anesthesiology VTNE – Flashcards
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the drug xylazine is best described as an: antiinflammatory analgesic and sedative antiemetic anesthetic
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analgesic and sedative
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detomidine is approved for use in which animal? dogs cats horses cattle
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horses but used in other species
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butorphanol is best describes as a/an: antiinflammatory analgesic anesthetic diuretic
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analgesic
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diazepam is considered to be a good choice in patients when which body system is compromised? Hepatic Renal Cardiovascular All body systems
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cardiovascular
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how does diazepam affect patients with impared renal or hepatic function?
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recovery may be significantly prolonged as a result of the metabolic requirements of diazepam
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In the US, Xylazine is not approved for use in: Dogs, cats, horses, or cattle?
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it is not approved for use in cattle, but is sometimes used
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Guaifenesin is most often used in horses and cattle to provide....
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Muscle relaxation
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the combination of Xylazine and butorphanol is used to...
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provide greater analgesia and muscle relaxation. These are synergistic, and together the dose of each is reduced, causing less side effects and more therapeutic effects
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which is the most potent sedative: Xylazine, Detomidine, Acepromazine, or Diazepam
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detomidine is much more potent on a volume to volume basis
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which drug is most likely to cause hypotension in normal doses: diazepam, butorphanol, acepromazine, or flunixin meglumine
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Acepromazine. It is an alpha blocker with significant potential to produce hypotension; this is rarely a problem in healthy, normovolemic patients
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acepromazine is an alpha blocker with significant potential to produce hypotention, is this usually a problem? Elaborate.
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it is rarely a problem in healthy, normovolemic patients
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the combo drug telazol contains what two drugs? Elaborate.
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Zolazepam is a benzodiazepine tranquilizer and tiletamine is a dissociative anesthetic
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Epidural techniques are used in many species, but the primary disadvantage in animals is what
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movement of patient. Epidurals are used for analgesia, but patient movement prevents use for many surgical procedures
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which inhalant anesthetic drug is most likely to cause cardiac arrhythmias in dogs and why
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halothane. It sensitizes the myocardium to catecholamines such as epinephrine, which can lead to arrhythmia.
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which inhalant anesthetic drug is biotransformed to the greatest extent in the animal body
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halothane
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is nitrous oxide an inhalant analgesic or an inhalant anesthetic
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it is an inhalant analgesic
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all of the following cross the placental barrier in significant amounts except: Acepromazine, diazepam, isoflurane, or neuromuscular blocking agents
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neuromuscular-blocking agents
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why do neuromuscular blocking agents have minimized placental transfer
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they are highly ionized and have high molecular weights, minimizing placental transfer
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which drug is not classified as a barbiturate: phenobarbital, Thiopental, Pentobarbital, or Propofol? Elaborate.
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propofol is an alkylphenol, nonbarbiturate, highly lipid-soluble hypnotic agent used to produce short term anesthesia
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which crosses the placental barrier, atropine or Glycopyrrolate
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atropine
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which has a longer duration of action, glycopyrrolate, or atropine
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glycopyrrolate
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which is less likely to cause cardiac arrhythmia, glycopyrrolate, or atropine
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glycopyrrolate
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which requires a larger dose volume, atropine, or glycopyrrolate?
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atropine requires a larger dose volume
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at normal doses, what effect does atropine have on the heart rate
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prevents decrease. It is often used to prevent drug or parasympathetic nervous system-induced bradycardia in anesthetized animals
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which drug is an antagonist of xylazine: butorphorhanol, detomidine, yohimbine, or pentazocine
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yohimbine antagonizes depressive effects of xylazine
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opiod drugs are used in anesthetic protocols primarily as...
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analgesics
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the advantage of xylazine over acepromazine is that it...
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produces a short period of analgesia (ace has no analgesic effects)
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why should routine use of atropine in horses be avoided
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it causes colic and
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how does the routine use of atropine negatively affect horses
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anticholinergic effects of atropine on the intestinal tract of horses may include ileus, intestinal distention, and colic
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atropine use in horses should be limited to treatment of what
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bradycardia caused by increases in vagal tone
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which drug should be avoided in the stallion because it may cause permanent prolapse of the penis: glycopyrrolate, acepromazine, xylazine, or diazepam
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acepromazine
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why should phenothiazine tranquilizers such as acepromazine be avoided in stallions
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they all have the potential to produce paralysis of the penis in stallions
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which is a narcotic antagonist: naloxone, atropine, pancuronium, or droperidol
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naloxone
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a 10% solution of thiopental sodium for antesthetic induction contains: 10 mg/ml, 100 mg/ml, 20 mg/ml, 40 mg/ml
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100 mg/ml
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what effect might depressant preanesthic medication have on the anesthesia procedure
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prolong recovery time
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diazepam is used to produce what effects
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muscle relaxation
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why does epinephrine increase the heart rate
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has adrenergic (sympathetic) effects
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why does the use of nitrous oxide in anesthesia decrease the amount of inhalant anesthetic needed
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it is an inhalant analgesic, and when used with potent inhalant anesthetics, it allows lower levels of more potent drugs to be used
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what is a disadvantage of breathing 50% nitrous oxide
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decreases arterial PaO2
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how many milligrams per milliliter (mg/ml) does a 2% lidocaine solution contain
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20 mg/ml
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what volume of thiopental sodium should be administered intravenously to a 500 kg horse for induction of anesthesia? The dosage is 8 mg/kg and you are using a 10% solution
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40 ml
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apneustic breathing patterns are frequently seen in cats with the use of what drug
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ketamine
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apneustic respirations are characterized by ...
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an inspiratory hold and rapid respirations
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which is not a good reason to use preanesthetics: calm patient, minimize dose of induction agent, smooth induction and recovery, or increase vagal activity
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increase vagal activity
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if 180 ml of a 5% solution of guaifenesin is administered to a 150 kg foal, how many mg/kg would be administered
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60 mg/kg
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are mask inductions more appropriate in aggressive or calm dogs and cats
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calm
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which is not an effect associated with atropine: tachycardia, excessive salivation, mydriasis, decreased gastrointestinal motility
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excessive salivation
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the dosage of acepromazine is 0.1 mg/kg and the maximum dose is 4 mg. how many milligrams would you administer to a 60 kg dog?
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4 mg
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halothane concentrations of 1% to 2% may produce any of the following except: hypotension, hypoventilation, hypothermia, increased cardiac output
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increase cardiac output. all inhalation anesthetics are expected to decrease cardiac output at working concentrations
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the adverse effects of anesthetic compounds are: nothing to worry about, never present with smaller doses, dose dependent, not dose dependent
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dose dependent- the more given the more adverse effects
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the most reliable sign of inadequate anesthetic depth is: increased heart rate, increased respiratory rate, active palpebral reflex, responsive movement
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responsive movement
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propofol is a/an: xylazine antagonist, ultrashort-acting barbiturate, ketamine-like dissociative, nobarbiturate intravenous anesthetic with hypotensive potential
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nonbarbiturate, intravenous anesthetic with hypotensive potential
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acepromazine should be avoided in which patients
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patients with a history of seizures
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why should acepromazine be avoided in patients with a history of seizures
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lowers seizure threshold
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in dogs, normal doses of opioids generally produce all of the following except: respiratory distress, decreased HR, analgesia, excitement
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excitement is rare
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when comparing inhalation anesthetics, you should use the minimum alveolar concentration (MAC) as a guide in assessing what
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potency of the agent
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what is MAC
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minimum alveolar concentration- percent at 1 atmosphere that prevents gross, purposeful skeletal muscle movement in response to noxious stimulus in 50% of patients. It is an expression of the potency of a drug.
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which drug is a dissociative anesthetic: thiopental sodium, ketamine, xylazine, or acepromazine
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ketamine
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which inhalant anesthetic is associated with the longest induction and recovery times?
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halothane
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in rabbits, intravenous anesthetics should be injected into which of the following veins: femoral, jugular, auricular, cephalic
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auricular provides easy access and adequate vessel size
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the oxygen flow rate necessary to prevent rebreathing of exhaled gases with an Ayre's T piece is: 0.5 L/min, 1L/min, 2L/min, or greater than 1.5 times the minute ventilation
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greater than 1.5 times the minute ventilation.
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a half-full tank of nitrous oxide gas has a pressure of how many psi
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750 psi
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when inflating lungs with the thoracic cavity open to the atmosphere, be sure that the pressure reached on the manometer is...
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20 cm H2O
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precision vaporizers, such as those used for isoflurane, work correctly when placed
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out of the circle
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if hte unidirectional valves are missing from an anesthetic machine, is it ok to use
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definitely not okay to use, except with a nonrebreather
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the absence of unidirectional valves allows the rebreathing of what
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carbon dioxide
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why can a non rebreather be used with the absence of unidirectional valves
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it is attached to the fresh gas port, which bypasses the circuit
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what does the oxygen flush valve do
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allows O2 to flow into the breathing system without going through the vaporizer, thus not adding additional amounts of anesthetic agent
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the advantages of a nonrebreathing system as compared with a circle breathing system include all of the following, except: reduced resistance to breathing, greater potential for hypothermia caused by high flows needed, reduced mechanical dead space, no soda lime required
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greater potential for hypothermia caused by high flows needed
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the minimum fresh gas flow in a semiclosed system is correctly determined by what
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patients metabolic rate determines the minimum gas requirement
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all inhalant anesthetic machines should have: nitrous oxide flowmeter, blood pressure monitors, respiratory monitors, or an anesthetic waste gas scavenging system
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anesthetic waste gas scavenging system
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vaporizers may be classified according to all of the following except the: method of regulating output, method of vaporization, location in the anesthetic circuit, or type of breathing circuit with which they can be used
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type of breathing circuit with which they can be used (all vaporizers can be used with any breathing circuit)
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why arent vaporizers classified according to the type of breathing circuit with which they can be used
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all vaporizers can be used with any breathing circuit
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an IV catheter should be large enough to allow adequate fluid delivery in case what occurs
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cardiac arrest
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the volume of the rebreathing bag on an anesthetic machine should be at least how many times the patient's tidal volume and why
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3Xs to ensure adequate vol of gases for patient's needs
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what do pulse oximetry monitoring devices give an estimate of
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percentage of hemoglobin saturation with oxygen in arterial blood
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which statement concerning soda lime is least accurate: removes carbon dioxide from breathing circuit, capacity should be at least one to two time patient's tidal volume, can be nonfunctional and still maintain norm color, should be changed once a monthe
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should be changed once a month. It should be changed based on the amount of hours it has been used
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if the rebreathing bag is empty during anesthesia, all of the following may be the cause, except: the O2 flow may be too light, the O2 flow may be too high, there may be a leak in the system, scavenging system not working properly
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O2 flow too high- this would cause the bag to overinflate
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what color are nitrous oxide cylanders
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blue is the standard color for medical nitrous oxide cylinders
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what is the approximate volume of O2 in an E cylinder
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700L
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the approximate volume of O2 in an H cylinder is...
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7000L
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the pressure of gas that enters the flowmeter of an inhalant anesthetic machine is...
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50-60 psi
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which statement concerning the pressure manometer in an inhalant anesthetic circuit is least accurate: calibrated in centimeters of water or millimeters of mercury, helpful when ventilating patients, related to pressure in patient's airway, measures O2 partial pressure
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least accurate: measures O2 pressure in patient's airway
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how is the pressure manometer in an inhalant anesthetic circuit calibrated
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centimeters of water of millimeters of mercury
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activated charcoal devices absorb all inhalation agents except
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nitrous oxide
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according to the National Institute for Occupational Safety and Health (NIOSH), the maximum recommended level of exposure of people to volatile anesthetic agents in the environment is...
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2 pp
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there is evidence of increased health risks among people exposed chronically to trace levels of inhalant anesthetic gases. All of the following conditions have been associated with such exposure except: abortion and congenital abnormalities, hepatic and renal disease, CNS dysfunction, or insomnia
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insomnia
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all of the following are methods that reduce waste gas levels except: scavenging systems, elimination of breathing circuit leaks, careful filling of vaporizers to avoid spillage, or chamber and mask inductions
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chamber and mask inductions cause increased waste anesthetic gas exposures to personnel
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when inflating the cuff on an endotracheal tube, you should change to a larger diameter tube if cuff inflation requires injection of more that what volume of air?
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5 ml
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if the diameter of the endotracheal tube is too small, what can occur?
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restricts patient ventilation and can cause pressure damage to tracheal lining
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Ideally an endotracheal tube should be inserted so that its tip is...
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its tip is midway between the thoracic inlet and the larynx
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why does the et tube tip need to be midway between the thoracic inlet and the larynx
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to reduce deadspace and prevent endobronchial intubation
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when an endotracheal tube is being inserted in a horse, how should the animal be placed
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lateral recumbency with head, neck, and back extended
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why does the horse need to be in lateral recumbency with its head, neck and back extended during entubation?
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in this position, a horse's long, soft palate will usually guide the tube into the larynx
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which animal is most likely to experience laryngospasm during endotracheal intubation: thoroughbred mare, hereford cow, persian cat, dalmation dog
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cats are most likely to experience laryngospasms than any other species listed
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which of the following is the most common complication of endotracheal intubation: tube in esophagus, damage to teeth and oral MM, overinflated cuff injuring trachea, underinflating cuff collapsing trachea
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all are complications, but most common is placing the tube in the esophagus
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teh best method for determining the proper inflation of an endotrachel tube cuff is...
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inject air while applying pressure from the reservoir bag until no air escapes around tube
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the preferred method for treating a cat with laryngospasm is to
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1-2 drops lidocaine and wait few minutes for relaxation
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which of the following is not an advantage of using an endotracheal tube: prevents atelectasis of lung alveoli, provides a means for treating respiratory and cardiac arrest, increases chances of airway obstruction, or encourages proper exam of animal's mouth, pharynx, and larynx
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increases chances of airway obstruction- the et tube is specifically used to decrease chances of having airway obstruction
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in a siamese cat, the endotracheal tube should be removed when
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as soon as swallowing and coughing... (nonbracycephalic)
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when should the ET tube be removed in a pug
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only after fully conscious and able to maintain free airway
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why should the ET tube be removed when the animal begins swallowing and coughing, if it is a non brachycephalic breed
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so they do not chew on tube and/or injure themselves
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why should the ET tube on a brachycephalic breed be removed only after full consciousness and ability to maintain free airway
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chances of respiratory complications are greater than other animals.
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what is the best technique to secure an endotracheal tube to an animal
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gauze strips around head in cats and brachy dogs, caudal to upper canines in other dogs
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which statement concerning use of IV anesthesia in large animals is least accurate: works well on procedures that require complete immobilization of patient, should not be used on procedures requiring more than 45-50 min to complete, requires use of preanesthetic for sedation an a barbiturate, or is routinely used for cast applications, castrations, and umbilical hernias
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least accurate: works well on procedures requiring complete immobilization of patient (with large animals)
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when monitoring the vital signs of an anesthetized patient, you must observe and record all of the following, except: MM color and CRT, HR and RR and depth, reflexes, pulse quality and strength
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reflexes (not vital signs)
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the responsibilities of the anesthetist during a surgical procedure include continuous monitoring of the patient's vital signs and recording observations at approximately what intervals
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at least every 3-5 minutes
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adequate O2 may be evaluated subjectively during anesthesia by...
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MM and CRT
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hypoventilation that occurs in the anesthetized patient is characterized by what
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decreased O2 levels and increased carbon dioxide levels
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how often do patients given anesthetic drugs hypoventilate
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always. every patient given anesthetic drug is hypoventilating
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concerning physical stimulation of the recovering anesthetized patient, which statement is LEAST accurate: stimulation should not include rubbing the chest because it may interfere with respiration, stimulation increases the flow of information to the reticular activation center of the brain, lack of stimulation may cause drowsiness in the conscious animal, stimulation can include talking to the patient, moving limbs, or pinching toes
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Least accurate: stimulation should not include rubbing the chest, because it may interfere with respiration. (rubbing the chest is good)
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It is advisable to turn the anesthetized patient from side to side during the recovery period of anesthesia. Which is LEAST accurate: turn every 10-15 min until regains consciousness, turning prevents pooling of blood, turn all animals dorsally not sternally to prevent GDV, turning patient helps stimulate respiration and consciousness
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turning the patient dorsally is the least accurate. In order to prevent GDV, the patient should be turned sternally.
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once extubated, all animals should be placed in what position
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sternal recumbency with neck extended to maintain patient airway
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following discontinuation of anesthetic gas, periodic bagging of the patient with pure oxygen is advisable, because...
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it helps reinflate collapsed alveoli
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in the anesthetized surgical patient, pale MM can indicate all of the following except: Inadequate O2 levels, cyanosis, excessive blood loss, decreased tissue perfusion
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cyanosis- this would be indicated by blue MM
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in patients with which characteristic is it recommended to wait longer period before extubation because of the likelihood of vomiting or airway obstruction
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brachycephalic
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the structure of a brachycephalic animal's nasal passages and palate makes them more prone to what after anesthesia
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vomiting and possible airway obstruction
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Which is not advisable for a patient immediately following surgery? ample bedding to prevent heat loss and increase comfort, fresh food and water once conscious, source of heat in hypothermia cases, postoperative analgesics as directed by veterinarian
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providing fresh food and water once conscious- some patients experience nausea and vomiting after anesthesia
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the minimum acceptable heart rate for an anesthetized medium-sized dog is...
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60 bpm
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it is cause for concern if an anesthetized cat's heart rate falls below...
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100 bpm
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When used as preanesthetics, atropine and acepromazine can cause all of the following, except: prolapse of nictitating membrane, respiratory depression, reduced salivation and tear production, pupil dilatation in cats
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respiratory depression- phenothiazines such as ace do not cause this
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a CRT that is over 2 seconds indicates: CHF, decreased peripheral blood perfusion, decreased ventilation, or hypertension
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decreased peripheral blood perfusion
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use of an indwelling catheter in an artery to monitor blood pressure is termed...
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direct monitoring
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direct monitoring refers to the measuring of...
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arterial blood pressure through use of an indwelling catheter placed in the femoral or dorsal pedal artery
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indirect monitoring refers to...
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use of external devices when recording blood pressure
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when monitoring the MM color of an anesthetized patient wiht pigmented gingivae, you could use each of the following alternative sites except: pinnae, tongue, buccal MM, membranes lining the prepuce or vulva
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pinnae
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alternative sites for monitoring MM color include...
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tongue, buccal mucous membranes, conjunctivae of lower eyelids, lining of prepuce or vulva
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during the maintenance period of anesthesia in a cat or dog, RR lower than how many bpm may indicate excessive anesthetic depth that should be reported to the veterinarian
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8 breaths per minute
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some anesthetists routinely bag the patient under inhalation anesthesia once every 5 minutes to help prevent what
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atelectasis
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what is atelectasis
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respiratory condition characterized by partially collapsed alveoli. May result in shallow breathing, which causes a decrease in tidal volume
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the causes of true hyperventilation and tachypnea during anesthesia may include all of the following except: progression from light to moderate anesthesia, response to metabolic acidosis, response to mild surgical stimulus, presence of pulmonary edema
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progression from light to moderate anesthesia- hyperventilation can occur from moderate to light anesthesia
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if the rectum of a patient is covered by a surgical drape or is otherwise inaccessible to the anesthetist, a rough estimate of body temperature can be obtained by...
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feeling temp of extremities, such as paws and ears
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throughout anesthesia, hypothermia can be prevented by all of the following except: warming stainless steel V trough before use, administering warm IV fluids, circulating warm water heating pad, or providing comfortable air temp in the surgery room
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all except- warming stainless steel V trough- impractical, metal doesn't retain heat, use towels/blankets to keep off stainless steel
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malignant hyperthermia is a potentially fatal syndrome to the anesthetized patient. which of these species is most prone to this condition: cattle, pigs, dogs, goats
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pigs- although may be seen in dogs anesthetized with ketamine or halothane, pigs are more prone to this condition
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use of succinylcholine in combination with general anesthetics may be advantageous to the surgeon during certain procedures, but it gives the anesthetist one less measure with which to monitor anesthetic depth. What measure would be of no use in monitoring patients given succinylcholine
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jaw muscle tone- this is a muscle-paralyzing agent that may be used to achieve pronounced muscle relaxation for certain procedures
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using ketamine as an anesthetic agent diminishes the value of what measure in assessing anesthetic depth
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eye position- does not cause eye rotation, even at moderate depths of anesthesia
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how does ketamine diminish the value of measuring anesthetic depth through assessment of eye position
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does not cause eye rotation, even moderate depths of anesthesia
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describe stage III, plane 3 of anesthesia
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eye usually central to slightly rotated, pupils moderately dilated and respond slowly to light or not at all
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describe stage III, plane 2 of anesthesia
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eyes usually rotated ventrally with slightly dilated pupils
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describe stage II of anesthesia
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eyes usually central, pupils may be dilated and responsive to light
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describe stage IV of anesthesia
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eyes central with widely dilated pupils that are unresponsive to light
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the presence or absence of salivary and lacrimal secretions may give clues regarding anesthetic depth. How might an animal that has not received an anticholinergic be affected
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tear and saliva production diminishes as anesthetic depth is increased
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Response to a painful stimulus during anesthesia may be indicated by all of the following except: considerable increase in heart rate an blood pressure, decrease in lacrimation and salivation, increase in respiratory rate, sweating on foot pads
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decreased lacrimation and salivation- if anesthesia was to light, these would be increased
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10 yr old dog anesthetized to remove skin tumor, is maintained on 2% iso. RR is 8 bpm and shallow, HR is 80 bpm, pupils central, jaw tone is slack, all reflexes absent. What stage and plane of anesthesia is this describing?
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stage III, plane 3
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10 yr old dog anesthetized to remove skin tumor, maintained on 2% iso, RR 8 bpm and shallow, HR 80 bpm, pupils central, jaw tone is slack, all reflexes absent. What should be your response or actions to the condition of this animal?
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reduce vaporizer to 1.5 iso, continue to monitor for signs of decreased depth. Prob to deep for given procedure. Age is also risk.
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what stage of anesthesia may be characterized by vocalization, struggling, and breath holding?
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stage II - "excitement stage"
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stage II of anesthesia is aka
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excitement stage
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how should the excitement stake aka stage II of anesthesia be avoided
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bolus of injectable anesthetic to take animal past phase of excitement
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dog received correct dose of Xylazine IM. 2nd degree heart block and bradycardia developed. Based on most common cause of this adverse reaction, what would be the best therapy
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glycopyrrolate. anticholinergic effects block vagal-induced bradycardia and 2nd degree heart block commonly associated with xylazine
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an abnormally elevated central venous pressure that develops during anesthesia and surgery in an animal receiving IV fluids may indicate....
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IV fluid overload
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a 1:10,000 dilution of epinephrine contains how much epinephrine per milliliter?
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0.1 mg/ml (1/10,000 = 0.01% = 0.1 mg/ml
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cardiac arrhythmias that occur during anesthesia are commonly associated with all of the following except: normocapnia, excessive halothane concentration, hypoxemia, myocardial ischemia
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normocapnia
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mean arterial blood pressure of the isoflurane-aneshthetized horse can be used as an indication of...
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anesthetic depth
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when dealing with a horse, which is a more accurate indicator of anesthetic depth, heart rate, or arterial pressure?
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arterial pressure
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surgical evaluation of a dog hit by a car revealed a PCV of 18% and plasma protein below 2.5 g/dl. All of the following are true, except the: patient predisposed to pulmonary edema, fluid admin rates should be watched closely, patient should receive plasma or whole blood before surgery, or patient should not receive fluids before surgery
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all are true except: patient should not receive fluids before surgery. Patient needs fluids to help compensate for blood loss indicated by low PCV and plasma protein levels
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the estimated blood volume in a dog is...
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75 ml/kg
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the volume of blood administered to a patient is determined by all of the following except: PCV of donor, PCV of recipient, desired PCV, age of recipient
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all except age of recipient
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horse under inhalation anesthesia, HR suddenly increases to 80 bpm, most appropriate response is to: increase delivered anesthetic concentration, administer IV 10 mg butorphanol, evaluate peripheral pulse, MM, and other vital organ function before responding, not be concerned, because horse is not moving
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most appropriate response would be to evaluate the peripheral pulse, MM, and other vital organ function before responding
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horse receiving O2 at rate of 8 L/min, iso at 2.5%, fluids at 10ml/kg/hr, blood pressure suddenly falls to 60 mm Hg, and peripheral pulse gets weak. Your first response:
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Lower iso and increase fluid delivery rate-falling BP indicates increasing depth of anesthesia in horse. lowering iso will lighten depth. Increased fluid will help increase BP.
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whole blood should be administered in which of the following presurgical situations: PCV 30%, PCV 14%, Von WIllebrands, or chronic anemia with PCV of 25%
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PCV 14%
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10kg dog: 50ug/kg/min of lidocaine. How many drops per min from a minidrip infusion set are necessary if the concentration of lidocaine is 1mg/ml?
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30----- 10kg x 50g/kg/min = 500g/min; 500g = 0.5mg = 0.5ml = 30 drops/min
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the most common arrhythmia associated wiht use of thiobarbiturates in dogs during induction of anesthesia is
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Bigeminy