anesthic class exam 2

the pain pathway follows these steps (top being 1st step) before reaching the brain

1.Transduction

2.Transmission

3. Modulation

4.Perception

A phenomenon in which an area close to the site of tissue injury is painful if stimulated with a nonnoxious stimulus

A- peripheral hypersensitivity

B-Adaptive pain

C-allodynia

D-Catabolic state

C

based on your knowledge of brachycephalics all of the following factors place rufus as a high risk patient except

a. BOAS

b.abnormally high parasympathetic tone

c.tachycardia

d. thickened laryngopharynx

C

once px and bloodwork are completed the DVM writes the following protocol Which combo offers great neuroleptanalgesia

a. dexmedatomidine and methadone

b. propofol and ketamine

c.dexmedatomidine and propofol

d. hydromorphone and propofol

a

methadone offers the following characteristics except

a. NMDA antagonist

b. Pure mu opioid agonist

c. somatic pain

d. profound sedation

d

what type of nerve block would be appropriate for a femur fracture

a. brachial plexus block

b. ring block

c.coccygeal block

d. epidural

d

surgery may take 4 hours to perform which drug will you choose for the epidural

a. lidocaine

b. dexmedetomidine

c. bupivacaine

d. epinephrine

c

you are preparing the anesthetic machine for the case. At 25kg Rufus will be placed on a non-rebreathing system

true or false

false

all of the following are ways to check for proper placement in the trachea except:

a. Palpable tubular structure

b. Check for condensation within the ETT

c.patient is able to vocalize

d. CO2 waveform & ETCO2 present

C

the surgeon asks you if they are ok to proceed which plane is the most optimal for surgery

a.stage II

b.Light Stage III

c. surgical plane III

d. Deep stage III

c

Surgical Stage III has the following parameters except

a. decreased or absent palpebral reflex

b. absent pedal reflex

c. ventromedial eye position

d.marked jaw tone

d

based on your parameters you determine the patient is hypotensive. All of the following can cause hypotension except.

a. excess anesthetic depth

b. blood loss

c.anesthesic agents

d.vasoconstriction

d

all of the following are strategies to correct hypotension except

a. administer crystalloid bolus

b.decrease vaporizer setting

c. start phenothiazine

d. start a dopamine CRI

c

which heart rhythm is being displayed on the monitor

a. normal heart rhythm

b.second degree AV block

c.ventricular premature contraction

d.sinus arrhythmia

b

which of the following can cause hypocapnia

a. esophageal intubation

b.hyperventilation

c. cardiac arrest

d. hypoventilation

b

10 minutes increasing the inhalant Rufus respiratory rate decreases how often should you breathe for Rufus.

a. none because the rebreathing bag moving

b. 1-2 breaths every 1 minute

c. non because parameters are in normal limits

d. 1-2 breaths every 5 minutes

d

Rufus ( brachycephalic) is ready to be extubated when he displays all of the following except

a. swallowed 2-3 times

a. lifting head without stimulation

c. lilfting his head with stimulation

d. voluntary limb movements

c

rufus has been extubated now I can start the next case since rufus does not require continued monitoring T OR F

False

you check Rufus’s temp he is 96 deg all of the following can be used to normalize temp except

a. fluffy bedding

b. warm air blanket

c warm water blanket

d. heating pad

d

when a patient codes under general anesthesia what is the first parameter that will alert you?

a.oscillating blood pressure

b. ECG

c Entitled CO2

d. SpO 2

c

	period of voluntary movement; patient begins to lose consciousness
	period of anesthetic overdose; that requires immediate resuscitation
	period of surgical anesthesia; planes ranging from light to deep
	period of involuntary movement; "excitement stage"

1	period of voluntary movement; patient begins to lose consciousness
4	period of anesthetic overdose; that requires immediate resuscitation
3	period of surgical anesthesia; planes ranging from light to deep
2	period of involuntary movement; "excitement stage"

	anesthetic depth
	peripheral perfusion
	electrical activity of the heart
	ventilation status
	oxygenation status
	manual HR/RR

patient reflexes anesthetic depth BP peripheral perfusion ECG electrical activity of the heart ETCO2 ventilation status SpO2 oxygenation status Stethoscope manual HR/RR

Which of the following are indicators of circulation? (select all that apply) 

Question options:

Indirect blood pressure

Venous blood gas analysis

Tidal volume

Arterial blood gas analysis

Pulse quality

Direct blood pressure

Mucous membrane color / CRT

Respiratory rate

Pulse oximetry

Heart rhythm

Heart rate

End-tidal CO2

Indirect blood pressure	answer
Venous blood gas analysis
Tidal volume
Arterial blood gas analysis
Pulse quality	answer
Direct blood pressure	answer
Mucous membrane color / CRT	answer
Respiratory rate
Pulse oximetry
Heart rhythm	answer
Heart rate	answer
End-tidal CO2

Which of the following are indicators of oxygenation? (select all that apply) 

Question options:

Tidal volume

Respiratory rate

Indirect blood pressure

End-tidal CO2

Pulse quality

Pulse oximetry

Arterial blood gas analysis

Heart rate

Mucous membrane color

Venous blood gas analysis

Heart rhythm

Direct blood pressure

Capillary refill time

The indicators of oxygenation are blood gas analysis, pulse oximetry, and MM color.

Which of the following are indicators of ventilation? (select all that apply) 

Question options:

End-tidal CO2

Direct blood pressure

Arterial blood gas analysis

Indirect blood pressure

Heart rate

Venous blood gas analysis

Tidal volume

Respiratory rate

Mucous membrane color

Pulse oximetry

Capillary refill time

Heart rhythm

Pulse quality

The indicators of ventilation are RR, tidal volume (TV), ETCO2, and blood gas analysis.

Monitoring cardiac electrical activity via ECG is a direct measurement of mechanical heart function.

T OR F

false

Sinus arrhythmia is classified as an expected, normal cardiac rhythm in cats.

T OR F

False

What percentage of the limb circumference should the width of an indirect blood pressure cuff (Doppler or oscillometric) equal?

a	40%
b	30%
c	50%
d	25%
e	20%

a

What is the expected range for end-tidal carbon dioxide (ETCO2) in an anesthetized patient?

Question options:

a	30-45mmHg
b	20-25mmHg
c	15-20mmHg
d	40-55mmHg

d

Which of the following blood pressure values is considered within normal limits for an anesthetized patient?

Question options:

a	Oscillometric MAP 50mmHg
b	Doppler systolic 90mmHg
c	Oscillometric MAP 55mmHg
d	Doppler systolic 70mmHg

b

Which of the following SpO2 readings indicates hypoxemia in an anesthetized patient?

Question options:

a	95%
b	97%
c	94%
d	98%

c

Which of the following heart rate ranges is considered acceptable for a canine patient under anesthesia?

Question options:

a	60-150bpm
b	80-140bpm
c	120-180bpm
d	100-160bpm

a

Which of the following heart rate ranges is considered acceptable for a feline patient under anesthesia? 

Question options:

a	100-160bpm
b	120-180bpm
c	80-140bpm
d	60-150bpm

b

Which of the following reflexes decreases in a reliable, continuous manner as anesthetic depth increases?

Question options:

a	Jaw tone
b	Pupil position
c	Palpebral reflex
d	Pupil size

a

 Surgical anesthesia is achieved when a patient reaches Stage III, Plane 2.

T OR F

true

Which of the following is considered the single most valuable monitoring "tool" for an anesthetized patient?

Question options:

a	SpO2
b	ECG
c	The veterinary technician
d	ETCO2
e	BP

c

Which of the following systemic responses suggests that a patient is reacting to a painful surgical stimulus?

Question options:

a	Decrease HR & decrease RR
b	Increase HR & increase RR
c	Decrease HR & increase RR
d	Increase HR & decrease RR

b

According to ACVAA monitoring guidelines, at what frequency must an anesthetist evaluate a patient's vital signs?

Question options:

a	Every 5 minutes
b	Every 15 minutes
c	Every 1 minute
d	Every 10 minutes

a

According to ACVAA monitoring guidelines, at what minimum frequency should a patient's vital signs be documented on the anesthetic record?

Question options:

a	Every 30 minutes
b	Every 15-20 minutes
c	Every 5-10 minutes
d	Every 1 minute

c

Under assisted ventilation, both the respiratory rate and tidal volume are dictated by the anesthetist.

True or False

False

Swallow- reflex-You should monitor for swallowing motions in the ventral neck region. It can happen when a patient is recovering from anesthesia and is a main indicator that tells you it is ok to remove the endotracheal tube.
Palpebral Reflex- you should give a light tap on the medial or lateral canthus of the eye and the patient should blink
Pedal reflex- You would need to vigorously squeeze or twist or pinch a digit or a pad and the patient should either flex or withdraw the limb in response.
Corneal reflex- you would need to stimulate the cornea of the eye which you can do by touching the cornea with a sterile object. The patient should then retract the eyeball within the orbit or have a blink response.
Pupillary light reflex- This is the reflex that occurs when you shine a light onto one of the retinas and the pupils should constrict.

State two clinical scenarios in which the use of an anesthetic ventilator is indicated.

If the  SpO2 is confirmed to be below 90%.

If a  high dose of opioid was given.

Taking all appropriate precautions completely eliminates the risk of anesthetic complications or emergencies.

T OR F

False

Managing an anesthetic emergency effectively relies on seamless collaboration among the entire veterinary team.

T or F

true

Knowing the location of emergency equipment and supplies (e.g., crash cart/kit) is solely the responsibility of the veterinary technician. 

T OR F

False

Which of the following factors does NOT contribute to inadequate anesthetic depth in a patient?

Question options:

a	Vaporizer setting
b	O2 flow rate
c	Bradycardia
d	Kinked ET tube

c

Which physiological characteristic makes pediatric patients uniquely vulnerable during anesthesia?

Question options:

a	Increased risk of airway obstruction
b	Poor distribution of anesthetic agents
c	Immature liver and kidney function
d	Less functional reserve

c

Which age-related physiological change elevates anesthetic risk in senior patients?

Question options:

a	Less functional reserve
b	Increased risk of airway obstruction
c	Immature liver and kidney function
d	Poor distribution of anesthetic agents

a

Which age-related physiological change elevates anesthetic risk in obese patients?

Question options:

a	Less functional reserve
b	Increased risk of airway obstruction
c	Immature liver and kidney function
d	Poor distribution of anesthetic agents

d

Which anatomical or physiological characteristic makes brachycephalic breeds particularly vulnerable under anesthesia?

Question options:

a	Poor distribution of anesthetic agents
b	Immature liver and kidney function
c	Less functional reserve
d	Increased risk of airway obstruction

d

Which of the following conditions is UNLIKELY to cause an elevated heart rate in an anesthetized patient?

Question options:

a	Hypoxia or poor oxygenation
b	Severe hypovolemia or blood loss
c	Normal fluid balance (euvolemia)
d	Pain or response to surgical stimulus

c

Which of the following conditions is a primary cause of intraoperative bradycardia?

Question options:

a	Hypertension
b	Hypothermia
c	Midazolam administration
d	Light anesthetic plane

b

Which intervention listed below would be ineffective or inappropriate for resolving hypotension in an anesthetized patient?

Question options:

a	Administer an IV fluid bolus
b	Decrease the inhalant vaporizer setting
c	Initiate vasopressor or inotropic therapy
d	Switch to a larger blood pressure cuff

d

Which of the following is an appropriate intervention for an anesthetized patient experiencing hypoventilation?

Question options:

a	Increase the inhalant vaporizer setting
b	Manually ventilate the patient
c	Decrease the oxygen flow rate
d	Troubleshoot the SpO2 monitor

b

All of the following are recommended steps to treat intraoperative hypoxemia EXCEPT:

Question options:

a	Begin manually ventilating the patient
b	Increase the oxygen flow rate
c	Immediately re-intubate the patient
d	Verify and check the primary oxygen supply source

c

Which of the following is UNLIKELY to cause a drop in body temperature during general anesthesia?

Question options:

a	Surgical site preparation using alcohol solutions
b	Shivering or active muscle contractions during light anesthesia
c	Small patient size relative to body surface area
d	Prolonged procedure with an open abdominal cavity

b

Which of the following is typically the earliest clinical indicator of cardiopulmonary arrest in an anesthetized patient?

Question options:

a	Sudden drop in SpO2
b	Lack of ECG tracing
c	Sudden drop in ETCO2
d	Sudden drop in BP

c

Which of the common cardiopulmonary arrest rhythms is typically the most difficult or challenging to treat?

Question options:

a	Ventricular fibrillation (V-fib)
b	Pulseless electrical activity (PEA)
c	Ventricular tachycardia (V-tach)
d	Pulseless ventricular tachycardia (VT)

d

Identify three examples of human error that can contribute to an anesthetic emergency. 

Drug calculations and errors,  failure to obtain adequate  history, inadequate training

List 3 causes related to equipment that may lead to anesthetic emergencies. 

Endotracheal tube blockage, failure of oxygen supply (flowmeter, oxygen tank),  carbon dioxide  absorbent exhaustion  (rebreathing system)

Identify two complications or issues that may occur during the anesthetic recovery period.

Vomiting , postanesthetic excitement (or seizures)

the period of time between discontinuing the anesthetic and the animal is able to stand and walk without assistance

process by which an animal loses consciousness and enters surgical anesthesia

anesthetic agents and adjuncts prescribed for a patient

a flexible tube placed inside the trachea

cone-shaped device used to administer oxygen and anesthetic gasses in non-intubated patients

process of keeping a patient in a state of general anesthesia

anesthetic recovery	the period of time between discontinuing the anesthetic and the animal is able to stand and walk without assistance
anesthetic induction	process by which an animal loses consciousness and enters surgical anesthesia
anesthetic protocol	anesthetic agents and adjuncts prescribed for a patient
Endotracheal tube	a flexible tube placed inside the trachea
anesthetic mask	cone-shaped device used to administer oxygen and anesthetic gasses in non-intubated patients
anesthetic maintenance	process of keeping a patient in a state of general anesthesia

Anesthetic protocols should be tailored to individual patients rather than standardized across all cases.

T OR F

true

Intravenous (IV) or intramuscular (IM) administration of injectable agents is the most frequent method of anesthetic induction.

T OR F

true

Which of the following is an inaccurate statement regarding the use of mask induction?

Question options:

a	Exposure of clinical personnel to waste anesthetic gas (WAG) is increased
b	Many patients struggle or experience stress during mask induction
c	Lower oxygen rates are required for mask induction than for maintenance
d	Patients with pre-existing respiratory compromise are poor candidates for mask induction

c

Which of the following is an accurate statement concerning chamber induction in veterinary patients?

Question options:

a	Exposure of personnel to WAG is increased
b	They are primarily used for small, calm, easy to handle patients
c	It's possible to accurately assess most monitoring parameters while the patient is in the chamber
d	Most chambers are small, opaque boxes that resemble an aquarium

a

produces unconsciousness within 10-20 minutes; animal has smooth, gradual CNS depression with little excitement

produces unconsciousness within seconds to minutes; animal passes through excitement phase quickly

produces unconsciousness within 5-10 minutes; animal passes through excitement phase more slowly

IM induction	produces unconsciousness within 10-20 minutes; animal has smooth, gradual CNS depression with little excitement
IV induction	produces unconsciousness within seconds to minutes; animal passes through excitement phase quickly
mask/chamber induction	produces unconsciousness within 5-10 minutes; animal passes through excitement phase more slowly

	soft palate
	arytenoid cartilage
	epiglottis

• A - soft palate

• B - epiglottis

• C - arytenoid cartilage

Laryngospasm is a primary intubation complication commonly encountered in dogs.

T or F

false

Which technique or intervention is most effective in preventing laryngospasm during intubation?

Question options:

a	Administer injectable induction agents rapidly
b	Administer injectable induction agents slowly
c	Administer lidocaine topically on the glottis
d	Administer lidocaine intravenously

c

Which anatomical landmarks are used to measure the proper length of an endotracheal (ET) tube prior to intubation?

Question options:

a	From the canine tooth to the point of the shoulder
b	Tip of the nose to the thoracic inlet
c	Tip of the nose to the mandible
d	From the canine tooth to the jugular furrow

b

To prevent airway trauma, a stylet used for intubation should protrude past the end of the endotracheal tube.

T OR F

False

Which complication can result from over-inflating an endotracheal (ET) tube cuff during intubation?

Question options:

a	Air leakage from the cuff
b	Cuff rotation within the trachea
c	Immediate dyspnea
d	Pressure necrosis

d

Which of the following observations confirms that a patient is ready for endotracheal tube placement?

Question options:

a	Muscle relaxation and patient cough
b	Patient sigh and eyes rotate ventromedial
c	Patient sigh and muscle stiffness
d	Muscle relaxation and eyes rotate centrally

b

At what point during anesthetic recovery is it appropriate and safe to remove the endotracheal tube in a canine or feline patient?

Question options:

a	The patient sits up indicating its neurologically stable for extubation
b	Respiratory rate is greater than 30 breaths per minute indicating the patient's respiratory system is stable for extubation
c	Once the patient is swallowing indicating swallow and gag reflex have returned
d	Immediately after inhalant is turned off and monitoring is disconnected

c

In which of the following clinical scenarios should the endotracheal tube cuff be fully deflated prior to extubation?

Question options:

a	Persian recovering from a neuter
b	Golden retriever recovering from a mass removal
c	Beagle recovering from a dental prophylaxis
d	Pug recovering from a spay

b

The recovery phase poses the highest risk of mortality for patients undergoing anesthesia.

T or F

true

Which of the following clinical benchmarks defines the completion of the anesthetic recovery phase?

Question options:

a	Immediately following the discontinuation of gas or injectable anesthetic agents
b	When the surgical procedure is completed and the anesthetic vaporizer is turned off
c	When the patient is conscious, has intact protective reflexes, and can maintain sternal recumbency without assistance
d	As soon as the swallowing reflex returns and the patient is extubated

c

What is the primary clinical rationale for continuing oxygen administration after turning off the volatile anesthetic vaporizer?

Question options:

a	To prevent carbon dioxide granules from absorbing residual moisture
b	To allow the oxygen flowmeter to return to baseline settings
c	To equalize internal temperature and pressure within the vaporizer
d	To wash out inhalant anesthetic from the circuit and assist patient oxygenation

d

Which physiological factor or patient condition is most likely to delay anesthetic recovery?

Question options:

a	Tachycardia
b	Hypertension
c	Hypothermia
d	Hypoesthesia

c

 Identify two key clinical or patient-related factors considered when designing an anesthetic protocol.

• Familiarity and availability of anesthetic agents

• Type of procedure to be performed

• History and physical exam (especially previous anesthetic episodes)

• Results of diagnostic tests

• Breed variations

• Patient disposition

State three clinical advantages of endotracheal (ET) intubation in an anesthetized patient.

It helps maintain a open airway. The inflated cuff helps prevent aspiration of vomitus, blood or saliva. It reduces anatomic dead space.

List three techniques or visual cues that verify an endotracheal tube has been correctly positioned within the trachea.

Watching for fogging of the tube. Visualizing and thinking about  the larynx and confirm if the tube is in the correct location. Feel for air movement from the tube connecter as patient exhales also watching reservoir bag as animal breathes.