Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

year 3 principles > Anaesthesia - general > Flashcards

Anaesthesia - general Flashcards

1
Q

What normally happens to urine output under anaesthesia?

A

decreased as ADH release from stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When is an animal hypoxaemic?

A

PaO2< 60 mmHg

SpO2<90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can cause hypoxaemia / hypoxia?

A 
low FiO2( fraction inspired O2)
hypventilation
V/Q mismatch
CVS depression
anaemia
increased O2 demand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can cause hypercapnia?

A 
hypoventilation
rebreathing
high BMR
tachycardia
hypertension
arrhythmias
high intracranial pressure
CVS depression
resp acidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How can you correct hypoxia / hypercapnia?

A

-check depth
-check if rebreathing
-increase FiO2
IPPV
ventolin in horse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is IPPV?

A

intermittent positive pressure ventilation

-get reduced venous return and CO as intrapleural pressure will be +ve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do you aim for with IPPV?

A 
Tidal vol : 10-15 ml/kg
RR : 10-20
Inspire : expire : 1:2 - 1:3
ET CO2 : 35-45 mmHg
Peak inspiratory pressure : <5cm H2O
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is classed as bradycardia?
What could be causing it?
What do you do?

A

<26bpm (horse)

  • due to: high vagal tone, acid-base distrubance, hypothermia, a 2 agonists , hypertension, high ICP, too deep
  • check : depthc, give atropine / glycopyrrolate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is classed as tacchycardia?
What could be causing it?
What do you do?

A

> 180 bpm (SA), > 50 bpm (horse)

  • due to: high catecholamines (pain, hypotension, hypovol, hypoxia, hypercapnia), hyperthermia, anaemia, drugs, tacchyarrhythmias
  • check depth and treat cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do you do with an AV block?

A

if not due to a2 agonist then give atropine / glycopyrrolate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what do you do with a VPC?

A

lidocaine

treat if haemodynamically significant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is cat, dog and horse blood volume?

A

dog and horse : 80-90 ml/kg

cat: 60-70 ml/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you correct hypvolaemia / hypotension?

A

fluids

Inotropes - dopamine, dobutamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What fluid do you give for 10% blood loss?

A

crystalloid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what type of fluid do you give for 10-25% blood loss?

A

colloid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of fluid do you give for over 25% blood loss?

A

blood product

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the consequences of hypothermia?

A
  • decreased anaesthetic need
  • prolonged recovery
  • increased blood loss
  • shivering increases oxygen need
  • increased infection risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how can you treat hypothermia?

A

warm fluid
warm lavage
bubble wrap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What effects does an increased intracranial pressure have?

A

high bp

bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How can you control high ICP?

A

hyperventilate

osmosis (mannitol, hypertonic saline, furosemide) to decrease blood viscosity and improve blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does pulse oximetry measure?

A

HbO2 sat, PaO2, Hr

used LED sensor to see how much oxygenated haemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where is pulse ox measured?

A 
tongue
mammary gland
toe
prepuce 
ear
23
Q

What are important things to consider with pulse ox?

A
  • if anaemic can still have high saturation but be hypoxic as not enough Hb
  • on 100% O2 cant hypoventilated enough to drop Pa02 so monitor during recovery and when not on O2
  • CO will still read as high saturation
24
Q

what does capnography measure?

A

expired CO2

25
Q

what is a normal end tidal CO2?

A

35-45 mmHg

26
Q

what can cause hypercapnia?

A

hypoventilation
high CO
hyperthermia
bicarb given

27
Q

What can cause hypocapnia?

A

hyperventilation
low CO
hypothermia

28
Q

what do you see on a capnograph if rebreathing?

A

non return to baseline

29
Q

What reflexes can be tested for depth?

A 
palpebral
ocular position
pupil diameter
jaw tone
lacrimation
salivation
nystagmus
30
Q

what drug can interfere with reflex assessment of depth?

A

ketamine

31
Q

Normal cat dog and horse bp?

A

dog = 100
cat =135
horse = 90

32
Q

ok bp for anaesthetissed SA?

A

over 70

33
Q

3 ways to measure bp?

A

doppler flow - sensor below cuff on limb / tail
oscillometric - automatic
direct - catheter in peripheral artery

34
Q

How is central venous pressure measured?

A

catheter from jugular to vena cava

how ‘ full’ the circulation is

35
Q

When do you intubate?

A

eyes rotated ventrally
minimal parapebral reflex
loose jaw tone
no swallowing reflex

36
Q

what drug is used for intubation?

A

llidocaine spray

*careful as easy to overdose cat

37
Q

what are the two type of ET cuff?

A

high pressure, low volume

low pressure, high volume

38
Q

what are some problems with ET tubes?

A
  • if too long then intubate one lung only
  • mucus in tube can occlude it
  • occlusion by tracheal wall prevented by murphy’s eye
  • overinflated cuff - compress tube lumen or compress trachea and get necrosis
39
Q

When do you extubate?

A

when swallowing reflex is back

40
Q

what do you extubate earlier?

A

cats

41
Q

who do you extubate later?

A

brachycephalic
vomiting risk
ruminants

42
Q

How does anaemia affect anaesthesia?

A
  • less Hb so although the Hb present may be fully saturated the oxygen content of the blood will be reduced
  • CO will increase to maintain oxygen delivery to tissues
  • be careful as most anaesthetic drugs decrease CO so can drop oxygen delivery to a critical level
  • consider transfusion if acute and have ongoing blood loss
43
Q

How does mitral valve disease affect anaesthesia?

A
  • increased SV but ejection fraction is reduced so get forward failure and reduced CO
  • compensatory increased ventricular filling and activation of RAAS
  • get pulmonary congestion
  • need to stabilise before anaesthesia
  • want to avoid bradycardia as can cause valve regurgitation
44
Q

How does pulmonary oedema affect anaesthesia?

A
  • very high risk if animal cyanotic and dyspnoiec
  • lungs wont expand as much and alveoli filled with fluid so will increase oxygen consumption as breathing is harder
  • will be V/Q mismatch and shunting so reduced blood oxygen content
  • treat before anaesthesia
45
Q

When is an animal cyanotic?

A

Hb under 75-85% sat

46
Q

how does hypoproteinaemia affect anaesthesia?

A
  • affect amount of drugs free / bound
  • will have more unbound drug so a greater response seen to a given dose
  • risk of oedema as oncotic pressure is lower
47
Q

How does azotaemia affect anaesthesia?

A
  • increased free drug concentrations due to acidosis
  • oxygen dissocation curve shifted to the right (reducing o2 affinity)
  • changes in serum potassium affecting myocardial contractility
  • pre-op fluids to increase GFR and induce diuresis
48
Q

How does HCM affect anaesthesia?

A

-have extra heart muscle which due to vasodilation from anaesthesia wont be perfused so more likely to get arrhythmias and arrest

49
Q

how is sepsis a complication with anaesthesia?

A

already hugely vasodilated

50
Q

What is anaesthesia?

A

loss of sensation resulting form pharmacological depression of nerve function

51
Q

What is a GA?

A

a state of unconsciousness produced by controlled reversible drug-induced intoxication of the CNS in which the patient neither receives or recalls noxious stimuli

52
Q

What do we want from a Ga?

A 
unconsciousness
analgesia
muscle relaxation
amnesia
homeostasis
normal oxygen delivery
53
Q

how long do you fast each species for pre-op?

A

cat and dog - 6 h
horse -12 h
cow - 24 h
rabbit - no

54
Q

what can N2O exposure do?

A

inhibit DNA synthesis and cause CNS damage

year 3 principles (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions