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Anesthesia > Final Exam- New Material > Flashcards

Final Exam- New Material Flashcards

1
Q

Fluid rate for CNS patients

A

3-5mL/kg/h

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2
Q

What conditions would it be necessary to place a pacemaker prior to surgery?

A

Sick sinus syndrome

Third degree AV block

Malignant vagal syndromes that are unresponsive to medical management

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3
Q

What premeds are a good idea in cardiac patients?

A

Opioids

Neuroleptanalgesia

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4
Q

What fluid is indicated in hypovolemic cardiac patients?

A

LRS or other balanced solution

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5
Q

What induction agent is best to use in ancient crabby cats?

A

Alfaxalone

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6
Q

What drugs should be avoided with GI cases?

A

Opioids

A2

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7
Q

What muscles are you targeting with darts?

A

Large hindlimb musces

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8
Q

T/F: Morning cardiac medications should not be given before surgery

A

False- give them their meds

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9
Q

What premed helps eliminate the dive response in birds?

A

Midazolam

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10
Q

What are the anesthetic goals for a patient with DM?

A

Prevent hypoglycemia

Prevent prolonged or severe hyperglycemia

Maintain normal fluid and electrolyte balance

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11
Q

What electrolyte abnormalities need to be corrected prior to anesthesia?

A

Hyperkalemia

Hyponatremia

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12
Q

T/F: Poor glycemic control increases risk of post-op infection

A

True

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13
Q

Induction agent combo to be used in high risk cardiac patients? Why?

A

Etomidate with Diazepam or Midazolam

Minimizes HR and Contractility changes

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14
Q

What is the MAP range that the kidney is autoregulated at?

A

80-180

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15
Q

Reflex bradycardia may occur when fixing a PDA…what is this called?

A

Branham’s sign

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16
Q

Wht happens to the PCV in pregnant animals?

A

Decreased

Plasma increases more than RBCs

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17
Q

Etorphine reversal?

A

Diprenorphine

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18
Q

What drugs are useful for muscle relaxation in a patient with an esophageal foreign body?

A

Benzos

GG

NMBA

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19
Q

What are some important clinical signs of Cushings that are relative to anesthesia?

A

Slow tissue healing

Hypercoagulability (post-op clots)

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20
Q

What breeds will you most commonly see DCM in?

A

Great danes

Cocker spaniels

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21
Q

Which anticholinergic should you avoid in rabbits and why?

A

Atropine

They break it down quickly

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22
Q

What do you want MAP to be in a geriatric patient with renal disease?

A

>70

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23
Q

How can you avoid capture myopathy?

A

Limit chase to 2m

Wait 1s in between failed attempts

Limit stress after capture

No handling for 6w post

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24
Q

In young, small animals, how much does the PCV drop in the first 4 weeks?

A

1/3

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25
Q

Jugular distension is indicative of what heart condition?

A

RSHF

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26
Q

What is the best sedative choice for CNS patients?

A

Benzodiazepenes

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27
Q

T/F: With TENS, increased pulse duration and stimulus intensity = greater analgesia

A

True

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28
Q

Best induction agents for liver patients?

A

Porpofol

Etomidate

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29
Q

What concerns do you have for a dog after GDV surgery?

A

Sepsis

Peritonitis

Reperfusion injury due to endotoxin release

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30
Q

What parameter is important to monitor in young patients?

A

BG

Consider supplementing dextrose in fluids

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31
Q

In birds, what does the stress response cause?

A

Release of epinephrine causes valve in renal portal system to open, sending blood to circulation

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32
Q

What drug delivery system do you use in wildlife 15-50m away?

A

Dart projectors

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33
Q

What type of pain is low-level laser therapy useful for?

A

Chronic and minor pain

Especially OA and muscle spasms

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34
Q

What drugs should be avoided with mitral valve insufficiency?

A

A2 agonists (increase SVR)

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35
Q

What sedatives are normally used in healthy geriatric patients?

A

Phenothiazines

A2

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36
Q

T/F: Potassium supplementation is needed for patients with DKA

A

True

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37
Q

Why do you want renal patients to mildly hyperventilate?

A

You already have a metabolic acidosis so you want to avoid adding in a respiratory acidosis

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38
Q

Non-high risk cardiac patients should be given this induction cocktail. Why?

A

Opiod + Benzo

Will decrease HR

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39
Q

Best NSAID to use in birds?

A

Meloxicam

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40
Q

Clinical signs associated with a BG 20-35?

A

Tachycardia, hypertension, tachypnea

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41
Q

What young patient factors will cause drugs to have prolonged/increased effects?

A

Hypoalbuminemia

Deficient hepatic microsomal enzymes

Decreased GFR

Higher permeability of BBB

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42
Q

What premed is best to use in horses with abdominal distress?

A

A2 agonists - xylazine best b/c of short DOA

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43
Q

T/F: Negative inotropic drugs should be avoided in hypothyroid patients

A

True

Prevent severe hypotension

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44
Q

What are neonates/pediatrics dependent on for cardiac output?

A

Heart rate

They have a minimal ability to increase contractility

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45
Q

In what animals are inspiration and expiration both an active process?

A

Reptiles

Birds

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46
Q

Induction agent for HCM?

A

Etomidate

Dopamine to increase CO

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47
Q

Most wildlife should be recovered in recumbency, but elephants should be in recumbency

A

Sternal- for drainage

Lateral

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48
Q

What MAP do you want to maintain in renal patients?

A

≥80 (SAP 110)

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49
Q

What should you do prior to anesthesia in a patient with paericardial tamponade or constrictive pericarditis?

A

Pericardiocentesis

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50
Q

MOA of amiodarone?

A

K+ channel blocker

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51
Q

T/F: It is safe to perform an elective procedure on an animal with ketonuria

A

False

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52
Q

An S3 gallop in cats is indicative of what heart condition?

A

DCM

Restrictive CM

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53
Q

T/F: With low-level laser therapy, more power = better

A

False

May do harm

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54
Q

What do you want to do when anesthetizing a patient with traumatic myocarditis?

A

Reduce HR

Avoid factors reducing myocardial O2 balance

Suppress arrhythmias

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55
Q

What medications should be given to an HCM patient 1-2w before surgery?

A

Beta Blockers or Calcium Channel Blockers

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56
Q

What anesthetic drug cannot be used in tigers?

A

Telazol

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57
Q

What drugs are not recommended for young patients?

A

Phenothiazines

A2 (vasoconstriction and reflex bradycardia)

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58
Q

Why do you want to withhold food for 1-2 days after insulinoma surgery?

A

Can get pancreatitis

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59
Q

Drugs that affect stroke volume?

A

Inhalants

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60
Q

Way to monitor great apes anesthestic depth?

A

Grip strength

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61
Q

High potency opioids used in large animals-like zoo, not horses…

A

Etorphien

Thiafentanil

Carfentanil

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62
Q

What drugs will affect systemic vascular resistance?

A

Phenothiazines

Barbituates

Inhalants

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63
Q

Why would an animal with DKA and altered protein binding and hepatic function be a poor anesthetic candidate?

A

Sensitive to anesthetic agents and increased duration of drugs

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64
Q

What is an alternat option to ETT in birds?

A

Air sac cannulation

Use left caudal thoracic or abdominal air sac

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65
Q

MOA of diltiazem and verapamil?

A

Ca2+ channel blockers

66
Q

What is the most useful index of cardiopulmonary fitness in dogs?

A

Exercise Tolerance

67
Q

What is a negative effect of opioids in CNS patients?

A

Cause hypoventilation which causes increased PaCO2 and increased CSF pressure

68
Q

Therapy used for acute inflammatory phase that reduces inflammation, edema, and pain?

A

Cryotherapy

69
Q

What route of administration may be best for pre-anesthetic medications in GI patients?

A

IV

Avoid IM/SQ

70
Q

Effect of azotemia on drugs in the CNS?

A

Changes BBB which increases drug penetration into CNS

71
Q

What induction drug should be avoided in cats with renal disease?

A

Ketamine

72
Q

What sedative should you use in liver patients?

A

Benzodiazepines

Caution in patients with hepatic encephalopathy

73
Q

In what condition should dobutamine not be used to increase contractility?

A

HCM

74
Q

An S4 gallop in a cat is indicative of what heart condition?

A

HCM

75
Q

What procedures in birds is it good to use air sac cannulation?

A

Beak fractures

Upper airway obstruction

TTM formation

Long term ventilatory support

76
Q

Why are NSAIDs not recommended in young patients?

A

Immature hepatic and renal function

77
Q

What nerves does TENS activate and inhibit?

A

Activates Abeta fibers in the skin

Inhibits C fibers in the dorsal horn of the spinal cord

78
Q

Opioids are good for liver patients but you should avoid morphine. Why?

A

Histamine release leading to hypotension

79
Q

T/F: You do not fast animals that are still nursing

A

True

If not nursing, fast 3-4 hours

80
Q

What sedatives should be avoided with liver patients?

A

Acepromazine

A2

81
Q

When checking BG in the morning before anesthesia, if it is 100-200, what do you do?

A

1/4 usual insulin dose

Begin 2.5% dextrose infusion

82
Q

Thermotherapy is best for what kind of pain?

A

Chronic pain

83
Q

Clinical signs associated with a BG 35-60?

A

Bradycardia, hypotension

84
Q

What BG do you want to maintain when anesthetizing a patient with an insulinoma?

A

BG>40

85
Q

What is the best premed combo for renal patients?

A

Opioid + benzo

86
Q

What is the most risky time in an anesthetic procedure in cardiac patients?

A

Recovery

87
Q

What drugs can you give for mitral valve insufficiency prior to anesthesia?

A

ACE inhibitors

Diuretics

Beta-1 agonists

Pimobendan

Low sodium diets

88
Q

What breed of cat is most commonly associated with HCM?

A

Maine coons

89
Q

An S3 gallop in a dog is indicative of what heart condition?

A

DCM

90
Q

What level of sodium should be given in fluids to cardiac patients?

A

Low sodium

91
Q

MOA of propranolol and atenolol?

A

B-adrenoreceptor blockers

92
Q

What is the blood glucose range you want to maintain during anesthesia?

A

150-250 mg/dL

93
Q

What type of pain is TENS useful for?

A

Chronic pain

94
Q

What is an anesthetic concern of a patient with severe hypoglycemia?

A

Can have brain damage that is not apparent until after anesthesia

95
Q

Drugs that affect heart rate?

A

Opioids

A2 Agonists

Dissociatives

Inhalants

96
Q

What drug may be suitable for sedation in cats with dynamic LVOT obstruction?

A

Medetomidine

97
Q

What is the importance of pneumatic bones in the anesthetic plan for birds?

A

You have to be careful with IO catheters

Need to avoid pneumatic bones

98
Q

What induction agents should be avoided in a patient with cardiac arrhythmias?

A

Thiopental

Ketamine

Halothane

99
Q

When checking BG in the morning before anesthesia, if it is >200, what do you do?

A

1/2 usual insulin dose

No dextrose infusion until BG falls below 150

100
Q

Way to monitor dolphins anesthetic depth?

A

Swimming reflex

101
Q

ETT should be avoided in what species?

A

Rodents

102
Q

Poor pulses found on a preop exam is indicative of what heart condition?

A

SAS

103
Q

What species can you use the dorsal coccygeal vein? Ventral coccygeal vein?

A

Dorsal = turtles

Ventral = lizards

104
Q

You want to minimize the use of drugs that block the stress response completely. What are these drugs?

A

Etomidate

A2

105
Q

Clinical signs associated with a BG <20?

A

Seizures, coma, death

106
Q

What species should you avoid using LRS?

A

Reptiles

107
Q

What medication should be given to control hypotension in a patient with aortic stenosis?

A

Phenylephrine

NOT positive inotropes- will increase hypotension

108
Q

What drugs can be used in mitral valve insufficiency to produce a mild reduction in SVR?

A

Low-dose acepromazine + opioid

109
Q

Why do you need to be careful with cuff inflation or not do it at all in birds?

A

They have complete tracheal rings

110
Q

What drugs should be avoided in hyperthyroid patients?

A

Atropine

Ketamine

111
Q

What should you do before anesthetizing a patient with hyperparathyroidism?

A

Decrease serum calcium levels

Monitor ionized calcium 48 hours post-op

112
Q

At what systemic MAP is autoregulation of CBF very effective?

A

60-140

113
Q

What is massage useful for?

A

Post-exercise to reduce muscle soreness

OA

Edema

114
Q

What do geriatric patients rely on to increase cardiac output?

A

Increased SV

115
Q

What drugs should be avoided in a patient with DM? Why?

A

A2

Cause dose-dependent trantient hypoinsulinemia and hyperglycemia

116
Q

How long should you fast birds prior to anesthesia? What is the weight cut off for fasting?

A

2-4 hours

Don’t fast if <200g

117
Q

What sedatives are generally used in less healthy geriatric patients?

A

Benzos

118
Q

What sedatives should be avoided with GDV?

A

Ace - hypotension

A2 - decreased CO

119
Q

What PaO2 will cause an increase in CBF?

A

<50

120
Q

Which benzo is better for young patients and why?

A

Midazolam

Metabolized faster so reduced side effects

121
Q

T/F: You do not need to fast rabbits and rodents

A

True

122
Q

What fluids should not be used in a patient with DKA?

A

Hypotonic fluids

123
Q

What is the desired PaCO2?

A

35

124
Q

What anesthetic drugs reduce CMRO2?

A

Iso/Sevo

Etomidate

Barbiturates

Ketamine

125
Q

Medications that should be given to DCM patients to control hypotension?

A

Dopamine or Dobutamine

Increases contractility

126
Q

Bounding arterial pulses is indicative of what heart condition?

A

PDA

127
Q

When checking BG in the morning before anesthesia, if it is <99, what do you do?

A

No insulin

Start 2.5% dextrose infusion

128
Q

Preferred opioid reversal in wildlife, why?

A

Naltrexone- long DOA (no renarcotization)

129
Q

What is the MOA of procainamide, quinidine, and lidocaine?

A

Na+ channel blockers

130
Q

What conditions can be exacerbated by a normal stress response?

A

CHF

ARF

131
Q

Definition: range of motion in joints in flexion and extension.

A

Goniometry

132
Q

What fluid rate should be given to normovolemic cardiac patients?

A

No Fluids

OR

1-3ml/kg/hr

133
Q

Preferred A2 agonist in wildlife? Why?

A

Xylazine- short DOA

134
Q

What drug delivery system do you use in wildlife 10-15m away?

A

Blowgun

135
Q

What is renarcotization? What animals does this occur in and with what drug?

A

Half life of agonist drug is longer than that of the reversal

Wildlife

Opioids

136
Q

What are geriatric patients dependent on for cardiac output?

A

Atrial kick

Normal sinus rhythm

137
Q

What is the Cushing’s response?

A

Rapid decompensation under anesthesia

Increased ICP along with increased MAP

138
Q

How often should you measure blood glucose in a patient with DM during surgery?

A

Every 30 minutes

Once in recovery

139
Q

What bones are used for IO catheters in birds?

A

Proximal tibia

Distal ulna

140
Q

Why do you give anticholinergics pre-op to young patients?

A

They cant increase SV or HR very well on their own

141
Q

What drug delivery system do you use in wildlife 3-4m away?

A

Pole syringe

142
Q

What happens to CO in pregnant animals?

A

increases 30-50%

143
Q

Why do pregnant animals have an increased risk of regurg and aspiration?

A

Decreased LES tone

144
Q

Why do pregnant animals have decreased pulmonary resistance?

A

Progesterone relaxes bronchial muscles

145
Q

Why do pregnant animals have a decreased functional residual capacity?

A

Increased abdominal volume

146
Q

Do pregnant animals have an increased or decreased MAC?

A

Decreased

147
Q

T/F: sedatives are not recommended for pregnant SA

A

true

148
Q

What sedative is routinely used in pregnant mares?

A

A2 agonists (detomidine best)

149
Q

When should opioids be administered during a C-section?

A

Once neonates are out of mom

150
Q

What induction agent is preferred for pregnant animals?

A

Propofol

151
Q

Is alfaxalone ok for C-sections? Etomidate? Ketamine

A

Yes for alphaxalone and etomidate- etomidate not as good though

Ketamine- controversial for SA, ok for large

152
Q

How does pregnancy affect dosing of locals?

A

Decreases dose

153
Q

How should you adjust epidural dosing for pregnant patients?

A

Decrease dose by 1/3

154
Q

What pregnant animals may receive NSAIDs?

A

Lactating cows

155
Q

Analgesia for pregnant ruminants?

A

Small- LS epidural w/ morphine

Cows- caudal epidural

156
Q

Analgesia options for horses for c-section?

A

Butorphanol

Caudal epidural

157
Q

Differences in small and large ruminants locoregionals for c-sections?

A

Small- line block, LS epidural

Large- paravertebral, L block

158
Q

What is normal V:Q

A

0.8-1

159
Q

What anesthetics drugs have minimal effect on respiration?

A

Benzos

Phenothiazines

Opioids

160
Q

At what PaO2 will you SpO2 drop below 90%?

A

60mmHg

Anesthesia (3 decks)

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