Exam II Flashcards
Which of the following is false regarding Plasmalyte M in 5% Dextrose?
a. Contain more Na+ (20-30 mmol/L) and less K+ (40-70mmol/L)
b. They’re maintenance crystalloid solutions
c. Contain less Na+ (40-70 mmol/ L) and more K+ (20-30mmol/L)
d. Used in paitents that have been stabilized by replacement fluids or those with low amounts for daily needs
a. Contain more Na+ (20-30 mmol/L) and less K+ (40-70mmol/L)
All of the following are true about crystalloids except:
a. Cause no change in electrolytes
b. Used in dehydrated patients
c. Avoid hypoalbuminemia
d. All the above are true
d. All the above are true
Which of the following is true:
a. Physiological saline (0.9% NaCl) are used for rapid IVF expansion if replacement solutions are unavailable
b. Low volumes of Physiological saline may dilute other electrolytes
c. Physiological saline is recommended for treating hypokalemic patients
d. Physiological saline is recommended for hyponatremic patients with hypoadrenocorticism
d. Physiological saline is recommended for hyponatremic patients with hypoadrenocorticism
15% BW makes up ____ TBW in the interstitial fluid.
3/12
5% BW and ____ TBW is found in the intravascular fluid.
1/12
Whch of the following is TRUE regarding the cell membrane?
a. permeable to water and impermeable to ions
b. permeable to water and small ions
c. permeable to water and impermeable to proteins
d. all the above are true
a. permeable to water and impermeable to ions
Which electrolyte is the backbone of ICF ions?
K+
True/False: The interstitial fluid and intravascular fluid make up the intracellular fluid.
False
** they make up the extracellular fluid
True/False: Na+ is the main electrolyte of the ECF since its found at high levels in the plasma (IVF) and interstitial fluid (ISF).
True
Which of the following is considered the backbone of the intravascular fluid (IVF)?
a. K+
b. Na+
c. protein
d. B and C
e. None of the above
c. protein
** Na+ is also found in high amounts in the IVF but its the backbone of the ECF
Which of the following definitions is correct?
a. isontonic has a small effect on RBC’s
b. Hypertonic expands RBC’s causing hemolysis
c. Hypotonic expands RBC’s causing hemolysis
d. Hypotonic shrinks RBC’s
c. Hypotonic expands RBC’s causing hemolysis
remember that there is a different effect on the cells than the name implies –> hypertonic will shrink the cells
Which is the most important determinant of colloid oncotic pressure?
Albumin
____ antagnoizes osmosis during fluid shifts driving fluid outwards.
Hydrostatic pressure
True/False: At the venous end of the capillary bed moves fluidbback into the IVF and the lymphatics are responible for moving the remainder of the ICF into the IVF.
True
What are the three forces that move both water and ions across the cell membrane and capilalry bed?
Osmolality
Colloid oncotic pressure
Hydrostatic pressure
What kind of fluids are Ringers, Plasmalyte R/ Normosol R?
Crystalloids- Balanced electrolyte solutions
What kind of fluids are Hetastarch, Dextrans, Gelatins, Albumin, and Oxyglobin?
Colloids
What is the crystalloid Normosol M in Dextrose 5% mainly used as?
Maintenance solution
Which of the following contain water, electrolytes, and non-electrolytes to replace small blood losses at 3:1 v/v ratio?
a. Colloids
b. Blood products
c. Cyrstalloids
d. Oncoids
c. Cyrstalloids
All of the follwoing are true about hypertonic saline (7.5% NaCl) except:
a. Causes rapid IVF compartment expansion
b. Has a slow onset and long duration
c. Used to treat cerebral edema if the BBB is intact
d. Limits accumulation of lung fluid
b. Has a slow onset and long duration
**fast onset, short duration
Which of the following rapidly metabolizes glucose with water as a by-product?
a. Dextrose 5%
b. Ringers lactate
c. Plasmalyte R
d. None of the above
a. Dextrose 5%
What are your synthetic colloids?
Hydroxyl- ether starch (HES)
Dextran
Gelatin
Which is your Hb-based oxygen carrying colloid solution?
Oxyglobin
Which of the following is false regarding colloids?
a. Whole blood, Plasma and Albumin are natural colloids
b. Expand and maintain ECF space volume allowing it to stay there for long
c. It has a large molecular weight
d. Replaces large volumes of blood loss at 3:1 v/v ratio
d. Replaces large volumes of blood loss at 3:1 v/v ratio
low blood loss at 1:1 ratio
Which colloid is most commonly used and can decrease factor VIII and von willebrand factor concentrations
Hetastarch
Which veins are used in pigs and ruminants for IV fluid therapy?
Auricular vein
Which colloid is more hyper oncotic than plasma and is a polymer of glucose?
Dextrans
Which colloid contains clotting factors and can be used for treating coagulopathies?
Plasma
Which of the following is false regarding why we use peri-anesthetic fluids?
a. Maintains preload < stroke volume
b. Compensates for peripheral vasodilation from drugs
c. Maintains whole body fluid volumes during long anesthetic procedures
d. Maintains IV catheter patency in case of CPR
a. Maintains preload < stroke volume
** should be preload > SV
Which colloid do you want to avoid in spetic patients because of its association to osmotic nephropathy?
Hetastarch
Which vein is used for IV fluid therapy in birds?
Brachial vein
Which cases would require less fluid (3-5 mL/kg/hr) for peri-anesthetic administration?
a. Young animals
b. Long procedures
c. Heart failure (MVI, DCM)
d. Renal disease (oliguric)
e. All the above
f. None of the above
e. All the above
When do you want to use the subcutaneous route with fluid therapy?
Small animals with loose skin
Mild deficits, not for shock therapy
Which of the following is false regarding routes for fluid therapy?
a. Intraperitoneal route is used with small lab animals
b. Intraosseous route is used in very dehyrated or difficul to catheter patients
Enteral route is used for shock therapy
d. None of the above are false
Enteral route is used for shock therapy
**Feeding tubes used with horses for pre-colic surgery
What is the standard rate of peri- anesthetic administration?
10 mL/kg/hour
True/False: You want to use Colloids for your peri-anesthetics.
False
** Use replacement (balanced) crystalloids
Which of the following is false regarding actute hypotension during anesthesia?
a. Decrease anesthetic depth if its the cause
b. Give extra fluid above the standard rates
c. Give less crystalloid and colloid fluids
d. Give cardio-active drugs (Epi, Phenyl-ephedrine, atropine) if non responsive after 2 boluses of fluid
c. Give less crystalloid and colloid fluids
**give crystalloid over 15 minutes and 5-10mL/kg/hr colloids in dogs and 1-5 mL/kg/hr colloids in cats
True/False: With minimal hemorrhage during anesthesia you want to give crystalloids and colloids for the exact amount of blood lost.
False.
**Cryalloids - give 3 times the volume of blood lost and colloids give the exact volume of blood lost
What do you want to do if there is excessive hemorrhage, >20% blood volume, during anesthesia?
Consider blood transfusion
NSAID’s are used in all the following except:
a. Well-hydrated, normotensive young to middle aged
b. Those with renal dysfunctions
c. Mild to moderate acute peri-surgical pain
d. In multi-modal analgesia combined with opioids
b. Those with renal dysfunctions
** used if they have normal renal function
NSAID’s affect all of the follwoing except:
a. Gastrointestinal
b. Platelet aggregation
c. Cadiovascular
d. Renal Function
e. Liver
f. It affects all the above
f. It affects all the above
Which of the following is not a contraindication of NSAID use?
a. Hypotensive and dehydrated paitents with GI diseases
b. Shock or trauma cases
c. Renal and hepatic insufficiency
d. Neonates and adults
d. Neonates and adults
**pediatric or geriatric patients
All of the following are reasons to take special precautions in feline patients except:
a. NSAID toxicity
b. Hemorrhagic gastritis
c. Kidney and liver injury
d. Higher doses at shorter intervals were used
e. They have a slower clearance and dose-dependent elimination
d. Higher doses at shorter intervals used
**Lower dosages at longer intervals were used
Which NSAID is preferential COX-2 inhibitor approved for dogs in N. America and can be given to horses and ruminants as well?
a. Meloxicam
b. Carprofen
c. Robenacoxib
d. Deracoxib
b. Carprofen
Which NSAID is a selective COX-2 inhibitor approved in cats and dogs with minimal adverse effects?
a. Meloxicam
b. Carprofen
c. Robenacoxib
d. Deracoxib
c. Robenacoxib
What are the three mildly chornic painful conditions that NSAID’s are most commonly used for?
Osteoarthritis
Neoplasia
Otitis
Which of the following is false about Phenylbutazone?
a. Comes as a powder form
b. Porlonged in cattle
c. Banned in dairy cattle older than 20 months to avoid milk residues
d. Can cause GI ulcers and renal toxicity in horses
e. Its a COX-2 inhibitor
f. Can be used in horses, cattle and dogs
e. Its a COX-2 inhibitor
** Its a non-selective COX inhibitor
Which of the following comes in a liquid formulation approved for dogs and cats with mainly GI adverse effects?
a. Meloxicam
b. Carprofen
c. Robenacoxib
d. Deracoxib
a. Meloxicam
True/False: Opoids last longer than NSAID’s
False.
** the other way around
Which of the following is a non-selective COX inhibitor mainly used in large animals and causes a concerning hemorrhagic adverse effect?
a. Phenylbutazone
b. Ketoprofen
c. Flunixine meglumine
d. Acetylsalicylic acid
b. Ketoprofen
Which of the following is a non-selective COX inhibitor not approved for vet use because of serious bleeding and GIT adverse effects?
a. Phenylbutazone
b. Ketoprofen
c. Flunixine meglumine
d. Acetylsalicylic acid
d. Acetylsalicylic acid
Which NSAID is very toxic to cats causing facial edema, hemolytic anemia, cyanosis, vomiting and fever, and can be treated with N-acetylcysteine?
Acetominophen
Which of the following is a non-selective COX inhibitor used mostly for colic pain in horses?
a. Phenylbutazone
b. Ketoprofen
c. Flunixine meglumine
d. Acetylsalicylic acid
c. Flunixine meglumine
Which NSAID can be given at low doses in dogs and cats but can present as aspirin toxicity due to the owner treatment overdose?
Acetylsalicylic acid (Aspirin)
What is the name of the anti-inflammatory drug that targets the PGE EP4 receptor associated with canine osteoarthritis pain?
Galliprant
Who do you report ADE (adverse drug events) to?
USFDA
Which are NSAID’s are selective (exclusive) COX-2 inhibitors?
Robenacoxib
Firocoxib
Deracoxib
Newer Coxibs
In addition to fluid therapy follwoing interventions which drugs may be used as GI ulcer prophylaxis and treatment?
Sucralfate
Misoprostol
Ranitidine
Omeprazole
True/False: You can give NSAID’s to a pediatric between the ages of 1-2 weeks.
False
**Avoid before 4 weeks of age
All of the following are precautionary measures to NSAID’s except:
a. BP control in critical cases
b. CVS load should be maintained
c. Food and water provision
d. All the above are precaution measure
d. All the above are precaution measure
Which of the following is false regarding special considerations of pregnancy?
a. You can give a single use after C- section
b. You can give during AI
c. COX-2 is expressed at ovulation, implantation and labour
d. Its necessary for nephrogenesis
b. You can give during AI
**Avoid during AI
How do you want to give COX-2 NSAID’s for fracture healing?
Low dose for a short period of time
Which are the preferential COX-2 inhibitors that are also weak COX-1 inhibitors?
Meloxicam
Carprofen
Etodolac
How long is the washout period for NSAID’s?
4-10 days
True/False: COX-1 is inducible in damaged or inflamed tissue and its inhibition prevents pain and fever analgesia.
False
**COX-2
What is the name for the soluble tablet registered for osteoarthritis treatment in dogs that inhibits COX as well as lipooxygenase?
Tepoxalin
What are the clinical effects of NSAID’s?
local and central analgesia
anti-inflammatory
anti-pyretic
Which of the following is not an indication of NMBD?
a. Microscopic ophthalmic surgery
b. Thoracic surgery and diaphragmatic hernia repair
c. Cardiovascular surgery
d. Eases stretching of muscles across a fracture line
c. Cardiovascular surgery
What is recurarization?
NMB addative effect
What two NMBD’s are in the amino-steroid group?
Vercuronium
Rocuronium
Which NMBD monitoring system is most accurate to assess surgical levels of muslce paralysis by delivering supramaximal impulses?
Train of Four
Which of the following NMBD’s was the first to be free of cardiovascular adverse effects?
a. Succinylcholine
b. Atracurium
c. Cis-atracurium
d. Vecuronium
d. Vecuronium
What are the two anti-cholinesterases NMBD’s are antagonized with?
Edrophonium
Neostigmine
What are the main effects of NMBD’s?
Analgesia
Narcosis
Muscle relaxation
True/False. NMBD’s can’t be antagonized and there is a risk of transecting nerves since the twitch response to nerve contact is lost during surgery.
False
**NMBD’s can be antagonzed
Which of the following is false regarding succinylcholine?
a. Rapid onset and short duration
b. Cardiac arrhythmias are adverse effects
c. Can cause histamine release
d. Ach receptor antagonist
d. Ach receptor antagonist
** Agonist
What can an aminosteroid type NMBD be antagonized with?
Sugammadex (cyclodextrin)
What are adverse effects of NMBD antagonists?
Bradycardia
Bronchoconstriction
GIT hypermotility
Which NMBD monitoring system is the most simple but not as accurate way of assessing the degree of relaxation?
Single twitch
Which nerves are stimulated in dogs and cats to monitor NMBD’s? Which nerves in horses?
Dogs + Cats: peroneal and ulnar nerve
Horses: facial and superficial peroneal nerves
Which of the following may cause seizures due to laudanosine which is a CNS stimulant?
a. Succinylcholine
b. Atracurium
c. Cis-atracurium
d. Vecuronium
b. Atracurium
Which of the following is TRUE regarding the amino steroid group NMBD’s?
a. Vecuronium induces arrhythmias and causes histamine release
b. Vecuronium and Rocuronium are mainly eliminated in the kidneys
c. Rocuronium activity can be terminated by Sugammadex
d. Rocuronium is the first NMBD free of CVS adverse effects
c. Rocuronium activity can be terminated by Sugammadex
Which of the following NMBD’s is more pure and potent than atracurium?
a. Succinylcholine
b. Atracurium
c. Cis-atracurium
d. Vecuronium
c. Cis-atracurium
Which of the following NMBD’s is rapidly metabolized becuase of its non-enzymatic degradation?
a. Succinylcholine
b. Atracurium
c. Cis-atracurium
d. Vecuronium
b. Atracurium
Which of the following may cause histamine release at high doses and therefore should be injected slowly and diluted?
a. Succinylcholine
b. Atracurium
c. Cis-atracurium
d. Vecuronium
b. Atracurium
Which NMBD monitor works with an accelerometer to quanitfy the extent of muscle movement when the target nerves are stimulated?
Peripheral nerve stimulators
Which of the following is false?
a. Onset of NMBD is 3-5 minutes
b. NMBD’s are non-cumulative
c. Pancuronium is short acting (<10 minutes)
d. None of the above are false
c. Pancuronium is short acting (<10 minutes)
**its long-acting (>30 minutes), Rapacuronium is short acting
All of the following are peri-operative indications of blood transfusions except:
a. Thrombocytopenia
b. Hypoalbuminemia
c. Clotting factor deficiency
d. Severe chronic hemorrhage from trauma
d. Severe chronic hemorrhage from trauma
**should say acute
You note sudden tachycardia and hypotension in a dog after a blood transfusion and suspect anaphylactic shock. How do you treat this?
a. Stop transfusion
b. Initiate Symptomatic support
c. Epinephrine and Dex
d. All the above
d. All the above
What are signs of an allergic reaction to a blood transfusion?
Fever, urticarial, angioedema, pruritis, tachypnea
Which of the following is false regarding whole blood?
a. Fresh for up to 10 hours after collection
b. Should be stored at 1 to 6 degree C
c. Can be used for up to 21-30 days after collection
d. Contains RBC, WBC, PLT, plasma proteins and coagulation factors
a. Fresh for up to 10 hours after collection
**fresh for up to 8 hours after collection
True/False: Pure plasma can be used fresh or frozen and it contains all clotting factors except platelets.
True
Which of the following is not a reason to start a blood transfusion?
a. PCV <20% due to anemia and anesthesia
b. Chornic anemia <15%
c. More than 5-10% blood volume loss intraoperatively
d. Acute blood loss >20%
c. More than 5-10% blood volume loss intraoperatively
**more than 10-15%
Which of the following is not a reason why we avoid hypoxemia in blood transfusions?
a. Anaerobic glycolysis for cell energy
b. Decreased lactic acid
c. Release of toxins and cytokines
d. Cellular acidosis
e. Cellular deterioration of liver, lungs and heart
b. Decreased lactic acid
**increased lactic acid
How do you treat an allergic reaction to a blood transfusion?
Stop transfusion
Diphenhydramine +/- Dex +/- epinephrine
Restart transfusion at a slower rate
True/False: Fresh frozen plasma that has been thawed several times is only rich in clotting factor VIII, von Willebrand factor, and fibrinogen
True
True/False: We only want to treat sympatomatic and anemic animals when considering blood transfusions.
True
Which of the following is a stabilized bovine hemoglobin based oxygen carrying solution used to treat anemia in dogs and cats?
a. Hetastarch
b. Albumin
c. Oxyglobin
d. Plasma
c. Oxyglobin
Cardiac arrhythmias, tremors and sizures are noted in a dog after blood transfusion. What is your diagnosis and how do you treat?
Citrate overdose induced hypocalcemia
Tx: calcium salts slowly over 20 minutes under ECG monitor
Which of the following is false?
a. tachypnea, fever, hemoglobinemia/uria, and shock are signs of acute hemolysis
b. Dex and ketoprofen are used to treat acute hemolysis
c. Maintain BP (80-100 mmHg)/ Dopamine
d. All the above are true
b. Dex and ketoprofen are used to treat acute hemolysis
**Dex and saline diuresis are used
How do you treat a non-hemolytic febrile reaction to a blood transfusion?
Stop transfusion
Dex and ketoprofen
Restart at a lower rate in 15 minutes
Signs of tachypnea, pulmonary edema and polyuria are noted after a blood transfusion. What is the diagnosis and how do you treat?
Circulatory overload
Tx: stop transfusion, O2 supplement, Furosemide, restart transfusion at a slower rate, consider different blood product
ECG abnormalities are noted after a blood transfusion and you suspect hyperkalemia. How do you treat?
Stop transfusion
Normal saline
Dextrose with regular insulin
Which is matched correctly?
a. Major cross-matching: add donor plasma/serum to recipients RBC
b. Minor cross-matching: add recipients plasma/serum to donor RBC
c. Agglutination means its ok to transfuse when cross matching
d. Add recipient plasma/serum to donor RBC’s in major cross matching
d. Add recipient plasma/serum to donor RBC’s in major cross matching
**Minor: add donor to recipient RBC
AGGLUTINATION MEANS DON’T TRANSFUSE
Which is false regarding blood groups?
a. Type A, C and Q are most common in horses
b. DEA 1.2 is most commonly used for 1st transfusion
c. Type A is most common in cats
d. DEA 1.1 and 1.2 negative are considered to be universal donors in dogs
b. DEA 1.2 is most commonly used for 1st transfusion
***DEA 1.1
True/False: There is no need to blood type for the frist ransfusion in cats because they lack alloantibodies.
False
**this is true for dogs, ALWAYS blood type cats!!
What premeds do we want to give IM before catheter placement in a dog?
Opioid
Sedative
Which induction drugs must be titrated to effect and given slowly in dogs?
Propofol, Alfaxalone, Etomidate
Which of the following is false regarding maintenance anesthesia in dogs?
a. Etomidate, propofol and alfaxalone can be given as CRI injectables
b. Sevo and Iso are the most common inhalant anesthetics
c. Fentanyl is the most common opioid
d. Lidocaine, Ketamine, Benzo and Opioids are adjunct drugs administered as CRI’s
a. Etomidate, propofol and alfaxalone can be given as CRI injectables
**can’t give etomidate becuase of adrenal suppression
What is a common anesthesia complication seen in dogs that can cause esophageal damage?
Regurgitation
Which is false regarding cardiovascular support in dogs?
a. Norepinephrine and vasopressin are required in very sick patients with hypotension
b. Blood volume is about 90mL/kg
c. Common rate of IV fluids is 10 mL/kg/hr
d. Dopamine, dobutamine and ephedrine are commonly used to treat hypotension in very sick patients
d. Dopamine, dobutamine and ephedrine are commonly used to treat hypotension in very sick patients
**common in relatively healthy patients
All of the following are ways to treat regurgitation if it occurs except?
a. Nose down for drainage
b. Swab or suction caudal oropharnx before extubation
c. Keep cuff inflatted or partially inflatted for extubation
d. Place in lateral recumbency ASAP
d. Place in lateral recumbency ASAP!
**Place in sternal recumbency ASAP!
Which of the following about dog breeds and anesthesia is false?
a. Greyhounds have a prolonged recovery with thiobarbiturates
b. Boxers are sensitive to acepromazine
c. Longer recovery in sighthounds with propofol and alfaxalone
d. Increased vagal tone is a concern in schnauzers
d. Increased vagal tone is a concern in schnauzer
**concern in brachycephalics and dachshunds
What is the effective frist choice drug for hypotention in cats (including cats with HCM)?
Dopamine
Which of the following is matched incorrectly?
a. Sick sinus syndrome: Schnauzers
b. Hemophilia: Dobermans
c. Increased vagal tone: Brachycephalics, dachshunds
d. Mitral valve diease: Small breeds
b. Hemophilia: Dobermans
***German shepherd
Which mu agonist is least likely to cuase vomiting?
Fentanyl
Methadone
Which of the following is matched incorrectly?
a. H1 antihistamine: give with IM premeds when removing mast cell tumor
b. Diphehydramine: vasoconstriction, leaky vessels
c. NK1 receptor antagonist: Maropitant (cerenia)
d. Cerenia can be given 30 minutes before opioid to decrease risk of vomiting
b. Diphehydramine: vasoconstriction, leaky vessels
**vasodilator
Which induction drug has a high therapeutic index and must be titrated higher than the calculated dose in dogs?
Ketamine
What is post anesthetic cortical blindness in cats associated with?
Secondary to decrease O2 delivery to the brain and mouth gags
True/False: MAC is higher in dogs than in cats
False
** higher in cats (iso 1.4-1.6)
Which drug cannot be given as an adjunct CRI in cats b/c it causes severe cardiovascular depression when given IV?
Lidocaine
Which drug is not FDA approved in cats for induction?
Propofol 28
Which of the following is true regarding induction drugs in cats?
a. Low doses of inhalant are required for induction
b. Chamber or mask induction can be used
c. Repeated propofol can cause heinz body anemia
d. Etomidate is contraindicated in cats
c. Repeated propofol can cause heinz body anemia
Which combination of IM drugs will provide immobilization for a fractious cat?
Alfaxalone or ketamine + alpha 2 agonist + opioid = “kitty magic”
Which of the following is false regarding premeds in cats?
a. Ace and Dex are both good sedatives
b. Benzodiazepine is better used IV at the time of induction
c. Lower doses are required compared to dogs
d. Dexmedetomidine causes vasoconstriction
c. Lower doses are required compared to dogs
**higher doses
True/False: Morphine or hydromorphone are preferred over oxymorphone and methadone in cat premeds
False
** other way around
True/False: all opioids can cause post-op hyperthermia in cats.
True
Which are prokinetic drugs in dogs?
Metoclopramide or Cisapride
What are common routes of anesthetic administration in lab animals?
Intra-peritoneal
Subcutaneous
Inhalation
Intravenous
What is false regarding lab animal anesthesia?
a. Ketamine is most commonly used
b. Relatively high drug doses are required
c. Induction chamber and fask mask are commonly used
d. Bupenorphine, butorphanol and Meloxicam are opioids used commonly
d. Bupenorphine, butorphanol and Meloxicam are opioids used commonly
** Meloxicam is an NSAID not opioid
Which of the following is false regarding anatomy of ectotherms?
a. They have 2 atria and 1 ventricle - three chamber heart
b. BP is usually lower
c. They have a dual blood supply to the kidney
d. IM injections should be given in the caudal body parts for good absorption
d. IM injections should be given in the caudal body parts for good absorption
**IM injections in caudal body parts may cause nephrotoxicity and/or rapidly excreted
Which of the following is false?
a. Ketamine and Propofol is commonly used for immobilization in crocodilians
b. Ketamine and Medetomidine are injectable anesthetics used in snakes
c. Ketamine, Propofol and Gas anesthesia are commonly used in Chelonians
d. MS-222 immersion can be used in both amphibians and fish
a. Ketamine and Propofol is commonly used in crocodilians
**Ketamine and Medetomidine
Which of the following is false regarding considerations prior to anesthesia?
a. Small birds become hyperglycemic quick due to high metabolic rates and glycogen reserves
b. IM injection in pectoral muscle of flying and thigh muscle of non-flying
c. IV injection in medial metatarsus, brachial or right jugular vein
d. Interosseous injection in proximal ulna or tibiotarsus
a. small birds become hyperglycemic quick due to high metabolic rates and glycogen reserves
**hypoglycemic b/c of high metabolic rates and poor glycogen reserves
Which of the following is TRUE regarding physical restraint of birds?
a. We want to control the neck in short necked birds
b. We want to restrain to control the head and feet
c. Small birds die easily from the stress of improper restraint
d. Clients don’t care how vets restrain birds
c. Small birds die easily from the stress of improper restraint
True/False: We have a faster induction and recovery in birds with sevoflurane
True
All of the following should be monitored during anesthesia except:
a. Large negative deflection of the S wave on ECG
b. Tachycardia since its not well tolerated by birds so we can quickly administer anticholinergics
c. Hypercapnea even if well oxygenated
d. High body surface area to weight ratio since prone to hypothermia
b. Tachycardia since its not well tolerated by birds so we can quickly administer anticholinergics
**bradycardia
Which of the following is true regarding recovering in birds?
a. Make sure to let them recover on their own so they don’t bite
b. Recovery from isoflurane should be over 5-10 minutes and longer if ketamine was used
c. With hold food for 4 hours after
d. Wrap in a towel holding the head if they’re a raptor and feet if they’re a parrot
b. Recovery from isoflurane should be over 5-10 minutes and longer if ketamine was used
Which of the following is false regarding bird anatomy and physiology?
a. Dorsal recumbency compresses air sacs and hinders chest movement
b. Fresh air enters lungs during respiration increasing efficiency
c. Avoid injecting drugs into hind limb muscles/ veins because of nephrotoxicity or diminished drug effect
d. Low BMR results in rapid utilization of tissue O2 reserves
d. Low BMR results in rapid utilization of tissue O2 reserves
**high
Which of the following is matched incorrectly?
a. Birds <200g BW: fast for at least 2 hours
b. Psittacines: 4-6 hour fasting
c. Raptors: 6-12 hour fasting
d. Ratties: 6-12 hour fasting
a. Birds <200g BW: fast for at least 2 hours
**NO fasting
Which of the following is false regarding injectable anesthesia of birds?
a. Weak opioids combined with Benzo’s or alpha 2 agonists IM or IV are used for sedation/analgesia
b. Sedation drugs combined with ketamine for immobilization
c. Morphine or fentanyl can be used for induction and maintenance
d. NSAID’s may be used to augment analgesia
c. Morphine or fentanyl can be used for induction and maintenance
**propofol, alfaxalone IV
Which IM drugs immobilize swine?
Ketamine and Midazolam
Which premeds are used in swine anesthesia?
Midazolam Azaperone Xylazine Medetomidine ACP
All of the following are induction drugs used in swine anesthesia except:
a. Ketamine
b. Xylazine
c. Telazol
d. Thiopental
e. All the above can be used
e. All the above can be used
Which are your swine maintenance drugs?
Iso and Sevo
Triple drip: GGE, Xylazine + Ketamine
Propofol for CRI’s
True/False: Analgesia and Opioids are used during recovery of anesthesia in swine.
True
What is the life threatening skeletal muscle pharmaco-genetic syndrom that can be triggered during anesthesia in Landrace pigs?
Malignant hyperthermia
Which of the following is false regarding malignant hyperthermia in swine?
a. Potbelly pigs are less susceptible
b. Stress, Inhalation anesthetics and depolarizing muscle relaxants are triggering factors
c. Pigs are deficient in the rhyanodine gene causing dysfunctional release of excessive Ca+ into the sarcoplasm
d. Pigs go into a hyper-metabolic state
c. Pigs are deficient in the rhyanodine gene causing dysfunctional release of excessive Ca+ into the sarcoplasm
**mutation in this gene
Which of the following is false regarding swine monitoring during anesthesia?
a. Place doppler on leg/tail to measure BP
b. Auricular artery catheterization for direct pressure measurement
c. Monitor RR and depth along with end tidal CO2
d. None of the above are false
d. None of the above are false
Which is false regarding recovery of swine from anesthesia?
a. Usually calm but leave undisturbed
b. Extubate before swallowing reflex returns
c. Look out for laryngospasms when extubating
d. Susceptible to hypothermia
b. Extubate before swallowing reflex returns
**extubate WHEN swallowing reflex returns
Which of the following is false about swine anesthesia?
a. Fast for 12 hours
b. No water for 2-4 hours
c. Semimembranous or semitendinous muscle is ideal for IM injections
d. Hypodermic needles should be used for IM injections
c. Semimembranous or semitendinous muscle is ideal for IM injections
**NO, avoid thick fat deposits
Which vein do you use for swine catheterization?
Auricular vein
How can you prevent malignant hyperthermia in susceptible swine?
pre treat with dantrolene
Which of the following is not a treatment for malignant hyperthermia in swine?
a. Cooling down the pig with water ice baths
b. Dantrolene and Na+ bicarb for acidosis
c. ACP for vasodilation
d. Terminating the inhalant anesthetic
b. Dantrolene and Na+ bicarb for acidosis
**just Na bicarb for acidosis and use dantrolene IV
Which of the following is not matched correctly?
a. Blow pipes: 10-15 meters
b. Pistol: 1-25 meters
c. Rifle: 5-60 meters
d. Pole Syringe: up to 50 meters
d. Pole Syringe: up to 50 meters
**3-4 meters
What is the aim of dart projectors?
To cause minimal tissue trauma with appropriate impact for drug delivery
Which of the following is not matched correctly regarding commonly used wildlife and zoo drugs?
a. Tranquilizers: phenothiazines and butyrophenones
b. Sedatives: bezodiazepine and alpha 2 agonists
c. Antagonists: opioids and Benzodiazepine
d. Immobilizers: potent opioids and cyclohexamines
c. Antagonists: opioids and Benzodiazepine
**opioids and alpha 2 agonists
Which of the following is false regarding the adverse effects opioids of wildlife and zoo anesthesia?
a. Etorphine, Carfentanil, and Thiafentanyl are all used to capture large herbivores and elephants
b. They can cause life threatening respiratory depression
c. They cause hypothermia and hypotension
d. Decreased gut motility predisposes them to bloat
c. They cause hypothermia and hypotension
**hypertension and hyperthermia
What term is used to describe the recurrence of signs of opioid induction and sedation in varied time after administration of opioid antagonists?
Renarcotization
Which of the following is false regarding renarcotization?
a. high stepping, star gazing, pacing, decreased response to stimuli and sedation are typical signs
b. caused by inadequate dose of opioid antagonist
c. can be due to the administration of the wrong antagonist
d. you don’t want to repeat the antagonist dose bc of the adverse side effects
d. you don’t want to repeat the antagonist dose bc of the adverse side effects
**repeat dose of antagonist (can be administered by dart)
Which are the two most commonly used dissociative agents for induction of general anesthesia in feral carnivores?
Ketamine
Tiletamine
Which two tranquilizers are used as adjuncts to opioids for immobilization of large animals and minimize stress is captive herbivores?
Butyrophenones and Phenothiazines
Which of the following is false regarding benzodiazepine sedatives used in wilflife and zoo anesthesia?
a. Diazepam is the most potent one
b. Midazolam, Zolazepam and Diazepam are all used
c. Zolazepam is mixed with tiletamine for carnivore immobilization
d. Diazepam can be irritable if injected IM or SQ so IV is recommended or given in feed preparations
a. Diazepam is the most potent one
**Midazolam is more potent
Which of the following is false regarding alpha 2 sedatives in wildlife anesthesia?
a. Xylazine has sedative effects for 1-2 hour and analgesia effects for 30 minutes
b. Medetomidine and Detomidine can both be used in herbivores
c. Detomidine is more potent than xylazine and can cause ataxia
d. Romifidine is a potent sedative that doesn’t cause muhc ataxia
b. Medetomidine and Detomidine can both be used in herbivores
**Romifidine and Detomidine are used in herbivores, Medetomidine is used in carnivores
What are specific antagonists of alpha 2 sedatives in wildlife and zoo anesthesia?
Atipamezole
Yohimbine
Tolazoline
Which of the following is false regarding drug combinations by wildlife and zoo species?
a. Black rhino have less respiratory depression and muscle rigitiy with opioids comapred to the white rhino
b. Etorpine and azaperone can both be used for white and black rhino’s as well as elephants for immobilization
c. We want to supplement with small doses of ketamine IV for elephants
d. Xylazine + Ketamine or Telazol can be combined for the red deer
c. We want to supplement with small doses of ketamine IV for elephants
**Supplement with small doses of etorphine IV
Which of the following is false regarding drug combinations by wildlife and zoo species?
a. Ketamine IM will cause excessive salivation and rigidity in coyote’s
b. Fentanyl and Medetomidine can be combined in wild dogs
c. Ketamine with xylazine or medetomidine can be combined for immobilization in bears
d. Telazol and Xylazine IM can be used ot restrain coyote’s
b. Fentanyl and Medetomidine can be combined in wild dogs
**Fentanyl and Xylazine
Which of the following is false regarding drug combinations for immobilization in bears?
a. Xylazine and ketamine IM
b. Medetomidine and ketamine IM
c. Etorphine and xylazine IM
d. Medetomidine and xylazine IM
c. Etorphine and xylazine IM
**etorphine and carfentanil are used alone IM
Which of the following is false regarding capture myopathy?
a. chronic syndrome causing death within a couple of days
b. There is muscle breakdown due to overexertion from capture/restraint
c. Its important to keep the animals temperature cool and apply fluids if possible
d. Hyper-flexion of the hock can occur 1-2 days post capture
e. Renal failure, acidosis, hyperkalemia and hypoglycemia can all result from this
a. chronic syndrome causing death within a couple of days
**acute syndrome causing death within 3-4 hours
Which vein is most commonly used in horses for a 12 gauge catheter placement?
Jugular vein
Which of the following is false regarding preanesthetic preparation in horses?
a. starve for 4-6 hours
b. withhold water for at least 2 hours
c. Pull out all shoes
d. Rinse mouth with pressureized water to clear foreign material that can still to the ETT
e. None of the above are false
e. None of the above are false
All of the following are premeds used in horses except:
a. Alpha 2 agonists
b. Acepromazine
c. Butrophanol
d. Morphine
e. Methadone
f. Ketamine
f. Ketamine
True/False: It is recommended to use GGE or a Benzo as a muslce relaxer before the induction agent.
True
Which are the main induction agents used in equine anesthesia?
Ketamine
Thiopentone
**GGE, Diazepam/Midazolam are used as muscle relaxers
What size tube is used for equine intubation if they’re averaging 500 kg?
26 mm diameter tube
Which of the following is false regarding maintenance of equine anesthesia?
a. Iso and sevo are commonly used with a circle circuit
b. 20 mL/kg/min O2 flow rate soon after induction and towards recovery
c. mechanical ventilation is prefered if its a surgery longer than 45 minutes
d. 15 mL/kg/min O2 flow rate during maintenance
e. None of the above are false
d. 15 mL/kg/min O2 flow rate during maintenance
**should be 10mL/kg/min
Which of the following is false regarding PIVA and TIVA in equine anesthesia?
a. The goal is to reduce MAC and CVS effects in PIVA
b. Ketamine, Medetomidine,and Lidocaine are used in TIVA
c. Ketamine GGE and Xylazine/ Romifidine are used in TIVA as well
d. TIVA can be toped up wiht Ketamine and Diazepam/Midazolam boluses
e. None of the above are false
b. Ketamine, Medetomidine,and Lidocaine are used in TIVA
**used in PIVA
Which of the following is false regarding maintenance and monitoring of equine anesthesia?
a. IPPV is most likely needed to assess ETCO2 since hypoventilation is likely
b. Ideally we want weak palpebral reflexes, no nystasgmus, weak anal tone and stable ANS reflexes
c. Absent palpebral and corneal reflex, dry cornea, bradycardia are seen if they’re too deep
d. Hypotension, blinking, dry eyes and mvoement of limbs are seen when they’re too light
d. Hypotension, blinking, dry eyes and mvoement of limbs are seen when they’re too light
***blinking and movement yes but no to dry eyes and hypotension that’s if they’re too deep
What are some techniques used for assisted recovery in equine anesthesia?
Manual assistance within recovery box
Head and tail rope
Deflating air pillow
Sling and Pool recovery
Which cardioprotective drugs are used to treat hypotension in equines?
Dobutamine
Phenylephrine
Which of the following is false regarding clinicopathological changes in equine with myopathies?
a. Myoglobinuria and hyperglobinemia
b. Decreased potassium and phosphorus
c. elevated CK, AST, and LDG
d. Inflammatory leukogram
e. elevated BUN and Creatinine
b. Decreased potassium and phosphorus
**Increased P and K, Decreased Na, Cl, and Ca
What are the 6 P’s associated with compartmental myopathy in equine?
Pain Paresis Paralysis Pallow Pulselessness Poikilothermia
Which of the following is false regarding compatmental myopathy in equine?
a. Failure to stand becuase of severe pain and the muscles will feel hard
b. Myoglobinuria and renal failure can result
c. DMSO, muscle relaxants, fluids, and analgesics can all be given
d. Dantrolene is the drug of choice for treatment
d. Dantrolene is the drug of choice for treatment
**Dantrolene is used with malignant hyperthermia
What is the name of the rare genetic train that affects Quarter horses resulting in the failure of the Na+ channels to deactivate?
Hyperkalemic Period Paralysis
A horse is presented with profuse sweating, tachycardia, prolapsed third eyelid, contracted masseters and flared nostrils. Which of the following is the most accurate diagnosis?
a. Compartmental myopathy
b. Malignant Hyperthermia
c. Hyperkalemic Period Paralysis
d. Neuropathy
b. Malignant Hyperthermia
A horse is presented to you with respiratory distress, swaying, sitting like a dog, and recumbent after he was transported to a new farm. Which of the following is at the top of your list for differentials?
a. Compartmental myopathy
b. Malignant Hyperthermia
c. Hyperkalemic Period Paralysis
d. Neuropathy
c. Hyperkalemic Period Paralysis
Which of the following is commonly persented with myopathy and possible affecting the facial and radial nerves along with possible causes of spinal malacia?
a. Compartmental myopathy
b. Malignant Hyperthermia
c. Hyperkalemic Period Paralysis
d. Neuropathy
d. Neuropathy
Dantrolene, Water/alcohol baths, ACP for vasodilation, Na bicarb for acodosis are all used to treat which of the following?
a. Compartmental myopathy
b. Malignant Hyperthermia
c. Hyperkalemic Period Paralysis
d. Neuropathy
b. Malignant Hyperthermia
All of the following are used to treat Hyperkalemic Period Paralysis except:
a. Acetazolamide
b. Dextrose
c. Diltiazem
d. Ca+ gluconate
c. Diltiazem
True/False: Dantrolene can be given as a pre-anesthetic to prevent malignant hyperthermia.
True
True/False: Surgery has to be done on horses with neuropathies since the nerves don’t revitalize once the swelling subsides.
False
**sympatomtic tx and TLC –> nerves may revitalise once swelling subsides
Which of the following is false regarding complications of equine anesthesia?
a. Nasal edema is common due to gravitational fluid extravasation
b. O2 supplementation should be used for nasal edema
c. Sedate with romifidine/detomidine to delay attempts at standing
d. Excited horses may suffer bone fractures during recovery
e. Remove the nasal tube during recovery to prevent nasal edema
e. Remove the nasal tube during recovery to prevent nasal edema
**place nasal tube until horse stands
Which drugs are very effective sedatives in foals versus adult horses and what can they be combined with for analgesia?
Benzodiazepine combined with Butorphanol
Which of the following is true regarding the foal anesthesia?
a. They are fine to stand during recovery and no physical restraint is required
b. Porpofol and Ketamine are used as induction drugs
c. A mask or nasotracheal tube can be used for maintenance
d. None of the above are true
b. Porpofol and Ketamine are used as induction drugs
Which of the following is false regarding donkey anesthesia?
a. Cathetherization is cut down for venous flow over the jugular furrow
b. They’re more sensitive to GGE
c. They’re more prone to excitement during induction or recovery periods
d. They’re more resistant to sedatives, anesthetic and analgesics compared to the horse
c. They’re more prone to excitement during induction or recovery periods
**less prone
True/False:Doxopram can be used to treat respiratory arrest.
False
**NO DOXOPRAM –> increases cerebral O2 demand
Which of the follwoing is false regarding basic life support (BLS)?
a. Apneic, unresponsive patient should be assessed for less than 5-10 minutes before starting compressions
b. Use 2 minute interrupted cycles
c. Chest compressions in the most important part
d. Consider airway management and ventilation
b. Use 2 minute interrupted cycles
**uninterrupted
Which of the following is false regarding chest compressions?
a. Elbows flexed
b. 2 minutes per person only then trade off without interruption
c. Only achieve less than or equal to 25-30% of normal CO
d. None of the above are false
a. Elbows flexed
**elbows locked
The ____ theory is direct compression of the ventricles between the ribs or spine- sternum and the ____ theory are compressions that cause increase in intrathoracic pressure
Cardiac pump theory, Thoracic pump theory
What kind of theory compressions are done on medium, large and giant breed dogs with rounded chests?
Thoracic pump theory compressions
True/False: Cadiopulmonary arrest (CPA) is usually preceded by respiratory arrest but if respiratory arrest is treated quickly we can prevent CPA.
True
What is the goal of CPR?
Maximize myocardial and cebral oxygenation
True/False: CPR has a better prognosis than CPA under anesthesia.
False
**CPA has a better pronosis under anesthesia and approximately 50% survive
What is found in the “crash cart”?
O2 source Endotracheal tubes, laryngoscopes IV catheters Fluids, drugs Defibrillator
Which of the following is false regarding the cardiac pump theory compressions?
a. For narrow, deep chested dogs but also used in cats
b. Compressions directly over the heart for larger dogs
c. Compressions over the widest part of the chest for larger dogs
d. One handed compressions can also be used in small dogs and cats
c. Compressions over the widest part of the chest for larger dogs
**thoracic pump theory compressions
What is the rate for chest compressions for a 1/3 -1/2 thorax width?
100-120 per minute
All of the following indicate when you perform internal cardiac massage except:
a. If the patient has pericardial effusion or pleural space disease
b. Intraoperative cardiac arrest if the abdomen is already open
c. Conditions that prevent effective external cardiac compressions
d. You use internal cardiac massage for all the above
d. You use internal cardiac massage for all the above
Which of the following is false regarding ventilation during CPR?
a. keep patient in lateral recumbency
b. ventilate for 5 breaths/minute
c. ambu bag or anesthesia machine can be used for 100% O2
d. All the above are true
b. ventilate for 5 breaths/minute
**ventilate for 10 breaths/min
Which of the following is false regarding End- tidal CO2 during CPR?
a. provides an indication of adequacy of cardiac compressions
b. dramatic decrease indicates ROSC (return of spontaneous circulation)
c. Should be > 15-20 mmHg
d. All the above are true
b. dramatic decrease indicates ROSC (return of spontaneous circulation)
**Increase
What fits between the end of the ETT and the ambu bag/breathing curcuit and creates a ngative intrathoracic pressure to increase venous return (preload)?
Impedance Threshold Device
True/False: Advanced life support (ALS) is initiated after BLS has started by using drugs and defibrillation.
True
Which of the following is true regarding ECG’s during CPR?
a. Abnormal Pulseless Electrical activity can be seen on ECG’s without cardiac contraction
b. Do not evaluate until after 2 minutes of uninterrupted compressions
c. Asystole and ventricular fibrillation are the most common arrests in vet med
d. All the above are true
b. Do not evaluate until after 2 minutes of uninterrupted compressions
**Asystole and PEA are the most common in vet med, PEA may appear as a normal ECG without cardiac contraction
Which of the following is false regarding asystole/PEA?
a. Vasopressin and Epinephrine are used every other cycle (q. 3-5 minutes)
b. Atropine is used every cycle especially with high vagal tone
c. Defibrillation is not indicated
d. Requires drug treatment along with BLS
b. Atropine is used every cycle especially with high vagal tone
**use every other cycle (q. 3-5 minutes)
Which of the following is TRUE regarding Vfib/ Pulseless Vtach?
a. Theyr’e not shockable rhythms
b. Defibrillation isn’t needed once the diagnosis is made
c. Vasopressor therpay is not needed for this
d. Biphasic defibrillator is preferred over monophasic
d. Biphasic defibrillator is preferred over monophasic
Which of the following is incorrect about defibrillation?
a. Patient should be positioned in sternal recumbency
b. Make sure no one is in contact with the patient or table
c. No alcohol bc it can cause a fire
d. resume compressions for 2 minutes before rechecking the ECG
a. Patient should be positioned in sternal recumbency
**dorsal recumbency
Which of the following is matched incorrectly based on anesthetic drugs that should be reversed during CPR?
a. Opioids - naloxone
b. Alpha 2 agonists- atipamezole
c. Benzodiazepines - flumazenil
d. None of the above are matched incorrectly
d. None of the above are matched incorrectly
____ and ____ are anti-arrhythmics that may be considered if defibrillation is not effective and ____ is used for torsades de pointes.
Amidarone and Lidocaine
Magnesium
True/False: Documented hypokalemia should be treated
False
** it may be treated but hyperkalemia should be treated
True/False: Corticosteroids are ercommended as other treatments for CPR.
False
When is it ok to give IV fluids to paitents during CPR?
patients that are hypovolemic
Which drugs are administered intratracheal mentioned in the CPR lecture?
Epinephrine
Atropine
Vasopressin
Which of the following is false based on PCA (post cardiac arrest)?
a. Includes multiorgan failure, cardiogenic shock, and anoxic brain injuries
b. Monitor body temperature, hyperthermia is neuroprotective
c. IV fluids, vasopressors and/or inotropes are used for treatment
d. Mannitor and hypertonic saline can be used to treat cerebral edema
b. Monitor body temperature, hyperthermia is neuroprotective
**hypothermia is neuroprotective
Which of the following is a competitive antagonists at the muscarinic Ach receptors?
a. Anticholinergics
b. Antiarrhythmisc
c. Vassopressors/ Inotropes
d. None of the above
a. Anticholinergics
Which of the following is false regarding anti-arrhythmics?
a. Lidocaine is a class IB Na cahnnel blocker used for ventricular arrhythmias
b. Short acting, give bolus then CRI
c. Treatment required if hypotensive, R on T phenomenon, multiform VPC, HR > 180
d. None of the above are false
d. None of the above are false
which of the following is false regarding paradoxical bradycardia?
a. May lead to AV block
b. More likely to occur at high doses of anticholinergics
c. Increases the release of Ach
d. Due to the blockade of presynatpic M1 receptors on the vagus
b. More likely to occur at high doses of anticholinergics
**low doses
Which of the following is true regarding glycopyrrolate?
a. Not used as an emergency drug bc of its slow onset
b. Fast onset, Short duration
c. Crosses the BBB and placenta barier causing mydriasis
d. Can cause mild-moderate tachycardia
a. Not used as an emergency drug bc of its slow onset
Wich of the following is false regarding atropine?
a. May cause marked tachycardia
b. Doesn’t cross the BBB or placenta barrier
c. Can be given IM,IV, SQ, and IT
d. none of the above are false
b. Doesn’t cross the BBB or placenta barrier
**does cross
What is the ultimate goal of the CVS?
Oxygen delivery to the tissues
Which of the following is false regarding CVS drug targets?
a. anticholinergics and anti arrhythmics are used to control HR
b. inotropes are used to control contractility
c. chronotropes are used to control afterload/preload
d. most anesthetic drugs cause vasodilation
c. chronotropes are used to control afterload/preload
**pressors
Which of the following increases firing rate of the SAN and conduction speed through the AVN?
a. Anticholinergics
b. Antiarrhythmisc
c. Vassopressors/ Inotropes
d. None of the above
a. Anticholinergics
What is the main side effect of anticholinergics that is a concern for horses and ruminants?
Ileus and colic
Which of the following is matched incorrectly regarding anti-arrhythmics?
a. Class II: used for severe sinus tachycarcia or ST especially if assocaited with pheochromocytoma
b. Esmolol is the most common Class IB drug
c. Class IB: Na channel blocker
d. None of the above are matched incorrectly
b. Esmolol is the most common Class IB drug
***most common class II injectable
Which of the following is matched regarding adrenergic receptors?
a. alpha 1 and 2 = vasoconstriction
b. B1 = increased intorpe and chronotrope
c. B2= vasoconstriction and bronchoconstriction
d. None of the above are matched incorrectly
c. B2= vasoconstriction and bronchoconstriction
**dilation for both
Which of the following is false regarding dopamine?
a. Dose dependent receptor agonism
b. long half life so it can’t be given as a CRI
c. common frist line treatment for hypotensive cats
d. none of the above are false
b. long half life so it can’t be given as a CRI
**short half life so it has to be given as a CRI
Which of the following is a non selective agonist for alpha, B1 and B2 used for CPR or anaphylactic shock?
a. Ephedrine
b. Epinephrine
c. Norepinephrine
d. Phenylephrine
b. Epinephrine
Which of the following is a mixed agonist that can cause reflex bradycardia and lasts 20-30 minutes?
a. Ephedrine
b. Epinephrine
c. Norepinephrine
d. Phenylephrine
a. Ephedrine
Which of the following is a mixed agonist indicated for refractory shock or non-responsive hypotension?
a. Ephedrine
b. Epinephrine
c. Norepinephrine
d. Phenylephrine
c. Norepinephrine
A horse comes in with nephorsplenic entrapment. What is the the drug to use for this because its an alpha 1 agnoist that causes splenic contraction?
a. Ephedrine
b. Epinephrine
c. Norepinephrine
d. Phenylephrine
d. Phenylephrine
Which of the following is used topically for nasal edema in horses?
a. Dobutamine
b. Isoproterenol
c. Norepinephrine
d. Phenylephrine
d. Phenylephrine
Which of the following acts mainly on B-1 to increase inotropy and has minimal effects on chronotropy used commonly in equine anesthesia?
a. Dobutamine
b. Isoproterenol
c. Norepinephrine
d. Phenylephrine
a. Dobutamine
Which of the following is a beta 1 and 2 agonist and is used for medical treatment of a 3rd degree AV block and bronchodilator?
a. Dobutamine
b. Isoproterenol
c. Norepinephrine
d. Phenylephrine
b. Isoproterenol
Which of the following is false regarding vasopressin?
a. Vasoconstrict via the V1 receptors
b. Can cause tissue ischemia
c. Used in CPR interchangeable with ephedrine
d. Indicated for refractory shock or non-responsive hypotension as a CRI
c. Used in CPR interchangeable with ephedrine
**epinephrine
Which of the following is false regarding strategies for hypotension?
a. Turn down the vaporizer if the patient is too deep for the current level of stimulation
b. add a MAC sparing drug if too light and then turn down vaporizer
c. Give colloid fluid bolus and evaluate response
d. Opioids, Benzo, Lidocaine, Ketamine are acceptable MAC sparing drugs
c. Give colloid fluid bolus and evaluate response
**give crystalloid fluid bolus
2 year old female beagle presented for OHE surgery. Patient is hypotensive and has bradycardia during surgery. Which drugs do we use to treat this problem?
Atropine or glycopyrrolate
12 year old GSD presented for hemoabdomen secondary to splenic hemangiosarcoma. VPC’s are noted on ECG and he is hypotensive. Which of the following is false regarding treatment?
a. Crystalloids and colloids can be used ot treat the hypotension
b. Blood transfusion should be considered for this patient
c. Lidocaine bolus + CRI can be used to treat the VPC
d. All the above should be considered, none are false
d. All the above should be considered, none are false
18 year old gelding presented for colic. He is hypovolemic and he is too light to decrease the inhalant and hes already recieving lidocaine CRI and intermittent butorphanol. What do we use to decresae intotropy?
Dobutamine
18 year old gelding presented for colic. He is hypovolemic and he is too light to decrease the inhalant and hes already recieving lidocaine CRI and intermittent butorphanol. What drugs cause vasodilation that we would want to use for this case to decresae preload?
Ephedrine (consider Dopamine, NE, Vasopressin if refractory)
5 month old DSH is presented for OHE surgery, the cat is hypotensive but also too light and inhalant cannot be decreased. What drug is very effective in cats that we can use to increase BP?
Dopamine
What is the mechanism of action of local anesthetics (esters and amides)?
Bind to sodium channels and slows the rate of depolarization
List the four commonly used amides.
Lidocaine
Bupivacaine
Mepivacaine
Prilocaine
Which of the following is the only one that can be given IV but is also available as a patch?
a. Lidocaine
b. Bupivacaine
c. Mepivacaine
d. Prilocaine
a. Lidocaine
List the three most commonly used esters
Procaine
Tetracaine and Proparacaine
Benzocaine
Which of the following has the highest CVS toxicity available as a liposome injectable suspension that can last up to 72 hours?
a. Lidocaine
b. Bupivacaine
c. Mepivacaine
d. Prilocaine
b. Bupivacaine
Which of the following is an anti-arrhythmic that decreses MAC, is a free radical scavenger, improves GI motility, and is also an analgesic?
a. Lidocaine
b. Bupivacaine
c. Mepivacaine
d. Prilocaine
a. Lidocaine
Which of the following is most commonly used in large animal for nerve blocks, and intra- articular procedures?
a. Lidocaine
b. Bupivacaine
c. Mepivacaine
d. Prilocaine
c. Mepivacaine
True/False: esters are more likely to accumulate than amides.
False
**other way around
Which comination of drugs are found in larngeal sprays for intubation that can cause severe methemoglobinemia in cats?
Bezocaine and tetracaine
Which of the following is false regarding systemic toxicity?
a. CVS collapse and death is the first sign seen with bupivicaine
b. lidocaine causes CVS signs then depression/sedation, twitching and seizures
c. The first sign of Epinephrine is increased HR when given IV
d. This is caused by inadvertent IV injection, excessive doses or if the patient is intolerant
b. lidocaine causes CVS signs then depression/sedation, twitching and seizures
**first we see depression/sedation, twitching, seizures then CVS signs
True/False: Preservative free versions should be used for epidural and spinal anesthesia.
True
Which drug is most damaging intra-articular and use should be avoided or minimized?
Bupivacaine
True/False: Mepivacaine is the most damaging and it can be used intra articular for equine lameness diagnosis.
False
**least damaging
Which of the following is false regarding treatment of arrest secondary to LA?
a. Start CPR
b. High dose epinephrine
c. Give 20% lipid emulsion
d. Avoid lidocaine, Ca+ channel blockers, Beta blockers and vasopressin
b. High dose epinephrine
**low dose
Which of the following is not a goal of local anesthesia?
a. Prevents central sensitization
b. Important part of multimodal anesthesia
c. May allow for an incresaed dose of systemic drugs
d. Provides analgesia before, during and after the procedure
c. May allow for an incresaed dose of systemic drugs
**decreased
What two things are used as topical anesthetics?
EMLA cream
Lidoderm
Which of the following is false regarding topical anesthesia?
a. Tetracaine or proparacaine is most commonly used for ophthalmic purposes
b. 2% Lidocaine can be used for intubating cats
c. IVC placement of EMLA cream is ideal
d. Lidoderm doesn’t provide a complete block but it has some analgesic effects
c. IVC placement of EMLA cream is ideal
**its sensitive in patients
Which of the following is false regarding wound soaker catheter?
a. Consistent and prolonged (1-2 days)
b. Decreased need for systemic analgesics
c. Used for total ear canal ablation, amputation, oncologic surgery and large wound closure
d. Place tourniquet at the proximal aspect of the limb
d. Place tourniquet at the proximal aspect of the limb
***for IVRA procedure
Which of the following is false regarding Intravenous regional anesthesia (IVRA)?
a. also called bier block
b. minimal blood loss/clear surgical field
c. IV catheter is placed as proximal as possible on the limb
d. exsanguinate the limb and elevate for 3-5 minutes
e. none of the above are false
c. IV catheter is placed as proximal as possible on the limb
**as distal as possible, tourniquet is placed at proximal aspect
What is the only local anesthetic that we want to inject into the catheter in an IVRA procedure?
Lidocaine
True/False: There is no time limit for how long the tourniquet can be placed on the animal.
False
**can’t be placed for more than 60-90 minutes and must be released slowly
Which of the following blocks CN III, IV, V, VI, and ciliary ganglion for enucleation or intraocular surgery?
a. retrobulbar block
b. maxilalry nerve block
c. infraorbital nerve block
d. inferior alveolar nerve block
e. mental nerve block
a. retrobulbar block
Which of the following provides anesthesia to the 3rd premolad and teeth mroe rostral?
a. retrobulbar block
b. maxilalry nerve block
c. infraorbital nerve block
d. inferior alveolar nerve block
e. mental nerve block
c. infraorbital nerve block
Which of the following affects the sensory branch of CN V and provides anesthesia to the lateral aspect of the nasal mucosa?
a. retrobulbar block
b. maxilalry nerve block
c. infraorbital nerve block
d. inferior alveolar nerve block
e. mental nerve block
b. maxilalry nerve block
Which is the prefered technique for a retrobulbar block?
Inferior -tempral palpebral
Which block requires heavy sedation or GA and chlorohex solution for intraoral injections?
Dental blocks
Which of the following provides globe immobility during surgery and a risk of intrathecal injection?
a. retrobulbar block
b. maxilalry nerve block
c. infraorbital nerve block
d. inferior alveolar nerve block
e. mental nerve block
a. retrobulbar block
Which of the following provides anesthesia for the mandibular teeth, rostral lower lip, and intermandibular space?
a. retrobulbar block
b. maxilalry nerve block
c. infraorbital nerve block
d. inferior alveolar nerve block
e. mental nerve block
d. inferior alveolar nerve block
Which of the following provides anesthesia for the rostral lower lip only?
a. retrobulbar block
b. maxilalry nerve block
c. infraorbital nerve block
d. inferior alveolar nerve block
e. mental nerve block
e. mental nerve block
Which of the following is false regarding the RUMM block?
a. anesthesia for distal thoracic limb excluding the carpus
b. involves radial, ulnar, median and musculocutaneous nerves
c. requires 2 injection sites, one medial and one lateral
d. none of the above are false
a. anesthesia for distal thoracic limb excluding the carpus
**includes the carpus
Which nerve may also be desensitized affecting the rostral 2/3 of the tongue in the inferior alveolar nerve block?
Lingual nerve
Which drug is divided between sites and can be diluted 1:! with saline to block for declaws?
Bupivicaine
True/False: Peripheral nerve blocks of the pelvis limb deals with the femoral and sciatic nerve while the thoracic limb blocks the brachial plexus
True
Which Peripheral nerve block provides anesthesia for the entire thoracic limb including the scapula and shoulder?
Cervical paravertebral
Which Peripheral nerve block provides anesthesia for the thoracic limb distal to the elbow?
Brachial plexus
which of the following is false regarding the intercostal nerve block?
a. nerves run with the artery and vein along the cranial aspect of the rib
b. nerves run with the artery along the caudal aspect of the rib
c. block at the incision space and 2 spaces cranial and caudal
d. anesthesia for thoracotomy, rib fractures, etc.
a. nerves run with the artery and vein along the cranial aspect of the rib
What do you want to do to your patient with an intrapleural regional block because of the effects of gravity?
Affected side down for at least 20 mins after injection
Which of the following is false regarding epidurals?
a. Most commonly performed at the L-S space in small animals
b. requires heavy sedation or anesthesia
c. anesthesia cranial to the unbilicus
d. single injection is more common than epidural catheter
c. anesthesia cranial to the unbilicus
**caudal
Which technique has to do with fluid in the hub of the needle needing to be aspirated upon entry in a sternal recumbent patient due to subatmospheric pressure?
Hanging drop
True/False: THe higher the volume of injection the more cranial the drug will spread
True
Which drug can provide L-S epidural analgesia to the thoracic wall and limbs?
Morphine
What is the most common complications of opioids considered with locoregional blocks in small animals?
urinary retention
Which locoregional nerve block prevents blining due to the block on the motor system of the eye only.
Auriculopalpebral nerve block
Which is true about the supraorbital nerve block in equine?
a. Injection made at the dorsal point of the zygomatic arch
b. Sensory to middle 2/3 of the upper eyelid and palpebral motor
c. Used for enucleation
d. All the above are true
b. Sensory to middle 2/3 of the upper eyelid and palpebral motor
Which two nerve blocks are mostly used in equine dental procedures?
Infraorbital nerve block
Mental nerve block
The ___ block is used for enucleation of the globe and esxtraocular structures
Retrobulbar block
True/False: in equine edipural anesthesia procedures we want the drug to mvoe caudal instead of cranial.
True!!
**this avoids losing hindlimb motor function
Which drugs can provide excellent analgesia for hindlimb pain?
Detomidine and morphine
Which of the following is false regarding equine epidural anesthesia?
a. There is no risk of weakness or motor blockade if morphine is used
b. Lidocaine is a local anesthetic that can be used in adult horses
c. Xylazine and detomidine are common alpha 2 agonists used for local analgesia
d. Xylazine is used to treat severe laminitis
d. Xylazine is used to treat severe laminitis
**morphine
Where is the epidual catheter placed in an equine caudal epidural?
Co1 - Co2 space
What is important we do with ruminants after performing the Peterson or retrobulbar block?
Keep animal out of sun, dust, wint, etc. until the eyelid motor function has returned
True/False: Lidocaine is used for both the line block and inverted L block.
True
Which is false regarding the proximal paravertebral thoracolumbar block?
a. Faster than line blocks
b. Injection side 3-5 cm from ventral midline
c. Done at the doral and ventral branches of T13, L1, L2 spinal nerves
d. There is a risk of penetrating great vessels
b. Injection side 3-5 cm from ventral midline
***dorsal midline
The distal paravertebral thoracolumbar is dorsal and ventral to transverse processes of ____, ____, and ____.
L1, L2 and L4
Which of the following is false regarding caudal epidurals?
a. S5-Co1 or Co1-Co2 spaces
b. commonly and easily performed
c. Use local anesthetics, alpha2 agonists, and benzodiazepiens
d. All the above are true
c. Use local anesthetics, alpha2 agonists, and benzodiazepiens
**morphine instead of benzo
Which epidural is good for immature cattle, small ruminants, camelids, and pigs in the L6-S1 space?
Lumbosacral epidural
All of the following are common canine pain behaviors except:
a. “praying position”
b. head tilt
c. guarding painful site
d. aggressive
e. all the above are common signs
e. all the above are common signs
All of the following are common feline pain behaviors except:
a. Missing the litter box
b. Squinting eyes and lowered ears
c. Head tilt
d. Decreased grooming or excessive licking of painful site
c. Head tilt
Which of the following is a common equine pain behavior?
a. low ears, angled eye with intense stare, flared nostrils and tense muzzle
b. increased appetite
c. increased interest in surroundings
d. All the above
a. low ears, angled eye with intense stare, flared nostrils and tense muzzle
Which of the following is not a typical ruminant pain behavior?
a. Bruxism (teeth grinding)
b. Eyeballs big and wide
c. Decrased milk production
d. Colic
e. Hypersalivation
d. Colic
True/False: Peripheral and central sensitizations are not prevented by general anesthesia.
True
Which of the following is false regarding pain scales?
a. Simple descriptive is very subjective and can’t detect small differences
b. Visual analog scale has high inter-observer variability
c. Max score in the short form is 20 for a ambulatory patient
d. Analgesics are recommended if score is greater than 6/24 or 5/20
c. Max score in the short form is 20 for a ambulatory patient
**20 if non-ambulatory and 24 if ambulatory
Which pain scale is a recommendation made to “reassess analgesic plan” at scores of 2-4 that are not evalutaed if an animal is sleeping?
Colorado state
Which of the following is matched incorrectly?
a. Wound soaker catheter: ear canal ablation
b. Brachial plexus block: thoracic limb distal to the elbow
c. Cervical paravertebral: entire limb including the shoulder and scapula
d. Sciatic and brachial block distal to the mid femur and done together
d. Sciatic and brachial block distal to the mid femur and done together
**Sciatic and femoral
Which of the following is matched correctly:
a. Mental: lower lip, +/- lingual
b. Inferior alveolar: rosral lower lip only
c. Maxillary: sensory of CN V
d. Retrobulbar: CN II, VI, X and cilliary ganglion
c. Maxillary: sensory of CN V
Which of the following is matched incorrectly?
a. Phenylephrine: alpha 1
b. Epinephrine: alpha, beta1 and beta 2
c. Dobutamine: beta 1
d. Dopamine: beta and alpha at moderate dose
d. Dopamine: beta and alpha at moderate dose
**high dose
Opiods affect what parts of the pain pathway?
Transduction
Modulation
Perception
NSAID’s affect what parts of the pain pathway?
Transduction
Modulation
Alpha 2 affects what part of the pain pathway?
Modulation
Perception
Which of the following is not correct regarding the ASA classe 1 procedures?
a. Canine spay: 2-3 doses pure mu post op and some NSAID 4-5 days post op
b. Feline spay: pure mu/ buprenorphine with premed
c. Feline catration: lidocaine post op with NSAID’s
d. Canine castration: NSAID’s only for 2-3 days post op with a testicular block
c. Feline catration: lidocaine post op with NSAID’s
**don’t need post op opioid if NSAID is given
What term is used to describe the summation of pain in the spinal cord by C-fibers contributing to central sensitization?
Wind up pain
____ allows lower doses of systemic anesthetics and analgesics during procedures and helps prevent central sensitization.
Pre-emptive
What is the MOA of local anesthetics?
Blocks Na+ gated channels in nerve fibers pregenting the propogation of action potentials
True/False: An induction dose of ketamine will provide adequate analgesia for any surgical procedure.
Fale
** does NOT provide adequate analgesia
Which NMDA antagonist is used ocassionally in conjunction with NSAID’s for chronic pain especially assocaited with osteoarthritis or cancer?
Amantadine
Which of the following is false regarding dental extractions?
a. If contraindication to NSAID’s atropine PO can be given
b. Tramadol is added with NSAID’s if pain is expected to be moderate-severe
c. Pure mu agonists with pre-med buprenorphine is adequate enough for cats
d. Local blocks are done with bupivacaine
a. If contraindication to NSAID’s atropine PO can be given
**tramadol
Which of the following definitions is not matched correctly?
a. Acute pain: disappears when stimulus is removed
b. Chronic pain: persists beyone the expected healing time
c. Visceral pain: poorly localized
d. Somatic pain: well localized and originates from internal organs
d. Somatic pain: well localized and originates from internal organs
**originates from damage to bone, joint, muscle, or skin
True/False: Myelinated fibers (Adelta) have slow transmission and sharp with a rapid onset and nonmyelinated (C fibers) have fast transmission and they’re chronic
False
**Myelinated - fast transmission, nonmyelinated - slow transmission
Which of the following definitions matches allodynia pain?
a. pain evoked by a stimulus that normally causes pain
b. pain evoked by a stimulus that causes an increased response
c. pain evoked by a stimulus that does not normally cause pain
d. none of the above
c. pain evoked by a stimulus that does not normally cause pain
What is hyperalgesia?
Increased/ exaggerated response to a stimulus that is normally painful
____ sensitization leads to primary and secondary to hyperalgesia and allodynia and ____ sensitization leads to primary hyperalgesia.
Central sensitization = both
Peripheral sensitization = primary hyperalgesia
Where does peripheral sensitization occur?
In the peripheral nerve terminals!!!
Which of the following is used ot prevent windup?
a. preemptive analgesia
b. multimodal analgesia
c. analgesia
d. none of the above
a. preemptive analgesia
Which of the following reduces pain by interrupting nociception at one or multiple levels?
a. preemptive analgesia
b. multimodal analgesia
c. analgesia
d. none of the above
c. analgesia
True/False: hot air, heating pads, heat device and hotdogs are all ok techniques used to warm up small animal patients.
False
**don’t use heating pads!
What nerves are affected in equine neuropathy?
Radial and facial nerve
Which breed do we want to be most concerned with upper airway obstruction?
Brachycephalics
Which of the following is true based on recovery from anesthesia?
a. Ruminants are smart and will stand when they’re ready
b. Rhabdomyolysis in equine can happen secondary to hyperperfusion
c. Hypermetabolic states will prolong the recovery in small animals
d. V/Q mismatch and hypoventilation are the most common ways equine get hypoxemia
a. Ruminants are smart and will stand when they’re ready
What do we do with airway obstruction in equine when theyr’e recovering?
Nasal tube + phenylephrine if nasal edema
In equine _____ and ____ are used for visceral pain and ____ is used for somatic pain
alpha 2 and Butorphanol are visceral
morphine is somatic
What is the main use of NMBD’s?
micro opathamic procedures
How can you reverse non-depolarizing NMBD’s?
Endrophonium/ Neostigmine with atropine or glycopyrrolate
What is the order of blockage of NMBD’s?
Face –> neck –> diaphragm –> distal limb –> proximal limb –> abdominal muscles –> intercostals
Which of the following is false regarding NSAIDs?
a. COX 2 selectivity is the best
b. don’t use if pediatric or pregnant
c. Cats only use Robenacoxib and Meloxicam
d. Phenylbutazone causes hemolytic anemia, cyanosis, fever and vomit in cats
d. Phenylbutazone causes hemolytic anemia, cyanosis, fever and vomit in cats
**Acetominophen
Which drugs do you want to give horses if they had gas anesthesia upon recovery?
Xylazine/ Romifidine
True/False: Free recovery is indicated in healthy horses that had a short surgery that was less than two hours.
True
True/False: Dogs are more likely to be hypotensive than cats.
False
** Other way around
Which drug is used as an emergency treatment for bradycardia secondary to vagal tone?
Atropine
True/False: Horses require ventilation upon recovery if not healthy with demand valve or nasal tube.
True
Which drug is slower than atropine and works for non emergency treatment of bradycardia?
Glycopyrrolate
Which is the 1st line of treatment for hypotension in cats?
Dopamine
Which is the drug of choice for CPR or anaphylactic shock and can also be used to treat V-fib?
Epinephrine
Which is the only drug used for equine anesthesia that incresaes inotropy but NOT chronotropy?
Dobutamine
Which of the following is not a complication assocaited with ruminant anesthesia?
a. Bloat
b. Regurgitation
c. Difficulty monitoring because palpebral reflex is not lost until in deep plane
d. None of the above
c. Difficulty monitoring because palpebral reflex is not lost until in deep plane
Which of the following is true about NMBD’s?
a. Paralysis of striated muscles
b. Work at the spinal cord
c. Provide analgesia
d. Causes unconsciousness
a. Paralysis of striated muscles
Which local block is used for a subpalpebral lavage?
Supraorbital
Which is not an indication for giving a blood transfusion?
a. provide volume
b. provide hemoglobin
c. provide coagulation factors
d. provide electrolytes
d. provide electrolytes
Which compartment has the most water?
a. ICF
b. Interstitium
c. ECF
d. Vascualture
a. ICF
If you have an animal that has asystole on ECG and you confrim with a stethoscope. Which drug is the single best choice?
Epinephrine
Which of the following is true about NMDA antagonists?
a. Ketamine can be used as an adjunct analgesic CRI
b. Ketamine can be used to provide adequate analgesia for light surgical procedures
c. Amantadine can’t be used with NSAID’s
d. all the above are true
a. Ketamine can be used as an adjunct analgesic CRI
Which of the following is a consequence of unmanaged pain?
a. Ileus
b. Bradycardia
c. Decreased cardiac work load
d. Blindness
a. Ileus
Which of the following is seen with capture myopathy?
a. Hypokalemia
b. Hyperkalemia
c. Hypercalcemia
d. Hypocalcemia
b. Hyperkalemia
Which drug should be avoided in hyperthyroid cats?
Ketamine
