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Anesthesia > Test 2 > Flashcards

Test 2 Flashcards

1
Q

If you puncture the dural sac when performing an epidural, what should you do?

A

Decrease the volume by 50%

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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

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1
Q

What are the starling forces that push water out of the blood vessels?

A

Capillary hydrostatic pressure

Interstitial oncotic pressure

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1
Q

What are the 4 types of adverse effects of transfusions?

A

Acute immunologic

Acute nonimmunologic

Delayed immunologic

Delayed nonimmunologic

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1
Q

How long does it take for the renal system to buffer H+?

A

Hours to days

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1
Q

What is the order of the pain perception pathway?

A

Transduction

Transmission

Modulation

Projection

Perception

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1
Q

What is the threshold of A delta fibers? C fibers?

A

A delta = low and high threshold

C = high threshold

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1
Q

What type of pain is caused by damage to body tissue from heat, cold, mechanical, or chemical stimuli?

A

Physiologic (nociceptive)

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2
Q

What is the equation used to calculate bicarbonate therapy?

A

mEq to infuse = base deficit x BW x 0.3

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3
Q

IPPV I:E ratio in SA? LA?

A

1: 2-1:3
1: 2-1:4.5

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3
Q

What are the side effects of isoproterenol?

A

Arrhythmias

Tachycardia

Hypotension (beta 2)

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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

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4
Q

Metabolic acidosis has what effects to bicarb and CO2?

A

Decreased bicarb first

Compensatory decrease in CO2

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5
Q

What nerves are you trying to block with a proximal paravertebral block?

A

T13, L1, and L2

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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

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6
Q

What is the blood volume for porcine?

A

50 mL/kg

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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

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6
Q

Where does the lateral column of the white matter of the spinal cord go to?

A

Somatic sensory to the brain

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6
Q

Is Xylazine more potent in ruminants or horses?

A

10x more potent in ruminants

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6
Q

What happens to the eyeball of cattle if they get too deep?

A

Dorsal rotation

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6
Q

What induction drugs enhance NMBAs?

A

Propofol

Ketamine

Thiopental

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7
Q

What are the indications for using packed RBCs (pRBC)?

A

Acute blood loss/hemorrhage

Anemia

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8
Q

What does a blood gas analyzer directly measure?

A

pH

PO2

PCO2

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8
Q

What is the most revealing clinical sign of impending malignant hyperthermia?

A

Rapidly increasing ETCO2

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9
Q

What receptors do dopamine act on?

A

Alpha 1 agonist

Beta 1 and 2 agonist

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11
Q

IPPV respiratory frequency?

Dogs

Cats

Horses/Cows

Pigs/Small Ruminants

A

Dogs: 8-14bpm

Cats: 10-14bpm

Horses/Cows: 6-10bpm

Pigs/Small Ruminants: 8-12 bpm

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11
Q

What are some indications for uring a soaker catheter?

A

Amputation

Thoracotomyu

Total ear canal ablation sites

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11
Q

Duration of action of colloids is dependent on what?

A

Size of the particles

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11
Q

What is the pH range that is compatible with life?

A

6.8-7.8

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12
Q

What is the effect of the supraorbital nerve block?

A

Anesthesia to the upper eyelid

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13
Q

What are some special considerations for horse anesthesia?

A

Obligate nasal breathers

Prone to V/Q mismatch

Myopathy and neuropathy

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14
Q

What are the chemical buffers used to buffer H+?

A

Phosphate

Hemoglobin

Proteins

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14
Q

How does the pH and pCO2 of venous blood compare to that of arterial blood?

A

Slightly lower pH and higher pCO2

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15
Q

What are the clinical uses for colloids?

A

Correct hypovolemia

Support colloid osmotic pressure

Hypoproteinemic patients (TP<3.5)

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15
Q

Which website can you consult to determine withdrawal times in food animals?

A

FARAD

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16
Q

What vertebrae are associated with the brachial plexus?

A

C6, C7, C8, T1

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16
Q

Ketamine is often use with what drugs for induction in horses?

A

Benzodiazepine

GG

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17
Q

What 3 arteries can be used for blood gas in donkeys?

A

Facial

Transverse facial

Lateral dorsal metatarsal

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17
Q

What are 3 normal common cardiovascular conditions seen in horses?

A

Second degree AV block

Wantering pacemaker

Biphasic P wave

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18
Q

What is the normal arterial blood CO2 concentration?

A

35-45 mmHg

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18
Q

For what type of procedures would a caudal epidural be indicated?

A

Tail, perineum, anus, rectum, vulva, prepuce, and skin of scrotum

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18
Q

What are the primary ICF anions?

A

Organic phosphaates and proteins

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18
Q

What fluids should not be given with infusions and why?

A

Calcium containing fluids b/c it overcomes anticoagulant properties of citrate

Hypotonic fluids b/c it causes hemolysis

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18
Q

What are some concerns associated with transfusions?

A

V/D

Urticaria

Hemoglobinuria

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18
Q

What are NSAIDs good for?

A

Post-op pain (w/ opioid)

Inflammatory conditions (itis)

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18
Q

Fasting time for pigs?

A

6-12 hours

Water is ok

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19
Q

What lab data is useful when monitoring fluid therapy?

A

Biochem profile (BUN and protein)

PCV/TP

A-B status

Serial lactate values

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19
Q

What is the normal range for PaCO2?

A

40

(35-45)

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19
Q

Windup occurs especially with which type of fiber?

A

C fibers

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20
Q

What are the most common causes of hypotension under anesthesia?

A

Vasodilation

Contractility

Bradycardia

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20
Q

What is the formula for maintenance fluid rates?

A

(BW in kg x 30) + 70 = mL/day

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20
Q

What is the main purpose of using replacement crystalloids?

A

Expand ECF volume w/o changges in electrolyte composition

It does not induce fluid shifts between ICF and ECF

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20
Q

T/F: It is acceptable to round up when calculating a dose of NSAIDs

A

False

Do NOT exceed upper dose limit

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20
Q

The dorsal pedal artery should be used for blood gas samples in what type of animal?

A

Small animals

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20
Q

Which system is responsible for the behavioral and emotional response to pain?

A

Limbic system

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21
Q

What are the 3 types of infiltrative local block?

A

Incisional line block

Inverted L block

Soaker catheters

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21
Q

What is the part of the medulla where the primary neurotransmitters are serotonin and norepinephrine?

A

Nucleus raphe magnus

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22
Q

Under what circumstances would you use hypertonic saline (7.5% NaCl)?

A

Increased ICP

Rapid hemorrhage

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22
Q

What are the different colloids?

A

Dextrans

Hydroxy-ethyl Starches (HES)

Polygelatins

Plasma/Albumin

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23
Q

What do you do after IPPV is discontinued?

A

Patient should continue to receive supplemental O2 and can be manually ventilated at 1-4 bpm until spontaneous ventilation has returned and stabilized

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24
Q

What premed can cause colic?

A

Opioids

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25
Q

What receptors do isoproterenol act on?

A

Beta agonist

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26
Q

How do you calculate functional residual capacity?

A

Expiratory reserve volume + Residual volume

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27
Q

What is the normal SaO2?

A

95-100%

(80-150 mmHg)

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29
Q

Respiratory alkalosis has what effects to bicarb and CO2?

A

Decreased CO2 first

Compensatory decrease in bicarb

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30
Q

How does the impedance threshold device work?

A

Prevents air flow in ETT -> more negative pressure in chest generated during chest recoil

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31
Q

What are things you should know going into a case with acute blood loss?

A

PCV/TP

Anticipated losses

Total blood volume and 10%; 20%

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32
Q

What is the onset of action for Lidocaine and Bupivicaine?

A

Lidocaine = 5-15 minutes

Bupivicaine = 15-30 minutes

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33
Q

What are the primary ECF anions?

A

Cl-

HCO3-

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35
Q

Definition: Noxious stimuli are converted into an electrical action potential by the terminal ends of sensory nerve fibers.

A

Transuction

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37
Q

What are the clinical uses of phenylephrine?

A

Significant vasoconstriction

Splenic contraction

Decrease epistaxis

Decrease nasal edema

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37
Q

Which NMBA has no CV effects and a lower histamine release potential?

A

Vercuronium

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38
Q

Calculate the drip rate for a 12 kg dog receiving 10 mL/kg/h fluids using a 15 drop/mL set.

A

12 x 10 x 15 / 60 / 60 = 1 drop/2 seconds

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38
Q

What NSAID is useful for colic pain?

A

Flunixin meglumate

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40
Q

What are the clinical uses of dopamine?

A

Treatment of hypotension

Increase urine output

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41
Q

Activation of which excitatory receptor leads to alterations in gene expression?

A

Metabotropic glutamate

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42
Q

What areas does an infraorbita nerve block desensitize?

A

Upper dental arcade (as far back as first premolar)

Upper lip and nose

Dorsal aspect of nasal cavity

Soft and hard palates

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43
Q

How do NSAIDs work to reduce pain?

A

Act primarily in the periphery to decrease production of pain causing substances (prostanoids)

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44
Q

T/F: General anesthesia prevents windup

A

False

It does not prevent the generation of action potentials in the primary afferents

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45
Q

At what age does the stomach of ruminants switch from a simple stomach to rumen functions?

A

3 months

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46
Q

What are the signs of LA toxicity?

A

CNS: sedation then tonic-clonic seizures, coma

Respiratory depression

Bradycardia, arrhythmias, hypotension

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46
Q

What is the difference in O2 saturation between arterial and venous blood?

A

Arterial = >88%

Venous = 65-75%

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47
Q

What are the effects of hypercapnia?

A

Vasodilatioin of peripheral arterioles and myocardial depression

Increases circulating catecholamines

Narcosis with PaCO2 values >95 mmHg (complete anesthesia at 245 mmHg)

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49
Q

Why might you not choose telazol for induction in horses?

A

Rough recovery

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50
Q

What type of blood sample is useful in determining acid-base status? Arterial or venous?

A

Venous

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51
Q

What is the effect when Beta 2 receptors are stimulated?

A

Vasodilation

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52
Q

What physiological signs are associated with blood loss?

A

Hypotension (decreased BP)

Tachycardia

Pale mm, prolonged CRT

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52
Q

Which NMBA is 4x more potent than atracuriuim, less histamine release, and less laudanosine production?

A

Cisatracurium

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53
Q

After doing compressions for how long is it acceptable to switch to internal cardiac massage?

A

After 2-5 minutes of inadequate circulation

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54
Q

What affect does hypothermia have on a blood gas sample?

A

Artificially elevates PaO2 and PaCO2

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54
Q

Where should you place a doppler on a pig?

A

Tail

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55
Q

What species is more prone to develop methemoglobinemia with Prilocaine and Benzocaine?

A

Cats

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56
Q

Which of the replacement crystalloids is not a balanced electrolyte solution?

A

Saline

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57
Q

Know this chart!

A
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58
Q

T/F: NSAIDs must be given with food

A

True

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58
Q

What is the normal range for PaO2 at room air?

A

100

(80-110)

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59
Q

What causes visceral pain?

A

Stretching, distantion, or inflammation of the viscera

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60
Q

What is the total body water in adult dogs and cats?

A

60%

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60
Q

How does the infusion rate of colloids compare to crystalloids?

A

Lower (2-5 mL/kg/h)

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61
Q

What are the clinical uses of isoproterenol?

A

Increase HR

Treatment of 3rd degree block

Potent inotrope

Potent chronotrope

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61
Q

Which tract projects transmission of deep pain and visceral sensations?

A

Spinoreticular tract

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61
Q

What is the effect of opioids at the limbic system?

A

Alter the emotional response to pain and make it more tolerable

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62
Q

What effect does lipid solubility have on the onset of action and duration of action of LA?

A

Slower onset

Longer duration

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62
Q

To perform a successful intercostal nerve block, how many rib spaces should be blocked?

A

4

2 cranial and 2 caudal to the incision

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62
Q

In which species does type and crossmatch have to be performed in prior to every whole blood, RBC, or plasma transfusion?

A

Cats

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62
Q

What type of pain originates from injury of the peripheral or central nervous system an is described as burning or shooting pain?

A

Neuropathic

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63
Q

Which opioids are used in cattle?

A

Butorphanol

Hydromorphone

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64
Q

About how long does it take for a horse to recover from anesthesia?

A

30 minutes after TIVA

1 hour after prolonged inhalant

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66
Q

What drugs are responsible for COX1 and 2 inhibition?

A

Aspirin

Phenylbutazone

Ketoprofen

Ketorolac

Flunixin

Meglumine

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67
Q

What are the primary ICF cations?

A

K+

Mg2+

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67
Q

Activation of which excitatory receptor leads to slower onset and longer lasting pain states caused by prolonged input from A delta and C fibers?

A

NMDA

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68
Q

Which NMBA is degraded by Hofmann elimination?

A

Atracurium

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69
Q

What two drugs can cause malignant hyperthermia in pigs?

A

Halothane

Succinylcholine

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71
Q

What effect does hypertonic saline have on the movement of fluid already in the body?

A

Draws fluid into the intrvascular space

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72
Q

How long does it take for the therapeutic effects of NSAIDs to occur?

A

≥45 minutes despite ROA

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74
Q

What is the RBC lifespan in canine?

A

110-120 days

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74
Q

What is a possible side effect of Ace in ruminants?

A

May increase the risk of regurgitation

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75
Q

What centrally acting analgesic binds weakly to u opioid receptors and inhibits reuptake of norepinephrine and serotonin?

A

Tramadol

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76
Q

What receptors do norepinephrine act on?

A

Alpha 1 and 2 agonist

Beta 1 and 2 agonist

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76
Q

What are the COX3 preferential drugs?

A

Acetaminophen

Diclofenac

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78
Q

What are the effects of dopamine?

A
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78
Q

What species is most sensitive to Xylazine?

A

Goats

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78
Q

T/F: In pigs, Xylazine causes more cardiovascular depression and less analgesia than Dexmedetomidine

A

True

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80
Q

T/F: The base excess value is the same in venous and arterial blood

A

True

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81
Q

What positions for ruminants are least likely to result in regurg?

A

Right lateral

Sternal recombency

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82
Q

What drug inhibits osteoclast-mediated bone resorption?

A

Alendronate

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83
Q

Out of the total body water, how much is ICF and how much is ECF?

A

60% TBW

40% ICF

20% ECF

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84
Q

How do A2 agonists affect pain?

A

Activate A2 receptors which decreases release of norepinephrine

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85
Q

T/F: Elimination of LA that have high affinity for proteins is faster

A

False

Its slower

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86
Q

What drug reverses Rocuronium and vecuronium block?

A

Sugammadex

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87
Q

T/F: Smaller non-myelinized fibers are more susceptible to LA

A

True

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88
Q

What is the formula to calculate the amount of blood to give?

A

(desired PCV - actual PCV) / donor PCV x patient blood volume

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89
Q

Which fibers are responsible for sympathetic postganglionic innervation?

A

C fibers

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90
Q

Which LA form remains at the receptor site longer, charged (cationic) or non-charged

A

Charged (cationic)

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90
Q

Generally, how much lower is the ETCO2 than PaCO2 in horses?

A

10-15 mmHg

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92
Q

How much donor blood will raise the PCV by 1%?

A

2mL/kg

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94
Q

What is COX3 associated with?

A

Fever initiation

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94
Q

In what situation would you use benzodiazepines in horses?

A

If its a foal

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95
Q

T/F: The higher the pKa of a LA, the slower the onset of action

A

True

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96
Q

What patient factor increases the prevalence of malignant hyperthermia in pigs?

A

High ration of muscle to total body mass and rapid growth

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97
Q

What drug can cause penile prolapse in horses?

A

Acepromazine

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98
Q

What nerve must be blocked when dehorning a cow?

A

Cornual branch of zygomaticotemporal

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99
Q

What enzyme turns AA into prostaglandins?

A

COX

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100
Q

Define Intermittent Mandatory Ventilation (IMV)

A

Operator sets a predetermined number of positive breaths, but the patient can also breathe spontaneously

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100
Q

What two drugs can delay the appearance of malignant hyperthermia signs in pigs?

A

Acepromazine

Thiopental

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101
Q

Which premed should not be used in sheep because of pulmonary hemorrhage and edema leading to hypoxemia?

A

A2 agonists

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103
Q

What drug causes apneustic respiration?

A

Ketamine

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103
Q

Where are ester LA metabolized?

A

Plasma

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104
Q

What areas does a mandibular nerve block desensitize?

A

Incisors, canine tooth, premolars, molars

Skin and mucosa of chin and lower lip

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105
Q

Where are amide LA metabolized?

A

Liver

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106
Q

Thiopental is used with what drug for IV induction in horses?

A

GG

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107
Q

What are the indications for using LA as antiarrhythmic agents?

A

Suppress reentrant ventricular arrhythmia

Increase ventricular fibrillatioin threshold

Decrease automaticity

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109
Q

T/F: The more a LA is bound to proteins, the shorter the duration of action

A

False

More protein binding = longer duration

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110
Q

Which vein can be used to get a blood gas sample in small animals?

A

Lingual vein

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110
Q

How can ketamine be used in regulating pain?

A

Sub-anesthetic dose prevents windup by blocking glutamate effects at the NMDA receptor

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112
Q

Why are anticholinergics not typically used in ruminants?

A

Salivary secretions become more viscous and could obstruct airway

Decreases GI motility causing bloat

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114
Q

What nerves must be blocked when dehorning a goat?

A

Cornual branch of infratrochlear

Cornual branch of zygomaticotemporal

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116
Q

Which type of fluids exert effects primarily on interstitium and ICF spaces?

A

Crystalloids

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117
Q

Which tract projects superficial pain and tactile sensation?

A

Spinothalamic tract

119
Q

What is a recruitment maneuver used for and how does it work?

A

Used to reinflate collapsed alveoli by applying a sustained pressure above normal PIP and using PEEP to prevent derecruitment

121
Q

What can be done to avoid the negative CV effects of mechanical ventilation?

A

CV effects can be overcome often with expansion of the extracellular fluid volume and administration of inotropic drugs

122
Q

What is COX2 associated with?

A

Prevents erosions and promotes healing of mucosa

Anti-inflammatory

Renal protection

123
Q

What is COX1 associated with?

A

Vicero-nociception

Thermal stimulation

Also works with COX2 on the brain, nerves, ovarian/uterine, bone metabolism, and kidneys

124
Q

What must you always do after administration of hypertonic saline?

A

Always follow up with replacement crystalloid

125
Q

Which premed can cause premature delivery in cattle and sheep?

A

Xylazine

126
Q

What is the blood volume for equine?

A

70 mL/kg

TB = 100 mL/kg

128
Q

IPPV Peak Inspiratory Pressure PIP in SA? LA?

A

15-20 H2O

20-30 H20

128
Q

What are some contraindications of NSAIDs?

A

Acute renal insufficiency

Hepatic insufficiency

Dehydration

Hypotension/hypovolemia

Coagulopathies

GI ulceration

128
Q

What position during anesthesia can cause compression atelectasis in horses?

A

Dorsal recumbancy

129
Q

What are the most common premeds used in pigs?

A

Xylazine with ketamine +/- opioid

Diazepam or midazolam

Azaperone is best but limited avaliability

130
Q

Why should you be cautious of using LRS with blood transfusions?

A

It contains calcium which interferes with anticoagulant in blood transfusions

130
Q

What type of pain is caused by tissue damage or alterations in the physiology or anatomy of the sensory nervous system?

A

Pathologic

130
Q

Which NMBAs should not be used with renal insufficiency?

A

Pancuronium

Doxacurium

131
Q

In what ways is vasopressin better than epinephrine?

A

Improved:

Neurologic outcome

Cerebral oxygen delivery

Resuscitation success

Blood flow to major organs

132
Q

What are teh 3 types of fluid and solute loss?

A

Loss of hypertonic fluids (solute in excess of water)

Isotonic loss

Loss of hypotonic fluids (water in excess of solute)

133
Q

What types of cases would it be necessary to use normal saline fluids?

A

Blocked cats

Chronic renal cases

134
Q

What is multi-modal analgesia?

A

Use of lower doses of multiple drugs classes provides higher safety and less negative side effects

136
Q

What are the 4 different capacities associated with air in the lungs?

A

Inspiratory capacity = TV + IRV

Functional residual capacity = ERV + RV

Vital capacity = IRV + TV + ERV

Total lung capacity = IRV + TV + ERV + RV

137
Q

T/F: The slower the firing rate of a nerve, the more susceptible it is to LA

A

False

The higher the firing rate, the more susceptible

138
Q

Which cranial nerve block can cause lingual paralysis?

A

Mandibular nerve block

More common when you do both sides

140
Q

Respiratory acidosis has what effects to bicarb and CO2?

A

Increase in CO2 first

Compensatory increase in bicarb

142
Q

What is the blood volume for feline?

A

65 mL/kg

143
Q

How often can you do a recruitment maneuver and how long should you hold it for?

A

Hold for 10-15 seconds once every 5 minutes

144
Q

Which drug in horses makes the eye reflexes less reliable?

A

Ketamine

145
Q

What factors determine the amount of gas delivered to a patient?

A

Resistance and compliance of breathing system

Patient’s respiratory system

145
Q

What receptors do dobutamine act on?

A

Beta agonist

146
Q

When is it acceptable to do an intravenous regional (beir) block?

A

Front or back leg

Biopsies

Small mass removals

Other procedures not expected to take longer than 90 minutes

147
Q

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?

A

Less than 5 days

149
Q

How do you calculate inspiratory capacity?

A

Tidal volume + Inspiratory reserve volume

149
Q

What are the clinical uses of ephedrine?

A

Treatment for hypotension

Increase cardiac output

150
Q

What is pain caused by a stimulus that does not normally cause pain?

A

Allodynia

152
Q

What is the goal of chest compressions?

A

Maximize cerebral and myocardial perfusion

153
Q

What is the RBC lifespan in feline?

A

75-80 days

155
Q

How can you reduce excitement in horses with opioid administration?

A

Co-administer with A2 agonists or Ace

156
Q

What are soem negative effects of colloids?

A

Volume overload

Coagulation

Renal failure

Hepatic failure

Anaphylaxis

Pruritus

158
Q

What are the duration of actions of Lidocaine, Mepivicaine, Bupivicaine, and Ropivicaine?

A

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
Q

What is a pharmacological consideration to using NSAIDs?

A

They are highly protein bound and may displace other drugs and increase their [plasma]

Caution when using with other highly protein bound drugs

161
Q

What effect do inhalants have on NMBAs?

A

Enhance intensity and block duration

163
Q

What is the indication for using fresh frozen plasma (FFP)?

A

Coagulopathies

165
Q

What are the important levels of ETCO2 during CPR?

A

>20 mmHg at 20 minutes CPR = increased chance of survival

166
Q

What induction agents are used in ruminants?

A

Telazol

Ketamine (with benzo or GG)

Propofol

168
Q

How should you alter your anesthetics and fluids when there is blood loss?

A

Decrease vaporizer setting or off

Decrease PIVA or CRIs

Increase fluid administration

169
Q

T/F: If you are giving colloids and crystalloids together, you should decrease the amount of crystalloids administered

A

True

170
Q

When is the eyeball ventrally rotated in cattle anesthesia?

A

Induction and deepening anesthesia

171
Q

Type of pain: The sensitivity of an injured area is enhanced which prevents use of the injured tissue and promotes healing

A

Inflammatory

173
Q

What class of drugs are most commonly used in horses for sedation, muscle relaxation, and analgesic properties?

A

A2 agonists

173
Q

What are the side effects of atracurium?

A

Seizure

Histamine release

174
Q

What are epidural catheters useful for?

A

Long term post-op pain control or painful ICU patients to reduce the amount of parenteral analgesics necessary

175
Q

T/F: C fibers are responsible for fast pain

A

False

Slow pain

177
Q

How long does it take for chemical mechanisms to buffer H+?

A

2-4 hours

178
Q

Where does the dorsal column of the white matter of the spinal cord go to?

A

Somatic sensory to the medulla

180
Q

What dose of epinephrine can you give during CPR?

A

0.01 mg/kg IV

182
Q

What do positive inotropic drugs do?

A

Increase cardiac output

Increase atrial filling pressures

183
Q

What are some patient factors that can affect the amount of fluids needed?

A

Duration of issue

Estimated losses

Eating/drinking

Panting, febrile

PCV, TP, USG

185
Q

What drugs should you administer prior to anticholinesterase reversal of NMBA?

A

Anticholinergic drugs

(atropine and glycopyrolate)

187
Q

What is the normal and ARDS range for the A-a gradient?

A

Normal = 0-10

ARDS = >30

188
Q

What level of O2 is generally safe for prolonged administration?

A

40-50%

188
Q

How do you calculate the fluid drip rate?

A

Weight x Fluid rate x Drops/mL / 60 / 60

(slide 34 of fluid lecture)

189
Q

Neuropathic pain in which no injury or lesion can be identified

A

Functional

191
Q

What does COX inhibition affect?

A

Primary platelet plug formation

Renal and gastric mucosa vascular tone

Smooth muscle contraction

Temp regulation

192
Q

What are some disadvantages of epinephrine?

A

Severe vasoconstriction

Increased O2 consumption due to increased cardiac work

Can induce v fib

192
Q

What is the system responsible for integrating sensory input and mediating motor, autonomic, and endocrine responses in the hypothalamus?

A

Reticula activating system (RAS)

193
Q

How do LA work?

A

Prevent the sodium channels from opening in neuronal axons, thus maintaining the fully polarized state and thus block nerve propagation

193
Q

What are the landmarks for the Inverted L block?

A

Caudal border of rib 13

Ventral to lateral processes of lumbar vertebrae

195
Q

What is the blood volume for canine?

A

90 mL/kg

196
Q

What procedures would a forefoot block be useful for?

A

Declaw

Toe amputation

196
Q

What should you monitor during transfusions?

A

Temp, HR, RR

q10 min for 30 min then q30

197
Q

What is the effect when Alpha receptors are stimulated?

A

Vasoconstriction

198
Q

What are the side effects of dobutamine?

A

Tachycardia

Arrhythmias

Vasodilation

Seizures/tremors

200
Q

T/F: The more lipid soluble a LA, the more potent it is

A

True

202
Q

What part of the spinal cord is an important relay for descending facilitative an inhibitory modulation of nociceptive input?

A

Periaqueductal gray matter (PAG)

203
Q

What is a normal PaO2:FiO2 ratio? Ratio for ARDS?

A

Normal = > 400

ARDS =

204
Q

What nutraceuticals are most commonly used to treat pain?

A

Diet

Glucosamine

Dasuquin

Adequan

Omega 3 fatty acids

206
Q

What are the advantages of using oxyglobin?

A

Multispecies use

No testing

T1/2 = 18-26 hours

207
Q

What areas does a mental nerve block desensitize?

A

Rostral mandible

Canine and incisors

208
Q

Metabolic alkalosis has what effects to bicarb and CO2?

A

Increased bicarb first

Compensatory increase in CO2

209
Q

What is the difference in PO2 between arterial and venous samples?

A

Arterial = 80-110 mmHg

Venous = 35-45 mmHg

210
Q

What effect will heparin have on your arterial sample?

A

Decreased pH

211
Q

If your patient has cardiac disease, anuric renal failure, or is geriatric, how should you adjust your fluid rate?

A

Decrease it to 2-5 mL/kg/h

213
Q

What procedures would indicate a hindlimb nerve block?

A

Procedures from the stifle distally

215
Q

Why should you not refrigerate whole blood?

A

It will inactivate platelets and WBCs

216
Q

What type of pain is described as deep, cramping, aching, gnawing, or poor localization?

A

Visceral

217
Q

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?

A

Lamina 1

218
Q

What is the normal BE in an arterial sample?

A

0+/-4

219
Q

What receptors are stimulated my dopamine depending on the dose? (low, medium, high)

A

Low = dopamine receptors

Medium = beta mainly with mild alpha

High = significant beta and alpha

220
Q

In what species does rotation of the globe not occur under anesthesia?

A

Sheep and goats

221
Q

Where do you place the ECG leads on a horse?

A

Negative on right jugular furrow

Positive on left throacic apex

Third lead distal to the heart

222
Q

What class of drugs will reverse nondepolarizing NMBA and what are the drugs?

A

Anticholinesterase drugs:

Edrophonium

Neostigmine

Pyridostigmine

223
Q

What is the acceptable oxygen flow rate for ruminants?

A

10-20 mL/kg/min

225
Q

When would you use a CRI of epinephrine?

A

In non-responsive hypotension

226
Q

What are some contraindications of an epidural?

A

Sepsis

Coagulopathy

Local infection at site

Lumbosacral fractures or dislocations

Uncorrected hypovolemia

227
Q

What are the starling forces that keep water inside blood vessels?

A

Interstitial hydrostatic pressure

Capillary oncotic pressure

229
Q

T/F: You can use NSAIDs together with corticosteroids and other NSAIDs

A

False

No concurrent corticosteroid or other NSAID administration

230
Q

What is a good indicator of anesthetic depth in pigs?

A

Jaw tone

232
Q

What receptors do vasopressin act on?

A

V1 and V2 agonist

233
Q

Adult sheep and goat fasting requirements?

A

12-18 hours for food

4-8 hours for water

235
Q

What is increased response to a stimulation that is normally painful at the site of injury or in surrounding undamaged tissue?

A

Hyperalgesia

236
Q

What are some ways in which water can be lost from the body?

A

Urinary

Fecal

Respiratory (panting)

Cutaneous evaporative

238
Q

How do opioids work centrally?

A

Modulate nociception in the dorsal horn via release of serotonin and norepinephrine

239
Q

In what scenario can you use ketamine alone for induction in horses?

A

Following heavy A2 agonist sedation (premed)

241
Q

What is the topical cream used for equine osteoarthritis?

A

Surpass (diclofenac)

242
Q

Define Continuous Positive Airway Pressure (CPAP)

A

Spontaneous breathing with positive pressure during both inspiratory and expiratory cycles

244
Q

What nerves can be monitored when using NMBAs in dogs and cats? Horses?

A

Dogs and cats = peroneal (fibular) nerve and ulnar nerve

Horses = facial nerve and superficial peroneal (fibular) nerve

245
Q

What are some indications for Peterson and Retrobulbar blocks?

A

Enucleation of eyeball

Removal of tumors from eye and eyelids

246
Q

If the environment becomes acidic due to infection, what will happen to the ability of the LA to penetrate membranes?

A

Less penetrates membranes leading to increased systemic absorption

247
Q

What factors increase systemic absorption of local anesthetics?

A

High dosage (volume and concentration)

Increased blood flow at site of injection

Vasodialtion

248
Q

How long should you fast a horse before anesthesia?

A

3-6 hours

250
Q

How does Mexiletine work to reduce pain?

A

Blocks sodium channels

250
Q

What artery is best for monitoring direct BP in cattle?

A

Cattle = auricular

251
Q

What is the order of the basic life support alphabet guide?

A

Chest compressions

Airway

Breathing

Circulation

Drugs

ECG

Fluids

253
Q

What gene mutation is responsible for contributing to malignant hyperthermia?

A

Porcine ryanodine receptor 1 gene

255
Q

What receptors do ephedrine act on?

A

Alpha 1 and 2 agonist

Beta 1 and 2 agonist

256
Q

What type of fluids exert primary effect on intravascular compartment?

A

Colloids

257
Q

What are the clinical uses for vasopressin?

A

Treatment during CPA

Vasodilatory shock

Von Willeband disease

259
Q

What is COX3 associated with?

A

Pyrexia

Analgesia

Less anti-inflammatory than 1 and 2

259
Q

What type of pain is described as localized, constant, sharp, aching, and throbbing?

A

Somatic

260
Q

Oncotic pressure is dependent on what?

A

Number of particles

261
Q

What is the RBC lifespan in ovine?

A

64-94 days

262
Q

What is increased sensitivity to sensation?

A

Hyperesthesia

262
Q

When is it safe to remove the ETT in horses?

A

When patient swallows

263
Q

The median artery can be used for blood gas in what species?

A

Sheep

264
Q

When performing chest compressions how many compressions should you do per minute? How often should you change people?

A

80-100

Every 2 minutes

266
Q

What is the order of presentation for LA toxicity? Which drug is the exception?

A
  1. CNs signs
  2. Respiratory system depression
  3. Cardiovascular system depression

Bupivicaine is the exception which causes cardiovascular depression first

267
Q

What are the clinical uses of adrenergic agonists?

A

Positive inotrope

Vasopressor support

Bronchospasm

Life threatening allergic reactions

268
Q

When replacing blood loss with crystalloids, how much fluids should you give?

A

3-4x the volume lost

270
Q

What is COX1 associated with?

A

Mucosal defense

Platelet function

272
Q

What are the balanced crystaloid fluids?

(composition resembles ECF)

A

LRS

Normosol-R

Plasma-Lyte 48

274
Q

When would you use norepinephrine?

A

Significant non-responsive hypotension

274
Q

What are some warning signs of CPA?

A

Obtunded

Hypothermia

Bradycardia

Hypotension

Dilated, unresponsive pupils

276
Q

What fluid is a nonbalanced crystalloid?

A

Saline

278
Q

How long does it take for the respiratory system to buffer H+?

A

Minutes to hours

279
Q

What are the COX2 preferential drugs?

A

Meloxicam

Carprofen

Etodolac

Vedaprofen

Tolfenamic acid

280
Q

What is the normal lactate value in arterial blood?

A
280
Q

How does the potency of Rocuronium compare to Vecuronium?

A

1/8 as potent

281
Q

What are some concerns involved with peri-anesthetic fluid management?

A

Hypo/hypervolemia

Anemia

Hypoproteinemia

A-B and electrolyte abnormalities

Abnormal glucose

281
Q

Activation of what two excitatory receptors signal the location, intensity and duration of peripheral stimulation?

A

AMPA

NK

283
Q

What pressure do you squeeze the reservoir bag to during IPPV?

A

10-20 cm H2O

284
Q

What areas does a brachial plexus block desensitize?

A

The elbow and distal

285
Q

What is the RBC lifespan in equine?

A

140-150 days

286
Q

What are the side effects of phenylephrine?

A

Decreased blood flow to GI, liver, and kidneys

Decreased cardiac output

Beta effects at high doses

288
Q

What is the minimum Hb concentration needed for appropriate O2 delivery?

A

7 mg/dL

289
Q

Anesthetic drugs and equipment dead space can cause what effect on the acid-base status of the body?

A

Respiratory acidosis

290
Q

Why would you want to complete the blood transfusion within 4 hours?

A

To avoid sepsis

291
Q

What is the effect when Beta 1 receptors are stimulated?

A

Increased contractility

293
Q

What drug can help with allodynia and opioid tolerance in chronic pain cases?

A

Amantadine

295
Q

IPPV respiratory time in SA? LA?

A

1-1.5 s

1.5-3s

296
Q

What product should you use to increase the COP?

A

Colloid - hetastarch

298
Q

How many nodes of Ranvier need to be blocked in order to stop the signal from traveling along a nerve?

A

2-3 nodes

299
Q

How do you calculate total lung capacity?

A

Inspiratory reserve volume + Tidal volume + Expiratory reserve volume + Residual volume

300
Q

What does a blood gas analyzer calculate?

A

HCO3-

BE

SaO2

301
Q

What areas does a maxillary nerve block desensitize?

A

Entire upper dental arcade

Maxilla

302
Q

What are the effects of epinephrine?

A
303
Q

What receptors do epinephrine stimulate?

A

Alpha 1 and 2 agonist

Beta 1 and 2 agonist

304
Q

What is the effect of an auriculopalpebral block?

A

Akinesia of eyelids

Does not desensitize the eyelids (only paralysis)

306
Q

Where does somatic pain originate from?

A

Bones

Joints

Muscles

Skin

307
Q

What ECG lead is used in horses? What does it accentuate?

A

Lead 1

Accentuates P wave

308
Q

Define Positive End-Expiratory Pressure (PEEP)

A

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
Q

What lab tests should be done on a patient with long term NSAID use?

A

U/A

ALT

Creatinine

311
Q

What are the indications for giving whole blood?

A

Acute blood loss/hemorrhage

Anemia

313
Q

What is the RBC lifespan in bovine?

A

140-160 days

315
Q

What are some anticipated complications of ruminant anesthesia?

A

Hypersalivation

Bloat (can’t erructate)

Hypoventilation (worse in dorsal recumbancy)

Regurgitation -> aspiration pneumonia

316
Q

What effect do air bubbles have on your arterial sample?

A

Increased PaO2

Decreased PaCO2

317
Q

What drug can be given prior to surgery in horses to reduce the chances of HYPP?

A

Oral acetazolamide

318
Q

What are the effects of dobutamine?

A

Increases contractility

Increases heart rate

320
Q

What are the colloid fluids?

A

Plasma

Dextrans

Hydroxyethyl starches

Hemoglobin-based oxygen carrying fluid

321
Q

Which injectable anesthetic drugs that we know of would be very damaging to tissues?

A

Thiopental

NSAIDs

322
Q

Why should you use caution when using Normosol-R or Plasmalyte 148 in diabetic ketoacidosis patients?

A

They increase blood [ketones]

323
Q

What are some reasons why a patient may require mechanical ventilation?

A

Respiratory center depression

Inability to adequately expand thorax

Airway obstruction

Inability to adequately expand lungs

Cardiopulmonary arrest

Pulmonary edema or pulmonary insufficiency

324
Q

What are the water requirements for dogs and cats?

A

Small dogs = 60 mL/kg/d

Large dogs = 40 mL/kg/d

Cats = 50-80 mL/kg/d

325
Q

How do you calculate vital capacity?

A

Inspiratory reserve volume + Tidal volume + Expiratory reserve volume

326
Q

What is the max dose of Bupivicaine you should use in dogs and cats?

A

2mg/kg in dogs

1mg/kg in cats

327
Q

What are the opthalmic NSAIDs?

A

Flurbiprofen

Suprofen

Ketorolac

Diclofenac

328
Q

What are the effects of norepinephrine?

A
329
Q

What are some complications of IV therapy?

A

Extravasation

Thrombosis/thrombophlebitis

Volume overload

Infection

Embolism

Exsanguination

329
Q

What parameters are monitored during fluid therapy?

A

HR

RR

CRT

MM color

Temp

Urine output

331
Q

What drug combo is often given to pigs for induction?

A

Dexmedetomidine-Ketamine-Butorphanol

Telazol-Ketamine-Xylazine

332
Q

When do you want to stop your lidocaine CRI?

A

30 minutes before the end of surgery

333
Q

What are the COX2 selective drugs?

A

Deracoxib

Firocoxib

Robenacoxib

334
Q

What are the causes of hypoxemia?

A

V/Q mismatch

Hypoventilation

Low FiO2

Right to left shunt

Diffusion impairment

335
Q

What is the blood volume for ovine?

A

60 mL/kg

337
Q

Which local anesthetic has the longest duration of action?

Lidocaine

Bupivicaine

Mepivicaine

Procaine

A

Bupivicaine

338
Q

How do you calculate minute ventilation?

A

Tidal volume x Respiratory frequency

340
Q

What are the clinical uses for dobutamine?

A

Treatment of hypotension

Common choice in equine hypotension

341
Q

Why is knowing 20% blood loss important?

A

Loss of ≥20% = PCV ≤20%

342
Q

What is the test dose for asministering infusions?

A

0.25 mL/kg for first 30 minutes

343
Q

What drug combination is used to maintain TIVA?

A

“Triple Drip”

GG

Ketamine

Xylazine (any A2 agonist)

344
Q

Which NMBA should not be used with hepatic insufficiency?

A

Vecuronium

345
Q

What would you do in order to treat anesthetic induced hypotension?

A

Give hourly crystalloid rate as rapid bolus (5-10 mL/kg over 15 minutes or less) in addition to continued hourly rate

346
Q

What is the most common pathologic arrhythmia in horses?

A

A fib

347
Q

Adult cattle fasting requirements?

A

12-18 hours for food

8-12 hours for water

349
Q

Young ruminant fasting requirements?

A

None if under 1 month old

2-4 hours if older than 1 month

350
Q

Define IPPV

A

Positive pressure maintained only during inspiration

351
Q

If your patient is on another highly protein bound drug, how many days after discontinuing that drug should you wait before starting NSAIDs?

A

7 days minimum

352
Q

Where do changes in hydration have the greatest effect?

A

ECF

353
Q

What are some reasons to administer IV fluids?

A

Maintain patent IVC

Counteract effects of anesthetic drugs

Replace insensible losses

Replace procedural losses

355
Q

What drug can you administer in horses when disconnecting the inhalant to make recovery safer? When is this not necessary?

A

A2 agonist (Xylazine)

Not necessary when using a triple drip

356
Q

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?

A

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
Q

What are the primary ECF cations?

A

Na+ most abundant

K+ present in small amounts

359
Q

What type of blood sample is used to evaluate respiratory gas exchange? Arterial or venous?

A

Arterial

360
Q

What is the blood volume for bovine?

A

60 mL/kg

361
Q

Which NMBAs should not be used with decreased esterase activity?

A

Mivacurium

Atracurium

362
Q

What nerves are blocked by the Peterson’s technique?

A

Oculomotor

Trochlear

Abducens

Trigeminal

Must do auriculopalpebral nerve block to paralyze eyelids

363
Q

Wat dose of vasopressin can you give during CPR?

A

0.2-0.8 U/kg IV

Can be used with or instead of epinephrine

364
Q

Which COX is upregulated during inflammatory states?

A

COX2

365
Q

Which premeds are not approved for use in food animals by the FDA?

A

Acepromazine

Xylazine

366
Q

What drug can be used in horses to treat hypotension?

A

Dobutamine

367
Q

How much blood can be held by a cotton tip applicator (CTA), gauze, lap sponges, and tubing of the suction apparatus?

A

CTA = 0.2mL each

Gauze = 5-10mL each

Lap sponges = 50-100mL each

Suction tubing = 120mL

368
Q

How much K+ can safely be given in an hour?

A

0.5 mEq/hr

369
Q

Which fibers feel fast pain? Slow pain?

A

Fast = A delta fibers

Slow = C fibers

370
Q

What is the first sign of toxicity you will witness in an awake animal administered Bupivicaine?

Seizures

GI ileus

CV depression

Respiratory depression

Vomiting

A

CV depression

371
Q

What % of TCO2 is from bicarb? Carbonic acid? CO2?

A

85% bicarb

10% carbonic acid

5% CO2

372
Q

Why would IPPV be needed during thoracic surgery?

A

Because the lungs cannot be inflated when the chest is open

373
Q

If you take too long to analyze your sample, what effects will this have?

A

Decreased PaO2 and pH

Increased PaCO2

374
Q

Does the charged (cationic) or non-charged form of LA repidly penetrate membranes?

A

Non-charged

375
Q

What is the COX+LOX drug?

A

Tepoxalin

376
Q

What percentage of the adult horse’s body weight is blood? Foals?

A

Adults = 8%

Foals = 9%

377
Q

What is the purpose of using vasoconstrictors with LA?

A

Increase duration of action

378
Q

What affect does hyperthermia have on a blood gas sample?

A

Artificially lowers PaO2 and PaCO2

379
Q

When giving the synthetic colloid HES, what enzyme is increased and why?

A

Amylase because that is how HES is metabolized

380
Q

What are some advantages of a distal paravertebral block over a proximal paravertebral block?

A

Lack of scoliosis

Lack of risk of penetrating major blood vessels

minimal weakness in the pelvic limb

Minimal ataxia

381
Q

What dose of atropine can you give during CPR?

A

0.04 mg/kg IV

382
Q

What is the normal range for bicarb in an arterial sample for carnivores and herbivores?

A

24

(15-24 in carnivores)

(20-28 in herbivores)

383
Q

What is the normal fluid rate used for dogs and cats?

A

Dogs = 10 mL/kg/h

Cats = 5 mL/kg/h

384
Q

What is the normal anion gap in dogs? Cats?

A

Dogs = 12-24

Cats = 13-27

385
Q

What is the alkalinizing agent in Normosol-R and Plasmalyte 148?

A

Acetate

386
Q

The caudal artery should be used for blood gas samples in what type of animal?

A

Small animal

387
Q

Activation of which two excitatory receptors is responsible for tactile sensations?

A

AMPa

Kainate

388
Q

Why is propofol not commonly used as an induction agent in horses?

A

Large volume

High cost

Poor quality induction

389
Q

What conditions is gabapentin useful in regulating pain?

A

Neuropathic conditions

OA

Cancer

390
Q

Do esters or amides more commonly cause allergic reactions?

A

Esters

391
Q

What are the 4 different volumes associated with air in the lungs?

A

Tidal volume

Inspiratory reserve volume

Expiratory reserve volume

Residual volume

392
Q

What is the total body water in neonates?

A

80%

393
Q

What is the key difference between central and peripheral sensitization?

A

Central allows low intensity stimuli and low-threshold Abeta sensory fibers to cause pain as a result of neuroplasticity in the spinal cord

394
Q

What receptors do phenylephrine act on?

A

Alpha 1 agonist

395
Q

What are your 3 options when trying to replaced lost blood volume?

A

Crystalloid

Colloid

Blood products (20% loss or greater; PCV≤20)

396
Q

When does the palpebral reflex disappear in ruminants?

A

Light anesthesia

397
Q

Why should you not use Doxapram during respiratory arrest?

A

It decreases cerebral blood flow while increasing cerebral O2 use

Anesthesia (3 decks)

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