Final

Question 1

Most common MOI in polytrauma dogs? Most common cause?

Answer 1

Blunt trauma; motor vehicle accidents

Question 2

With high velocity penetrating wounds, you should be concerned about which type of damage?

Answer 2

solid organ damage

Question 3

Most frequently injured:

1) skeletal structure
2) abdominal organ

Answer 3

1) pelvis

2) liver

Question 4

Name 3 common thoracic injuries

Answer 4

1) pulmonary contusions
2) pneumothorax
3) fractured ribs

Question 5

Shock in trauma patients should be considered to be due to ________ (unless proven otherwise)

Answer 5

hypovolemia

Question 6

What are the components of the lethal triad?

Answer 6

Acidosis
Hypothermia
Coagulopathy

Question 7

Describe the theory of “permissive hypotension” as it relates to hypotensive resuscitation

Answer 7

Goal is maintain just enough perfusion to prevent re-bleeding (SBP: 80-90, MAP: 40-60) until hemorrhage is able to be controlled

*Limiting out use of isotonic crystalloids to replace volume loss because they increase blood loss and worsen hypotension

Question 8

In what instance is permissive hypotension NOT indicated

Answer 8

severe head injury with hypovolemic shock

*need to maintain CPP (requires adequate MAP)

Question 9

In critical patients, it’s best to select drugs which are ______ and ______

Answer 9

short-acting and reversible

Question 10

What are the 3 categories of drugs used for pre-anesthesia

Answer 10

1) Anticholingerics
2) Neuroleptics (Benzo, Alpha-2, & Phenothiazine)
3) Opioids

Question 11

Give two advantages of using a pre-anesthetic agent

Answer 11

1) marked decreased in amount of induction agent needed

2) significant decrease in MAC of inhalants

Question 12

Neuroleptanalgesia combines the drug effects of which two types of drugs?

Answer 12

Neuroleptic + opioid

Question 13

Reversal agent for:

1) Benzodiazepines
2) Alpha-2 agonists

Answer 13

1) Flumazenil

2) Atipamezol

Question 14

Name the 3 classes of drugs included under Neuroleptics and 1-2 drugs in each class

Answer 14

1) Benzodiazepines (Diazepam, Midazolam)
2) Alpha-2 agonists (Dexmedetomidine & Medetomidine)
3) Phenothiazines (Ace)

Question 15

The biggest downside of benzodiazepines is their lack of?

Answer 15

intrinsic analgesic properties

Question 16

Alpha-2 agonists have limited usefulness for critically ill patients because……

Answer 16

can cause profound CV changes

Question 17

T/F: Acepromize is an excellent, safe choice for critically ill patients

Answer 17

FALSE

• Should be AVOIDED–>hypotension
• Also no analgesia & no reversal

Question 18

What are the 3 categories of opioids and name a drug from each

Answer 18

1) pure mu-agonists (fentanyl)
2) partial agonists (buprenorphine)
3) agonist-antagonist (butorphanol)

Question 19

Which type of opioid is a good choice for a cat?

Answer 19

partial agonist (i.e. buprenorphine)

Question 20

Which opioid is inadeqaute for use with intense pain and why?

Answer 20

Butorphanol–Ceiling effect!!

Question 21

Ketamine should be avoided or used with caution in patients with what types of problems (3)

Answer 21

1) cardiac disease
2) renal disease
3) liver disease

*still okay for blocked cats!!

Question 22

Which induction agent shouldn’t be used if your patient has sepsis?

Answer 22

Etomidate

Question 23

T/F: ALL inhalant anesthetics produce some degree of Cv & resp depression; however, the effects are related to dose

Answer 23

TRUE

Question 24

Concerning local anesthetic agents:

1) which one shouldn’t be used in cats due to CNS toxicity
2) which can NEVER be given IV (why?)

Answer 24

1) Lidocaine

2) Bupivacaine (cardiotoxic)

Question 25

Primary method used by dogs to dissipate heat?

Answer 25

Evaporation

Question 26

In order to prevent heat-related injury, dogs need time to acclimize to which to important factors?

Answer 26

1) the hot/humid environment
2) strenuous work/exercise
* minimum for 14days

Question 27

Our biggest electrolyte concern in obstructed cats?

Answer 27

Hyperkalemia

*Ca gluconate protects heart!

Question 28

If a patient is sedated but you still are unable to pass a catheter due to high urethral tone, what might be a good next step?

Answer 28

coccygeal epidural block

Question 29

most common cause for an elevated blood lactate?

Answer 29

decreased perfusion

Question 30

Which component of BP is most important for maintaining perfusion?

Answer 30

MAP

Question 31

The two components that make up BP (multiply them together)

Answer 31

1) CO (preload, afterload, contractility)

2) SVR (vessel tone, blood viscosity)

Question 32

Which artery is most commonly used for measuring arterial BP

Answer 32

dorsopedal

Question 33

Name the 3 MAIN causes of hypotension

Answer 33

1) decreased preload
2) decreased cardiac function
3) decreased SVR

Question 34

Which cause of hypotension will NOT respond to fluid therapy (may make it worse)

Answer 34

primary cardiogenic (DCM, HCM)

Question 35

If hypotension in your patient is persisting depsite fluid therapy, what class of drug should you reach for first/?

Answer 35

Beta-agonist (Dobutamine, Dopamine)

Question 36

4 common causes for HYPERtension

Answer 36

1) CKD
2) DM
3) Hyperthryoidism
4) HAC

Question 37

Gold standard for measuring oxygenation?

Answer 37

arterial blood gas (PaO2)

Question 38

Most common cause of hypoxemia?

Answer 38

Ventilation-perfusion mismatch (V/Q mismatch)

Question 39

Which cause of hypoxemia will NOT respond to O2 therapy?

Answer 39

Shunt

Question 40

Which parameters are used to assess:

1) oxygenation
2) ventilation

Answer 40

1) PaO2, SpO2

2) PaCO2, ETCO2

Question 41

The life-threatening abnormality assoc. with GDV

Answer 41

SHOCK

Question 42

Which component of septic peritonitis tx needs to be implemented ASAP

Answer 42

antimicrobial therapy

Question 43

T/F: If the patient’s BP is normal, you don’t have to worry about perfusion deficits

Answer 43

FALSE–perfusion can be decreased even with normal BP

Question 44

Cardiac arrythmias in critically ill patients need to be addressed if… (2 things)

Answer 44

1) they are impacting perfusion

2) are malignant

Question 45

When assessing renal function/urine output; what is normal urine output rate?

Answer 45

1-2 ml/kg/hr