is oxygenation monitored

A

Pulse oximetry

Arterial blood gas

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25
Q

What is Ventilation

A

The process of delivery air to the alveoli within the lungs. ‘The act of breathing’

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26
Q

What is capnography

A

A measurement of inspired and expired carbon dioxide

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27
Q

What is end tidal CO2

A

The partial pressure of cO2 at the end of exhaled breath

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28
Q

What can a decreased CO2 mean

A

reduced cardiac output
reduced metabolic rate
hypothermia

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29
Q

what is myocardial oxygenation

A

the balance between myocardial oxygen delivery and myocardial oxygen demand

30
Q

What will happen if the myocardium becomes hypoxic

A

it will throw arrhythmias and wont contract efficiently

31
Q

What are 5 things that cardiac disease may influence on anaesthesia

A
  1. the cardiovascular functional reserve may be eroded
  2. Drugs used may impair the cardio function.
  3. Cardio disease effect organ systems
  4. Cardiac disease alters drug disposition and distribution
  5. Treatment of cardio disease including medication can interact with GA
32
Q

What are 5 anaesthetic considerations when dealing with a cardiac patient

A 
Keep giving cardiac meds up until GA 
Avoid stress 
Pre and post oxygenation 
Avoid fluid overload 
ensure adequate analgesia
33
Q

What is an opioid

A

A drug that acts on opioid receptors to produce morphine like effects

34
Q

Where are opioid receptors found

A

central and peripheral nervous system

GI tract

35
Q

What is an agonist

A

a chemical that binds to and activates the receptor to produce a biological response

36
Q

What is an antagonist

A

A chemical that binds to a receptor and blocks the receptor but does not activate

37
Q

Full agonist

A

Bind to a activates the receptors with maximum response

38
Q

Partial agonist

A

drug that binds to and activates a given receptor but only has partial efficacy compared to a full agonist

39
Q

What are the 3 classes of opioids

A

Mu
Kappa
Delta

40
Q

What is fentanyl

A

a full mu agonist

41
Q

what is morphine

A

a full mu receptor agonist

42
Q

what is methadone

A

a full mu receptor agonist

NDMA receptor

43
Q

What is buprenorphine

A

partial mu receptor agonist

44
Q

What is butorphanol

A

mu opioid antagonist and kappa opioid agonist

45
Q

What is an NSAID

A

Non steroidal anti inflammatory drug

46
Q

How to NSAIDS work

A

by the inhibition of COX1/COX2 enzyme which make certain mediators (prostaglandins)

47
Q

What is prostaglandins in terms of NSAIDs

A

prostaglandins are involved in the inflammatory response and coagulation

48
Q

What is the COX 1 enzyme responsible for

A

house keeping - GI protection
coagulation
renal blood regulation

49
Q

what is COX2 enzyme responsible for?

A

Producing prostanoids mediating inflammation

50
Q

What does a local anaesthetic do?

A

It decreased transduction or transmission of a noxious stimulus to the spinal chord or the brain

51
Q

What will a local agent do that an analgesic agent wont

A

a local agent will completely get rid of pain

52
Q

What affect with an alpha 2 have on the body

A

vasoconstriction and increase in afterload
decrease in heart rate and increase in stroke volume
reduced cardiac output

53
Q

What is the transduction pain path way and an example

A

A nociceptive stimulus that turns a noxious stimulus into a transmissible signal
example - skin bone tissues

54
Q

What is the transmission pain path way

A

The message from the transduction pain is transmitted via peripheral nerves to the spinal chord/dorsal horn

55
Q

What is the modulation pain path way

A

The modulation of pain involves changing or inhibiting transmission of the pain impulses in the spinal chord

56
Q

What is the perception pain path way and an example

A

The cerebral cortex knows exactly where the pain is from (or where it will hurt). e.g pain, fear or pleasure

57
Q

What are the 4 pain pathways

A

Transduction
Transmission
Modulation
Perception

58
Q

Define pain

A

An unpleasant sensory and emotional experience that associated with actual or potential tissue damage

59
Q

Define acute pain

A

Pain that lasts less than 3 months

60
Q

Define chronic pain

A

pain that lasts more than 3 months

61
Q

Define Allodynia

A

central pain sensation following a normal non painful stimuli

62
Q

Define hyperalgesia

A

Increased sensitivity to stimuli that would normally be painful

63
Q

Somatic pain

A

Occurs when pain receptors in tissue are activiated (skin,muscle, joint, connective)

64
Q

Visceral pain

A

Pain that results from the activation or nociceptors of the thoracic pelvis or abdominal viscera.

65
Q

What is a recumbent patient

A

a patient that cannot rise and involuntarily lies down

66
Q

What is a critical patient

A

a patient that requires a highly level of nursing intervention and anything can change at any moment

67
Q

what is Kirbys rule of 20

A 
veterinary  nursing check list for critical patients 
fluid balance 
o2 and ventilation 
heart rate and rhythm 
Glucose 
Temp 
Albumin 
electrolytes
Mentation 
RBC haematology 
GI mobility 
nutrition 
renal function 
coags 
infection control and immune systems 
drug dose metabolism 
wound care 
nursing TLC
68
Q

What is the suggested formula for calculating RER

A

(70xBTW)^0.75

69
Q

What are some types of nutritional feeding tubes

A

naso-oesophageal
oesophageal
Gastrotomy
enerostomy/jejunostomy

70
Q

What is a HAI

A

Hospital acquired infection

71
Q

What are 4 causes of HAI

A

animal person contact
indirect contact
droplets (airborne)

NCERT ECC IMPROVE INTERNATIONAL (8 decks)

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