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Anesthesia CBC > Midterm > Flashcards

Midterm Flashcards

1
Q

What are the reasons for using preanesthetic drugs prior to induction?

A

Reduce anxiety.
Relieve pain.
Reduce dose of anesthetic.
Provide smooth induction.

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2
Q

What mechanism is responsible for bradycardia induced by pressure on the eye?

A

Oculocardiac reflex

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3
Q

Which mechanism is responsible for further decreases in HR when atropine is administered to treat bradycardia?

A

Stimulation of central vagal nucleus in medulla

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4
Q

Why can’t glycoperrolate diffuse across the blood brain barrier easily?

A

Large molecular size

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5
Q

Which species does atropine cause a significant decrease in GI and ruminal motility that can result in ileus and ruminal stasis?

A

Horses, ruminants

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6
Q

Which species is least resistant to atropine toxicity?

A

pigs

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7
Q

What kind of drug is Ace classified as?

A

major tranquilizer

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8
Q

What action is responsible for hypotension after admin of Ace?

A

alpha-1 blockade

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9
Q

What are the pharmacological effects of Ace?

A

Anti-emetic
Anti-arrythmic
Decreased seizure threshold
Anti-histaminic effect

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10
Q

What should be given to treat the severe hypotension that results from epinephrine reversal after giving Ace?

A

Phenylephrine

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11
Q

What drug causes permanent penile paralysis in horses?

A

Ace

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12
Q

What pre-existing conditions are contraindicated for Ace admin?

A

Seziure, hypovolemia, hypotension, excessive hemorrhage

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13
Q

Which class of drugs produces good analgesia and muscle relaxation

A

Alpha 2 agonists

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14
Q

Rank the alpha 2 agonists from high to low for alpha 2:alpha 1 selectivity.

A
  1. Medetomidine (most selective)
  2. Romifidine
  3. Detomidine
  4. Clonidine
  5. Xylazine (least selective)
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15
Q

Changes in arterial BP after admin of xylazine are characterized by a biphasic response that increases BP initially then secondarily decreases. What is the mechanism behind this?

A

Initial increase is a result of stimulation of POSTsynaptic alpha 2 receptors and secondary decrease is a result of stimulation of PREsynaptic alpha 2 receptors.

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16
Q

What drug ca cause vomiting in dogs and cats?

A

xylazine

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17
Q

What drug can cause a significant increase in urine output and therefore should be used with caution in patients with urethral obstruction?

A

xylazine

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18
Q

Which alpha 2 agonist is often preferred for standing dentals because it causes less ataxia and less lowering of head position during sedation?

A

Romifidine

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19
Q

Which alpga 2 agonist is preferred for diagnostic procedures like Rads or CT scans that requires deep sedation but not general anesthesia in dogs?

A

Medetomidine

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20
Q

Which alpha 2 agonist is most likely to cause premature parturition in pregnant ruminants during the last trimester?

A

xyalzine

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21
Q

Which alpha 2 antagonists can be given to reverse the effects of alpha 2 agonists?

A

Atipamazole, tolazoline, yohimbine

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22
Q

What species is more sensitive to tolazolines? (ie have to use lower dose)

A

camelids and ruminants

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23
Q

Which alpha 2 antagonist is more effect in antagonizing CNS depression from alpha 2 agonists?

A

Atipamazole

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24
Q

Central muscle relaxation is produced by transmission of what location?

A

Internuncial neurons in the spinal cord

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25
Q

Which drugs can produce central muscle relaxtion?

A

Diazepam, midazolam, guafinesin, xylazine

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26
Q

Transient hypotension can occur following rapid IV admin of diazepam because of _______ which is used as a vehicle to increase solubility of the drug.

A

propylene glycol

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27
Q

Which tranq has minimal CV effects and is often used as part of an anesthetic regimen in high risk animals?

A

Diazepam

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28
Q

What drug can be used to produce reliable sedation when other tranq of sedatives fail?

A

chloral hydrate

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29
Q

What drug relies on it’s metabolite to produce CNS effects?

A

chloral hydrate

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30
Q

What drug is often administered to produce tranquilization in viscous dogs?

A

Innovar Vet

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31
Q

What is the primary pharm effect of diazepam?

A

Anxiolytic effect

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32
Q

What reflexes can animals maintain during ketamine anesthesia?

A

Palpebral, corneal, swallowing

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33
Q

What injectable anesthetic is used for it’s minimal CV depression?

A

Etomidate

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34
Q

What anestheic can be administered as a CRI at a subanesthetic dose to produce long duration of anesthesia?

A

ketamine

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35
Q

What receptors are responsible for the analgesic effect produced by ketamine?

A

opiate receptors and NMDA receptors

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36
Q

What injectable anesthetic increases ICP and thus is not an ideal anesthetic for use in patients with pre-existing ICP?

A

ketamine

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37
Q

What drug produces central muscle relaxation and is often used in combo with ketamine to improve muscle relaxation?

A

xylazine

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38
Q

What mechanism does recovery from anesthesia depend on?

A

Redistribution to peripheral muscle and fat tissue

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39
Q

Telazol is a proprietary combo of ______ and _______.

A

Zolazepam and Tilatamine

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40
Q

What species experiences emergence hallucination or excitement during recovery when given telazol?

A

Horses

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41
Q

Regarding telazol, ______ lasts longer than ______ in dogs.

A

Tiletamine lasts longer than Zolazepam.

42
Q

What anesthetic is often used in animals with severely compromised cardiac function?

A

Etomidate

43
Q

Which anesthetic decreases cortisol secretion?

A

Etomidate

44
Q

Propofol anesthesia is often accompanied by _______ _______ and ______.

A

Transient apnea, vasodilation

45
Q

What is responsible for longer shelf life of propofol 28?

A

20 mg/mL benzyl alcohol

46
Q

What occurs with guafenisin admin when 3-4xs appropriate dose is given in a short time period?

A

respiratory muscle paralysis

47
Q

What barbituate is given to humanely euthanize animals?

A

pentobarbital

48
Q

Why are local anesthetics less effective when injected into infected tissue?

A

More ionized form of local anesthetic in the infected area.

49
Q

Concerning local anesethetics, which drug is more cardiotoxic between bupivicane, lidocaine, and mepivicane?

A

Bupivicane cardiotixicity»lidocaine and mepivicane

50
Q

Rank local anesthetics based on duration of action from shortest to longest.

A

Lidocaine

51
Q
  1. You are maintaining anesthesia on 20kg dog for spay. Iso is set to 2%. One hour of procedure notice that reservoir bag on circle system is deflated so you utilize O2 flush valve to refill reservoir. What effect can this have on inspired Iso concentration?
A

Will decrease it

52
Q

An E tank has a pressure of 200 psi, how many liters of gas approximately does it contain?

A

70L

53
Q

In the US, what color are medical air grade cylinders?

A

yellow

54
Q

Storing a gas cylinder upright and unsecured constitutes risk of the cylinder becoming a ______.

A

missile

55
Q

A modern Iso vaporizer is also compatible with which agents?

A

Nothing besides Iso, specific agents must be used

56
Q

How is patient prevented from rebreathing CO2 when connected to a circle system?

A

Sodasorb scavenges CO2, valves prevent the patient from rebreathing CO2

57
Q

What is an advantage of semi-open over semi-closed?

A

Less risk of mechanical failure

58
Q

Which type of anesthesia breathing circuit would be most advantageous in a situation where there is limited supply of O2?

A

Closed

59
Q

An activated charcoal canister used for active scavenging of inhalant anesthetics needs to be replaced when _____ changes.

A

weight

60
Q

What are the benefits of using an endotracheal tube in an anesthetized patient?

A

Reduced risk of aspiration
Reduced risk of airway obstruction
Accuracy in monitoring expired CO2

61
Q

What is the primary disadvantage of Sevo over Iso?

A

cost (sevo more expensive)

62
Q

For maintenance of anesthesia, what advantages do inhalants have over injectables?

A

Safety, cost, rapid adjustment of effect

63
Q

Based on blood:gas parturition coefficient, how do you determine which will give a more rapid induction?

A

Lowest blood:gas parturition coefficient will give most rapid (50:1 is faster than 2001:)

64
Q

How is the amount of Sevo being given to a patient clinically measured?

A

Volume percent

65
Q

Calculation question: Beginning anesthetic procedure with naïve machine…

  • Circle breathing volume=6L
  • Oxygen flowmeter set at 2L/min
  • Iso vaporizer set at 1.5%
  • How long till iso conc in circuit is 1.47%?
A

6L x 2L/min=3 min time constant
1.47%= about 4 time constants
4 TC x 3 min=12 minutes until Iso concentration is 1.47%

66
Q

Calculation question: Administering anesthesia for 2 hr procedure…

  • Breathing circuit volume=5L
  • Oxygen flowmeter=0.5L/min
  • Iso vaporizer=2%
  • At the end of the procedure you turn of the vaporizer and inc fresh gas flow to 5L/min. What is inhalant conc one minute after you make the adjustment?
A

2% vaporizer turned down to 0%, so 2-0=difference of 2
Find new time constant:
5L/5L/min=1 min, new TC which is 63% change in concentration
Asking for concentration after 1 min, which is one time constant.
So multiply 2 x 0.63=1.26% CHANGE, so have to subtract this from original concentration.
2-1.26=0.74% for concentration after ONE MINUTE.

67
Q

Calculation question: Administering anesthesia for 2 hr spay

  • Breathing circuit volume=5L
  • Oxygen flowmeter=0.5L/min
  • Iso vaporizer=1%
  • After uterus has been removed, you inc vaporizer to 2% to facilitate muscle relaxation. How long before patient is inspiring ~2% iso?
A

5L volume x 0.5L/min=10 min time constant

10 min x 4 TC=40 minutes until it’s at 2%

68
Q

What is included in capacity volume when predicting the time constant?

A

Vaporizer voume, patient tidal volume (sodasorb canister volume NOT included)

69
Q

True/False: Uptake of volatile anesthetics by muscle is a beneficial effect.

A

False

70
Q

What causes a patient with rapid, shallow breathing pattern to take longer to induce on Sevo than a patient with a normal breathing pattern?

A

Decreased depth of breath.

71
Q

What subset of the population has been shown to be at increased risk to developing health problems due to exposure of waste anestethic gases?

A

NONE (not even pregnant ladies)

72
Q

MAC is a standard _______ of ______.

A

Index of potency

73
Q

MAC represents what portion of a population?

A

ED50

74
Q

How can you reduce MAC?

A

Administer analgesics

75
Q

True/False: MAC is inconsistent between species.

A

False

76
Q

What is the MAC of Iso and Sevo in a dog?

A

Iso=1.3-1.6

Sevo=2.3-2.6

77
Q

What characteristics will decrease the MAC of an inhalant?

A

Pregnancy
Hypothermia
Very old patient
Ace as a premed

78
Q

What is the mechanism of inhalant anesthetics?

A

Not fully understood

79
Q

What process results in action potential being created by a nociceptor?

A

Transduction

80
Q

What pain fiber is responsible for transmission of slow, generalized, persistent nociception?

A

C fiber

81
Q

What is the gold standard for assessing pain?

A

NONE

82
Q

 3 y/o MN lab returns for recheck for a recheck 6 mo after uncomplicated repair of tibial fracture. The fracture healed completely but the o reports that p still appears painful. During PE the patient screams when you pull at his hair on the affected limb. You hospitalize him and put him on CRI of fentanyl. After 24 hours the patient shows no signs of improvement. His signs are consistent with what type of pain?

A

Neuropathic pain

83
Q

Modulation of the afferent pain input occurs where?

A

Spinal cord

84
Q

What are the two main effects of eicosanoids on the peripheral tissue as related to the production of pain?

A

Sensitization of pain receptors

Vasodilation

85
Q

What is labeled with peri-operative use in cats?

A

Robenacoxib

86
Q

What drug is contraindicated for pre-op admin in the following situations:

  • ->6 year old female spayed cocker spaniel presented for cutaneous mass removal. Patient has hx of immune modulated thrombocytopenia and has platelet count of 50,000 (low)
  • ->11 year old DSH cat presenting for dental and extractions. Patient has 1 year hx of chronic RENAL FAILURE managed with diet and SQF. Patient is approx 7% DEHYDRATED at presentation.
A

NSAIDs

87
Q

What NSAIDs inhibit the COX 1 enzyme?

A

phenylbutazone, flunixin, carprofen (all NSAIDs inhibit COX 1)

88
Q

What does NOT describe the effects of eicosanoids in the CNS?

A

increases glutamine activity

it DOES increase Ca activity and activate microglia

89
Q

What is butorphanol classified as?

A

Mu antagonist, Kappa agonist

90
Q

What is the decreasing order of onset (slowest to fast)?

Hydropmorphone, remifentanil, morphine, fentanyl

A

Morphine–>hydromorphine–>fentanyl–>remifentanil

91
Q

You have anesthetized a 1 year old female mixed breed canine for an OHE. As the surgeon breaks the suspensory lig the patient shows signs of nociceptive stimulation. You decide to treat with a rapid bolus of morphine given IV. The next vital sign readings show the patient has signs of low BP accompanied by a rapid HR. What is the most likely cause of this low BP?

A

Histamine release

92
Q

What opioid receptors produce analgesia when stimulated?

A

Mu, Kappa

93
Q

Opioids produce their analgesic effects at what step of the pain pathway?

A

Modulation

94
Q

What are five disadvantages of NMBA blocking agents

A 
Mechanical ventilation
Monitoring
Uncertainty of duration
Residual weakness
side effects
95
Q

True/False: One of the side effects of Atracurium is myalgia.

A

False

96
Q

How do edrophonium, neostigmin, and pyridostigmine antagonize the effects of NMDA?

A

Increases the level of chemical messenger (Ach) in the neuromuscular junction

97
Q

What is the most commonly seen clinical side effect from admin of Neostigmine?

A

Bradycardia

98
Q

What amount of nicotinic receptors need to be blocked by NMDA before a reduction in twitch strength is noted by peripheral nerve stimulation?

A

75%

99
Q

Where is legal guidance for appropriate means of euthanasia documented?

A

State Practice Act

100
Q

What can be used BY ITSELF to confirm death after euthanasia?

A

Rigor mortis

101
Q

You perform an OVE on a bitch 55 days into gestation. Is it AVMA panel on euthanasia recommendation that you inject each fetus in the removed uterus with pentobarb to insure there is no suffering?

A

NO, false

102
Q

What are acceptable causes of death following euthanasia?

A

Direct hypoxia
Indirect hypoxia
Chemical depression of neurons
Physical destruction of the brain

Anesthesia CBC (1 decks)

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