Deck 1 Quiz Flashcards
Name 5 opioids
- morphine
- hydroxymorphone
- oxymorphone
- fentanyl
- meperidine
Define shock
Shock = condition in which the cardiovascular system fails to
perfuse tissues adequately
An impaired cardiac pump, circulatory system, and/or volume can
lead to compromised blood flow to tissues
Factors to be considered when performing physical examination (9)
- General body condition - obesity, cachexia, pregnancy,
hydration, temp, attitude, temperament - Cardiovascular - heart rate & rhythm, auscultation (murmurs), arterial blood pressure, pressure quality & regularity, capillary
refill time - Pulmonary - resp rate, depth & effort, MM colour, auscultation
(wheezes, crackles), upper airway obstruction, percussion - NS - special senses: seizure, coma, or stupor, syncope (temporary
loss of consciousness caused by a fall in BP), vision, hearing - GIT - D+, vom abdom distension, auscultation (gut sounds),
rectal palpation if indicated - Hepatic - icterus, bleeding abnormalities, altered mentation 7. Renal - kidney palpation, urinary bladder palpation,
oliguria/anuria, polyuria/polydipsia - Integument - neoplasia, trauma, parasite infestation, hair loss
- Musculoskeletal - weakness, lameness, ataxia, fractures, muscle mass
Signalment and history factors
- Signalment - species, breed, age, sex, body weight
- History:
- Presenting complaint - duration and severity
- Symptoms of organ system disease - D+, vom, polyuria/poldypsia, seizures, behaviour change, exercise intolerance, coughing, dyspnoea, weight loss, poor body
condition - Concurrent medications - organophosphates, H2-blockers, antibiotics (e.g. aminoglycosides), cardiac glycosides, phenobarbital, NSAIDs, calcium channel blockers, B-blockers,
catecholamine-depleting drugs
Previous anaesthesia - Allergies
- Recent feeding
Dosage of colloids
Colloids - given IV
* Hexastarch & Dextran 70 can be administered at rates of 1-2
ml/kg/hour if used for on going oncotic support
* Alternatively, rapid admin up <20ml/kg is used in a patient in an
acute hypotensive/hypovolemic crisis
How to calculate size of breathing bag
A bag volume of 5x the patient’s tidal volume (10-15 ml/kg) is
generally suitable
Stages of anaesthesia
- Not anesthetized
- Excitatory phase not anesthetized
- Anaesthesia:
* Plane, 1 - light anesthesia
* Plane 2 - moderate anesthesia (surical alane)
* Plane 3 - deeR anesthesia - Overdose
- Death
Differences between balanced & unbalanced crystalloids
Crystalloid solutions can be termed balanced if their components are
similar to those contained in extracellular fluid and unbalanced if
this is not the case
Indications for fluid therapy
Indicated in a multitude of circumstances in which an animal is
unable to compensate for changes in its fluid & electrolyte
balance
- Nature of therapy is specific to each circumstance & should be
based on the individual patient’s needs
Examples of when additional fluid support is required - traum
infection periteritis, hemorrhare
Sedatives and their functions
Sedatives are central nervous system (CNS) depressants, a category of drugs that slow normal brain function. Most of them affect the neurotransmitter gamma-aminobutyric acid (GABA) → works by decreasing brain activity
Increase GABA activity and produce relaxing effect
- For example anesthetics, barbiturates, antihistamines and
opioid narcotics
What id propofol? category & use
an intravenous anaesthetic ink used for induction & maintenance of anaesthesia
–> recovery is rapid : full standing recovery generally observed within 20 mins
- Drug that slows activity of your brain and nervous systemic
- Used to help relaxation before and during general anesthesia
Function of albumin on calcium
Albumin is the predominant protein bound to calcium (80-90%), & changes in serum albumin will change the measured total
serum calcium
* Adjusting the total serum calcium level to account for this variation is particularly important when the serum albumin level
is outside of the normal range
* Formula used to adjust the total serum calcium is as follows:
adjusted Ca (mg/dL) = measured Ca (cog/dI.) - albumin (g/dl.) +
3.5
* This formula should not be used to adjust for changes in albumin
in young dogs or cats
* It is true in these patients that decreases in albumin are associated with decreases in serum calcium, but a linear
relationship does not exist, precluding the use of this formula
* The adjusted total serum calcium is relevant only because it is
used to reflect the ionized calcium value
* If albumin values are not available or there is a question regarding the adjusted value, the ionized calcium should be
measured
Hypernatremia fluid
- Fluid administration to a beernatremic patient, especially one with concurrent dehydration, can result in cerebral oedema if a
change in serum sodium occurs too rapidly - Dehydrated patients requiring anaesthesia should receive an
isotonic fluid with a sodium cons similar to normal plasma - Typically, hypernatremia resolves with correction of dehydration
- If hypernatremia persists, 0.45% NaCl with 2.5% dextrose, or 5% dextrose in water can be given slowly, while the serum sodium
cong is serially measured to ensure a decrease no faster than 0.5-
1 mEg/hr - This typically can be achieved using a fluid rate of 3-6ml/kg/hr,
depending on the sodium conc in the administered fluid
Anticholinergic drugs and function
Anticholinergics block the action of neurotransmitter, a chemical messenger in the brain, called acetylcholine
By this they block acetylcholine from causing involuntary muscle movements in the lungs, gastrointestinal tract, urinary tract and other areas of the body
These drugs can treat various conditions: - GIT disorders, genitourinary disorders, respiratory disorders, insomnia and dizziness for example
They cause decreased saliva production and cause sedation
metabolic oxygen consumption in dog and cat
10 ml/kg/min
Is it acceptable to use an adult-size circle system for 5kg cat
Yes - research on the work of breathing of cats attached to a circle
system indicates that it is acceptable to use a circle system with cats
as small as 2.5 kg
name toxins that accumulate in the breathing circuit
- Methane, ethanol, acetone, carbon monoxide, metabolites of
volatile anaesthetics, compound A, argon, & nitrogen - This build-up is more likely to occur with low gas flow &
prolonged anaesthesia
Classification of ASA system
- American Society of Anesthesiologists (ASA) system of
classification - Based on the integration of info obtained from signalment, history & physical exam findings, patients can be placed into 1 of
5 potential categories - Classification of overall health is an essential part of any anaesthetic record system & should be done for every patient
undergoing anaesthesia
Category Physical Status
1. Normal, healthy patient - e.g. routine ovariohysterectomy,
prophylactic dental cleaning
2. Patient with mild systemic disease - cruciate rupture repair,
equine arthroscopy
3. Patient with severe systemic disease - femur fracture repair
with myocardial contusions, feline urethral obstruction
4. Patient with severe systemic disease that is a constant threat to life - equine large bowel torsion, haemorrhaging, splenic
baemangiosarcoma
5. Moribund patient not expected to survive 24h with or without surgery - any of the above in extreme shock, with massive
tissue damage, severe metabolic derangement etc.
What clinical changes can be seen in anaesthetised patients that are associated with electrolyte abnormalities
Cardiac Arrhythmias:
· = most significant change
· Arrhythmias freq develop during anaesthesia in previously asymptomatic animals
Hypotension:
· Typically hypotension resolves with fluid admin or lightening of the patient’s anaesthetic depth
· Patients with pre-existing electrolyte disorders more commonly have hypotension that is unresponsive to fluid admin & lightening the anaesthetic depth results in patient movement with minimal improvement in mean arterial BP
What is the main oxygen cylinder used in small animals
E cylinders are in general use
