Anesthesiology Exam I Material Flashcards by Chris Bessette

Anesthetized patients encounter respiratory depression from anesthetic drugs, so we supplement their oxygen to avoid hypoxemia. What is considered the minimum F_IO₂?

Minimum F_IO₂ = 35%

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T/F: It is fine to use the quick flush valve on a small patient attached to a low volume breathing system because you’re a badass and you play by your own rules

No. It’s not.

You would pop your patient.*
…wouldn’t be very badass then.*

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What are the two main functions of any patient breathing system (PBS)?

Deliver oxygen +/- anesthetic gas
- Eliminate carbon dioxide

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According to the ACVA, how often should you record findings while an animal is under anesthesia?

Every 5-10 minutes

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__________ bypasses the vaporizer and delivers O₂ directly to the patient breathing circuit

Quick Flush

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What flow rate is typically used with a non-rebreathing system?

200-300 ml/kg/min

Throughout the entire procedure

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What is the equation you use to calculate proper size of rebreathing bag?

Body weight x Tidal volume x 5

Normal tidal volume = 10-20 mls/kg

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The pressure reduction valve reduces cylinder pressure to a fixed _____ psi

50 psi

Provides a constant pressure of 50 psi to the flowmeter

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What is the main function of the ‘pop-off’ valve?

limits pressure buildup within the circuit

ALWAYS keep open unless delivering manual, controlled, or assisted ventilation

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Loss of sensitivity to pain is termed:

analgesia

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At what temperature (Farenheit) do we consider the patient hypothermic?

96^oF or less

Below 94^oF anesthetic requirements are reduced, recovery may be prolonged, CV function depressed

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How do you calculate remaining oxygen within an ‘E’ Cylinder?

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A state characterized by CNS depression accompanied by drowsiness is termed:

sedation

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What is the mechanism of action for Atropine?

Antimuscarinic

Competitively inhibits acetylcholine (and other cholinergic stimulators) at the postganglionic parasympathetic neuroeffector site

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In order to avoid hypoxemia, N₂O:O₂ should not exceed a ratio of ____

2:1

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What monitoring adjunct assesses the effects of anesthesia drugs on synaptic activity?

Electroencephalography (EEG)

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A drug induced state of deep sleep from which a patient cannot be easily aroused:

narcosis

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Is this an example of a VOC or VIC?

VOC

Vaporizer Out of Circuit. These are precision vaporizers.

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What is the SVP for Desflurane at 20^oC?

660 mmHg

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T/F: Manual palpation of pulse provides an objective measure of adequacy of cardiac output and tissue perfusion

False

Manual palpation of pulse provides a _sub_jective measure of adequacy of cardiac output and tissue perfusion

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How many liters of oxygen can fit in an E Cylinder?

660 L

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What is the reversal agent for dexmedetomidine?

Atipamezole

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What is the SVP for Sevoflurane at 20^oC?

160 mmHg

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In an anesthesia machine, what flow meter is always last in the series?

Oxygen Flow Meter

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At what pressure should E and H Cylinders be changed?

**500 psi**

T/F: **Pin Index Safety System** is used for E cylinders *only*

**True!** *The purpose of the PISS is to avoid improper cylinder connection (i.e. oxygen mismatch)*

T/F: If no compensating mechanism is present, altitude can have an effect on output concentration of the anesthetic vaporizer

**True**

T/F: There is an inverse relationship between temperature and saturated vapor pressure (SVP)

**False** *There is a direct relationship between temperature and saturated vapor pressure (SVP). As temperature increases, SVP increases.*

As temperature increases, saturated vapor pressure (SVP) \_\_\_\_\_\_\_\_\_\_

**increases**

At what stage of anesthesia are vomiting and swallowing reflexes lost?

**Stage III (Surgical Anesthesia)**

T/F: Dogs will often experience laryngospasm during intubation

**False** *_Cats_ will often experience laryngospasm during intubation.*

T/F: Rebreathing (circle) systems increase resistance for smaller patients

**True** *For this reason, we try to avoid using these rebreathing systems for small patients (guinea pigs, small cats, rats, etc.)*

T/F: You should always use non-rebreathing systems for patients under 3 kg

**True**

Does this vaporizer have back-pressure compensation?

**No.** This is a _non-precision_ vaporizer. Only precision vaporizers have back-pressure compensation

T/F: alpha-2 agonists cause vasoconstriction & increased BP, followed by a reflex bradycardia

**True**

Name the agent that is used for reversal of benzodiazepines:

**Flumazenil**

Gas passing through the oxygen **flowmeter** is reduced from 50 psi to about ____ psi

**15 psi**

T/F: When inflating the cuff, there should be no escape of gas from around the endotracheal tube when the APL valve is closed and the rebreathing bag is squeezed to 30 cmH₂O

**FALSE** * When inflating the cuff, there should be no escape of gas from around the endotracheal tube when the APL valve is closed and the rebreathing bag is squeezed to **_20 cmH₂O_*** * When squeezed to _30 cmH₂O,_ air should be able to escape around the tube. if not, air should be removed from the pilot balloon to prevent over-inflation*

What is the mechanism of action (MOA) for Acepromazine?

**Dopamine (D1 and D2) receptor antagonist**

How many liters of oxygen can fit in an H Cylinder?

**6600 L**

What stage of anesthesia is considered **anesthetic overdose**?

**Stage IV**

T/F: Anal sphincter tone is a good indicator of anesthetic depth

**True** *Tight in Stage II; relaxes thereafter*

If the patient is holding their breath out of excitement, which stage of anesthesia is the patient likely in?

**Stage I**

T/F: Charcoal absorption systems are useful because they absorb halogenated anesthetic gases, N₂O, and CO₂

**False** *Charcoal absorption systems absorb halogenated gases (iso, sevo, des), but do NOT absorb N₂O or CO₂*

T/F: **Butorphanol** is a partial mu agonist and an antagonist at kappa receptors

**False!** ***Buprenorphine** is a partial mu agonist and an antagonist at kappa receptors* ***Butorphanol** is an agonist at kappa receptors and partial mu receptor agonist/antagonist*

T/F: Precision vaporizers can be used with rebreathing or non-rebreathing systems

**True**

T/F: **Doppler** provides reliable detection of systolic pressure, but is generally unreliable for diastolic pressure

**True**

T/F: Nitrous oxide can produce general anesthesia on its own

**False**

What is the SVP for **Isoflurane** at 20^oC?

**240 mmHg**

The **check valve** prevents transfilling of one tank to another. If this valve breaks, what would happen to the temperature as a result of rapid transfilling?

**Temperature would increase** \*\*risk of FIRE\*\*

Would these hoses be used for re-breathing or non-rebreathing systems?

**rebreathing**

Name the agent that is used to reverse pure mu and mixed agonist/antagonists because of its high affinity for mu and kappa receptors

**Naloxone**

What is the mechanism of action (MOA) of **barbiturates**?

**↓ GABA dissociation from GABA_A receptor** **Direct activation of GABA_A receptor Cl^- channel**

T/F: **Propofol** is a rapid-acting, long duration induction agent

**False** *Propfol is rapid-acting, _ultra-short duration_ (\<20 mins)*

What is the mechanism of action of Propofol?

**Enhances inhibitory effects of GABA at GABA_A receptors**

Induction and maintenance of general anesthesia with intravenous drugs is termed:

**Total Intravenous Anesthesia (TIVA)**

Simultaneous use of injectables and inhalant for general anesthesia is termed:

**Partial Intravenous Anesthesia (PIVA)**

Plasma concentration (Cp) of IV anesthestic drugs is at 90% of Cp steady state after ____ half-lives

**3.3** *Plasma concentration (Cp) of IV anesthestic drugs is at 90% of Cp steady state after _3.3_ half-lives*

**Clearance = dose/AUC** *This is not a question, but remember it anyway.*

Yeah.

What is the consequence of leaving the APL closed for a long period of time?

**Build of pressure leading to barotrauma**

Induction Agents associated with which mechanism of action result in dose-related respiratory depression and apnea?

**Enhances GABA on GABA_A receptor**

The MAC of Tingflurane is 5.4%. The MAC of Stagflurane is 3.6%. Which is more potent?

**Stagflurane** The lower the MAC, the more potent the agent

The blood gas solubility for Tingflurane is 0.4. The blood gas solubility for Stagflurane is 1.5. Which would have a faster onset of induction?

Tingflurane The lower the blood solubility, the faster the onset of induction

What is the boiling point for **Desflurane**?

**74^oF**

Between halothane and sevoflurane, which has a higher vapor pressure?

**Halothane** *Desflurane \> Halothane \> Isoflurane \> Sevoflurane*

Between halothane and sevoflurane, which has a higher **blood gas solubility**?

**Halothane** *Blood gas solubility: Halothane \> Isoflurane \> Sevoflurane \> Desflurane* ***Halothane has the _highest_ blood gas solubility and therefore is the most POTENT*** *Desflurane has the lowest blood gas solubility, which means it has the fastest onset and the fastest recovery*

T/F: The higher the MAC, the higher the potency

**False!** * The higher the MAC, the **_LOWER_** the potency* * Potency ranking: Halothane \> Isoflurane \> Sevoflurane \> Desflurane*

What is the basic MAC value for Isoflurane?

**1.3%**

What is the basic MAC value for Sevoflurane?

**2.3%**

What is the basic MAC value for Halothane?

**0.87%**