Exam 1 Flashcards
What is the purpose of triage in the emergency setting?
To determine who needs immediate care and to prioritize the rest
Which is an additional stressor that veterinary personnel must experience than those in human emergency medicine do not?
Euthanasia
Which scenario best contributes to patient stabilization of an emergent patient?
a. A client stands by the treatment table to soothe the patient during stabilization.
b. The team allows access to the treatment room to calm a hysterical client.
c. A client waits in an exam room while stabilization is initiated.
d. A client sits in a chair and soothes the patient during stabilization.
c. A client waits in an exam room while stabilization is initiated.
Which step comes first in approaching a new arrival in the emergency room?
a. Call primary veterinarian to ensure pet is UTD on vaccines
b. Greet the pet by saying its name and note response.
c. Obtain vitals (temperature, pulse, respiration—TPR).
d. Instruct owner to fill out new patient paperwork.
b. Greet the pet by saying its name and note response.
Which items are most essential on any stabilization cart or stand?
a. Fluid packs
b. Chest tap kit
c. Blocked cat kit
d. Scrub and IV catheters
d. Scrub and IV catheters
Which step should come first when a patient is in a life-threatening situation?
a. Ask client to fill out new patient paperwork so patient information can be added to computer and a detailed estimate for treatment can b. Inform client that immediate stabilization is needed; verbal and signed consent are obtained.
c. Inform client of concerns and escort them to exam room for a full TPR.
d. Obtain complete history so proper stabilization technique can be administered.
b. Inform client that immediate stabilization is needed; verbal and signed consent are obtained.
Which CPR code commonly indicates “open chest included if necessary”?
Green
Which treatment relies on electrical repolarization to help the heart resume normal activity?
Defibrillation
A team initiates basic life support on a cat and starts intubation even as chest compressions are being performed. Which patient position is best?
Lateral recumbency
What does interposed abdominal compression (IAC) involve?
a. Alternating abdominal and chest compressions
b. Interposed aortic and chest compressions
c. Internal abdominal compressions
d. Internal aortic compressions
a. Alternating abdominal and chest compressions
Which effect is expected with ROSC in a patient undergoing CPR?
a. Stable, unchanging ETCO2
b. Absence of ETCO2
c. Drop in ETCO2
d. Rise in ETCO2
d. Rise in ETCO2
A veterinary ER team questions whether or not a patient is in cardiopulmonary arrest (CPA). Which step should be performed first?
a. Put the patient on ventilation and airway support; then begin CPR.
b. Conduct basic ECG for 30 to 60 seconds; then reassess.
c. Assess agonal breaths for 30 to 60 seconds.
d. Initiate chest compressions immediately.
d. Initiate chest compressions immediately.
What are the most prominent effects of atropine?
a. Antidiuretic
b. α-adrenergic
c. Parasympatholytic
d. Class 1 antiarrhythmic
c. Parasympatholytic
Shortly before experiencing cardiac arrest, a patient was administered an opioid. Which is best to administer to this patient?
a. Naloxone
b. Epinephrine
c. Flumazenil
d. Atipamezole
a. Naloxone
Internal cardiac compression should not be considered in the presence of:
a. rib fracture.
b. pleural effusion.
c. pneumothorax.
d. ROSC within 5 minutes of cardiac arrest
d. ROSC within 5 minutes of cardiac arrest
Which drug’s strong α-adrenergic properties cause vasoconstriction?
a. Sodium bicarbonate
b. Epinephrine
c. Lidocaine
d. Atropine
b. Epinephrine
Which route of drug administration is most often preferred during CPR?
a. Intracardial
b. Intratracheal
c. Intraosseous
d. Central venous
d. Central venous
A veterinary team begins performing CPR on a dog. At what point should intubation be performed?
a. In recovery, so as not to interfere with CPR
b. Before beginning chest compressions
c. After establishing a heartbeat
d. During CPR procedure
d. During CPR procedure
How many people are needed for effective cardiopulmonary resuscitation (CPR) in a Labrador Retriever?
3 to 5
Which drug is a class 1 antiarrhythmic agent and is most commonly used to treat ventricular tachycardia?
a. Atropine
b. Lidocaine
c. Epinephrine
d. Vasopressin
b. Lidocaine
Why is a grated surgical prep table not recommended for performing CPR?
a. The grated surface is not firm enough.
b. Drainage holes allow too much loss of blood.
c. The surface is too abrasive against skin that is not oxygenated.
d. The porous surface does not allow retention of valuable body heat.
a. The grated surface is not firm enough.
What type of shock results from decreased intravascular volume?
a. Obstructive
b. Distributive
c. Cardiogenic
d. Hypovolemic
d. Hypovolemic
Vasoconstriction causes which of the following?
a. Thready pulse
b. Increased vessel size
c. Elevated stroke volume
d. Increased intravascular volume
a. Thready pulse
Which most frequently causes cardiogenic shock?
a. Heart failure
b. Caval syndrome
c. Cardiac tamponade
d. Decreased intravascular volume
a. Heart failure
Which of the following would you expect to see in distributive shock?
a. Diminished preload
b. Increased cardiac output
c. Increase in stroke volume
d. Total decrease in blood volume
a. Diminished preload
A patient suffers anaphylaxis and sepsis. Which type of shock is this patient most likely to develop?
a. Hypovolemic
b. Cardiogenic
c. Distributive
d. Obstructive
c. Distributive
A veterinary technician sees the abbreviation “DO2” in a patient’s chart. Which does this stand for?
a. Stroke volume
b. Total cardiac output
c. Blood oxygen content
d. Volume of oxygen transported to the tissues
d. Volume of oxygen transported to the tissues
A patient has a faster than normal CRT, indicating the presence of which condition?
a. Diminished perfusion
b. Severe anemia
c. Vasodilation
d. Bradycardia
c. Vasodilation
Which condition is associated more with obstructive shock than other forms of shock?
a. Blood loss
b. Fluid losses
c. Gastric torsion
d. Third-space loss
c. Gastric torsion
Which of the following is most effective in treating hypovolemic shock?
a. Dextrose in water
b. Half-strength saline
c. Isotonic crystalloids
d. Half-strength lactated Ringer’s
c. Isotonic crystalloids
Which best defines shock?
a. Low blood flow
b. Poor tissue perfusion
c. Inadequate cellular energy production
d. Unevenly distributed blood circulation
c. Inadequate cellular energy production
Which is the simplest method of oxygen delivery?
a. Mask oxygen
b. Flow-by oxygen
c. Trans-tracheal oxygen
d. Nasal cannula
b. Flow-by oxygen
While inserting a nasopharyngeal catheter, once inserted into the nostril, how should the catheter be directed?
a. Ventromedially
b. Ventrolaterally
c. Dorsomedially
d. Dorsolaterally
a. Ventromedially
Which comes first in approaching a traumatic emergency patient?
a. Action
b. Assessment
c. Recognition
d. Reassessment
c. Recognition
Which must always be the first step in assessing the traumatic injury patient?
a. Airway
b. Body temperature
c. Fracture assessment
d. Soft tissue or organ damage
a. Airway
During emergency surgery, a large volume of the patient’s blood is aspirated from the abdominal cavity and infused directly back into the blood stream using a closed system. Which is necessary during this procedure?
a. Bleach
b. Small careful measures of air infusion
c. Anticoagulant
d. Blood filter
d. Blood filter
In treating hypothermia, the core should be warmed because warming the periphery leads to:
a. Narrowed blood vessels
b. Reduced blood flow
c. Core hyperthermia
d. Vasodilation
d. Vasodilation
Which type of muzzle is usually preferred in treating a dog with a traumatic injury?
a. Standard professional muzzle that fits firmly over the bridge of the nose
b. Plastic basket muzzle with holes that covers entire nose and mouth
c. Soft blanket or large jacket to cover the animal’s head
d. Tie or belt wrapped around the dog’s muzzle
b. Plastic basket muzzle with holes that covers entire nose and mouth
Which is a sign of immediate respiratory distress?
a. Absence of abdominal wall movement with respiration
b. Paradoxical chest wall movement
c. Flexed head and neck
d. Adducted elbows
b. Paradoxical chest wall movement
Which is not an appropriate question when taking a patient’s history, according to the AMPLE mnemonic?
a. Does the animal have Allergies?
b. What Medications does this animal take regularly?
c. Is the patient in any Pain?
d. When was the patient’s last meal, urination/defecation, and medication?
c. Is the patient in any Pain?
Which is a part of the “trauma triad of death”?
a. Hemophilia
b. Hyperthermia
c. Hyperoxemia
d. Metabolic acidosis
d. Metabolic acidosis
Which of the following is one of the signs of decompensated shock?
a. Eupnea
b. Delayed capillary refill
c. Rapid eye movement
d. Fever
b. Delayed capillary refill
An emergency patient is receiving O2 and IV fluids; which size catheter is preferred for the fluids?
a. Long, large-bore
b. Long, small-bore
c. Short, large-bore
d. Short, small-bore
c. Short, large-bore
Which is most effective for resuscitation for a patient in shock from blood loss?
a. Hydroxyethyl starch combination
b. Interstitial crystalloids
c. Synthetic colloids
d. Whole blood
d. Whole blood
Before clipping and cleaning a puncture wound, how can the technician keep hair from getting lodged in the wound?
a. Rinse with a surgical disinfecting solution
b. Apply sterile water-soluble lubricant
c. Flush with tap water under pressure
d. Rinse with tap water
b. Apply sterile water-soluble lubricant
How often should a recumbent patient be turned?
a. Every 30 minutes
b. Every 60 minutes
c. Every 2 hours
d. Twice daily
c. Every 2 hours
Which of the following injuries most likely represents penetrating trauma?
a. Animal is stepped on
b. Animal is hit by a car
c. Animal is partially impaled
d. Animal has fallen into a hole
c. Animal is partially impaled
A technician knows not to remove an impaled object from a trauma patient until the wound tract is explored completely. What is the only exception to this rule?
a. The object is touching the heart.
b. The object is lodged in the abdominal aorta.
c. The object is severely compromising respiration.
d. The object is in the patient’s lower abdominal side.
c. The object is severely compromising respiration.
Which emergency presentation is most indicative of canine heartworm disease?
a. Pulmonary edema
b. Caval syndrome
c. Arrhythmia
d. Cyanosis
b. Caval syndrome
Which agent can best help to increase heart contractility?
a. Dopamine
b. Furosemide
c. Butorphanol
d. Procainamide
a. Dopamine
Which drug is preferred for the treatment of 2nd degree AV block arrhythmias?
a. Atropine
b. Propranolol
c. Epinephrine
d. Calcium gluconate
a. Atropine
Which test uses the length of the thoracic vertebrae as a reference for determining heart size?
a. Auscultation
b. VHS technique
c. Echocardiography
d. Electrocardiography
b. VHS technique
Which factor in systolic function is multiplied by stroke volume to determine the volume of blood pumped in 1 minute (i.e., cardiac output)?
a. Preload
b. Afterload
c. Heart rate
d. Contractility
c. Heart rate
Which factor is a measure of how much the ventricle is stretched at the end of diastole?
a. Preload
b. Afterload
c. Heart rate
d. Contractility
a. Preload
Which factor’s increase will make it harder for blood to leave the heart, causing a decrease in stroke volume?
a. Preload
b. Afterload
c. Heart rate
d. Contractility
b. Afterload
For which emergency condition is pericardiocentesis most useful?
a. Atrial fibrillation
b. Cardiac tamponade
c. Cardiac arrhythmia
d. Ventricular tachycardia
b. Cardiac tamponade
Which disorder is best improved with the use of a pacemaker?
a. Supraventricular arrhythmia
b. Pericardial effusion
c. Cardiac tamponade
d. Severe bradyarrhythmia
d. Severe bradyarrhythmia
A cat survives a blood clot that travels from the heart to a systemic artery but loses part of a leg to ischemic necrosis and needs treatment with heparin and strong analgesics. Which condition does this most closely describe?
a. Congestive heart failure
b. Cardiogenic shock
c. Caval syndrome
d. Feline aortic thromboembolism (FATE)
d. Feline aortic thromboembolism (FATE)
Which is a typical symptom of laryngeal paralysis?
a. Groggy
b. Cyanotic
c. Pruritic
d. Hypothermic
b. Cyanotic
Which best describes inspiratory stridor?
a. Dry, hacking cough
b. Wet, constant “tickle”-type cough
c. Harsh, raspy sounds during inspiration
d. Wheezing, whooping sounds during inspiration
c. Harsh, raspy sounds during inspiration
Which is a key component of emergency treatment for laryngeal paralysis?
a. Avoid sedation.
b. Protect against heat loss.
c. Administer butorphanol.
d. Avoid immediate oxygen supplementation.
c. Administer butorphanol.
Which surgery is most often recommended for laryngeal paralysis?
a. Unilateral arytenoid lateralization
b. Internal rib fixation
c. Thoracentesis
d. Thoracotomy
a. Unilateral arytenoid lateralization
Which anatomic feature is most likely to contribute to a patient developing BAS?
a. Shortened soft palates
b. Shortened nasal passages
c. Hyperplastic trachea
d. Enlarged nares
b. Shortened nasal passages
A feline patient with pulmonary edema is intubated, and the tube immediately fills with a foamy edema fluid. What is the best immediate response?
a. Elevate hind end and chest
b. Administer oxygen therapy
c. Administer diuretic therapy
d. Administer mechanical ventilation
a. Elevate hind end and chest
Which type of pneumonia is most frequently associated with megaesophagus?
a. Viral pneumonia
b. Fungal pneumonia
c. Bacterial pneumonia
d. Aspiration pneumonia
d. Aspiration pneumonia
Which treatment strategy is appropriate in treating brachycephalic airway syndrome?
a. Keeping the animal alert
b. Physical movement
c. Active cooling
d. Slow warming
c. Active cooling
This ECG tracing is an example of:
a. Ventricular fibrillation
b. Atrial fibrillation
c. Ventricular tachycardia
d. 3rd degree AV block
a. Ventricular fibrillation
This ECG tracing is an example of:
a. Supraventricular tachycardia
b. Premature Ventricular Contraction
c. Normal sinus rhythm
d. Sinus arrhythmia
d. Sinus arrhythmia
This ECG tracing is an example of:
a. 1st degree AV block
b. 2nd degree AV block
c. 3rd dergee AV block
d. 4th degree AV block
b. 2nd degree AV block
This ECG tracing is an example of:
a. Premature ventricular contraction
b. Sinus tachycardia
c. Premature atrial contraction
d. Electrical interference
a. Premature ventricular contraction
Squishy, the 26# cat needs a CRI of Lipozene at 5mg/kg/hr. Lipozene comes in a concentration of 100mg/mL. The veterinarian asks you to put the Lipozene in Squishy’s fluids that are running at 25mL/hr. Squishy has 500mL left in her fluid bag. How many mL of Lipozene will you add to the fluids?
26/2.2 = 11.82kg
11.82 x 5 / 100 = 0.59mL/hr
500/25 = 20hr
0.56 x 20 = 11.8mL
Answer: 11.8 ml
Chompers, the very aggressive 154# mastiff, ate 5 grapes and needs to be hospitalized in your clinic for 72 hours on IV fluids. The veterinarian wants Chompers to receive 75mL/kg/day of fluids. After sedating Chompers with dexmedetomidine so an IVC could be placed, the doctor decides to keep Chompers on a CRI of dexmedetomidine. The CRI will be set at 5mcg/kg/hr and will be placed on a syringe pump. The doctor says to draw up just enough medication to last the dog’s entire hospitalization stay. Dexmedetomidine’s concentration is 500mcg/mL.
How many mL/hr will you set the syringe pump to run?
How many mL of dexmedetomidine will you draw up?
How many mL/hr of IV fluids will Chompers receive?
154/2.2 = 70kg
70 x 5mcg/kg/hr / 500 = 0.7mL/hr
0.7 x 72 = 50.4mL
70 x 75ml/kg/day = 5250mL/day / 24 = 219mL/hr
Answers:
a. 1 ml/hr
b. 50.4 ml
c. 219 ml/hr
Sweet Tart, the diabetic cat, needs a dextrose in her fluids. She needs 3% dextrose in her 500mL bag of saline. Dextrose comes in a 50% solution. How will you make this happen?
50 x X = 3 x 500
X= 30mL
Remove 30mL saline from fluid bag and add 30mL of 50% dextrose to bag to create 3% soultion for Sweet Tart.
