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RUSVM Anesthesiology > Final Exam > Flashcards

Final Exam Flashcards

1
Q

True/False: In pregnant patients we want to decrease the dose of a local anesthetic by 1/3 to avoid cranial spread and avoid hypotension.

A

True

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2
Q

Which of the following is true regarding horse dystocia?

a. Its important to get the baby out as soon as possible
b. Foals delivered >30 mins after membrane rupture usuaslly survive
c. C-section should be done before controlled vaginal delivery
d. None of the above are true

A

a. Its important to get the baby out as soon as possible

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3
Q

Which of the following is false regarding physiologic changes in pregnant patients?

a. They have a decreased lower esophageal sphincter tone incresing the risk of regurgitation/ aspiration
b. Cardiac output increases by 30-50%
c. They have a high MAC making them more sensitive to local anesthetics
d. They have increased O2 consumption and decreased PaCO2

A

c. They have a high MAC making them more sensitive to local anesthetics

**decreased MAC

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4
Q

Which of the following is not an ideal drug protocol?

a. Maximize O2 delivery to fetus and minimize drug effects
b. Acepromazine, Benzodiazepines and Alpha 2 agonists are not recommended for small animals
c. Detomidine may cause less increase in uterine tone compared to xylazine in large animals
d. Opioids rapidy cross the placenta and are irreversible so aren’t recommended to mom

A

d. Opioids rapidy cross the placenta and are irreversible so aren’t recommended to mom

**reversible, administer to mom after neonates are delivered, 2-6 days for fetal elimination

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5
Q

True/False: Most drugs easily diffuse across the placenta making it dangerous for fetuses since htey have a slow drug metabolism.

A

True

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6
Q

Which of the following induction agents has rapid metabolism in neonates and can be used as a CRI instead of iso/sevo?

a. Propofol
b. Alfaxalone
c. Etomidate
d. Ketamine

A

a. Propofol

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7
Q

Which of the following induction drugs is safe and effective for C-section in dogs?

a. Atropine
b. Alfaxalone
c. Etomidate
d. Ketamine

A

b. Alfaxalone

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8
Q

True/False: Ketamine can be used safely in small animal pregnancy.

A

False

**controversial in small animal safe in large animal

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9
Q

Which of the following is false regarding inhalation agents used in pregnancy patients?

a. Commonly used for maintenance of anesthesia
b. Causes hypotension and hypoventilation
c. MAC is lower during pregnancy making them more sensitive to inhalants
d. All the above are true

A

d. All the above are true

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10
Q

Which of the following is false regarding local anesthetics?

a. Esters are more likely to accumulate becasue they’re metabolized by plasma esterase’s
b. Amides are metabolized by hetpatic microsomal enzymes
c. Pregnancy decresaes the dose requirement
d. They’re weak bases that bind to Na channels in nerves resulting in no action potential

A

a. Esters are more likely to accumulate becasue they’re metabolized by plasma esterase’s

**amides are more likely to accumulate

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11
Q

True/False: NSAID’s are not recommended for use during pregnant patients.

A

True

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12
Q

Which of the following is not a way to maintain fetal O2 delivery during anesthesia of a pregnant patient?

a. Maintaining maternal BP and oxygenation
b. Avoid using Anticholinergics which can cause uterine contraction
c. Avoid uterine vasoconstriction
d. All the above are true

A

d. All the above are true

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13
Q

Which two drugs can be used in small animals for a lumbosacral epidural/ line block?

A

Lidocaine or bupivacaine

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14
Q

Which of the following is added for an epidural for prolonged analgesia?

a. Ketamine
b. Etomidate
c. Morphine
d. Bupivicaine

A

c. Morphine

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15
Q

What is the most common complication of epidurals in a pregnant patient?

a. Hypoventilation
b. Hypotension
c. Hypertension
d. Hyperventilation

A

b. Hypotension

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16
Q

Which of the following can be used in pregnant dogs but is contraindicated in cats?

a. Tramadol
b. Buprenorphine
c. Morphine
d. Acetominophen

A

d. Acetominophen

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17
Q

Which of the following is paried incorrectly?

a. Small ruminant: Line block or lumbosacral epidural
b. Small animal: Lumbosacral epidural or Line block
c. Large animal: Inverted L block or lumosacral epidural
d. All are paired correctly

A

c. Large animal: Inverted L block or lumosacral epidural

**Inverted L block or paravertebral block

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18
Q

Which of the following is true regarding geriatric animal physiology?

a. They have an increased liver mass and prolonged DOA of drugs
b. CO depends on heart rate
c. They have a decreased GFR increasing the effect of drugs
d. They have a decrased work of breathing

A

c. They have a decreased GFR increasing the effect of drugs

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19
Q

Which of the following is false regarding neonate physiology?

a. PCV decreases 1/3 in the first 28 days in small animals
b. They’re deficient in hepatic microsomal enzymes prolonging the effect of drugs
c. High glucose metabolism making them susceptible to hyperglycemia
d. They have low body fat making them susceptible to hypothermia

A

c. High glucose metabolism making them susceptible to hyperglycemia

**high metabolism and minimal hepatic glycogen makes them susceptible to HYPOglycemia

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20
Q

True/False: Neonate cardiac output depends on stroke volume

A

False

**CO depends on HR

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21
Q

What is included in the suggested minimum database (quads) in a young and healthy patient?

A

PCV
TP
Glucose
BUN (azostick)

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22
Q

Which two sedatives are not recommended in neonates?

A

Alpha 2 agonists and Phenothiazines (Ace)

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23
Q

Which tests should be done to eveluate liver and kidney function of geriatric patients?

A

CBC/ Chem/ UA

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24
Q

True/Fale. Phenothiazines and alpha 2 agonists are contraindicated in a healthy older patient.

A

False

**they can be used

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25
Q

Which of the following drugs do we want to use when sedating an ancient crabby cat?

a. Ketamine
b. Dexmedetomidine
c. Acepromazine
d. Alfaxalone

A

d. Alfaxalone

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26
Q

Which of the following can be used for a brachycephalic having an ophtho procedure done causing vagal stimulation?

a. Atropine
b. Ketamine
c. Alfaxalone
d. Etomodate

A

a. Atropine

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27
Q

Which of the following must be avoided in CRF or suspected heart diseased cats?

a. Diazepam
b. Etomidate
c. Ketamine
d. Butorphanol

A

c. Ketamine

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28
Q

What do you want the MAP to be above in a geriatric small animal patient with renal disease?

A

MAP > 70mmHg

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29
Q

Which of the following is true regarding diabetes insipidus?

a. Must schedule procedure in the morning and have half of their insulin
b. Use 1-5% dextrose in balanced electrolyte solution as needed intraoperatively
c. Check sodium levels every hour and don’t increase or decrease it more than 0.5 meq/L per hour
d. Check blood glucose every 30-60 minutes and keep it between 150-250

A

c. Check sodium levels every hour and don’t increase or decrease it more than 0.5 meq/L per hour

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30
Q

Which of the following is true regarding diabetes mellitus?

a. Restrict water and food before any procedure
b. Check sodium levels every hour and don’t increase or decrease it more than 0.5 meq/L per hour
c. These patients are normally hypoglycemic
d. Use 1-5% dextrose in balanced electrolyte solution as needed intraoperatively

A

d. Use 1-5% dextrose in balanced electrolyte solution as needed intraoperatively

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31
Q

Which of the following is true regarding insulinoma?

a. They’re commonly hyperglycemic and we want to stabilize them first
b. Keep BG >50 mg/dL by supplementing dextrose in fluids
c. Diazoxide is contraindicated in these patients
d. All the above are true

A

b. Keep BG >50 mg/dL by supplementing dextrose in fluids

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32
Q

True/False: You never want to restrict water in your diabetes patients before a procedure.

A

True

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33
Q

Which of the following drugs are contraindicated in a hyperthyroid cat?

a. Dopamine
b. Ketamine
c. Etomidate
d. Diazepam

A

b. Ketamine

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34
Q

Which of the following is the best protocol for a C- section?

a. No premed, alfaloxone, and opioids after delivery
b. Diazepam premed, etomidate, and tramadol after delivery
c. Propofol induction, ketamine, and buprenorphine after
d. No premed, etomodate, and high dose of esters

A

a. No premed, alfaloxone, and opioids after delivery

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35
Q

Which of the following is not commonly associated with a hypothyroid dog?

a. Bradycardia
b. Hypothermia
c. Hypoventilation
d. Hyperventilation

A

d. Hyperventilation

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36
Q

True/False: A marked chronic hypocalcemia is commonly seen in patients with hypoparathyroidism.

A

False

**HYPERcalcemia

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37
Q

Which of the follwoing is false regarding hypopadrenocorticism (Addison’s)?

a. GIve glucocorticoid and mineralocorticoids the morning of surgery
b. Hyperglycemia, hyperkalemia and hypervolemia are commonly seen with it
c. We don’t want to use etomidate becuase it causes adrenal suppression
b. We want to start steroids ASAP post-op and monitor for GI clinical signs

A

b. Hyperglycemia, hyperkalemia and hypervolemia are commonly seen with it

**hypoglycemia and volemia

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38
Q

Which of the following is not associated with Cushing’s disease?

a. Hypertension
b. Hypercoagulability
c. Hepatomegaly
d. Hyperventilation

A

d. Hyperventilation

**hypoventilation

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39
Q

What would a sharp drop in EtCO2 indicate in a patient with Cushing’s disease under anesthesia?

A

PTE
Cardiopulmonary arrest
Sudden hypotension
Cardiopulmonary bypass

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40
Q

How do you treat the hypocalcemia seen in a patient with hyperparathyroidism?

A

Ca gluconate and PO calcium

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41
Q

What can you give a patient with pheochromocytoma pre-op for several weeks to stabilize BP and HR?

a. Ketamine
b. Phenoxybenzamine
c. Atropine
d. Propofol

A

b. Phenoxybenzamine

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42
Q

What is the most common short acting, injectable beta blocker used for tachyarrythmia treatment in a patient with pheochromocytoma?

a. Atenolol
b. Lidocaine
c. Dobutamine
d. Esmolol

A

d. Esmolol

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43
Q

All of the following can be used to treat the hypotension and bradycardia that occurs after removing a tumor of the adrenal medulla except:

a. Phenothiazine
b. Phenylephrine
c. Ephedrine
d. Dobutamine

A

a. Phenothiazine

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44
Q

All of the following can result in hypoglycemia except:

a. Insulinoma
b. Phenochromocytoma
c. Diametes mellitus
d. Addison’s disease

A

c. Diametes mellitus

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45
Q

The cushing’s reflex includes all of the following except:

a. Hypertension
b. Reflex bradycardia
c. Irregular breathing pattern
d. Decrased ICP

A

d. Decrased ICP

**Increased ICP

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46
Q

True/False: All volatile anesthetics at >1 MAC increase ICP and CBF via cerebral vasodilation.

A

True

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47
Q

Which of the following can be used in the acute phase of tissue injury in a horse and after rehab exercise?

a. Superficial thermal heat
b. Cryotherapy
c. Passive range of motion
d. Active range of motion

A

b. Cryotherapy

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48
Q

Which term measures the maximum flexion and extension in a joint?

A

Goniometer

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49
Q

Which of the followng has a high amplitude and energy and may be a painful procedure that is commonly done in horses?

a. Cryotherapy
b. Superficial theraml heat
c. Extracorporeal shockwave
d. None of the above

A

c. Extracorporeal shockwave

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50
Q

Which of the following is the most common arrythmia associated with a splenic bleed?

a. Atrial fibrillation
b. Ventricular premature complex
c. 3rd degree AV block
d. Accelerated idioventricular rhythm

A

b. Ventricular premature complex

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51
Q

Which of the following is contraindicated in a patient with GDV?

a. Alfaloxone
b. Butorphanol
c. Ketamine
d. Dexdomitor

A

d. Dexdomitor

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52
Q

What is the goal of the cardiovascular system?

A

To deliver O2 to the tissues

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53
Q

HCM cat has a MAP of 45 mmHg and a HR of 180 bpm. Which of the following should be given to this cat?

a. Dobutamine
b. Dopamine
c. Ketamine
d. Acepromazine

A

b. Dopamine

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54
Q

Which of the following is false regarding an animal with mitral valve insufficiency?

a. ACE-inhibitor should be withheld the morning of surgery
b. Ketamine should be avoided if tachycardic or if they have a-fib
c. Vasopressors can be given if hypotensive
d. Ace, alpha 2 agonist, propofol and pre-op atropine should be avoided

A

c. Vasopressors can be given if hypotensive

**no vasoperssors because increase afterload, use dobutamine/dopamine

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55
Q

Which of the following is absorbed by an F canister?

a. N2O and CO2
b. Halogenated gases and N2O
c. Halogenated gases
d. Only N2O

A

c. Halogenated gases

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56
Q

Renal blood flow (RBF) is constant with a mean arterial pressure of __ - __mmHg

A

80-180 mmHg

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57
Q

Intra-operatively the MAP of a renal compromised small animal patient should be maintained above __ -___ mmHg to maintain adequate renal blood flow.

A

70 - 80 mmHg

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58
Q

Cerebral blood flow (CBF) is normally maintained by autoregulation which is effective over MAP _ - _ mmHg.

A

MAP 50-150 mmHg

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59
Q

True/False: CBF increases nearly linearly with PaO2.

A

False

**PaCO2

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60
Q

Which of the following is not safe to use in a patient with increase intracranial pressure?

a. Acepromazine
b. Diazepam
c. Fetanyl
d. Atipamezole

A

d. Atipamezole

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61
Q

Which of the following injectable anesthetics is not recommended with increased ICP and CBF?

a. Alfazalone
b. Ketamine
c. Etomidate
d. Propofol

A

b. Ketamine

62
Q

Which neuromuscular blocker is not recommended because it incresaes ICP?

A

Succinylcholine

63
Q

Which of the following is false regarding CNS specific procedures?

a. Keep head elevated for myelographs because contrast can cause seizures
b. Ventral slot can increase vagal stimulation and cause respiratory arrest
c. Mechanical ventilation and a sling post-op must be used for cervical vertebral instability in equine patients
d. All the above are true

A

d. All the above are true

64
Q

Equine ___ injections cause violent behavioral reactions and seizures

A

Intracarotid

65
Q

Which of the following is not a function of the liver?

a. Metabolizes drugs, hormones, and toxins
b. Produces coagulation factors
c. Stores vitamine A, D, K, B12 and iron
d. Converts urea to ammonia

A

d. Converts urea to ammonia

66
Q

True/False: Liver enzymes are increased with injury, leakage, bile stasis and are specific indicators of liver function.

A

False

**NOT a specific indicator of liver function

67
Q

Which of the following is not a patient factor that can increase anesthtic risk in a liver patient?

a. Hypertension leading to ascites
b. Excessive hemorrhage due to increased coagulation factors
c. Hypoglycemia from decreased gluconeogenesis
d. Encephalopathy from increased ammonia and other toxins

A

b. Excessive hemorrhage due to increased coagulation factors

**decreased coagulation factors

68
Q

True/False: Benzodiazepines may worsen signs of hepatic encephalopathy.

A

True

69
Q

All of the following are contraindicated in a patient with liver disease except:

a. Halothane
b. Succinylcholine
c. Atracurium
d. Guaifenesin

A

c. Atracurium

70
Q

Which of the following drugs is not preferred in a patient with liver disease?

a. Propofol
b. Atracurium
c. Etomidate
d. Diazepam

A

d. Diazepam

**Benzo’s may worsen hepatic encephalopathy

71
Q

True/False: Hypotension in a patient with portosystemic shunt may not be responsive to dobutamine/dopamine treatments.

A

True

72
Q

Which of the following is false regarding megaesophagus?

a. Avoid prolonged fasting
b. Morphine and hydromorphone can be used as pre-meds
c. Keep sternal, inflate ETT cuff ASAP before positioning in lateral
d. All the above are true

A

b. Morphine and hydromorphone can be used as pre-meds

**avoid vomiting so don’t use these drugs as pre-meds

73
Q

You have a dog that comes in with severe weakness, collapse, hypotensive and tachycardic with pale mucous membranes. Which of the following do you want to do next?

a. Give him ballanced replacement crystalloids like LRS
b. Do an abdominal exploratory to figure out what the issue is
c. Do radiographs on him
d. Go ahead and perform surgery on him or a hemoabdomen

A

a. Give him ballanced replacement crystalloids like LRS

**you want to stabilize him first they’re hypovolemic!

74
Q

True/False: With a hemoabdomen patient you want to resuscitate them to normal awake BP values .

A

False

**avoid this b/c it may disrupt clots that have formed

75
Q

The MAP of a hemoabdomen patient should be maintained above __ mmHg

A

> 60 mmHg

76
Q

You have a patient that comes in vomiting and has abdominal pain. You perform a serum chemistry and find that he has hypochloremic metabolic alkalosis. Which of the following drugs should you administer to this patient?

a. Acepromazine
b. Hydromorphone IV
c. Dexmedetomidine
d. Propofol

A

b. Hydromorphone IV

***Early stages of GI foreign body, don’t withhold opioids in vomiting patient. Very unlikely to cause vomiting in a painful patient if given IV

77
Q

What is the first thing we want to do with a patient who has a hemoabdomen and is hypotensive?

a. Give dopamine to treat hypotension
b. Turn down the inhalant anesthetic
c. Use a combo of lidocaine and dopamine
d. None of the above

A

b. Turn down the inhalant anesthetic

78
Q

Lucky comes in with severe abdominal pain, brick red mucous membranes, and vomiting. You note that he is hypoglycemic and hypocalcemic. Which drugs can you give Lucky to make him feel better?

a. Acepromazine and Dexmedetomidine
b. Diazepam and Fetanyl
c. Propofol and Acepromazine
d. Etomidate and Diazepam

A

b. Diazepam and Fetanyl

**septic patient with a GI foreign body, use opioid and benzodiazepines combo

79
Q

A lactate reading > __ mmol/L is a negative prognostic indicator for a patient with GDV.

A

lactate > 6 mmol/L

80
Q

Which of the following is not associated with a patient that has GDV?

a. Hypovolemic shock
b. Ventricular arrhythmias
c. Hyperventilation
d. Hypotension

A

c. Hyperventilation

**Hypoventilation

81
Q

Which of the following is the drug of choice for a patient under anesthesia with a GI disease?

a. Propofol
b. Acepromazine
c. Dexdomitor
d. Lidocaine

A

d. Lidocaine

**almost all have ventricular arrhythmias aossicated with the GI disease

82
Q

Which of the following is not a complication associated with equine colic?

a. Hypocalcemia
b. Hypertension
c. Hypoxemia
d. Hypercania

A

b. Hypertension

83
Q

True/False: Patients with equine colic usually need high peak inspiratory pressures (PIP) which can lead to decreased venous return and cardiac output.

A

True

84
Q

Which of the following is false regarding cardiovascular diseases?

a. Left sided CHF leads to pulmonary edema and pleural effusion
b. Right sided CHF leads to ascites
c. Goal is to maintain CVS function as close to awake values as possible
d. We want to use higher Na fluids (0.9% NaCl) to reduce the fluid rate

A

d. We want to use higher Na fluids to reduce the fluid rate

**lower Na fluids

85
Q

Which of the following would you use in patient with CV shock?

a. Phenothiazine
b. Ketamine
c. Propofol
d. Atropine

A

b. Ketamine

86
Q

Which of the following can be used in a CKCS with mitral valve disease?

a. Etomidate
b. Dexmedetomidine
c. Pre-op atropine
d. Acepromazine

A

a. Etomidate

87
Q

True/False: Dilated cardiomyopathy is a diastolic dysfunction and hypertrophic cardiomyopathy is a systolic dysfunction.

A

False

**other way around

88
Q

Which of the following should never be used in a cat with HCM because it can cause CHF?

a. Dopamine
b. Alfaxalone
c. Ketamine
d. Diazepam

A

c. Ketamine

89
Q

Which of the following can be used to treat a patient with PDA resulting in increased diastolic BP and Branham’s sign (reflex bradycardia)?

a. Lidocaine
b. Atropine
c. Acepromazine
d. Propofol

A

b. Atropine

90
Q

Piper comes in becuase her owner notices that she is frequently fainting. She has a heart rate of 35 bpm. What drug can be given to piper?

a. Morphine and Butorphanol
b. Acepromazine and Atropine
c. Dexmedetomidine and Diazepam
d. Butorphanol and Diazepam

A

d. Butorphanol and Diazepam

91
Q

What are the five causes of hypoxemia?

A
  1. Hypoventilation
  2. Right to left shunt
  3. Low inspired FiO2
  4. Diffusion impairment
  5. V/Q mismatch
92
Q

Hypoxemia indicates a PaO2 < ___ mmHg and SpO2 of ___.

A

PaO2: <60 mmHg
SpO2: 90%

93
Q

What is the normal arterial O2 to fractional inspired O2 ratio?

A

500

94
Q

What is the normal values for the alveolar- arterial O2 gradient (A-a gradiaent)?

A

<10-15 mmHg

95
Q

Which of the following is the determinant for ventilation?

a. PaCO2
b. PaO2
c. SpO2
d. HCO3

A

a. PaCO2

96
Q

What is the most common reason there would be an Arterial O2 to fractional inspired O2 ratio <500?

A

V:Q mismatch

97
Q

Which of the following causes significant respiratory depression?

a. Alfaxalone
b. Diazepam
c. Acepromazine
d. Dexmedetomodine

A

a. Alfaxalone

98
Q

Which of the following is true regarding controlled ventilation?

a. PEEP is achieved at the end of inspiratoin
b. IPPV decreases PaCO2 and increases PaO2
c. PIP is used to prevent alveolar collapse
d. With IPPV you want to squeeze the bag to 35 cmH2O

A

b. IPPV decreases PaCO2 and increases PaO2

99
Q

What is the msot common side effect of a patient on mechanical ventilation?

a. Hypoventilation
b. Hypotension
c. Hypercapnia
d. Hyperventilation

A

b. Hypotension

100
Q

Which of the following is false regarding treatment of hypoxemia?

a. Sternal recumbency especially while awake
b. Sternal recumbency with good lung up
b. Increase PIP
d. Consider bronchodilator especially if bronchoconstriction suspected

A

b. Sternal recumbency with good lung up

**Lateral recumbency

101
Q

Which of the following is a replacement/ balanced solution?

a. Plasmalyte M in dextrose
b. 0.9% NaCl
c. 7.5% NaCl
d. LRS

A

d. LRS

102
Q

Which of the following local anesthetics has the highest cardiovascular toxicity?

a. Lidocaine
b. Bupivacaine
c. Mepivacaine
d. Prilocaine

A

b. Bupivacaine

103
Q

Which of the following is not a patient risk factor when using local anesthetics?

a. Hyperproteinemia
b. Pregnancy
c. Beta or calcium channel blockers
d. Hypoxemia

A

a. Hyperproteinemia

**hypoproteinemia and acidosis are also risk factors

104
Q

Which of the follwoing is the appropriate treatment of cardiac arrest secondary to local anesthetics?

a. Start CPR, and give a high dose of epinephrine and monitor with ECG
b. GIve high dose of epinephrine, Start CPR and monitor with ECG
c. Start CPR, low dose epinephrine, give 20% lipid emulsion
d. GIve low dose epinephrine and 20% lipid emulsion

A

c. Start CPR, low dose epinephrine, give 20% lipid emulsion

105
Q

Which of the following is false regarding chest compressions during CPR?

a. Most important part of BLS
b. 3 minute interrupted cycles
c. Direct compression of the ventricle
d. Perpendicular to the patient

A

b. 3 minute interrupted cycles

**2 minute uninterrupted cycles

106
Q

Which of the following is not a shockable rhythm?

a. Asystole
b. Pulseless ventricular tachycardia
c. Ventricular fibrillation
d. None of the above

A

a. Asystole

107
Q

True/False: NSAID’s are recommended for use during pregnancy.

A

False

108
Q

Which of the following is an alpha 1 agonist?

a. Dopamine
b. Vasopressin
c. Epinephrine
d. Phenylephrine

A

d. Phenylephrine

109
Q

Which of the following works mainly on B1 and increased inotropy with minimal effects on chronotropy?

a. Dopamine
b. Dobutamine
c. Norepinephrine
d. Ephedrine

A

b. Dobutamine

110
Q

Which of the following is not an effect of NSAID’s?

a. Analgesia
b. Anti-inflammatory
c. Anti-pyretic
d. Anti-emetic

A

d. Anti-emetic

111
Q

What are the main side effects of NSAID’s?

a. Hepatotoxicity and Hemostatic abnormality
b. Renal imapirment and Hepatotoxicity
c. GI effects and pulmonary edema
d. GI effects and renal impairment

A

d. GI effects and renal impairment

112
Q

All of the following NSAID’s are not approved for cats except?

a. Carprofen
b. Meloxicam and Robenacoxib
c. Deracoxib and Firocoxib
d. Phenylbutazone

A

b. Meloxicam and Robenacoxib

113
Q

All of the following can be used for peripheral nervous system pain except:

a. NSAID’s
b. Glucocorticoids
c. NMDA antagonists
d. Local anesthetics

A

c. NMDA antagonists

114
Q

What is the correct order of the pain pathway?

a. Transduction, perception, transmission, modulation
b. Transmission, transduction, perception, modulation
c. Transduction, transmission, modulation, perception
d. Perception, modulation, transmission, transduction

A

c. Transduction, transmission, modulation, perception

115
Q

What is the best option for providing coagulation factors?

a. Cryoprecipitate
b. Fresh whole blood
c. Fresh plasma
d. Fresh frozen plasma

A

a. Cryoprecipitate

116
Q

What is the best option for providing functional platelets?

a. Cryoprecipitate
b. Fresh whole blood
c. Fresh plasma
d. Fresh frozen plasma

A

b. Fresh whole blood

117
Q

Which is not typically consdiered a transfusion side effect?

a. Induced hypercalcemia
b. Sepsis
c. Transmission of infectious disease
d. Blood type incompatibility

A

a. Induced hypercalcemia

118
Q

Which of the following is considered a long term affect of hypothermia?

a. Increased O2 demand
b. Prolonged recovery
c. Discomfort
d. Infection

A

d. Infection

119
Q

Which drug is commonly used for a local block in dental extraction in small animal patient?

a. Lidocaine
b. Bupivacaine
c. Buprenorphine
d. Tramadol

A

b. Bupivacaine

120
Q

True/False: Ketamine alone is acceptable for analgesia for some surgical procedures.

A

False

121
Q

Which of the following is not a highly potent opioid used in megaherbivores?

a. Etorphine
b. Carfentanil
c. Thiopental
d. Thiafentanyl

A

c. Thiopental

122
Q

Which of the following can be used to reverse a rhino having adverse reactions to carfentanil?

a. Naloxone
b. Naltrexone
c. Buprenorphine
d. Etorphine

A

b. Naltrexone

123
Q

Due to Renarcotization we want:

a. Sedatives that have longer half lives than the reversal agent
b. Reversals that have longer half lives than the sedative used
c. To use Naloxone as a reversal agent
d. None of the above

A

b. Reversals that have longer half lives than the sedative used

124
Q

All of the following are true regarding HYPP except?

a. Rare genetic trait
b. Mutation results in failure of Ca++ channels to deactivate
c. May develop during recovery
d. Signs including dog sitting

A

b. Mutation results in failure of Ca++ channels to deactivate

**should be Na+ channnels

125
Q

Which of the following is not a trigger factor for malignant hyperthermia?

a. Stress
b. Opioids
c. Inhalant anesthetics
d. Succinyl choline

A

d. Succinyl choline

126
Q

True/False: Gas exchange is more effective in birds than in mammals.

A

True

127
Q

Birds don’t tolerate ___ and ___ very well.

A

Bradycardia and apnea

128
Q

True/False: Lidocaine and Bupivacaine are esters.

A

False

**amides

129
Q

Which of the following is false regarding lidocaine?

a. Only local anesthetic that may be given IV
b. Slow onset, long duration
c. Anti-arrhythmic
d. Decreases MAC (MAC sparing)

A

b. Slow onset, long duration

130
Q

Which of the following is the correct flow of gas through the anesthetic machine?

a. Flowmeter –> Regulator –> Cylinder Pressure Gauge
b. O2 cylinder –> Regulator –> Vaporizer
c. Vaporizer –> Flowmeter –> Cylinder pressure gauge
d. Vaporizer –> Fresh gas inlet –> Flowmeter

A

b. O2 cylinder –> Regulator –> Vaporizer

131
Q

A patient with controlled diabetes mellitus receiving insulin would be classified as:

a. ASA 1
b. ASA 2
c. ASA 3
d. ASA 4

A

b. ASA 2

132
Q

All of the following are GABA agonists except:

a. Ketamine
b. Propofol
c. Etomidate
d. Thiopental

A

a. Ketamine

**NMDA antagonist

133
Q

Which drug would you use for induction in a hymodynamically unstable patient?

a. Etomidate
b. Alfaxalone
c. Propofol
d. Ketamine

A

a. Etomidate

134
Q

Which of the following is the drug of choice for C-sections?

a. Thiopental
b. Propofol
c. Ketamine
d. Etomidate

A

b. Propofol

135
Q

Which of the following is not suitable for TIVA?

a. Morphine
b. Fentanyl
c. Etomidate
d. Lidocaine

A

c. Etomidate

136
Q

Which of the following will not decrease MAC?

a. Hypothermia
b. Drugs causing CNS depression
c. Hyponatremia
d. Hyperthermia

A

d. Hyperthermia

137
Q

Which of the following describes an opioid that binds to receptors but does not activate them?

a. Partial agonists
b. Agonists
c. Antagonists
d. Mixed agonist/ antagonists

A

c. Antagonists

138
Q

Which of the following is false regarding darts?

a. Velocity has the greatest effect on the kinetic energy and potential for dart injury
b. We would prefer to hit the animal in the neck with the dart
c. Darts can be delivered via pole syringe, blow gun or dart projectors
d. The most common dart used is the compressed air dart

A

b. We would prefer to hit the animal in the neck with the dart

139
Q

Which is the most commonly used opioid used in birds?

a. Morphine
b. Fentanyl
c. Butorphanol
d. Hydromorphine

A

c. Butorphanol

140
Q

Which of the following would give you the best indicator of oxygen saturation in a bird?

a. Pulse oximeter
b. Arterial blood gas analysis
c. EtCO2
d. Blood pressure

A

b. Arterial blood gas analysis

141
Q

Which of the following procedures would using a NMBD be most warranted?

a. Feline spay
b. Canine GI foreign body removal
c. Corneal surgery
d. Feline declaw

A

c. Corneal surgery

142
Q

Which of the following blocks is used to provide anesthesia to the entire thoracic limb including the scapula and shoulder joint?

a. Mental nerve block
b. Brachial plexus block
c. RUMM block
d. Cervical paravertebral block

A

d. Cervical paravertebral block

143
Q

Which of the following is true about partial mu agonists?

a. They bind to mu receptors but don’t fully stimulate them even at high doses
b. They bind to mu receptors and stimulate them fully
c. They do not bind to mu receptors
d. They bind to mu receptors and inactivate them

A

a. They bind to mu receptors but don’t fully stimulate them even at high doses

144
Q

Which local anesthetic doesn’t match the procedure?

a. Brachial plexus block with forelimb amputation
b. Cervical paravertebral block with shoulder and scapula
c. RUMM block with distal thoracic limb procedure
d. Femoral and sciatic nerve block for pelvic limb procedure

A

a. Brachial plexus block with forelimb amputation

145
Q

Which of the following is true about volatile anesthetics?

a. They decrease ICP over 1 MAC
b. They decrease GFR
c. They cause tachycardia
d. All the above are true

A

b. They decrease GFR

146
Q

Which of the following is true about Doppler?

a. Measure mean blood pressure
b. It is the most accurate way to measure blood pressure
c. Doppler of >80 mmHg is normal in small animals
d. Dopper of >60 mmHg is normal in donkeys

A

c. Doppler of >80 mmHg is normal in small animals

147
Q

A patient with an active hemorrhaging hemangiosarcoma would be considered:

a. ASA I
b. ASA II
c. ASA III
d. ASA IV

A

d. ASA IV

148
Q

Which of the following interrupts transduction of the nociception pathway?

a. Local nerve block
b. Epidural
c. Topical local anesthetics
d. None of the above

A

c. Topical local anesthetics

149
Q

Which of the following is false regarding Tramadol?

a. It is given orally to dogs and cats
b. It is great as a sole analgesic agent for moderate pain
c. It has weak mu activity
d. It inhibits serotonin reuptake

A

b. It is great as a sole analgesic agent for moderate pain

150
Q

Which of the following drugs would you not want to use in a hypoadrenocorticism patient?

a. Prednisone
b. Atropine
c. Etomidate
d. Diphenhydramine

A

c. Etomidate

151
Q

Which of the following is the most commonly used agent for induction of general anesthesia in feral carnivores?

a. Opioids
b. Butyrophenones
c. Phenothiazines
d. Cyclo-hexamines

A

d. Cyclo-hexamines

RUSVM Anesthesiology (4 decks)

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