Anesthesia 1Final Exam Review

55 multiple choice3 calculations

scantron

Preanesthetic Time Period

5 questions

ASA Risk Assessment

• Class 1• Class 2• Class 3• Class 4• Class 5

• Slight risk, minor disease

• High risk, significantly compromised

• Moribund• Normal, healthy• Moderate risk, obvious

disease

• You shine a light into the right eye of a dog and the left pupil constricts. What is the best explanation?

• A. head trauma• B. neuropathy• C. normal reflex• D. this is not possible

Preanesthetics

10 questions

Preanesthetics

1. Anticholinergics2. Tranquilizers and Sedatives phenothiazines benzodiazepines alpha-2 agonists

3. Opioids

• What are anticholinergics primarily used for?• A. To sedate patients• B. To relieve anxiety• C. To relieve pain• D. To “protect the heart”

Premedications

• Acepromazine• Rompun• Valium• Morphine• Glycopyrrolate

• Benzodiazepine• Narcotic• Anticholinergic• Phenothiazine• Alpha-2 Agonist

Premedications

• Butorphanol• Atropine• Hydromorphone• Dexdomitor• Chlorpromazine• Zolazepam

• Benzodiazepine• Narcotic• Anticholinergic• Phenothiazine• Alpha-2 Agonist

Reversal Agents

• Yohimbine• Narcan• Antisedan• Flumazinel • Nalbuphine

• Valium• Fentanyl• Xylazine • Dexmedetomidine • Morphine

• List some effects of anticholinergics.

• Prevent bradycardia• May cause tachycardia at high doses• Mydriasis • Blocks stimulation of vagus nerve

Induction Agents and Injectables

10 questions

Injectables

• Barbiturates• Propofol• Dissociatives• Etomidate• Guafenesin• Locals• Neuromuscular blocking agents

• The combination drug Telazol contains• A. Diazepam and ketamine• B. Diazepam and xylazine• C. Zolazepam and tiletamine• D. xylazine and tiletamine

• Which of the following would not provide any analgesic effects?

• A. dexdomitor• B. narcan• C. lidocaine• D. xylazine

• Which of the following is not an example of an analgesic?

• A. tetracaine• B. diprivan • C. N2O• D. butorphanol

• Caudal epidural administration of lidocaine in the dog is

• A. Useful to prevent movement• B. Not to be used for cesarean section• C. An excellent caudal analgesic• D. An old procedure with little value in

veterinary anesthesia today

Injectables

• Thiopental• Pancuronium• Propofol• Bupivicaine• Etomidate • Guaifenesin• Tiletamine

• Dissociative• Local• Muscle relaxant• Non-barbiturate

anesthetic• Barbiturate• NMB• Heart friendly induction

• Which of the following is not a barbiturate?• A. pentobarbital• B. thiopental• C. phenobarbital• D. etomidate

Injectable Anesthetics

• Used to induce anesthesia• Given 15-20 minutes after a pre-medication• Ideal characteristics: Rapid onset and recovery Non-toxic Lack of adverse cardiovascular and respiratory effects Rapid metabolism Analgesic effects Muscle relaxation

• When possible, they should be given to effect.

• All could be used for epidural anesthesia except:

• A. lidocaine• B. morphine• C. ketamine

Inhalants

8 questions

Advantages of Inhalants

• Concentration of anesthesia in the body is changed by adjusting the delivered concentration to the patient– This is done by adjusting the vaporizer on the machine.

• Inhalants are eliminated by the lungs on exhale, and have minimal metabolism.

• At appropriate concentrations, they provide analgesia by creating unconsciousness

• They can be used as maintenance agents and duration time is not an issue

• Use of nitrous oxide in anesthesia• A. Decreases the amount of inhalant

anesthetic required• B. Slows the induction process• C. Has no effect on the time or amount of

anesthetic required• D. Increases the amount of inhalation

anesthetic required

• The ideal inhalant anesthetic would have all of the following characteristics except

• A. Low vapor pressure• B. High solubility coefficient• C. Low MAC• D. Provide good muscle relaxation

Biotransformation

• 0.2%• 2-5%• 0.02• 20-46%

• Desflurane • Halothane• Isoflurane• Sevoflurane

Variables

• MAC• Solubility Coefficient• Vapor Pressure

• Delivery method• Induction recovery rates• Potency

Monitoring

8 questions

• Pulse oximeters give an estimate of• A. Percentage of hemoglobin saturation with

oxygen in arterial blood• B. Respiratory rate• C. Cardiac output• D. Oxygen content of arterial blood

Equipment

• Pulse oximeter• Esophageal stethoscope• EKG • Capnograph• Blood Gas• Blood Pressure

• HR and rhythm• Expired CO2• Blood pH• Systolic and diastolic• HR and RR• Saturation of

hemoglobin

Parameters

• 1. vital signs HR, RR and depth, MM, CRT, pulse strength, BP and temperature

• 2. reflexes (involuntary response to stimuli) Palpebral, corneal, pedal, swallowing, laryngeal, PLR

• 3. other indicators Movement, eye position, pupil size, muscle tone, nystagmus,

secretions, response to surgical stimuli

* The most reliable sign of inadequate depth is patient movement.

Stages and Planes

• Stage 1• Stage 2• Stage 3, plane 1• Stage 3, plane 2• Stage 3, plane 3• Stage 3, plane 4• Stage 4

• Excitement phase• Overdose• Early overdose• Too light• Too deep• Optimum• Voluntary movement

Endotracheal Intubation

6 questions

Endotracheal Tube Types

• Red rubber• Vinyl• Silicone• Anode

• Cheap• Least irritating • High volume, low

pressure cuff• Low volume, high

pressure cuff• Armored • Can see respirations

Intubation

• Confirming proper placement• Equipment used• Tube size• Cuff inflation• Extubation

• Which of the following best describes a silicone endotracheal tube?

• A. Relatively inexpensive, flexible, low volume and high pressure cuff and a tendency to dry and crack over time

• B. More expensive, less irritating to tissues with a high volume and low pressure cuff

• C. Transparent, stiffer tube comprised of PVC requiring manual deflation of cuff

• D. Contains a coil of metal or nylon embedded into the rubber to resist collapse

Equipment

8 questions

Machine• 8 questions on machine• Know these parts• O2 and N2O cylinders• O2 pressure gauge• Vaporizer• O2 flush valve• Charcoal canisters• CO2 canisters• Manometer• Breathing bag• Circuits (rebreathing and non-rebreathing)• Scavenging systems

• The oxygen pressure gauge• A. indicates how much oxygen is in the

cylinder• B. indicates how much oxygen in L/min is

delivered to the patient• C. reduces pressure of oxygen entering the

low pressure system• D. all of the above

• A.

• A non-precision vaporizer would be placed

• A. out of the circle• B. in the circle• C. in the high pressure portion of the system• D. either in or out of the circle

• B. non precision are also known as VIC

• Which of the following machine parts will remove carbon dioxide from the system?

• A. scavenger system• B. charcoal canister• C. soda lyme canister• D. humid vent

• C.

• Flow meter setting are read in• A. mmHg• B. L/min• C. cm/H2O• D. %

• B.

• The manometer is used to evaluate• A. pressure of oxygen in cylinder• B. pressure in the breathing circuit• C. inhalant and oxygen flow rate• D. pressure in the oxygen line

• B.

• A non-rebreather is used when the patient• A. is larger than 80 pounds• B. suffering from alkalosis• C. under anesthesia for brief procedures only• D. is smaller

• D.

• Rebreathing systems allow for all of the following except

• A. retention of heat• B. recycling of inhalant• C. faster response to dial changes on the

vaporizer• D. the use of a carbon dioxide canister

• C. you may see slower response to dial setting changes due to the recirculation of inhalant to the patient.

• All machines require• A. a compressed gas source• B. a scavenger• C. a reservoir bag• D. all of the above

• D.