Bryan - Anesthesiology - Test 1B - Spring 2Nd Year

Front 1

T or F:
Anesthetic blood levels are roughly that of brain levels.

Back 1

True!

Front 2

What is the measure of safety for injectable anesthesia? How is this calculated?

Back 2

Therapeutic index = LD50/ED50

Front 3

What are the dissociative anesthetics used for injectable anesthesia? What routes are these given?

Back 3

Ketamine; Tiletamine
Given IV or IM

Front 4

Describe the cardiovascular and respiratory effects of ketamine.

Back 4

CV - Increased HR, BP, and CO (via sympathtetic)
Resp - mild depression

Front 5

What drugs are commonly administered with ketamine to smooth out recovery?

Back 5

Guaifenisen
Acepromazine
Benzodiazepines
Alpha 2 adrenergics

Front 6

This ultrashort acting barbituate causes tissue necrosis if injected perivascularly.

Back 6

Thiopental

Front 7

What are the cardiovascular effects of the barbiturates?

Back 7

Moderate hypotension
Arrhythmogenic (bigeminy)
Splenic engorgement

Front 8

What respiratory effects are seen with the barbiturates?

Back 8

Respiratory depression and apnea

Front 9

T or F:
Barbiturates offer no analgesia.

Back 9

True

Front 10

Which barbiturate is short acting and has no "hangover" effect?

Back 10

Propofol

Front 11

How do the cardiovascular effects of propofol differ from the other barbiturates?

Back 11

Propofol is non-arrhythmogenic

Front 12

What is the drug of choice for patients with significant cardiovascular disorders?

Back 12

Etomidate

Front 13

Which drug works like propofol and is NOT available in the US (yet)?

Back 13

Alfaxan

Front 14

What is a very common central-acting muscle relaxant used in large animals?

Back 14

Guaifenisin

Front 15

Which of the common inhaled anesthetics has the highest blood/gas solubility? The lowest?

Back 15

Highest --> Methoxyflurane
Lowest --> N2O

Front 16

T or F:
Potency of an inhaled anesthetic agent is inversely proportional to its blood/gas solubility.

Back 16

True! Thus, methoxyfluorane is the most potent!

Front 17

The point where 50% of patients under gas anesthesia move in response to a painful stimulus describes...

Back 17

MAC (mean alveolar concentration)

Front 18

Metabolism of inhalants is (choose one) directly/indirectly proportional to their blood/gas solubility.

Back 18

metabolism is directly proportional to blood/gas solubility

Front 19

What are drawbacks to using methoxyflurane?

Back 19

Slow induction, recovery, and plane transition.
Nephrotoxic
Hepatotoxic

Front 20

Which inhalant is most likely to cause malignant hyperthermia?

Back 20

Halothane

Front 21

Which inhalant is very arrhythmogenic?

Back 21

Halothane

Front 22

Which inhalant causes more severe respiratory depression than the others?

Back 22

Isoflurane (also sevoflurane)

Front 23

Which inhalant has no cardiovascular effects?

Back 23

N2O

Front 24

Increased cardiac output (choose one) increases/decreases inhaled anesthetic effect.

Back 24

Increased CO decreases anesthetic effect.

Front 25

Where can pulse strength be assessed in dogs and cats? What are normal rates?

Back 25

Dorsal pedal, femoral, coccygeal, lingual, metacarpal/tarsal;
Dog is 65 - 180bpm
Cat is 100 - 220bpm

Front 26

Where can pulse be assessed in a horse? What are normal rates?

Back 26

Facial, transverse facial, dorsal metatarsal, radial, caudal auricular;
Adult 30-50bpm
Juvenile 50-70bpm

Front 27

Where can pulses be assessed in ruminants/camelids/swine? What are normal rates?

Back 27

Saphenous a.; caudal auricular a.;
adults - 60-100bpm
Juvenile 80-120bpm

Front 28

Where are good sites to place a catheter for a blood pressure transducer in dogs/cats; in horses; in camelids?

Back 28

dogs/cats --> dorsal pedal
horses --> facial; dorsal metatarsal
camelids --> common digital; saphenous

Front 29

T or F:
A Cardell type BP monitor measures systolic and diastolic pressures and calculates a mean arterial pressure from this.

Back 29

False!
They measure MAP and calculate systolic/diastolic from this

Front 30

What is normal BP and MAP for a dog?

Back 30

80/40 to 120/80;
MAP 60-100

Front 31

What is normal BP and MAP for a cat?

Back 31

80/40 to 150/80;
MAP 60 - 120

Front 32

What is normal BP and MAP for a horse?

Back 32

95/65 to 120/90;
MAP 75-100

Front 33

What is normal BP and MAP for a cow?

Back 33

120/75 to 150/100;
MAP 90-120

Front 34

What are good tidal volume estimates for small animals? Equine? Ruminants?

Back 34

dog/cat --> 8-10 ml/kg
horse --> 8-12 ml/kg
cow --> 5-8 ml/kg

Front 35

End tidal CO2 is always (choose one) higher/lower than alveolar CO2.

Back 35

Higher

Front 36

Spontaneous ventilation should occur when CO2 goes above what value?

Back 36

usually 40-75 torr

Front 37

What values may be obtained with a blood gas analysis?

Back 37

Acid/base status
Pa CO2 & Pa O2
Electrolytes
Lactate
Glucose

Front 38

Which ocular reflexes or positions are assessed during anesthesia?

Back 38

Eye position
Palpebral reflex
Corneal reflex
Nystagmus
Pupil constriction/dilation

Front 39

Describe the bovine eye position as it relates to anesthetic depth.

Back 39

Starts in center, rolls ventrally as gets light, comes BACK to center at surgical anesthesia, rolls BACK DOWN as depth increases

Front 40

Nystagmus is a good indicator of anesthetic depth in which species? What other periocular response is useful in this species?

Back 40

Horses; lacrimation is also a good indicator of perfusion pressure in horses

Front 41

What are some indications for mechanical ventilation?

Back 41

hypoventilation
thoracic surgery
prolonged procedures
abdominal tympany
use of muscle relaxants
when hypoxemia is present
HORSES!!

Front 42

During mechanical ventilation, cycling changes in _______________ compress bellows.

Back 42

air pressure

Front 43

What are some possible complications to mechanical ventilation?

Back 43

Barotrauma
excessive anesthetic depth
excessive positive chest pressure can cause hypotension

Front 44

What mechanical ventilation settings for breaths/minute, tidal volume, and inspiratory pressure should be used for small animals?

Back 44

10-12 bpm
15ml/kg tidal volume
<20cm H2O pressure

Front 45

What mechanical ventilation settings for breaths/minute, tidal volume, and inspiratory pressure should be used for horses?

Back 45

6-8 bpm
15 - 20 ml/kg tidal volume
25-30 cm H2O pressure

Front 46

What mechanical ventilation settings for breaths/minute, tidal volume, and inspiratory pressure should be used for foals?

Back 46

10-12 bpm
15-20 ml/kg tidal volume
20-25 cm H2O pressure

Front 47

Choose osmolar or oncotic as a descriptor...
...independent of membrane.

Back 47

Osmolar

Front 48

What are the effective osmoles responsible for ECF and ICF tonicity?

Back 48

Na+ ECF
K+ ICF

Front 49

T or F:
The only safe, effective, osmole for extracellular admistration is Na+.

Back 49

True!

Front 50

What are the three ways that colloid fluid therapies are classified?

Back 50

Electrolyte composition
Tonicity
Acid-base effect (pH)

Front 51

Which two routes of fluid administration are available during anesthesia administration?

Back 51

IV and intraosseus

Front 52

What is the recommended maximum rate of administration for K+ containing fluids?

Back 52

0.5mEq/kg/hr

Front 53

Which of the following parameters does a blood gas machine directly measure? Which are calculated?
a) pH
b) HCO3-
c) PCO2
d) PO2
e) Base excess

Back 53

pH, PCO2, PO2 are directly measured; the rest are calculated

Front 54

When is bicarb therapy indicated (in terms of pH and base excess)?

Back 54

when pH is <7.20 or BE is <-10

Front 55

How can bicarb therapy be calculated?

Back 55

mEq of bicarb=Wt (kg) * |BE|*0.3

Front 56

What are the 4 types of drugs (by effect) that are commonly used for anesthesia supportive care?

Back 56

Cardiovascular
Respiratory
CNS
Muscle relaxant

Front 57

What muscle relaxant is used for fracture reduction? What more must be done to ensure patient safety when using this drug?

Back 57

Atracarium paralyzes diaphragm; need to mechanically ventilate

Front 58

MAP in a horse should be maintained above what value?

Back 58

>75

Front 59

When does bradycardia become an issue?

Back 59

when BP is too low!!

Front 60

Choose atropine or glycopyrrolate...
...does not cross BBB.

Back 60

Glycopyrrolate

Front 61

Choose atropine or glycopyrrolate...
...faster onset.

Back 61

Atropine

Front 62

What drug group can change heart contractility? Heart rate? Stroke volume? Peripheral vascular resistance?

Back 62

Inotropes (contractility)
Chronotropes (HR)
Fluids (SV)
Alpha1/alpha2 agonists (PVR)

Front 63

Which receptors control vasoconstriction?

Back 63

Alpha 1 (arteries > veins)
Alpha 2 (veins > arteries)

Front 64

Which receptors control vasodilation?

Back 64

Beta 2
DA

Front 65

Which receptors control heart contractility? Heart rate?

Back 65

Beta 1 does both!

Front 66

What receptors does dobutamine act on? What effect does this have then?

Back 66

Mostly beta 1, a little beta 2;
Thus positive inotrope/chronotrope

Front 67

What is the best positive chronotrope/inotrope to use in the horse?

Back 67

Dobutamine

Front 68

What receptors does dopamine act upon? What effect does this cause?

Back 68

Dopamine, then alphas and beta 1, then beta 2;
Vasoconstriction, positive chronotrope/inotrope, RENAL VASODILATION

Front 69

What receptors does ephedrine affect? What effect does this cause?

Back 69

Alphas and Betas; positive inotrope/chronotrope; less effective than DA or dobutamine

Front 70

Which two drugs have primarily alpha 1 effects? Which is seldom used and which is very potent?

Back 70

Phenylephrine (seldom used) and Vasopressin (POTENT)

Front 71

What are some other non-adrenergic or dopinergic preparations that can increase contractility?

Back 71

Calcium preparations (CaCl2 and Ca gluconate)

Front 72

What is the most commonly used antiarrhythmic drug? This is contraindicated in which species?

Back 72

Lidocaine; not for cats!

Front 73

What bronchodilator can be used in animals?

Back 73

Albuterol