DVM Anesthesia and Pain Management 5 — Questions and Answers
Question 1: Which of the following is a CONTRAINDICATION to the use of ketamine as the sole induction agent in a dog?
- Hypertrophic cardiomyopathy
- Hepatic lipidosis
- Uncontrolled epilepsy (Correct answer)
- Hyperthyroidism
Correct answer: Uncontrolled epilepsy
Ketamine lowers the seizure threshold and can provoke seizures in patients with uncontrolled epilepsy; it should be avoided or used with extreme caution in these patients.
Question 2: In epidural anesthesia in dogs, at which intervertebral space is the injection MOST commonly performed?
- C6-C7
- T13-L1
- L7-S1 (Correct answer)
- S1-S2
Correct answer: L7-S1
The lumbosacral (L7-S1) space is the standard site for epidural injection in dogs because the spinal cord ends cranial to this space, minimizing the risk of cord trauma.
Question 3: A rabbit undergoing ovariohysterectomy develops bradycardia and hypotension after induction with dexmedetomidine and ketamine. What is the MOST appropriate pharmacological intervention?
- Atropine IV to treat bradycardia
- Atipamezole IM to reverse dexmedetomidine (Correct answer)
- Epinephrine IV bolus
- Dobutamine CRI
Correct answer: Atipamezole IM to reverse dexmedetomidine
Atipamezole reverses dexmedetomidine-induced alpha-2 agonist effects, restoring heart rate and vascular tone without requiring additional drugs.
Question 4: Which nociceptive pathway is PRIMARILY responsible for the slow, burning, poorly localized pain associated with tissue inflammation?
- A-beta fibers via the dorsal column-medial lemniscal pathway
- A-delta fibers via the spinothalamic tract
- C fibers via the spinothalamic tract (Correct answer)
- A-alpha fibers via the corticospinal tract
Correct answer: C fibers via the spinothalamic tract
Unmyelinated C fibers transmit slow, burning, diffuse pain from tissue inflammation via the spinothalamic tract to the thalamus and cortex.
Question 5: A dog undergoing splenectomy for a ruptured splenic mass suddenly develops peaked T-waves and wide QRS complexes on the ECG monitor. What is the MOST likely electrolyte abnormality?
- Hypokalemia
- Hyperkalemia (Correct answer)
- Hypocalcemia
- Hyponatremia
Correct answer: Hyperkalemia
Hyperkalemia causes peaked T-waves, QRS widening, and can progress to sine-wave pattern and ventricular fibrillation; it can occur with massive tissue release from tumor necrosis.
Question 6: Which statement regarding feline pain assessment is MOST accurate?
- Cats reliably vocalize when in pain, making assessment straightforward
- The Grimace Scale based on facial action units is a validated tool for acute pain assessment in cats (Correct answer)
- Cats show identical pain behaviors to dogs and can be assessed with the same scales
- Sedation scores in cats correlate directly with pain intensity
Correct answer: The Grimace Scale based on facial action units is a validated tool for acute pain assessment in cats
The Feline Grimace Scale (FGS) uses facial action units (ear position, orbital tightening, muzzle tension, whisker change, head position) and is validated for acute pain assessment in cats.
Question 7: Which factor MOST significantly increases the risk of anesthetic mortality in equine patients compared to small animals?
- Greater sensitivity to opioid-induced dysphoria
- Myopathy and neuropathy from prolonged recumbency under anesthesia (Correct answer)
- More frequent cardiovascular arrhythmias during inhalant anesthesia
- Higher prevalence of hepatic disease affecting drug metabolism
Correct answer: Myopathy and neuropathy from prolonged recumbency under anesthesia
Equine anesthetic-associated mortality is significantly higher than small animals, largely due to post-anesthetic myopathy and neuropathy from compression ischemia during recumbency.
DVM Anesthesia and Pain Management 5
Which of the following is a CONTRAINDICATION to the use of ketamine as the sole induction agent in a dog?