Block 3 More Flashcards
(144 cards)
1
Q
How do you treat metabolic shock/
A
Dextrose
2
Q
How do you treat anemic shock?
A
Red blood cell transfusion
3
Q
What is an additional concern with GI of shock?
A
Sepsis
Bacteria can enter bloodstream through GI
4
Q
How does sepsis from shock initially present?
A
Bloody diarrhea
5
Q
What are the 3 components of the feline lethal triad of shock?
A
Hypothermia
Hypotension
Bradycardia
6
Q
What is a downside to warming you patient?
A
Warmth makes vasodilation worse
7
Q
Should you give steroids to shock patients?
A
NO!
8
Q
How do you not want to administer fluids in a patient that is likely actively bleeding?
A
Bolus
9
Q
What is a drug that has major cardiovascular effects during analgesia?
A
Dex, dont use dex
10
Q
What does the doxy for treating HW attack?
A
Wolbachia
11
Q
What is wolbachia?
A
Endo-symbiotic bacteria inside HW
12
Q
What should you consider when treating HW with melarsomine?
A
Sedation and analgesia
13
Q
What is really important to do during the treatment protocol at home?
A
Exercise restriction
14
Q
What are the 4 things beginning at day 0 of diagnosis of HW?
A
Exercise restriction
Prednisone if symptomatic
HW preventative
Day 0-28 of doxy
15
Q
When is first melarsamine injection give?
A
Day 61
16
Q
When are 2nd and 3rd melarsamine injections given
A
90 and 91
17
Q
What is the susceptibility gap?
A
Period when juveniles are present that are not killed by preventative nor melarsomine
18
Q
How do you fix the susceptibility gap?
A
2 month lag
Allows juveniles to become adults
19
Q
What is contraindicated in cats with HW?
A
Adultacide therapy
20
Q
What can be given with HW that are severe and symptomatic?
A
Sildenafil as pulmonary vasodilator
21
Q
What is caval syndrome
A
Large worm burden causing retrograde movement of worms into tricuspid valve orifice
22
Q
What can caval syndrome cause?
A
Right CHF
23
Q
What is often seen with caval syndrome?
A
Hemoglobinuria
24
Q
With caval syndrome, you will likely need to do surgery, mortality is still 40% and need to go through melamine protocol
A
25
What is the slow kill method for HW?
Administer macrocyclic lactones and doxy only
26
How long does slow kill method take?
>2 years for 95% to die
27
When can you consider slow kill method?
Anaphylaxis to melarsomine, older patient that can't go through procedure
28
"You must test for HW prior to prescribing HWP because giving HWP to an infected dog could be dangerous"
The potential danger depends on the microfilaria load and the type of preventative used
29
What are the 2 reasons for dogs on preventatives still getting infected?
Susceptibility gap
Macrocyclic lactone lack of efficiency
Owner compliance
Resistant strains
30
Where are most of the resistant strains?
Mississippi River Valley
31
What is the ML-resistance strain called?
MP3 (Miss Piggy)
32
What is Cheyne-Stoker respiration?
Occurs with heart failure and end of life
33
Biot's respiration?
Sequence of gasps, apnea, and several deep gasps
Trauma, stroke, opioids
34
Kussmaul's Respiration?
Regular deep respirations without pause
Metabolic acidosis
35
Apneustic respiration?
Holding an inspired breath at the end of inhalation for a short period before exhaling
Brain trauma and ketamine
36
What is number for failure to ventilate?
PaCO2 > 60
37
What is number for failure to oxygenate?
PaO2 <60
38
First step in treating failure to oxygenate?
Supplemental oxygen
39
What is the rule of thumb to prevent oxygen toxicity?
Maintain PaO2<250mmHg
Generaly is FiO2<0.5
40
What is objective of PEEP?
Recruit all lung units to stay open
PEEP helps keep lung lobes oxygenating
41
What does positive pressure require?
Intubation
42
What does positive pressure decrease?
FRC (area of lung left after a deep breath)
43
What are ascending bellows?
Bellow ascends during exhalation phase
44
What type of ventilator is an anesthesia ventilator?
Descending
45
Does descending ventilator have PEEP?
No
46
What are the 3 types of ventilator types?
Controlled (machine does all work)
Assisted (patient triggers)
Assist/Controlled (combination of both)
47
What is the I:E ration?
Time spent on respiratory cycle
Inhaled = 1 sec
Exhale = 2 sec
1:2 is normal
48
What are the 4 types of ventilator induced lung injury?
Barotrauma
Volutrauma
Atelectrauma
Biotrauma
49
What is barotrauma?
Regional lung distention due to increased pressure in SOME areas of the lung
50
What is volutrauma?
Over distention associated with high peak airway pressure. Lung stretch causing diffuse alveolar damage
51
What is atelectrauma?
Ventilation at low volumes related to opening and closing of lung units
52
What is biotrauma?
Inflammatory injury due to any of the previous 3
53
What does capnogrpahy look like with hypoventilation?
Increased plateaus
54
What does capnogrpahy look like with hyperventilation??
Decreased plateaus
55
What does capnogrpahy look like with cardiac arrest?
waves going down
56
Notches occur in spontaneous breathing during PPV
Cardiogenic oscillations are common causing decreasing wave in small steps
57
What does partial obstruction look like?
Prolonged slope with fall at end
58
Equation to remember:
Hb = 1/3PCV
59
What is normal pH?
7.4
60
What is normal PaCO2?
40
61
What is normal PaO2?
5 x inspired O2 level
62
What mutation causes a decreased response to a drug?
MDR1
63
How long does it take for a HW to get to L5?
45-60 days
64
How long does it take to get to adult phase of microfilaria?
6-7m
65
With non compliance, how often do you have to test to ensure the patient is HW free?
Day 0
Day 180
Day 360
66
If a HW is resistant to one ML is it likely to be resistant to all ML?
Yes
67
What is the formula for swine and water consumption?
About 1 gallon per 100lbs
68
Extra-label use of drugs in animal feed is not permitted
69
How is mycoplasma mostly controlled (antibiotic)
Lincosamide
70
What can't you do with tilmicosin?
INJECT IT!
71
What is the most common cause of polyp?
Inflammation
72
How do you visualize a polyp?
Retract soft palate
73
How do you treat a eustachian tube polyp?
Traction and pull
Steroids post op
74
What is stage 1 laryngeal collapse?
Everted saccules
75
What is stage II laryngeal collapse?
Medial displacement of cuneiform process
76
What is stage III of laryngeal collapse?
All plus airway obstruction
77
How do you treat a dog with car par?
"Arytenoid lateralization" aka tie back
78
What do you do for dogs that have failed the tie back?
Permanent tracheostomy
79
What is the most common tumor of the nasal planum?
SCC for cats and dogs
80
What is treatment for nasal planum disease?
Nasal planectomy
81
What is a QOL complication of nasal planectomy?
Stricture
82
What normally causes stricture?
Dehiscence then stricture
83
What is the most common lung tumor in cats?
Adenocarcinoma
84
What is the most common lung tumor in dogs?
Bronchoalveolar carcinoma
85
What is seen in metastasis of lung cancers?
Lung digit syndrome
86
What is treatment for lung cancer?
Lung lobectomy
(chemotherapy not great)
87
What is the volume of each lunch?
L: 42%
R: 58%
88
Which species has a better prognosis after lung lobectomy?
Dogs
89
Does size matter for lung cancers?
Yes!
90
What are the 4 respiratory diseases to rule out?
Newcastle
Infectious bronchitis
Infectious larygnotracheitis
Avian influenze
91
How can you treat infectious larygotracheitis?
Can vaccinate because it spreads slow
92
What is something noteworthy about infectious coryza?
Recovered birds can be carriers
93
What is the parasite in chickens?
Syngamus trachea
94
Can you vaccinate for EHM in horses?
NO!!! (Only EHV1 but doesn't prevent EHM)
95
What is a hallmark for EHV1 neurological disease?
Urinary incontinece
96
What is the most common respiratory infection in horses?
Equine influenza
97
What is the treatment for influenza?
Supportive care
98
What "breed" is more susceptible to influenza?
Foals and donkeys - high mortality
99
When should you vaccinate a foal with influenza?
9-11 months of age
Too early may impair future responses
100
What type of bacteria is strep equi equi?
Gram (+)
101
How is strangles spread?
nose to nose
102
What can be done in complicated cases of strangles?
Tracheostomy and penicillin
103
How can you treat purpura hemorrhagica?
Penecillin and immunosurppressive Dex
104
What should you not do after a strangles outbreak?
Vaccinate for strangles
105
When do foals pick up R. equi and when do they become symptomatic?
Within first 7 days
At weaning
106
What is treatment for R. equi?
"mycin" antibiotic
Clarithromycin is given 2x a day and if you need to add rifampin, it is also given 2x a day. Easiest
107
What are the adverse effects of treatment of R. equi?
Diarrhea
Hyperthermia (anergy?)
Usually aligns with August too
108
How to treat pleuropneumonia in horses?
Broad spectrum antibiotic
109
What is a strong signal of equine asmthma?
expiratory wheezes
110
What pattern is seen on thoracic ultrasound of equine asthma?
Bronchial pattern
111
What is seen on cytology of BAL for equine asthma?
Kirshman's spirals
phospholipids on top too of tap
112
What is #1 clinical sign in equine asthma?
Cough
113
What is considered diagnostic on BAL cytology?
>20% non-regenerative neutrophils
114
How should you first treat equine asthma?
Management (outside all the time)
115
What is the medical treatment of equine asthma?
Steroid (dex)
Bronchodilator (Albuterol)
116
What is #1 nasal tumor in dogs?
Carcinomas
117
What is T1 classification of Adam's modified system?
Confined to one nasal passage with no bony involvement
118
What is T2 classification of Adam's modified system?
Bony involvement
119
What is T3 classification of Adam's modified system?
Involvement of bone, orbit, or nasopharynx
120
What is T4 classification of Adam's modified system?
Tumor through cribriform plate
121
Does addition of NSAIDs help prolong survival time with nasal tumors?
No
122
What is #1 cause of nasal tumor in cats?
lymphoma
123
Are most malignant
Yes!!
124
Are most canine nasal tumors malignant?
No
125
Is radiation therapy helpful in dogs?
No
126
Is radiation therapy helpful in cats?
Yes!
127
Do all PDAs need closed?
No
128
What is medical therapy for PDAs?
Pimo
Enalpril
Furosemide
129
Is surgical ligation a valid treatment option for PDAs?
yeah
130
What percent of dogs die from PDA within 3 years of PDA?
90%
131
What is the best option for dogs with a right to left VSD?
Surgery
132
What should you do with an ASD without evidence of cardiac chamber enlargement?
No therapy, monitor
133
What is the most common cause of atrial standstill?
Hyperkalemia
134
What is treatment for first degree AV block?
Nothing
135
What do you treat with 3rd degree AV block that is fainting
Pacemaker
136
What type of drug is telmisartan?
ARB
137
Is amlodipine used with pulmonary hypertension?
No
138
What can you add to SAS prophylactically?
Antibiotics
139
Do you do balloon valvuloplasty for SAS?
No
140
What do you treat with any stenotic disease?
ATENOLOL
141
*** Atenolol reduces heart rate and contractility and thus myocardial oxygen consumption. It has anti-ischemic effects and anti arrhythmic effects
142
Is PS ever cured?
No!
143
In a dog with a history of syncope and weakness due to severe mitral valve stenosis, what therapy should not be considered?
Amlodipine
144
