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 ofaction, dosing regimen, and any unique features. (9 marks)c) Name two (2) additional drugs that could potentially be used as prokinetics in apatient with regurgitation and/or gastrointestinal ileus. Describe their mechanismof action, dosing regimen, and any unique features. (6 marks)d) Discuss the arguments for and against early and delayed enteral nutrition inpancreatitis. (7 marks)e) List advantages and disadvantages of four (4) enteral feeding tube options. Donot include comparisons of cost in your answer. (16 marks)Continued over pageVeterinary 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 2082. Answer all parts of this question:a) Explain how mean arterial pressure (MAP) is calculated using the systolicarterial 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 beidentified. (5 marks)d) Identify cause(s) of underdamped and overdamped fluid-filled monitoringsystems. (4 marks)e) Define pulse pressure and use an equation to relate the two (2) main factors thatdetermine pulse pressure. (2 marks)f) List two (2) causes each of a narrow pulse pressure and a high (wide) pulsepressure. (4 marks)g) Describe the theory behind, and potential clinical utility of, pulse pressurevariation (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) limitationfor each methodology listed (do not list the same limitation for multiplemethodologies). (16 marks)i) Once the cardiac output is measured, oxygen delivery (DO2) and oxygenconsumption (VO2) can be calculated. State the formulas for calculating thesetwo oxygen-derived variables. (3 marks)j) Define systemic vascular resistance (SVR) and provide a formula for itscalculation following determination of patient CO. (2 marks)k) Define pulmonary artery occlusion pressure, how is it measured, and how can itbe helpful in assessment of critically ill patients? Include four (4) factors thatcould result in deviation of pulmonary artery occlusion pressure from normal,and the nature of that deviation. (5 marks)

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