Flashcards in Final Deck (45)
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1
Most common MOI in polytrauma dogs? Most common cause?
Blunt trauma; motor vehicle accidents
2
With high velocity penetrating wounds, you should be concerned about which type of damage?
solid organ damage
3
Most frequently injured:
1) skeletal structure
2) abdominal organ
1) pelvis
2) liver
4
Name 3 common thoracic injuries
1) pulmonary contusions
2) pneumothorax
3) fractured ribs
5
Shock in trauma patients should be considered to be due to ________ (unless proven otherwise)
hypovolemia
6
What are the components of the lethal triad?
Acidosis
Hypothermia
Coagulopathy
7
Describe the theory of "permissive hypotension" as it relates to hypotensive resuscitation
Goal is maintain just enough perfusion to prevent re-bleeding (SBP: 80-90, MAP: 40-60) until hemorrhage is able to be controlled
*Limiting out use of isotonic crystalloids to replace volume loss because they increase blood loss and worsen hypotension
8
In what instance is permissive hypotension NOT indicated
severe head injury with hypovolemic shock
*need to maintain CPP (requires adequate MAP)
9
In critical patients, it's best to select drugs which are ______ and ______
short-acting and reversible
10
What are the 3 categories of drugs used for pre-anesthesia
1) Anticholingerics
2) Neuroleptics (Benzo, Alpha-2, & Phenothiazine)
3) Opioids
11
Give two advantages of using a pre-anesthetic agent
1) marked decreased in amount of induction agent needed
2) significant decrease in MAC of inhalants
12
Neuroleptanalgesia combines the drug effects of which two types of drugs?
Neuroleptic + opioid
13
Reversal agent for:
1) Benzodiazepines
2) Alpha-2 agonists
1) Flumazenil
2) Atipamezol
14
Name the 3 classes of drugs included under Neuroleptics and 1-2 drugs in each class
1) Benzodiazepines (Diazepam, Midazolam)
2) Alpha-2 agonists (Dexmedetomidine & Medetomidine)
3) Phenothiazines (Ace)
15
The biggest downside of benzodiazepines is their lack of?
intrinsic analgesic properties
16
Alpha-2 agonists have limited usefulness for critically ill patients because......
can cause profound CV changes
17
T/F: Acepromize is an excellent, safe choice for critically ill patients
FALSE
*Should be AVOIDED-->hypotension
*Also no analgesia & no reversal
18
What are the 3 categories of opioids and name a drug from each
1) pure mu-agonists (fentanyl)
2) partial agonists (buprenorphine)
3) agonist-antagonist (butorphanol)
19
Which type of opioid is a good choice for a cat?
partial agonist (i.e. buprenorphine)
20
Which opioid is inadeqaute for use with intense pain and why?
Butorphanol--Ceiling effect!!
21
Ketamine should be avoided or used with caution in patients with what types of problems (3)
1) cardiac disease
2) renal disease
3) liver disease
*still okay for blocked cats!!
22
Which induction agent shouldn't be used if your patient has sepsis?
Etomidate
23
T/F: ALL inhalant anesthetics produce some degree of Cv & resp depression; however, the effects are related to dose
TRUE
24
Concerning local anesthetic agents:
1) which one shouldn't be used in cats due to CNS toxicity
2) which can NEVER be given IV (why?)
1) Lidocaine
2) Bupivacaine (cardiotoxic)
25
Primary method used by dogs to dissipate heat?
Evaporation
26
In order to prevent heat-related injury, dogs need time to acclimize to which to important factors?
1) the hot/humid environment
2) strenuous work/exercise
*minimum for 14days
27
Our biggest electrolyte concern in obstructed cats?
Hyperkalemia
*Ca gluconate protects heart!
28
If a patient is sedated but you still are unable to pass a catheter due to high urethral tone, what might be a good next step?
coccygeal epidural block
29
most common cause for an elevated blood lactate?
decreased perfusion
30
Which component of BP is most important for maintaining perfusion?
MAP
31
The two components that make up BP (multiply them together)
1) CO (preload, afterload, contractility)
2) SVR (vessel tone, blood viscosity)
32
Which artery is most commonly used for measuring arterial BP
dorsopedal
33
Name the 3 MAIN causes of hypotension
1) decreased preload
2) decreased cardiac function
3) decreased SVR
34
Which cause of hypotension will NOT respond to fluid therapy (may make it worse)
primary cardiogenic (DCM, HCM)
35
If hypotension in your patient is persisting depsite fluid therapy, what class of drug should you reach for first/?
Beta-agonist (Dobutamine, Dopamine)
36
4 common causes for HYPERtension
1) CKD
2) DM
3) Hyperthryoidism
4) HAC
37
Gold standard for measuring oxygenation?
arterial blood gas (PaO2)
38
Most common cause of hypoxemia?
Ventilation-perfusion mismatch (V/Q mismatch)
39
Which cause of hypoxemia will NOT respond to O2 therapy?
Shunt
40
Which parameters are used to assess:
1) oxygenation
2) ventilation
1) PaO2, SpO2
2) PaCO2, ETCO2
41
The life-threatening abnormality assoc. with GDV
SHOCK
42
Which component of septic peritonitis tx needs to be implemented ASAP
antimicrobial therapy
43
T/F: If the patient's BP is normal, you don't have to worry about perfusion deficits
FALSE--perfusion can be decreased even with normal BP
44
Cardiac arrythmias in critically ill patients need to be addressed if... (2 things)
1) they are impacting perfusion
2) are malignant
45
