Anesthesia 3.0

ECG

100

See #1 

Ventricular tachycardia 

200

See #2 

2nd degree type 2 AV block 

300

See #3 

Atrial flutter

400

See #4

Unifocal VPC

500

See #5

Premature atrial contractions

Capnograph

100

See #1

Cardiac oscillations 

200

See #2

Expiratory resistance

300

See #3

Hypocapnia 

400

See #4 

Hyperventilation 

500

See #5

Rebreathing CO2

Blood gas

100

We use measured PaCO2 to determine respiratory pH. What is the definition of respiratory pH?

What is what the pH would be if all change in pH was due solely to CO2? 

200

Calculate the base excess/deficit: 

pH 7.24, PaCO2 84, predicted resp pH 7.18

What is 4 mEq/L base excess? 

300

Interpret: 

pH 7.08, PaCO2 82 

82-40 = 42 * ½ = 0.21

7.40 – 0.21 = 7.19 predicted respiratory pH

Since the measured pH is lower than the predicted respiratory pH, this is a respiratory acidosis (high CO2) and a metabolic acidosis

400

Interpret: 

pH 7.21, PaCO2 80

80 – 40 = 50 * ½ = 0.20

7.40 – 0.20 = 7.2 predicted respiratory pH

Since the measured pH is close to the predicted respiratory pH, this is a respiratory acidosis

500

Interpret: 

pH 7.45, PaCO2 16

40 – 16 = 24 * 0.1 = 0.24

7.40 + 0.24 = 7.64 predicted respiratory pH

Based on the predicted respiratory pH, this appears to be a respiratory alkalosis with metabolic compensation

Drugs

100

Name the MOA of dobutamine 

Beta agonist 

200

This is the duration of action of dexmedetomidine 

What is around 1 hour? 

300

What is the MOA of ketamine? 

What is a noncompetitive NMDA antagonist? 

400

What is the MOA of lidocaine? 

What is sodium channel blocker? 

500

This drug is more effective for analgesia in cats than in dogs because cats produce the main active metabolite that is more potent than the drug itself and has a higher affinity for opioid receptors and dogs do not

What is tramadol? 

Special Considerations

100

Name a drug that would be contraindicated in cases of dilated cardiomyopathy 

What is anything that causes bradycardia? 

200

Which drug would be contraindicated in the case of an intracranial mass because it DIRECTLY increases intracranial pressure?

What is ketamine? 

300

This drug should not be drawn up the night before and only mixes well with ketamine because of its propylene glycol base

What is diazepam? 

400

What is the DEA schedule of alfaxalone?

What is schedule 4? 

500

You have a patient with respiratory concerns. Which induction agent(s) may not be the best idea?

What is ketamine?

OR 

What is etomidate?