RCVS Statutory Membership Examination Veterinary Anaesthesiology & Analgesia: practice questions

1 · Cornual nerve block · medium

A goat kid is to be disbudded. Which nerves must be blocked on each side to anaesthetise the horn bud?

1. Only the cornual branch of the lacrimal nerve, exactly as it is done in the calf
2. Cornual branches of the lacrimal nerve and of the infratrochlear nerve
3. The auriculopalpebral nerve together with the great auricular nerve
4. The supraorbital nerve and the first cervical spinal nerve's dorsal branch

2 · Paravertebral block · medium

A 500 kg cow receives a proximal paravertebral block with 15 mL of 2% lidocaine below and 5 mL above the intertransverse ligament at each of three sites. What total mass of lidocaine has been given?

1. 120 mg
2. 900 mg
3. 1,200 mg
4. 12,000 mg

3 · Paravertebral block · medium

What is a recognised disadvantage of the inverted L block compared with a paravertebral block for flank surgery in cattle?

1. It causes marked scoliosis that makes closing the flank incision much more difficult
2. It requires a long spinal needle to be walked off the vertebral transverse processes
3. It needs more drug and relaxes the deep abdominal muscles less completely
4. It paralyses the pelvic limb on the blocked side and causes the cow to lie down

4 · Anaesthetic monitoring · medium

During an anaesthetic the capnograph trace suddenly falls from 40 mmHg to zero. Which is the most likely explanation?

1. Gradual hypoventilation from a steadily deepening plane of anaesthesia
2. Exhausted soda lime in the circle system
3. Disconnection or accidental extubation, or cardiac arrest
4. Malignant hyperthermia in a susceptible pig

5 · Anaesthetic emergencies · medium

A 20 kg dog in cardiopulmonary arrest is to receive low-dose adrenaline at 0.01 mg/kg IV using a 1 mg/mL (1:1000) solution. What volume is given?

1. 2 mL
2. 0.02 mL
3. 20 mL
4. 0.2 mL

6 · Pain scoring · medium

Why is heart rate alone a poor indicator of pain in hospitalised animals?

1. Heart rate never changes in response to pain in any domestic animal species
2. Heart rate can only be measured under general anaesthesia in cats and dogs
3. Pain always lowers heart rate, which is hard to detect at normal rates
4. Fear, stress, hypovolaemia and drugs also change it, so it lacks specificity

7 · Multimodal analgesia · easy

What is the mechanism of action of grapiprant?

1. Antagonism of the prostaglandin EP4 receptor
2. Non-selective inhibition of COX-1 and COX-2
3. Agonism at mu opioid receptors in the dorsal horn
4. Blockade of NMDA receptors in the spinal cord

8 · Multimodal analgesia · medium

Why is buprenorphine given into the mouth effective in cats?

1. Cats swallow it and absorb it completely from the stomach with no first-pass loss
2. It is converted to morphine by salivary enzymes, which is then rapidly absorbed
3. It acts directly on taste receptors, which relay analgesic signals to the brain
4. The alkaline pH of the feline oral cavity favours absorption through the oral mucosa

9 · Injectable anaesthesia · medium

Which statement about alfaxalone is correct?

1. It is a neuroactive steroid acting at GABA-A that can be given intramuscularly in cats
2. It is an NMDA antagonist that must always be combined with a benzodiazepine
3. It is a barbiturate that often causes tissue necrosis if injected outside the vein
4. It is a potent opioid that is reversed with naloxone at the end of surgery

10 · Pain scoring · hard

A cat after ovariohysterectomy scores 6 out of 20 on the Glasgow feline composite scale. What should be done?

1. Take no action, because 6/20 is within the normal range after routine surgery
2. Give a sedative only, as cats score high on this scale because of fear
3. Give analgesia because the score exceeds the 5/20 intervention level, then reassess
4. Wait 12 hours, since feline scales are only valid the next morning