anesthesia II Flashcards
(113 cards)
1
Q
Blood volume as BW % in a dog
A
9%
2
Q
Blood volume as a % BW in a cat
A
6.5%
3
Q
at birth total body weight is > ____%
A
75%
4
Q
backbone ICF ion
A
K+
5
Q
backbone ECF ion
A
Na+
6
Q
IVF backbone
A
protein
7
Q
exerted by fluids due to their weight. Antagonizes osmosis (ICF, ECF) during fluid shifts. Drives fluids outwards
A
hydrostatic pressure
8
Q
freely permeable to water and small solutes, but not to protein
A
capillaries
9
Q
T/F
crystalloids can enter all body fluid compartments
A
TRUE
10
Q
T/F
replacement (balanced) crystalloid solutions cause changes in the electrolytes
A
FALSE - no electrolyte changes
11
Q
why should replacement (balanced) crystalloid solutions be avoided in hypoalbuminemia
A
Excessive large volume dilute proteins
12
Q
Ringers, Ringers lactate, Plasmalyte R (Normosol R) fall under what fluid category
A
replacement (balanced) crystalloid
13
Q
Plasmalyte M (Normosol M) in Dextrose 5% is what type of fluid
A
maintenance fluid crystalloid
14
Q
Used in patients that have been stabilized by replacement fluids or those not taking in adequate amounts to meet daily requirements
A
maintenance solutions
15
Q
maintenance fluid requirement
A
40-60mL/kg/day
16
Q
T/F
use maintenance fluids for peri-anaesthetic use
A
FALSE
17
Q
Avoid infusion rates higher than ______ in maintenance solutions
A
0.5mEq/kg/hour
18
Q
May be used for rapid ECF expansion if replacement solutions unavailable
A
Physiological saline (0.9% NaCl)
19
Q
Recommended for hyperkalemic, hyponatremic patients with hypoadrenocorticism
A
Physiological saline (0.9% NaCl)
20
Q
May be used to treat cerebral edema provided BBB is intact and limits accumulation of lung fluid
A
Hypertonic Saline (7.5% NaCl)
21
Q
list 3 natural colloids
A
Whole blood, plasma, albumin
22
Q
Hb-based oxygen carrying solutions colloid
A
oxyglobin
23
Q
what are these:
hydroxyl-ethyl starch (HES), Dextran, Gelatin
A
synthetic colloids
24
Q
most commonly used colloid
A
HES: Hetastarch
25
why is HES: Hetastarch avoided in septic patients
Been associated with osmotic nephropathy
26
what are reasons for using peri-anesthetic fluids
Maintaining IV catheter patency; essential in case of CPR
Correction of deficits (fasting) and ongoing normal fluid losses
Maintenance of whole body fluid volumes during long anesthetic procedures
Supporting cardiovascular function (blood pressure)
Maintaining preload > stoke volume
27
standard rate peri-anesthetic fluids
10ml/kg/hour peri-anesthetic period
28
Procedures and testing required for the preparation and administration of blood or blood products from one animal to another, usually of the same species.
transfusion medicine
29
blood is what percent BW
5%
| 1/12 is plasma
30
what are the components of blood
Cells = Erythrocytes, Leukocytes, Platelets
Ions and molecules
Water
31
whole blood is called Called fresh whole blood for up to ____ hours after collection
8 hours
32
what is in whole blood
Contains RBCs, WBCs, platelets, plasma proteins and coagulation factors.
Old blood lacks some (unstable) clotting factors.
33
how many days after collection can whole blood be used
21 - 30
34
what are indications for giving whole blood
actively bleeding,
hypovolemia
secondary acute hemorrhage
35
contains only Red Blood Cells
packed red blood cells
36
Ideal for patients with allergic reactions to plasma proteins or with febrile non-hemolytic reactions to WBCs, not commonly used in veterinary practice
packed red blood cells
37
what is the PCV of packed red blood cells
70%
38
Harvested from fresh whole blood less than 8 hours old and has not been cooled to below 20 oC
platelet rich plasma
39
what is the indication for platelet rich plasma
\severe bleeding in thrombocytopenic animals
40
Contains plasma proteins and all clotting factors except
| platelets
pure plasma
41
T/F
| pure plasma can be viable for over a year
TRUE
42
Stabilized Bovine hemoglobin-based oxygen-carrying solution
oxyglobin
43
what is oxyglobin used for
Used to treat anemia in dogs,, and cats
44
indication for blood transfusion intra-operatively
Severe acute hemorrhage
45
start blood transfusion if acute blood loss > ___% blood volume or ____% intraoperatively
20%
10-15%
46
target completing an acute blood loss blood transfusion in ___ hours
4
47
how much blood to administer for anemic hemorrhage
the target PCV
dog = 25–30%
cat = 20%
48
how many days do dog RBC survive
110-120
49
how many days do cat RBC survive
75-80
50
how many days do horse RBC survive
140-150
51
how many days do cattle RBC survive
140-160
52
signs of allergic rxn during blood transfusion
fever, urticarial, angioedema, pruritus, tachypnea
53
signs of anaphylactic shock during blood transfusion
sudden tachycardia, hypotension, cardiac arrest, collapse
54
signs of acute hemolysis during blood transfusion
tachypnea, fever, hemoglobinemia, hemoglobinuria, shock
55
signs of a non hemolytic febrile reaction during blood transfusion
temp rise by over 1 degree C, bradycardia
56
signs of volume overload in blood transfusion
tachypnea, pulmonary edema, polyuria
57
sign of hypothermia in a blood transfusion
low body temp
58
signs of Citrate overdose induced hypocalcemia in blood transfusion
cardiac arrhythmias, tremors, seizures
59
sign of hyperkalemia in blood transfusion
ECG abnormalities
60
dogs develop antibodies how many days after their first RBC transfusion
5-7 days
61
what dog breed has a prolonged recovery when using thiobarbiturates
greyhounds/sighthounds
62
T/F
| keep brachycephalics on O2 until extubation
TRUE
63
why should you avoid excitement in small dog anesthesia
tracheal collapse
Remember increased air flow speed --> decreased intra-tracheal pressure --> collapse
64
Which mu agonists are LEAST likely to cause vomiting when premed in dog
Fentanyl, methadone
```
vomiting could cause Increased intracranial or intraocular pressure, patient unable to
protect airway (laryngeal paralysis, decreased mentation), megaesophagus, etc.
```
65
what IM drugs should doggo get before catheter placement
Usually an opioid + sedative IM
66
T/F
| in dog if an IVC is present, can give premeds IV before induction
TRUE
67
Recommended to give with IM premeds when removing a
| mast cell tumor
H1 antihistamine -- Diphenhydramine
68
what affect does histamine have on blood vessels
vasodilation, leaky vessels
69
May be given 30 minutes before opioid to decrease risk of vomiting
NK1 receptor antagonist
| Maropitant (Cerenia)
70
sedative that will cause hypotension
Acepromazine - systemically healthy patients
71
sedative that will cause Hypertension, reflex bradycardia, decreased cardiac output
dexdomitor - systemically healthy patients
72
sedative that is Cardiovascular and respiratory sparing (minimal effects) in dogs
benzodiazepines
73
drugs for hypotension in dogs
Dopamine, dobutamine, ephedrine
74
venous catheter in horse
jugular vein, 12 g
75
food and water deprivation in horse
4-6 hours food
| 2 hours water
76
drug could cause penile prolapse in horses
acepromazine
77
abortion in third trimester in horses
xylazine
78
T/F
| give a muscle relaxant to horses before induction
TRUE
79
what muscles relaxants can horses get before induction
GGE = Glyceryl Guaicolate Ether
| - Benzodiazepine: Diazepam or Midazolam
80
PIVA drugs for horses
ketamine
medetomidine
lidocaine
81
horse triple dip / TIVA
ketamine
GGE
xylazine (or romifidine)
82
horse that is showing lacrimation and nystagmus and corneal reflex present under anesthesia
TOO LIGHT
83
horse that has absence of palpebral and corneal reflex, dry corneas, apnea, and bradycardia
TOO DEEP
84
T/F
| during recovery of a horse, rotate them into the opposite recumbency they were in from surgery
FALSE -- keep in same Lat recumbency entire recovery so only one lung could undergo atelectasis
85
complications of horse anesthesia
1. Sudden unheralded heart failure
2. Hypotension
3. Hypoventilation
4. Hypoxaemia (V/Q mismatch)
5. Myopathies: postanesthetic rhabdomyolysis
6. Myelopathies: esp radial n, obturator n, facial nerve
7. Excitement and ataxia: // recovery
8. Nasal obstruction: //recovery
9. Jugular vein thrombosis
86
Anesthesia associated myopathies with rhabdomyolysis in horses
Compartmental myopathy
| Malignant hyperthermia
87
Anesthesia associated myopathies without rhabdomyolysis in horses
Hyperkaelemic periodic paresis
88
what clinical pathology signs do you see in myopathies
Myoglobinuria & hyperglobulinaemia
Muscle enzymes (CK, AST & LDH elevated)
Electrolytes (P & K elevated, Na, Cl, Ca decreased)
BUN & creatinine elevated
CBC: inflammatory leukogram

89
compartmental myopathy predisposing factors in horses
Muscle and nerve tissue ischemia associated with inadequate perfusion
o heavily muscled horse: > 600 kg
o fit or nervous horse
o persistently low MAP: < 70 mmHg
o improper positioning: peri-operatively o prolonged anesthesia time: > 2 hours o halothane maintenance

90
6 ps of compartmental myopathy in horses
Pain, paresis, paralysis, pallor, pulselessness, poikilothermia
91
horse fails to stand after anesthesia, muscles are super hard and painful, there is myoglobinuria and subsequent renal failure
compartmental myopathy
92
Life-threatening skeletal muscle pharmaco-genetic disease in humans pigs and horses
malignant hypothermia
93
Mutations in ryanodine (RyR1) gene cause dysfunctional release of excessive calcium into sarcoplasm
malignant hyperthermia
94
clinical signs of malignant hyperthermia
```
Hyper-metabolicstate:hyperthermia,hypercapnea, lactic acidosis
• profuse sweating
• tachypnea
• tachycardia & arrythymias
• hypertension
• prolapse of third eyelid
• flared nostrils
• contracted masseters
• muscle rigidity & twitching
• myoglobinuria
• death & per-acute rigor mortis
```
95
Tx malignant hyperthermia
```
Dantrolene
Water / alcohol baths
ACP for vasodilation
Na+ bicarb. for acidosis
TLC
```
96
Rare genetic trait that affects Quarter horses (most commonly), less commonly in Appaloosas & their crosses
Hyperkelemic Period Paralysis (HYPP)
97
Mutation results in failure of Na+ channels to deactivate – excessive Na+ influx and K+ outward flux in mm. cells
HYPP
98
what can trigger HYPP episodes in horses
o transportation
o stress
o sedation
o anesthesia
could develop myopathy at recovery of anesthesia
99
TX HYPP myopathy in horses
Increase K excretion by acetazolamide
dextrose
Ca gluconate
TLC
100
how can nasal edema be prevented in horses
nasal intubation until horses stands and oxygen supplementation
101
foal induction drugs
Propofol, Ketamine
102
T/F
| premed foals away from their moms
false
103
brachycephalics commonly develop ____ during recovery
upper airway obstruction
104
a dysphoric patient will become more _____ with opioids
distressed
105
what breed cat commonly gets HCM
maine coon
106
repeated doses of propofol in cats
heinz body anemia
107
all opioids cause ____ in cats post -op
hyperthermia
108
most highly recommended premed for swine
midazolam
109
how long to withhold food and water from a horse
food - 4-6 hours
| water 2 hours
110
causes penile prolapse in horse
ace
111
most common analgesic used in horses
butorphanol
112
horse induction
```
- Advisable to administer a muscle relaxant before the induction agent
GGE = Glyceryl Guaicolate Ether
Benzodiazepine: diazepam or midazolam
Ketamine 2.2 mg/kg
Thiopentone 5 mg/kg
```
113
horse oxygen flow rate
20ml/kg/min soon after induction (30-60 mins) and towards recovery
10ml/kg/min during maintenance
