anesthesia

Question 1

what is the ideal flow rate for a patient in an anesthetic chamber?

Answer 1

5-10L/min

Question 2

what lungs would you expect to hear post-op in a healthy patient?

Answer 2

light whooshing sound

Question 3

what will happen if there is an accumulation of fluid and secretions in the small airways post anesthesia?

Answer 3

rales (crackling)

Question 4

t/f - all of the following patients are at risk for atelectasis

a) sternally positioned anesthetized patient
b) orthopneic feline patient with asthma
c) laterally recumbent brachycephalic patient

Answer 4

true

Question 5

your patient is apneic and you must provide ventilation - what is your strategy?

Answer 5

provide ventilation at a rate of 1 breath every 10 seconds

Question 6

a patient’s heart rate has consistently decreased during anesthesia - what drug would address this?

Answer 6

anticholinergic (ex. atropine)

Question 7

there is no sign of regurgitation in your bulldog patient - how do you remove the ET tube?

Answer 7

allow patient to maintain the ET tube until they are chewing at it - specific to bulldogs!

Question 8

when would you remove the ET tube from your feline patient?

Answer 8

at the first sign of arousal (i.e. ear twitch)

Question 9

2% lidocaine is what concentration?

Answer 9

2g/100ml (remember- % equals g/100dL)

Question 10

350 mcg is equal to how many milligrams?

Answer 10

0.35mg (divide by 1000 to get mg)

Question 11

a 10% w/v solution is equal to what concentration?

Answer 11

100mg/ml

Question 12

the maximum dose of 10mg/ml acepromazine in cats is 1mg - what is the maximum dose in ml?

Answer 12

0.1ml

Question 13

what is the legal maximum waste anesthetic gas level of halogenated gases?

Answer 13

2ppm

Question 14

propofol was used to induce your patient - what is an expected side effect?

Answer 14

no movement of flutter valves - patient becomes apneic with admin of propofol and will hold its breath - HAVE TO GIVE THEM A FEW BREATHS

Question 15

what assessment would not be reliable for intubation in an 8 week old puppy?

Answer 15

jaw tone

Question 16

ventromedial eye positioning is found in which of the following anesthetic stages?

Answer 16

stage IIIb

Question 17

doppler blood pressure monitors assess which blood pressure value?

Answer 17

systolic

Question 18

t/f - propofol, ketamine, isoflurane, glycopyrrolate and acepromazine all cause hypotension

Answer 18

false - only propofol, ketamine and isoflurane cause hypotension

Question 19

what is a possible side effect of isoflurane administration?

Answer 19

decreased temp

Question 20

if a patient wakes up very quickly, is the blood:gas coefficient for the inhalant low or high?

Answer 20

low

Question 21

t/f - pigmented tongues can affect pulse oximeter readings

Answer 21

true

Question 22

what does the R-R interval on an ECG represent?

Answer 22

seconds between ventricular depolarizations

Question 23

if your anesthetized patient is apneic what will the capnograph read?

Answer 23

0 mmHg

Question 24

your patient is hyperventilating - what is the capnograph reading?

Answer 24

<40 mmHg

Question 25

which patient is at greatest risk for anesthetic hyperthermia? a) 3yr old obese bulldog b) 12wk old jack russell terrier c) 16yr old bichon frise

Answer 25

a) the 3yr old obese bulldog

Question 26

prolonged anesthetic recovery is most likely to happen at which temperature? 33.3C or 38.5C

Answer 26

33.3C

Question 27

you want to administer warm IV fluids to your patient - what temperature should they be?

Answer 27

37.5C

Question 28

what is the appropriate ambient temperature for an anesthetized patient?

Answer 28

24C

Question 29

what type of measurement is required for successful ventilation of your patient?

Answer 29

qualitative

Question 30

you cannot hear any breath sounds during anesthesia - is this normal for the patient?

Answer 30

yes - normal finding d/t decreased tidal volume

Question 31

which of the following patients would benefit most from ventilation? a) hypoventilation b) hyperventilation atelectasis

Answer 31

they could all benefit from ventilation

Question 32

concerns for hypoxia requiring immediate therapy occurs at what pulse oximeter reading?

Answer 32

SpO2 of 85-89%

Question 33

the DVM is incising into the abdomen for a spay surgery - what is the ideal eye position for the patient?

Answer 33

ventromedial

Question 34

what respiratory change would you expect if your patient anesthetic depth is too LIGHT?

Answer 34

tachypnea

Question 35

what cardiovascular change is consistent with a patient at stage IIIc?

Answer 35

hypotension

Question 36

what blood pressure parameter best represents tissue perfusion?

Answer 36

mean arterial pressure (MAP)

Question 37

t/f - it is normal for a patient's tidal volume to decrease by 50% during anesthesia

Answer 37

false - it should only decrease by 25%

Question 38

which of the following drugs would affect jaw tone assessment? a) diazepam b) glyco c) ketamine d) propofol

Answer 38

diazepam

Question 39

your patient is at stage IIIb - what should happen when you tap gently on the medial canthus?

Answer 39

no movement to the eyelids

Question 40

t/f - the anesthetic protocol should be included in the minimum patient database

Answer 40

false - signalment, history and physical exam only

Question 41

is temperament included in the patient signalment?

Answer 41

no

Question 42

t/f - vomiting is the passive process of expelling gastric contents

Answer 42

false - vomiting is active not passive

Question 43

what risk is associated with regurgitation under anesthesia?

Answer 43

aspiration

Question 44

the initial O2 flow rate on a non-rebreathing circuit should be ____ to the maintenance flow rate

Answer 44

equal to

Question 45

a dam should be pre-oxygenated for a minimum of how long prior to c-section?

Answer 45

5 minutes

Question 46

C-section using hydromorphone, propofol and isoflurane - puppy is in respiratory arrest - what drug do you give?

Answer 46

naloxone

Question 47

what is the greatest concern for the c-section patient clipped and prepped in dorsal recumbency?

Answer 47

venous return

Question 48

you have a neonate who is breathing poorly immediately after birth - what do you do first?

Answer 48

suction nose, mouth and throat

Question 49

the newly born neonate is bradycardic - how do you administer atropine?

Answer 49

sublingually

Question 50

a very small kitten is unable to self regulate body temp post-anesthesia - what is the prognosis?

Answer 50

good

Question 51

during your pediatric patient's surgery the O2 tank becomes empty - what is your first step?

Answer 51

disconnect ET tube

Question 52

a bulldog with 12 pups requires a c-section - her PCV is 22% - what do you do?

Answer 52

monitor for hypoxia and perform c-section

Question 53

the patient is on oxygen post-op for 3-5 minutes but isn't swallowing yet - pulse ox is 98% - what do you do?

Answer 53

disconnect ET tube from oxygen

Question 54

50lb dog - dosing at 5mg/kg with 15% w/v sol'n - what is the concentration of solution in mg/ml?

Answer 54

150mg/ml

Question 55

``` HAG recipe - 4ml 10mg/ml H - 1ml 10mg/ml A - 5ml 0.2mg/ml G what is the final concentration of A? ```

Answer 55

1mg/ml

Question 56

3kg yorkie - circle system - propofol IV - isoflurane | what is the major flaw with this description?

Answer 56

re-breathing circuit - patient is TOO SMALL

Question 57

what is a component of brachycephalic syndrome?

Answer 57

narrow trachea

Question 58

why would an anesthetist cut the ET tube for a pediatric patient?

Answer 58

decreased dead space

Question 59

the anesthetist calculated emergency atropine dose for the pediatric patient - why?

Answer 59

cardiac output is heart rate dependent

Question 60

asthmatic cat - preoxygenated for 10min with nasal catheter - pulseox of 90% - what next?

Answer 60

continue to preoxygenate

Question 61

blocked cat - dull, large, painful bladder - HR 120 - RR 60 - tacky, pale MM - what is next?

Answer 61

prepare calcium gluconate immediately for administration

Question 62

CN exam abnormal post trauma - hydro ace premed - ketval induction - iso maintenance - error?

Answer 62

avoid dissociative anesthetics

Question 63

obese patient - ETco2 elevates - positive palpebral reflex under anesthesia - what do you do?

Answer 63

perform PPV