Intro to Anesthesia(and Patient Prep)
In gathering a patient history, which of the following would be the best way to frame a question about a patient's exercise level?
"How many times a week does your pet go for a walk or exercise, Mrs. Jones?"
A patient exhibiting extreme cachexia would have a body condition score (BCS) of:
1/9
With dogs and cats, food is most commonly withheld before anesthesia for
10-12 hours
The normal rectal temperature of an adult cat is
100° F to 102° F
What are the normal temperature/pulse rate/respiration rate (T/P/R) of a cow?
101.5 F, 60/min, 20/min
The California Medical Board states that a veterinarian should examine a patient within what time frame prior to a general anesthetic?
12 hours
Most IV drugs should be given over a course of:
15-60 secs
What would the fluid rate be for a 18.0 kg dog at a prescribed rate of 10 mL/kg/hr?
180 mL/hr
What is the normal range for a packed cell volume (PCV) for a cat?
25-46%
Normal mucosal bleeding time in a dog is
30-90 seconds
What is the normal range for a packed cell volume (PCV) for a dog?
36-54%
The PCV of a normal adult dog is
37%-55%
You should select a microdrip set if the fluid rate is:
<100 mL/hr
Which patient is least likely to have special anesthetic needs? A. A 19 year old Poodle presenting for a splenectomy B. A 0.5 kg teacup Chihuahua presenting for an OHE C. A 95 kg Great Dane presenting for castration and preventive gastropexy D. A 9 year old DSH presenting for routine dental prophylaxis
A 9 year old DSH presenting for routine dental prophylaxis
Define 'minimum patient database':
A compilation of pertinent information from the patient history, physical examination, and diagnostic tests
Define 'tranquilization':
A drug induced state of calm, patient is aware but reluctant to move
Define sedation:
A drug-induced central nervous system depression and drowsiness
A patient in ASA class 1 physical status is
A normal patient with no organic disease
A patient in ASA class 4 physical status is
A patient with severe systemic disease that is a constant threat to life
Define 'therapeutic index':
A ratio of the toxic to the therapeutic dose of a drug
Dehydration greater than 10% is
A seriously morbid state
Kidney function can be assessed by the following preanesthetic screening tests except A. ALT B. BUN C. Creatinine D. Urinalysis
ALT
What physical status classification would be assigned to a normal, healthy patient?
ASA I
A patient with severe systemic disease would have a physical status classification of:
ASA III
What information is included in the patient's signalment? A. Age, gender, breed B. "Proceed with caution" signals (e.g., "will bite") C. Previous surgery D. All of the above
Age, gender, breed
Which of the following should be assessed during the history taking?
All of the above Patient's attitude and mental status, patient's previous medical problems and treatments, patient's ability to see and hear, and patient's gait and body condition.
Which of the following should be performed on the day of the surgery? A. Thorough physical examination. B. Review of the patient's medical history with the owner. C. Verbal review of the consent form and obtaining of the owner's signed consent for anesthesia and surgery D. All of these E. None of these
All of these
If consent forms are signed by a minor, they
Are not legally binding
What would be defined as: Administration of multiple drugs concurrently in smaller quantities than would be required if each were given alone, to produce sedation, tranquilization, muscle relaxation, analgesia or a variety of other effects needed for a particular patient.
Balanced anesthesia
Pediatric patients younger than 3 months that undergo general anesthesia are at a higher risk than adult patients for all of the following except
Biting the endotracheal tube in half
Why are leading questions inappropriate to ask during the history taking?
Both a and b They make the owner feel compelled to answer a certain way and they may encourage the owner to answer inaccurately
Which breed is most sensitive to acepromazine? A. Maltese B. Labrador retriever C. Boxer D. Chihuahua
Boxer
You are going to perform anesthesia on a 2-year-old, male neutered, French bulldog, who is undergoing a neuter. How does his signalment affect his anesthesia?
Brachycephalic dogs can be difficult to intubate and need a smaller ET tube than other dogs of similar size
When placing an IVC, what is important to do after flushing the T-port?
Clamp the line to prevent back flow
Refers to a patient that cannot be aroused and is unresponsive to all stimuli, including pain:
Comatose
A form signed by the client confirming that he or she has been told about and understands the nature of the procedure to be performed, including the risks involved.
Consent form
Anticholinergic drugs should not be used in which species? A. Cat B. Mouse C. Horse D. Cow
Cow
A capillary refill time that is over 2 seconds indicates
Decreased peripheral blood perfusion
An elevation in packed cell volume (PCV) most likely indicates:
Dehydration
Patients that have water withheld for long periods before surgery and general anesthesia may be prone to
Dehydration and hypotension
On physical assessment prior to a neuter it is discovered that the patient is cryptorchid. How does this affect the anesthetic plan?
Different surgical preparation and longer surgery time
What complication is prevented by fasting our patients prior to anesthesia?
Esophageal reflux and aspiration
Which species are prone to excess airway secretions?
Felines and ruminants
Which breed is sensitive to barbiturates? A. Pomeranian B. Greyhound C. Rottweiler D. Bloodhound
Greyhound
Thiobarbiturates should be administered with great care, or not at all, to
Greyhounds
Which of the following is not a part of the preanesthetic physical examination? A. Ausculting the patient's heart B. Hydration assessment C. Grooming D. Obtaining the patient's weight
Grooming
Which of these IV fluids would increase oncotic (osmotic) pressure? A. Normal saline B. Hetastartch C. Lactated ringer D. 5% dextrose in water
Hetastarch
Which species is most sensitive to opioids? A. Dog B. Pig C. Sheep D. Horse
Horse
Which of the following fasting times is least advisable? A. Dog: 8-12hours B. Cow: 24-48hours C. Horse: 2-4hours D. Small ruminant: 12-18hours
Horse: 2 to 4 hours
Which of the following is a benefit of clear, honest, and timely communication with clients? A. A shorter anesthetic times B. Get to know more people C. Improve client satisfaction D. Make more money
Improve client satisfaction
In which of the following circumstances should a barbiturate drug be avoided? A. In a patient with respiratory alkalosis B. In sight hounds and very thin patients C. In obese patients D. In hyperproteinemic patients
In sight hounds and very thin patients
Which of the following signs of disease in a calm canine patient would be most significant in terms of the potential to increase the risk of anesthesia? A. Increased respiratory effort B. Lethargy C. A body temperature of 103.4 degrees F D. A sinus arrythmia
Increased respiratory effort
An intravenous catheter should be:
Large enough to allow adequate fluid delivery, if cardiac arrest occurs
Term used to refer to the patient's responsiveness to stimuli or how easily it can be aroused, used to assess brain function:
Level of consciousness
When a male dog is presented to the hospital for a castration procedure, the technician should do all of the following except
Make sure the dog is not in heat
Balanced anesthesia commonly includes all of the following agents, except A. Muscle-paralyzing agents B. Dissociative agents C. Nitrous oxide and an inhalant anesthetic D. Thiobarbiturates
Muscle-paralyzing agents
Define 'stridor':
Noisy breathing caused by turbulent air flow in the upper airways
Indications of poor cardiac functions include all of the following except: A. Poor perfusion B. Cardiac arrhythmias C. Normal pulse D. Cyanosis in patients with a PCV OF 45%
Normal pulse
Frankenstein, a 4 month on intact male DLH presents for routine castration. Pre-anesthetic evaluation shows no parameters outside of normal limits. What would Frankenstein's physical status classification be?
PS1
Sunflower, a 4-year-old intact female Golden Retriever is present for an emergency ovariohysterectomy due to acute pyometra. She has a PCV of 23% and temperature of 103.2 F. What would Sunflower's physical status classification be?
PS4
A comprehensive patient history should contain all of the following except A. Discharge summary B. Patients pedigree history C. Clinical signs D. Vaccination status
Patient's pedigree history
In which patients is it important to restrict water intake before anesthesia? A. Patients with a history of regurgitation B. Patients having a long anesthetic C. Patients with renal disease D. Patients undergoing a dental procedure
Patients with a history of regurgitation
Which of the following is not done on a routine physical examination of a cat? A. Perform a rectal examination B. Open the mouth and look at the teeth, tongue, and gums C. Palpate the abdomen for masses D. Listen to the heart and lungs
Perform a rectal examination
Hypothermia
Prolongs anesthetic recovery
The breed of dog that requires a smaller dose of thiobarbiturate anesthetic per pound than that calculated by its weight is the
Saluki
When assessing skin turgor in a canine patient, which area of the body is best to avoid? A. The thoracolumbar junction B. The neck C. The chest area D. The lumbar area
The neck
When gathering historical information about signs of illness, what is the least appropriate question to ask?
The patient's sleeping area
Define 'extra-label drug use':
The use of an approved drug in a manner that is not in accordance with the approved label directions
Which of the following examples of species associations is not correct? A. Horses may fracture limbs during anesthetic recovery and thus require special attention during the recovery period. B. Horses and cats are more sensitive to opioids than dogs and ruminants. C. The use of anticholinergics is recommended in ruminants to avoid airway occlusion. D. Large animals are prone to respiratory depression and dependent atelectasis and thus often require ventilatory support.
The use of anticholinergics is recommended in ruminants to avoid airway occlusion
Which of the following heart rhythms is not normal in a resting horse? A. Second degree AV block B. Third degrees AV block C. NSR D. SA
Third degree AV block
Which preanesthetic test is especially important for a 10-year-old, female spayed, chihuahua with a 4/6 systolic heart murmur? A. Urinalysis B. Thoracic radiographs C. Fecal analysis D. Abdominal ultrasound
Thoracic radiographs
Perivascular injection of a barbiturate solution, such as thiopental, can cause
Tissue sloughing
Why would a buccal mucosal bleeding time (BMBT) test be performed prior to surgery on a Doberman Pincher?
To determine the likelihood of bleeding that day
Which is not a purpose of IVC placement? A. Blood transfusions B. Fluid therapy C. Vaccine administration D. Medication administration
Vaccine administration
A factor included in body condition score of dogs and cats is
Visible waist
When obtaining a preanesthetic patient history, it is important to ask all of the following questions, except: A. What is the patient's favorite treat? B. Is the patient up to date of vaccines? C. What time did the patient last eat? D. Is the patient currently on any medications?
What is the patient's favorite treat?
Before administering a general anesthetic, which of the following is the least important part of an animal's history? A. Whether the animal has a concurrent disease B. When the animal last ate C. When the animal was last vaccinated D. Prior anesthetic history
When the animal was last vaccinated
Ruminants are sensitive to what drugs?
Xylazine
Define 'hypnosis':
a sleep-like state from which the patient can be aroused with sufficient stimulation
Define 'analgesia':
absence of pain
A loss of sensitivity to pain:
analgesia
Which of the following literally means the "study of no feeling"? A. Analgesia B. Analgesiology C. Anesthesiology D. Hypoesthesiology
anesthesiology
Any drug used to induce a loss of sensation with or without unconsciousness:
anesthetic agent
For which of the following species is ketamine use approved? A. Birds B. Horses C. Dogs D. Cats
cats
You are evaluating a patient's hydration. The skin elasticity is mildly slowed, the patient's mucous membranes are tacky, the CRT is 1.5 seconds, but the eyes are in a normal position in the orbit. Your patient is:
hydrated
A sleeplike state from which the patient can be aroused with sufficient stimulation.
hypnosis
Which of the following is not a sign of fluid overload? A. Ocular and nasal discharge B. Increased lung sounds and respiratory effects C. Dyspnea D. Hypotension
hypotension
The values of the PCV/TP may indicate that all of the following are present except
infection
The values of the PCV/TP may indicate that all of the following are present except A. Dehydration B. Anemia C. Hypoproteinemia D. Infection
infection
A loss of sensation in a small area of the body produced by administration of a local anesthetic agent in proximity to the area of interest:
local anesthesia
A loss of sensation in a small area of the body:
local anesthesia
Define anesthesia:
loss of sensation
Which of these compounds is not found in lactated Ringer solution?
magnesium chloride
Depressed and unable to be fully aroused:
obtunded
A graded assessment of a patient's physical condition. Used to plan patient management prior to administering anesthetics and to gauge patient risk.
physical status classification
______ analgesia is the administration of an analgesic before the pain develops.
preemptive
You are monitoring a patient under anesthesia. Fluid therapy helps:
raise the blood pressure
Loss of sensation in a limited area of the body produced by administration of a local anesthetic or other agent in proximity to sensory nerves.
regional anesthesia
The oxygen-carrying capacity of blood can be assessed by measuring all of the following except: A. PCV B. Hematocrit C. Total solids D. Hemoglobin
total solids
Besides skin tenting, one of the best physical signs to access fluid status is
weight
