How would you describe a Cole ET tube?

Sized differently (using a French system) compared to other ET tubes, narrows at a certain point to create a shoulder that sits at the larynx, Uncuffed, The only tube you should use on a bird

What are contra-indications for using benzodiazipines?

c-sections, hepatic disease (hepatic metabolism)

What size ET tube should be used and why?

Larger diameter = less resistance to O2 flow, The largest possible that will fit without forcing through the larynx

How is the avian cardiovascular system different?

Sensitive to inhalants, Larger heart (higher CO, BP, HR), High metabolic demand

What are contraindications for using acepromazine?

cardiac/renal/hepatic disease, old/young/sick, c-section

What are advantages of epidural anaesthesia?

Less systemic side effects, Longer duration of action, Less drug is needed

how does SOLUBILITY of an inhalation agent affect uptake and distribution?

less soluble = reaches equilibrium faster = effects seen faster

What are potential complication of induction agents?

hypotension, bradycardia, arrythmias, Apnea, Excitement, vomiting

What can be used to give an indication of tissue oxygenation?

mucous membrane colour - should be pink

What flow rate is required for a non-rebreathing system?:

1.5 x the minute volume (around 300ml/kg/min)

What are the important aspects of patient preparation prior to anaesthesia?

fasting, Telling the patient he's a good boi, stabilisation and support

What are possible side effects of epidural anaesthetic?

morphine can cause urine retention, post op motor paresis, segmental vasodilation

What are the relevant consequences of birds and small mammals having a small body size in relation to anaesthesia?

hypoxaemia, faster metabolism of anaesthetic drugs, hypoglycaemia, higher heart rate

What flow rate is used initially for a rebreathing system?

30 ml/kg/min(minimum of 1L/min)

What are possible complications of isotonic solution fluid therapy?

dilution (anaemia, low COP, coagulopathy), oedema

What factors will influence the signs and reflexes of anaesthetic stages and planes?

Individual patients, The agents used, Species

How is an intrapleural block done?

local anaesthetic diluted with saline and inserted through a chest tube

What factors influence the uptake and distribution of inhalation agents?

solubility, cardiac output, alveolar to venous partial pressure difference

How do you test for leaks in the low pressure system of the anaesthetic machine when the flow meter is set to 1L/min?

occlude fresh gas outlet. If no leaks, flow meter will drop to 500ml/min

How is the avian respiratory system different?

No epiglottis, Wider longer trachea (larger dead space), Complete tracheal rings

How can fluid therapy be monitored?

Physical exam, surrogated parameters of peripheral perfusion urinary output, venous O2 sat, Haemodynamic parameters

What are possible side effects of alpha2 agonists?

hypo/hyper thermal, hyperglycaemia, emesis, hypertension and respiratory depression

How does the pressure gauge reading of Oxygen tanks compare to nitrous oxide?

N2O pressure reading will only decrease when the cylinder is empty, O2 pressure reading decreases proportional to amount left in cylinder

What happens during the first stage of anaesthesia?

usually passed through very quickly, increased heart rate and rapid respiration, voluntary excitement

What are possible causes of hypoxaemia?

Diffusion impairment, Hypoventilation, Low FiO2, Shunt & V/Q mismatch

What flow rate is used for rebreathing systems after the room air has been removed?

10 ml/kg/min(minimum of 300 ml/min)

What determines net water movement between ICF and ECF?

Sodium (Na) concentration in the ECF

What can be used to monitor blood pressure?

Doppler, Oscillometric, Direct catheterisation

How can respiratory rate be assessed?

Observe the rebreathing bag movement, Watching the patient breath

What is included in a triple drip for horses?

xylazine, guaifenesin, ketamine

Of extracellular fluid (20%), how much is interstitial fluid and how much is intravascular fluid?

Intravascular 5%, Interstitial 15%

How does thiopentone need to be prepared and why?

It needs to be reconstituted before use, It comes in a powder form as the solution is unstable

In what ways can a patient lose heat?

Conduction, radiation, Convection, Evaporation

What are the benefits of ET intubation?

Ensures adequate ventilation and oxygenation, delivery of inhalation agents while reducing environmental contamination, allows cardiopulmonary resuscitation, minimises the risk of aspiration

How is the cardiovascular system typically affected by anaesthesia?

Heart rate declines, CRT increases, BP declines

What are characteristics of Halothan as an inhalation agent?

Halothane hepatitis, Myocardial depression and bradycardia, arrhythmogenic, Malignant hypothermia

How do anticholinergics work?

Blocks parasympathetic activity, prevent binding of acetylcholine to muscarinic receptors

What effects are created by opioids?

Euphoria, Excitation, Sedation, Analgesia

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ANAESTHESIA #1

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Questions 95

Answers

1
How would you describe a Cole ET tube?
Sized differently (using a French system) compared to other ET tubes
narrows at a certain point to create a shoulder that sits at the larynx
Uncuffed
The only tube you should use on a bird
2
What are contra-indications for using benzodiazipines?
c-sections
Fleas
hepatic disease (hepatic metabolism)
internal parasites
3
What size ET tube should be used and why?
Larger diameter = less resistance to O2 flow
The smallest tube possible
Smaller diameter = less resistance to O2 flow
The largest possible that will fit without forcing through the larynx
4
How is the avian cardiovascular system different?
Requires Red Bull energy drink to power flight
Sensitive to inhalants
Larger heart (higher CO, BP, HR)
High metabolic demand
5
What are contraindications for using acepromazine?
cardiac/renal/hepatic disease
old/young/sick
c-section
dehydration
6
What are advantages of epidural anaesthesia?
Less systemic side effects
has a hallucinogenic effect for bonus fun
Longer duration of action
Less drug is needed
7
how does SOLUBILITY of an inhalation agent affect uptake and distribution?
It doesn't
more soluble = reaches equilibrium faster = effects seen faster
less soluble = reaches equilibrium faster = effects seen faster
dictates which machine you can use it in
8
What are potential complication of induction agents?
hypotension, bradycardia, arrythmias
Apnea
Excitement
vomiting
9
What can be used to give an indication of tissue oxygenation?
Pulse rate and strength
Capillary refill time - should be <2 seconds
pinch the skin and watch how long it takes to snap back to normal
mucous membrane colour - should be pink
10
What flow rate is required for a non-rebreathing system?:
4.5 x the minute volume (around 900ml/kg/min)
3 x the minute volume (around 600ml/kg/min)
1.5 x the minute volume (around 300ml/kg/min)
6 x the minute volume (around 1.2L/kg/min)
11
What are the important aspects of patient preparation prior to anaesthesia?
fasting
inserting the ET tube correctly
Telling the patient he's a good boi
stabilisation and support
12
What is dextrose metabolised to?
amino acids
pure water
glucose
fatty acids
13
What are possible side effects of epidural anaesthetic?
morphine can cause urine retention
post op motor paresis
segmental vasodilation
a decreased desire to hammer
14
What are the relevant consequences of birds and small mammals having a small body size in relation to anaesthesia?
hypoxaemia
faster metabolism of anaesthetic drugs
hypoglycaemia
higher heart rate
15
How are inhalational drugs eliminated from the body?
In the urine
In the faeces
By the body metabolising and breaking down the drug
By respiration
16
At which stage of anaesthesia is there both palpebral and corneal reflexes and strong jaw tone?
Stage 3 plane 4
Stage 3 plane 1
Stage 3 plane 3
Stage 3 plane 2
17
What can be used to monitor the respiratory system?
capnograph
apnoea alert
Doppler
Pupillary light reflex
18
What flow rate is used initially for a rebreathing system?
120 ml/kg/min(minimum of 4L/min)
10 ml/kg/min(minimum of 300ml/min)
60 ml/kg/min(minimum of 2L/min)
30 ml/kg/min(minimum of 1L/min)
19
What happens if you use a mixture of lidocaine and bupivicaine as a local anaesthetic?
slower onset shorter duration
faster onset longer duration
faster onset shorter duration
slower onset longer duration
20
What are possible complications of isotonic solution fluid therapy?
Decreased Blood pressure
dilution (anaemia, low COP, coagulopathy)
oedema
Dehydration
21
What factors will influence the signs and reflexes of anaesthetic stages and planes?
Individual patients
The agents used
The weather
Species
22
What are contraindications for hypertonic solutions
Dehydration
A passion for skydiving
excessive caffiene consumption
Hypernatremia
23
What are the respiratory rates of cats and dogs under anaesthesia?
dogs: 6-25
cats: 12-25
Cat 25-50
Dogs 30-60
24
How is an intrapleural block done?
ketamine injected into the epidural space
Ring block
local anaesthetic diluted with saline and inserted through a chest tube
Square block
25
What factors influence the uptake and distribution of inhalation agents?
solubility
cardiac output
alveolar to venous partial pressure difference
The acidity of the stomach contents
26
How do you test for leaks in the low pressure system of the anaesthetic machine when the flow meter is set to 1L/min?
turn off the flow meter and blow into the tube
You don't, just hope for the best
occlude fresh gas outlet, if no leaks, flow meter will increase to 2L/min
occlude fresh gas outlet. If no leaks, flow meter will drop to 500ml/min
27
How is the avian respiratory system different?
No epiglottis
has three lungs instead of 2
Wider longer trachea (larger dead space)
Complete tracheal rings
28
What happens to the capnograph if the patient is hypoventilating?
EtCO2 decreases
EtCO2 disappears completely
EtCO2 stays the same
EtCO2 increases
29
How can fluid therapy be monitored?
Physical exam
surrogated parameters of peripheral perfusion urinary output, venous O2 sat
Haemodynamic parameters
Watching the patient breathe
30
What are possible side effects of alpha2 agonists?
hypo/hyper thermal
hyperglycaemia
emesis
hypertension and respiratory depression
31
How does the pressure gauge reading of Oxygen tanks compare to nitrous oxide?
N2O pressure reading decreases proportional to amount left in cylinder
N2O pressure reading will only decrease when the cylinder is empty
O2 pressure reading will only decrease when the cylinder is empty
O2 pressure reading decreases proportional to amount left in cylinder
32
What happens during the first stage of anaesthesia?
usually passed through very quickly
increased heart rate and rapid respiration
voluntary excitement
involuntary excitement
33
What are possible causes of hypoxaemia?
Diffusion impairment
Hypoventilation
Low FiO2
Shunt & V/Q mismatch
34
What flow rate is used for rebreathing systems after the room air has been removed?
20 ml/kg/min(minimum of 600 ml/min)
40 ml/kg/min(minimum of 1.2L/min)
5 ml/kg/min(minimum of 150 ml/min)
10 ml/kg/min(minimum of 300 ml/min)
35
What determines net water movement between ICF and ECF?
Iron (Fe) concentration in the ECF
Bouyancy
Sodium (Na) concentration in the ECF
Drug concentration in the ECF
36
How do rebreathing circuits prevent inhalation of CO2?
Soda Lime
Lime & tequila
Key Lime pie
One way valves
37
What can be used to monitor blood pressure?
Doppler
Capnography
Oscillometric
Direct catheterisation
38
What happens if a larger volume of epidural anaesthetic is given?
a smaller area is blocked
a larger area is blocked
The patient will die
you'll get a faster onset but a shorter duration
39
How can respiratory rate be assessed?
listening to the heart
Observe the rebreathing bag movement
Singing the songs of your people
Watching the patient breath
40
What is included in a triple drip for horses?
xylazine
Alfaxalone
guaifenesin
ketamine
41
At what stage of anaesthesia can a patient be intubated?
Stage 2
Stage 3 plane 4
Stage 1
Stage 3 plane 1
42
Of extracellular fluid (20%), how much is interstitial fluid and how much is intravascular fluid?
Intravascular 5%
Interstitial 15%
Intravascular 15%
Interstitial 5%
43
How does thiopentone need to be prepared and why?
It needs to be reconstituted before use
It comes in a powder form as the solution is unstable
Baked in the oven for an hour before use
To kill potential bacteria
44
In what ways can a patient lose heat?
Conduction
radiation
Convection
Evaporation
45
What are the benefits of ET intubation?
Ensures adequate ventilation and oxygenation
delivery of inhalation agents while reducing environmental contamination
allows cardiopulmonary resuscitation
minimises the risk of aspiration
46
How is the cardiovascular system typically affected by anaesthesia?
Heart rate declines
Brain function ceases
CRT increases
BP declines
47
How can VPC (Ventricular premature complexes) be treated?
ketamine
With your sweet salty tears
Atropine
Lignocaine
48
What are the major types of ET tube?
Cole
Magill
Murphy
Clive
49
What are characteristics of Halothan as an inhalation agent?
Halothane hepatitis
Myocardial depression and bradycardia
arrhythmogenic
Malignant hypothermia
50
How do anticholinergics work?
Blocks parasympathetic activity
prevent binding of acetylcholine to muscarinic receptors
Gives you wiiiiiiiings
induces a state of euphoria
51
What effects are created by opioids?
Euphoria
Bradycardia
Excitation
Sedation
Analgesia
Insomnia
52
What are the effects of alpha2 agonists?
insomnia
analgesia
Sedation = dose dependent
muscle relaxation
53
What does the absence of the pupillary light reflex indicate?
Deep Plane of anaesthesia
The animal is wide awake - no anaesthesia
Light plane of anaesthesia
Moderate plane of anaesthesia
54
What are possible side effects of acepromazine
hypothermia ---> thermoregulatory depression/vasodilation
Increased blood pressure
reflex tachycardia
vasodilation ---> hypotension
55
What are different loco-regional block techniques?
peripheral nerve block
topical/intracavity & tissue infiltration
neuroaxial
Intravenous Regional Anaestisia (IVRA)
56
How can atrial fibrilation be treated?
Calcium Blocker
Ketamine
Beta blocker
Lignocaine
57
What does acetate from an acetated solution fluid form?
lactic acid in the muscle
bicarbonate in muscle
Nitrogen in the muscle
Calcium in the muscle
58
What are frequently used injectable agents for anaesthetic maintenance?
Triple Drip in horses (guaifenesin, ketamine & xylazine)
Isoflurane
Propofol
Alfaxalone
59
What can be used to monitor the cardiovascular system?
ECG
Blood gas analyser
Pulse oximeter
Stethoscope
60
What is a normal mean arterial pressure?
80-120 mmHg (get worried below 60mmHg)
45 -60 mmHg (get worried below 40mmHg)
60-90 mmHg (get worried below 40mmHg)
120 - 140 mmHg (get worried below 100mmHg)
61
What is often given to birds as premedication?
midazolam
ketamine
Opioids
alfaxalone
62
What adjuvants can be added to local anaesthetics?
Vasoconstrictors
Bicarbonate
Opiods
Chocolate
63
What happens to the capnograph waveform if the heart stops?
Waves will start to look like an ECG pattern
waves decrease in magnitude
waves increase in magnitude
waves disappear completely and immediately
64
What are the two main types of local anaesthetic?
tetrahydrocannabinol
amides
opiods
esters
65
What aspects of the respiratory system should be assessed while monitoring anaesthesia?
tissue oxygenation
Lung colour
tidal volume
respiratory rate and pattern
66
What are the risks associated with endotracheal intubation?
leaks
tracheal stenosis from overinflated cuff
accidental endobronchial intubation
laryngospasm
67
What is something to be aware of when administering acetated solution for fluid therapy?
Can cause hypertension if given rapidly
can cause hypotension if given rapidly
can cause the animal to spontaneously start singing
Can cause sudden death if given rapidly
68
At what stage of of anaesthesia is there NO palpebral reflex, but there is a corneal reflex, and relaxed jaw tone?
Stage 2
Stage 3 plane 1
Stage 3 plane 2
Stage 3 plane 3
69
What does lactate from Lactated Ringers Solution (LRS) produce?
Sedation
negative osmotic pressure
Bicarbonate in the liver
Glucose
70
What features should be present in a recovery area?
well ventilated
Classical music playing
warm and quiet
easy access to oxygen and emergency equipment
71
What are the effects of benzodiazepines?
anti-convulsant
muscle relaxant
Sedative
appetite stimulant
72
What is a normal EtCO2? (End Tidal CO2)
20-35 mmHg
35-45 mmHg
15-20 mmHg
60-90 mmHg
73
What happens to the capnograph if the patient is rebreathing
baseline doesn't return to 0
Death
Baseline will go below 0
Baseline stays at 0
74
How does the potency of inhalation agents relate to MAC?
Lower potency = lower MAC
Somebody get me a big MAC
Higher potency = lower MAC
Higher potency = higher MAC
75
How can a 2nd degree AV block be treated?
Atropine
lignocaine
beta blockers
administering fluids
76
What are consequences of respiratory depression?
Hypercapnia ----> tissue acidosis
Hypoxaemia ---> hypoxia
acceptance of your inevitable demise
A sense of calmness
77
What is something to be aware of when administering normal saline for fluid therapy?
can cause spontaneous and continuous urination
can cause acidosis
can cause necrotising fasciitis
can cause sudden death
78
What are possible side effects of opioids?
Bradycardia (minimal effect on BP)
respiratory depression
decreased GI motility (Ileum)
nausea and vomiting
79
What are contraindications for epidural anaesthesia?
Coagulopathy
Infectious dermatitis
High intracranial pressure (ICP)
Pregnant
80
What are potential disadvantages of premed?
cost and need to stock additional agents
Cardiovascular and respiratory depression
synergism with anaesthetic agents
prolonged recumbency
81
What are the effects of anticholinergics?
NO sedation or analgesia
increase HR & bronchodilation
reduce respiratory tract and salivary secretions
decrease in GI motility
82
What are characteristics of isoflurane as an inhalation agent?
will prolong your life for up to 5 years
Smells like roses
No contraindications
Pungent odor
83
How would you describe a Murphy ET tube?
The walls of the tube run parallel to each other
One end of the tube narrows
Can be cuffed or uncuffed
Same as the Magill tube, but with an eye (opening) at the end
84
What determines net water movement between Interstitial Fluid (ISF) and Intravenous Fluid (IVF)?
AKA Starling Hypothesis
AKA Hawke Hypothesis
Colloid osmotic pressure and hydrostatic pressure
Potassium (K) concentration in the ISF
85
What happens to respiration under anaesthesia?
overall decrease in minute ventilation and blood oxygen content
Rate increases
Rate declines
Tidal volume declines
86
What determines the effects of opioids?
Hydration status of the patient
Species
Room Temperature
agonist vs antagonist (full or partial)
87
How does a patient's cardiac output affect uptake and distribution of inhalation agents?
No cardiac output = ideal
lower cardiac output = less agent taken up by organs
Faster effects in changes of concentration
Equilibrium in blood is reached faster
88
What are the beneficial effects of injectable agents for anaesthetic maintenance?
Better quality of recovery
Neuro-protective
Gives the animal power over static electricity for a short period of time.
Cardiovascular stability
89
How would you maintain anaesthesia if you suspected intracranial disease?
With injectable agent
with acupuncture and medicinal herbs
With a mallet to the noggin
With inhalation agent
90
How does the recovery from anaesthesia maintained by injectable compare to inhalation?
Injectable = rapid but potentially rough recovery
Inhalational = prolonged but smoother recovery
Inhalational = rapid but potentially rough recovery
Injectable = prolonged but smoother recovery
91
What are the characteristics of nitrous oxide as an inhalation agent?
Tends to diffuse into air filled cavities more rapidly than air.
Good analgesia
Will make you go faster
Possible teratogenic effects
92
What are contraindications for alpha-2 agonists?
Young/old/sick animals
cardiovascular disease
hypovolemia / dehydration
diabetic
93
Of total water in the body (60%), how much is extracellular and how much is intracellular fluid?
Extracellular 20%
Intracellular 20%
Extracellular 40%
Intracellular 40%
94
What happens during the second stage of anaesthesia?
struggling, irregular breathing, dilated pupils
involuntary excitement
voluntary excitement
usually passed through very quickly
95
How does recovery from thiopentone occur?
excreted in urine
redistribution of drug into fat
You don't recover from thiopentone
excreted in faeces

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