Lab: Anesthesia Quiz Flashcards by Sarah Sabler

How can you treat hypotension?

Decrease AX amount
Gvie IVF bolus
Drugs: Dopamine, Dobutamine, Ephedrine

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What does the QRS complex on a ECG represent?

Ventricular depolarization and atrial repolarization

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What does a capnometer measure? What does a capnograph display?

ET CO2

ET CO2 vs Time

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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

65-75

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What is the IVF rate for dogs under AX?

10mg/kg/hr

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What does the p wave of an ECG reflect?

Atrial depolarization

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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

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What is the drug of choice for a hypotensive cat?

Dopamine

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What is the normal temperature range for equids? Ovids?

Equine: 99-101F

Ovine: 102-104F

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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

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Which induction agent causes transient adrenal suppression?

Etomidate

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What is the most common cause of A-a difference?

V/Q mismatch

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What are 2 effects of hypotension?

Compromised ability of kidney to maintain GFR

Compromises cerebral perfusion

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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

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What does a F air cannister NOT absorb? When must it be discarded?

N2O

When it has gained 50g

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What does the T wave on a ECG represent?

Ventricular repolarization

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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)

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What are normal blood gas values for PaO2 (if getting 100% O2) and Lactate?

PaO2: >500mmHg

Lactate: 1-2 mmol/L

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What are advantages and disadvantages of re-breathing systems?

(+): Requires lower fresh gas flow

(-): Higher resistance (valves), slower [AX] change, more components

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What pressure do you use to check for leaks in the AX machine/system? How much leakage is acceptable (mL)?

30cmH2O

Up to 300mL

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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

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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

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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

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What do each of these capnograph wave forms represent?

Orange/top: Normal breathing

Yellow/middle: Hyperventilation

Red/bottom: Hypoventilation

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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?

1. Color coding and labelling 2. Diameter index (gas-specific threaded connections) 3. Pin index (gas-specific pin pattern) 4. Quick connectors 5. Regulator (pressure-reducing valve) 6. Flow meter (gas specific) 7. 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