Anesthesia Review

Which of the following organ systems is not routinely monitored?

renal

What is the minimal accepted heart rate for an anesthetized dog?

60 bpm

What is the minimal accepted respiratory rate for anesthetized animals?

8 bpm

Which of the following is not recommended to supply heat to anesthetized patients?

electric heating pad

Which of the following is the most accurate method of measuring blood pressure?

direct blood pressure measurement

A reading of 90% on a pulse oximeter corresponds to which reading of?

60 Pao2

What is the accepted value for capnography on an anesthetized patient?

35-40 mmHg

A capnography reading of 52 mmHg would indicate which of the following?

hypoventilation

Which of the following reflexes would not be present at a medium anesthetic depth?

swallowing

The maximum one can tilt the surgical table is?

15 degrees

Perhaps the most clinically important side effects of NSAIDs is:

GI ulceration and bleeding

One should not delay extubating a cat because it can cause?

laryngospasm

It is advisable to turn the recovering patient how often to prevent blood pooling?

every 10-15 minutes

What is the percentage of blood loss that a healthy animal may tolerate?

15%

Concerning the use of corticosteroids in the treatment of pain, which statement is the most accurate?

corticosteroids should not be used with NSAIDs due to the increased risk of GI ulceration

significant impairment of wound healing and masking of the underlying disease can occur with prolonged high doses of corticosteroids

Which of the following statements is false about the effects of barbiturates?

it causes respiratory depression, but no apnea

You have just given a bolus of methohexital, how long should you wait before giving more?

30 seconds

Which of the following is not an ultrashort barbiturate?

pentobarbital

Which of the following statements about propofol is false?

repeated doses are cumulative

The barbiturates are categorized based on their duration of action. Which of the following is false?

ultrashort: 2-5 minutes

You are giving a bolus of a barbiturate intravaneously and the needle slips out of the vein. You are pretty sure some of the barbiturate has been injected outside of the vein. Which of the following should you do?

infiltrate area with isotonic saline

apply a pressure wrap over the injected area

inject 2% lidocaine in the area

apply an ice pack to reduce swelling

Which of the following statements is false about ketamine?

recovery is very quick

Which of the following dogs should not receive barbiturates?

whippets

Which of the following statements is false about guaifenesin?

causes respiratory depression

In looking at solubility of the drug, as expressed as partition coefficient, which of the following drugs would allow the fastest induction? A (13), B (1.41), C (0.47), D (2.4)

C (0.47)

You are trying to mask down a very excitable cat. Compared to a normal cat, you would expect this cat to induce in what manner?

slower than normal

Which of the following drugs would be the most potent (MAC)? A (2.3), B (0.87), C (0.23), D (1.28)

C: MAC = 0.23

How do you prevent diffusion hypoxia after shutting off the N20 when using it in general anesthesia?

increase the O2 flow rate for at least 5 minutes

You are unsure whether a ferret, who has received an adrenalectomy, is experiencing a significant amount of pain. What is the best way to determine whether this patient needs analgesics?

rule of thumb: if a procedure would be painful for you to endure, it is likely that it’s painful for the animal

You are running a total of 3 L of gas per minute. Which of the following is the most appropriate ratio of nitrous oxide and oxygen to obtain a second gas effect?

2 L nitrous oxide to 1 L oxygen

The recommended levels of anesthetic waste gas should not exceed?

2 ppm

T/F: if the odor of an anesthetic gas is present, the room air is not safe and the gas concentration could be above the maximal recommended dose.

true

In general, an anesthetic machine leak test should be performed at least:

daily

How can anesthetic waste gas levels be monitored in the hospital?

dosimetry badges

gas-detector tubes

with professional monitoring services

The analgesic effects of NDAIDs is due to:

inhibition of cyclooxygenase

Local anesthetics work by which mechanism?

they block depolarization

Which of the following techniques would require the most anesthetic drug?

line block

How many ml’s of local anesthetic would you need for an epidural on a mature cow?

6 ml

All of the following are risks that can occur with manual ventilation except?

brain edema may occur

A well-stocked emergency crash cart includes:

airway, drug, and catheter drawers

blood pressure monitoring equipment

electrocardiography (ECG) equipment

oxygen-delivery equipment

What is recorded in a cardiopulmonary resuscitation (CPR) log?

the cause and time of cardiac/pulmonary arrest, drugs given, and other details regarding CPR performed for each patient arrested

For maximal preparedness, a checklist of all emergency cart contents is best reviewed ________ by the technician

at the beginning of every shift

T/F: hospital administration-approved, exact protocols for handling emergencies minimize staff stress, reduce errors, and ensure consistency of care.

true

Concerning transporting a seriously injured animal from the accident site, which statement is most accurate?

an injured animal that refuses to lie down and becomes agitated when forced to do so may have respiratory impairment and should not be overly restrained

An animal that is in shock?

warrants immediate medical attention

After alerting the vet team, what should the tech do if an animal stops breathing?

intubate and ventilate with 100% oxygen

An ECG strip on a critically ill patient suddenly begins to show the following arrhythmia: wide, bizarre QRS complexes with no P waves. This is a ________ and requires ________ attention.

ventricular arrhythmia; immediate

Pulse strength and quality, jugular distention, and MM color are examples of peripheral perfusion parameters, which indicate:

the adequacy of blood/oxygen delivery to peripheral (non-organ) tissues

A conscious patient slow to respond to stimuli is:

mentally depressed

When evaluating the pupils of a patient with head trauma, you notice the eyes moving in a rhythmic, periodic manner from side to side, fast to one side and slow to the other. This abnormality should be recorded as:

nystagmus

Oxygen supplementation, level or elevated head positioning, precise maintenance of blood-oxygen and blood-carbon dioxide levels, and avoiding jugular venipuncture are all designed to ______ in an unconscious head-trauma patient.

reduce intracranial pressure

Which of the following best defines shock?

ineffective circulation and failure to provide adequate oxygen-rich blood to organs

The biggest risk associated with high shock doses of crystalloid fluids is:

overhydration, causing pulmonary edema (fluid in the alveolar spaces)

The main purpose of basic cardiac life support is to maintain organ function by promoting adequate blood flow to the cerebral and coronary arteries. What are the coronary arteries?

they branch from the aorta and supply the entire heart muscle with blood

A patient in the clinic stops breathing, but his heart is still beating slowly. You alert the emergency team, place an ET tube, and start ventilating the animal with an ambu bag. The animal begins to breathe on his own in a regular pattern but is still unconscious. What is done next?

start oxygen supplementation

T/F: during CPR, compress the chest over the widest part of the thorax in animals weighing less than 7 kg, and directly over the heart in animals weighing more than 7 kg.

false

CPR should continue until:

the heart is beating on its own

the pet’s owner requests no further resuscitation

the primary clinician requests no further resuscitation

Concerning the administration of drugs during CPR, which statement is most accurate?

deliver agents into an ET tube with a syringe and urinary catheter

Which term describes the drugs given before general anesthesia?

preanesthetic agents

Which of the following is the most commonly used alpha-2 agonist in dogs and cats?

dexmedetomidine

Which of the following is not a side effect of NSAID administration?

respiratory depression. liver and kidney damage and GI ulcerations are common side effects of NSAIDs

Which of the following induction agents can cause muscle tremors, muscle twitching, nystagmus, and paddling?

propofol

What will the tank pressure gauge read when the oxygen tank is half full?

1100 psi. the full oxygen tank is is 2200 psi

Which of the following statements is true of isoflurane?

all of the above: a precision vaporizer is used to administer isoflurane; isoflurane has no analgesic properties; isoflurane is stable at room temperature

A tank of nitrous oxide is present in what state(s)?

liquid and a gas

All of the following sites can be used for placement of an arterial catheter used to measure arterial pressures during anesthesia except:

the lingual artery (on the tongue)

Which condition causes a decrease in the requirements for general anesthesia?

hypothermia - slows metabolism so the patient does not need as much drug as they would at a normal temperature

What shows the amount of oxygen a patient is receiving?

flowmeter

Which of the following is not a recommended method of actively warming a patient while under anesthesia?

radiant heat via heat lamp. safe methods include circulating warm water blankets, connective warm air devices, and commercial bubble wrap

Which of the following is an example of a monitoring parameter that would be useful during the recovery process?

all of the above: continuous ECG monitoring, temperature monitoring, and post-op pain scoring

The reservoir bags minimum size can be calculated as?

60 mL/kg

If a patient regurgitates while waking up from anesthesia, what is the best course of action?

remove the regurgitation and lavage the esophagus with saline

What is the function of the pop-off valve?

to prevent excess gas pressure from building up within the breathing circuit

Which term describes the drugs given after general anesthesia and after the surgical stimulus is finished?

postanesthetic medications

Which of the following drugs is a phenothiazine tranquilizer commonly used to calm patients in the recovery period?

acepromazine

The pressure manometer reading should not exceed _____ when a small animal patient is bagged

20 cm H2O

Which of the following medications would be a good choice for providing sedation and analgesia in the recovery period?

dexmedetomidine

Of the following drugs listed, which would not be the best choice to use for a patient recovering from surgery because it does not have analgesic properties?

benzodiazepines

What is the maintenance flow rate of non-rebreathing systems?

very high (>200 mL/kg/min)

Which of the following terms describes a diminished volume or a lack of air in part or all of a lung lobe?

atelectasis

All of the following techniques can be used to prevent laryngospasm in cats except?

spraying the ET tube with lidocaine. methods that will prevent laryngospasm include spraying the larynx with local anesthetic, ensuring adequate depth before intubating, and using a gentle intubation technique

When is the negative pressure relief valve important?

if there is a failure of oxygen flow through the system

Which of the following is a reason why red rubber ET tubes should no longer be used?

red rubber ET tubes are hard to detect occlusions due to their color, the tube can soften and crack, and they are much harder to clean than PVC or silicone tubes

What is the tidal volume of an anesthetized patient in mL/kg of body weight?

10-15 mL/kg

What should the pressure be between the flow meters and breathing circuit?

15 psi

For which of the following patients would it be advantageous to use a laryngeal mask airway?

all of the above: brachycephalic dogs, rabbits, and pigs

What is the function of a laryngoscope?

to facilitate endotracheal tube intubation by allowing direct visualization of the opening to the trachea

Which anesthetic used in today’s practice is associated with neurologic and adverse reproductive effects?

nitrous oxide

What is the function of an endotracheal tube?

to provide a way for oxygen and anesthetic gases to be delivered into the lungs

Which type of laryngoscope is composed of a straight blade with a light source on a handle?

miller

Which of the following endotracheal tubes can be heat-sterilized with steam from an autoclave?

silicone tubes

In the US, the National Institute for Occupational Safety and Health (NIOSH) recommends that the levels of waste anesthetic gases for anesthetics such as isoflurane, halothane, or methoxyflurane should not exceed _____ ppm.

2 ppm

Anesthesia machines do all of the following except?

remove oxygen. anesthesia machines provide four functions: deliver oxygen, deliver anesthetic, remove carbon dioxide, and remove waste gases

The minimum alveolar concentration (MAC) of isoflurane in horses is?

1.31%

What is the function of a flush valve within the anesthetic circuit?

to deliver a burst of pure oxygen into the breathing system

Which of the following is used to effectively monitor waste anesthetic gases?

passive dosimeter badge

The numbers in the vaporizer dial indicate the:

concentration (in %) delivered at the output of the vaporizer

How often is a low-pressure leak test conducted on an anesthesia machine?

before the use of the machine each day

Which of the following breathing systems is made of an inspiratory tube running within an expiratory tube for the purpose of aiding in the warming and humidification of inspired gases?

universal F

What is the normal capillary refill time in veterinary patients?

1-2 seconds