Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

VET 433c > Cardio/ Resp pt.2 > Flashcards

Cardio/ Resp pt.2 Flashcards

1
Q

Myxomatous Mitral Valve Degeneration (MMVD)

A
  • degenerative valvular disease leading to valve incompetency, left atrial enlargement, volume overload, and CHF
  • also called mitral valve endocardiosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

MMVD (pathology)

A
  • expansion of spongiosa valve layer w/ glycosaminoglycans and proteoglycans
  • valve leaflets thicken and roll at edges
  • can affect chordae tendineae
  • valve may prolapse and leak; chordae may rupture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MMVD (pathophysiology)

A
  • mitral valve regurge leads to L atrial enlargement
  • volume overload
  • left ventricular enlargement
  • elevated LA pressure, pulmonary venous distention
  • left-sided congestive herat failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MMVD compensation

A
  • mitral valve regurge may be compensated for
  • MMVD reduces flow to kidneys and activates RAAS
  • RAAS increases volume and generates volume overload and eccentric hypertrophy
  • inc stretch = inc contraction and systolic function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MMVD (signalment)

A
  • disease of old, small breed dogs

- Cavalier King Charles Spaniels (also will have younger age of onset)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MMVD (physical exam)

A
  • systolic click (high-pitched sound caused by prolapsed MV)
  • often cough/ resp distress if CHF present
  • L apical systolic regurgitant murmur (severity corresponds to intensity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MMVD (ECG)

A
  • typical sinus rhythm
  • possibly APCs, VPCs, A-fib
  • pattern of chamber enlargment (P mitrale, LV enlargement)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MMVD (Chest rads)

A
  • symptomatic dogs have rads consistent with CHF (LA large, pulm venous distension)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MMVD (Echo)

A
  • thickened mitral valve leaflets
  • mitral valve regurge
  • Left atrial and ventricular distension
  • hyperdynamic LV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F: the most reliable indication of diseases severity of MMVD is LA size

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ABP impacts on MMVD

A
  • systemic pressure elevation worsens MMVD
  • slight reduction in systemic pressures can reduce regurgitant fraction
  • use of amlodipine is a useful stretegy for managing MMVD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MMVD (therapy prior to CHF)

A
  • Pimobendan

- Enalapril/ Benazapril

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MMVD (prognosis)

A
  • 15 months from stage B2 to CHF with pimobendan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

MMVD (therapy post CHF)

A
  • diuretics (furosemide)
  • ace-inhibitors (enalapril, benaazapril)
  • pimobendan
  • spirinolactone
  • low salt diet
  • amlodipine if hypertensive
  • diltiazem +/- digoxin if a-fib
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

DIlated Cardiomyopathy

A
  • heart muscle disease with characteristic systolic dysfunction and ventricular dilation (eccentric hypertrophy)
  • can affect both, but mainly left
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DCM ( Etiology)

A
  • familial/ genetic
  • nutritional
  • viral
  • metabolic

–> DCM appearance is the same regardless of etiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

DCM (Signalment)

A
  • large breed dogs

- doberman is classic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

DCM (pathogenesis)

A
  • reduced cardiac output
  • RAAS activation
  • Na and H2O retention, vasoconstriction, cardiac remodeling
  • further reduction in heart function
  • increased preload
  • progression of disease, CHF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

DCM (Outcomes)

A

once symptomatic:

  • exercise intolerance
  • syncope
  • CHF
  • sudden death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

DCM (Physical Exam)

A
  • soft left apical systolic murmur
  • pulse defecits
  • weak pulses (poor cardiac output)
  • variable pulses (maybe a-fib)
  • tachycardia, tachypnea, soft crackles (L-sided CHF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

DCM (ECG)

A
  • typical sinus rhythm
  • L-sided VPCs
  • may see a-fib
  • patterns of LVH (wide QRS)
  • wide p waves possible w/ LA enlargement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

T/F; gold standard diagnosis of DCM is echo

A

T:

you will see reduced fractional shortening, increased heart size, and mitral regurge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

DCM (treatment pre-CHF)

A
  • Ace-inhibition if volume overload observed (enalapril)
  • pimobendan
  • give taurine if nutritionally mediated DCM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

DCM (treatment post-CHF)

A
  • O2 when in resp distress
  • diuretics (furosemide)
  • ace-inhibitors (enalapril)
  • pimo
  • spironolactone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

DCM (prognosis)

A

roughly 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Canine Arrhythmogenic Right Ventricular Cardiomyopathy

A
  • heat muscle disease with characteristic right ventricular tachyarrhythmias and fibro-fatty infiltration of the RV
  • may spread to involve left heart as it progresses
  • leads to syncope and sudden death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

ARVC (diagnosis)

A
  • holter monitor is the only antemortem gold standard
  • -> >300VPCs of RV origin
  • -> <100VPCs normal for Boxer
  • -> 100-300 meh
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Three forms of ARVC

A
  1. asymptomatic
  2. collapse and syncope due to more sever arrhythmias
  3. structural heart changes may lead to CHF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

ARVC (etiology)

A
  • genetic disease of the desmosome

- autosomal dominant pattern of inheritance with incomplete penetrance in the boxer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

ARVC (prognostic value of genetic test)

A
  • homozygous positive is the worst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

T/F: ARVC with Mutation =/= Disease and Mutation Free =/= Disease Free

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

ARVC (Treatment)

A
  • if symptomatic (syncopal)
  • if CHF (treat as DCM)
  • Sotalol, Mexiletine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

ARVC (prognosis)

A
  • generally good
  • bad if positive homozygous for striatin mutation
  • bad if structural heart disease observed (type 3)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

T/F: most congenital heart diseases are uncommon and are managed medically more often than surgically

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Common CHDs for dogs and cats

A

Dogs:

  • PDA - 26%
  • SAS - 24%
  • PS - 22%

Cats:

  • VSD - 18%
  • PDA - 11%
  • TVD - 11%
  • MVD - 10%
36
Q

Pulmonary Valve Stenosis (PVS)

A
  • malformation of the right ventricular outflow tract
  • varying degrees of valve thickening and commissural fusion
  • +/- hypoplasia of pulmonary annulus/ artery
  • stenosis of the RVOT
  • varying severities
37
Q

Pulmonary Valve Stenosis (Clinical Recognition)

A

Signalment:
- young, usually smaller breed (brachycephalics)

Physical Exam:

  • loud, incidentally detected, left basilar systolic murmur
  • jugular venous distention or pulsation
  • right heart failure
38
Q

PVS (Pathophysiology)

A
  • stenotic RVOC –> pressure overload of right ventricle
  • -> post-stenotic PA dilation
  • -> concentric RV hypertorphy
39
Q

PVS (diagnostics)

A
  • echocardiography –> diagnosis and severity assessment
40
Q

PVS (treatment)

A
  • do nothing
  • pulmonary balloon valvuloplasty
  • open heart surgery
  • beta-blockers (atenolol)
41
Q

PVS (adverse outcomes)

A
  • exercise intolerance
  • syncope
  • sudden death
  • right heart failure
  • cyanosis
42
Q

PVS (prognosis)

A
  • mild PS –> normal life; no treatment
  • moderate PS –> treatment?
  • Severe PS –> adverse outcome and shortened life-span are likely (atenolol and balloon valvuloplasty likely to help)
43
Q

Subaortic stenosis

A
  • malformation of the left ventricular outflow tract
  • -> fibrous ridge or ring underneath aortic valve
  • -> stenosis of LVOT
  • -> varying severities (murmur correlates)
44
Q

SAS (Clinical regonition)

A

Signalment:
- young, usually larger breeds

Physical Exam:

  • Loud, incidentally detected, left basilar systolic murmur
  • weak and late delayed femoral arterial pulses
  • left heart failure
45
Q

SAS (Pathophys)

A
  • stenotic LVOT –> pressure overload of left ventricle
  • post-stenotic Ao dilation
  • concentric LV hypertrophy
46
Q

SAS (diagnosis)

A
  • echo
47
Q

SAS (treatment)

A
  • do nothing
  • beta-blockers (atenolol)
  • open heart surgery
  • aortic balloon valvuloplasty
48
Q

SAS (adverse outcomes)

A
  • exercise intolerance
  • syncope
  • sudden death (arrhythmia)
  • left heart failure
  • bacterial endocarditis
49
Q

SAS (prognosis)

A
  • mild –> normal life
  • mod –> treatment?
  • severe –> adverse outcomes and shortened life-span likely, median survival (untreated) is 1-2 year, atenolol might help, avoid overexertion
50
Q

Mitral and Tricuspid Valve Dysplasia

A
  • malformed AV valves –> variable degrees of valve irregularity and thickening, shortened chordae tendineae, +/- valve malpositioning
  • typically results in regurge but stenosis may occur
  • labs get tricuspid valve dysplasia (familial)
51
Q

Identify and label ECG waveforms ( P, RR, QRS, ST, T, QT)

A

P-wave –> atrial depolarizaiton
PR interval –> conduction from SA node to ventricular myocardium
QRS –> ventricular depolarizaiton
- ST segment –> early ventricular repolarization
- T wave –> ventricular repolar
- QT interval –> time for ventricular depolar and repolar

52
Q

Path of electrical activity through the heart

A
  1. SA node in RA initiates impulse
  2. flows through internodal conduction tracts in atrium in the AV node
  3. current spreads slowly through the AV node
  4. initiates fast impulse onuction via the Bundle of His
  5. impulse reaches penetrating Purkinje fibers quicly and is carried to the myocytes
  6. cell-to-cell conduction
53
Q

Types of arrhythmias (sinus)

A

Sinus:

  • tachycardia
  • bradycardia
  • arrhythmias
  • arrest
  • sick sinus syndrome
54
Q

Types of arrhythmias (supraventricular)

A
  • a-fib
  • atrial tachycardia (SVT)
  • APCs
55
Q

Types of arrhythmias (Ventricular)

A
  • VPCs
  • V-tach
  • V escape
  • V-flutter
  • V-fib
56
Q

Types of arrhythmias (conduction Disturbances)

A
  • AV blocks
  • RBBB
  • LBBB
57
Q

Calculating Heart Rate

A

25 paper speed
–> 1500/blocks = bpm

50 paper speed
–> 3000/blocks = bpm

58
Q

Sick Sinus Syndrome

A
  • sinus arrest - period of >2 seconds without sinus node function
  • if ventricular escape fails the arrest may go uninterrupted and causes collapse
59
Q

Ventricular Arrhythmia

A
  • wide and bizarre
  • config may change
  • does not look like the sinus beats
  • no p wave initiating the complex
60
Q

When might you see a lack of P waves?

A
  • ectopic ventricular beats
  • a fib
  • hyperkalemia
  • atrial standstill
61
Q

Atrial Fibrillation

A
  • tachycardia
  • no P waves
  • Irregular R-R interval
  • +/- fibrillatory (f) waves/ undulating baseline
  • Variable R wave amplitude
62
Q

Hyperkalemia (ECG)

A
  • P waves go away
  • bradycardia
  • T waves become tented
63
Q

Ventricular Tachycardia

A
  • HR > 160-180
  • paroxysmal (bursts)
  • sustained (>30 sec)
  • monomorphic (1 VPC configuration)
  • polymorphic (multiple configuration)
64
Q

P Mitrale (long duration)

A
  • L atrial enlargement

- often see with mitral valve endocardiosis, DCM, PDA

65
Q

P Pulmonale (high amplitude)

A
  • R atrial enlargement

- often seen with pulmonic stenosis, pulmonary hypertension, TVD

66
Q

Increased QRS duration

A
  • ventricular enlargement

- bundle branch blocks

67
Q

Reduced QRS size

A
  • pericardial or pleural effusion

- obesity or hypothyroidism

68
Q

Deep Sharp S waves

A

Right ventricular enlargement

69
Q

Increased P wave amplitude

A
  • L ventricular enlargement
70
Q

Right/Left Bundle Branch Block

A
  • QRS duration > 80 msec
  • MEA points to right/ left
  • Negative, wide QRS (positive w/ left)
71
Q

2nd Degree AV Block (Type 1)

A
  • P-R gradula prolongs until a P wave is blocked completely
  • Increased vagal tone
  • sitmulus or atropine can obliterate
  • not organic heart disease
72
Q

2nd Degree AV Block (Type 2)

A
  • Random P waves are blocked completely

- no appreciable pattern of PR prolongation

73
Q

3rd Degree AV Block

A
  • all P waves are blocked
  • QRS complexes are not associated with P waves
  • QRS complexes are ventricular escape beats
74
Q

Lead 1

A

(-) R front

(+) L front

75
Q

Lead 2

A

(-) L front

(+) L hind

76
Q

Lead 3

A

(-) R front

(+) L hind

77
Q

What tests are available for feline HCM?

A
  • Auscultation (innocent murmurs present in 25-69% of cats)
  • Chest rads (only present when symptomatic)
  • Biomarkers (MYBPC-3)
  • ECG (presence of arrhythmias may be useful)
  • Echo
78
Q

Therapy for HCM cats prior to CHF

A
  • Beta blockers (atenolol)
  • Ca-channel blockers (diltiazem-xr)
  • No treatment
  • ACE inhibition (enalapril/ benazapril)
  • Platelet inhibition (clipidogrel)

–> ACE and platelet should begin when mod-severe LA enlargement

79
Q

Outcomes of HCM

A
  • congestive heart failure
  • thromboembolic complications
  • sudden death (arrhythmias, syncope, infarcts)
80
Q

Feline Heart Failure vs Pulmonary Disease

A
  • challenging
    younger –> congential
    v old cats –> more often pulmonary
81
Q

CHF in Cats (PE)

A
  • dyspnea/ tachypnea
  • heart murmur/ gallop sounds
  • arrhythmias
  • muffled heart sounds
    occasional crackles
82
Q

CHF in Cats (Testing for Congestive HF)

A
  • Thoracic Ultrasound (pleural or pericardial effusion, obvious cardiomegaly)
  • Cardiac Biomarkers (NT-ProBNP)
  • Echo (therapy guiding)
  • Chest rads
83
Q

CHF in Cats (Thoracocentesis)

A
  • has both therapeutic and diagnostic value
84
Q

Emergency Treatment of CHF cats

A
  • sedation is not the enemy (torb and buprenorphine)
  • O2 cage
  • furosemide
  • albuterol
85
Q

In hospital care or CHF in Cats

A
  • Furosemide
  • sedation
  • pimo
  • O2
  • thoracocentesis
86
Q

Chronic Therapy of CHF

A
  • Furosemide
  • ACE-inhibitors
  • Anti-thrombotics
  • Pimo

VET 433c (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions