Critical care

Question 1

About catecholamines (wrong answer) :
- α effects of epinephrine are partially offset by β2 vasodilation
- norepinephrine has no β2 effect
at intermediate doses, dopamine is inotropic and dromotropic
- dobutamine is a fairly selective α1 agonist
- dobutamine has a minimal impact on peripheral vascular tone

Answer 1

dobutamine is a fairly selective α1 agonist (it is a fairly selective β1 agonist, with a dose dependent dobutamine is a fairly selective α1 and β2 activities)

Question 2

Class the following vasoactive drugs from the least vasoconstrictive to the more vasoconstrictive :
- Dobutamine < Dopamine 5ug/kg/min < Dopamine 15ug/kg/min < Norepinephrine
- Dobutamine < Dopamine 15ug/kg/min < Dopamine 5ug/kg/min < Norepinephrine
- Dopamine 15ug/kg/min < Dopamine 5ug/kg/min < Dobutamine < Norepinephrine
- Dopamine 5ug/kg/min < Dopamine 15ug/kg/min < Dobutamine < Norepinephrine

Answer 2

Dobutamine < Dopamine 5ug/kg/min < Dopamine 15ug/kg/min < Norepinephrine

Question 3

Optimizing tissue perfusion and oxygen delivery is important in shocked patients. To optimize perfusion, which central venous pressure, mean arterial pressure and urine output are target therapeutic end point for a dog in shock ?
* CVP 0-5cm H2O, MAP 60-80mmHg, urine output 1ml/kg/h
* CVP 0-5cm H2O, MAP 100-150mmHg, urine output 1ml/kg/h
* CVP 5-10cm H2O, MAP 70-120mmHg, urine output 1ml/kg/h
* CVP 5-10cm H2O, MAP 100-150mmHg, urine output 2ml/kg/h

Answer 3

CVP 0-5cm H2O, MAP 60-80mmHg, urine output 1ml/kg/h

Question 4

Which systemic abnormality can cause atrial fibrillation ?
* Digoxin toxicity
* Hypokalemia
* Hypothyroidism
* Severe anemia

Answer 4

Hypothyroidism

Question 5

Which is the correct definition for Multiple Organ Dysfunction Syndrome ?
* A clinical syndrome caused by systemic inflammation of infectious or non-infectious origin
* Altered function of two or more organs secondary to the SIRS such that homeostasis cannot be maintained without intervention
* The systemic inflammatory response to bacteremia associated with organ dysfunction and manifestations of hypo perfusion and hypotension
* The systemic inflammatory response to infection with hypotension, despite adequate fluids resuscitation along with the manifestations of hypo perfusion

Answer 5

b. Altered function of two or more organs secondary to the SIRS such that homeostasis cannot be maintained without intervention