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Breathing and Cir. Exam 3 > Anesthesia > Flashcards

Anesthesia Flashcards

1
Q

Of the ruminant groups (dairy, beef, and small) which need lower doses of anesthetic drugs? Two answers.

A

Dairy and small

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2
Q

What is important for a halter not to do when being used on a camelid?

A

Slip forward on nose, could compromise the airway and lead to stress and panic (and more hissing, kicking, spitting, and biting, how lovely)

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3
Q

How long should large ruminants fast to reduce their risk of tympany, regurgitation and aspiration and avoid emptying the rumen too much?

A

24-48 hours

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4
Q

Why should anticholinergic use be avoided in ruminants? Two answers.

A

Ileus and increases viscosity of saliva which ruminants already produce a lot of → increased risk of airway obstruction

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5
Q

Why is it common for camelids to be on omeprazole when they might be undergoing stress, such as anesthesia?

A

Omeprazole = antacid; camelids = stress ulcers

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6
Q

What does the degree of regurgitation in ruminants and camelids depend on?

A

Animal position

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7
Q

In which position is the incidence of regurgitation the highest?

A

Dorsal recumbency

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8
Q

What can be done when a ruminant/camelid is in a lateral position to reduce the incidence of regurgitation?

A

Elevate middle portion of the neck with a pillow/towel, allows any regurge that occurs to drain out of the mouth instead of going back into the oral cavity

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9
Q

In which position is ruminal tympany less likely to occur?

A

Sternal

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10
Q

What can distention of the rumen result in? Four answers.

A

Reduced lung volume, respiratory distress, hypoxemia, and decrease cardiac output

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11
Q

Ruminants and camelids have smaller/larger tidal volumes and higher/lower respiratory rates than dogs and cats.

A

Smaller, higher

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12
Q

What two side effects of anesthesia related to gas content of their blood are common in ruminants/camelids during spontaneous ventilation?

A

Hypercapnia and hypoxemia

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13
Q

What monitoring equipment would let you know that a patient has the abnormalities that answer the question above? (Hypercapnia and hypoxemia)

A

Hypercapnia - EtCO2 or blood gases; hypoxemia - pulse ox

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14
Q

What is the oxygen flow rate for an adult bovine patient?

A

15 L/min

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15
Q

How can dorsal/lateral positioning of a ruminant or camelids lead to hypoxemia?

A

Weight of abdominal viscera decreases the functional reserve capacity of the lungs which leads to a ventilation-perfusion mismatch = hypoxemia

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16
Q

Dorsal/lateral position of a ruminant/camelid compresses the caudal vena cava, what does this lead to?

A

Decreased venous return → decreased cardiac output and blood pressure

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17
Q

Which three nerves are more commonly affected when a ruminant/camelid is left in a dorsal/lateral position for too long with inadequate padding?

A

Radial, peroneal, and tibial

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18
Q

What do you need to ensure to prevent myopathy?

A

Ensure normal blood pressure

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19
Q

(T/F) Camelids do not have a jugular groove.

A

True

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20
Q

Which side of the neck is preferred for a jugular catheter in camelids?

A

Right

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21
Q

Why might a venous and arterial sample of blood look similar in terms of bright redness in a camelid patient?

A

Camelids are high altitude animals = high oxygenation even in venous blood

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22
Q

How can you test in a camelid patient if your catheter is in an artery versus a vein?

A

Open the port, if it gushes, probably an artery; isn’t vet med nice

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23
Q

What shape are camelid erythrocytes?

A

Ellipsoidal

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24
Q

What are alternative veins that can be used for small ruminants if you cannot hit the jugular? Four answers.

A

Auricular, cephalic, saphenous, and coccygeal

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25
Q

If you fast a calf, kid, lamb, or cria for greater than > 4 hours, what are you putting them at risk of?

A

Hypoglycemia

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26
Q

Why should you avoid excessive fasting in ruminants/camelids? Two answers.

A

Change in ruminal flora and risk of ketosis

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27
Q

Which alpha 2 agonist are ruminants very sensitive to and which can induce abortions in the third trimester similarly to oxytocin?

A

Xylazine

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28
Q

What is the dose for alpha 2 agonists for large ruminants/camelids when compared to the dose for horses?

A

Large ruminants → 1/10 of the dose for a horse

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29
Q

Why should alpha 2 agonist use be avoided in small ruminants? Two answers.

A

Causes pulmonary edema and hypoxemia

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30
Q

What side effect is associated with large doses and prolonged treatment with opioids in ruminants/camelids?

A

GI stasis

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31
Q

(T/F) Ruminants and camelids love benzodiazepines.

A

True

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32
Q

Which route of administration should be used for diazepam always?

A

IV

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33
Q

What three drugs are in a ‘ketamine stun’, which is used for standing sedation?

A

Butorphanol, xylazine, and ketamine

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34
Q

Give some examples of when you might use a ketamine stun (Dr. P listed 3 and that’s what I will list but there’s probably lots more).

A

Laparotomy in range cattle, endoscopy, head examinations

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35
Q

Are the MACs for iso and sevo lower/higher/same for ruminants/camelids when compared to small animal MACs?

A

Iso - lower; sevo - same

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36
Q

What is the weight cut off for using a small animal anesthesia machine in a ruminant/camelid?

A

<150 kgs

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37
Q

(T/F) A majority of ruminant/camelid surgical procedures are done with regional anesthesia and sedation.

A

True

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38
Q

What is the shorter acting regional block drug mixture (where morphine lasts 20-24 hours, this lasts 5 hours)?

A

Lidocaine and xylazine

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39
Q

Why is it necessary to use a stylet when intubating a small ruminant?

A

Their mouth is small, putting the ET tube in occludes your vision so use small stylet first then feed tube over, voila

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40
Q

In which species of ruminants (bovine, caprine, ovine, camelids) does the position of the eyeballs correlate well with depth of anesthesia?

A

Bovine

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41
Q

What position should ruminants and camelids be recovered in if they still have an intubation tube in?

A

Sternal position with head down

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42
Q

Why do you only want to partially deflate your cuff before extubating a ruminant/camelid patient?

A

The slightly inflated cuff will draw out any potentially regurgitated material and prevent it from going into the trachea

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43
Q

Why should you manually restrain the neck of camelids when recovering them from anesthesia?

A

Tend to slam their neck around, restraint can prevent trauma/injury

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44
Q

What is administered to camelids, who are obligate nasal breathers, to avoid nasal obstruction?

A

Phenylephrine nasal spray

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45
Q

Why are pigs difficult to restrain? Two answers.

A

Body shape and lack of ungraspable appendages

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46
Q

What are pigs susceptible to during intubation that is similar to cats?

A

Laryngeal spasms

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47
Q

What species do you find a palatal ostium that WILL get in your way during intubation?

A

Guinea pigs

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48
Q

Why are small exotics susceptible to hypoxemia, hypercapnia, and respiratory arrest?

A

Resp rate is normally high and tidal volume is very small; if you cut out the high respiratory rate by inducing anesthesia, the tidal volume is still very small → hypoxemia, hypercapnia, respiratory arrest

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49
Q

Which vein is most commonly used in pigs for administration of drugs or placement of a catheter?

A

Auricular

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50
Q

If you administer alpha 2 agonists to a pig patient, why might you then have difficulty in placing your catheter?

A

Vasoconstriction

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51
Q

Of the veins listed below, give the small exotic species that you may use it in for injections or catheter placements.
- Cephalic vein
- Saphenous vein
- Jugular vein
- Marginal ear vein
- Lateral coccygeal vein

A
  • Cephalic vein (Hamsters, guinea pigs, rabbits)
  • Saphenous vein (Hamsters, guinea pigs, rabbits)
  • Jugular vein (Rabbits)
  • Marginal ear vein (Rabbits)
  • Lateral coccygeal vein (Rats)
52
Q

Do you need to administer a higher or lower dose of alpha 2 agonists to a swine patient?

A

Higher

53
Q

Why would you administer ondansetron or maropitant to a swine patient?

A

Both are antiemetics, can be given to pig patients with hx of GI issues/vomiting to prevent vomiting and subsequent aspiration pneumonia

54
Q

What anesthetic depth sign is consistent across all species which makes it particularly useful in pigs who are difficult to monitor depth for?

A

Jaw tone

55
Q

What are the triggers for malignant hyperthermia in porcine patients? Four answers.

A

Transport/restraint, warm temperatures, volatile inhalants, succinylcholine

56
Q

What porcine breeds are predisposed to malignant hyperthermia? 6 answers.

A

Pietran, landrace, poland-china, large white, hampshire, yorkshire

57
Q

Is EtCO2 high or low when a patient has malignant hyperthermia?

A

High

58
Q

What should you do FIRST when you begin treating a patient with malignant hyperthermia?

A

Turn of inhalant

59
Q

Why should you change the anesthesia machine and breathing circuits for a patient with malignant hyperthermia?

A

If it’s the inhalant causing the issue, you’ll be treating the issue as you continue to cause it

60
Q

What drug can be administered to a swine patient with malignant hyperthermia under anesthesia by blocking the excess calcium being released?

A

Dantrolene

61
Q

Small pet exotics have a high metabolic rate, why is that important to know? Two answers.

A

Hypoglycemia if fasted too long and rapid drug metabolism

62
Q

Why do small exotics have a low tolerance to hypoxemia and rapid inhalant induction/elimination?

A

B/c they have high oxygen consumption rates

63
Q

How long should adult swine patients be fasted?

A

12 hours

64
Q

What length of needle should be used in swine patients when aiming to give IM sedation?

A

1.5-2 inches

65
Q

(T/F) Small exotic patients should not be fasted.

A

True

66
Q

The smaller a patient gets, the _____ (more/less) important it is to have an accurate weight.

A

More

67
Q

Why is ketamine used alone not ideal in swine patients?

A

No muscle relaxation

68
Q

Of sevoflurane or isoflurane, which is best for mask induction in a heavily sedated swine patient?

A

Sevoflurane

69
Q

When should a small exotic patient be removed from an induction chamber?

A

Loss of righting reflex

70
Q

You have a swine patient that is 217kgs, can you use a small animal anesthesia machine for it?

A

No, >200kgs

71
Q

What drug is used for total intravenous anesthesia [TIVA] in swine patients?

A

Propofol

72
Q

When using inhalant anesthesia in small exotic patients…
- Resistance should be ________ (lower/higher) when compared to dogs/cats.
- Non-rebreathing fresh gas flow should be proportionally __________ (lower/higher) when compared to dogs/cats.

A
  • Resistance should be ________ (lower/higher) when compared to dogs/cats. (Lower)
  • Non-rebreathing fresh gas flow should be proportionally __________ (lower/higher) when compared to dogs/cats. (Higher)
73
Q

Pain assessment in swine patients is typically based on changes in what?

A

Behavioral changes

74
Q

What are the four contributing factors for anesthetic mortality in equine patients?

A

Age, duration of surgery, drugs for sedation, and inhalants

75
Q

What arrhythmias are common with equine patients that should be known prior to anesthesia?

A

1st and 2nd degree AV blocks and atrial fibrillation

76
Q

Why is it important to rinse a horse’s mouth out prior to anesthesia?

A

Can store lots of bits in there that you don’t want to take down the trachea with the ET tube upon intubation

77
Q

What can let you know an equine patient is adequately sedated before proceeding with your induction? Four answers.

A

Feet planted, head and lip dropped, minimally responsive to external stimuli

78
Q

What advantage does the ketamine/diazepam combo have over the ketamine/propofol combo used for induction of equine patients?

A

Less volume needed with ketamine/diazepam

79
Q

(T/F) Intubation in equine patients is typically blind.

A

True

80
Q

What should be done if you are attempting to intubate an equine patient and you feel resistance?

A

Pull ET tube back, rotate 90 degrees and readvance

81
Q

Of inhalant anesthesia and total intravenous anesthesia…
- Which causes less cardiorespiratory depression?
- Which has both a lower morbidity and mortality?
- Which has superior analgesia?
- Which has minimal drug accumulation over time?
- Which has good muscle relaxation?

A
  • Which causes less cardiorespiratory depression? (TIVA)
  • Which has both a lower morbidity and mortality? (TIVA)
  • Which has superior analgesia? (TIVA)
  • Which has minimal drug accumulation over time? (Inhalant)
  • Which has good muscle relaxation? (Inhalant)
82
Q

What plane of anesthesia is desired in an equine patient?

A

Light plane

83
Q

What eye signs do you want to see in an equine patient in the optimal plane of anesthesia? Four answers.

A

Slow palpebral, strong corneal, tearing, and slow nystagmus

84
Q

What types of drugs can interfere with eye signs?

A

Dissociatives

85
Q

When can the ET tube be removed in an equine patient?

A

At swallowing or earlier

86
Q

What is one of the most common complications during anesthesia besides hypotension?

A

Hypothermia

87
Q

What bodily changes occur that cause hypothermia in anesthetized patients?

A

Decreased heat production and increased heat loss

88
Q

Are smaller or larger patients more likely to have hypothermia?

A

Smaller

89
Q

(T/F) It is much easier to rewarm a patient post operatively rather than prevent heat loss.

A

F, other way around

90
Q

(T/F) Hypothermia during anesthesia can decrease healing post operatively.

A

True

91
Q

You will need to decrease/increase your anesthesia (whether inhalant or injectable) when your patient is hypothermic.

A

Decrease

92
Q

How much does shivering increase oxygen consumption?

A

400%

93
Q

What heart abnormalities are associated with hypothermia?

A

Arrhythmias

94
Q

What can you use to keep heat in a patient you are taking an MRI on when heating equipment is not MRI compatible?

A

Bubble wrap

95
Q

What class of drugs can cause hyperthermia in cats?

A

Opioids

96
Q

Do your anesthetic requirements increase or decrease with hyperthermia?

A

Increase

97
Q

At what temperature and higher does CNS injury occur?

A

More than 107

98
Q

What are the two goals of anesthetic monitoring?

A

To give early warning to the practitioner to maximize patient care and avoidance of human errors

99
Q

What is your most important anesthetic monitor?

A

Trained assistant/LVT

100
Q

What are the 5 constant anticipated problems in an anesthetized small animal?

A

Hypotension, hypothermia, bradycardia, hypoventilation, and pain

101
Q

What are the three ways you can identify an anesthetized patient is hypoventilating?

A

Respiratory rate, chest excursions, and high end title CO2

102
Q

How do you treat hypoventilation in an anesthetized patient?

A

Adjust anesthetic depth → decrease; manual or mechanical ventilation

103
Q

What are the two locations to take a temperature in an anesthetized small animal patient?

A

Rectal or esophageal

104
Q

How would you minimize/treat hypothermia in an anesthetized patient? Two answers.

A

Minimize loss, use active warming devices

105
Q

How can you determine if an anesthetized animal is bradycardic? Four answers.

A

Esophageal stethoscope, pulse palpation, ECG, pulse oximetry

106
Q

How can you treat bradycardia in an anesthetized patient? Three answers.

A

Decrease anesthetic depth, anticholinergics, sympathomimetics

107
Q

What do you depend the use of invasive versus noninvasive blood pressure monitoring in a small animal patient on?

A

Criticality of the patient

108
Q

How do you treat hypotension in an anesthetized patient? Three answers.

A

Decrease anesthetic depth, bolus of fluids, sympathomimetic drugs → dobutamine , dopamine

109
Q

How do you identify pain in an anesthetized patient?

A

Sympathetic stimulation from surgical stimulation → increases in blood pressure and heart rate

110
Q

What drug class is used to treat pain in anesthetized patients?

A

Analgesics

111
Q

How do you determine anemia developing in an anesthetized patient? Two answers.

A

Approximation of blood loss via suction bottle and/or gauze used, serial PCVs

112
Q

In a patient suspected to be hemorrhaging, what can be done to aid in quick administration of blood products as needed while in surgery? Three answers.

A

Place second catheter, blood type/cross matching, make sure have appropriate blood products available

113
Q

Why is hypoglycemia more of a worry under anesthesia than hyperglycemia?

A

Anesthesia masks the signs of hypoglycemia → hunger and seizures

114
Q

(T/F) Diabetic patients should eat the morning of anesthesia as well as receive a fraction of their insulin dose.

A

True

115
Q

What is the normal glucose range under anesthesia for a small animal patient?

A

100-300 mg/dL

116
Q

What should be administered to a patient that drops below the normal anesthetic glucose range?

A

Dextrose

117
Q

What should be administered to a patient that goes above the normal anesthetic glucose range?

A

Regular insulin

118
Q

What are the 5 constant anticipated problems in an anesthetized equine patient?

A

Hypoventilation, pain, hypoxemia, myopathy/neuropathy, recovery accidents

119
Q

How can you determine if an anesthetized equine patient is hypoxemic?

A

PaO2 and/or SpO2

120
Q

How do you treat hypoxemia in an anesthetized equine patient?

A

Mechanical ventilation with PEEP (positive end expiratory pressure)

121
Q

How can tissue hypoxia be identified in an anesthetized equine patient?

A

Presence of cyanosis and increased lactate

122
Q

Why is the minimum optimal MAP higher in anesthetized equine patients when compared to small animal patients?

A

Muscle perfusion more important in large equine patients

123
Q

You should always keep extra of what drug with you pre, peri, and postoperatively when working with an equine patient?

A

Ketamine

124
Q

(T/F) Myopathies and neuropathies can only be identified post operatively.

A

True

125
Q

What three ways can you minimize myopathies/neuropathies in anesthetized equine patients?

A

Well padded surfaces and minimize pressure points, remove halter, and keep MAP >70 mmHg

Breathing and Cir. Exam 3 (7 decks)

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