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Anesthesia/Analgesia
Veterinary Technician Anesthesia/Analgesia Test Prep
| Type/Term/Question | Effects/Definition/Answer |
|---|---|
| Which drug class causes premature parturition in Cows? | Alpha2-Agonists |
| Which drug class should not be used in combination with anticholinergics due to prolonged tachycardia? | Alpha2-Agonists |
| Which drug class helps reverse bradycardia, reduces salivation and lacrimal secretions but causes thick/ropy saliva in ruminants? | Anticholinergics (Atropine / Glycopyrrolate) |
| Which drug class may cause the eyes to remain open and central during anesthesia? | Dissociatives |
| Which drug class does not provide significant sedation unless mixed with Ketamine/Opioids? | Benzodiazepines |
| Yohimbine and Tolazoline are reversal agents for which drug? | Xylazine |
| Neuroleptanalgesia can be defined as: | A combination of Opioids and Tranquilizing agents to produce sedation and analgesia |
| Which drug class takes 30-60 minutes to take effect, regardless of the route? | NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) |
| Define Cachexia: | a.k.a 'Wasting Syndrome' - marked muscle and weight loss usually from disease or malnourishment |
| Define Cyanosis: | Purple/Blue discoloration of mucous membranes indicating low blood O2 concentration and possible decrease in tissue perfusion. |
| Define Syncope: | Fainting, often from hypoxemia, low blood pressure or cardiac disease |
| Define Vapor Pressure: | The measure of a liquid's tendency to evaporate | The amount of pressure exerted by the gaseous form of a substance when liquid and gas are in equilibrium |
| What is the Blood-gas Partition Coefficient? | The solubility of inhalation agent in the blood vs. alveolar gas | An agent with low blood-gas ratio is less soluble in blood |
| What is MAC? | Minimum Alveolar Concentration: the lowest concentration at which 50% of patients show no response to painful stimulus. |
| What is Dead Space? | Extra space created by ET tubes that are too long or inappropriate anesthesia machine set up/choice that increases the necessary respiratory effort of the patient to get the same amount of usable air or anesthetic gas. |
| What does a Pulse Oximeter measure? | Oxygen Saturation of hemoglobin |
| Describe the Oxygen Saturation ranges: | >= 95% - ideal for Anesthesia 90-94% - Hypoxemia <90% - indicates a need for therapy <85% - medical emergency |
| What is the difference between assisted and controlled ventilation? | Assisted = increased volume of O2 & Gas delivered to patient while they still respirate Controlled = All O2 & Gas delivered to patient without them spontaneously respirating |
| Define Dynamics as it pertains to Veterinary Anesthesia: | The changes in the level of consciousness (LOC) over time and how quickly they occur. |
| Define Stridor | Noisy respiration usually caused by upper airway obstruction or in brachycephalic patients. |
| Describe the proper placement of ECG machine electrodes on small animals | RA = Right Forelimb (White) LA = Left Forelimb (Black) RL = Right Hind Limb (Green) LL = Left Hind Limb (Red) |
| Describe the proper placement of ECG machine electrodes on a horse | RA = (White) Right jugular furrow LA = (Black) Right jugular furrow placed a few cms from white electrode LL = (Red) Left lateral thorax at the apex of the heart |
| Describe the P Wave: | The 1st waveform which precedes contraction of the atria. Separated from the QRS complex by the P-R interval |
| Describe the P-R Interval: | The time required for the impulse to move from the sinoatrial node to the Purkinje fibers. Begins at P Wave, ends at beginning of QRS complex. |
| What are the normal parameters for the P-R interval in dogs, cats and horses? | 0.06-0.13 - Dogs 0.05-0.09 - Cats 0.22-0.56 - Horses |
| Describe the QRS Complex: | Contraction of the ventricles. The largest waveform seen on an ECG. Measured from point it leaves the baseline to point of return. |
| Describe the T Wave: | Repolarization of ventricles in preparation for the next contraction. Measured from end of S-T segment to return to baseline. |
| Describe the S-T Segment: | Sits between the end of QRS complex and beginning of T Wave. |
| A 'sawtooth' pattern on an ECG reading can indicate what? | An artifact error caused by electrode contact with metal (operation table, surgery tools, etc.) |
| What is MAP? | Mean Arterial Pressure. The most important indicator of blood perfusion of internal organs. |
| What are the ideal levels of MAP to prevent hypoxia? | 60mmHg or greater in Dogs & Cats 70mmHg or greater in Horses |
| List the locations used to assess Pulse Strength and if there are species limitations: | Lingual = Dogs only Femoral = small animals & ruminants Dorsal Pedal Facial = Horses Auricular = Large Animals Carotid Artery |
| Describe the first two stages of Anesthesia and the signs associated with each: | Stage I = Disorientation, struggling, fear, + HR, + RR, panting Stage II = Excitement, vocalization, paddling, reflex struggling, chewing, irregular RR, + HR |
| Describe the difference between Light and Surgical Anesthesia and the signs associated with each: | Stage III Light = Unconscious, possible movement from surgical stimuli, regular RR, strong pulse, HR normal Stage III Surgical = Unconscious, immobile, RR regular to decreased & shallow, HR normal to decreased |
| Describe Deep and Stage IV Anesthesia and the signs associated with each: | Stage III Deep = Unconscious, immobile, RR below normal, shallow, abdominal breathing, HR low to very low, prolonged CRT, pale mucous membranes, significant decrease in pulse strength Stage IV = Unconscious, immobile, Apnea, Cardiovascular collapse |
| What is the Palpebral reflex? | Blink reflex in response to a light tap on the medial or lateral canthus of the eye. Absent in surgical anesthesia, present in light. |
| What is the Pedal reflex? | Flexion or withdrawal of the limb in response to vigorous squeezing, twisting or pinching. Absent in surgical anesthesia. |
| Define PLR: | Pupillary Light Reflex - constriction of pupils from bright light. Absent in surgical anesthesia. |
| What position is the eye in light, surgical and deep anesthesia? | Central during light Ventromedial during surgical Central during deep |
| What is Nociception? | Detection by the nervous system of the potential for or actual occurrence of tissue injury. |
| List and describe the stages of Nociception: | Transduction = transformation of noxious stimuli into pain receptors Transmission = impulses sent to nerve fibers Modulation = impulses either amplified or suppressed Perception = impulses sent to brain for recognition |
| What is Multi-Modal Therapy? | Drugs used that ideally target more than one of the steps of nociception in order to best manage pain. |
| What is Allodynia? | The area close to the site of tissue injury that is painful if stimulated with non-noxious stimuli |
| Physiologic pain is also known as: | "Ouch" - adaptive pain felt to warn of greater injury (sharp, hot, chemically noxious, etc.) |
| Define Pathologic pain: | An amplified response to normally innocuous stimuli generally as a result of nerve damage/malfunction |
| What is Wind-Up? | Exaggerated response to low-intensity pain stimuli resulting in worsening of post-operative pain. |
| A patient in a depressed state that cannot be fully aroused with normal stimuli can be described as: | Obtunded |
| A patient in a sleep-like state that can only be aroused with painful stimulus can be described as: | Stuporous |
| A patient mildly depressed but aroused with minimal difficulty can be described as: | Lethargic |
| A patient that cannot be aroused via painful stimulus and is unresponsive to all external stimuli is described as: | Comatose |
| What is the difference between Tranquilization and Sedation? | Sedation = CNS depression and drowsiness. Minimal awareness of surroundings but can be aroused by noxious stimuli Tranquilization = state of calm and reluctance to move. Aware but unconcerned with surroundings |
| What is the difference between Hypnosis and Narcosis? | Hypnosis = sleep-like state impairing ability to respond to stimuli Narcosis = sleep from which a patient is not easily aroused |
| Which ASA Physical status is assigned for low risk, somatic or superficial procedures (skin tumor removal) | PS2 |
| Which ASA Physical status is assigned for castration, declawing and other elective procedures? | PS1 |
| Small rodents have a blood volume of approximately: | 70ml/kg |
| What is the minimum size for a reservoir bag? | 50ml/kg |
| The Tidal Volume of an anesthetized animal is considered to be ____ml/kg of body weight? | 10ml/kg |
| A pressure manometer should not exceed____cm H2Owhen bagging small animals and ____cm H2O for large animals. | 20cm H2O and 40cm H2O |
| A microdrip system is set at ____/ml | 60gtt/ml |
| Why is Bupivacaine not used for Bier Blocks? | Because it is more cardiotoxic via IV administration than Lidocaine |
| A subcutaneous dose of Lidocaine should not exceed____mg/kg in dogs ____mg/kg in cats. | 10mg/kg - Dogs 4mg/kg - Cats |
| A subcutaneous dose of Bupivacaine should not exceed____mg/kg in dogs ____mg/kg in cats. | 2mg/kg - Dogs 0.5mg/kg - Cats |
| What factors can affect the output of anesthetic gas? | Temperature, Flowrate of carrier gases, respiratory rate and depth, back pressure |
| Describe some of the uses for the Reservoir bag: | Allows observation of patient respiration, Allows manual delivery of gas/O2 to patient, Movement of the bag in time with patient, respiration indicates proper ET tube placement Helps re-inflate collapsed alveoli (atelectasis) |
| Which anesthetic machine type should be used for patients weighing under 2.5-3kg? | Non-Rebreathing system |
| What is TIVA? | Total Intravenous Anesthesia induced by using IV boluses of ultra-short acting agents such as propofol. Anesthesia can be maintained with additional boluses administered every 3-5 minutes as needed. |
| What is Titration? | A series of bolus injections given, then discontinued when the desired anesthetic depth is reached. |
| Why shouldn't you delay extubation in a cat? | It can predispose them to laryngospasm |
| Why is important to turn recovering patients every 10-15 minutes? | To prevent pooling of blood in the dependent lung/tissues. Also known as hypostatic congestion. |
| What does the layman's term "Tying Up" mean? | Muscle hardness, pain, weakness |
| What are the signs of appropriate sedation in a horse? | Lowering of head/neck, drooping lower lip, reluctance to move, wide stance, lack of interest in surrounding activity |
| Which drugs comprise "Triple-Drip" and what species is it commonly used on? | Guaifenesin/Ketamine/Xylazine - Horses |
| Which species is more likely to develop hypoxemia, hypoventilation and hypotension during anesthesia? | Horses |
| What are the benefits of fasting in a ruminant prior to anesthesia? | Reduces size of the rumen, decreases microbial activity, decreases gas production during anesthesia which can prevent bloat. |
| What are the clinical signs of bloat in a ruminant? | distended/tight abdomen, decreased blood pressure, increased heart rate, decreased ventilation |
| Which drugs comprise "TKX" and what species is it commonly used on? | Telazol/Ketamine/Xylazine - Swine b/c they are very resistant to sedatives |
| What is Porcine Stress Syndrome? | a.k.a: malignant hyperthermia caused by a mutation in the gene controlling calcium metabolism in the muscle. |
| What are the symptoms of malignant hyperthermia (Porcine Stress Syndrome)? | Muscle rigidity, rapid rise in temperature, hypercapnia, hyperkalemia, death. |
| Which drug is used to treat Porcine Stress Syndrome? | Dantrolene and high O2 rate. |
| What is the normal respiratory rate per minute in small rodents and rabbits respectively? | 50-100 RRpm for rodents 30-60 RRpm for rabbits |
| Which analgesic drugs are best used pre-operatively in small rodents/rabbits to avoid renal issues? | Carprofen or Meloxicam |
| Why is fasting prior to anesthesia not recommended for rodents/rabbits? | They don't vomit so there is no risk of aspiration and fasting can cause enterotoxemia. Okay to withhold food approx. 1 hour prior to induction. |
| Why is Glycopyrrolate preferred over Atropine for reduction of saliva production in rabbits? | They have a naturally high occurrence of atropinase in their system which makes Atropine ineffective. |
| Why are high doses of Propofol contraindicated in rabbits? | It can cause respiratory arrest |
| List some of the causes of problems/emergencies in veterinary anesthesia. | human error, equipment malfunction/issues, adverse drug reactions, patient risk due to age, weight, illness, etc. |
| Why should you avoid pre-anesthetic drugs in a patient with Hepatic disease? | Most are metabolized via the liver which may cause further distress or damage. |
| Describe some of the difficulties that can complicate anesthesia for a Cesarean? | lung capacity decreased due to diaphragm being pushed by distended uterus; aspiration of vomit possible b/c of full stomach; increased heart workload; anemia b/c same vol. of blood is circulated for both fetuses and dam, drugs pass placential barrier |
| What is Dyspnea? | Inability to obtain sufficient O2 or unable to adequately remove CO2 - often seen with Cyanosis and often caused by upper airway obstruction. |
| Which drug classes can cause Tachycardia? | Anticholinergics (Atropine, Glycopyrrolate) Dissociatives (Ketamine) Catecholamines (Epinephrine) |
| Which drug classes can cause Bradycardia? | Alpha2-Agonists or Opioids, especially if no anticholinergic has been given in combination with these drugs. |
| What is the Cardiac Pump Theory? | That the blood flow to tissues, back to lungs is caused by direct compression of the ventricles between the ribs (when lateral) or sternum & spine (when dorsal) |
| What is the Thoracic Pump Theory? | That blood flow to tissues is from the compression of the aorta caused by compression of the chest wall. The return of blood to the lungs is a result of the negative pressure from the recoil between compressions. |
| Which ECG tracing types respond to basic life support measures & vasopressers? | Asystole & Pulseless Electrical Activity (PEA) |
| Which ECG tracing types respond to basic life support measures & defibrilation? | Ventricular fibrillation (VF & Pulseless Ventricular Tachycardia (VT) |
| What are Vasopressors? | Antihypotensive medications that increase mean arterial pressure |
| What steps should you take in the event of a patient seizure? | Remove external stimuli (light/sound), administer IV or rectal diazepam (Propofol if diazepam unavailable or ineffective), monitor for hyperthermia and cyanosis. |
| Why should you never use alcohol on an ECG electrode when defibrilating? | It can cause an explosion - Use physiologic saline or ECG gel instead. |
| The figure used for blood volume calculation is approx. ______ml/kg in dogs and large animals and ____ml/kg in cats. | 80-90ml/kg - dogs and large animals 40-60ml/kg in cats |
| What is the IV administration rate for Crystalloids? | 10ml/kg/hr for first hour, followed by 5ml/kg/hr for remainder of procedure |
| When blood loss occurs at least ____ml of crystalloid fluids must be given for every ___ml of blood lost. | 3ml crystalloid for every 1ml blood lost |
| List the signs indicating that a patient is 5% dehydrated | minimal loss of skin turgor, semi-dry mucous membranes, eyes look normal |
| List the signs indicating that a patient is 8% dehydrated | Moderate loss of skin turgor, dry mucous membranes, weak rapid pulses, depressed eye globes within orbit |
| List the signs indicating that a patient is 10% dehydrated | Considerable loss of skin turgor, extremely dry mucous membranes, tachycardia and weak pulse, hypotension, sunken eyes, altered level of consciousness |
| To maintain surgical anesthesia, the vaporizer should be set at approx.____ x MAC | 1.5 x MAC |
| What are the minimum acceptable heart rates for the various animal species that, if lower, may indicate Bradycardia? (dogs, cats, horses, cows) | 60-70bpm - Dogs 100bpm - Cats 25bpm - Horses 40bpm - Cows |
| What are the maximum acceptable heart rates for the various animal species that, if exceeded, may indicate Tachycardia? (dogs, cats, horses, cows) | 140-160bpm - Dogs 200bpm - Cats 60bpm - Horses 100bpm - Cows |
| A respiratory rate of less than ___breaths per minute in a dog should be reported. | 6 breaths per minute |
| When used in a line block, a local anesthetic will have a direct effect on the: | Peripheral nervous system |
| Local anesthetics block transmission of nerve impulses from: | Sensory, motor and autonomic neurons |
| Which drug is used to treat hypotension in an anesthetized horse? | Dobutamine |
| Why is the eye position a poor indicator of anesthetic depth in rodents? | It remains central regardless of anesthetic plane |
| An advantage of using dexmedetomidine+ketamine for anesthesia of rodents/rabbits is: | It can be partially reversed which allows for faster recovery. |
| Which drug acts as a reversal agent for dexmedetomidine? | Atipamezole |
| Why should you avoid using Acepromazine in Horses? | It can cause penile prolapse |
| Which drug is most commonly used for epidural analgesia? | Morphine |
| Why is Ketamine only given via IV in dogs? | It may cause seizures and excitement |
| List 3 Alpha2 Agonists used in Anesthesia. | Xylazine, Dexmedetomidine, Romifidine, Detomidine, Clonidine |
| List the 2 common Anticholinergic's used in Anesthesia. | Atropine, Glycopyrrolate |
| What are the MAC and Maintenance Percentages of Isoflurane? | MAC = 1.3-1.63% Maintenance = 1.5-2.5% |
| What are the MAC and Maintenance Percentages of Sevoflurane? | MAC = 2.34-2.58% Maintenance = 2.5-4% |
| When should you change a Carbon Dioxide Absorber canister? | After 6-8 hours of use or after 30 days (whichever comes soonest) |
| How can you discern fresh Carbon Dioxide Absorber Granules from spent/used ones? | Fresh granules are white & crumbly Spent are off-white to purple/pink & hard/brittle |
| List indicators that can be used to determine anesthetic depth | Swallowing, Palpebral (blink), Pedal, PLR (pupillary light reflex), eye position, salivary/lacrimal secretions |
| What are the most commonly used Colloid solutions in Vet Medicine? | Hetastarch and Pentastarch |
| What are colloids generally used for? | To support the expansion of blood volume & blood pressure |
| What are Alpha2-Agonists used for in veterinary anesthesia? | Sedation, analgesia & muscle relaxation |
| What are Anticholinergics used for in veterinary anesthesia? | To treat and/or prevent anesthetic and pre-anesthetic bradycardia, salivary secretions, bronchodilation |
| What are Barbiturates used for in veterinary anesthesia? | As a sedative, CNS depressant and anticonvulsant |
| What are Dissociatives used for in veterinary anesthesia? | Amnesia, analgesia, to help with induction and maintenance of anesthesia. |
| What are Phenothiazines used for in veterinary anesthesia? | Sedation and tranquilization for minor procedures , antiemetic, ease induction and recovery |
| Why should you avoid giving higher doses of Ketamine than the indicated amount? | Higher doses increase the duration but not the anesthetic effects. It accumulates in the body so may cause hepatic or renal issues. |
| Why is Acepromazine a poor pre-anesthetic drug choice in rodents? | It provides sedation, but won't immobilize them. |
| What is the benefit of using Acepromazine combined with Butorphanol in rabbits? | It dilates the ear veins making it easier to access for samples, catheterization, etc. |
| Why should you avoid using Alpha2-Agonists as part of pre-anesthesia in brachycephalic patients? | It can cause severe respiratory depression. Benzodiazepines or low dose acepromazine are better choices. |
| Which drug classes should be avoided as a preanesthetic if a patient has cardio disease? | Alpha2-Agonists and dissociatives. Alfaxalone or Etomidate better b/c they have less cardio effects than Propofol. |
| If a patient is suffering from Dyspnea, describe the steps you would take to remedy the situation: | Verify O2 tank isn't empty - replace if needed Turn off vaporizer and bag w/100% O2, observe chest for movement, bag till cyanosis improves or oximeter >=95% Administer reversal agents, Provide supplemental O2 during recovery |
| If a patient is showing signs of Tachypnea, describe the steps you would take to remedy the situation: | Make sure CO2 crystals don't require changing, check capnogram to rule out hypercapnia, Check anesthetic depth, Adjust vaporizer if needed, wait 1-2 min for self-correction. |
| If a patient is at an inadequate level of anesthesia, describe the steps you would take to remedy the situation: | Check the amount of liquid anesthetic in vaporizer, check the vaporizer setting, confirm ET tube isn't blocked and the bag expands/contracts, check for leaks in tubing, check O2 flow |
| If a patient is at an excessive anesthetic depth, describe the steps you would take to remedy the situation: | decrease the vaporizer and inform veterinarian, ventilate with pure O2 if resuscitation needed, Close pop-off valve and manually bag - repeat every 5 sec until HR increase, improved mucous membrane color. IV fluids, reversal agents and blankets may help |
| What are some signs of Cardiac Arrest? | No heart beat auscultated or palpated, normal QRS complexes absent from ECG, Blood pressure 25mmHg or less, Cyanosis, dilated pupils with no PLR, absent respiration except agonal breaths (gasps) |
| If a patient shows signs of Apnea, when should you provide ventilation? | Only if end-tidal CO2 > 45-55mmHg. One manual breath every 30-60 seconds to prevent hypoxia. Apnea often self-corrects. |
| What are the 5 CPR tasks? | Chest compressions - 100-120bpm. Switch w/someone at 2 minutes to maintain effective compression ET Intubation/Ventilation, ECG & end-tidal CO2 monitoring, IV catheter, Admin of reversal agents (if applicable) |
| What actions are part of BLS? | Basic Life Support (BLS) includes heart compressions & manual ventilation - most important factor leading to ROSC |
| What actions are part of ALS? | Advanced Life Support (ALS) drugs, fluids, monitoring, defibrilation |
| What actions should follow ROSC? | Return of spontaneous circulation (ROSC) O2 therapy, IV fluids, vasopressor drugs, body temperature control |
| What is Pulseless Electrical Activity (PEA)? | normal or nearly normal tracing on an ECG but no heart beat present. No contractions mean no forward movement of blood. |
| If a patient is suffering from Respiratory arrest, describe the steps you would take to remedy the situation: | If not intubated, insert ET tube and apply 100% O2 immediately, if intubated, turn off vaporizer, verify O2 flow, check HR to rule out cardiac arrest, rule out airway obstruction, bag every 3-5 sec until improvement, IV fluids for shock, reversal agents |
| What are some causes of Tachypnea? | hypoxemia, hypercarbia, inadequate anesthetic depth. Obese patients more prone to have tachypnea |
Created by:
AmySichta
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