Lab: Anesthesia Quiz Flashcards
How can you treat hypotension?
- Decrease AX amount
- Gvie IVF bolus
- Drugs: Dopamine, Dobutamine, Ephedrine
What does the QRS complex on a ECG represent?
Ventricular depolarization and atrial repolarization
What does a capnometer measure? What does a capnograph display?
ET CO2
ET CO2 vs Time
An arterial blood sample with have an SO2 > ___% while a venous sample will have SO2=____%. This is a good way to determine whether you have indeed obtained an arterial blood sample
88
65-75
What is the IVF rate for dogs under AX?
10mg/kg/hr
What does the p wave of an ECG reflect?
Atrial depolarization
What are the 3 ways to measure BP (note which are direct and which are indirect and where they are placed)?
Direct and invasive via arterial catheter
- Facial, Transverse Facial artery in Horses
- Dorsal pedal, Metatarsal artery in Dogs
- Dorsal pedal, coccygeal in Cats
- Auricular artery in Cattle
- Median artery in Sheep/goats
- Real time BP measurement
Indirect - Oscillometric (vibrations from blood flow in artery)
- Gives MAP SAP and DAP
- Better in large animals
Indirect- Doppler (ultrasound)
- Dog on Palmar Digital A
- Sheep on Median A
- Horse on Tail
- Only SAP
- Cuff 30-40% limb circumference
- Underestimates BP in cats
What is the drug of choice for a hypotensive cat?
Dopamine
What is the normal temperature range for equids? Ovids?
Equine: 99-101F
Ovine: 102-104F
List 3 drugs that can be used to induce dogs quickly? What drug is slower but has a wider safety margin?
Propofol, Alfaxalone, Etomidate
Ketamine
Which induction agent causes transient adrenal suppression?
Etomidate
What is the most common cause of A-a difference?
V/Q mismatch
What are 2 effects of hypotension?
Compromised ability of kidney to maintain GFR
Compromises cerebral perfusion
What is the main indication for mechanical ventilation? List some other specific indications. What are the 2 biggest side effects caused by mechanical ventilation?
Main: Decreased PaCO2 if intubated, hypoxemia if getting <100%O2
Other: NM blockage, Thoracic sx, Controlling ICP, Chest wall/diaphragm trauma
Side effects: Hypotension, Hypercapnea
What does a F air cannister NOT absorb? When must it be discarded?
N2O
When it has gained 50g
What does the T wave on a ECG represent?
Ventricular repolarization
What are 2 types of re-breathing systems? What are 2 types of non-rebreathing systems?
Rebreathing: Circle/Y hose, Universal F
Non-rebreathing: Mapleson A-F, Bain (modified Mapleson D)
What are normal blood gas values for PaO2 (if getting 100% O2) and Lactate?
PaO2: >500mmHg
Lactate: 1-2 mmol/L
What are advantages and disadvantages of re-breathing systems?
(+): Requires lower fresh gas flow
(-): Higher resistance (valves), slower [AX] change, more components
What pressure do you use to check for leaks in the AX machine/system? How much leakage is acceptable (mL)?
30cmH2O
Up to 300mL
SpO2 75%= ____PaO2
SpO2 88%= ____PaO2
SpO2 90% = ____PaO2 *Hypoxia upper limit*
SpO2 98% (breathing room air)= ____PaO2
SpO2 100%= ____PaO2
75%= 40mmHg
88%= 55mmHg
90%= 60mmHg
98%= 110mmHg
100%= 550mmHg
What do the letters A-E represent?
A: Start of expiration
B: Dead space gas replaced by alveolar gas
C-D: Pure alveolar gas
D: Start of inspiration (ETCO2)
E: Dilution of aleveolar gas by inspired fresh gas
How do you calculate bag size for small animals? Large animals?
Small: 15mL/kg x 6 = 90xBW (=ml)
Large: 30L bag or 20L ventilator capacity
What do each of these capnograph wave forms represent?
Orange/top: Normal breathing
Yellow/middle: Hyperventilation
Red/bottom: Hypoventilation
Where can temperature measurements be taken?
Rectal
Esophagus
Pharynx
Nasal
What can cause decreased SaO2 and pO2?
Acidosis
Hyperthermia
In a re-breathing system, what is the O2 flow rate for animals <50kg (induction, maintenance, recovery)? >50kg?
mL/kg/min
<50kg: I and R 50-100
M 20-50
>50kg: I and R 20-50
M 10-20
What is normal EtCO2?
35-45mmHg
What does BP reflect?
Perfusion
What is the normal RR range for equids? Ovids?
Equine: 8-20
Ovine: 12-20
What is the O2 flow rate for non-re-breathing systems? What happens if you use a setting that is too low?
300mL/kg/min (2-3x tdal volume)
Too low=CO2 rebreathing
What are normal blood gas values for pH and PaCO2?
pH: 7.35-7.45
PaCO2= 35-45 mmHs (Cats 30+/-2)
Which blood gas values are measured and which are calculated?
Measured: pH, PaCO2, PaO2
Calculated: HCO3-, BE, O2 content
How do you obtain SaO2? What does it reflect?
Arterial blood gas analysis
Direct measurement of the oxygen content of the blood
What can you use to increase contact between ECG electrodes and the skin?
ECG gel
Saline
(NO ALCOHOL!)
What type of lead system is used in small animals? Where are the leads placed?
Lead II
White (-) on right arm
Black (+) on left arm
Red on left stifle
What type of lead system is used in large animals? Where are the leads placed?
Lead I (Base-Apex system)
White (-) R jugular furrow/whithers
Black (+) ventral midline under heart apex
Red away from the heart/left flank
What is the most common place for leaks of an AX machine to occur?
CO2 absorbent canister
What is the normal HR range for equids? Ovids?
Equine: 28-44
Ovine: 70-90
E cylinder: ____L _____psi
660
2200
What does this capnograph waveform represent and how can you resolve the problem?
Bronchospams
Administer B2 agonist (e.g. Albuterol, Tertbutaline)
What is the best location for obtaining a blood gas sample in small animals? Large animals?
Small: Dorsal pedal artery
Large: Facial, transverse facial, auricular artery
What affects PulsOx measurements? What pathologies can cause artifically high readings?
Tissue thickness
Hypoperfusion
Vasoconstriction
Anemia
Pigmentation
CO and CN poisoning = reading is artifically higher
Mechanical ventilation: _____ limits flow, ______ limits volume.
Resistance
Compliance
How do you treat elevated lactate intra-operatively?
IVF
What are advantages and disadvantages of non-re-breathing systems?
(+): Minimal dead-space, can change [AX] quickly, fewer potential places for leaks
(-): Patient breaths cold and dry gas, more expensive, more environmental pollution
What are the 5 causes of hypoxemia?
V/Q mismatch
Hypoventilation
Low FiO2
Right to Left shunt
Diffusion impairment
What are 2 drugs that you can give for refractory shock and non-responsive hypotension?
Norepinephrine
Vasopressin
What has the most significant effect on endotracheal tube resistance?
Radius/diameter
Which drug can be used topically for nasal edema?
Phenylephrine
What is the normal MAP and SAP range for small animals? Large animals?
Small animals: SAP-60 MAP-80
Large animals: SAP-70 MAP-90
What is the normal HR range for dogs? Cats?
Dogs: 60-120
Cats: 120-180
What are the 2 types of scavenging systems?
Active (quick connector)- more common
Passive (F air canister)- more resistance
Which drug is indicated for CPR and anaphylactic shock?
Epinephrine
What is the minimum acceptable FiO2? What is the metabolic O2 requirement?
0.3-0.35 / 30-35%
Metabolic requirement: 5-10 mL/kg/min
What pre-med drug class can be given to prevent opioid dysphoria?
Phenothiazines
T/F: A normal heart rate and strong pulse indicates adequate cardiac output even if there isn’t a normal sinus rhythm.
True
Match the drugs with their antagonists.
Naloxone
A2 agonists
Flumazenil
Benzos
Atipamazole
Opioids
Opioids- Naloxone
A2-Atipamazole
Benzos-Flumazenil
What are the 7 anesthesia machine related safety systems?
- Color coding and labelling
- Diameter index (gas-specific threaded connections)
- Pin index (gas-specific pin pattern)
- Quick connectors
- Regulator (pressure-reducing valve)
- Flow meter (gas specific)
- Vaporizer agent-specific keyed filler port
Which 2 drugs are counterindicated in sheep during AX?
Atropine
Xylazine
(Avoid A-2s because they cause pulmonary damage)
What is the normal RR range for dogs? Cats?
Dogs: 10-30
Cats: 20-40
What does the PulsOx measure? What is normal?
SpO2 - % Hb saturated w/O2
>95%
What are normal blood gas values for HCO3- and BE?
HCO3-: 24+/-4 mEq/L (cats 22+/-2, herbs 30+/-5)
BE: 0 +/- 4 mEq/L
What is the normal temperature range for dogs? Cats?
Dogs: 100.4-102.2F
Cats: 101.3-102.2F
What are 2 methods for measuring HR?
Esophageal stethoscope
ECG