Fear Free Module 7b
A
If ketamine or tiletamine-zolazepam is a necessary addition to a Fear Free protocol: A. Consider this to be general anesthesia and monitor/support the patient appropriately B. Don't worry about the patient because these drugs don't cause any adverse effects C. The patient is probably an ASA V D. The patient is probably easy to handle since these are weak drugs
C
Ketamine is best for all but: A. that need extra chemical control but not necessarily general anesthesia B. Patients who weigh <7kg C. Patients who no longer need sedation D. Hospitals that do not want to carry tiletamine-zolazepam
Pain
Opioids are among the key drugs used to treat _____ in veterinary patients: Anxiety Parasites Aggressive behavior Pain None of the above
D
Pain in your patients: A. Can exacerbate or even cause FAS and/or aggression B. Should be treated before the patient comes to the hospital if at all possible C. Can be a problem in patients that have received naloxone or atipamezole D. All of the above are true
B
A 10-year old Pomeranian with controlled heart failure comes into your hospital for collection of blood and urine for part of an evaluation of inappropriate urination. The dog is shaking violently and tries to bite at even light restraint. The best protocol for sedation in this patient is: A. Midazolam alone B. Midazolam + opioid C. No sedation - only restraint D. Alpha-2 agonist + opioid
D
A 10-year old VERY aggressive German Shepherd dog, health status unknown, comes into your hospital for collection of blood and urine for part of an evaluation of inappropriate urination. The best protocol for sedation of this patient is: A. Acepromazine alone B. Benzodiazepine alone C. Acepromazine + opioid D. Alpha-2 agonist + opioid
D
A 6-year old healthy Springer Spaniel comes into the hospital exhibiting signs of mild FAS and some signs of pain from his bilateral stifle osteoarthritis. You need to sedate him for radiographs. The best protocol for sedation in this patient is: A. Acepromazine alone B. Benzodiazepine alone C. Alpha-2 agonist alone D. Alpha-2 agonist + opioid
B
A very fearful cat, whose age and health status is unknown, arrives at the hospital for an exam and aspiration of a nodule. The cat reacts violently to attempts at being lifted from his carrier. The most appropriate protocol for this cat is: A. Midazolam + opioid + ketamine B. Alpha-2 agonist + opioid + ketamine C. Acepromazine + midazolam D. Midazolam + opioid
E
Abrupt, perioperative discontinuation of chronic medications should be avoided because: A. There is threat of clinical relapse in the patient B. This can cause discontinuation syndrome C. The owner may forget to start the medications again D. The patient may stop breathing E. The first and second statement are correct
False
Benzodiazepines have a high level of cardiovascular, neurologic, and respiratory adverse effects True False
B
Regarding reversal of drugs like alpha-2 agonists and opioids, which statement is correct: A. All patients should be reversed for safety reasons B. Some patients should be allowed to quietly recover without reversal C. patients should be reversed so that the degree of pain can be evaluated D. Aggressive patients should be reversed since the alpha-2 agonists are not anxiolytics
B
Sedation in patients with signs of mild FAS should generally be administered: A. after the patient has repeatedly proven that it can't be handled B. Before the situation escalates to a higher level of FAS C. As soon as it walks in the door since things are sure to get worse D. Never, since sedation is not appropriate for mild FAS
C
Sedation in veterinary patients in-hospital is: A. Scary and should never be used B. for calm patients but not FAS patients because the results are not predictable in FAS patients C. Often an integral part of a Fear Free visit D. More dangerous than excessive restraint
C
Select the statement below that is false related to the drug acepromazine: A. Acepromazine is a sedative B. Acepromazine can be administered orally, trans-mucosally, or injected C. Acepromazine is a true anxiolytic D. Acepromazine is rarely used as a single agent drug
D
The alpha-2 agonists are one of the most useful drug classes for sedation of FAS or aggressive dogs and cats because A. Profound sedation can be achieved B. The drugs are effective when administered IM C. Alpha-2 agonists are reversible D. All of the above are true
E.
The dissociative class of drugs includes: A. Diazepam B. Acepromazine C. Ketamine D. Tiletamine-zolazepam E. The third and fourth statement are correct
A
The use of PVP in patients with FAS and/or aggression: A. May result in a decreased dosage of in-hospital sedation and a prolonged recovery from sedation B. Is okay in healthy (ASA I-II) patients but not recommended for sicker (ASA III-IV) patients C. Is really not necessary in any patient since it is easier to sedate them in the hospital D. Is complicated since most of the drugs used for PVP cannot be used in conjunction with the in-hospital drugs
True
Tiletamine-zolazepam is best for very aggressive patients in which a quick knockdown is required in a facility that can handle a prolonged recovery True False
C
Which of the following is false regarding why inhalant mask or chamber induction of patients is a poor option for dealing with stressed patients? A. chamber induction can increase risk of death because of the high inhalant dosages needed to achieve anesthesia B. Chronic staff exposure to inhalants may cause health problems C. Inhalation of the anesthetics reduces stress because inhalants are anxiolytics D. Adverse cardiovascular and respiratory effects can occur secondary to inhaling high gas concentrations