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Final Exam Flashcards

1
Q
A

Reptiles

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2
Q

CRI that is used in Equine Acute Abdominal Distress that Increases Heart Contractility

A

Dobutamine

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3
Q

Patients with _____ get increased Drug penetration into the CNS because the BBB becomes more Permeable

A

Azotemia

*Need to Decrease our Drug dosages in patients with Azotemia because more drug will cross the BBB into the CNS

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4
Q

In Patients with Renal Disease, we want to Maintain MAP > ____mmHg

A

80

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5
Q

Maintenance drugs used in Avian Patients

A

Isoflurane or Sevoflurane

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6
Q

In Patients with Renal Disease, during Anesthesia we want to AVOID ______

A

STRESS

*Minimize stress to Avoid Catecholamine Release

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7
Q

Concept when the Half Life of your Agonist Drug is Longer than that of the Antagonist (Reversal) Drug, where the animal will Recover but then become Sedate/Anesthetized again once Reversal Agent wears off

A

Renarcotization

*Try to have your Reversal Agent have a Similar or Longer Duration of Action compared to Anesthetic Drug

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8
Q

Local Anesthesia Technique that is commonly used in Conjunction with General Anesthesia on Pregnant Animals

A

Lumbosacral Epidural

*Epidural Blood Volume is decreased by 1/3rd in Pregnant Patients

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9
Q

____ Complete Cycles of Inspiration and Expiration are needed to exchange Inhaled gas in Birds

A

Two

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10
Q

12 Year Old Warmblood Mare, 695 kg

History: Rolling in Stall, Watching Flank

Presenting Complaint: Colic

Physical Exam: Tachycardia, Dehydration, Abdominal Pain

What Preansthetic Medication should be used?

A

Xylazine

*Alpha 2 Agonists must be used in these Cases!!

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11
Q

In Patients with Diabetes Mellitus, Severe Hypoglycemia can lead to ____ that is not apparent until after Anesthesia

A

Brain Damage

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12
Q

Inspiration and Expiration are BOTH ACTIVE processes in which Species?

A

Reptiles

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13
Q

Review of this Chart:

On Gas Anesthesia, The Cerebral Blood Flow increases even Higher in Response to Increased PaCO2. You’re not going to need as High of Levels of PaCO2 to Increase Cerebral Bloow Flow

Even with Normal Ventilation PaCO2 (40mmHg), Cerebral Blood Flow is going to Increase Significantly under Inhalant

We are going to Midly Hyperventilate patients with CNS Disease under Inhalant Anesthesia, because with Inhalants normal Levels of CO2 will still Increase Intracranial Pressure

A
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14
Q

For Anesthetic Managment in Patients with Diabetes Mellitus your goal is to Prevent ______ at all times, prevent Prolonged Hyperglycemia and Maintain a Normal Fluid and Electrolyte Balance

A

Hypoglycemia

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15
Q

Crocodiles have _______ (Dive Response) where Blood Bypasses the Lungs

A

Right-Left Shunting

*How do you get them to sleep if Inhalants will Bypass the Lungs? We don’t use Inhalants exclusively in Crocodiles because if they shunt they will wake up

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16
Q

Preanesthetic Medication used on this Patient

A

Morphine

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17
Q

In Patients with Insulinomas, prior to Surgery they have MInimal Fasting (4-6 Hours) and the goal is to maintain a Blood Glucose above ____ mg/dL during Surgery

A

40

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18
Q

In Pregnant Patients under Anesthesia the Cardiac Ouput _____ by 30-50%

A

Increases

*Cardiac Output increases to meet the Oxygen Demands of the Fetus

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19
Q

Three Antagonists used to reverse the High Potency Opioids

A

Naltrexone (Preferred)

Naloxone

Diprenorphine- Etorphine Reversal

*Naltrexone has a long duration of action and prevents lRenarcotization

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20
Q

Reptiles Rely on External or Environmental Heat Sources for Thermoregulation. It is Crucial to maintain each species at Optimum Preferred Temperature between _____

A

25-35 Degrees Celsius

(77-95 Degrees Farenheit)

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21
Q

During Anesthesia in Hyperthyroid Patients, _____ are used to Slow Heart Rate and Decrease Myocardial Oxygen Consumption

A

Opioids

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22
Q

_____ Lung is Vestigial in Snakes

A

Left

*Vestigial- degenerate, rudimentary, or atrophied, having become functionless in the course of evolution.

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23
Q

If a Wildlife patient receives a Dart Injury, such as a Hematoma, the wound should be clipped, scrubbed, and flushed and long-term _____ administered

A

Antibiotic (Ex. Penicillin)

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24
Q

Best Preanesthetic Medication for Patients with CNS Disease

A

Benzodiazepenes + Opioids

*Anticonvulsant Activity and Minimal Cardiovascular effects

Wait to give Opioids until Ventilation is Controlled!! Opioids lead to Hypoventilation and Increased PaCO2 that can Increase Intracranial Pressure- Wait to give Opioids until the patient is on a Ventilator

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25
Q

True/False: In Patients with Diabetes Insipidus, prior to Anesthesia, Oral Water should be Withheld

A

False

*DO NOT Withold Water from patients with Diabetes Insipidus

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26
Q

The Goals of Anesthesia in patients with CNS Disease is to Keep Inhalant Low, and Avoid _____ and ______

A

Hypoxemia

Hypercapnia

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27
Q

Two Drugs that should not be used in Anesthesia in Patients with Endocrine Disease

A

Etomidate

Alpha 2 Agonists

*Patients with Endocrine Disease have Decreased Stress Response - We want to Avoid Drugs that Block the Stress Response Completely such as Etomidate and Alpha 2 Agonists

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28
Q

Electrolyte Abnormalities common in patients with Addisons Disease

A

Hyperkalemia

Hyponatremia

*Check for Electrolyte Abnormalities

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29
Q

Best Induction agent in patients with Renal Disease

A

Propofol or Etomidate

*Never Box or Mask patients with Renal disease because it is too Stressful

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30
Q

In Patients with Liver Disease you want to check your ______ Profile prior to Surgery (PT, PTT)

A

Coagulation

*Patients with Liver Disease that go into surgery with Abnormal Coagulation Factors have the Potential for Thromboembolic Complications

*Picture- Laboratory Findings in someone with Liver Disease- Monitor Hydration, Blood Glucose, and Plasma Protein Concentrations

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31
Q

Stabilization Plan for Equine Acute Abdominal Distress

A

FLUIDS

*Hypertonic Saline with a Lot of Balanced Electrolyte Solution (LRS)- 25-35 Liters of LRS

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32
Q

CO2 Diffuses ____ Times More Rapidly than Oxygen

A

20x’s

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33
Q

Endocrine Disease characterized as Insulin Deficiency

A

Diabetes Mellitus

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34
Q

Treatment for Hypoxemia

A

Resolve any Airway Obstruction

Position in Sternal

PEEP

Consider Bronchodilator, especially in Large Animals

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35
Q

In Patients with Diabetes Insipidus you want to Monitor Serum ____ Concentrations and keep below 160 mEq/L

A

Sodium

*If Patient is Hypernatremic, the Correction not be made too Rapidly, but rather should be make over 72 Hours

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36
Q

Condition resulting from Blood Entering Arterial System without going through Ventilated Area of Lung that can result in Hypoxemia

A

Right-Left Shunt

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37
Q

Pregnancy, due to Progesterone, _____ the Dose Requirement of Local Anesthetics

A

Decreases

*Pregnant Patients are more sensitive to Local Anesthetics

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38
Q

True/False: ALL Anesthetics are likely to affect Renal Blood Flow

A

True

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39
Q

Best Maintenance for Patients with Liver Disease

A

Isoflurane

*AVOID Halothane because it decreases Hepatic Blood Flow and is 20% metabolized by the Liver

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40
Q

Anesthetic Managment plan in a Patient with Diabetes Mellitus that has been Fasted Overnight and has a Blood Glucose < 99 mg/dL

A

No Insulin and Start 2.5% Dextrose Infusion

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41
Q

Best Premedication in Patients with Cardiac Disease

A

Just Opioid or Opiod with a Benzodiazapine

*DO NOT use Alpha 2 Agonists in Patients with Cardiac Disease

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42
Q

What is the Cushings Triad seen in Patients with CNS Disease under Anesthesia

A

Increased Arterial Blood Pressure

Irregular Breathing

Bradycardia (Reflex)

*What Drug would you want to avoid that may cause Cushings Response in CNS Patients going to Anesthesia? Dexmetatomadine (Alpha 2 Agonist)

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43
Q

No IV access before Induction

How will we Induce this Patient?

A

Mask Administration with Sevoflurane or Isoflurane

*Then use Uncuffed Endotracheal Tube

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44
Q

True/False: NSAIDs are NOT recommended for use during Pregnancy

A

True

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45
Q

_____ have a Three Chambered Heart that Functions as a Five Chamber Heart, leading to Mixing of Oxygenated and Deoxygenated Blood

A

Reptiles

*Lizard, Snake and Turtles

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46
Q

Review of this Chart:

In a normal animal, Cerebral Blood Flow will be normal between 60-140 MAP. If the MAP is above or below that Interval there will not be Normal Cerebral Blood Flow

The Cerebral Blood Flow begins to Increase when the PaO2 Drops below 50- Flow will Increase to try to get more Oxygenation to Tissues

PaCO2 has a Linear Relationship with Cerebral Blood Flow (CBF). As PaCO2 Increases, so does Cerebral Blood Flow

A
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47
Q

How would you Handle this Patient?

A

Bunny Burrito

*Helps to Avoid Kicking and Fractures

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48
Q

Treatment Indicated for Patients in Chronic Pain where Increased Temperature leads to Vasodilation and Increased Blood Flow that helps with Connective Tissue extensibility and Muscle Relaxation

A

Thermotherapy

*Contraindicated during Acute Inflammation

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49
Q

In Patients with Mitral Valve Insufficiency, Preoperative Preparation is aimed at Reducing the Regurgitant Fraction and Controlling ______

A

Pulmonary Edema

*Low Sodium Diets are Important

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50
Q

Case: 7 Year Old Male Canine Great Date 45kg

History: Non Productive Retching, Drooling, Abdominal Distention when owner came home from work

Physical Exam: HR= 160 bpm, RR= Panting, T= 99.3

CRT= 3 Seconds, mm = Pale Pink, Poor Pulses

What Induction Agent would you use in this Patient?

A

Propofol

*Small Dose just to get the patient Intubated

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51
Q

Best Sedatives to use in Geriatric Patients

A

Benzodiazepines

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52
Q

Preferred Place on Patients body to hit with a Dart

A

Large Muscles on Hindlimb

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53
Q

12 Year Old Warmblood Mare, 695 kg

History: Rolling in Stall, Watching Flank

Presenting Complaint: Colic

Physical Exam: Tachycardia, Dehydration, Abdominal Pain

What Drugs are used for Induction?

A

5% GG + Ketamine

*Do Not Titrate Induction agent in large animals, push all the drug at once

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54
Q

True/False: Anticholinergics are recommeneded for Routine Premedication in Geriatric Patients

A

False

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55
Q

Expect a _____ Mean Arterial Blood Pressure in Neonates under Anesthesia

A

Lower

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56
Q

______ are generally NOT recommended for Anesthesia in Pregnant Small Animals

A

Sedatives

(Ex. Acepromazine, Benzodiazepines or Alpha 2 Agonists). Most Sedatives will lead to Fetal Depression

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57
Q

Patients with Gastric DIlation-Volvulus should be Maintained with ___ Levels of Inhalant

A

Low

*Sicker the Patient the less Inhalant you need

*Add CRI to Keep Inhalant Low- Fentanyl or Morphine CRI

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58
Q

True/False: Reptiles commonly have Prolonged Recovery

A

True

*Want to use short acting and reversible drugs to help decrease the time of Recovery. Turn off Inhalant 15 Minutes before Procedure ends

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59
Q

Avians and Reptiles do NOT have _____, where both Inspiration and Expiration are Active

A

Diaphrams

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60
Q

How will we Preoxygenate Patients with Gastric Dilation Volvulus?

A

Face Mask

*Well Fitted with High Oxygen Flow Rate for 3-5 Minutes

*Must Preoxygenate all the way through to Intubation- Do NOT stop Preoxygenation during Induction

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61
Q

True/False: Opioids are a good choice for Analgesia in Geriatric Patients

A

True

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62
Q

True/False: A Failing Heart May Not tolerate an Increased Fluid Load due to a Change in the Frank Starling Curve

A

True

*Increased Preload Does NOT Equal Increased Cardiac Output in Patients with a Failing Heart

*Increasing Pre-Load in a Failing Heart can lead to Congestion

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63
Q

Two Distinct Functional Compartments of the Avian Respiratory System

A

1. Ventilation- Trachea and Air Sacs

2. Gas Exchange- Parabronchial Lung (Nonexpandable)

*Trachea- Forms complete Cartilagenous Rings_- Do not use Cuffed Tubes in Birds_

*Airsacs Everywhere- be very Careful with Restraint!!!

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64
Q

True/False: Neonates have a Higher Daily Fluid Requirement and are more tolerant to Fluid Overload

A

False

*Less Tolerant to Fluid Overload

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65
Q

Which High Potency Opioid Antagonist has Opioid Agonist Properties as well?

A

Diprenorphine

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66
Q

Which of the Following can Perform Physical Rehabilitation:

A. Licensed Veterinarian

B. Certified Veterinary Technician Trained in Physical Rehab

C. Licensed Physical Therapist educated in Veterinary Antaomy

A

All of the Above

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67
Q

What Pre-anesthetic Medication can be used?

A

Sedative + Opioid (Ex. Midazolam + Butorphanol)

*Rabbits Sedate really well with Midazolam.

Give Prior to Removal from own Cage

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68
Q

In Patients with Addisons Disease, Exogenous ____ Therapy is Required to Prevent Adrenal Crisis and Circulatory Collapse

A

Glucocorticoid

*Most commonly Dexamethasone

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69
Q

What Fluid Therapy should be used in this Patient?

A

Balance Electrolyte Solution (LRS)

10-20 mL/kg/h IV

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70
Q

True/False: Birds Loose Heat Fast under General Anesthesia and a Forced Air Warmer must be used

A

True

*Core Temperature is best measured by an Esophageal Probe

*Monitor Temperature Carefully in Birds- Gain and Loose Heat very quickly. Caution to Prevent Overheating- Birds can NOT dissociate Heat through their skin

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71
Q

NSAID that can be given for Analgesia post Delivery in Pregnant Canine Patients, but should be AVOIDED in cats

A

Acetaminophen

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72
Q

High PaCO2 (> 40mmHg) that will Result in Hypoxemia if Breathing Room Air

A

Hypoventilation

*Generally will not result in Hypoxemia if breathing 100% O2- For the Most part under Anesthesia, Hypoventilation is not a cause of Hypoxemia

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73
Q

Which Species can be Ventilated during Anesthesia by Extension and Flexion of the Hind Legs

A

Chelonians (Turtles)

*IPPV in Chelonians- Leg Extension and Flexion

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74
Q

Treatment that helps with the Acute Inflammatory phase that reduces Inflammation, Edema and Pain by using Cold Therapy, such as Crused Ice, Frozen Peas or Cold Immersion Baths

A

Cryotherapy

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75
Q

______ Regulation is Important in Small Mammals because they have an Increased Surface Area to Body Weight Ratio

A

Temperature

*Small Mammals can be Cooled down rapidly but also Heated up Rapidly

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76
Q

Ferrets have a Deficient Glucuronidation Pathway, therefore Caution is taken when Administering _____ because it can cause Toxicity

A

NSAIDs

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77
Q

Application of High Energy, High Amplitude Acoustic Pressure Waves to Tissue that stimulates Healing

A

Extracorporeal Shock Wave Therapy

*Can be Uncomfortable and makes a loud noise so heavy Sedation or Anesthesia is required

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78
Q

Best Drug for Induction in a Cat with Hypertrophic Cardiomyopathy

A

Etomidate

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79
Q

In _____ Patients Following Anesthesia, Slow Recovery with Hypothermia can occur, you should provide Active Warming Sources

A

Hypothyroid

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80
Q

As PaCO2 Increases, Cerebral Blood Flow (CBF)______ and Intracranial Pressure _______

A

Increases

*PaCO2 and CBF have a Linear Relationship- as CO2 Increases, the Cerebral Blood Flow increases. If the tissue senses high levels of CO2 the vessels will Vasodilate to increase perfusion and try to get the extra CO2 out of there

*The More CO2, the more Cerebral Blood Flow, The More Intracranial Pressure- BAD. We want to keep the CO2 LOW

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81
Q

Three Drug Delivery Methods used in Wildlife

A

Pole Syringe (3-4 Meters)

Blowgun (15 Meters)

Dart Projectors (up to 50 Meters)

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82
Q

Case: 7 Year Old Male Canine Great Date 45kg

History: Non Productive Retching, Drooling, Abdominal Distention when owner came home from work

Physical Exam: HR= 160 bpm, RR= Panting, T= 99.3

CRT= 3 Seconds, mm = Pale Pink, Poor Pulses

What Maintenance would you use in this Patient?

A

Isoflurane in 100% O2

*Only about 0.5-1%

*Keep Inhalant Low- CRIs of Fentanyl and Lidocaine Help

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83
Q

In a Canine Patient with Gastric Dilation Volvulus, what is our Fluid Plan?

A

Shock Rate Dose (LRS) at 90mL/kg

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84
Q

Hearing an S4 Gallop Rythym in a Cat is a sign of _____

A

Hypertrophic Cardiomyopathy

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85
Q

Preferred Induction Agent in many Small Reptiles

A

Propofol

*Tail Vessels often used

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86
Q

______ Patients have:

Decreased MAC

Decreased Muscle Mass

Decreased Plasma Volume

Decreased Metabolic Rate

A

Geriatric

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87
Q

Pregnancy _____ MAC during Anesthesia and Pregnant Patients have an Increased Sensitivity to Local Anesthetics

A

Decreases

*Pregnancy Decreases MAC- KNOW THIS

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88
Q

Daily Fluid Maintenance used in Avian Species

A

40-60 mL/kg/day

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89
Q

Premedication Recommended in Small Mammals

A

Sedative + Opioid

*Administer Preanesthetic Medication BEFORE Removal from Home Cage or Pen- Small Animals are more comfortable in thier Pens

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90
Q

In what Two Species is Inspiration and Expiration BOTH Active Processes

A

Reptiles

Birds

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91
Q

Case: 7 Year Old Male Canine Great Date 45kg

History: Non Productive Retching, Drooling, Abdominal Distention when owner came home from work

Physical Exam: HR= 160 bpm, RR= Panting, T= 99.3

CRT= 3 Seconds, mm = Pale Pink, Poor Pulses

What Fluid Therapy should be Given to this Patient?

A

90mL/kg Bolus (Shock Dose)

*Gastric Dilation-Volvulus

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92
Q

Foals may be Induced with Iso/Sevo via _____

A

Nasotracheal Tube

*Smooth Induction and Minimal Environmental Contamination

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93
Q
A

Hyperkalemia

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94
Q

Injectable Premedications used as Sedatives in Reptiles

A

Alpha 2 Agonists

Benzodiazepines

*Reversibility is a Benefit

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95
Q

Best Drug used for Maintenance in a Patient with Renal Disease

A

Isoflurane

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96
Q

True/False: When Using Acupuncture as an Adjunct Treatment, Western Diagnosis and Medicine is a MUST

A

True

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97
Q

Range of Motion in Joints in Flexion and Extension are Measured using a _____ during Physical Rehabilitation

A

Goniometer

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98
Q

Anesthetic Managment plan in a Patient with Diabetes Mellitus that has been Fasted Overnight and has a Blood Glucose 100-200 mg/dL

A

1/4 Usual Insulin Dose and Begin 2.5% Dextrose Infusion

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99
Q

In Patients with a ______,

Increased Ventilation will Decrease PaCO2 Linearly

BUT Increased Ventilation only MINIMALLY Increases O2

A

V/Q Mismatch

*CO2 diffuses much more Rapidly than O2

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100
Q

Normal Fluid Therapy Volume used in Patients with CNS Disease

A

3-5 mL/kg/h

*Don’t want to give too high of a volume, because that will Increase Intracranial Pressure

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101
Q

Goals of _____:

Improve Muscle Strength and Reduce Atrophy

Increase Rate of TIssue Healing

Remodeling of Scar Tissue

Decrease Pain, swelling, and Muscle Spasm

A

Physical Rehabilitation

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102
Q

Best Preanesthetic Medication in patients with Renal Disease

A

Opioid + Benzodiazepine

*Avoid- Acepromazine because these patients cannot tolerate Hypotension

*Avoid Alpha 2 Agonists because Decreased Renal Perfusion

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103
Q

In Neonates a _____ is commonly given with Premedication because Neonates are dependent on Heart Rate for Cardiac Output

A

Anticholinergics

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104
Q

Delivery of an Electrical Current to the skin by Surface Electrodes placed over the Painful Region that provides analgesia by activating non-noxious large myelinated Nerve Fibers

A

Transcutaneous Electrical Nerve Stimulation (TENS)

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105
Q

True/False: Avoid Needling Tumors, Infected Skin and Wounds during Acupuncture

A

True

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106
Q

How would we Induce this Patient?

A

Isoflurane by Mask

*Than Place uncuffed ETT

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107
Q

Anesthetic concerns in patients with Gastric Dilation-Volvulus include Cardiac ______

A

Arrhythmias

*Ventricular Premature Contractions are the most common

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108
Q

True/False: V/Q varies throughout Different Areas of the Lung

A

True

*V/Q is NOT the same in all parts of the Lung. Overall it decreases from the Top to the Bottom of the Lung

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109
Q

Best Induction Agents in Patients with Cardiac Disease

A

Etomidate + Diazepam

_*_Start with Lower than Normal dose Initially and give it at a Slower Rate

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110
Q

Two Dissociative Anesthetics that are commonly used in Zoo and Wildlife Animals for Induction

A

Ketamine

Tiletamine

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111
Q

______ Needles are commonly placed in Reptiles (Except Snakes) for administration of Drugs and Fluids

A

Intraosseous

*Humerus, Femur or Tibia

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112
Q

Sedatives Recommended for Neonates

A

Benzodiazepines (Midazolam)

*Avoid Alpha 2 Agonists and Phenothiazines- Significant Cardiovascular effects

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113
Q

True/False: MAC is Higher during Pregnancy

A

False

*MAC is Lower during Pregnancy

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114
Q

Reflex that is a Mechanism to Match V/Q, that is Decreased by Anesthetic Drugs, especially Inhalants

A

Hypoxic Pulmonary Vasoconstriction

*I_n cases of Alveolar Hypoxia, this reflex leads to Vasoconstriction of Small Pulmonary Arteries. However, Under anesthesia this Reflex is Decreased leading to V/Q Mismatching_

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115
Q

Drugs used during Anesthesia to Increase Heart Contractility in Patients with Dilated Cardiomyopathy

A

Dopamine or Dobutamine

*Patients may benefit from Increased Heart Rate in order to Maintain Cardiac Output

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116
Q

Anticholinergic that May be Added into Rabbit Premedication because Rabbits have an Inherently High Heart Rate

A

Glycopyrrolate

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117
Q

In Patients with Hyperthyroid, we should treat with _____ for 6-12 weeks to Reduce total Thyroxine to reference Range before Thyroidectomy, which Significantly reduces Perioperative Mortality

A

Methimazole

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118
Q

True/False: We want to AVOID Elevated Intracranial Pressure (ICP) in Patients with CNS Disease

A

True

*We want to avoid anything that is going to occulude the Neck- No Neck Leashes or Jugular Catheters in Patients with CNS Disease

119
Q

What should be done for Induction

A

Mask with Isoflurane then Intubate with Nasotracheal Tube

*Always use a Capnograph to help us during Intubation

120
Q

_____ Patients have these Pathologies:

Limited Ability to Increase Heart Rate

Decreased Atrial/Myocardial Compliance

Decreased Function of Lungs

Decreased Thoracic Compliance

Decreased Liver/Renal Mass

A

Geriatric

*Decreased Liver and Renal Mass- Decreased Drug Clearance and Decreased GFR = Prolonged Duration of Action of the Drugs

121
Q

In Patients with Mitral Valve Insufficiency we can produce Mild Reductions in SVR and Promote Forward Flow by using Low-Dose ______ Plus and Opioid

A

Acepromazine

*Can be used to Reduce Regrugitation in Patients with Mitral Valve Insufficiency

122
Q

Ideally for an Elective Procedure, Stabilize a Hypothyroid Patient with _____ for 1-2 Weeks prior to Surgery

123
Q

If _____ is Present the Patient should NOT be Anesthetized unless the Condition requiring Therapy/Surgery is Life Threatening

A

Pulmonary Edema

*You want to Postpone Anesthesia in this Patient or else Complications can Arise

124
Q

Do NOT Fast Avian Patients that are

A

200

*Fast Birds that are > 200g for 2-4 Hours prior to Anethesia to avoid Regurgitation

125
Q

Common Vein used for IV Access in Snakes and Turtles

A

Jugular Vein

*In Turtles can also use: Dorsal Coccygeal Vein

126
Q

Best Induction agents used in Neonates

A

Propofol or Alphaxalone

127
Q

Reptiles can Tolerate Severe _____ and ______

A

Hypoxemia

Hypothermia

128
Q

Maintenance used in Neonates

A

Sevoflurane or Isoflurane

129
Q

Review Diagram on V/Q

A

Normal Alveolus- V/Q of 0.8

Shunt- V/Q = 0 (Perfusion without Ventilation)

Dead Space- V/Q = Infinity (Ventilation without Perfusion)

130
Q

Single Wavelength Light that leads to Photochemical Reaction in the Cells that is useful for managing Chronic and Minor Pain

A

Low Level Laser Therapy

*Protective Eye gear must be worn

131
Q

2 Regions of the Lungs in Reptiles

A

Vascular Lung- Gas Exchange

Air Sac- Regulates Air Flow

*Air Sacs are not Involved in Gas Exchange

132
Q

Induction agents used in Pregnant Large Animals

A

Ketamine + Benzodiazepine

133
Q

Which Premedications should not be used in small animal patients with CNS Disease because it looks similar to Cushings Response?

A

Alpha 2 Agonists (Dexmetatomadine)

*Alpha 2 Agonists are still used as a premedication in Large Animals with CNS Disease

134
Q

In Patients with Equine Acute Abdominal Distress we use all the monitoring equipment we have available, include Arterial Blood Pressure. What is the MAP in Equines?

A

MAP > 70mmHg

135
Q

Pressure Maintained in Airway to Prevent Alveolar Collapse

A

Peep

*Positive End-Expiratory Pressure

136
Q

What Fluid Type should be Avoided in Reptiles

A

Lactated Ringers

*Potential Prolonged Half-Life of Lactate in Reptiles

*Best to use Normosol R in Reptiles

137
Q

Three High Potency Opioids that are used for Wildlife

A

Etorphine

Thiafentanil

Carfentanil- Most Potent (8,000x Morphine)

*Commonly used for Large Mammals- Elephants, Rhinos ect.

138
Q

Which Sedatives are Routinely Used in Pregnant Large Animals (Ex. Mares)

A

Alpha-2 Agonists (Detomidine or Xylazine)

139
Q

Compared to Mammals, which Species has:

140
Q

What kind of Breathing System will you use?

A

Nonrebreathing System

*Patient

141
Q

5 Causes of Hypoxemia

A

Hypoventilation

Anatomic R to L Shunt

Low Inspired O2 (FiO2)

Diffusion Impairment

Ventilation-Perfusion (V/Q) Mismatch

142
Q

Horse _____ is a True Emergency, because Foals normally do not survive past 90 Minutes after Membrane Rupture

143
Q

True/False: Rabbits and Rodents Vomit

A

False

*Rabbits and Rodents DO NOT Vomit- Food and Water Not Witheld

144
Q

Preanesthetic Medications used in in Avian Patients

A

Midazolam + Butorphanol (Sedative + Opioid)

*Birds Sedate very well with Midazolam

*Avoid Alpha 2 Agonists in Avian Patients- Decreases Heart Rate by 50% and causes severe Bradycardia

145
Q

Three Anesthetic Concerns with Equine Acute Abdominal Distress

A

Decreased Ventilation

Decreased Cardiovascular Function

Metabolic Acidosis

146
Q

Two ways to Assess Oxygenation Ability

A

Alveolar-Arterial O2 Gradient

PaO2:FiO2

147
Q

The Kidneys recieve 25% of total Cardiac Output. Renal Blood Flow is Autoregulated within a Mean Arterial Pressure (MAP) Range of _______mmHg

A

80-180mmHg

*Any patient with Renal Disease needs a MAP of at least 80mmHg

148
Q

Most Reliable Vein for IV access in Lizards

A

VENTRAL Coccygeal Vein

149
Q
A

E. Atrial Standstill and Junctional Rhythm

*Cannot be Sinus Bradycardia because there are NO P Waves

*If there are No P Waves = Atrial Standstill. Ventricle Contracts on its own- Junctional Rhythym

150
Q

In order to Prevent ______ in Wildlife:

Limit Chase to 2 Minutes

Wait 1 Day between Failed Attempts

Limit Stress after Capture

No handling or Stress for 6 weeks Post Capture

A

Capture Myopathy

151
Q

True/False: In Patients with Renal Disease, we want to Correct Hydration Status Prior to Anesthesia episode and Maintain immediately Post

152
Q

Drugs that Have _____ Respiratory Depression:

Benzodiazepines

Phenothiazines

Opioids

153
Q

True/False: Hyperthermia and Hypothermia can be Life-threatening in Wildlife Anesthesia and Capture should be based on weather, time of day and season

154
Q

The ____ Rate of a Gas is Proportional to:

Tissue Area

Partial Pressure Difference

Solubility of Gas in the Tissue

A

Diffusion

The Larger the Tissue area, the faster the Diffusion Rate

The Greater the Partial Pressure Difference, the Faster the Diffusion Rate

The Greater the Solubility of the Gas, the Faster the Diffusion Rate

155
Q

How many Acupuncture points should be used?

A

Resuscitation- GV26

156
Q

In Patients with Hyperthyroidism we Manage Tachycardia and Arrhythmias with ______, given 3-5 Days prior to Surgery

157
Q

Type of Acupunture where an Electric Current is Applied to Acupuncture Needles

A

Electroacupuncture

*Enhances Treatment and most patients Tolerate it well

*High Frequency = Short Term Analgesia

Low Frequency = Long Term Analgesia

158
Q

Sodium (Na+) Channel Blocker that is used to Treat Malignant Ventricular Arrhythmias

159
Q

_____ is common in Anesthetized Large Wildlife Animals and Supplemental Oxygen is strongly recommended

160
Q

Use of Needles applied to Stimulate Certain Points in the body in order to:

Treat Disease

Relieve Pain

Return Homeostatis

A

Acupuncture

161
Q

Condition caused by Prolonged Muscle Exertion common in Hoofstock that causes:

Hyperthermia

Lactic and Metabolic Acidosis

Myocyte Death and Rupture

Release of Potassium and Myoglobin

A

Exertional (Capture) Myopathy

*Hyperkalemia- Cardiac Arrhythmias and Death

*Myoglobinemia- Acute Renal Failure

162
Q

In what Bones could we place and Intraosseous Catheter?

A

Tibia

Ulna

163
Q

Pregnant Patients under Anesthesia have _____ Oxygen Consumption and _____ PaCO2

A

Increased

Decreased

164
Q

Autoregulation of Cerebral Blood Flow is very Effective when Systemic Mean Arterial Pressure (MAP) is between _____ mmHg

A

60-140mmHg

*You want to maintain pressures Minimally above 60mmHg

*Between 60-140 MAP you are going to have Normal Cerebral Blood Flow

165
Q

Neonates have a High Metabolism and Minimal Hepatic Glycogen, making them Susceptible to _____. Neonates also have Higher Permeability of Blood-Brain Barrier leading to more Profound drug Effects

A

Hypoglycemia

166
Q

What Two Induction Agents should be avoided in Patients with Gastric Dilation-Volvulus who have Cardiac Arrhythmias

A

Thiopental

Ketamine

167
Q
A

Atrial Fibrillation

*No P Waves and the Baseline is Fibrillating

*Irregularly Irregular- QRS Complexes are at a Random Distance

168
Q

Birds have _____ Bones that must be avoided when Placing an Interosseous Needle

A

Pneumatic

*Pneumatic Bones are connected directly to the air sacs. Do NOT want to place an interosseous Needle in any of these bones because Fluids will be delivered to the Airsacs

169
Q

Normal Ratio for Ventilation-Perfusion

A

0.8-1

*V is Equal to Q

As Ventilation Decreases and Perfusion Increases the V/Q Mismatch goes to Zero

As Ventilation Increases and Perfusion Decreases the V/Q Mismatch goes to Infinity

170
Q

Contraindications to which form of Acupuncture?

A

Electroacupuncture

171
Q
A

R-on-T phenomenon

*If you see the R-on-T Phenomenon you should be concerned because the Patient will probably go into Fibrillations soon

172
Q

Best Maintenance for Patients with CNS Disease

A

Isoflurane/Sevoflurane

*Try to use a Balanced Protocol in order to keep Inhalant levels low

173
Q

Normal Oxygenation with PaO2:FiO2 is ____

174
Q

Three common Lab Abnormalities found in Patients with Renal Disease

A

Hyperkalemia

Azotemia

Acidemia

175
Q

Side Effects of ______:

Excitation- Running, Pacing

Regurgitation

Respiration Depression- Hypoxemia

Muscle Rigidity

A

High Potency Opioids

*Hard to Control these side effects out on the Field

176
Q

What Maintenance was used in this Patient

A

Isoflurane or Sevoflurane

177
Q

Most Patients needing Rehabilitation are ____, so this must be addressed or the therapy will not be Optimal

A

Pain

*Multimodal Approach to Treating Pain is Ideal

178
Q

12 Year Old Warmblood Mare, 695 kg

History: Rolling in Stall, Watching Flank

Presenting Complaint: Colic

Physical Exam: Tachycardia, Dehydration, Abdominal Pain

What Drug can be given during surgery to Decrease the Effects of Endotoxin Release?

A

Flunixin Meglumine

179
Q

Two Bones where Interosseous Cathethers for Fluid and Drug Administration can be placed in Avian Species

A

Tibia

Ulna

*Avoid the Humerus and Femur- Pneumatic Bones

*Interosseous Catheters for Fluid Aministration is MORE stable than IV in Avian Species

180
Q

Preferred Induction Agent in Pregnant Small Animals

A

Propofol

*Propofol can be used as a CRI during C-Section

*Alphaxalone can also be used

181
Q

12 Year Old Warmblood Mare, 695 kg

History: Rolling in Stall, Watching Flank

Presenting Complaint: Colic

Physical Exam: Tachycardia, Dehydration, Abdominal Pain

What Maintenance drugs would be Best?

A

Isoflurane + IPPV

LRS Fluids

Dobutamine- Increase Heart Contractility

182
Q

Mice, Rats, Guinea Pigs and Chinchillas are considered _____

183
Q

Drugs of Choice for Analgesia in Neonates

A

Opioids (Pure mu Agonist- Ex. Morphine, Butorphanol)

*Opioids are a good choice for Analgesia in Neonates because they are REVERSIBLE

184
Q

Contraindication in Cases of Esophageal Foreign Bodies

A

Inducing Emesis

185
Q

True/False: Thiobarbiturates are the best Induction agents for patients with Liver Disease

A

False

*Avoid Thiobarbiturates in Patients with Liver Disease because Thiobarbiturates are extrememly dependent on Liver Metabolism

186
Q

Anesthetic Managment plan in a Patient with Diabetes Mellitus that has been Fasted Overnight and has a Blood Glucose >200 mg/dL

A

1/2 usual Insulin Dose

*No Dextrose Infusion until Blood Glucose falls below 150 mg/dL

187
Q

In Patients with Insulinomas, during Anesthesia we want to measure Arterial Blood Pressure and Blood Gases to Avoid _____

A

Hypotension

*Prolonged Periods of Hypotension can lead to Pancreatitis

188
Q

What Premedications are used in this Patient?

A

Midazolam + Butorphanol

189
Q

Commonly used Alpha 2 Agonist that is combined with High Potency Opioids for Sedation in Wildlife Animals

190
Q

How are Avian Species MOST commonly Induced

A

Mask

*Rare that we get a good enough Premedication effect in birds to get a good enough IV Catheter in place for Induction Drugs

191
Q

For Patients with CNS Disease, Avoid Increased ______ via Head Positioning, Jugular Occlusion or Vomiting

A

Intracranial Pressure

192
Q

Very _____ Patients have:

Minimal Ability to Increase Contractility

Increased Extrcellular Fluid Volume

Higher Metabolic Rate

High Resting Respiratory Rate/Minute Ventilation

Hypoalbuminemia

Deficient in Heptic Microsomal Enzymes

A

Young (

*Neonates are Hypoalbuminemic, Deficient in Microsomal Enzymes, and Decreased GFR = Prolonged Effects of Drugs Extreted in Urine and Drugs that are Highly Protein Bound

193
Q

Hyperthyroidism can mask _____

A

Renal Insufficiency

194
Q

Geriatric Patients have a Limited Ability to Increase Heart Rate because their _____ Receptors are LESS Responsive

195
Q

What is the Cushings Response in Patients with CNS Disease under Anesthesia?

A

Rapid Decompensation under Anesthesia

*An Increase in Systemic Blood Pressure leading to an Increase in Intracranial Pressure because the Body is attempting to maintain adequate Cerebral Perfusion Pressure

196
Q

Which Drugs are Essential for the Managment of Equine Acute Abdominal Distress

A

Alpha 2 Agonists (Xylazine)

*Alpha 2 Agnoists can provide some Analgesia and decrease the amount of Inhalant that is needed

*Use in Horses despite the Cardiovascular depression

197
Q
A

Idioventricular Rhythm

*Ventricular- Wide Bizzare QRS Complexes

198
Q

During Anesthesia and Recovery of Wildlife, it is best to have patients in _____ Recumbancy

A

Sternal

*Exception- Elephants are put in Lateral

199
Q

Recommended Induction Agents for Patients with Gastric Dilation Volvulus

A

Propofol or Alphaxalone at Low Doses

200
Q

During Pacemaker Implantation, the Patient may be Unresponsive to Anticholinergic, so a Temoprary _____ should be placed prior to Anesthesia

A

Transvenous Pacemaker

201
Q

Goal of Actupuncture for both Eastern and Western Approaches

A

Restore Homeostasis

202
Q

Which Species has Complete Tracheal Rings where we do NOT Inflate the Cuff on Endotracheal Tubes

203
Q

True/False: Acupuncture is Complementary to Western Medicine, NOT a Replacement

204
Q

Major Determinant of Content of Oxygen in Blood (CaO2)

A

Hemoglobin

*An Anemic Patient may have Normal PaO2 but marked Tissue Hypoxia. Not Resolved by Increasing PaO2 but rather by Increasing Hemoglobin

205
Q

True/False: Fast Nursing Animals prior to Anesthesia

A

False

*NO FASTING for Nursing Animals- Concern for Hypoglycemia

206
Q

Muscle Relaxation is Helpful in Cases of Esophageal Foreign Bodies (Ex. Swalloed a Bone). What drugs can be given for Muscle Relaxation

A

Benzodiazepines and Neuromuscular Blocking Agents

*Guafenisin- Large Animals

207
Q

Match These Terms with The Definition

  1. Tidal Volume
  2. Functional Residual Capacity
  3. Vital Capaticy
  4. Residual Volume

A. Remaining Gas in Lung after Max Expiration

B. Max Expiratory Volume after Max Inspiration

C. Remaining Gas in Lung after Normal Expiration

D. Normal Breath Volume

208
Q

How many Channels are there in Acupuncture?

209
Q

Which Two Drugs are AVOIDED as Premedications in Patients with Liver Disease?

A

Acepromazine

Alpha 2 Agonists

*Acepromazine- Causes Hypotension and we don’t want to decrease hepatic blood flow. Inhibition of Platelet Aggregation- Patients with Liver disease already have Coagulation Factor issues and we don’t want to add a platelet problem on top of it

*Alpha 2 Agonists decrease Hepatic Blood Flow

210
Q

In which Small Mammals do we NOT Intubate?

A

Rodents

*Rats, Mice, Chinchillas and Guinea Pigs

211
Q

What Sedatives should be avoided in Patients with Gastric Dilation Volvulus

A

Acepromazine

Alpha 2 Agonists

212
Q

During Anesthesia of Pregnant Animals we want to Maintain Fetal _____ Delivery and we want to Avoid _____, which will decrease Fetal Perfusion

A

Oxygenation

Uterine Contraction/Vasoconstriction

213
Q

Vein used for IV access in Rats

A

Lateral Tail Vein

214
Q

Condition in Dogs with S3 Gallop Rhythyms Characterized by Marked Ventricular Dilation and Poor Ventricular Performance

A

Dilated Cardiomyopathy

215
Q

Best Drug for Induction in patients with Pericardial Tamponade

216
Q

Normal Oxygenation with Alveolar-Arterial O2 Gradient should be ______mmHg

A

5-10mmHg

*If > 10mmHg, then there is an Oxygenation Problem

217
Q

Induction Agents used in Avian Species

A

Ketamine + Benzodiazepine (Need Benzo for Muscle Relaxation)

or

Propofol (Marked Respiratory Depression- Provide IPPV)

218
Q

During Anesthesia in Patients with Mitral Valve Insufficiency we want to Produce a Modest Increased Heart Rate, to Avoid Bradycardia and Hypertension. What Drug can be used as a CRI To keep the Cardiac Contractility Up?

A

Dobutamine

219
Q

Animals with Pleural Effusion or Pneumothorax should have _____ ASAP

A

Thoracocentesis

220
Q

True/False: Start Medical Managment for Hepatic Encephalopathy PRIOR to Surgery

221
Q

Anesthetized patients with Insulinoma can be at risk for _____, leading to Cerebral Damage

A

Hypoglycemia

222
Q

Recommended Premedication for Patients with Gastric Dilation Volvulus

A

Benzodiazepine and Pure Mu Agonist Opioid IV

*Safest choice with Unstable Cardiovascular Function

223
Q

When Monitoring Patients with CNS Disease under Anesthesia we want to know the End-Tidal CO2. What End-Tidal CO2 is best for these patients under anesthesia?

A

30-35mmHg

*PaCO2 should be around 35mmHg

224
Q

In Patients with Diabetes Mellitus we Avoid _____ because they cause Transient Hypoinsulinemia and Hyperglycemia

A

Alpha 2 Agonists

225
Q

During Post Operative Care in Patients with Renal Disease, we want to AVOID _____ drugs such as NSAIDs and Aminoglycosides

A

Nephrotoxic

226
Q

True/False: Most Anesthetic Drugs easily Diffuse across Placenta to the Fetus

227
Q

Patients with Issues in their Oral Cavity and Pharynx have what Contraindication?

A

Inducing Emesis

*If the Patient has trouble opening its mouth and it vomits- Huge Aspiration Concern

*Want to avoid- Alpha 2 Agonists in these Patients. Wait to give Opioids until the patient is intubated or give opioid IV because it lowers the Risk of Vomiting

228
Q

True/False: There is a Predominance of mu Receptors in Reptiles, so Pure mu Agonists, such as Morphine, should provide good Analgesia

229
Q

Birds are MORE Sensitive to _____ Anesthetic Toxicity

A

Local

*Use small doses of Local Anesthetics in Avian Patients- Max dose of 2 mg/kg of Lidocaine

230
Q

Three veins that can be used for Fluid Support (Catheter) in Avian Species

A

Basilic (Ulnar) Vein

Median Metatarsal Vein

Right Jugular Vein

231
Q

Common Electrolyte Abnormality in patients with Renal Disease that we should Treat prior to Anesthesia

A

Hyperkalemia

232
Q

True/False: IPPV can lead to Decreases in Cardiac Output and Blood Pressure

A

True

*I:E Ratio should be 1:3 or Less

233
Q

Pregnant Patients under Anesthesia have:

______ Functional Residual Capacity

_____ Pulmonary Resistance

_____ Gastric Emptying

A

Decreased Functional Residual Capacity

Decreased Pulmonary Resistance

Delayed Gastric Emptying

*Delayed Gastric Emptying and Decreased Lower Esophageal Spincter Tone leaves Pregnant Patients at a higher risk for Regurgitation and Aspiration

234
Q

In Patients with What Endocrine Disease should we Plan for Procedures to go First in the Morning

A

Diabetes Mellitus

235
Q

True/False: In Patients having an Emergency C-Section, you want to correct Underyling Problems FIRST

236
Q

Condition in Cats with S4 Gallop Rhythyms characterized by Ventricular Hypertrophy, Decreased Ventricular Filling, and Reduced Cardiac Output

A

Hypertrophic Cardiomyopathy

237
Q

True/False: Must be VERY Careful with Restraint and Body Positioning in Birds due to their numerous Air Sacs

A

True

*Always providing IPPV to Birds under Anesthesia

238
Q

______ has the Greatest effect on Kinetic Energy and Potential for Dart Injury. We use the Lowest ____ Possible for reach and Accuracy

239
Q

Rabbits are given a Post Procedural ____ as soon as they are able to hold their heads up

A

Snack

*Rabbits have High Metabolsim and can become Hypoglycemic if Food is Witheld

240
Q

Which Two Species have NO Epligottis, where there is Easy Visualization of the Glottis at the base of the Tongue

A

Reptiles

Avian

241
Q

Primary Consideration when Anesthetizing Wildlife

A

Safety

*Personnel Safety comes first!!

242
Q

What Veins can be used for Venous Access of Fluid and Drug Administration

A

Ulnaris Vein

Right Jugular Vein

Dorsal Metatarsal Vein

243
Q

In Patients with a Patent Ductus Arteriosus, during Ligation you will see an Increased Blood Pressure followed by a Reflex Bradycardia known as ____ Sign

A

Branham’s Sign

244
Q

During Acupuncture we insert a Needle into tissue that causes _____, leading to Inflammation which will stimulate Repair, Anti-Inflammation, Pain Modulation and Continued Tissue Healing

A

Microtrauma

*Causing Microtrauma that will Release Factors to Promote Healing

245
Q

AVOID Premedication with _____ in Patients with CNS Disease because it is long acting, non reversible, and causes Hypotension

A

Acepromazine

*Do not use Acepromazine as a Premed in patients with CNS Disease

246
Q

Anesthesia with ____ quickly Reverses Life-Threatening Hypoxemia secondary to Hypoventilation

247
Q

Common Endocrinopathy typically seen in older Dogs that Causes these Clinical Signs:

A

Hypothyroidism

248
Q

True/False: Loudness of Heart Murmur = Degree of Pathology

249
Q

Which of the Following are Part of the Initial Evaluation for Physical Rehabilitation:

A. Physical Examination

B. Posture/Gait Assessment

C. Range of Motion in Hip, Stifle, Hock ect.

D. Palpation of limbs and Spine

A

All of the Above

250
Q

Best Induction agent for Patients with Liver DIsease

A

Propofol

*Etomidate can be a good Induction agent as well

251
Q

Ideal Induction Agent in Patients with Mitral Valve Insufficiency

252
Q

True/False: It is the Responsibility of the Individual Practicing Veterinary Physical Therapy to know the Legal Issues related to both Veterinary and Physical Therapy Practice acts in their Respective State

253
Q

_____ is Indicated in Dyspneic Animals because it will Decrease Anxiety and Work of Breathing

A

Sedation (Butorphanol)

254
Q

In which Species is there often NO IV access before Induction

255
Q

Cats with Hypertrophic Cardiomyopathy should be Treated with a _______ 1-2 Weeks Prior to Anesthesia in order to Control Arrhythmias and Decrease Stress on the Myocardium

A

Beta-Blocker or Calcium Channel Blocker

*Want to Slow the Heart Down in these Patients- Aim to Maintain a normal Heart Rate and DO NOT Increase Contractility as this will cause dynamic outflow obstruction from the Heart

256
Q

Best Induction agents to use in Geriatric Patients

A

Propofol or Alfaxalone

257
Q

In Patients with Pericaridal Tamponade (Fluid within the Pericardium), _____ is Recommended Prior to Anesthesia

A

Pericardiocentesis

*To Remove the Fluid around the heart prior to Anesthesia

258
Q

Which of the following Induction agents causes Minimal Changes in Cardiopulmonary Function therefore making it a safe choice for a patient with Cardiovascular Disease

259
Q

For Patients with CNS Disease, during Anesthesia you need to make sure to Maintain MAP >/= ______mmHg for Cerebral Blood Flow Autoregulation

260
Q
A

Electrical Alternans

*Height Difference between some of these

261
Q

During Endotracheal Intubation in Avian Species you want to Prevent _____ Membrane Formation

A

Trans-Tracheal Membrane Formation

*In Avian Species we DO NOT inflate the cuff on endotracheal tubes. We want to Minimize Head and Neck movement during procedure to prevent the endotracheal tube from banging against and damaging the Trachea

*Trans-tracheal Membrane Formation- A month after Intubation the Bird will return in respiratory distress because there is now scarring where the tube was batting against the mucosa and causes a stricture

262
Q

_____ Occurs in 15-82% of Cats following Bilateral Thyroidectomy, so Calcium should be monitored daily for 5 days postop and treatment only needed if Clinical Signs Develop

A

Hypocalcemia

*Due to Accidently removing the Parathyroid gland as well, which regulates Calcium

263
Q

Inability to Eructate Rumen Gases, which leads to Decreased Venous Return and Cardiac Output

A

Bloat (Rumen Tympany)

*Place patients in Sternal Recumbancy

264
Q

What Induction Agent was used in this Patient?

A

Propofol

*Administered in Coccygeal Tail Vein

265
Q

Fluids should not be administered ______ in Avian Patients because Subcutaneous Fluids will burn with the Heating Elements

A

Subcutaneous

*During anesthesia we provide external heat for these patients and pockets of fluid subutaneously will Burn and Slough the skin

*Isotonic, nonirritating fluids ONLY

266
Q

Case: 7 Year Old Male Canine Great Date 45kg

History: Non Productive Retching, Drooling, Abdominal Distention when owner came home from work

Physical Exam: HR= 160 bpm, RR= Panting, T= 99.3

CRT= 3 Seconds, mm = Pale Pink, Poor Pulses

How would you correct the Hypokalemia in this Patient?

A

Maximum of 0.5 mEq/kg/hr of Potassium “Spiked” Fluids

*Correct Hypokalemia as soon as Possible

267
Q

Best Induction Agent for Patients with CNS Disease

268
Q

Best Preanesthetic Medication to use in Patients with Liver Disease

A

Benzodiazepine (Diazepam or Midazolam) + Opioid

*Avoid Morphine (Opioid)- Can cause Histamine release leading to Hypotension that decreases Hepatic Blood Flow

269
Q

During Inhalant Anesthesia, We ______ Patients with CNS Disease in order to Reduce Cerebral Blood Flow and Decrease Intracranial Pressure

A

Hyperventilate

*Under Inhalants we know that even at normal ventilation Cerebral Blood Flow is Increased. We want the PaCO2 levels to be very low so we Hyperventilate patients with CNS Disease under Inhalant Anesthesia

*You want yor PaCO2 to be about 35mmHg, so your Capnograph is going to read between 30-35 mmHg

270
Q

In Patients with Liver Disease, Hypotension and Bradycardia may occur with Biliary Tree Manipulation. Consider _____ in the Anesthetic Plan

A

Anticholinergic (Atropine)

271
Q

Alternative to Endotracheal Intubation in Avian Patients where a Cannula is inserted into and Air Sac for Induction and maintenance using Inhalant

A

Air Sac Cannulation

*Use the LEFT Caudal Thoracic or Abdominal Air Sac

*Useful for Beak Fractures and Upper Airway obstruction ect.

272
Q

Clinical Signs relevant to Anesthesia with what Endocrine Disease

A

Cushings Syndrome

273
Q

True/False: During Physical Rehabilitation, have the owner keep a log or journal of the patients daily activities so it can be reviewed at regular intervals by the veterinary team

274
Q

Anesthetic Concerns of which Gastrointestinal Disease

A

Gastric Dilation Volvulus

*Decreased Ventilation- Stomach pushes Cranially and Compresses the Lungs

*Decreased Cardiovascular Function- Stomach Pushes up and Compresses the Caudal Vena Cava and Aorta

275
Q

Patients with _____ are Extremely Poor Anesthetic Candidates for the Following Reasons:

A

Diabetic Ketoacidosis

*Want to Stabilize this Patient before performing Anesthesia- Don’t want to Take patients with Diabetic Ketoacidosis to Surgery.

276
Q

During Procedures in Pregnant Patients you want to Carefully Position the Patient to avoid _____ Compression

A

Aortocaval

*Best not to put the animal is straight Dorsal, shifting them one way or the other to make sure the weight of the urterus is not on the great vessels

277
Q

True/False: Avoid Elective Anesthesia in Patients with Pulmonary Disease

A

True

*Fix Underlying Disease before putting under Anesthesia

278
Q

True/False: Physical Trauma, Dart Injury, Hypoxemia, Regurgitation and Capture Myopathy are Possible Complications of Zoo/Wildlife Anesthesia

279
Q
A

Sustained Supraventricular Tachycardia

*Ventricular Tachycardia- the complexes would be Wide and Bizarre

*Supraventricular- The Complexes look Normal

*Paroxysmal- Tachycardia that Stops and Starts

280
Q

Providing an Epidural with _____ can provide up to 24 hours of Analgesia in Pregnant Small Animals

281
Q

In Patients with Pericardial Tamponade, we Pretreat with ____ to Ensure Optimal Venous Return

282
Q

Definition of Hypoxemia is a PaO2

283
Q

Pathology in the ____ and _____ can lead to:

Difficult Intubation

Difficulty Maintaining Patent Airway

Aspiration

A

Oral Cavity and Pharynx

284
Q

The Pulmonary System is a Low Resistance system, where the Pressure in the Pulmonary Artery is _____

A

15mmHg

*Pulmonary System = Low Pressure System

285
Q

Best Inhalant Anesthetics used in Reptiles

A

Isoflurane and Sevoflurane

*Decrease MAC with Decreased Body Temperature

286
Q

Which two Drugs should be Avoided during Anesthesia of Hyperthyroid Patients

A

Atropine

Ketamine

*Best Induction agent for patients with Hyperthyroidism- Alfaxalone or Propofol

287
Q

Rehibilitation Technique that provides Pain Relief, Relaxation, and Promotes Circulation that is used Post-Exercise to Reduce muscle Soreness

A

Massage

*Contraindications- Open Wounds, Unstable Fractures, Severe Pain

288
Q

Endocrine disease characterized by Secretion of Excess Amounts of Glucocorticoids by the Adrenal Cortex

A

Cushings Syndrome (Hyperadrenocroticism)

289
Q

No IV access Before Induction

What Premedications will we use for this Patient?

A

Midazolam + Butorphanol

*Give Opioid that is a Kappa Receptor Agonist- Butorphanol

290
Q

What should be Given for General Anesthesia

A

Isoflurane or Sevoflurane

291
Q

In Patients with Diabetes Mellitus we measure Blood Glucose every ___ Minutes during Anesthesia and once in Recovery

A

30

*We want to maintain Blood Glucose between 150-250 mg/dL

292
Q

During Surgery in Patients with Insulinomas we are Checking the Blood Glucose every ___ Minutes

A

15-30 Minutes

293
Q

True/False: Nutritional Plan should be included as part of Rehabilitation Therapy

Anesthesiology (4 decks)

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