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RUSVM Anesthesiology > Anesthesia Lab > Flashcards

Anesthesia Lab Flashcards

1
Q

Delivering anesthetic gas (21% O2) in air would lead to _____ due to hypoventilation and V/Q mismatch.

A

Hypoxemia

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2
Q

What is the minimum requirement of O2 acceptable for people and small animals?

A

30-35% O2 (FiO2 = 0.30-0.35)

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3
Q

What is the metabolic requirement for oxygen?

A

5-10 mL/kg/min

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4
Q

Which of the following cyclinder colors is matched incorrectly?

a. Green: oxygen
b. Blue: nitrous oxide
c. Yellow: Medical air
d. None of the above are matched incorrectly

A

d. None of the above are matched incorrectly

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5
Q

Cylinder pressure is ususally measure in ____ and breathing system pressures are measured in ____

A

psi = cylinder pressure cmH2O = breathing system pressure

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6
Q

Gas cylinders, yokes, pressure gauges, and regulators are considered high, intermediate or low pressure systems?

A

High pressure systems (100-2200+ psi)

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7
Q

Which are the low pressure systems?

A

Breathing system = pressure in patietns’ lungs <15 psi

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8
Q

Which are the intermediate (50psi) pressure systems?

A

Central O2 supply Post-regulator Flush valve Input to flowmeter Driving gas for ventrilator

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9
Q

What is the volume capacity of a ____ cylinder is 660L and the volume capacity found in the ____ cylinder is 6600L.

A

E cylinder: 660L H cylinder: 6600L

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10
Q

Both the H and E cylinder are filled to a pressure of ____ psi.

A

2200Psi

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11
Q

True/False: Pressure is inporportional to volume

A

False **proportional

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12
Q

What is the calculation to determine the remianing O2 in a tank?

A

2200psi/660L = psi left on E tank / x liters

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13
Q

How do you figure out how many minutes of O2 are left?

A

minutes remianing = x liters/ flow (liters/min)

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14
Q

True/False: It is not possible to calculate the amount of N2O gas remaining in the cylinder based upon the pressure of liquid that remains.

A

True

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15
Q

What decreases tank pressure ot a safe working pressure (approximately 50 psi) which is then supplied to the flowmeter?

A

Regulator

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16
Q

True/False: Gas enters at the bottom of the flowmeter at 50 psi and exits at the top of the flowmeter at 15 psi.

A

True

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17
Q

What system delivers O2 from the intermediate pressure area of the machine (50psi)?

A

Quick flush

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18
Q

What are examples of vapor inhalants

A

Halothane Isoflurane Sevoflurane Desflurane

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19
Q

What controls the rate of gas flow through the vaporizer?

A

Flowmeter

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20
Q

What is the first thing that you should do before the O2 flush valve is used?

A

Disconnect the patient from the curcuit temporarily

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21
Q

Where do we read the flow?

A

Middle of the ball and top of the bobbin

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22
Q

Between what rate does the quick flush deliver gas directly to the patient circuit?

A

35-75 L/min

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23
Q

Where is the O2 flowmeter located?

A

Right of the N2O flowmeter

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24
Q

What would be the % O2 delivered to a patient if there was 1L of O2 and 6 L N2O?

A

14% 1 L O2 + 6 L N2O = 7 O2 = 1 / 7 = 14%

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25
Q

When do you want to use the quick flush?

A

In an emergency or recovery to quickly decrease anesthtic gas % in the circuit

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26
Q

What are examples of gas inhalants?

A

N2O Xenon

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27
Q

Which of the following is false regarding vapor pressure?

a. Pressure exerted by vapor molecules when liquid and vapor phases are in equilibrium
b. Depends on pressure
c. Inversely realted to boiling point
d. All the above are true

A

b. Depends on pressure

**Depends on temperature –> increases with increasing temperature

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28
Q

What is a possible complication of using the quick flush?

A

Pneumothorax

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29
Q

A specific concentration of anesthetic vaporizers is created by ____ system, where fresh gas flows over a reservoir of liquid anesthetic and mixes with carrer gas.

A

Varibale bypass

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30
Q

Which of the following requires electrical heated vaporizers?

a. Halothane
b. Desflurane
c. Isoflurane
d. Sevoflurane

A

b. Desflurane

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31
Q

Histamine release may occur with IV administration of this opioid

A

Morphine

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32
Q

This induction agent is contraindicated in cats with cardiac or renal disease.

A

Ketamine

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33
Q

The primary side effect of this sedative is vasodilation and hypotension.

A

Acepromazine

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34
Q

This class of sedative produce vasoconstriction, reflex bradycardia and decrased CO.

A

Alpha 2 agonists

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35
Q

The PaO2 corresponding to a SpO2 of 90%

A

60 mmHg

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36
Q

The species that is especially prone to tracheal tears due to improper cuff inflation or breathing tube traction

A

Cat

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37
Q

“Triple drip” is an injectable anesthetic mixture used commonly in this species.

A

Horses

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38
Q

This group of animals should be extubated with the ETT cuff inflated

A

Ruminants

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39
Q

Bradycardia is the primary indicatoin for administering which class of drug?

A

Anticholinergics

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40
Q

You should check a coagulation profile before surgery patients with dysfunction of this organ

A

Liver

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41
Q

This operator error will result in excessive breahting system pressure and patient death

A

Closure of the APL or “pop off” valve

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42
Q

The primary indication for this alpha and beta agonist is CPR

A

Epinephrine

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43
Q

This species is most likely to develop malignant hyperthermia

A

Pig

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44
Q

This drug is a class 1B anti-arrhythmic agent used commonly to treat ventricular arrhythmias

A

Lidocaine

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45
Q

This class of animal has complete tracheal rings

A

Birds

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46
Q

Serum sodium levels are a special concern when anesthetizing patients with this disease

A

Diabetes insipidus

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47
Q

These 2 ECG rhythms are treated with defibrillation (“shockable” rhythms)

A

Ventricular fibrillation and pulseless ventricular tachycardia

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48
Q

This class of sedatives may cause hyperglycemia and should be avoided in DM patients

A

Alpha 2 agonists

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49
Q

Inhalants administered at >1 MAC should be avoided in these patients

A

Patients with increased ICP

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50
Q

This ECG diagnosis indicates a complete absence of electrical activity

A

Asystole

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51
Q

The concentration of an anesthetic preventing movement in 50% of patients exposed to a noxious stimulus

A

Minimum alveolar concentration (MAC)

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52
Q

This common induction agent should be used in very low doses or not at all in shocky patients

A

Propofol

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53
Q

The treatment for the following arterial blood gas:

pH = 7.238

pCO2 = 68

pO2 = 438

HCO3 = 29

BE = 2

A

IPPV

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54
Q

What receptors does Butorphanol act on?

A

mu antagonist and kappa agonist

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55
Q

Buprenorphine works on what receptors?

A

partial mu agonist

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56
Q

What can you combine ketamine with to avoid a catatonic state?

A

Alpha 2 agonist or Benzodiazepine

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57
Q

Which is the most common drug for induction of anesthesia in horses?

A

Ketamine

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58
Q

Which drug is contraindicated in sheep becuase of the hypoxemic effects it can casue?

A

Xylazine

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59
Q

Which is the strongest available sedative in all animals except for pigs?

A

Alpha 2 agonists

60
Q

Which drugs can be used in hemodynamically unstable/ at risk patients?

A

Opioids

Etomidate

Alfaxalone

Benzodiazepine

61
Q

Which stage of anesthesia can we not intubate the patient because of a strong jaw tone?

A

Stage 2

62
Q

Which stage of anesthesia do we have central eyes, dilated pupils and no corneal or palpebral reflexes?

A

Stage 3, Plane 3

63
Q

Which stage of anesthesia do we perform surgeries?

A

Stage 3

64
Q

Which stage can we perform simple procedures/ exams and we have nystagmus, constricted pupils, and weak palpebral and corneal reflexes?

A

Stage 3, Plane 1

65
Q

Which plane of anesthesia do we have the most adequate muscle relaxation for most surgical procedures?

A

Stage 3, Plane 2

66
Q

What are the common signs that we see with the eyes of a patient when we use ketamine?

A

nystagmus, blinking, central eyes, and dilated pupils

67
Q

Which drug has a direct negative inotropy effect and indirect catecholamine release increasing HR and contractility?

A

Ketamine

68
Q

What kind of drugs are our dissociative anesthetics?

A

NMDA antagonists

69
Q

All of the following have no analgesia effects except:

a. Propofol
b. Etomidate
c. Xylazine
d. Diazepam

A

c. Xylazine

70
Q

Which is the most common injectable anesthetic in small animals and can also be used as a TIVA drug because it doesn’t accumulate?

A

Propofol

71
Q

Which of the following is the number one choice for induction in hemodynamically unastable patients?

a. Etomidate
b. Alfaxalone
c. Diazepam
d. Fetanyl

A

a. Etomidate

72
Q

Wich of the following has minimal CV effecsts and can be useful for C-sections?

a. Etomidate
b. Alfaxalone
c. Thiopental
d. None of the above

A

b. Alfaxalone

73
Q

Which drug can’t be used as a CRI becuase of its adrenal suppression and propylene glycol accumulation?

A

Etomidate

74
Q

Which drug is used in large animal anesthesia that is centrally acting and casues skeletal muscle relaxation with little effect on respiratory muscles?

A

Guaifenesin

75
Q

What NMBD drug is used to treat malignant hyperthermia and is peripherally acting on the muscle cells?

A

Dantrolene

76
Q

Which drug is not used in cats that is used in dogs for the MLK infusion?

A

Lidocaine

77
Q

Which drugs are part of the triple drip anesthetic mixture for horses?

A

Guaifenesin, Xylazine (or other alpha 2) and Ketamine

78
Q

True/False: Fetanyl is prefered over morphine as a CRI because of its slow onset and long duration of action.

A

False

**other way around, morphine is preferred over fetanyl

79
Q

Which CRI can be used to relieve abdominal pain in colic horses and abdominal and neuropathic pain in dogs?

A

Lidocaine CRI

80
Q

Which CRI is contraindicated in cats due to its cardiotoxic effects?

A

Lidocaine

81
Q

Which drugs make up the anesthetic component of my TIVA?

A

Propofol

Alfaxalone

Ketamine

82
Q

Which of the following is matched incorrectly regarding the physical status classification of a patient?

a. ASA II: fever, pregnancy, mild anemia
b. ASA III: moderate/ severe systemic disease, morbidly obese, CHF
c. ASA IV: GVD, shock, sepsis, hemorrhagic spleen
d. ASA V: won’t survive for 25 hours with or without surgery

A

b. ASA III: moderate/ severe systemic disease, morbidly obese, CHF

***moderate heart disease

83
Q

Which drugs are my GABA agonists?

A

Alfaxalone

Etomidate

Propofol

Isoflurane

Benzodiazepiens

Thiopental

Sevoflurane

“After Eating Pizza Its Best To Sleep”

84
Q

What is the MAC of sevo and iso in dogs?

A

Iso: 1.3

Sevo: 2.3

85
Q

Which of the following is false regarding increasing the alveolar delivery?

a. To increase the anesthetic concentration incrase the vaporizer, fresh gas and circuit volume
b. To increase the alveolar ventilation increase minute ventilation
c. To increase alveolar ventilation decrease dead space
d. All the above are true

A

a. To increase the anesthetic concentration incrase the vaporizer, fresh gas and circuit volume

**decrease the circuit volume

86
Q

True/False: Equilibrium of anesthetic vapors is reached when partial pressures are equal but the number of molecules are not equal.

A

True

87
Q

Which of the following does not pertain to a decreased MAC?

a. Pregnancy
b. Hyperthermia
c. Hypothermia
d. Decreased MAP <50 mmHg

A

b. Hyperthermia

***increased MAC

88
Q

What is the main result from an exhausted soda lime that no longer removed CO2 from the expired gases?

A

Hypercapnia

89
Q

What is this a picture of?

A

CO2 rebreathing waveform

90
Q

What are the three possibilities of CO2 rebreathing?

A
  1. Stuck inspired/ expired valves
  2. Exhausted soda lime
  3. Inadequate O2 flow in a non-rebreathing system
91
Q

What is the main indication of this waveform?

A

Hypoventilation

92
Q

Which breed of dogs has a long recovery with thiobarbiturates, propofol, and alfaloxone?

A

Sight Hounds

93
Q

Which breeds are more prone to tracheal collapse so we want to make sure to use a longer ETT?

A

Small breeds

94
Q

Which drug can cause Heinz body anemia in cats?

A

Propofol

95
Q

Which breed of cats is prone to CHF with ketamine or telazol?

A

Mainecoon

96
Q

Which drugs make up “kitty magic”?

A

Ketamine, alpha 2 and opioid

97
Q

Which species can get post-op hyperthermia with the use of opioids?

A

Cats

98
Q

Which non-anesthetic drug can decrease opioid vomiting in cats?

A

Cerenia

99
Q

Which opioids inhibit vomiting in dogs?

A

Fetanyl and Methadone

100
Q

What is the DOC to treat hypotension in cats?

A

Dopamine

101
Q

Which NSAID is safe to use in cats with renal disease but its not FDA approved?

A

Meloxicam

102
Q

Which drug acts on the beta 1 receptor and is used in my equine anesthesia?

A

Dobutamine

103
Q

Which of the following is the most commonly used opioid in cattle?

a. Bupernorphine
b. Butorphanol
c. Morphine
d. Hydromorphone

A

b. Butorphanol

104
Q

What is the induction drug used in young cattle?

A

Propofol

105
Q

Which two drugs can be used as a “double drip” in cattle?

A

Ketamine and GGE

106
Q

What is the SAP and MAP we want in large animals?

A

MAP: >70

SAP: >90

107
Q

What is the MAP and SAP that we want in small animals?

A

MAP: >60

SAP: >80

108
Q

True/False. A rebreathing machine can be used in kids and lambs.

A

False

**Non-rebreathing with their heads lower than the rest of their body

109
Q

Alpha two agonists can cause hypoxemia with pulmonary parenchymal damage in which animals?

A

Sheep and goats

110
Q

Where do you place the ECG in large animlas?

A

White –> right jugular furrow, Black –> apex of the heart, and Red –> caudal to the black

111
Q

Which of the following is true regarding ECG in small animals?

a. Lead II is commonly used
b. There is a prominant negative S wave
c. They have a type B heart
d. All the above are true

A

a. Lead II is commonly used

112
Q

How do you administer porpofol to effect for sheep anesthesia?

A

About 3 mg/kg IV over 10-15 minutes

113
Q

Where do you want to place the doppler in your sheep patients?

A

Median artery

114
Q

What are the landmarks for your IM/SQ premed injection in sheep?

A

Between the transverse process of the cervical vertebrae, nuchal ligament and the cranial aspect of the scapula

115
Q

What is the srugical maintenance rate for your sheep anesthesia?

A

10 mL/kg/hr

116
Q

Which of the following is false regarding the breathing systems of a patient that is 1 kg?

a. Bain system can be used
b. Mapleson F system can be used
c. Purple soda lime color indicates that the CO2 absorber is exhausted
d. None of the above are false

A

c. Purple soda lime color indicates that the CO2 absorber is exhausted

***there is no soda lime or unidirectional valve present in your non-rebreathing system which is what’s used for patients <3kg

117
Q

What is the induction/ recovery and maintenance O2 flow rate for small animals?

A

Induction/recovery: 50-100 mL/kg/min

Maintenance: 20-50 mL/kg/min

118
Q

What is the induction/recovery and maintenance O2 flow rate in your large animals > 50kg?

A

Induction/recovery: 20-50 mL/kg/min

Maintenance: 10-20 mL/kg/min

119
Q

How do you calculate the reservoir bag size in small animals?

A

(~15mL/kg) x 6 –> round up

120
Q

A closed ____ will increase pressure and there will be no exhaust which can lead to CVS arrest

A

APL valve

121
Q

Which of the following is matched incorrectly?

a. Rebreathing: circle and universal F
b. Non-rebreathing: Mapleson A-F
c. Rebreathing: minimal dead space and unidirectional flow
d. Non-rebreathing: no soda lime or unidirectional valves

A

c. Rebreathing: minimal dead space and unidirectional flow

**no dead space

122
Q

What are your three types of ETT?

A

Murphy

Cole

Wire- reinforced (armored)

123
Q

What endobronchial complications can occur if the ETT goes past the thoracic inlet?

A

Hypoxemia, +/- hypercapnia

124
Q

Which scaneging system doesn’t absorb N2O and should be discarded when >50g?

A

F air canister

125
Q

Which ETT is used in your avian species?

A

Cole

126
Q

Which ETT can be used during eye procedures because it prevents tube collapse when in extreme flexsion?

A

Wire-reinforced (armored)

127
Q
A
128
Q

Ventilation refers to a PaCO2 of _____ (range) and we can use the arterial blood gas or ___ to measure this.

A

35-45, capnograph

129
Q

Oxygenation refers to a PaO2 or SpO2 of _____ at 100% O2 and we can use the arterial blood gas or ___ to measure this.

A

>500 mmHg, pulse ox

130
Q

True/False: we can’t improve O2 while on 100% O2 with more ventilation

A

True

131
Q

What are the five causes of hypoxemia?

A
  1. Decreased FiO2/ PiO2
  2. Hypoventilation
  3. Diffusion impairment
  4. V/Q mismatch
  5. Right to left shunt
132
Q

True/False: Atelectasis is the most common cause of V/Q mismatch.

A

True

133
Q

What do anticholinergics work on?

A

Muscarinic antagonists on acetylcholine receptors

134
Q

Which breed of dog is sick sinus syndrome most commonly seen with?

A

Miniature Schnauzers

135
Q

What is the main side effect of mechanical ventilation?

A

Hypotension

136
Q

What is the parameter used to measure blood gas ventilation?

A

PaCO2

137
Q

What is the arrow pointing to on this capnograph?

A

Where ET CO2 is measured

138
Q

Which phase indicates the beginning of inspiration on the capnograph?

A

Phase IV

139
Q

Which of the following induces vomiting?

a. Fetanyl
b. Hydromorphone
c. Methadone
d. Butorphanol

A

b. Hydromorphone

140
Q

True/False: A loading dose followed by a CRI will make the onset of TIVA drugs fast.

A

True

141
Q

Which of the following have minimal cardiovascular and respiratory effects?

a. Alpha 2 agonists
b. Anticholinergics
c. Benzodiazepines
d. Opioids

A

c. Benzodiazepines

142
Q

True/False: a low blood gas partition coefficient has a fast induction and recovery rate.

A

True

143
Q

Which of the following is not a GABA agonist?

a. Propofol
b. Etomidate
c. Alfaxalone
d. Ketamine

A

d. Ketamine

“After Eating Pizza Its Best To Sleep”

144
Q

Which of the following is matched incorrectly regarding the heart rate of these species?

a. Dog: 50-160
b. Cat: 100-200
c. Cow: 48-90
d. Sheep/goat: 28-50

A

d. Sheep/goat: 28-50

**60-150 for sheep and goats and 28-50 for horses

145
Q

True/False: This waveform is indicating hypoventilation.

A

False

***Hyperventilation

RUSVM Anesthesiology (2 decks)

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