reviewwwww Flashcards by Tara Butler

albumin must be what magic number to maintain vasculature permeability?

> 1.5g/dL

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when should you NOT use colloids?

dehydrated, coagulopathy, head trauma, impaired renal functioning

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how much fluid replacement do we do (%) in a dehydrated p in a 24 hour period before sx?

replace 75-80% dehydrated fluid deficit in 24 hr period prior to anesthesia to prevent fluid overloading

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Hgb Should be more than ____ and TP should be more than ____

Hgb > 7g/dL
TP >4g/dL

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alpha drugs cause ____ and beta drugs cause ____ and them mixed help maintain BP

vasoconstriction; volume expansion

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what drug blocks alpha adrenergic receptors?

Acepromazine which is a phenothiazine

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What drug is a 1B anti-arrhythmic?

Lidocaine

is also a free radical scavenger, increases GI motility, cheap, good for visceral pain, lowers MAC, synergistic w opioids

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why would myocardial necrosis occur in stress dog?

Massive catecholamine releases causing focal coag. necrosis with neutrophilic inflammation –> necrosis

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why do we read lead 2 in ECG’s?

gives us the greatest surface area of heart electricity

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With sinus arrh. will see short QRS during ____ and long QRS during _____

inspiration; expiration

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what does a sinus bradycardia indicate?

high vagal tone (in brachycephalics but also due to alpha-2’s or high ICP patients)

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sinus tachycardia is regular sinus that is faster than n and is the most common arrhythmia in dogs and cats due to what??

due to sympathetic tone/pain/stress/ any shock

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P with NO QRS-T (dropped beat) is what arrhythmia? How do we tx it?

2nd degree AV block, tx with atropine or glycopyrrolate
caused from impulses not making it all the way to the ventricle

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What is the mobitz type 1 2nd degree AV block?

Wenckebach rhythm, P-R interval increases gradually and then beat is dropped completely
irregular

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What is the mobitz type 2 2nd degree AV block?

P-R interval does not lengthen, no pattern at all, seriousness involves how wide th QRS complex gets, worse than type 1

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What is the most severe AV block?

3rd degree

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What occurs in 3rd degree AV block???

complete block –> atria and ventricle work independently, P wave with wide QRS complex, if QRS narrow –> impulse from His Bundle/Purkinje, anticholinergics do nothing

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? is irregularly irregular orginiation from the atrial foci other than SA node and P-R interval is shorter HR is n and is due to atrial enlargement (HCM)

Premature atrial contractions

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How to tx premature atrial contractions:

digoxin/ Ca2+ channel blockers

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Atrial tachycardia–

supraventricular arrhythmia, rapid and regular from ectopic atrial site, can look like sinus tachycardia but weird P waves due to ambiguity of P/T wave almost overlapping, due to large atria/HCM/hyperthyroid, treat with vagal maneuver (ocular/carotid sinus pressure)/lidocaine/Ca channel blockers/beta blockers

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Atrial flutter–

looks like saw blade, treat with vagal maneuver (ocular/carotid sinus pressure)/lidocaine/Ca channel blockers/beta blockers

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ventricular beats usually have _____ QRS and ____ P or T waves

wide; absent P or T wave

V tach

Wide and ugly QRS complexes with no T or P waves, no to weak pulses and tx with lidocaine or calcium channel blockers

VPC in repeating pattern is called…

bigeminy

cat lung capacity is about ____ mL do not put more than ___ mL in the tube

400mL; 3mL

Emergence delirium vs dysphoria

Emergence delirium--> uncoordinated thrashing of p due to partial consciousness a anesthesia Dysphoria- uncontrolled pain or airway obstruction, or other issues causing the freak out

hypotension is Systole less than ___ MAP less than ___ Diastole less than ___

Systole less than 80 MAP less than 60 Diastole less than 40

what drugs can cause increased HR?

Alfaxalone, ketamine, atropine, dopamine

Hypertension is defined as Systolic over ___ MAP over ___

Systolic over 160 MAP over 120

why does opioids not cause nausea in sick old p?

Bc most Mu receptors already taken up due to disease process

Sevoflurane allows for quicker recoveries over isoflurane because it is...

not as soluble

pig tail wave form on capnograph means....

poor compliance due to obese p

bronchospasm looks like this shape on capnograph waveform:

Shark fin with shark head going toward left

What does it mean when capnograph waveform is opposite of shark fin?

Emphysema or alveolar slope from increase compliance

Controlled drugs and their classes

Opioids are Class 2 Tramadol, benzodiazepines, and butorphanol class 4 buprenorphine class 5 Ketmine and Telazol Class 3

Steps for correcting hypotension in order:

Decrease inhalant.... bolus crystalloid..... bolus a colloid.... vasopressor

requires ___ mL/kg of plasma to increase albumin eve ____ g/dL

require 45mL/kg plasma to increase albumin 1g/dL

base excess= high ____ Base deficit = low ____

HCO3-; HCO3-

T/F anemia causes hypoxemia

FALSEEE

what are the best combo drugs to use w renal p?

Ace and alpha 2 DO NOT use sevo

HCM vs. DCM

HCM is decreased chamber size with issues w vent. filling DCM is increased chamber size w poor CO

ETCO2 < ____ < ____

ETCO2 < PACO2 (alveolar) < PaCO2 (arterial)

What happens if you have p on torb but then something painful happens?

you can use fentanyl but would have to use a lot bc you need to compete for the receptors

fentanyl is a full ___ ___

mu agonist

Cannot do lidocaine CRI to cats- why?

Can cause toxicosis bc metabolized in the liver

buprenorphine

Slow onset, takes about 30 minutes to get on board, has long duration (can last up to 6-12 hours) Mild to moderate analgesia Has a ceiling effect which means you cannot decrease pain threshold as much as you need so you will not be helping that p as far as pain control even when you increased the dose/re-dosed ***Has higher affinity for the mu receptor, latches on and does not let go until its metabolized and that sucks in cases where your patient is still in pain and cannot use full mu because the receptor is still being used by buprenorphine Good in some cases with cats for post-op, makes cats happier and hungry, and successful but not the case in dogs, we don’t love it for dogs unless we do not have anything else does very good at its job

What happens if you p is on buprenorphine but now we are doing

Affects the drugs because we wanted to use fent, so you would have to give more fent to override buprenorphine which is very hard bc has very high affinity for mu receptors, so have to use a lot of fentanyllllll

why do we not want to use CRI lidocaine in cats?

it can cause toxicosis bc metabolized by the liver

What is the henderson hasselbach equation?

pH= pKa + log base/acid

what are the 3 hydrogen ion regulation buffer systems in the body?

blood ventilatory responses (fast) renal responses (slow)

RULE OF 4 for knowing normal values:

PaCO2 40 pH 7.4 Bicarb 24 Base Excess (BE) -4 to +4

Bicarb is always ___ than ___

Bicarb is always lower than PaCO2

Anion gap should always be lower than ___

how can we tx hypovent?

increase mechanical ventilation