Ch. 21 Anesthesia Principles

Question 1

How many half lives does it take for an infusion to reach maintenance level if it is given at the maintenance dose?

Answer 1

5 half lives - that is why we usually give loading doses

Question 2

What two factors influence the administration of a drug into the body?

Answer 2

redistribution to other areas of the body
metabolism and excretion of the drug
*drugs that are more lipid soluble take longer to achieve steady state because they readily redistribute to many areas of the body (a larger volume of distribution)

Question 3

How do we divide the body into three groups from the perspective of general anesthetic action?

Answer 3

vessel rich group - receive a large percentage of the cardiac output and usually have high rate of oxygen consumption (heart, brain, kidneys)
muscle group
vessel poor group - low metabolic rates like fat

Question 4

What factors influence the time necessary to achieve a steady state of anesthetic (particularly an inhalent)?

Answer 4

the minute ventilation (which is functionally the rate of delivery of drug into the body)
the cardiac output (delivery of the drug to the target organs)
the speed of redistribution (away from the target organs)
amount of drug that is eliminated from the circulation (metabolism or exhalation)

Question 5

Rule of six to administer drugs at 1 ug/kg/hr at 1 ml/hr

Answer 5

body weight of the patient in kg is multipled by 6 and then that number is the number of mg added to 100 ml of diluent.
Ex: a 5 kg cat will need dopamine. Multiple 5 by 6 –> 30… 30 mg of dopamine is what you add to 100 ml of diluent so that you can run the pump at 1 ml/hr for the patient to get 1 ug/kg/hr
You can also multiply by 60 to run it at 1 ml/hr but receive 10 ug/kg/hr

Question 6

What kind of inhalent will be less dissolved in blood and therefore will have less redistribution?

Answer 6

a less soluble drug like desflurane will be less dissolved in the blood and will have less redistribution… it will therefore achieve a faster equilibrium to the delivered percentage in the lungs and target organ

Question 7

What is the concept behind low flow (close circuit) anesthesia?

Answer 7

at equilibrium, only enough inhalant must be supplied to make up for that lost from the system by redistribution or metabolism. and only enough oxygen must be supplied to meet the animal’s metabolic demands
this is because at the induction of anesthesia, a relatively high concentration of inhalant is in the arterial blood and a low concentration in venous blood. The transfer from blood to tissue follows a concentration gradient - as anesthesia continues, less anesthetic will be taken up by the tissues because it begins to equal that of arterial blood and meanwhile, the venous concentrations are rising. As the amount of anesthetic returned to the lungs increases, anesthetic levels in the exhaled gas rise… then an equilibrium is formed and very little additional drug is needed

Question 8

How do we classify vaporizers for anesthesia

Answer 8

regulation of output
method of vaporization
vaporizer location in the anesthetic circuit
temperature compensation
agent specificity
Most vaporizers today are out of circuit, variable bypass, flow over, temperature compensated, and agent specific

Question 9

What is the saturated vapor pressure?

Answer 9

the pressure at the point where the gas of the anesthetic agent is in dynamic equilibrium with the liquid agent
it is too high to be clinically useful and must be diluted with a carrier gas

Question 10

Vaporizer output - what are the two kinds?

Answer 10

variable bypass vs measured flow

Question 11

Variable bypass vaporizer output

Answer 11

splits the incoming fresh gas flow to direct a variable portion through the vaporizing chamber and the remainder through a bypass chamber - then merge before exiting the vaporizer
most widely used

Question 12

measured flow vaporizer output

Answer 12

uses two flow meters - one that passes through the vaporizer and is saturated with drug and the other controlling the carrier gas. You need to calculate these gas flows independently
not really used

Question 13

What are the three methods of vaporization?

Answer 13

flow over
bubble through
direct injection

Question 14

Describe a flow over vaporizer

Answer 14

the carrier gas passes over a reservoir of inhalant and picks up the anesthetic vapor as it does so (the concentration of vapor being relative to the specific vapor pressure of the agent)
may use wicks in the vaporizer to increase surface area for contact between the inhalant and carrier gas
most commonly used

Question 15

Describe a bubble through vaporizer

Answer 15

bubbles the carrier gas through the bottom of the reservoir of the anesthetic to pick up the vapor
rarely used now

Question 16

Describe injection type vaporizers

Answer 16

inject an atomized spray of inhalant into the stream of the carrier gas, rapidly vaporizing the inhalant

Question 17

Describe out vs in circuit vaporizers

Answer 17

for in circuit, they can have highly variable output depending on the ambient temperature, patient ventilation, and volatility of the selected agent. In circuits are hardly used
Out of circuit are situated before the common gas outlet of the machine and are not part of the patient circuit… as a result, out of circuit vaporizers deliver a constant dose of anesthetic agent to the circuit, regardless of the patient’s respiratory minute volume

Question 18

How does temperature affect the anesthetic vaporizer?

Answer 18

vaporization of inhalant from the reservoir lowers the reservoir temperature
as the temp of the reservoir decreases, fewer molecules are liberated to a gaseous state and that lowers the output from the vaporizer

Question 19

Desflurane vaporizer

Answer 19

desflurane has a very high saturated vapor pressure, it is nearly a gas at standard temperature and pressure.
creation of an externally warmed desflurane vaporizer
will need an additional power source to warm it

Question 20

How does soda lime act as an absorbant for a rebreathing system?

Answer 20

CO2 exhaled by the patient reacts with water to form carbonic acid on the surface of the absorbant granules
the carbonic acid then dissociates to free protons and carbonate
these then associate with the strong bases to form water and calcium carbonate
an indicator dye (ethyl violet) changes color on reaction with acid

Question 21

What is the minimum oxygen flow for the rebreathing system?

hint - it is equal to the patient’s metabolic oxygen demand

Answer 21

estimated as 10 x kg^0.75

Question 22

T/F: in a rebreathing system, the concentration of inhalant the patient inspires will be less than that set on the vaporizer

Answer 22

true because the gas is rebreathed and mixed with the fresh gas, and that rebreathed gas will have a lower concentration of inhalant

Question 23

Where is the dead space in a rebreathing system?

Answer 23

at the y piece where the inspiratory and expiratory breathing tubes meet at the patient
therefore, rebreathing systems are reserved for patients larger than 5 kg

Question 24

What is the recommended fresh gas flow rate for a non rebreathing system?

Answer 24

three times the patient’s respiratory minute volume

Question 25

How do you calculate a patient's respiratory minute volume?

Answer 25

MV = respiratory rate x tidal volume | estimated tidal volume is 15 ml/kg

Question 26

What is a patient's estimated tidal volume?

Answer 26

15 ml/kg

Question 27

How quickly will a patient develop hypoxemia from apnea or obstruction on room air versus 100% oxygen

Answer 27

30 seconds versus almost 5 minutes! this is why we preoxygenate at induction

Question 28

Why might the use of 100% oxygen result in relatively more alveolar collapse than 40% oxygen:air combo?

Answer 28

the nitrogen contained in air is not readily absorbed from the alveoli. the nitrogen, therefore, provides structural support to the alveoli (called a nitrogen scaffold) because oxygen is rapidly absorbed form the alveoli, an alveolus filled with 100% oxygen will gradually collapse as that oxygen is removed by the pulmonary blood flow (called absorption atelectasis)

Question 29

For a green oxygen tank, what is the PSI and volume of gas in a full tank?

Answer 29

1900 PSI | 660 Liters

Question 30

For a white oxygen tank, what is the PSI and volume of gas in a full tank?

Answer 30

2200 PSI | 6900 L

Question 31

To what pressure does the internal pressure regulator on the anesthesia machine reduce the carrier gas pressure from the tank or wall?

Answer 31

the internal pressure regulator lowers the pressure from the wall/tank to 50 PSI

Question 32

How fast does oxygen flow from an oxygen flush valve? units are liters per minute

Answer 32

30-50 liters/min

Question 33

What are the two types of bellows of an anesthesia ventilator?

Answer 33

ascending or descending ascending is considered superior (ascend during expiration) because a leak can be noticed easier than for a descending (descend during expiration)

Question 34

What factors influence oxygen delivery to tissue?

Answer 34

blood flow through the body (generated by cardiac output) | oxygen content of the arterial blood (dictated by hemoglobin concentration)

Question 35

Which organs are most susceptible to hypoxemia?

Answer 35

brain kidney heart

Question 36

How does hypoventilation lead to respiratory acidosis?

Answer 36

hypoventilation results in an increase in CO2 causing a respiratory acidosis. When there is hyperventilation, the CO2 decreases and a respiratory alkalosis is seen

Question 37

Why does hypoxemia have a less dramatic effect on the the oxygen content of the arterial blood than anemia does?

Answer 37

oxygen content will change more radically with a decrease in hematocrit than with a decrease in PaO2 up to values less than 70 mmHg. PaO2 less than 70 mmHg will lead to a rapid drop in the oxygen content of arterial blood - review figure 21.6 in Tobias

Question 38

Why is blood pressure used as a surrogate for cardiac output monitoring?

Answer 38

Hard to measure cardiac output. Therefore, we use BP because BP = CO x SR where SR is systemic resistance

Question 39

How is the mean arterial pressure (MAP) calculated?

Answer 39

MAP = DAP + [{SAP-DAP}/3]

Question 40

At what MAP will perfusion and oxygen delivery to the brain or kidney be insufficient to meet requirements for aerobic metabolism

Answer 40

60 mmHg

Question 41

How does the doppler ultrasound help us measure indirect BP?

Answer 41

the crystal emits an ultrasonic wave that interacts with the moving blood, causing a shift in frequency of the wave, which is then received by the crystal and transduced into an audible noise In cats, the doppler may underestimate the systolic arterial pressure by up to 25 mmHg

Question 42

What is photoplethysmography?

Answer 42

a variation on the doppler method where you use the waveform on a pulse oximeter device we can only really do this on the webbing of the toes and offers no advantage to doppler readings

Question 43

are oscillometric devices useful on cats?

Answer 43

oscillometric devices tend to underestimate the systolic arterial pressure in cates but are pretty precise for mean and diastolic arterial pressure For dogs, oscillometric devices underestimate all three pressures

Question 44

What is electromechanical dissociation?

Answer 44

formerly termed pulseless electrical activity, it is when there is an ECG trace without a contraction of the heart

Question 45

What is hypercarbia?

Answer 45

synonomous to hypoventilation, it is when there is too much CO2 it results in respiratory acidosis, vasodilation, increased intracranial pressure, sympathetic nervous system stimulation, anxiety in awake patients, arrhythmias, and narcosis partial pressure of CO2 greater than 55 mmHg but not going to cause consequences until about 65 mmHg

Question 46

What is hypocarbia?

Answer 46

hyperventilation low CO2 - less than 25 mmHg may cause respiratory alkalosis, vasoconstriction, and dizziness

Question 47

Why is it that we can use end tidal CO2 as an accurate measurement of CO2 in arterial blood?

Answer 47

in patients with normal pulmonary function, CO2 is efficiently passed from the pulmonary blood into the alveoli and then breathes out **because perfusion of the alveoli is required to deliver CO2 to the alveoli, end tidal CO2 is also appropriate to monitor changes in pulmonary perfusion and cardiac output

Question 48

What is the primary factor that dictates oxygen content of arterial blood?

Answer 48

hemoglobin concentration

Question 49

What does a pulse oximeter measure?

Answer 49

estimates the percentage of hemoglobin that is saturated with oxygen under normal circumstances, it exists as oxyhemoglobin or deoxyhemoglobin Each type of hemoglobin absorbs infrared light at a different frequency A pulse oximeter emits two light frequencies, one for oxy and one more deoxyhemoglobin Relies on pulsatile nature of arterial blood to measure only arterial hemoglobin

Question 50

What are the five causes of hypoxemia?

Answer 50

``` high altitude hypoventilation diffusion impairment shunting V/Q mismatch ```

Question 51

What is the difference between a transmittance and reflectance pulse oximeter

Answer 51

transmittance is a clip and the light is sent out and then measured by a sensor on the other side reflectance probes are flat and emit light that is reflected back

Question 52

What is the partial pressure of oxygen in arterial blood when breathing room air at sea level

Answer 52

PaO2 110 mmHg | Also correspondes to 100% oxygen saturation

Question 53

what is the oxygen saturation of a patient with PaOq of 60 mmHg

Answer 53

90%

Question 54

What should the PaO2 be in a patient breathing 100% oxygen?

Answer 54

500 mmHg | A significant disturbance in blood oxygen levels must occur before a pulse oximeter reads less than 98%

Question 55

Can anemia affect a pulse oximeter reading?

Answer 55

Technically yes but the Hct must be less than 10% for that to occur

Question 56

What is the normal central venous pressure?

Answer 56

0-8 cm H20 or 0-5 mmHg

Question 57

Thermodilution

Answer 57

a method of non invasive cardiac monitoring placement of a thermistor tipped pulmonary artery catheter via the jugular vein a bolus of room temp or cold saline is injected into a port proximale to the thermistor the saline is then pumped by the heart through the pulmonary arter and the thermistor will register a change in the temp of the blood this is a reliable and accurate reading but requires placement of a pulmonary artery catheter

Question 58

Lithium dilution cardiac output

Answer 58

- method to measure cardiac output - a jugular or peripheral venous catheter and a peripheral arterial catheter are necessary - a bolus of lithium is injected into the venous catheter and blood is simultaneously aspirated from the arterial catheter across a lithium sensor - as the lithium is pumped by the heart through the body, it reaches the lithium sensor, similar to the thermodilution method

Question 59

Pulse contour analysis

Answer 59

- method of cardiac output measurement - algorithms calculated from the arterial blood pressure waveform - must be calibrated against another device at the beginning and again after any significant alteration in CO

Question 60

Noninvasive cardiac output

Answer 60

- method to measure cardiac output - NiCO device - relies on the modified Fick principle using CO2 measurement to estimate cardiac output - the Fick principle uses oxygen consumption and the arterial venous oxygen concentration to calculate cardiac output - the uptake of a substance is equal to the product of the blood flow to the tissue and the arterterial venous concentration gradient of the substance - inaccurate in patients with significant lung disease, ongoing thoracic surgery, cannot use in dogs <20 kg

Question 61

How do opioid receptors work?

Answer 61

- all opioid receptors are G protein coupled receptors with endogenous ligans including endorphins, enkephalins, and dynorphins - activiation of the receptors results in an influx of K+ and decrease in Ca2+ - This decreases the release of neurotransmitters such as substance P and glutamate causes hyperpolarization of the post synaptic cell - net result is a decrease in neuronal activity and transmission of pain signals

Question 62

Why is oral administration of opioids generally not satisfactory?

Answer 62

poor absorption as well as extensive first pass metabolism

Question 63

Why is vomiting induced commonly for IM or SQ opioid administration?

Answer 63

stimulates the chemoreceptor trigger zone

Question 64

Characteristics of morphine

Answer 64

- prototypical opioid agonist that is compared to others - relative potency is 1 - can cause histamine release, especially if given IV - acts for 3-4 hours - give diluted if you must give it IV - preferred opioid for most epidurals because of low lipophilicity - can last 12-24 hours

Question 65

Characteristics of hydromorphone

Answer 65

- 8x more potent than morphine at mu receptor - does not cause massive histamine release - analgesia of 2-4 hours

Question 66

Characterstics of oxymorphone

Answer 66

- 10 x potency of morphine - does not cause big histamine release - may cause less dysphoria, excitement, passive gastroesophageal reflux than morphine - expensive

Question 67

characteristics of meperidine

Answer 67

- 10x less potent than morphine - causes significant histamine release - dangerous to give IV - may cause serotonin syndrome in patients also receiving MAOIs (monoamine oxidase inhibitor)

Question 68

characteristics of methadone

Answer 68

- 2x as potent as morphine | - also an NMDA receptor antagonist, therefore could lead to fewer excitatory responses in cats versus other opioids

Question 69

Characteristics of fentanyl

Answer 69

- 100x more potent than morphine - duration of 20-40 min - more likely to cause bradycardia or apnea when given as a bolus than any other opioid

Question 70

characteristics of remifentanil

Answer 70

-unique among opioids in that it is metabolized by plasma esterases - extremely short half life that does not requre hepatic nor renal metabolism

Question 71

characteristics of buprenorphine

Answer 71

-40x more potent than morphine at mu receptor - partial mu agonist - binds very strongly to the mu receptor and does not fully activate it - a reduced analgesic effect compared to the full mu agonsits does not cause the side effects typically seen with full mu agonists like nausea, emessis, histamine release and respiratory depression -dose dependent duration of 4-6 hours -might cause less ileus -because of the pH of the feline mouth, absorption is rapid in the mouth

Question 72

characteristics of butorphanol

Answer 72

- k receptor agonist and mu receptor antagonist - duration of 30 min to 2 hours - as a CRI, may provide good sedation - Not that strong a pain relief - has some anti emetic properties

Question 73

characterstics of tramadol

Answer 73

- analogue of codeine with weak action at the mu receptor - analgesic properties are related to serotonin and adrenergic receptor effects - nausea and ileus still seen with tramadol

Question 74

characterstics of naloxone

Answer 74

binds competitively to mu, kappa, and delta short duration of action - only 30-60 min nalmefene and naltrexone are similar to naloxone but much longer duration of effect

Question 75

How do benzodiazepenes work?

Answer 75

- enhance the effects of gamma aminobutyric acid (GABA) which is an inhibitory neurotransmitter - the GABA receptor is activated and allows chloride to enter neurons, hyperpolarizing the cell and preventing the propagation of action potentials - the distribution of GABA receptors within the central nervous system accounts for species difference in response to benzodiazepines - no signficant CV or respiratory depresion

Question 76

Characteristics of diazepam

Answer 76

- formulated in a propylene glycol solution - 2 hour duration of effect - adsorbs to plastic IV tubing and is light sensitive so its hard to use as a CRI - processed into the active metabolites nordiazepam and oxazepam which can have more sedative activity

Question 77

Characteristics of midazolam

Answer 77

- water soluble benzo - duration of effect is about an hour - processed into 1-hydroxymethyl midazolam which has minimal biologic activity - therefore it is a good choice for a patient with hepatic dysfunction

Question 78

characteristics of acepromazine

Answer 78

-a phenothiazine tranquilizer that depresses dopamine activity in the reticular activating system - acts as an alpha1 receptor antagonist --> therefore causes vasodilation leading to hypotension but may protect the heart from arrhythmias -anti histaminic and antiemetic properties -4-6 hour duration irreversible

Question 79

alpha 2 agonists mechanism

Answer 79

- alpha 2 agonists cause a decrease of norepinephrine release in the central nervous system - some activity at the peripheral alpha 1 receptors (which is why they cause vasoconstriction, hypertension, arrhythmogenicity, paradoxical excitation) - the hypertension can cause a reflex braadycardia - may also cause hyperglycemia, diuresis, respiratory depresion

Question 80

characteristics of xylazine

Answer 80

has an alpha 2:alpha 1 receptor selectivity of 160:1 15-20 min duration can be used to induce vomiting associated with a big increase in anesthetic complications and death in dogs

Question 81

characteristics of medetomidine

Answer 81

has an alpha 2:alpha 1 receptor selectivity of 1600:1 duration of 60-90 min increasing the dose prolongs the effect but doesnt really change the degree of effect profound depression on cardiac output

Question 82

characteristics of dexmedetomidine

Answer 82

this is the dextrorotary isomer of medetomidine | may have slightly less degree and duration than medetomidine

Question 83

characterstics of trazodone

Answer 83

a phenylpiperazine antidepressant that is a serotonin antagonist and reuptake inhibitor oral trazodone reaches peak plasma concentrations after 7 hours

Question 84

characteristics of propofol

Answer 84

- acts via agonism at the GABA receptors --> increasing inhibition through the central nervous system - available as an emulsion that is susceptible to bacterial growth and also a version with benzyl alcohol which is good for 28 days - the benzyl alochol version can lead to malaise in cats - rapidly redistributed and metabolized - extrahepatic sites of metabolism too so okay for patients in liver failure - causes hypotension as a result of vasodilation and then compensatory tachycardia

Question 85

characteristics of dissociative agents ketamine and tiletamine

Answer 85

- acts via antagonism of the NMDA receptor - dissociative anesthesia is characterized by a catatonic state wherin dissociation exists between higher brain functions and unconsious functions --> this means that body systems like airway reflexes usually maintain a basal level of function - mild sympathomimetic effects with ketamine which might increase myocardial work - in patients with depleted sympathetic reserves, it may produce a decrease in cardiac output - metabolized to norketamine, which requires renal elimination and therefore should be avoided in patients with renal dysfunction - has analgesic properties but is not a good primary somatic analgesic

Question 86

characteristics of etomidate

Answer 86

- an imidazole derivative unrelated to barbiturates - like other induction agents, works at the GABA receptor rapidly metabolized minimal CV depression etomidate alone for induction will have muscle rigidity and myoclonus induces adrenal suppression - therefore is not good for animals already in septic shock with a relative renal insufficiency

Question 87

characteristics of alfaxalone

Answer 87

steroid anesthetic that enhances GABA and glycine mediated central nervous system depression depresses cardiac output and causes apnea but less commonly than with propofol

Question 88

what is minimum alveolar concentration

Answer 88

the concentration of anesthetic (in volume/volume percent) required to prevent purposeful movement in response to a standard painful stimulus in 50% of patients It is a measure of the spinal cord afferent and efferent transmission - because it measures purposeful movement the concentration of anesthetic required to prevent movement during surgery is usually 1.2-1.5 times the MAC

Question 89

minimum alveolar concentration awake definition

Answer 89

the concentration that prevents a conscious response to a verbal command in 50% of patients usually about 30% of the MAC in people - maybe 60-80% in dogs? we dont know

Question 90

minimum alveolar concentration BAR

Answer 90

concentration of inhalant that prevents a CV response from a painful stimulus - usually higher than the MAC

Question 91

what is the anesthetic triad?

Answer 91

analgesia lack of consciousness (aconscious) lack of movement (akinesia)

Question 92

What is the MAC for isoflurane in a cat and dog?

Answer 92

cat - 1.7% | dog - 1.3%

Question 93

What is the MAC for sevoflurane in a cat and dog?

Answer 93

cat - 3.1% | dog - 2.1%

Question 94

What is the MAC for desflurane in a cat and dog?

Answer 94

cat - 10.3% | dog - 7.2%

Question 95

What determines absorption of an inhalant?

Answer 95

blood/gas solubility (lambda) patient's cardiac output and minute ventilation difference in inhalant concentration between the alveolus and the venous blood **less soluble agents do not have to dissolve as much in the blood before they exert their clinical effects **a higher cardiac output creates a larger pool of blood that must be saturated and therefore causes slower absorption **the greater the gradient from alveolus to pulmonary blood, the more rapid the absorption

Question 96

How are the common inhalants metabolized?

Answer 96

minimally! barely metabolized by the liver. they need to go back into the blood and then be exhaled. so fat patients take a long time to wake up because it takes a while for the inhalant to leave the fat and reenter the blood to be exhaled But this does mean that inhalants are great for liver dysfunction patients

Question 97

characteristics of desflurane

Answer 97

highly insoluble | may result in faster recoveries which is especially useful for obese patients or brachycephalics

Question 98

characteristics of sevoflurane

Answer 98

lower solubility and higher MAC than iso | may interact with soda lime to create compound A

Question 99

How do local anesthetics work?

Answer 99

They exert a dose and activity dependent blockage of fast sodium channels on afferent nerves, inhibiting nociceptive afferent transmission resulting in analgesia

Question 100

Characteristics of lidocaine

Answer 100

- relatively lipophilic and results in fast onset (5 min) but shorter duration of action (45-60 min) - like other local anesthestics, it is a weak base

Question 101

Characteristics of bupivicaine

Answer 101

- higher lipid solubility and protein binding than lidocaine so longer duration (6-8 hours) but may take up to 45 min for effect to begin - like other local anesthestics, it is a weak base

Question 102

What is a Bier block?

Answer 102

IV regional anesthesia

Question 103

How does succinylcholine act as a neuromuscular blockade?

Answer 103

Mimics the effects of acetylcholine at the NMJ and causes an initial depolarization of all skeletal muscle may be a trigger for malignant hyperthermia

Question 104

How do non depolarizing agents act as neuromuscular blockades and what are some examples

Answer 104

the drugs that end in ium like atracurium, vecuronium stop depolarization at the NMJ reversed with neostigmine and edrophonium by inhibiting the actions of acetylcholinesterase --> may result in a cholinergic crisis so you may need to have an anticholinergic available just in case and you should not reverse the blocade before all four twitches of the train of four caused by a nerve stimulator are visible

Question 105

Because the heart fills in diastole, a DAP of less than _____ indicates poor coronary artery perfusion, and possible cardiac ischemia.

Answer 105

40 mmHg

Question 106

Color, PSI, and volume of an oxygen tank in this country

Answer 106

Green 1900 PSI 660 Liters

Question 107

Color, PSI, and volume of a nitrous oxide tank in this country

Answer 107

Blue 745 PSI 1590 Liters

Question 108

Color, PSI, and volume of a carbon dioxide tank in this country

Answer 108

Grey 838 PSI 1590 Liters

Question 109

Color, PSI, and volume of a nitrogen tank in this country

Answer 109

Black 2200 PSI 6400 Liters

Question 110

Color, PSI, and volume of a medical air tank in this country

Answer 110

Yellow (but internationally can be black and white) 2200 PSI 6550 Liters

Question 111

Color, PSI, and volume of an oxygen tank internationally

Answer 111

White 2200 PSI 6900 Liters

Question 112

Toxic dose of lidocaine in cat and dog?

Answer 112

6 mg/kg cat | 8 mg/kg dog

Question 113

toxic dose of bupivicaine in cat and dog?

Answer 113

2 mg/kg cat | 4 mg/kg dog