Test 2 Flashcards
(397 cards)
1
Q
If you puncture the dural sac when performing an epidural, what should you do?
A
Decrease the volume by 50%
1
Q
What are the side effects of vasopressin?
A
Decreased tissue perfusion
Contraction of the baldder and gal bladder
Local irritation at injection site
Skin necrosis if extravasation
1
Q
What are the starling forces that push water out of the blood vessels?
A
Capillary hydrostatic pressure
Interstitial oncotic pressure
1
Q
What are the 4 types of adverse effects of transfusions?
A
Acute immunologic
Acute nonimmunologic
Delayed immunologic
Delayed nonimmunologic
1
Q
How long does it take for the renal system to buffer H+?
A
Hours to days
1
Q
What is the order of the pain perception pathway?
A
Transduction
Transmission
Modulation
Projection
Perception
1
Q
What is the threshold of A delta fibers? C fibers?
A
A delta = low and high threshold
C = high threshold
1
Q
What type of pain is caused by damage to body tissue from heat, cold, mechanical, or chemical stimuli?
A
Physiologic (nociceptive)
2
Q
What is the equation used to calculate bicarbonate therapy?
A
mEq to infuse = base deficit x BW x 0.3
3
Q
IPPV I:E ratio in SA? LA?
A
1: 2-1:3
1: 2-1:4.5
3
Q
What are the side effects of isoproterenol?
A
Arrhythmias
Tachycardia
Hypotension (beta 2)
4
Q
During CPR, if breathing does not resume, how often do you ventilate and what pressure should you ventilate to?
A
10-12 bpm
20 cm water
4
Q
Metabolic acidosis has what effects to bicarb and CO2?
A
Decreased bicarb first
Compensatory decrease in CO2
5
Q
What nerves are you trying to block with a proximal paravertebral block?
A
T13, L1, and L2
6
Q
What is the max dose of Lidocaine you should inject into dogs and cats?
A
4mg/kg in dogs
2mg/kg in cats
6
Q
What is the blood volume for porcine?
A
50 mL/kg
6
Q
When doing compressions on a patient 7-10kg, where should you place your hands?
A
Apex of the heart between 4-6 intercostal spaces at the c-c junction
6
Q
Where does the lateral column of the white matter of the spinal cord go to?
A
Somatic sensory to the brain
6
Q
Is Xylazine more potent in ruminants or horses?
A
10x more potent in ruminants
6
Q
What happens to the eyeball of cattle if they get too deep?
A
Dorsal rotation
6
Q
What induction drugs enhance NMBAs?
A
Propofol
Ketamine
Thiopental
7
Q
What are the indications for using packed RBCs (pRBC)?
A
Acute blood loss/hemorrhage
Anemia
8
Q
What does a blood gas analyzer directly measure?
A
pH
PO2
PCO2
8
Q
What is the most revealing clinical sign of impending malignant hyperthermia?
A
Rapidly increasing ETCO2
9
What receptors do dopamine act on?
Alpha 1 agonist
Beta 1 and 2 agonist
11
IPPV respiratory frequency?
Dogs
Cats
Horses/Cows
Pigs/Small Ruminants
Dogs: 8-14bpm
Cats: 10-14bpm
Horses/Cows: 6-10bpm
Pigs/Small Ruminants: 8-12 bpm
11
What are some indications for uring a soaker catheter?
Amputation
Thoracotomyu
Total ear canal ablation sites
11
Duration of action of colloids is dependent on what?
Size of the particles
11
What is the pH range that is compatible with life?
6.8-7.8
12
What is the effect of the supraorbital nerve block?
Anesthesia to the upper eyelid
13
What are some special considerations for horse anesthesia?
Obligate nasal breathers
Prone to V/Q mismatch
Myopathy and neuropathy
14
What are the chemical buffers used to buffer H+?
Phosphate
Hemoglobin
Proteins
14
How does the pH and pCO2 of venous blood compare to that of arterial blood?
Slightly lower pH and higher pCO2
15
What are the clinical uses for colloids?
Correct hypovolemia
Support colloid osmotic pressure
Hypoproteinemic patients (TP\<3.5)
15
Which website can you consult to determine withdrawal times in food animals?
FARAD
16
What vertebrae are associated with the brachial plexus?
C6, C7, C8, T1
16
Ketamine is often use with what drugs for induction in horses?
Benzodiazepine
GG
17
What 3 arteries can be used for blood gas in donkeys?
Facial
Transverse facial
Lateral dorsal metatarsal
17
What are 3 normal common cardiovascular conditions seen in horses?
Second degree AV block
Wantering pacemaker
Biphasic P wave
18
What is the normal arterial blood CO2 concentration?
35-45 mmHg
18
For what type of procedures would a caudal epidural be indicated?
Tail, perineum, anus, rectum, vulva, prepuce, and skin of scrotum
18
What are the primary ICF anions?
Organic phosphaates and proteins
18
What fluids should not be given with infusions and why?
Calcium containing fluids b/c it overcomes anticoagulant properties of citrate
Hypotonic fluids b/c it causes hemolysis
18
What are some concerns associated with transfusions?
V/D
Urticaria
Hemoglobinuria
18
What are NSAIDs good for?
Post-op pain (w/ opioid)
Inflammatory conditions (itis)
18
Fasting time for pigs?
6-12 hours
Water is ok
19
What lab data is useful when monitoring fluid therapy?
Biochem profile (BUN and protein)
PCV/TP
A-B status
Serial lactate values
19
What is the normal range for PaCO2?
40
| (35-45)
19
Windup occurs especially with which type of fiber?
C fibers
20
What are the most common causes of hypotension under anesthesia?
Vasodilation
Contractility
Bradycardia
20
What is the formula for maintenance fluid rates?
(BW in kg x 30) + 70 = mL/day
20
What is the main purpose of using replacement crystalloids?
Expand ECF volume w/o changges in electrolyte composition
It does not induce fluid shifts between ICF and ECF
20
T/F: It is acceptable to round up when calculating a dose of NSAIDs
False
Do NOT exceed upper dose limit
20
The dorsal pedal artery should be used for blood gas samples in what type of animal?
Small animals
20
Which system is responsible for the behavioral and emotional response to pain?
Limbic system
21
What are the 3 types of infiltrative local block?
Incisional line block
Inverted L block
Soaker catheters
21
What is the part of the medulla where the primary neurotransmitters are serotonin and norepinephrine?
Nucleus raphe magnus
22
Under what circumstances would you use hypertonic saline (7.5% NaCl)?
Increased ICP
Rapid hemorrhage
22
What are the different colloids?
Dextrans
Hydroxy-ethyl Starches (HES)
Polygelatins
Plasma/Albumin
23
What do you do after IPPV is discontinued?
Patient should continue to receive supplemental O2 and can be manually ventilated at 1-4 bpm until spontaneous ventilation has returned and stabilized
24
What premed can cause colic?
Opioids
25
What receptors do isoproterenol act on?
Beta agonist
26
How do you calculate functional residual capacity?
Expiratory reserve volume + Residual volume
27
What is the normal SaO2?
95-100%
| (80-150 mmHg)
29
Respiratory alkalosis has what effects to bicarb and CO2?
Decreased CO2 first
Compensatory decrease in bicarb
30
How does the impedance threshold device work?
Prevents air flow in ETT -\> more negative pressure in chest generated during chest recoil
31
What are things you should know going into a case with acute blood loss?
PCV/TP
Anticipated losses
Total blood volume and 10%; 20%
32
What is the onset of action for Lidocaine and Bupivicaine?
Lidocaine = 5-15 minutes
Bupivicaine = 15-30 minutes
33
What are the primary ECF anions?
Cl-
HCO3-
35
Definition: Noxious stimuli are converted into an electrical action potential by the terminal ends of sensory nerve fibers.
Transuction
37
What are the clinical uses of phenylephrine?
Significant vasoconstriction
Splenic contraction
Decrease epistaxis
Decrease nasal edema
37
Which NMBA has no CV effects and a lower histamine release potential?
Vercuronium
38
Calculate the drip rate for a 12 kg dog receiving 10 mL/kg/h fluids using a 15 drop/mL set.
12 x 10 x 15 / 60 / 60 = 1 drop/2 seconds
38
What NSAID is useful for colic pain?
Flunixin meglumate
40
What are the clinical uses of dopamine?
Treatment of hypotension
Increase urine output
41
Activation of which excitatory receptor leads to alterations in gene expression?
Metabotropic glutamate
42
What areas does an infraorbita nerve block desensitize?
Upper dental arcade (as far back as first premolar)
Upper lip and nose
Dorsal aspect of nasal cavity
Soft and hard palates
43
How do NSAIDs work to reduce pain?
Act primarily in the periphery to decrease production of pain causing substances (prostanoids)
44
T/F: General anesthesia prevents windup
False
It does not prevent the generation of action potentials in the primary afferents
45
At what age does the stomach of ruminants switch from a simple stomach to rumen functions?
3 months
46
What are the signs of LA toxicity?
CNS: sedation then tonic-clonic seizures, coma
Respiratory depression
Bradycardia, arrhythmias, hypotension
46
What is the difference in O2 saturation between arterial and venous blood?
Arterial = \>88%
Venous = 65-75%
47
What are the effects of hypercapnia?
Vasodilatioin of peripheral arterioles and myocardial depression
Increases circulating catecholamines
Narcosis with PaCO2 values \>95 mmHg (complete anesthesia at 245 mmHg)
49
Why might you not choose telazol for induction in horses?
Rough recovery
50
What type of blood sample is useful in determining acid-base status? Arterial or venous?
Venous
51
What is the effect when Beta 2 receptors are stimulated?
Vasodilation
52
What physiological signs are associated with blood loss?
Hypotension (decreased BP)
Tachycardia
Pale mm, prolonged CRT
52
Which NMBA is 4x more potent than atracuriuim, less histamine release, and less laudanosine production?
Cisatracurium
53
After doing compressions for how long is it acceptable to switch to internal cardiac massage?
After 2-5 minutes of inadequate circulation
54
What affect does hypothermia have on a blood gas sample?
Artificially elevates PaO2 and PaCO2
54
Where should you place a doppler on a pig?
Tail
55
What species is more prone to develop methemoglobinemia with Prilocaine and Benzocaine?
Cats
56
Which of the replacement crystalloids is not a balanced electrolyte solution?
Saline
57
Know this chart!
58
T/F: NSAIDs must be given with food
True
58
What is the normal range for PaO2 at room air?
100
| (80-110)
59
What causes visceral pain?
Stretching, distantion, or inflammation of the viscera
60
What is the total body water in adult dogs and cats?
60%
60
How does the infusion rate of colloids compare to crystalloids?
Lower (2-5 mL/kg/h)
61
What are the clinical uses of isoproterenol?
Increase HR
Treatment of 3rd degree block
Potent inotrope
Potent chronotrope
61
Which tract projects transmission of deep pain and visceral sensations?
Spinoreticular tract
61
What is the effect of opioids at the limbic system?
Alter the emotional response to pain and make it more tolerable
62
What effect does lipid solubility have on the onset of action and duration of action of LA?
Slower onset
Longer duration
62
To perform a successful intercostal nerve block, how many rib spaces should be blocked?
4
2 cranial and 2 caudal to the incision
62
In which species does type and crossmatch have to be performed in prior to every whole blood, RBC, or plasma transfusion?
Cats
62
What type of pain originates from injury of the peripheral or central nervous system an is described as burning or shooting pain?
Neuropathic
63
Which opioids are used in cattle?
Butorphanol
Hydromorphone
64
About how long does it take for a horse to recover from anesthesia?
30 minutes after TIVA
1 hour after prolonged inhalant
66
What drugs are responsible for COX1 and 2 inhibition?
Aspirin
Phenylbutazone
Ketoprofen
Ketorolac
Flunixin
Meglumine
67
What are the primary ICF cations?
K+
Mg2+
67
Activation of which excitatory receptor leads to slower onset and longer lasting pain states caused by prolonged input from A delta and C fibers?
NMDA
68
Which NMBA is degraded by Hofmann elimination?
Atracurium
69
What two drugs can cause malignant hyperthermia in pigs?
Halothane
Succinylcholine
71
What effect does hypertonic saline have on the movement of fluid already in the body?
Draws fluid into the intrvascular space
72
How long does it take for the therapeutic effects of NSAIDs to occur?
≥45 minutes despite ROA
74
What is the RBC lifespan in canine?
110-120 days
74
What is a possible side effect of Ace in ruminants?
May increase the risk of regurgitation
75
What centrally acting analgesic binds weakly to u opioid receptors and inhibits reuptake of norepinephrine and serotonin?
Tramadol
76
What receptors do norepinephrine act on?
Alpha 1 and 2 agonist
Beta 1 and 2 agonist
76
What are the COX3 preferential drugs?
Acetaminophen
Diclofenac
78
What are the effects of dopamine?
78
What species is most sensitive to Xylazine?
Goats
78
T/F: In pigs, Xylazine causes more cardiovascular depression and less analgesia than Dexmedetomidine
True
80
T/F: The base excess value is the same in venous and arterial blood
True
81
What positions for ruminants are least likely to result in regurg?
Right lateral
Sternal recombency
82
What drug inhibits osteoclast-mediated bone resorption?
Alendronate
83
Out of the total body water, how much is ICF and how much is ECF?
60% TBW
40% ICF
20% ECF
84
How do A2 agonists affect pain?
Activate A2 receptors which decreases release of norepinephrine
85
T/F: Elimination of LA that have high affinity for proteins is faster
False
Its slower
86
What drug reverses Rocuronium and vecuronium block?
Sugammadex
87
T/F: Smaller non-myelinized fibers are more susceptible to LA
True
88
What is the formula to calculate the amount of blood to give?
(desired PCV - actual PCV) / donor PCV x patient blood volume
89
Which fibers are responsible for sympathetic postganglionic innervation?
C fibers
90
Which LA form remains at the receptor site longer, charged (cationic) or non-charged
Charged (cationic)
90
Generally, how much lower is the ETCO2 than PaCO2 in horses?
10-15 mmHg
92
How much donor blood will raise the PCV by 1%?
2mL/kg
94
What is COX3 associated with?
Fever initiation
94
In what situation would you use benzodiazepines in horses?
If its a foal
95
T/F: The higher the pKa of a LA, the slower the onset of action
True
96
What patient factor increases the prevalence of malignant hyperthermia in pigs?
High ration of muscle to total body mass and rapid growth
97
What drug can cause penile prolapse in horses?
Acepromazine
98
What nerve must be blocked when dehorning a cow?
Cornual branch of zygomaticotemporal
99
What enzyme turns AA into prostaglandins?
COX
100
Define Intermittent Mandatory Ventilation (IMV)
Operator sets a **predetermined number of positive breaths**, but the patient can also breathe spontaneously
100
What two drugs can delay the appearance of malignant hyperthermia signs in pigs?
Acepromazine
Thiopental
101
Which premed should not be used in sheep because of pulmonary hemorrhage and edema leading to hypoxemia?
A2 agonists
103
What drug causes apneustic respiration?
Ketamine
103
Where are ester LA metabolized?
Plasma
104
What areas does a mandibular nerve block desensitize?
Incisors, canine tooth, premolars, molars
Skin and mucosa of chin and lower lip
105
Where are amide LA metabolized?
Liver
106
Thiopental is used with what drug for IV induction in horses?
GG
107
What are the indications for using LA as antiarrhythmic agents?
Suppress reentrant ventricular arrhythmia
Increase ventricular fibrillatioin threshold
Decrease automaticity
109
T/F: The more a LA is bound to proteins, the shorter the duration of action
False
More protein binding = longer duration
110
Which vein can be used to get a blood gas sample in small animals?
Lingual vein
110
How can ketamine be used in regulating pain?
Sub-anesthetic dose prevents windup by blocking glutamate effects at the NMDA receptor
112
Why are anticholinergics not typically used in ruminants?
Salivary secretions become more viscous and could obstruct airway
Decreases GI motility causing bloat
114
What nerves must be blocked when dehorning a goat?
Cornual branch of infratrochlear
Cornual branch of zygomaticotemporal
116
Which type of fluids exert effects primarily on interstitium and ICF spaces?
Crystalloids
117
Which tract projects superficial pain and tactile sensation?
Spinothalamic tract
119
What is a recruitment maneuver used for and how does it work?
Used to reinflate collapsed alveoli by applying a sustained pressure above normal PIP and using PEEP to prevent derecruitment
121
What can be done to avoid the negative CV effects of mechanical ventilation?
CV effects can be overcome often with expansion of the extracellular fluid volume and administration of inotropic drugs
122
What is COX2 associated with?
Prevents erosions and promotes healing of mucosa
Anti-inflammatory
Renal protection
123
What is COX1 associated with?
Vicero-nociception
Thermal stimulation
Also works with COX2 on the brain, nerves, ovarian/uterine, bone metabolism, and kidneys
124
What must you always do after administration of hypertonic saline?
Always follow up with replacement crystalloid
125
Which premed can cause premature delivery in cattle and sheep?
Xylazine
126
What is the blood volume for equine?
70 mL/kg
TB = 100 mL/kg
128
IPPV Peak Inspiratory Pressure PIP in SA? LA?
15-20 H2O
20-30 H20
128
What are some contraindications of NSAIDs?
Acute renal insufficiency
Hepatic insufficiency
Dehydration
Hypotension/hypovolemia
Coagulopathies
GI ulceration
128
What position during anesthesia can cause compression atelectasis in horses?
Dorsal recumbancy
129
What are the most common premeds used in pigs?
Xylazine with ketamine +/- opioid
Diazepam or midazolam
Azaperone is best but limited avaliability
130
Why should you be cautious of using LRS with blood transfusions?
It contains calcium which interferes with anticoagulant in blood transfusions
130
What type of pain is caused by tissue damage or alterations in the physiology or anatomy of the sensory nervous system?
Pathologic
130
Which NMBAs should not be used with renal insufficiency?
Pancuronium
Doxacurium
131
In what ways is vasopressin better than epinephrine?
Improved:
Neurologic outcome
Cerebral oxygen delivery
Resuscitation success
Blood flow to major organs
132
What are teh 3 types of fluid and solute loss?
Loss of hypertonic fluids (solute in excess of water)
Isotonic loss
Loss of hypotonic fluids (water in excess of solute)
133
What types of cases would it be necessary to use normal saline fluids?
Blocked cats
Chronic renal cases
134
What is multi-modal analgesia?
Use of lower doses of multiple drugs classes provides higher safety and less negative side effects
136
What are the 4 different capacities associated with air in the lungs?
Inspiratory capacity = TV + IRV
Functional residual capacity = ERV + RV
Vital capacity = IRV + TV + ERV
Total lung capacity = IRV + TV + ERV + RV
137
T/F: The slower the firing rate of a nerve, the more susceptible it is to LA
False
The higher the firing rate, the more susceptible
138
Which cranial nerve block can cause lingual paralysis?
Mandibular nerve block
More common when you do both sides
140
Respiratory acidosis has what effects to bicarb and CO2?
Increase in CO2 first
Compensatory increase in bicarb
142
What is the blood volume for feline?
65 mL/kg
143
How often can you do a recruitment maneuver and how long should you hold it for?
Hold for 10-15 seconds once every 5 minutes
144
Which drug in horses makes the eye reflexes less reliable?
Ketamine
145
What factors determine the amount of gas delivered to a patient?
Resistance and compliance of breathing system
Patient's respiratory system
145
What receptors do dobutamine act on?
Beta agonist
146
When is it acceptable to do an intravenous regional (beir) block?
Front or back leg
Biopsies
Small mass removals
Other procedures not expected to take longer than 90 minutes
147
If you are using DEA- donor, and the type and crossmatch were not performed on 1st transfusion, how many days after the initial dose is it safe to continue giving transfusions?
Less than 5 days
149
How do you calculate inspiratory capacity?
Tidal volume + Inspiratory reserve volume
149
What are the clinical uses of ephedrine?
Treatment for hypotension
Increase cardiac output
150
What is pain caused by a stimulus that does not normally cause pain?
Allodynia
152
What is the goal of chest compressions?
Maximize cerebral and myocardial perfusion
153
What is the RBC lifespan in feline?
75-80 days
155
How can you reduce excitement in horses with opioid administration?
Co-administer with A2 agonists or Ace
156
What are soem negative effects of colloids?
Volume overload
Coagulation
Renal failure
Hepatic failure
Anaphylaxis
Pruritus
158
What are the duration of actions of Lidocaine, Mepivicaine, Bupivicaine, and Ropivicaine?
Lidocaine (65% protein bound) = 90-200 minutes
Mepivicaine (75% protein bound) = 120-240 minutes
Bupivicaine (95% protein bound) = 180-600 minutes
Ropivicaine (95% protein bound) = 180-400 minutes
159
What is a pharmacological consideration to using NSAIDs?
They are highly protein bound and may displace other drugs and increase their [plasma]
Caution when using with other highly protein bound drugs
161
What effect do inhalants have on NMBAs?
Enhance intensity and block duration
163
What is the indication for using fresh frozen plasma (FFP)?
Coagulopathies
165
What are the important levels of ETCO2 during CPR?
\>20 mmHg at 20 minutes CPR = increased chance of survival
166
What induction agents are used in ruminants?
Telazol
Ketamine (with benzo or GG)
Propofol
168
How should you alter your anesthetics and fluids when there is blood loss?
Decrease vaporizer setting or off
Decrease PIVA or CRIs
Increase fluid administration
169
T/F: If you are giving colloids and crystalloids together, you should decrease the amount of crystalloids administered
True
170
When is the eyeball ventrally rotated in cattle anesthesia?
Induction and deepening anesthesia
171
Type of pain: The sensitivity of an injured area is enhanced which prevents use of the injured tissue and promotes healing
Inflammatory
173
What class of drugs are most commonly used in horses for sedation, muscle relaxation, and analgesic properties?
A2 agonists
173
What are the side effects of atracurium?
Seizure
Histamine release
174
What are epidural catheters useful for?
Long term post-op pain control or painful ICU patients to reduce the amount of parenteral analgesics necessary
175
T/F: C fibers are responsible for fast pain
False
Slow pain
177
How long does it take for chemical mechanisms to buffer H+?
2-4 hours
178
Where does the dorsal column of the white matter of the spinal cord go to?
Somatic sensory to the medulla
180
What dose of epinephrine can you give during CPR?
0.01 mg/kg IV
182
What do positive inotropic drugs do?
Increase cardiac output
Increase atrial filling pressures
183
What are some patient factors that can affect the amount of fluids needed?
Duration of issue
Estimated losses
Eating/drinking
Panting, febrile
PCV, TP, USG
185
What drugs should you administer prior to anticholinesterase reversal of NMBA?
Anticholinergic drugs
| (atropine and glycopyrolate)
187
What is the normal and ARDS range for the A-a gradient?
Normal = 0-10
ARDS = \>30
188
What level of O2 is generally safe for prolonged administration?
40-50%
188
How do you calculate the fluid drip rate?
Weight x Fluid rate x Drops/mL / 60 / 60
(slide 34 of fluid lecture)
189
Neuropathic pain in which no injury or lesion can be identified
Functional
191
What does COX inhibition affect?
Primary platelet plug formation
Renal and gastric mucosa vascular tone
Smooth muscle contraction
Temp regulation
192
What are some disadvantages of epinephrine?
Severe vasoconstriction
Increased O2 consumption due to increased cardiac work
Can induce v fib
192
What is the system responsible for integrating sensory input and mediating motor, autonomic, and endocrine responses in the hypothalamus?
Reticula activating system (RAS)
193
How do LA work?
Prevent the sodium channels from opening in neuronal axons, thus maintaining the fully polarized state and thus block nerve propagation
193
What are the landmarks for the Inverted L block?
Caudal border of rib 13
Ventral to lateral processes of lumbar vertebrae
195
What is the blood volume for canine?
90 mL/kg
196
What procedures would a forefoot block be useful for?
Declaw
Toe amputation
196
What should you monitor during transfusions?
Temp, HR, RR
q10 min for 30 min then q30
197
What is the effect when Alpha receptors are stimulated?
Vasoconstriction
198
What are the side effects of dobutamine?
Tachycardia
Arrhythmias
Vasodilation
Seizures/tremors
200
T/F: The more lipid soluble a LA, the more potent it is
True
202
What part of the spinal cord is an important relay for descending facilitative an inhibitory modulation of nociceptive input?
Periaqueductal gray matter (PAG)
203
What is a normal PaO2:FiO2 ratio? Ratio for ARDS?
Normal = \> 400
ARDS =
204
What nutraceuticals are most commonly used to treat pain?
Diet
Glucosamine
Dasuquin
Adequan
Omega 3 fatty acids
206
What are the advantages of using oxyglobin?
Multispecies use
No testing
T1/2 = 18-26 hours
207
What areas does a mental nerve block desensitize?
Rostral mandible
Canine and incisors
208
Metabolic alkalosis has what effects to bicarb and CO2?
Increased bicarb first
Compensatory increase in CO2
209
What is the difference in PO2 between arterial and venous samples?
Arterial = 80-110 mmHg
Venous = 35-45 mmHg
210
What effect will heparin have on your arterial sample?
Decreased pH
211
If your patient has cardiac disease, anuric renal failure, or is geriatric, how should you adjust your fluid rate?
Decrease it to 2-5 mL/kg/h
213
What procedures would indicate a hindlimb nerve block?
Procedures from the stifle distally
215
Why should you not refrigerate whole blood?
It will inactivate platelets and WBCs
216
What type of pain is described as deep, cramping, aching, gnawing, or poor localization?
Visceral
217
Which lamina of the grey matter of the spinal cord is important in sensory relay for pain and temperature from A delta and C fibers?
Lamina 1
218
What is the normal BE in an arterial sample?
0+/-4
219
What receptors are stimulated my dopamine depending on the dose? (low, medium, high)
Low = dopamine receptors
Medium = beta mainly with mild alpha
High = significant beta and alpha
220
In what species does rotation of the globe not occur under anesthesia?
Sheep and goats
221
Where do you place the ECG leads on a horse?
Negative on right jugular furrow
Positive on left throacic apex
Third lead distal to the heart
222
What class of drugs will reverse nondepolarizing NMBA and what are the drugs?
Anticholinesterase drugs:
Edrophonium
Neostigmine
Pyridostigmine
223
What is the acceptable oxygen flow rate for ruminants?
10-20 mL/kg/min
225
When would you use a CRI of epinephrine?
In non-responsive hypotension
226
What are some contraindications of an epidural?
Sepsis
Coagulopathy
Local infection at site
Lumbosacral fractures or dislocations
Uncorrected hypovolemia
227
What are the starling forces that keep water inside blood vessels?
Interstitial hydrostatic pressure
Capillary oncotic pressure
229
T/F: You can use NSAIDs together with corticosteroids and other NSAIDs
False
No concurrent corticosteroid or other NSAID administration
230
What is a good indicator of anesthetic depth in pigs?
Jaw tone
232
What receptors do vasopressin act on?
V1 and V2 agonist
233
Adult sheep and goat fasting requirements?
12-18 hours for food
4-8 hours for water
235
What is increased response to a stimulation that is normally painful at the site of injury or in surrounding undamaged tissue?
Hyperalgesia
236
What are some ways in which water can be lost from the body?
Urinary
Fecal
Respiratory (panting)
Cutaneous evaporative
238
How do opioids work centrally?
Modulate nociception in the dorsal horn via release of serotonin and norepinephrine
239
In what scenario can you use ketamine alone for induction in horses?
Following heavy A2 agonist sedation (premed)
241
What is the topical cream used for equine osteoarthritis?
Surpass (diclofenac)
242
Define Continuous Positive Airway Pressure (CPAP)
Spontaneous breathing with **positive pressure during both inspiratory and expiratory cycles**
244
What nerves can be monitored when using NMBAs in dogs and cats? Horses?
Dogs and cats = peroneal (fibular) nerve and ulnar nerve
Horses = facial nerve and superficial peroneal (fibular) nerve
245
What are some indications for Peterson and Retrobulbar blocks?
Enucleation of eyeball
Removal of tumors from eye and eyelids
246
If the environment becomes acidic due to infection, what will happen to the ability of the LA to penetrate membranes?
Less penetrates membranes leading to increased systemic absorption
247
What factors increase systemic absorption of local anesthetics?
High dosage (volume and concentration)
Increased blood flow at site of injection
Vasodialtion
248
How long should you fast a horse before anesthesia?
3-6 hours
250
How does Mexiletine work to reduce pain?
Blocks sodium channels
250
What artery is best for monitoring direct BP in cattle?
Cattle = auricular
251
What is the order of the basic life support alphabet guide?
Chest compressions
Airway
Breathing
Circulation
Drugs
ECG
Fluids
253
What gene mutation is responsible for contributing to malignant hyperthermia?
Porcine ryanodine receptor 1 gene
255
What receptors do ephedrine act on?
Alpha 1 and 2 agonist
Beta 1 and 2 agonist
256
What type of fluids exert primary effect on intravascular compartment?
Colloids
257
What are the clinical uses for vasopressin?
Treatment during CPA
Vasodilatory shock
Von Willeband disease
259
What is COX3 associated with?
Pyrexia
Analgesia
Less anti-inflammatory than 1 and 2
259
What type of pain is described as localized, constant, sharp, aching, and throbbing?
Somatic
260
Oncotic pressure is dependent on what?
Number of particles
261
What is the RBC lifespan in ovine?
64-94 days
262
What is increased sensitivity to sensation?
Hyperesthesia
262
When is it safe to remove the ETT in horses?
When patient swallows
263
The median artery can be used for blood gas in what species?
Sheep
264
When performing chest compressions how many compressions should you do per minute? How often should you change people?
80-100
Every 2 minutes
266
What is the order of presentation for LA toxicity? Which drug is the exception?
1. CNs signs
2. Respiratory system depression
3. Cardiovascular system depression
Bupivicaine is the exception which causes cardiovascular depression first
267
What are the clinical uses of adrenergic agonists?
Positive inotrope
Vasopressor support
Bronchospasm
Life threatening allergic reactions
268
When replacing blood loss with crystalloids, how much fluids should you give?
3-4x the volume lost
270
What is COX1 associated with?
Mucosal defense
Platelet function
272
What are the balanced crystaloid fluids?
(composition resembles ECF)
LRS
Normosol-R
Plasma-Lyte 48
274
When would you use norepinephrine?
Significant non-responsive hypotension
274
What are some warning signs of CPA?
Obtunded
Hypothermia
Bradycardia
Hypotension
Dilated, unresponsive pupils
276
What fluid is a nonbalanced crystalloid?
Saline
278
How long does it take for the respiratory system to buffer H+?
Minutes to hours
279
What are the COX2 preferential drugs?
Meloxicam
Carprofen
Etodolac
Vedaprofen
Tolfenamic acid
280
What is the normal lactate value in arterial blood?
280
How does the potency of Rocuronium compare to Vecuronium?
1/8 as potent
281
What are some concerns involved with peri-anesthetic fluid management?
Hypo/hypervolemia
Anemia
Hypoproteinemia
A-B and electrolyte abnormalities
Abnormal glucose
281
Activation of what two excitatory receptors signal the location, intensity and duration of peripheral stimulation?
AMPA
NK
283
What pressure do you squeeze the reservoir bag to during IPPV?
10-20 cm H2O
284
What areas does a brachial plexus block desensitize?
The elbow and distal
285
What is the RBC lifespan in equine?
140-150 days
286
What are the side effects of phenylephrine?
Decreased blood flow to GI, liver, and kidneys
Decreased cardiac output
Beta effects at high doses
288
What is the minimum Hb concentration needed for appropriate O2 delivery?
7 mg/dL
289
Anesthetic drugs and equipment dead space can cause what effect on the acid-base status of the body?
Respiratory acidosis
290
Why would you want to complete the blood transfusion within 4 hours?
To avoid sepsis
291
What is the effect when Beta 1 receptors are stimulated?
Increased contractility
293
What drug can help with allodynia and opioid tolerance in chronic pain cases?
Amantadine
295
IPPV respiratory time in SA? LA?
1-1.5 s
1.5-3s
296
What product should you use to increase the COP?
Colloid - hetastarch
298
How many nodes of Ranvier need to be blocked in order to stop the signal from traveling along a nerve?
2-3 nodes
299
How do you calculate total lung capacity?
Inspiratory reserve volume + Tidal volume + Expiratory reserve volume + Residual volume
300
What does a blood gas analyzer calculate?
HCO3-
BE
SaO2
301
What areas does a maxillary nerve block desensitize?
Entire upper dental arcade
Maxilla
302
What are the effects of epinephrine?
303
What receptors do epinephrine stimulate?
Alpha 1 and 2 agonist
Beta 1 and 2 agonist
304
What is the effect of an auriculopalpebral block?
Akinesia of eyelids
Does not desensitize the eyelids (only paralysis)
306
Where does somatic pain originate from?
Bones
Joints
Muscles
Skin
307
What ECG lead is used in horses? What does it accentuate?
Lead 1
Accentuates P wave
308
Define Positive End-Expiratory Pressure (PEEP)
Airway pressure at the end of expiration is **maintained above ambient pressure**
Applied when positive pressure is maintained between inspirations that are delivered by a ventilator
310
What lab tests should be done on a patient with long term NSAID use?
U/A
ALT
Creatinine
311
What are the indications for giving whole blood?
Acute blood loss/hemorrhage
Anemia
313
What is the RBC lifespan in bovine?
140-160 days
315
**What are some anticipated complications of ruminant anesthesia?**
Hypersalivation
Bloat (can't erructate)
Hypoventilation (worse in dorsal recumbancy)
Regurgitation -\> aspiration pneumonia
316
What effect do air bubbles have on your arterial sample?
Increased PaO2
Decreased PaCO2
317
What drug can be given prior to surgery in horses to reduce the chances of HYPP?
Oral acetazolamide
318
What are the effects of dobutamine?
Increases contractility
Increases heart rate
320
What are the colloid fluids?
Plasma
Dextrans
Hydroxyethyl starches
Hemoglobin-based oxygen carrying fluid
321
Which injectable anesthetic drugs that we know of would be very damaging to tissues?
Thiopental
NSAIDs
322
Why should you use caution when using Normosol-R or Plasmalyte 148 in diabetic ketoacidosis patients?
They increase blood [ketones]
323
What are some reasons why a patient may require mechanical ventilation?
Respiratory center depression
Inability to adequately expand thorax
Airway obstruction
Inability to adequately expand lungs
Cardiopulmonary arrest
Pulmonary edema or pulmonary insufficiency
324
What are the water requirements for dogs and cats?
Small dogs = 60 mL/kg/d
Large dogs = 40 mL/kg/d
Cats = 50-80 mL/kg/d
325
How do you calculate vital capacity?
Inspiratory reserve volume + Tidal volume + Expiratory reserve volume
326
What is the max dose of Bupivicaine you should use in dogs and cats?
2mg/kg in dogs
1mg/kg in cats
327
What are the opthalmic NSAIDs?
Flurbiprofen
Suprofen
Ketorolac
Diclofenac
328
What are the effects of norepinephrine?
329
What are some complications of IV therapy?
Extravasation
Thrombosis/thrombophlebitis
Volume overload
Infection
Embolism
Exsanguination
329
What parameters are monitored during fluid therapy?
HR
RR
CRT
MM color
Temp
Urine output
331
What drug combo is often given to pigs for induction?
Dexmedetomidine-Ketamine-Butorphanol
Telazol-Ketamine-Xylazine
332
When do you want to stop your lidocaine CRI?
30 minutes before the end of surgery
333
What are the COX2 selective drugs?
Deracoxib
Firocoxib
Robenacoxib
334
What are the causes of hypoxemia?
V/Q mismatch
Hypoventilation
Low FiO2
Right to left shunt
Diffusion impairment
335
What is the blood volume for ovine?
60 mL/kg
337
Which local anesthetic has the longest duration of action?
Lidocaine
Bupivicaine
Mepivicaine
Procaine
Bupivicaine
338
How do you calculate minute ventilation?
Tidal volume x Respiratory frequency
340
What are the clinical uses for dobutamine?
Treatment of hypotension
Common choice in equine hypotension
341
Why is knowing 20% blood loss important?
Loss of ≥20% = PCV ≤20%
342
What is the test dose for asministering infusions?
0.25 mL/kg for first 30 minutes
343
What drug combination is used to maintain TIVA?
"Triple Drip"
GG
Ketamine
Xylazine (any A2 agonist)
344
Which NMBA should not be used with hepatic insufficiency?
Vecuronium
345
What would you do in order to treat anesthetic induced hypotension?
Give hourly crystalloid rate as rapid bolus (5-10 mL/kg over 15 minutes or less) in addition to continued hourly rate
346
What is the most common pathologic arrhythmia in horses?
A fib
347
Adult cattle fasting requirements?
12-18 hours for food
8-12 hours for water
349
Young ruminant fasting requirements?
None if under 1 month old
2-4 hours if older than 1 month
350
Define IPPV
Positive pressure maintained **only during inspiration**
351
If your patient is on another highly protein bound drug, how many days after discontinuing that drug should you wait before starting NSAIDs?
7 days minimum
352
Where do changes in hydration have the greatest effect?
ECF
353
What are some reasons to administer IV fluids?
Maintain patent IVC
Counteract effects of anesthetic drugs
Replace insensible losses
Replace procedural losses
355
What drug can you administer in horses when disconnecting the inhalant to make recovery safer? When is this not necessary?
A2 agonist (Xylazine)
Not necessary when using a triple drip
356
Since you need to base fluids on lean body mass, how would you calculate the lean body mass on a patient that is normal weight, obese, and thin?
Normal body weight x 0.8 = lean body mass
Obese body weight x 0.7 = lean body mass
Thin body weight x 1.0 = lean body mass
357
What are the primary ECF cations?
Na+ most abundant
K+ present in small amounts
359
What type of blood sample is used to evaluate respiratory gas exchange? Arterial or venous?
Arterial
360
What is the blood volume for bovine?
60 mL/kg
361
Which NMBAs should not be used with decreased esterase activity?
Mivacurium
Atracurium
362
What nerves are blocked by the Peterson's technique?
Oculomotor
Trochlear
Abducens
Trigeminal
Must do auriculopalpebral nerve block to paralyze eyelids
363
Wat dose of vasopressin can you give during CPR?
0.2-0.8 U/kg IV
Can be used with or instead of epinephrine
364
Which COX is upregulated during inflammatory states?
COX2
365
Which premeds are not approved for use in food animals by the FDA?
Acepromazine
Xylazine
366
What drug can be used in horses to treat hypotension?
Dobutamine
367
How much blood can be held by a cotton tip applicator (CTA), gauze, lap sponges, and tubing of the suction apparatus?
CTA = 0.2mL each
Gauze = 5-10mL each
Lap sponges = 50-100mL each
Suction tubing = 120mL
368
How much K+ can safely be given in an hour?
0.5 mEq/hr
369
Which fibers feel fast pain? Slow pain?
Fast = A delta fibers
Slow = C fibers
370
What is the first sign of toxicity you will witness in an awake animal administered Bupivicaine?
Seizures
GI ileus
CV depression
Respiratory depression
Vomiting
CV depression
371
What % of TCO2 is from bicarb? Carbonic acid? CO2?
85% bicarb
10% carbonic acid
5% CO2
372
Why would IPPV be needed during thoracic surgery?
Because the lungs cannot be inflated when the chest is open
373
If you take too long to analyze your sample, what effects will this have?
Decreased PaO2 and pH
Increased PaCO2
374
Does the charged (cationic) or non-charged form of LA repidly penetrate membranes?
Non-charged
375
What is the COX+LOX drug?
Tepoxalin
376
What percentage of the adult horse's body weight is blood? Foals?
Adults = 8%
Foals = 9%
377
What is the purpose of using vasoconstrictors with LA?
Increase duration of action
378
What affect does hyperthermia have on a blood gas sample?
Artificially lowers PaO2 and PaCO2
379
When giving the synthetic colloid HES, what enzyme is increased and why?
Amylase because that is how HES is metabolized
380
What are some advantages of a distal paravertebral block over a proximal paravertebral block?
Lack of scoliosis
Lack of risk of penetrating major blood vessels
minimal weakness in the pelvic limb
Minimal ataxia
381
What dose of atropine can you give during CPR?
0.04 mg/kg IV
382
What is the normal range for bicarb in an arterial sample for carnivores and herbivores?
24
(15-24 in carnivores)
(20-28 in herbivores)
383
What is the normal fluid rate used for dogs and cats?
Dogs = 10 mL/kg/h
Cats = 5 mL/kg/h
384
What is the normal anion gap in dogs? Cats?
Dogs = 12-24
Cats = 13-27
385
What is the alkalinizing agent in Normosol-R and Plasmalyte 148?
Acetate
386
The caudal artery should be used for blood gas samples in what type of animal?
Small animal
387
Activation of which two excitatory receptors is responsible for tactile sensations?
AMPa
Kainate
388
Why is propofol not commonly used as an induction agent in horses?
Large volume
High cost
Poor quality induction
389
What conditions is gabapentin useful in regulating pain?
Neuropathic conditions
OA
Cancer
390
Do esters or amides more commonly cause allergic reactions?
Esters
391
What are the 4 different volumes associated with air in the lungs?
Tidal volume
Inspiratory reserve volume
Expiratory reserve volume
Residual volume
392
What is the total body water in neonates?
80%
393
What is the key difference between central and peripheral sensitization?
Central allows low intensity stimuli and low-threshold Abeta sensory fibers to cause pain as a result of neuroplasticity in the spinal cord
394
What receptors do phenylephrine act on?
Alpha 1 agonist
395
What are your 3 options when trying to replaced lost blood volume?
Crystalloid
Colloid
Blood products (20% loss or greater; PCV≤20)
396
When does the palpebral reflex disappear in ruminants?
Light anesthesia
397
Why should you not use Doxapram during respiratory arrest?
It decreases cerebral blood flow while increasing cerebral O2 use
