reviewwwww Flashcards
albumin must be what magic number to maintain vasculature permeability?
> 1.5g/dL
when should you NOT use colloids?
dehydrated, coagulopathy, head trauma, impaired renal functioning
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
Hgb Should be more than ____ and TP should be more than ____
Hgb > 7g/dL
TP >4g/dL
alpha drugs cause ____ and beta drugs cause ____ and them mixed help maintain BP
vasoconstriction; volume expansion
what drug blocks alpha adrenergic receptors?
Acepromazine which is a phenothiazine
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
why would myocardial necrosis occur in stress dog?
Massive catecholamine releases causing focal coag. necrosis with neutrophilic inflammation –> necrosis
why do we read lead 2 in ECG’s?
gives us the greatest surface area of heart electricity
With sinus arrh. will see short QRS during ____ and long QRS during _____
inspiration; expiration
what does a sinus bradycardia indicate?
high vagal tone (in brachycephalics but also due to alpha-2’s or high ICP patients)
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
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
What is the mobitz type 1 2nd degree AV block?
Wenckebach rhythm, P-R interval increases gradually and then beat is dropped completely
irregular
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
What is the most severe AV block?
3rd degree
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
? 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
How to tx premature atrial contractions:
digoxin/ Ca2+ channel blockers
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
Atrial flutter–
looks like saw blade, treat with vagal maneuver (ocular/carotid sinus pressure)/lidocaine/Ca channel blockers/beta blockers
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 ___
12
how can we tx hypovent?
increase mechanical ventilation
