Difference between revisions of "Injectable Anaesthesia and Analgesia Quiz"
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− | |Review= | + | |Review= '''Juliet Duncan''' BVM&S MSc DipECVAA MRCVS <br> '''Richard Hammond''' BSc BVetMed DipECVA DVA PhD MRCVS |
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{{QuizCat|topic=Drug|topicsubcategory=I}} | {{QuizCat|topic=Drug|topicsubcategory=I}} | ||
{{QuizCat|topic=clinical|topicsubcategory=I}} | {{QuizCat|topic=clinical|topicsubcategory=I}} | ||
+ | |||
+ | <WikiQuiz | ||
+ | questionnumber="1" | ||
+ | question="Naloxone is a reversal agent for which group of drugs?" | ||
+ | choice4="Opioids" | ||
+ | choice3="Alpha-2 agonists" | ||
+ | choice2="Benzodiazepines" | ||
+ | choice1="Butyrophenones" | ||
+ | choice5="Phenothiazines" | ||
+ | correctchoice="4" | ||
+ | feedback4="'''Correct!''' Naloxone is an antagonist to exogenous and endogenous opioids. It is frequently used in human medicine to antagonise opioid narcotics in the incidence of overdose. Naloxone may be administered intravenously, intramuscularly, intrathecally or subcutaneously. It has a short duration of action (1-2 hours) and so repeated administrations may be necessary. Although diprenorphine (LA Revivon) is the licensed reversal agent for LA Immobilon in animals, naloxone should also be drawn up in case of accidental self-injection which can be rapidly fatal in man.[[Opioids#Opioid Antagonists|WikiVet Article: Opioids]]" | ||
+ | feedback3="'''Incorrect.''' Alpha-2 agonists can be antagonised with atipamazole. Naloxone is an antagonist to exogenous and endogenous opioids. It is frequently used in human medicine to antagonise opioid narcotics in the incidence of overdose. Naloxone may be administered intravenously, intramuscularly, intrathecally or subcutaneously. It has a short duration of action (1-2 hours) and so repeated administrations may be necessary. Although diprenorphine (LA Revivon) is the licensed reversal agent for LA Immobilon in animals, naloxone should also be drawn up in case of accidental self-injection which can be rapidly fatal in man.[[Opioids#Opioid Antagonists|WikiVet Article: Opioids]]" | ||
+ | feedback2="'''Incorrect.''' Benzodiazepines can be antagonised by flumazenil and sarmazenil. Naloxone is an antagonist to exogenous and endogenous opioids. It is frequently used in human medicine to antagonise opioid narcotics in the incidence of overdose. Naloxone may be administered intravenously, intramuscularly, intrathecally or subcutaneously. It has a short duration of action (1-2 hours) and so repeated administrations may be necessary. Although diprenorphine (LA Revivon) is the licensed reversal agent for LA Immobilon in animals, naloxone should also be drawn up in case of accidental self-injection which can be rapidly fatal in man. Link to Wiki Vet: opioids.[[Opioids#Opioid Antagonists|WikiVet Article: Opioids]]" | ||
+ | feedback1="'''Incorrect.''' Butyrophenones have no reversal agent. Naloxone is an antagonist to exogenous and endogenous opioids. It is frequently used in human medicine to antagonise opioid narcotics in the incidence of overdose. Naloxone may be administered intravenously, intramuscularly, intrathecally or subcutaneously. It has a short duration of action (1-2 hours) and so repeated administrations may be necessary. Although diprenorphine (LA Revivon) is the licensed reversal agent for LA Immobilon in animals, naloxone should also be drawn up in case of accidental self-injection which can be rapidly fatal in man. Link to Wiki Vet: opioids." | ||
+ | feedback5="'''Incorrect.''' Phenothiazines have no reversal agent. Naloxone is an antagonist to exogenous and endogenous opioids. It is frequently used in human medicine to antagonise opioid narcotics in the incidence of overdose. Naloxone may be administered intravenously, intramuscularly, intrathecally or subcutaneously. It has a short duration of action (1-2 hours) and so repeated administrations may be necessary. Although diprenorphine (LA Revivon) is the licensed reversal agent for LA Immobilon in animals, naloxone should also be drawn up in case of accidental self-injection which can be rapidly fatal in man.[[Opioids#Opioid Antagonists|WikiVet Article: opioids.]]" | ||
+ | image=""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="2" | ||
+ | question="In which dog breed can acepromazine cause fainting and syncope?" | ||
+ | choice4="Boxer" | ||
+ | choice1="Cavalier King Charles Spaniel" | ||
+ | choice3="St Bernards" | ||
+ | choice5="German shepherd dogs" | ||
+ | choice2="Doberman" | ||
+ | correctchoice="4" | ||
+ | feedback4="'''Correct!''' In Boxers given acepromazine, spontaneous fainting and syncope can occur due to sinoatrial block caused by excessive vagal tone. Acepromazine should be used at low doses or avoided in this breed. [[Phenothiazines#Acepromazine|WikiVet Article: phenothiazines.]]" | ||
+ | feedback1="'''Incorrect.''' Acepromazine has not been associated with fainting and syncope in Cavalier King Charles Spaniels. In Boxers given acepromazine, spontaneous fainting and syncope can occur due to sinoatrial block caused by excessive vagal tone. Acepromazine should be used at low doses or avoided in this breed. [[Phenothiazines#Acepromazine|WikiVet Article: phenothiazines.]]" | ||
+ | feedback3="'''Incorrect.''' Acepromazine has not been associated with fainting and syncope in Cavalier King Charles Spaniels. In Boxers given acepromazine, spontaneous fainting and syncope can occur due to sinoatrial block caused by excessive vagal tone. Acepromazine should be used at low doses or avoided in this breed. [[Phenothiazines#Acepromazine|WikiVet Article: phenothiazines.]]" | ||
+ | feedback5="" | ||
+ | feedback2="'''Incorrect.''' Acepromazine has not been associated with fainting and syncope in Dobermans. In Boxers given acepromazine, spontaneous fainting and syncope can occur due to sinoatrial block caused by excessive vagal tone. Acepromazine should be used at low doses or avoided in this breed. [[Phenothiazines#Acepromazine|WikiVet Article: phenothiazines.]]" | ||
+ | image=""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="3" | ||
+ | question="Which injectable anaesthetic should be avoided in sighthounds?" | ||
+ | choice5="Thiopentone" | ||
+ | choice1="Propofol" | ||
+ | choice2="Ketamine" | ||
+ | choice3="Alfaxalone" | ||
+ | choice4="Fentanyl-fluanisone" | ||
+ | correctchoice="5" | ||
+ | feedback5="'''Correct!''' Initial recovery from anaesthesia induced by thiopentone is dependent on redistribution of thiopentone from the plasma to the fat. Greyhounds and other sight hounds may exhibit longer recovery times than other breeds. This may be due to these breeds low body fat levels or differences in the metabolic handling of the thiobarbiturates. Propofol and alfaxalone are preferable induction agents in sighthounds. [[Barbiturates#Thiopental|WikiVet Article: thiopentone.]]" | ||
+ | feedback1="'''Incorrect.''' Propofol is an appropriate induction agent in sighthounds. Initial recovery from anaesthesia induced by thiopentone is dependent on redistribution of thiopentone from the plasma to the fat. Greyhounds and other sight hounds may exhibit longer recovery times than other breeds. This may be due to these breeds low body fat levels or differences in the metabolic handling of the thiobarbiturates. Both propofol and alfaxalone are preferable induction agents in sighthounds.[[Barbiturates#Thiopental|WikiVet Article: thiopentone.]]" | ||
+ | feedback2="'''Incorrect.''' Propofol is an appropriate induction agent in sighthounds. Initial recovery from anaesthesia induced by thiopentone is dependent on redistribution of thiopentone from the plasma to the fat. Greyhounds and other sight hounds may exhibit longer recovery times than other breeds. This may be due to these breeds low body fat levels or differences in the metabolic handling of the thiobarbiturates. Both propofol and alfaxalone are preferable induction agents in sighthounds.[[Barbiturates#Thiopental|WikiVet Article: thiopentone.]]" | ||
+ | feedback3= "'''Incorrect.''' Alfaxalone is an appropriate induction agent in sighthounds. Initial recovery from anaesthesia induced by thiopentone is dependent on redistribution of thiopentone from the plasma to the fat. Greyhounds and other sight hounds may exhibit longer recovery times than other breeds. This may be due to these breeds low body fat levels or differences in the metabolic handling of the thiobarbiturates. Both propofol and alfaxalone are preferable induction agents in sighthounds. [[Barbiturates#Thiopental|WikiVet Article: thiopentone.]]" | ||
+ | feedback4="'''Incorrect.''' Fentanyl-fluanisone is not licensed in dogs, it is only licensed in rabbits, guinea pigs, rats and mice. Initial recovery from anaesthesia induced by thiopentone is dependent on redistribution of thiopentone from the plasma to the fat. Greyhounds and other sight hounds may exhibit longer recovery times than other breeds. This may be due to these breeds low body fat levels or differences in the metabolic handling of the thiobarbiturates. Propofol and alfaxaolne are preferred induction agents in sighthounds. [[Barbiturates#Thiopental|WikiVet Article: thiopentone.]]" | ||
+ | image=""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="4" | ||
+ | question="Which drug is commonly used for total intravenous anaesthesia (TIVA) in dogs?" | ||
+ | choice1="Propofol" | ||
+ | choice3="Thiopentone" | ||
+ | choice2="Ketamine" | ||
+ | choice4="Alfaxalone" | ||
+ | choice5="Fentanyl-fluanisone" | ||
+ | correctchoice="1" | ||
+ | feedback1="'''Correct!''' Propofol has a very high volume of distribution and so a rapid re-distribution. It also has a very fast clearance by the liver metabolism in dogs therefore it is non-cumulative and can be used for TIVA. This is not true in cats, they can not metabolise propofol as effectively and so repeated doses can cause Heinz body anaemia, anorexia, diarrhoea and prolonged aneasthetic recovery.[[Propofol#Pharmacological Considerations|WikiVet Article: propofol.]]" | ||
+ | feedback3="'''Incorrect.''' Thiopentone is cumulative following repeated doses so is not suitable for TIVA in any animal. Propofol has a very high volume of distribution and so a rapid re-distribution. It also has a very fast clearance by the liver metabolism in dogs therefore it is non-cumulative and can be used for TIVA. This is not true in cats, they can not metabolise propofol as effectively and so repeated doses can cause Heinz body anaemia, anorexia, diarrhoea and prolonged aneasthetic recovery.[[Propofol#Pharmacological Considerations|WikiVet Article: propofol.]]" | ||
+ | feedback2="'''Incorrect.''' Ketamine is not licensed for intravenous administration in dogs and so can not be used for TIVA. Propofol has a very high volume of distribution and so a rapid re-distribution. It also has a very fast clearance by the liver metabolism in dogs therefore it is non-cumulative and can be used for TIVA. This is not true in cats, they can not metabolise propofol as effectively and so repeated doses can cause Heinz body anaemia, anorexia, diarrhoea and prolonged aneasthetic recovery. [[Propofol#Pharmacological Considerations|WikiVet Article: propofol.]]" | ||
+ | feedback4="'''Incorrect.''' Alfaxalone is a relatively new anaesthetic which can be used for TIVA but it is not yet commonly used for this in practice. Propofol has a very high volume of distribution and so a rapid re-distribution. It also has a very fast clearance by the liver metabolism in dogs therefore it is non-cumulative and can be used for TIVA. This is not true in cats, they can not metabolise propofol as effectively and so repeated doses can cause Heinz body anaemia, anorexia, diarrhoea and prolonged aneasthetic recovery. [[Propofol#Pharmacological Considerations|WikiVet Article: propofol.]]" | ||
+ | feedback5="'''Incorrect.''' Fentanyl-fluanisone is not licensed for use in dogs in the UK. Propofol has a very high volume of distribution and so a rapid re-distribution. It also has a very fast clearance by the liver metabolism in dogs therefore it is non-cumulative and can be used for TIVA. This is not true in cats, they can not metabolise propofol as effectively and so repeated doses can cause Heinz body anaemia, anorexia, diarrhoea and prolonged aneasthetic recovery.[[Propofol#Pharmacological Considerations|WikiVet Article: propofol.]]" | ||
+ | image=""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="5" | ||
+ | question="Which injectable anaesthetic increases intracranial pressure and central nervous system (CNS) excitement?" | ||
+ | choice5="Ketamine" | ||
+ | choice3="Thiopentone" | ||
+ | choice2="Propofol" | ||
+ | choice4="Alfaxalone" | ||
+ | choice1="Fentanyl-fluanisone" | ||
+ | correctchoice="5" | ||
+ | feedback5="'''Correct!''' Ketamine increases intracranial pressure and CNS excitement which is not usually a problem in healthy animals but it should be avoided in cases where increasing intracranial pressure may be detrimental or those with a history of seizures. [[Dissociative Agents#Ketamine|WikiVet Article: ketamine.]]" | ||
+ | feedback3="'''Incorrect.''' Thiopentone actually reduces intracranial pressure and is excellent at treating and preventing seizures so it is often selected for anaesthetising animals with seizures or intracranial disease. Ketamine increases intracranial pressure and CNS excitement which is not usually a problem in healthy animals but it should be avoided in cases where increasing intracranial pressure may be detrimental or those with a history of seizures. [[Dissociative Agents#Ketamine|WikiVet Article: ketamine.]]" | ||
+ | feedback2="'''Incorrect.''' Propofol actually reduces intracranial pressure and it also has anticonvulsant properties and so can be used to anaesthetise a seizuring animal when other treatments, such as diazepam, have been ineffective. Ketamine increases intracranial pressure and CNS excitement which is not usually a problem in healthy animals, but it should be avoided in cases where increasing intracranial pressure may be detrimental or those with a history of seizures. [[Dissociative Agents#Ketamine|WikiVet Article: ketamine.]]" | ||
+ | feedback4="'''Incorrect.''' Alfaxalone does not increase intracranial pressure. Ketamine increases intracranial pressure and CNS excitement which is not usually a problem in healthy animals, but it should be avoided in cases where increasing intracranial pressure may be detrimental or those with a history of seizures. [[Dissociative Agents#Ketamine|WikiVet Article: ketamine.]]" | ||
+ | feedback1="'''Incorrect.''' Fentanyl-fluanisone does not increase intracranial pressure. Ketamine increases intracranial pressure and CNS excitement which is not usually a problem in healthy animals, but it should be avoided in cases where increasing intracranial pressure may be detrimental or those with a history of seizures. [[Dissociative Agents#Ketamine|WikiVet Article: ketamine.]]" | ||
+ | image=""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="6" | ||
+ | question="Which local anaesthetic also has anti-arrhythmogenic properties?" | ||
+ | choice5="Lidocaine" | ||
+ | choice4="Bupivicaine" | ||
+ | choice1="Mepivicaine" | ||
+ | choice3="Procaine" | ||
+ | choice2="Proxymetacaine" | ||
+ | correctchoice="5" | ||
+ | feedback5="'''Correct!''' Lidocaine is an amide-linked local anaesthetic, which also has anti-arrhythmic properties. Lidocaine has class 1b antiarrhythmic actions; decreasing the rate of ventricular firing, action potential duration and absolute refractory period, and increasing relative refractory period. However do not give lidocaine preparations containing adrenaline intravenously. [[Local Anaesthetics#Lidocaine|WikiVet Article: lidocaine.]]" | ||
+ | feedback4="'''Incorrect.''' Bupivicaine does not have anti-arrhythmogenic properties. Lidocaine is an amide-linked local anaesthetic, which also has anti-arrhythmic properties. Lidocaine has class 1b antiarrhythmic actions; decreasing the rate of ventricular firing, action potential duration and absolute refractory period, and increasing relative refractory period. However do not give lidocaine preparations containing adrenaline intravenously. [[Local Anaesthetics#Lidocaine|WikiVet Article: lidocaine.]]" | ||
+ | feedback1="'''Incorrect.''' Mepivicaine does not have anti-arrhythmogenic properties. Lidocaine is an amide-linked local anaesthetic, which also has anti-arrhythmic properties. Lidocaine has class 1b antiarrhythmic actions; decreasing the rate of ventricular firing, action potential duration and absolute refractory period, and increasing relative refractory period. However do not give lidocaine preparations containing adrenaline intravenously. [[Local Anaesthetics#Lidocaine|WikiVet Article: lidocaine.]]" | ||
+ | feedback3= "'''Incorrect.''' Procaine does not have anti-arrhythmogenic properties. Lidocaine is an amide-linked local anaesthetic, which also has anti-arrhythmic properties. Lidocaine has class 1b antiarrhythmic actions; decreasing the rate of ventricular firing, action potential duration and absolute refractory period, and increasing relative refractory period. However do not give lidocaine preparations containing adrenaline intravenously. [[Local Anaesthetics#Lidocaine|WikiVet Article: lidocaine.]]" | ||
+ | feedback2="'''Incorrect.''' Proxymetacaine does not have anti-arrhythmogenic properties. Lidocaine is an amide-linked local anaesthetic, which also has anti-arrhythmic properties. Lidocaine has class 1b antiarrhythmic actions; decreasing the rate of ventricular firing, action potential duration and absolute refractory period, and increasing relative refractory period. However do not give lidocaine preparations containing adrenaline intravenously. [[Local Anaesthetics#Lidocaine|WikiVet Article: lidocaine.]]" | ||
+ | image=""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="7" | ||
+ | question="Which local anaesthetic has the longest duration of action?" | ||
+ | choice1="Bupivicaine" | ||
+ | choice2="Lidocaine" | ||
+ | choice5="Mepivicaine" | ||
+ | choice3="Procaine" | ||
+ | choice4="Proxymetacaine" | ||
+ | correctchoice="1" | ||
+ | feedback1="'''Correct!''' Bupivicaine has a time to onset of 20-30 minutes and it has a duration of action of around 8 hours. [[Local Anaesthetics#Bupivicaine|WikiVet Article: bupivicaine.]]" | ||
+ | feedback2="'''Incorrect.''' Lidocaine has a time to onset of action of 3-10 minutes and a duration of action of 60-90 minutes. Bupivicaine has a time to onset of 20-30 minutes and it has a duration of action of around 8 hours. [[Local Anaesthetics#Bupivicaine|WikiVet Article: bupivicaine.]]" | ||
+ | feedback5="'''Incorrect.''' Mepivicaine has a time to onset of action of 5-10 minutes and a duration of action of 90- 180 minutes. Bupivicaine has a time to onset of 20-30 minutes and it has a duration of action of around 8 hours. [[Local Anaesthetics#Bupivicaine|WikiVet Article: bupivicaine.]]" | ||
+ | feedback3="'''Incorrect.''' Procaine has an onset of action of 15-20 minutes and a duration of action of 45-60 minutes. Bupivicaine has a time to onset of 20-30 minutes and it has a duration of action of around 8 hours. [[Local Anaesthetics#Bupivicaine|WikiVet Article: bupivicaine.]]" | ||
+ | feedback4="'''Incorrect.''' Proxymetacaine has an onset of action of 10 seconds and a duration of action of 10-20 minutes. Bupivicaine has a time to onset of 20-30 minutes and it has a duration of action of around 8 hours. [[Local Anaesthetics#Bupivicaine|WikiVet Article: bupivicaine.]]" | ||
+ | image=""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="8" | ||
+ | question="Atipamazole is the reversal agent for which group of drugs?" | ||
+ | choice3="Alpha-2 agonists" | ||
+ | choice4="Benzodiazepines" | ||
+ | choice2="Butyrophenones" | ||
+ | choice1="Opioids" | ||
+ | choice5="Phenothiazines" | ||
+ | correctchoice="3" | ||
+ | feedback3="'''Correct!''' Atipamazole is licensed for the reversal of the sedative effects of dexmedetomidine and medetomidine, however it will also reverse other alpha-2 agonists to provide a quick recovery from anaesthesia and sedation. [[Alpha-2 Agonists|WikiVet Article: alpha-2 agonists.]]" | ||
+ | feedback4="'''Incorrect.''' Benzodiazepines can be antagonised by flumazenil and sarmazenil, not atipamazole. Atipamazole is licensed for the reversal of the sedative effects of dexmedetomidine and medetomidine, however it will also reverse other alpha-2 agonists to provide a quick recovery from anaesthesia and sedation. [[Alpha-2 Agonists|WikiVet Article: alpha-2 agonists.]]" | ||
+ | feedback2="'''Incorrect.''' Butyrophenones have no reversal agent. Atipamazole is licensed for the reversal of the sedative effects of dexmedetomidine and medetomidine, however it will also reverse other alpha-2 agonists to provide a quick recovery from anaesthesia and sedation. [[Alpha-2 Agonists|WikiVet Article: alpha-2 agonists.]]" | ||
+ | feedback1="'''Incorrect.''' Opioids can be antagonised by naloxone, not atipamazole. Atipamazole is licensed for the reversal of the sedative effects of dexmedetomidine and medetomidine, however it will also reverse other alpha-2 agonists to provide a quick recovery from anaesthesia and sedation. [[Alpha-2 Agonists|WikiVet Article: alpha-2 agonists.]]" | ||
+ | feedback5="'''Incorrect.''' Phenothiazines have no reversal agent. Atipamazole is licensed for the reversal of the sedative effects of dexmedetomidine and medetomidine, however it will also reverse other alpha-2 agonists to provide a quick recovery from anaesthesia and sedation. [[Alpha-2 Agonists|WikiVet Article: alpha-2 agonists.]]" | ||
+ | image=""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="9" | ||
+ | question="Which non-steroidal anti-inflammatory (NSAID) drug is banned in food producing animals because it has caused death by aplastic anaemia in man?" | ||
+ | choice1="Phenylbutazone" | ||
+ | choice3="Flunixin" | ||
+ | choice2="Meloxicam" | ||
+ | choice5="Carprofen" | ||
+ | choice4="Ketoprofen" | ||
+ | correctchoice="1" | ||
+ | feedback1="'''Correct!''' Phenylbutazone has caused death by aplastic anaemia in man, and since safe milk and meat residue levels cannot be established, it is banned in food producing animals. Horses treated with phenylbutazone may never be slaughtered for human consumption. [[NSAIDs#Phenylbutazone|phenylbutazone.]]" | ||
+ | feedback3="'''Incorrect''' Animals treated with flunixin must not be slaughtered for human consumption during treatment but they can be slaughtered after an appropriate withdrawal period. Phenylbutazone has caused death by aplastic anaemia in man, and since safe milk and meat residue levels cannot be established, it is banned in food producing animals. Horses treated with phenylbutazone may never be slaughtered for human consumption. [[NSAIDs#Phenylbutazone|phenylbutazone.]]" | ||
+ | feedback2="'''Incorrect''' Animals treated with meloxicam must not be slaughtered for human consumption during treatment but they can be slaughtered after an appropriate withdrawal period. Phenylbutazone has caused death by aplastic anaemia in man, and since safe milk and meat residue levels cannot be established, it is banned in food producing animals. Horses treated with phenylbutazone may never be slaughtered for human consumption. [[NSAIDs#Phenylbutazone|phenylbutazone.]]" | ||
+ | feedback5="'''Incorrect''' Cattle treated with carprofen must not be slaughtered for human consumption during treatment but they can be slaughtered after an appropriate withdrawal period. Carprofen should not be used in horses intended for human consumption. Phenylbutazone has caused death by aplastic anaemia in man, and since safe milk and meat residue levels cannot be established, it is banned in food producing animals. Horses treated with phenylbutazone may never be slaughtered for human consumption. [[NSAIDs#Phenylbutazone|phenylbutazone.]]" | ||
+ | feedback4="'''Incorrect''' Animals treated with ketoprofen must not be slaughtered for human consumption during treatment but they can be slaughtered after an appropriate withdrawal period. Phenylbutazone has caused death by aplastic anaemia in man, and since safe milk and meat residue levels cannot be established, it is banned in food producing animals. Horses treated with phenylbutazone may never be slaughtered for human consumption. [[NSAIDs#Phenylbutazone|phenylbutazone.]]" | ||
+ | image= ""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="10" | ||
+ | question="Which opioid should never be given intravenously as it will cause massive histamine release?" | ||
+ | choice2="Pethidine" | ||
+ | choice4="Methadone" | ||
+ | choice1="Morphine" | ||
+ | choice3="Buprenorphine" | ||
+ | choice5="Fentanyl" | ||
+ | correctchoice="2" | ||
+ | feedback2="'''Correct!''' If pethidine is given i.v. it results in histamine release which causes hypotension, tachycardia and bronchoconstriction. [[Opioids#Pethidine|opioids.]]" | ||
+ | feedback4="'''Incorrect''' Methadone can be given i.v. without causing histamine release. If pethidine is given i.v. it results in histamine release which causes hypotension, tachycardia and bronchoconstriction. [[Opioids#Pethidine|opioids.]]" | ||
+ | feedback1="'''Incorrect''' Morphine can be given i.v. however it should be given slowly to avoid histamine release. If pethidine is given i.v. it results in histamine release which causes hypotension, tachycardia and bronchoconstriction. [[Opioids#Pethidine|opioids.]]" | ||
+ | feedback3="'''Incorrect''' Buprenorphine can be given i.v. If pethidine is given i.v. it results in histamine release which causes hypotension, tachycardia and bronchoconstriction. [[Opioids#Pethidine|opioids.]]" | ||
+ | feedback5="'''Incorrect''' Fentanyl can be given i.v. If pethidine is given i.v. it results in histamine release which causes hypotension, tachycardia and bronchoconstriction. [[Opioids#Pethidine|opioids.]]" | ||
+ | image= ""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="11" | ||
+ | question="Which opioid is a partial OP3 (μ) receptor agonist?" | ||
+ | choice3="Buprenorphine" | ||
+ | choice4="Butorphanol" | ||
+ | choice5="Methadone" | ||
+ | choice2="Pethidine" | ||
+ | choice1="Fentanyl" | ||
+ | correctchoice="3" | ||
+ | feedback3="'''Correct!''' Buprenorphine is a partial agonist at the OP3 (μ) receptor. This gives it a bell-shaped dose response curve, with large experimental doses actually causing opioid receptor antagonism. Buprenophine may therefore cause partial reversal of administration of full OP3 agonists such as morphine, methadone, pethidine or fentanyl. [[Opioids#Buprenorphine|opioids.]]" | ||
+ | feedback4="'''Incorrect'''Butorphanol is an antagonist at the OP3 (μ) receptor and an agonist at the OP2 (κ) receptor. Buprenorphine is a partial agonist at the OP3 receptor. This gives it a bell-shaped dose response curve, with large experimental doses actually causing opioid receptor antagonism. Buprenophine may therefore cause partial reversal of administration of full OP3 agonists such as morphine, methadone, pethidine or fentanyl. [[Opioids#Buprenorphine|opioids.]]" | ||
+ | feedback5="'''Incorrect''' Methadone is a full OP3 (μ) receptor agonist.Buprenorphine is a partial agonist at the OP3 receptor. This gives it a bell-shaped dose response curve, with large experimental doses actually causing opioid receptor antagonism. Buprenophine may therefore cause partial reversal of administration of full OP3 agonists such as morphine, methadone, pethidine or fentanyl. [[Opioids#Buprenorphine|opioids.]]" | ||
+ | feedback2="'''Incorrect''' Pethidine is a full OP3 (μ) receptor agonist. Buprenorphine is a partial agonist at the OP3 receptor. This gives it a bell-shaped dose response curve, with large experimental doses actually causing opioid receptor antagonism. Buprenophine may therefore cause partial reversal of administration of full OP3 agonists such as morphine, methadone, pethidine or fentanyl. [[Opioids#Buprenorphine|opioids.]]" | ||
+ | feedback1="'''Incorrect''' Fentanyl is a full OP3 (μ) receptor agonist.Buprenorphine is a partial agonist at the OP3 receptor. This gives it a bell-shaped dose response curve, with large experimental doses actually causing opioid receptor antagonism. Buprenophine may therefore cause partial reversal of administration of full OP3 agonists such as morphine, methadone, pethidine or fentanyl. [[Opioids#Buprenorphine|opioids.]]" | ||
+ | image= ""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="12" | ||
+ | question="Which opioid is an agonist-antagonist?" | ||
+ | choice4="Butorphanol" | ||
+ | choice3="Buprenorphine" | ||
+ | choice5="Methadone" | ||
+ | choice1="Pethidine" | ||
+ | choice2="Fentanyl" | ||
+ | correctchoice="4" | ||
+ | feedback4="'''Correct!''' Butorphanol is an antagonist at the OP3 (μ) receptor and an agonist at the OP2 (κ) receptor. This means they provide poorer analgesia (due to OP3 antagonism) but it does provide good sedation. If full OP3 agonists are to be used following butorphanol use, they will not be as effective so higher doses may be needed. [[Opioids#Butorphanol|opioids.]]" | ||
+ | feedback3="'''Incorrect''' Buprenorphine is a partial OP3 (μ) receptor agonist.Butorphanol is an antagonist at the OP3 receptor and an agonist at the OP2 (κ) receptor. This means they provide poorer analgesia (due to OP3 antagonism) but it does provide good sedation. If full OP3 agonists are to be used following butorphanol use, they will not be as effective so higher doses may be needed. [[Opioids#Butorphanol|opioids.]]" | ||
+ | feedback5="'''Incorrect''' Methadone is a full OP3 (μ) receptor agonist.Butorphanol is an antagonist at the OP3 receptor and an agonist at the OP2 (κ) receptor. This means they provide poorer analgesia (due to OP3 antagonism) but it does provide good sedation. If full OP3 agonists are to be used following butorphanol use, they will not be as effective so higher doses may be needed. [[Opioids#Butorphanol|opioids.]]" | ||
+ | feedback1="'''Incorrect''' Pethidine is a full OP3 (μ) receptor agonist. Butorphanol is an antagonist at the OP3 receptor and an agonist at the OP2 (κ) receptor. This means they provide poorer analgesia (due to OP3 antagonism) but it does provide good sedation. If full OP3 agonists are to be used following butorphanol use, they will not be as effective so higher doses may be needed. [[Opioids#Butorphanol|opioids.]]" | ||
+ | feedback2="'''Incorrect''' Fentanyl is a full OP3 (μ) receptor agonist.Butorphanol is an antagonist at the OP3 receptor and an agonist at the OP2 (κ) receptor. This means they provide poorer analgesia (due to OP3 antagonism) but it does provide good sedation. If full OP3 agonists are to be used following butorphanol use, they will not be as effective so higher doses may be needed. [[Opioids#Butorphanol|opioids.]]" | ||
+ | image= ""> | ||
+ | </WikiQuiz> | ||
+ | |||
+ | <WikiQuiz | ||
+ | questionnumber="13" | ||
+ | question="Azaparone is used as a premedicant in which species?" | ||
+ | choice3="Pig" | ||
+ | choice2="Horse" | ||
+ | choice5="Cattle" | ||
+ | choice1="Sheep" | ||
+ | choice4="Goats" | ||
+ | correctchoice="3" | ||
+ | feedback3="'''Correct!''' Azaperone is a butyrophenone which is only licensed for use in pigs. It is used against aggresssion and transport stress, to aid obstetrical intervention and as a premedicant. [[Butyrophenones|butyrophenones.]]" | ||
+ | feedback2="'''Incorrect''' Azaperone is not licensed in horses in the UK, it is only licensed for use in pigs. It is used against aggresssion and transport stress, to aid obstetrical intervention and as a premedicant. [[Butyrophenones|butyrophenones.]]" | ||
+ | feedback5="'''Incorrect''' Azaperone is not licensed in cattle in the UK, it is only licensed for use in pigs. It is used against aggresssion and transport stress, to aid obstetrical intervention and as a premedicant. [[Butyrophenones|butyrophenones.]]" | ||
+ | feedback1="'''Incorrect''' Azaperone is not licensed in sheep in the UK, it is only licensed for use in pigs. It is used against aggresssion and transport stress, to aid obstetrical intervention and as a premedicant. [[Butyrophenones|butyrophenones.]]" | ||
+ | feedback4="'''Incorrect''' Azaperone is not licensed in goats in the UK, it is only licensed for use in pigs. It is used against aggresssion and transport stress, to aid obstetrical intervention and as a premedicant. [[Butyrophenones|butyrophenones.]]" | ||
+ | image= ""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="14" | ||
+ | question="Which premedicant is contraindicated in breeding stallions?" | ||
+ | choice4="Acepromazine" | ||
+ | choice1="Azaperone" | ||
+ | choice5="Diazepam" | ||
+ | choice2="Xylazine" | ||
+ | choice3="Detomidine" | ||
+ | correctchoice="4" | ||
+ | feedback4="'''Correct!''' Acepromazine is contraindicated in breeding stallions because it may cause penis protrusion and priapism. [[Phenothiazines#Side Effects and Contraindications|phenothiazines.]]" | ||
+ | feedback1="'''Incorrect''' Azaperone is not licensed for use in horses in the UK. Acepromazine is contraindicated in breeding stallions because it may cause penis protrusion and priapism. [[Phenothiazines#Side Effects and Contraindications|phenothiazines.]]" | ||
+ | feedback5="'''Incorrect''' Diazepam is not contraindicated in breeding stallions. Acepromazine is contraindicated in breeding stallions because it may cause penis protrusion and priapism. [[Phenothiazines#Side Effects and Contraindications|phenothiazines.]]" | ||
+ | feedback2="'''Incorrect''' Xylazine is not contraindicated in breeding stallions. Acepromazine is contraindicated in breeding stallions because it may cause penis protrusion and priapism. [[Phenothiazines#Side Effects and Contraindications|phenothiazines.]]" | ||
+ | feedback3="'''Incorrect''' Detomidine is not contraindicated in breeding stallions. Acepromazine is contraindicated in breeding stallions because it may cause penis protrusion and priapism. [[Phenothiazines#Side Effects and Contraindications|phenothiazines.]]" | ||
+ | image= ""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="15" | ||
+ | question="Which opioid has the longest duration of action at standard therapeutic doses?" | ||
+ | choice1="Buprenorphine" | ||
+ | choice4="Morphine" | ||
+ | choice3="Methadone" | ||
+ | choice2="Pethidine" | ||
+ | choice5="Butorphanol" | ||
+ | correctchoice="1" | ||
+ | feedback1="'''Correct!''' Buprenorphine has an onset of action of 45 minutes and its actions last 6-8 hours. [[Opioids#Buprenorphine|opioids.]]" | ||
+ | feedback4="'''Incorrect''' Morphine has a 10-15 minute onset of action and a duration of action of 2-4 hours. Buprenorphine has an onset of action of 45 minutes and its actions last 6-8 hours. [[Opioids#Buprenorphine|opioids.]]" | ||
+ | feedback3="'''Incorrect''' Methadone has a 15-30 minute onset of action and a duration of action of around 4 hours. Buprenorphine has an onset of action of 45 minutes and its actions last 6-8 hours. [[Opioids#Buprenorphine|opioids.]]" | ||
+ | feedback2="'''Incorrect''' Pethidine has a 5-10 minute onset of action and a duration of action of 30-60 minutes. Buprenorphine has an onset of action of 45 minutes and its actions last 6-8 hours. [[Opioids#Buprenorphine|opioids.]]" | ||
+ | feedback5="'''Incorrect''' Butorphanol has a 15 minute onset of action and a duration of action of 2-4 hours. Buprenorphine has an onset of action of 45 minutes and its actions last 6-8 hours. [[Opioids#Buprenorphine|opioids.]]" | ||
+ | image= ""> | ||
+ | </WikiQuiz> | ||
+ | <WikiQuiz | ||
+ | questionnumber="16" | ||
+ | question="Which drug, when used as a premedicant, significantly reduces the risk of death during anaesthesia in horses?" | ||
+ | choice4="Acepromazine" | ||
+ | choice1="Azaperone" | ||
+ | choice3="Diazepam" | ||
+ | choice2="Xylazine" | ||
+ | choice5="Detomidine" | ||
+ | correctchoice="4" | ||
+ | feedback4="'''Correct!''' The risk of anaesthetic fatalities is much higher in horses than in other species, in fact 1 in 100 horses die within 7 days of anaesthesia and surgery. A study by Johnston et al. showed that there was a marked decrease in risk when acepromazine was used as a premedicant. [[Phenothiazineshttp://www3.interscience.wiley.com/journal/118928761/abstract|phenothiazines. Link to relevant webpage: The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2.]]" | ||
+ | feedback1="'''Incorrect''' Azaperone has not been shown to reduce anaesthetic risk in horses, in fact it is not licensed in horses in the UK. The risk of anaesthetic fatalities is much higher in horses than in other species, in fact 1 in 100 horses die within 7 days of anaesthesia and surgery. A study by Johnston et al. showed that there was a marked decrease in risk when acepromazine was used as a premedicant. [[Phenothiazineshttp://www3.interscience.wiley.com/journal/118928761/abstract|phenothiazines. Link to relevant webpage: The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2.]]" | ||
+ | feedback3="'''Incorrect''' Diazepam has not been shown to reduce anaesthetic risk in horses. The risk of anaesthetic fatalities is much higher in horses than in other species, in fact 1 in 100 horses die within 7 days of anaesthesia and surgery. A study by Johnston et al. showed that there was a marked decrease in risk when acepromazine was used as a premedicant. [[Phenothiazineshttp://www3.interscience.wiley.com/journal/118928761/abstract|phenothiazines. Link to relevant webpage: The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2.]]" | ||
+ | feedback2="'''Incorrect''' Xylazine has not been shown to reduce anaesthetic risk in horses on its own. The risk of anaesthetic fatalities is much higher in horses than in other species, in fact 1 in 100 horses die within 7 days of anaesthesia and surgery. A study by Johnston et al. showed that there was a marked decrease in risk when acepromazine was used as a premedicant. [[Phenothiazineshttp://www3.interscience.wiley.com/journal/118928761/abstract|phenothiazines. Link to relevant webpage: The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2.]]" | ||
+ | feedback5="'''Incorrect''' Detomidine has not been shown to reduce anaesthetic risk in horses on its own. The risk of anaesthetic fatalities is much higher in horses than in other species, in fact 1 in 100 horses die within 7 days of anaesthesia and surgery. A study by Johnston et al. showed that there was a marked decrease in risk when acepromazine was used as a premedicant. [[Phenothiazineshttp://www3.interscience.wiley.com/journal/118928761/abstract|phenothiazines. Link to relevant webpage: The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2.]]" | ||
+ | image= ""> | ||
+ | </WikiQuiz> |
Latest revision as of 18:36, 29 March 2010
|
Questions reviewed by: | Juliet Duncan BVM&S MSc DipECVAA MRCVS Richard Hammond BSc BVetMed DipECVA DVA PhD MRCVS |
1 |
Naloxone is a reversal agent for which group of drugs? |
2 |
In which dog breed can acepromazine cause fainting and syncope? |
3 |
Which injectable anaesthetic should be avoided in sighthounds? |
4 |
Which drug is commonly used for total intravenous anaesthesia (TIVA) in dogs? |
5 |
Which injectable anaesthetic increases intracranial pressure and central nervous system (CNS) excitement? |
6 |
Which local anaesthetic also has anti-arrhythmogenic properties? |
7 |
Which local anaesthetic has the longest duration of action? |
8 |
Atipamazole is the reversal agent for which group of drugs? |
9 |
Which non-steroidal anti-inflammatory (NSAID) drug is banned in food producing animals because it has caused death by aplastic anaemia in man? |
10 |
Which opioid should never be given intravenously as it will cause massive histamine release? |
11 |
Which opioid is a partial OP3 (μ) receptor agonist? |
12 |
Which opioid is an agonist-antagonist? |
13 |
Azaparone is used as a premedicant in which species? |
14 |
Which premedicant is contraindicated in breeding stallions? |
15 |
Which opioid has the longest duration of action at standard therapeutic doses? |
16 |
Which drug, when used as a premedicant, significantly reduces the risk of death during anaesthesia in horses? |