Surgery Dr Q: Chapter 2

  1. VIC
    Veterinarian in charge
  2. What is minimum patient database?
    Patient history, physical examination and diagnostic tests
  3. What is preinduction care of the patient
    Medication administered, IV catherization, fluid administration and stabilization
  4. 4 points to ask in regards to symptoms
    • Duration
    • Volume/severity 
    • Frequency
    • Character/appearance
  5. What type of consent to get from owner before a procedure
    Written and oral
  6. When confirming a surgical procedure check the following specifics
    • If surgery on a limb confirm affected limb
    • Removing tumor know exact location
    • If removing tumor confirm owners request with histopathology or cytology 
    • Determine if client wishes doctor to use their judgement regarding unforeseen decisions during surgery
  7. Signalment is...
    • Species
    • Breed
    • Age
    • Sex
    • Reproductive status
  8. Which species are sensitive to opioids
    • Horse
    • Cat
  9. Which species requires lower doses of lidocaine
  10. Which species is more resistant to the effect of phenothiazine
  11. Which species tend to have rougher recoveries from inhalant anesthetics
  12. Anticholinergics should be avoided in which species
    Ruminants, can make their saliva thick and can lead to airway occlusion
  13. Ruminants are more sensitive to which drug that requires 1/10 the dose of horses
  14. Small pediatric animals are prone to what under anesthesia?
    • Hypercarbia (elevated CO2 in blood) 
    • Hypoexmia
  15. Dead space
    Breathing passages and tubes convey fresh O2 from the source to the alveoli but in which no gas exchange can occur
  16. Which species are prone to airway blockage
    • Cats
    • Ruminants
  17. Which species are prone to bloating
  18. Which breeds are sensitive to barbiturates because of their lack of body fat and slow metabolism
  19. Which breed is more sensitive to acepromazine
  20. Which breed is resistant to acepromazine
  21. Which breeds are more difficult to intubate
  22. Which breeds of horses are sensitive to sedatives
    Draft horses
  23. Which age of animals are less capable of metabolizing injectable drugs because the necessary liver metabolic pathways are not fully developed
    • Neonates (up to 2 weeks old)
    • Pediatric (2-8 weeks old)
  24. Which age of animals may not be able to tolerate normal drug doses because of poor hepatic or renal function
  25. Reproductive status refers to what..
    Whether the patient has been spayed, neutered, intact or if being used for breeding purposes
  26. Why not to perform a spay when an animal is in heat
    Uterus is enlarged and more extensive blood supply, can also bleed excessively due to effects of estrogen
  27. Which drug can cause penile prolapse in stallions
  28. Which drug can cause uterine contractions in third trimester in sheep and cattle
  29. Epinephrine given with which drugs can cause cardiac arrhythmias
    • Cyclohexamines
    • Xylazine
    • Barbiturates 
    • Halothane
  30. Antidepressants such as ___ and___ may cause cardiac arrhythmias and excessive responses to anticholinergics and CNS depressants
    • Amitriptyline
    • Clomipramine
  31. Which drug may decrease biotransformation of barbiturates and anesthetics, may also prolong propofol and ketamine
  32. If given within 14 days of each other some monoamine oxidase inhibitors such as ___ and ___ may increase effects of morphine and other opioids
    • Amitraz
    • Selegiline
  33. May cause an increase in CNS and respiratory depression if given with opioids
  34. Change in an animals behavior could indicate...
    • CNS disease
    • Pain
    • Systemic illness
  35. Exercise intolerate could indicate...
    • Heart disease
    • Anemia
    • Muscoskeletal pain
  36. Syncope
  37. Fainting could indicate...
    • Hypoxemia 
    • Low blood pressure
    • Cardiac disease
  38. Seizures may indicate..
    • CNS disease
    • Toxin ingestion 
    • Metabolic disorders
  39. CPCR
    Cardiopulmonary cerebrovascular resuscitation
  40. Dehydration increases the risk for these anesthetic complications
    • Hypotension (low blood pressure)
    • Poor tissue perfusion 
    • Kidney damage
  41. Anemia decreases...
    Oxygen carrying capacity of the blood and predisposes patient to hypoxemia
  42. Bruising lesions on the skin or mucous membranes indicate...
    Clotting disorder
  43. Numeric assessment of patients weight compared with the ideal body weight
    Body condition score
  44. Ideal body conditioning score in dogs
    4 or 5
  45. Ideal body conditioning score in cats
  46. Body condition score of 1 indicates
    Extreme cachexia
  47. Excessive thinness in patient may indicate
    • Hyperthyroidism 
    • Parasite overload
  48. Parameters indicating hydration levels
    • Skin turgor
    • Position of eye in orbit
    • Mucous membranes
    • Refill and moisture level
    • Heart rate
    • Pulse strength
  49. LOC
    Loss of consciousness
  50. EENT
    Eyes, ears, throat, nose
  51. Stridor
    Noisy breathing
  52. PLR
    Pupillary light reflex
  53. Direct light reflex
    Observe and compare pupil sizes, direct light into right eye and note size of pupil
  54. Pupil constriction
  55. Consensual light reflex
    While light shining in right eye observe the pupil size of the left eye, pupil should be the same size as the right
  56. Dog normal heart rate
  57. Cat normal heart rate
  58. Horse normal heart rate
  59. Cow normal heart rate
  60. Sheep/goat normal heart rate
  61. NSR
    Normal sinus rhythm
  62. SA
    Sinus arrhythmia
  63. Regular rhythm with no irregularities to pause between beats is...
    Normal sinus arrhythmia
  64. Rhythm in which the heart rate cyclically increase during inspiration and decreases during expiration
    Sinus arrhythmia
  65. First degree heart block is caused by what
    Conduction delay through the AV node and prolonged PR interval
  66. Second degree heart block caused by what
    Periodic block of electrical conduction through the AV node and missing QRS complex
  67. Where to palpate pulse
    • Femoral artery
    • Medial side of rear leg
  68. Cyanotic mucous membranes indicates
    Reduced oxygen saturation
  69. Dyspneic patients show signs of..
    • Mouth breathing
    • Flared nostrils
    • Excessive panting
    • Exaggerated chest or abdominal movements on inspiration 
    • Wheezing
  70. Gut sounds
  71. Complete blood cell count consists of
    • PCV
    • Plasma protein (PP)
    • Hemoglobin
    • RBC count
    • WBC count
    • Platelet count
  72. Elevated PCV or RBC count is often caused by ___ and may cause...
    • Dehydration
    • Decrease in blood volume
    • Affect cardiac output, blood pressure, and tissue perfusion
  73. PP is measurement of blood protein including...
    Albumin, globulins, fibrinogen
  74. Hypoproteinemia results from...
    Decreased protein production by the liver or increased loss from GI tract, kidneys or blood loss
  75. PP with less than ___ should be reported
  76. Changes in WBC counts can be associated with...
    • Infection
    • Parasitism
    • Leukemia
  77. Kidneys regulate...
    • Electrolyte and water balance
    • Blood pressure
    • Elimination of anesthetics
  78. Specific gravity for a dog
  79. Specific gravity for a cat
  80. Specific gravity for large animals
  81. Color, clarity, odor and biochemistry of a urinalysis can indicate...
    • Diabetes
    • Liver/Renal disease
    • Systemic disorders
  82. Blood chemistry test asses...
    • Circulating enzymes
    • Electrolytes
    • Proteins
    • Metabolites
  83. Which tests should be performed on patients that have preexisting coagulation disorders
    • Prothrombin time (PT)
    • Activated partial thromboplastin time (APTT)
  84. Which breeds might have hereditary coagulation disorders
    • Dobermans
    • Rottweilers
    • Scottish terriers
  85. Records electrical activity of the heart
  86. P1
    Normal, healthy, minimal risk
  87. P2
    Mild systemic disease, neonatal geriatric or obese patients, low risk
  88. P3
    Severe systemic disease, anemia, moderate dehydration, compensated major organ disease, moderate risk
  89. P4
    Severe systemic disease that is a constant threat to life, high risk
  90. P5
    Moribund, not going to survive without operation, extreme risk
  91. Which gases require precision vaporizer
    • Isoflurane
    • Sevoflurane
  92. Active expulsion of stomach contents that occurs in conscious patients
  93. Passive process that may occur in an unconscious or conscious patient, results in flow of stomach contents into  esophagus and mouth
  94. Fluid administration helps maintain __ and ___
    Blood volume and blood pressure
  95. CRI
    Constant rate infusion
  96. 2 types of catheters
    • Through the needle
    • Over the needle
  97. What size catheter for small animals
    16-24 gauge 3/4-2 inch
  98. Air embolism
    Air going into catheter and vein
  99. Almost all anesthetic drugs decrease ___ and cause ____, in turn decreasing flow of blood from heart
    • Force of heart muscle contractions (inotropy)
    • Bradycardia
  100. Increase in intravascular volume
  101. Fluids aid in oxygen delivery by___ and ___
    • Increasing blood volume and cardiac output
    • AKA blood pressure and tissue perfusion
  102. What percentage of body weight in adult animals is water
  103. What percent of body weight is intracellular fluid
  104. Extracellular fluid is broken down into two different types...
    • 15% interstitial
    • 5% intravascular
  105. What percent of body weight is extracellular fluid
  106. Solutes important in fluid therapy
    • Ions
    • Colloids
    • Glucose
    • Small proteins
  107. Cations
    • Na+
    • K+
    • Mg++
    • Ca++
  108. Proteins are important in what 3 things
    • Drug transport
    • Oncotic pressure
    • Blood clotting
  109. Anions
    • Cl-
    • HCO3-
    • Phosphates
    • Proteins
  110. Constant state within the body created and maintained by normal physiologic processes
  111. Small ions and particles diffuse ____ until ___ ____
    • Freely
    • Equilibrium balanced
  112. Colloids dont diffuse and act to increase ___ ___ and draws fluids into __ ___.
    • Oncotic pressure 
    • Vascular space
  113. Blood volume of dogs
    90 mL/kg
  114. Blood volume of cats
    60 mL/kg
  115. Increase in K+ causes
    Heart to stop
  116. Osmolarity solute concentration
    300 mOsm/L
  117. What increases water loss
    Dehydration, exercise, heat stroke, vomiting, diarrhea
  118. What decreases osmolarity
    Chronic heart failure
  119. Increase in Ca++ will cause
  120. Naturally occurring form of glucose
  121. Fluids are classified into two different types
    • Crystalloids
    • Colloids
  122. Fluids subdivided by mix and quantity of solutes as..
    • Replacement
    • Balanced/Unbalanced
    • Isotonic
    • Hypotonic
    • Hypertonic
  123. Contain water and small molecular weight solutes such as electrolytes
  124. Isotnic, polyionic replacement solution
    Contains ions such as sodium, potassium and chloride, is some cases magnesium and/or calcium
  125. Examples of isotonic, polyionic replacement solutions
    • Lactated ringers (LR)
    • Normosol-R (NR)
    • Plasma-Lyte A (PA and PR)
    • Isolyte (IS)
  126. Examples of isotonic, polyionic maintenance solution
    • Normosol-M in 5% dextrose (NM5)
    • Plasma Lyte 56 in 5% dextrose
  127. Normal saline solution AKA physiologic saline examples
    • 0.9% saline 
    • Sodium chloride 0.9%
  128. Hypertonic saline solutions
    Concentrated saline solution given with isotonic crystalloids to treat patients with shock
  129. Dextrose solutions
    Rapidly metabolized to CO2 and water and most of the plain water diffuse into the interstital compartment
  130. Contain large molecular weight solutes that cont freely diffuse across vascular endothelium and stay in intravascular space
    Colloid solutions
  131. 2 types of colloid solutions
    • Synthetic colloids
    • Blood products
  132. Synthetic colloid solutions
    Contain Dextran, pentastarch, hetastarch or gelatin products. 30-60% stays in plasma after 24 hours and smaller amount remains for as long as days to week
  133. Dose of synthetic colloids
    • Dogs: 10-20 mL/kg/day
    • Cats: 5-10 mL/kg/day
  134. Blood products
    • Plasma and whole blood contain albumin and other natural colloids.
    • Plasma used to support expansion of blood volume or treat hypoproteinemia
  135. IV fluid flow rate
    10  mL/kg/hr during first hour and 5 mL/kg/hr for maintenance
  136. Shock doses old school way
    • Dogs: 90 mL/kg/lb
    • Cats: 55 mL/kg/lb
  137. Shock doses new way
    • Dogs: 10-20 mL/kg/15 mins
    • Cats: 5-10 mL/kg/15 mins
  138. Maintenance fluid rates
    • Dogs: 3-6 mL/kg/hr
    • Cats: 2-3 mL/kg/hr
  139. Signs of overhydration
    • Ocular/nasal discharge 
    • Chemosis
    • Edema of conjunctiva
    • SQ edema
    • Increased lung sounds
    • Increased respiratory rate
    • Dyspnea
  140. Macrodrip used for patients __kg or more
  141. Microdrip used for patients less than __ kg
  142. Pain medicine administered before a procedure
    Preemptive analgesia
  143. No signs detectable for dehydration
    < 5
  144. Mild loss of skin elasticity
  145. Definite loss of skin elasticity, may have dry mucous membranes, may have depressed globes within orbits
  146. Persistent skin ten with slow return because of loss of skin elasticity
  147. Persistent skin tent because of loss of skin elasticity, depressed globes within orbits, dry mucous membranes, CRT > 2 seconds
  148. Signs of shock , death
  149. Fully conscious, alert, engaged and interested in enviornment
  150. Fully conscious and alert but not engaged, owing to fear, pain, illness. Subdued or quiet
  151. Mildly depressed, aware of surroundings. Can be aroused with minimal difficulty
  152. Very depressed. Uninterested in surroundings. Responds to but cannot be fully aroused by a verbal or tactile stimulus
  153. Sleeplike state, nonresponsive to a verbal stimulus. Can be aroused by a painful stimulus
  154. Sleeplike state. Cannot be aroused by any means.
  155. Anesthetic protocol that uses anesthetic drugs to maximize benefits and minimize risk
    Balanced anesthesia
  156. Abnormal heart rhythms can be differentiated from sinus arrhythmia by observing ___ while auscultating heart
  157. Healthy dogs and cats should withhold food for ___ and water for ___ before anesthesia
    • 8-12 hours
    • 2-4 hours
Card Set
Surgery Dr Q: Chapter 2
Surgery Dr Q: Chapter 2