Condition-specific AX Flashcards
T/F Patients with diabetic ketoacidosis should not be anesthetized. Should emergency surgery be necessary, regular insulin, aggressive fluid replacement, as well as potassium and dextrose supplementation are required before anesthesia.
True
Up to how many weeks is a dog or cat considered a neonate? What about a calf or foal? Up to how many weeks is a dog considered pedaitric?
6 weeks
2 weeks
12 weeks
Muffin, the 9 year old Standard poodle, has an insulinoma. Which drug class can you give to promote gluconeogenesis? Which one could you give to inhibit insulin release?
Glucocorticoids - promote gluconeogenesis
Diazoxide- inhibits insulin release
During surgery, Muffin the poodle with insulinoma you are unable to maintain her BG with dextrose and glucocorticoids. Which drug that promotes gluconeogenesis and glycogenolysis can you give?
Glucagon
One disadvantage of IPPV is that it causes (increased/decreased?) blood pressure.
Decreased
T/F Diabetic patients should never be fasted prior to surgery so that they can receive a normal AM dose of insulin before the surgery.
False, routine fasting (8-12 hours) is warranted and HALF of the normal insulin dose should be given.
Cookie is a 10 year old boxer with an insulinoma. His BG intra-operatively is 70mg/dl. What do you do?
Nothing, this is a normal BG for a patient with an insulinoma. As long as the BG is over 50mg/dl no action is necessary.
Water should never be withheld from patients with __________ or _________
Diabetes mellitus
Diabetes insipidus
T/F: In patients with hypothyroidism tachycardia, hyperthermia, and hyperventilation may be more likely.
False, opposite
Bradycardia, hypothermia, hypoventillation
Spazz the cat is hyperthyroid. Suddenly his heart rate and blood pressure spikes, his heart rate becomes irregular he has a fever. What is this called and what caused it?
Thyroid storm
Catecholamine release
You want to avoid giving drugs to Spazz, the hyperthyroid cat, that increase heart rate, myocardial work, and oxygen consumption. You also want to avoid drugs that cause significant CV changes. The same drugs should be avoided in patients with phenochromocytoma. Which of the following drugs do you want to avoid?
Acepromazine Dexmedetomidine Propofol Hydromorphone Ketamine Isofluorane Atropine pre-med Xylazine
Acepromazine
Dexmedetomidine & xylazine (all alpha-2’s)
Ketamine
Atropine pre-med (routine use)
What class of drugs should be avoided in patients with diabetes mellitus? Why?
Alpha-2 agonists (xyalizine, dexdemetomidine)
Cause hyperglycemia (by inhibiting insulin release or stimulating glucagon release)
Why should you use short-acting drugs or those that can be reversed in patients with DM?
So you can feed them ASAP (resume normal feeding and insulin schedule)
Spazz the hyperthryoid cat needs BP support intra-operatively. What drug should you use?
Dopamine
T/F: Analgesia in younger patients is less crucial since their nervous system is not fully developed yet.
False, important in patients of any age.
Pain experienced as a neonate may cause altered pain perception for life.
Serum iCa should be decreased in hyperparathyroid patients before anesthesia. This is because chronic hypercalcemia can lead to ______ _______.
Ventricular arrhythmias
especially v-fib
T/F To maintain BG in DM patients, D5W (5% dextrose in water) should be used as needed intraoperatively.
False, 1-5% dextrose in balanced electrolyte solution.
For bolus use fluids without dextrose.
What is the normal BG range you want to maintain with DM patients? How often should you check the BG intra-operatively? How often post-op?
150-250 mg/dl
q30-60min (depending on initial values)
q1-2 hours until patient is eating
What electrolye do you want to check before induction in patients who have Diabetes insipidus? What level do you want to maintain?
Sodium
<160mEq/L
What can you use to treat a common post-op complication in hyperparathyroid patients? What is this complication?
Ca gluconate
Oral calcium
Hypocalcemia
What are the signs of adrenal insufficiency that you should monitor post-op in dogs with Addision’s?
Vomiting Diarrhea Inappetance Lethargy Weakness
Which drug should you avoid with dogs who have Addision’s disease as well as septic patients? Why?
Etomidate
Causes adrenocortical supression
Sodium in a patient with DI should not be increased or decreased faster than ____mEq/L per hour. This is done to prevent fatal ____ _______.
0.5
Brain hemorrhage (central pontine myelinolysis, aka osmotic demyelination syndrome)
Which shorting-acting injectable beta blocker used for tachyarrythmias is most commonly used in patients with pheochromocytoma?
Esmolol
A 1 month-old puppy will have a (lower/higher?) blood pressure under anesthesia. An awake 1 month-old puppy will have a BP around (50/100/150?) mmHg.
Lower
50
T/F: Most patients with hemoabdomen require less inhalant anesthesia, so the vaporizer should be turned down to 0.25-1% iso (1-2% sevo) or less.
True
What is the definition of colic?
Abdominal pain
T/F: Fetal drug metabolism is fast which is why drug dosages must be drastically adjusted.
False, drug metabolism is slow due to immature hepatic microsomal enzyme system
A patient with DI should be given hypotonic fluids intra-operatively as needed. Which 2 of the following are hypotonic fluids?
D5W LRS Normasol-R 7.5% NaCl 0.45% NaCl + 2.5% dextrose
D5W
0.45% NaCl + 2.5% dextrose
Which monitoring device will reveal the your Cushinoid patient has developed pulmonary embolism (PTE)? What will you see?
Capnograph
An exponential decrease in ETCO2, a sharp drop in ETCO2
A pregnant bitch’s cardiac output _____ 30-50%
Increases
What form of blood pressure monitoring provides accurate systolic, diastolic and mean pressure values and allows for the evaluation of a pulse pressure wave?
Invasive (direct) blood pressure
Match the terms with their definition:
- Tidal Volume
- Functional Residual Capacity
- Vital Capacity
- Residual Volume
Maximum expelled volume after maximum inspiration
Remaining gas in lung after maximum expiration
Remaining gas in lung after normal expiration
Normal breath volume
Tidal Volume: Normal breath volume
Functional Residual Capacity: Remaining gas in lung after normal expiration
Vital Capacity: Maximum expelled volume after maximum inspiration
Residual Volume: Remaining gas in lung after maximum expiration
Blood pressure in dogs with Cushing’s disease should be kept (higher/lower?) than normal during anesthesia.
Higher (due to loss of autoregulatory control at the tissue level)
Which long-acting alpha antagonist can be used pre-operatively in patients with pheochromocytoma to stabilize blood pressure and heart rate?
Phenoxybenzamine
What class of local anesthetic is more likely to accumulate because it is metabolized by hepatic microsoal enzymes? What are some examples of these local anesthetics?
Esters
Procaine, Tetracaine
Foals are normally delivered less than ___ minutes after membrane rupture. After about ____ minutes almost no foals survive birth.
30
90
A ___ epidural is common in small animals, while a ____ epidural is more common in cows.
L-S
Caudal
Once a pheochromocytoma is removed, an acute drop in catecholamines may occur. What drugs can you use to treat the hypotension and bradycardia this causes?
Dobutamine
Ephedrine
Phenylephrine
T/F: Dyspnic patients should not be sedated.
False, light sedation is indicated (such as torb +/- benzo or low dose ace)