Anesthesia

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Terms in this set (...)

State of reduced anxiety and relaxation, but still aware of surrounding with no CNS depression
tranquilization
State of CNS depression and drowsiness with reduced awareness of surroundings
sedation
A total loss of sensation in a part or the whole body, generally induced by a drug that depresses nervous tissue
anesthesia
Artificially induced sleep or trance from which the patient can be aroused
hypnosis
Drug-Induced sleep from which the patient is not easily aroused
narcosis
Weak or minimal reflexes
hyporeflexia
Determined by monitoring jaw tone
muscle relaxation
Perception of a painful stimulus
nociception
Causing pain or injury
noxious stimulus
Absence of pain perception or the relief of pain without loss of consciousness
analgesia
Drug agents that are dangerous due to their addictive nature; their use is regulated by the Drug Enforcement Agency
controlled substance
A high risk patient with pre-existing systemic disease would be assessed which of the following ASA Grades?
ASA V
A patient assessed an ASA Grade I may require or should receive which of the following?
Standard protocols and techniques
(T/F): A patient must be at a surgical plane of anesthesia in order for endotracheal intubation to be successful
false
A patient with slight to mild systemic disturbances who is compensating for their disease processes would be assessed which of the following ASA grades?
ASA II
Important aspects of recording controlled substances in practice:
Surgery Log
Controlled Substance Log
Patient's medical record
An anticholinergic drug would cause an _____________ in "SLUDGE"
decrease
At this plane of anesthesia the patient experiences cardiovascular collapse and apnea. The pupils are fully dilated and unresponsive. The patient requires immediate resuscitation
stage IV
At this plane of anesthesia the patient's capillary refill time is prolonged and their mucous membranes are pale; they develop an abdominal component to their respirations. This plane of anesthesia is not safe.
stage III plane 4
(T/F): b-1 antagonists like timolol, atenolol and propranolol are also known as "Beta-blockers"
true
(T/F): Cardiac afterload should NOT be thought of as a function of systemic vascular resistance
false
During periods of hypertension afterload is increased. The body maintains cardiac output (CO) by increasing heart rate (HR)
increasing HR & decreasing SV
(T/F): During periods of hypotension preload is decreased. The body maintains cardiac output (CO) by increasing heart rate (HR)
true
During this stage of anesthesia the patient is conscious, but disoriented. The patient will exhibit voluntary movement, usually with ataxia. Reflexes are present. Towards the end, they will lose their righting reflex and become recumbent
a. Stage II
b. Stage III, Plane 1
c. Stage III, Plane 2
d. Stage III, Plane 3
e. Stage III, Plane 4
f. None of these
f. none of these
During this stage of anesthesia the patient may experience excitement prior to losing consciousness. Exaggerated reflexes are common. The patient will lose control of voluntary movement, and paddling, vocalizing and struggling can occur.
a. Stage II
b. Stage III, Plane 1
c. Stage III, Plane 2
d. Stage III, Plane 3
e. Stage III, Plane 4
f. None of these
a. Stage II
During which stage of anesthesia do the swallowing and gagging reflexes diminish to the point where endotracheal intubation is possible?
a. Stage I
b. Stage II
c. Stage III, Plane 1
d. Stage III, Plane 2
e. Stage IV, Plane 3
f. None of these
c. Stage III plane 1
During which stage of anesthesia is the patient at greatest risk for developing cardiac arrhythmias secondary to release of catecholamines such as epinephrine and norepinephrine?
Select one:
a. Stage II
b. Stage III, Plane 1
c. Stage III, Plane 2
d. Stage III, Plane 3
e. Stage III, Plane 4
f. None of these
a. Stage II
In practice, you may need some form of tranquilization, sedation or anesthesia to accomplish which of the following procedures?
Examination
Surgical procedures
External coaptation
Grooming
Murmurs associated with which cardiac valve will be best auscultated over the left fifth intercostal space in small animal patients?
mitral
Murmurs associated with which cardiac valve will be best auscultated over the right fourth intercostal space in small animal patients?
Select one:
a. Aortic
b. Mitral
c. None of these
d. Pulmonic
e. All of these
c. None of these
Neurotransmitter for the parasympathetic nervous system
Acetylcholine (Ach)
Neurotransmitters for the sympathetic nervous system
Epinephrine (EPI)
Norepinephrine (NE)
The _____________ are located between the ventricles and the great vessels exiting the heart, while the _____________ are located between the atria and the ventricles
Semilunar valves, AV valves
(T/F): The pulmonary veins are the only blood vessels which carry deoxygenated blood away from the heart
false
This is a deep plane of anesthesia with significant cardiovascular and respiratory depression. The patient's pupillary light reflex is very sluggish to absent, the eyes are centrally located and skeletal muscle tone is greatly reduced.
Select one:
a. Stage III, Plane 1
b. Stage III, Plane 2
c. Stage III, Plane 3
d. Stage III, Plane 4
e. Stage IV
f. None of these
c. Stage III, Plane 3
What is the correct order of the cranial nerves I - VI?
Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens
What is the function of cranial nerve X?
sensory and motor
What is the function of the glossopharyngeal nerve?
sensory and motor
What is the name and function for cranial nerve VII?
Select one:
a. Vagus, Sensory
b. Vagus, Motor
c. Vagus, Both
d. Vestibulocochlear, Sensory
e. Vestibulocochlear, Motor
f. None of these
f. None of these
What is the function of cranial nerve XII?
motor
Which cardiac valves cannot be auscultated over the left thoracic wall?
pulmonic and mitral
Which of the following are NOT considerations when creating an anesthetic protocol for a patient?

Select one:
a. Availability of equipment or facilities
b. The RVT bears ultimate legal responsibility for prescribing anesthetic drugs to animals
c. The timing, or urgency of the procedure
d. How painful we anticipate the procedure to be
e. All of these
f. None of these
b. The RVT bears ultimate legal responsibility for prescribing anesthetic drugs to animals
Which of the following are NOT effects of a-2 agonists?
Select one:
a. Increase in blood glucose
b. Decrease in heart rate
c. Increase in GI motility and salivation
d. Decrease in blood pressure
e. All of these
f. None of these
c. Increase in GI motility and salivation
Which of the following are NOT true in regards to cardiac output (CO)?

Select one:
a. CO is the amount of blood pumped by the heart per minute
b. CO = SV x HR
c. CO can be affected by the autonomic nervous system
d. Cardiac output can be affected by changes in blood pressure
e. All of these
f. None of these
a. CO is the amount of blood pumped by the heart per minute
Which of the following drugs are NOT a-2 agonists?

a. Dexmedetomidine
b. Yohimbine
c. Atipamezole
d. Xylazine
b. Yohimbine
c. Atipamezole
Which of the following drugs are NOT a-2 antagonists?

a. Dexmedetomidine
b. Yohimbine
c. Atipamezole
d. Xylazine
a. Dexmedetomidine
d. Xylazine
Which of the following is true in regards to a balanced multimodal approach to anesthesia?

a. Two or more drugs are administered concurrently
b. Drug(s) can be administered in larger doses / volumes
c. Minimizes benefits of each agent(s)
d. Maximizes adverse effects of each agent(s)
e. All of these
f. None of these
a. Two or more drugs are administered concurrently
Which of the following pertains to cardiac preload?

a. Can also be thought of as end diastolic volume (EDV)
b. Relates to the volume or pressure of blood within the ventricle before contraction
c. Is affected by venous return
d. Is related to the stretching of the myocardium at the end of diastole
e. All of these
f. None of these
e. All of these
Which of the following receptor types are found in the sympathetic nervous system?

a. a-1, a-2
b. b-1, b-2
c. Muscarinic
d. Nicotinic
a. a-1, a-2
b. b-1, b-2
Which of the following statements regarding controlled substances is NOT true?

a. Records of all purchases, receipts, inventory and use / dispensing must be kept for 1 year
b. A schedule V controlled substance has a higher potential for abuse than a schedule II controlled substance
c. Schedule I controlled substances have no accepted medical use and cannot be used for research in the USA
d. Ketamine, buprenorphine and anabolic steroids are all schedule IV controlled substances
e. All of these
f. None of these
e. All of these
A patient with 10% dehydration would exhibit which of the following clinical signs?

a. Loss of skin turgor with extremely dry MM. Weak, thready pulses; hypotension, severe enophthalmus
b. Moderate skin turgor with dry mucous membranes, a weak pulse accompanied by tachycardia; enophthalmus
c. Mild skin turgor with tacky mucous membranes (MM)
d. None of these
a. Loss of skin turgor with extremely dry MM. Weak, thready pulses; hypotension, severe enophthalmus
A patient with 5% dehydration would exhibit which of the following clinical signs?

a. Moderate skin turgor with dry mucous membranes, a weak pulse accompanied by tachycardia; enophthalmus
b. Mild skin turgor with tacky mucous membranes (MM)
c. Loss of skin turgor with extremely dry MM. Weak, thready pulses; hypotension, severe enophthalmus
d. None of these
b. Mild skin turgor with tacky mucous membranes (MM)
A patient with 8% dehydration would exhibit which of the following clinical signs?

a. Loss of skin turgor with extremely dry MM. Weak, thready pulses; hypotension, severe enophthalmus
b. Moderate skin turgor with dry mucous membranes, a weak pulse accompanied by tachycardia; enophthalmus
c. Mild skin turgor with tacky mucous membranes (MM)
d. None of these
b. Moderate skin turgor with dry mucous membranes, a weak pulse accompanied by tachycardia; enophthalmus
A patient's previous medical history should include which of the following?

a. Has the pet been anesthetized before?
b. Is the pet fasted?
c. Any history of chronic disease or conditions?
a. Has the pet been anesthetized before?
c. Any history of chronic disease or conditions?
A stress leukogram consists of which of the following?

a. Lymphoma
b. Eosinophilia
c. Monocytosis
d. Neutropenia
e. All of these
f. None of these
c. Monocytosis
An 18 ga. IV catheter is _____________ in diameter than a 22 ga. IV catheter.

a. Larger
b. Smaller
a. Larger
An eosinophilia would not be expected with which of the following?

a. Allergic disease
b. Demodicosis
c. Flea infestation
d. Ringworm infection
e. All of these
f. None of these
d. Ringworm infection
Decreased packed cell volume (PCV), or anemia, could be caused by which of the following?

a. Increased production of erythrocytes
b. Decreased destruction of red blood cells
c. Dehydration
d. Hemorrhage
e. All of these
f. None of these
d. Hemorrhage
Dehydration would cause an _____________ in serum sodium levels.

a. Increase
b. Decrease
a. Increase
How is maintenance fluid rate calculated?
Select one:
a. 10 - 20 mL/kg
b. 5 mL/kg/hr
c. 3 mL/kg/hr
d. 60 mL/kg/hr
e. (BW in kg) x % dehydrated x 1000
f. None of these
f. None of these
If you were only able to evaluate three systems on a preanesthetic physical examination, which of the following systems would you prioritize?

a. Neurologic, hepatic, cardiovascular
b. Cardiovascular, renal, pulmonary
c. Pulmonary, hepatic, cardiovascular
d. Hepatic, cardiovascular, renal
e. Cardiovascular, pulmonary, hepatic
f. None of these
f. None of these
Obese animals may experience problems with which of the following both before and during anesthesia?

a. Venipuncture
b. Assessing dehydration status
c. Auscultation
d. Dyspnea at rest
e. All of these
f. None of these
e. All of these
Obstructive shock is NOT caused by which of the following conditions?

a. Caval syndrome
b. Acute hemorrhage
c. Gastric Dilatation and Volvulus (GDV)
d. Cardiac tamponade
a. Caval syndrome
b. Acute hemorrhage
c. Gastric Dilatation and Volvulus (GDV)
d. Cardiac tamponade
Patients are fasted prior to anesthesia for which of the following reasons?

a. Anesthetic drugs may cause patients to become nauseated
b. Both the swallowing reflex and lower esophageal sphincter tone increase
c. Esophageal reflux may lead to esophagitis
a. Anesthetic drugs may cause patients to become nauseated
c. Esophageal reflux may lead to esophagitis
Prerenal azotemia can be caused by _____________, while postrenal azotemia can be caused by _____________.

a. Kidney disease, urethral obstruction
b. Dehydration, kidney disease
c. Kidney disease, dehydration
d. Dehydration, urethral obstruction
e. Urethral obstruction, dehydration
d. Dehydration, urethral obstruction
The body regulates blood glucose (BG) levels very tightly. _____________ increases BG levels, while _____________ decreases BG levels.

a. Insulin, glargine
b. Glucagon, insulin
c. Insulin, glucagon
d. Glargine, insulin
e. Glipizide, insulin
b. Glucagon, insulin
The IV fluid shock rate for feline patients is approximately _____________, while the IV fluid shock rate for canine patients is approximately _____________.

a. 5 mL/kg/hr, 3 mL/kg/hr
b. 60 mL/kg/day, 30 mL/kg/day
c. 3 mL/kg/hr, 5 mL/kg/hr
d. 90 mL/kg, 55 mL/kg
e. 55 mL/kg, 90 mL/kg
f. None of these
e. 55 mL/kg, 90 mL/kg
When performing intermittent positive pressure ventilation or a pressure check on your anesthesia machine, the manometer should never read higher than _____________.

a. 20 mmHG
b. 15 mmHG
c. 20 cm H2O
d. 15 cm H2O
e. Atmospheric pressure
c. 20 cm H2O
Which of the following actions or statements would NOT be an example of providing an owner with informed consent?

a. "Please use this permanent marker and draw an 'X' on the leg we have agreed to operate on."
b. "The most common complications with this procedure include hemorrhage, urinary or fecal incontinence and urethral stricture."
c. "I see that Ruby is here for a routine ovariohysterectomy, what time would you like to pick her up this evening?"
d. "While I believe that repairing this fracture using a bone plate will give us the fastest return to function, it may also be amenable to a splint or cast."
e. All of these
f. None of these
c. "I see that Ruby is here for a routine ovariohysterectomy, what time would you like to pick her up this evening?"
Which of the following are NOT indications for IV fluid therapy?

a. To replace insensible fluid losses during surgery
b. To maintain cardiac output and perfusion
c. To maintain an adequate and effective blood volume
d. To ensure that IV catheter remains patent
e. All of these
f. None of these
f. None of these
Which of the following are requirements for informed consent?

a. The owner acknowledges full understanding of the risks associated with the procedure
b. The owner agrees to the procedure
c. The owner has been counseled as to alternate therapies / procedures
d. The owner understands that every anesthetic procedure carries the risk of death
e. All of these
f. None of these
e. All of these
Which of the following does not pertain to a patient's current medical history?

a. Reproductive status
b. When was the patient last fed?
c. Vaccination status
d. Clinical signs of illness
e. All of these
f. None of these
f. None of these
Which of the following does not pertain to circulatory shock?

a. Characterized by a loss of intravascular volume
b. Can be treated with colloid fluids administered as fast as possible
c. Can be treated with crystalloid fluids administered in ¼ to 1/3 of a "shock dose"
d. Responds to IV volume rescusctiation
e. All of these
f. None of these
b. Can be treated with colloid fluids administered as fast as possible
Which of the following is an example of a colloid?

a. Plasmalyte
b. Lactated Ringer's Solution (LRS)
c. Saline
d. Packed red blood cells (pRBC's)
e. All of these
f. None of these
d. Packed red blood cells (pRBC's)
Which of the following is an example of a crystalloid?

a. Whole blood
b. Fresh frozen plasma (FFP)
c. Packed red blood cells (pRBC's)
d. Dextrose
e. All of these
f. None of these
d. Dextrose
Which of the following statements regarding intravenous (IV) catheter placement are NOT true?

a. It is much less difficult to place an IV catheter prior to induction than it is during a crisis.
b. We should always recommend that an IV catheter be placed prior to induction
c. Central line catheters are the most commonly used type of IV catheter in general practice.
d. You should always select the largest gauge IV catheter that can be safely placed in your patient
e. All of these
f. None of these
c. Central line catheters are the most commonly used type of IV catheter in general practice.
Which of the following test results would NOT be increased / elevated as a result of dehydration?

a. Packed Cell Volume (PCV)
b. BUN
c. Total Protein (TP)
d. Creatinine
e. All of these
f. None of these
f. None of these
Which of the following would NOT be a reason for fasting a patient prior to surgery?

a. Endoscopy to obtain duodenal biopsies is to be performed
b. To avoid regurgitation
c. To promote hypoglycemia in a neonatal or critical patient
d. A gastrotomy will be performed to remove a gastric foreign body
e. All of these
f. None of these
c. To promote hypoglycemia in a neonatal or critical patient
Which of the following would not cause leukocytosis in your patient?

a. Canine parvovirus
b. Inflammation associated with a surgical incision
c. Bacterial infection
d. physiologic stress
e. All of these
f. None of these
a. canine parvovirus
(T/F): a-2 agonists increase blood glucose (BG) levels by suppressing insulin release.
true
(T/F): Anesthetic doses should be calculated based on an animal's actual body weight
false
(T/F): Both vonWillebrand's (vWD) disease and Bassett Hound Thrombopathia (BHT) are examples of disorders affecting secondary hemostasis
false
(T/F): Colloids are small molecules which readily leave the vascular space. They provide water, electrolytes and alkalinizing agents
false
(T/F): Corticosteroids increase blood glucose (BG) levels
true
(T/F): Crystalloids consist of large molecules and provide oncotic support; they do not leave the vascular space
false
(T/F): Dextran and hetastarch are examples of synthetic colloids
true
(T/F): Fluid therapy is usually indicated in cases of circulatory shock
true
(T/F): Intravenous (IV) catheters are placed in anesthetic patients to safely and easily administer both induction agents and IV fluids
true
(T/F): Ruminant patients should never have water withheld prior to anesthesia, as it would increase their risk of developing bloat
false
(T/F): Signalment is important because breed or species sensitivities to anesthetic agents may exist
true
(T/F): Some anesthetic drugs may not be as safe or as effective in anxious or aggressive animals as they would be in a calm or docile animal
true
(T/F): Urine specific gravity will be increased in the face of dehydration
true
(T/F): Viral infections like panleukopenia or canine parvovirus can cause a profound leukocytosis
false