DVM Anesthesia and Pain Management 3 — Questions and Answers
Question 1: A brachycephalic breed dog is presented for soft palate resection. Which preoperative concern is MOST critical for anesthetic planning?
- Risk of hypoglycemia
- Airway obstruction during recovery (Correct answer)
- Increased sensitivity to opioids
- Hepatic dysfunction affecting drug metabolism
Correct answer: Airway obstruction during recovery
Brachycephalic dogs are at highest risk for postoperative airway obstruction due to edema and anatomic abnormalities, making recovery the most critical phase.
Question 2: Which alpha-2 adrenergic agonist is MOST commonly used for sedation and analgesia in horses at the field setting?
- Acepromazine
- Xylazine (Correct answer)
- Medetomidine
- Dexmedetomidine
Correct answer: Xylazine
Xylazine is the most widely used alpha-2 agonist for equine sedation in field conditions due to its availability, rapid onset, and effective sedation at appropriate doses.
Question 3: What is the mechanism by which NSAIDs provide analgesia in veterinary patients?
- Blockade of sodium channels in peripheral nerves
- Inhibition of cyclooxygenase (COX) enzymes reducing prostaglandin synthesis (Correct answer)
- Activation of descending inhibitory pain pathways
- Antagonism of NMDA receptors in the dorsal horn
Correct answer: Inhibition of cyclooxygenase (COX) enzymes reducing prostaglandin synthesis
NSAIDs inhibit COX-1 and/or COX-2 enzymes, reducing prostaglandin synthesis and thereby decreasing peripheral and central sensitization.
Question 4: A feline patient under isoflurane anesthesia develops hypothermia (rectal temperature 34°C). Which consequence is MOST immediately clinically relevant?
- Prolonged drug metabolism and recovery (Correct answer)
- Increased risk of wound infection
- Hypertension from peripheral vasoconstriction
- Tachycardia from shivering
Correct answer: Prolonged drug metabolism and recovery
Hypothermia slows hepatic enzyme activity and drug metabolism, leading to prolonged anesthetic recovery and potential overdose effects.
Question 5: When performing a retrobulbar block in a dog for enucleation, which serious complication must the clinician be vigilant for?
- Corneal ulceration
- Brainstem injection (Correct answer)
- Hemorrhage into the anterior chamber
- Horner's syndrome
Correct answer: Brainstem injection
The optic nerve sheath connects to the subarachnoid space, and inadvertent injection can lead to brainstem spread of local anesthetic, causing apnea and cardiovascular collapse.
Question 6: Which of the following correctly describes the concept of 'minimum alveolar concentration' (MAC) of an inhalant anesthetic?
- The concentration at which 50% of patients are fully recovered
- The alveolar concentration that prevents movement in 50% of patients exposed to a noxious stimulus (Correct answer)
- The lowest concentration that produces unconsciousness in all patients
- The concentration required to prevent autonomic responses to surgery
Correct answer: The alveolar concentration that prevents movement in 50% of patients exposed to a noxious stimulus
MAC is defined as the alveolar concentration of an inhalant agent that prevents gross purposeful movement in response to a supramaximal noxious stimulus in 50% of patients.
Question 7: A dog receiving a morphine CRI post-surgery develops respiratory depression (rate 4 breaths/min). What is the CORRECT reversal agent and dose strategy?
- Atipamezole at full reversal dose IM
- Naloxone titrated IV in small incremental doses (Correct answer)
- Flumazenil IV bolus
- Yohimbine IV at 0.1 mg/kg
Correct answer: Naloxone titrated IV in small incremental doses
Naloxone is the opioid antagonist of choice; small incremental IV doses reverse respiratory depression while minimizing the risk of acute pain and cardiovascular excitation.
DVM Anesthesia and Pain Management 3
A brachycephalic breed dog is presented for soft palate resection.
Which preoperative concern is MOST critical for anesthetic planning?