Describe the pathophysiology of vomiting

1. Answer all parts of this question:
a) Describe the pathophysiology of vomiting. (10 marks)
b) List three (3) anti-emetic drugs of different classes, describe their mechanism of
action, dosing regimen, and any unique features. (9 marks)
c) Name two (2) additional drugs that could potentially be used as prokinetics in a
patient with regurgitation and/or gastrointestinal ileus. Describe their mechanism
of action, dosing regimen, and any unique features. (6 marks)
d) Discuss the arguments for and against early and delayed enteral nutrition in
pancreatitis. (7 marks)
e) List advantages and disadvantages of four (4) enteral feeding tube options. Do
not include comparisons of cost in your answer. (16 marks)
Continued over page
Veterinary Emergency Medicine and Critical Care Paper 2 Page 3 of 7
© 2016 The Australian and New Zealand College of Veterinary Scientists ABN 00 50 000894 208
2. Answer all parts of this question:
a) Explain how mean arterial pressure (MAP) is calculated using the systolic
arterial blood pressure (SAP) and diastolic arterial blood pressure (DAP).
(2 marks)
b) Explain how accuracy of this MAP calculation is affected by patient heart rate.
(1 mark)
c) Using an appropriate diagram, describe how to perform a ‘square wave test’,
explain what this is for, and how overdamping and underdamping would be
identified. (5 marks)
d) Identify cause(s) of underdamped and overdamped fluid-filled monitoring
systems. (4 marks)
e) Define pulse pressure and use an equation to relate the two (2) main factors that
determine pulse pressure. (2 marks)
f) List two (2) causes each of a narrow pulse pressure and a high (wide) pulse
pressure. (4 marks)
g) Describe the theory behind, and potential clinical utility of, pulse pressure
variation (PPV) in anaesthetised patients. (4 marks)
h) List four (4) techniques specifically used for measurement of cardiac output
(CO). Describe how each technique is performed and provide one (1) limitation
for each methodology listed (do not list the same limitation for multiple
methodologies). (16 marks)
i) Once the cardiac output is measured, oxygen delivery (DO2) and oxygen
consumption (VO2) can be calculated. State the formulas for calculating these
two oxygen-derived variables. (3 marks)
j) Define systemic vascular resistance (SVR) and provide a formula for its
calculation following determination of patient CO. (2 marks)
k) Define pulmonary artery occlusion pressure, how is it measured, and how can it
be helpful in assessment of critically ill patients? Include four (4) factors that
could result in deviation of pulmonary artery occlusion pressure from normal,
and the nature of that deviation. (5 marks)


 

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