Zuku VTNE Pain Mgt/Analgesia

Which of the following patients is most likely to be suffering from neuropathic pain?

Cat with abscess

Canine or equine castration

Ovariohysterectomy in a cat

Neonate dewclaw removal

Dachshund with intervertebral disc disease

Dachshund with intervertebral disc disease

Which of the following electrical devices for pain control functions effectively over a bandage?

Transcutaneous electrical nerve stimulation (TENS)

Pulsed electromagnetic field therapy (PEMF)

Photobiomodulation

Extracorporeal shockwave therapy

Neuromuscular electrical stimulation (NEMS)

Pulsed electromagnetic field therapy (PEMF)

In which of these procedures would the patient benefit from a sacrococcygeal block?

Tube cystotomy in a goat

Pelvic limb amputation for osteosarcoma in a dog

Perineal urethrostomy surgery in a cat

Dehorning a calf

Displaced abomasum surgery in a cow

Perineal urethrostomy surgery in a cat

A veterinarian plans to administer an injection of hyaluronic acid and triamcinolone to a horse. What condition is this mosy likely treating, and how is the injection administered?

Equine prorozoal myelitis; intrathecally (into the subarachoid space)

Guttural pouch empyema; into the guttural pouch

Osteoarthritis; intraarticularly (into a joint)

Equine viral ateritis; intracenously

Arytenoid chrondropathy; topically onto the laryngeal tissues

Osteoarthritis; intraarticularly (into a joint)

Which drug reverses the effects of dexmedetomidine (Dexdomitor)?

Epinephrine

Naloxone

Atipamezole

Atropine

Ketamine

Atipamezole

A dog recovering from surgery seems restless and wakes frequently throughout the night. Which surgical consequence does this behavior most directly illustrate?

A side effect of opioid administration that causes hyperactivity and prevents the animal from settling into restful sleep

Altered sleep patterns caused by pain, which can worsen emotional well-being

Hunger secondary to the metabolic demands of surgical recovery

Separation anxiety triggered by the unfamiliar hospital environment

Normal postoperative restlessness that will resolve without intervention once the effects of anesthesia fully wear off

Altered sleep patterns caused by pain, which can worsen emotional well-being

Why do patients experiencing wind-up require more than standard analgesic therapy, such as NSAIDs alone?

Patients with wind-up have higher metabolism, so they break down most analgesics too quickly for them to reach therapeutic levels

Wind-up alters nervous system pain processing so conventional medications no longer work effectively on their own

NSAIDs are toxic to patients with chronic pain and must always be avoided in these cases

Wind-up increases blood pressure, which prevents conventional analgesics from reaching the target receptors

NSAIDs only treat inflammation, and wind-up is not an inflammatory process

Wind-up alters nervous system pain processing so conventional medications no longer work effectively on their own

How can passive range of motion (PROM) maintain joint health?

Joint movement circulates synovial fluid, bathing chondrocytes in nutrient-dense fluid

Amplifies nerve firing in the muscles around the joint to promote sodium and calcium fluxes within synovial fluid

Stretching tendons and then allowing for recoil elicits tension on the joints

Increases chondrocyte sensitivity to insulin, which increases cellular glucose uptake and utilization

Joint movement circulates synovial fluid, bathing chondrocytes in nutrient-dense fluid

A canine patient who had spinal surgery eight weeks ago is still resistant to go for short walks and remains moderately ataxic in the pelvic limbs. The veterinarian recommends rehabilitation therapy with an underwater treadmill. Why is the underwater treadmill especially valuable for patients with neurologic deficits?

It eliminates all weight-bearing, which prevents further injury to the nervous system

Many patients can take steps in water before they can perform voluntary motion on land

It strengthens the thoracic limbs first, which then supports recovery of the pelvic limbs over time

Warm water stimulates nerve regeneration directly at the site of injury

Neurologic patients require the structured resistance of a treadmill belt to retrain normal gait patterns

Many patients can take steps in water before they can perform voluntary motion on land

A-fibers and C-fibers are both involved in pain transmission. How do these fiber types differ?

A-fibers and C-fibers both transmit the same type of pain, but A-fibers are much slower than C-fibers

A-fibers activate with trauma to muscle and adipose tissue; C-fibers are responsible for pain transmission in bone and nerve tissue

A-fibers transmit sharp, immediate pain with acute injury; C-fibers transmit dull, persistent sensations with chronic pain

A-fibers are the primary pain transmission fibers in dogs, cats, and camelids; C-fibers are the primary pain transmission fibers in horses, cows, and sheep

A-fibers transmit chronic pain, hallmarked by throbbing; C-fibers transmit acute pain, characterized by burning sensations

A-fibers transmit sharp, immediate pain with acute injury; C-fibers transmit dull, persistent sensations with chronic pain

A cow with dystocia is to receive an epidural to assist in a vaginal delivery. What is a drawback to using an epidural in this case?

The dam cannot assist in delivery

If the team is not ready, the calf could exit the birth canal too quickly

Epidurals slow gastrointestinal motility and increase risk of bloat

The morphine in the epidural produces euphoria, making the cow's behavior less predictable

The dam will still feel pain and require systemic opioids

The dam cannot assist in delivery

Which drug is preferred for treating neuropathic pain?

Tramadol

Gabapentin

Robenacoxib

Prednisolone

Codeine

Gabapentin

Which of the following is not a method of stimulating an acupuncture point?

Aqua-acupuncture

Electroacupuncture

Moxibustion

Pneumoacupuncture

Effleurage

Effleurage

How do alpha-2 agonists produce analgesia and sedation?

Stimulate serotonin release, therefore reducing pain perception

Inhibit release of norepinephrine, an excitatory neurotransmitter

Prevent prostaglandin synthesis at the site of tissue injury

Block sodium channels in peripheral nerve fibers, stopping pain signals from reaching the brain

Bind GABA receptors and block pain transmission in the spinal cord

Inhibit release of norepinephrine, an excitatory neurotransmitter

Which of the following are nociceptors?

Prostaglandin and thromboxane

Acetylcholine and GABA

Histamine and serotonin

Alpha and beta receptors

A- and C-fibers

A- and C-fibers

Why should noxious procedures be performed outside of the patient's cage whenever possible?

Reduces the animal's association between the cage and unpleasant experiences

OSHA policy requires all procedures to take place at a treatment table regardless of the patient's condition

It keeps the cage clean and reduces the risk of contamination from procedural materials

It allows other team members to observe the patient and provide assistance if complications arise during handling

Performing procedures outside the cage gives the technician more room to work and reduces the chance of accidental injury to staff

Reduces the animal's association between the cage and unpleasant experiences

Acupuncture is typically safe and helpful for controlling pain. However, into which of the following tissues should we avoid inserting acupuncture needles?

Limb muscles of a dog recovering from a hemilaminectomy

Atrophied epaxial muscles of a cat with lumbosacral stenosis

Areas of the body with high concentrations of lymphatic tissue

The shoulder tissue of a horse with osteoarthritis

Scar tissue over a surgical site

Scar tissue over a surgical site

A dog receives dexmedetomidine alongside an opioid before surgery. What analgesic advantage does this combination offer compared to using either drug alone?

Alpha-2 agonists block opioid receptor downregulation, preventing tolerance from developing during prolonged opioid therapy in hospitalized patients

Opioids cancel out the cardiovascular side effects of dexmedetomidine, making the combination safer with no change in analgesic effect

Alpha-2 agonists work synergistically with opioids, increasing duration of pain relief and allowing lower doses of analgesics

Dexmedetomidine converts the opioid into a longer-acting compound through hepatic metabolism

The combination eliminates the need for any additional analgesic agents during or after the procedure

Alpha-2 agonists work synergistically with opioids, increasing duration of pain relief and allowing lower doses of analgesics

Which of the following is a pure mu-opioid receptor agonist?

Naloxone

Nalbuphine

Butorphanol

Buprenorphine

Oxymorphone

Oxymorphone

Which of the following opioids do veterinary professionals use for epidurals and intraarticular blocks?

Methadone

Butorphanol

Buprenorphine

Morphine

Oxymorphone

Morphine

How quickly do small animal patients typically respond after administering atipamezole to reverse dexmedetomidine?

Awaken in five to 10 minutes and can stand within 20 minutes

Awake and standing within two to five minutes, regardless of size, temperature, or organ function

Start to paddle within 20 minutes and are ambulatory within 30 minutes

Atipamezole does not reverse dexmedetomidine in small animal patients

Recover within one to two hours but this depends on body weight

Awaken in five to 10 minutes and can stand within 20 minutes

What drug does the "M" of an "MLK" infusion refer to (L = lidocaine, K = ketamine), and why does combining these three drugs provide better pain control than using any one of them alone?

Medetomidine; this combination works by saturating all available pain receptors simultaneously

Morphine; combining an opioid, a local anesthetic, and an NMDA antagonist inhibits pain at multiple sites

Methadone; ketamine makes methadone and lidocaine more bioavailable so lower doses may be used

Morphine; each drug targets a different type of receptor in the peripheral nervous system, but none in the central nervous system so the animal remains alert

Medetomidine; alpha-2 agonists, local anesthetics, and NMDA antagonists are all metabolized very slowly so have long duration of action

Morphine; combining an opioid, a local anesthetic, and an NMDA antagonist inhibits pain at multiple sites

What type of pain receptors drive up wind-up phenomenon?

Mu

GABA

Alpha-2

NMDA

G protein-coupled

NMDA

Which class of drugs ends with the suffix '-caine' in the name?

Diuretics

Narcotics

Nonsteroidal anti-inflammatories

Glucocorticoids

Local anesthetics

Local anesthetics

Which choice provides a visual and descriptive method for the evaluation of acute pain in dogs and cats?

World Small Animal Veterinary Association (WSAVA)

Colorado State University Pain Scale

Visual Analog Scale (VAS)

Health-Related Quality of Life Scale (HRQLS)

Pre-emptive Scoring System (PESS)

Colorado State University Pain Scale

Which allows a possibly painful stimulus to be transmitted to the brain?

Stimulates chemical and mechanical receptors

Exceeds nociceptor's threshold

Consciousness - i.e., wakefulness

Causes secondary inflammation

Animal has reached maturity

Exceeds nociceptor's threshold

A dog presents with a lick granuloma and receives treatment with gabapentin to address neuropathic pain.

What is the most common side effect that clients may see in pets treated with gabapentin?

Excessive salivation

Rear leg weakness

Sleepiness

Increased thirst

Miotic pupils

Sleepiness

Which analgesic drug combination is contraindicated for concurrent use in dogs and cats?

Midazolam and dexmedetomidine

Meloxicam and dexamethasone

Acepromazine and butorphanol

Fentanyl patch and firocoxib

Gabapentin and hydromorphone

Meloxicam and dexamethasone

Which of the following is the most commonly used nonsteroidal anti-inflammatory drug (NSAID) for musculoskeletal pain in horses?

Firocoxib

Meloxicam

Phenlybutazone

Butorphanol

Fentanyl

Phenlybutazone

Avoid which simultaneous analgesic drug combination in dogs and cats?

Acepromazine and butorphanol

Fentanyl patch and firocoxib

Carprofen and hydromorphone

Amantadine and robenacoxib

Meloxicam and dexamethasone

Meloxicam and dexamethasone

Which of the following patients is most likely to be suffering from neuropathic pain?

Canine or feline castration

Cat with abscess

Horse with chronic laminitis

Ovariohysterectomy in a cat

Acute laceration on the flank of a cow

Horse with chronic laminitis

What is the best place for fentanyl patch application on a horse?

Lateral neck

Under the jaw

Base of tail

Distal hindlimb

Left flank

Lateral neck

Which choice best describes multimodal analgesia?

Combining gas anesthesia with heat during recovery

Effect of one drug cancelling out another and causing more pain

Using two or more classes of drugs to address pain perception

Role of distraction on the feeling of pain and distress

Only administering drugs after the pain response has been documented

Using two or more classes of drugs to address pain perception

Nociception is correctly defined by which of the following choices?

How cancer cells spread through the body

Ability to hear in stereo

Method by which ruminants digest their food

Transduction of a reflex arc

Physiologic process that results in perception of pain

Physiologic process that results in perception of pain

Which of the following best describes the behavior of a horse free from pain?

Head facing corner of the stall, back arched, standing squarely on all four limbs

Holds head at the level of the withers, swishing tail

Stands with one hind leg cocked, moves to stall door when opened

Not careful in movements around people, shifting weight between limbs

Muscle tremors after palpation, pins ears when approached

Stands with one hind leg cocked, moves to stall door when opened

Which species is most prone to hyperthermia after administration of hydromorphone?

Cattle

Horses

Sheep

Cats

Dogs

Cats

The vet has diagnosed a lame 15-year-old Quarterhorse gelding with hock arthritis.

Which pain medication may the vet recommend to allow comfort, even during a low level of work (e.g., light trail rides) for this horse with chronic pain?

Phenylbutazone

Gabapentin

Buprenorphine

Robenacoxib

Acepromazine

Phenylbutazone

Which analgesic medication can be used either for a local nerve block or as a constant rate infusion (CRI)?

Bupivacaine

Carprofen

Buprenorphine

Lidocaine

Ketamine

Lidocaine

Methadone is an opioid pain medication available for use in dogs, cats, and horses.

What is the anticipated duration of analgesia in cats?

20-40 minutes

12-18 hours

36 hours

2-8 hours

24 hours

2-8 hours

How long do the analgesic effects of butorphanol typically last?

Butorphanol has no analgesic effects

45 minutes

8 hours

Up to 3 days

2 hours

45 minutes

What drug reverses the effects of dexmedetomidine (Dexdomitor®)?

Epinephrine

Naloxone

Ketamine

Atropine

Atipamezole

Atipamezole

Which veterinary species is particularly sensitive to possible overdosing with lidocaine when performing local anesthesia?

Goats

Ferrets

Horses

Rabbits

Cattle

Goats

The surgeon is beginning to close the incision after completing a cranial cruciate ligament repair in a dog. They ask you to get a dose of Nocita® prepared. What is Nocita®?

A medication that can only be administered via epidural

A sterile suspension of liposomes containing bupivacaine

An old formulation of lidocaine no longer in use

A type of IV fluid

An injectable opioid labeled for patients having a cranial cruciate ligament repair surgery

A sterile suspension of liposomes containing bupivacaine

Which of the following is a type of complementary therapy that may also provide analgesia?

Acupuncture

COX-1 sparing nonsteroidal anti-inflammatories

Gabapentin

Nutraceuticals

Good nursing care

Acupuncture

An adult, healthy dog undergoes a simple, elective orthopedic procedure, such as tibial plateau leveling osteotomy (TPLO). How long do we expect the dog to require analgesia following surgery?

Three to 4 days

There are no standards for this

One week

Until hospital discharge

A month

One week

The vet says she wants to do an abaxial sesamoid nerve block on a horse's forelimb. Where might you expect her to inject the lidocaine?

Medial and lateral aspects of limb 1 cm proximal to the coronary band

In a ring at the level of the fetlock

In a ring at the level of the pastern

Cranial and caudal aspects of the limb just distal to the fetlock

Medial and lateral aspects of limb at the palmar fetlock

Medial and lateral aspects of limb at the palmar fetlock

How long can local anesthesia with bupivacaine last?

2-3 hours

1-2 hours

6-8 hours

3-4 hours

Less than 1 hour

6-8 hours

How much time is needed for topical anesthetics to be effective?

Less than 5 minutes

20-30 minutes

Topical anesthetics are not effective in haired animals

50 to 60 minutes

10 to 15 minutes

20-30 minutes

The doctor asks you to prepare a dose of Simbadol™ for a cat. What type of medication is this?

Anti-inflammatory

Diuretic

Emetic

Analgesic

Antibiotic

Analgesic

Which of the following correctly describes the phenomenon of allodynia?

Stimuli that are not normally painful produce a pain response

Lack of reaction to a typically painful stimulus

Painful reaction occurs when other members of species are stimulated

Decreased reaction to stimuli that usually cause pain

A heightened sense of pain to normally painful stimuli

Stimuli that are not normally painful produce a pain response

How can we mitigate the "sting" associated with injection in awake patients when using local blocking agents (e.g., lidocaine, bupivicaine)?

Combine with diluted epinephrine

Mix with equal volume sterile saline

Use lidocaine and bupivacaine together

Add sodium bicarbonate

Ensure needle is placed directly over nerve

Add sodium bicarbonate

Wind-up phenomenon refers to which of the following?

Unresponsive estrus

Heightened pain response

Drug reversal using an antagonist

Chronic vomiting

Reverse sneezing

Heightened pain response

Which is an example of preemptive analgesia?

Giving an opioid to a dog that has been bitten by a venomous snake

Giving an NSAID to a dog with a severe chronic ear infection

Dosing a sedative after surgery so the patient is less likely to move and evoke pain

Administering an epidural to a cat with a fractured femur

Performing a dental nerve block prior to tooth extraction

Performing a dental nerve block prior to tooth extraction

The vet is treating a horse for pain and possible ileus with flunixin meglumine and a continuous infusion of lidocaine following surgical correction of a small intestinal volvulus.

After about an hour, the horse at first seems sleepy, then begins twitching, shaking, and becomes ataxic.

Which of the following is the most likely explanation of this scenario?

Hypocalcemia is common with colic; tremors are seen when calcium is low

Anaphylaxis to the flunixin or another medication is developing

A severe systemic inflammatory response is underway

Inadequate pain management

These are signs of lidocaine toxicity

These are signs of lidocaine toxicity

Dexmedetomidine belongs to which class of analgesics?

NMDA-receptor agonist

Alpha-2 agonist

Opioid

Nonsteroidal antiinflammatory

Local

Alpha-2 agonist

Which veterinary species is particularly sensitive to possible overdosing with lidocaine when performing local anesthesia?

Pigs

Goats

Rabbits

Dogs

Horses

Goats

Which one of the following narcotic drugs can be absorbed transmucosally in cats?

Oxymorphone

Hydromorphone

Butorphanol

Buprenorphine

Fentanyl

Buprenorphine

Where along the pain pathway do N-methyl-D-aspartate (NMDA) antagonists exert their effects?

Spinal cord

Site of injury

Brain

Inflammatory pathway

Peripheral nerves

Spinal cord

Which of the following most correctly describes physiologic pain?

Occurs when homeostasis is disturbed, as when disease is present

Originates from damage to peripheral nerves or the central nervous system

A protective response to an actual or potentially damaging insult

Results from a long-lasting trauma and tissue damage

Developing from the spinal roots

A protective response to an actual or potentially damaging insult

Which of the following is the correct explanation of pre-emptive analgesia?

Combination of different types of analgesic medications and procedures to treat pain

Use of higher doses of pain medication given previously to a patient to achieve adequate analgesia

Administration of pain medication prior to tissue damage or surgical insult

Anticipating pain when performing procedures, but waiting until signs of pain are seen to treat

Use of an antagonist to reverse dangerous side effects of an analgesic medication

Administration of pain medication prior to tissue damage or surgical insult

Which of the following patients would benefit the most from the use of pre-emptive analgesia?

German shepherd with osteosarcoma of the humerus

Cat for an amputation following hit by car

Beagle with a fractured dew claw

Dog presented for ovariohysterectomy

Horse with chronic laminitis

Dog presented for ovariohysterectomy

What nerve block(s) are necessary for a cat with resorptive lesions undergoing general anesthesia to extract multiple maxillary and mandibular teeth?

Trigeminal

Infraorbital and mandibular

Anesthetize each affected tooth root separately

Incisive and mental

Nerve blocks are unnecessary under anesthesia

Infraorbital and mandibular

Which of the following is a possible sign of pain in dogs?

Curiosity about surroundings

Snoring while sleeping

Guarding the affected body part

Normal gait in order to hide injury

Upright head carriage

Guarding the affected body part

Which one of the following opioids can be associated with hyperthermia in cats?

Butorphanol

Naloxone

Buprenorphine

Methadone

Hydromorphone

Hydromorphone

Which stress hormone, released when an animal is in pain, may result in reduced wound healing?

Vasopressin

Glucagon

Insulin

Erythropoietin

Cortisol

Cortisol

The surgeon performed a surgical repair of a patent ductus arteriosus via thoracotomy in a four-month-old Labrador puppy.

In recovery, you find the puppy crying and whining in his cage. His breaths are short and fast. He tries to get away, cowers in the corner, and cries louder when you try to comfort him.

Which of the following is the best explanation of this scenario?

This puppy is painful, pain management is inadequate

Opioid overdose

Recovery is prolonged, stage II signs are still occurring

Labradors often do this in recovery, they have low pain tolerance

The patient has cerebral hypoxia, likely due to sustained hypotension

This puppy is painful, pain management is inadequate

Which of the following is a medication most commonly used specifically as an anti-spasmodic to relieve colic (i.e., abdominal pain) in horses?

Mineral oil

Lidocaine

Furosemide

Buprenorphine

N-butylscopolammonium bromide

N-butylscopolammonium bromide

A horse is presented for routine lameness examination. Which choice correctly describes how the vet will determine the grade of lameness (American Association of Equine Practitioners grade 0-5)?

Take radiographs or ultrasound the affected region

Dynamic and static flexions of upper and lower limbs, all four legs

Walk and trot on hard and soft ground, in hand and on lunge

Thorough history and physical examination

Utilize diagnostic nerve blocks (regional anesthesia)

Walk and trot on hard and soft ground, in hand and on lunge

Which of the following patients is most likely to develop central sensitization of the pain response?

Dog hit by car with fractures and no analgesia for 1 week

Feline castration with intratesticular lidocaine anesthesia

Acute superficial corneal ulceration in a horse

Flank laceration in a horse

Dewclaw removal in a puppy receiving a local anesthetic block

Dog hit by car with fractures and no analgesia for 1 week

Which term correctly identifies pain that exists in the absence of disease?

Prickling

Acute

Unmyelinated

Selective

Maladaptive

Maladaptive

Which of the following statements regarding visceral pain is correct?

Acute pain is visceral, chronic pain is somatic

Gastric dilation/volvulus causes visceral pain

A femoral fracture causes visceral pain

Visceral pain is easier to identify than somatic pain

Visceral and somatic pain are transmitted by the same pathways

Gastric dilation/volvulus causes visceral pain

Which of the following correctly describes the function of the nociceptors?

Transduce painful stimuli into electrical signals for transmission to the spinal cord and brain

Perceive innocuous stimuli in the cerebral cortex and coordinate the emotional and physical response

Modulate nerve impulses arriving from the periphery into the spinal cord

Transmit painful stimuli via A-beta fibers to first order neurons in the spinal cord

These receptors are located in the periphery and respond only to thermal stimuli

Transduce painful stimuli into electrical signals for transmission to the spinal cord and brain

Which of the following correctly describes the phenomenon of hyperalgesia?

Absence of response to a typically painful stimuli

Stimuli that are not normally painful produce a pain response

Protective response to an actual or potentially damaging insult

Exaggerated reaction to a normally painful stimulus

Increased analgesic effect seen when treating a patient in pain

Exaggerated reaction to a normally painful stimulus

The vet castrates a healthy, one-year-old cat under anesthesia with dexmedetomidine, butorphanol, ketamine, and an intratesticular block with lidocaine. You give a dose of meloxicam and buprenorphine for post-operative analgesia and place the cat in recovery after 45 minutes.

One hour following surgery, you note that the cat is lying quietly in sternal recumbency in his cage. He rouses a bit when stimulated, but remains quiet if left alone.

His heart rate is 160 (N=180-220), mucous membranes are pink, capillary refill time is 1-2 seconds.

Which of the following is the best interpretation of this scenario?

Hypothermia may be prolonging recovery

Internal bleeding must be present, causing somnolence

Everything is fine, this cat is comfortable, good pain management

Hypotension has slowed elimination of the anesthetic drugs

The cat is not yet completely awake, so an accurate assessment is not possible

Everything is fine, this cat is comfortable, good pain management

A cat undergoes an exploratory laparotomy for a linear foreign body. At surgery, the vet removes a 10-inch long boot lace from the small intestine via three different enterotomies.

In recovery, she is hunched up in the back of the cage. She is not asleep, but she is very quiet, and does not respond or hiss during interaction with the recovery technician.

Which of the following is the best explanation of this scenario?

Hypothermia after anesthesia is common and is likely prolonging recovery

The cat probably is not quite awake yet

This is a normal post-operative recovery

This cat is painful, pain control is inadequate

Blood loss during the surgery may have resulted in obtundation

This cat is painful, pain control is inadequate

How long is an average, healthy dog or cat expected to require analgesia after a simple, elective soft tissue procedure, such as an ovariohysterectomy?

One week

Three to four days

Less than 24 hours

Two weeks

Ten days

Three to four days

What is the safest, most commonly used oral dose of meloxicam for acute or chronic pain in cats?

1 mg/kg every 12 hours

0.5 ml/cat every 24 hours for three doses

3 mg/kg loading dose

0.3 mg/kg twice daily for five days

0.1 mg/kg once

0.1 mg/kg once

Which of the following patients is most likely to develop central sensitization of the pain response?

Flank laceration in a horse

Feline castration

Dewclaw removal in a puppy

Tear duct flushing in a brachycephalic dog

Dog with fractures following hit by car

Dog with fractures following hit by car

What are signs of local anesthetic toxicity?

Seizures, coma, vomiting, and cardiovascular collapse

Polyuria and polydipsia

Risk of developing osteosarcoma near where the local anesthetic was instilled

Hives and itching

Seizures, coma, vomiting, and cardiovascular collapse

Which of the following opioids is more potent than morphine, given most often via continuous rate intravenous infusion, or can be administered via transdermal patch?

Fentanyl

Buprenorphine

Oxymorphone

Tramadol

Naloxone

Fentanyl

Which opioid choice provides good long-duration analgesia for mild to moderate pain in cats and can be given IM, IV, SQ, and transmucosally?

Butorphanol

Naloxone

Morphine

Buprenorphine

Oxymorphone

Buprenorphine

When is preemptive analgesia administered?

In advance of leaving the hospital

After the surgeon creates the initial incision

Before tissue damage or surgical insult

During recovery from anesthesia

After anesthetic recovery

Before tissue damage or surgical insult

What is the best approach to manage pain for a cat who will undergo ovariohysterectomy?

Utilize a preemptive, multimodal, and follow-up analgesia plan

Give no analgesics because cats evolved to manage their own pain through behavior modification

Give only non-opioid medications to reduce the risk of side effects

Reduce negative consequences of pain meds by only giving analgesics if the cat indicates she is in pain

Administer a large IV dose of buprenorphine as part of the premedication since it lasts for five days

Utilize a preemptive, multimodal, and follow-up analgesia plan

Which of the following parameters may be used to distinguish pain from dysphoria in a postoperative patient?

Inconsolable vocalization

Increased body temperature

Elevated heart rate

Decreased SpO2

Raised third eyelids

Elevated heart rate