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Section 12 Emergency and Critical Care questions and answers updated
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SECTION 12 EMERGENCY AND CRITICAL CAREQUESTIONS AND ANSWERS UPDATED 2024 - 2025
Answer is A: D5W is a hypotonic fluid and is least useful. It is oxidized to CO2 and H2O, providing free
water, and it should be used in the face of a free-water deficit or hypernatremia. Plasma-Lyte 48 is an
isotonic crystalloid and will provide rapid intravascular volume expansion. Hypertonic saline is a
hypertonic crystalloid, and Hetastarch is a colloid. Both will expand vascular volume and are useful for
patients that will not tolerate a large volume of fluids (head trauma, heart failure). ANS - Which is least
useful when resuscitating a dog in shock?:
(A) D5W
(B) Hetastarch
(C) Hypertonic saline
(D) Plasma-Lyte 48
Answer is A: Diazepam is a benzodiazepine and is considered the drug of choice to treat seizures in both
dogs and cats. It is considered a first-line drug, whereas pentobarbital is a second-line drug, and
propofol is a third. Potassium bromide is a maintenance drug and is not used as an emergency
treatment for status epilepticus. ANS - First drug of choice for a cat that has status epilepticus
(A) Diazepam
(B) Pentobarbital
(C) Potassium bromide
(D) Propofol
,Answer is C: A tension pneumothorax occurs when air is able to enter the pleural space but is unable to
escape (it has been compared to a one-way valve that allows air in, but air is not able to exit). Pressure
builds up in the pleural space, and after that pressure becomes greater than atmospheric pressure, the
patient is unable to expand the lungs. A tension pneumothorax will not resolve without a
thoracocentesis to remove air from the pleural space. ANS - Tension pneumothorax occurs when
pressure in the thoracic pressure
(A) Less than atmospheric pressure
(B) Equal to atmospheric pressure
(C) Greater than atmospheric pressure
(D) Constant as animal breathes in and out
Answer is B: Hydrocarbons, such as fuels, solvents, etc., are life threatening because of the possibility of
aspiration pneumonia. Aspiration can occur when the substance is ingested or when the patient vomits.
Because of this risk, inducing emesis is contraindicated. The less viscous (thinner) a hydrocarbon, the
more likely it is to be aspirated. The lungs are very vulnerable to hydrocarbons, and aspiration <1 mL can
lead to death. Emesis is beneficial when a patient has ingested organophosphates (pesticides,
insecticides), salicylates (aspirin), and anticholinergics (commonly found in medications). ANS - Emesis
should not be induced in patients that have ingested
(A) Anticholinergics
(B) Hydrocarbons
(C) Organophosphates
(D) Salicylates
Answer is B: Septic shock occurs when there is circulatory failure secondary to sepsis. Early in septic
shock, there is a hyperdynamic response (tachycardia, vasodilation, fever, and bounding pulses) causing
,hyperemic (red) mucous membranes. Icteric (yellow) mucous membranes are caused by an excessive
amount of bilirubin in the blood. Bilirubin increases with liver disease or the breakdown of RBCs. Pale
mucous membranes are seen when there is vasoconstriction or a decrease in perfusion (both of which
decrease blood flow to the membranes) or anemia. Cyanosis (blue mucous membranes) is seen when
hemoglobin is not carrying oxygen. This deoxygenated hemoglobin causes the blood to be blue in color.
To detect cyanosis, there must be >5 g/dL of deoxygenated hemoglobin present in the blood (5 g/dL is
equivalent to a PCV of 15%). Cyanosis is not detectable in a patient that is severely anemic, and it cannot
be relied on to in ANS - MM of a dog in septic shock is
(A) Cyanotic
(B) Hyperemic
(C) Icteric
(D) Pale
Answer is C: Propofol does not cross the placental barrier and so is the safest induction agent in regard
to the fetuses. Etomidate crosses the placental barrier but is eliminated quickly, so it may be a good
second choice if the bitch cannot tolerate propofol. Diazepam and thiopental cross the placental barrier
and have adverse effects on the neonates. ANS - Most desirable induction agent for emergency C
section in a dog
(A) Etomidate
(B) Diazepam
(C) Propofol
(D) Thiopental
Answer is A: The most common cause of feline aortic thromboembolism is a cardiomyopathy. The
turbulent blood flow seen with cardiomyopathy causes the formation of thrombi. This clot (or pieces of
, a clot) breaks free, travels through the circulatory system, and becomes lodged in the distal aorta where
it causes an aortic thromboembolism. This is commonly known as a saddle thrombosis and causes the
loss of the use of one, or both, hind limbs. Common clinical signs include acute loss of motor in the hind
legs, loss of femoral and/or dorsal pedal pulses, and cyanotic pads or toenail beds. Because it is cardiac
in origin, the liver, renal, and respiratory systems do not apply. ANS - Underlying disease for most cases
of feline aortic thromboembolism is ___ in origin
(A) Cardiac
(B) Hepatic
(C) Renal
(D) Respiratory
Answer is D: Mannitol is an osmotic diuretic that decreases intracranial pressure by reducing blood
viscosity. This allows for an increase in blood flow (and thus an increase in oxygen delivery) to the brain,
and it causes a decrease in the water content of the brain as well. Atropine is an anticholinergic used to
treat bradycardia, as a preanesthetic, or as an antidote for organophosphate toxicity. Diazepam is a
benzodiazepine used for sedation, muscle relaxation, or treatment of seizure activity. Dexamethasone is
a glucocorticoid that is often used to decrease inflammation. However, it is contraindicated in head
trauma and should never be administered as frequently as every 4-6 hours. ANS - To reduce IC pressure
that results from trauma, ____ may be given every 4-8 hours
(A) Atropine
(B) Dexamethasone
(C) Diazepam
(D) Mannitol
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