Emergency medicine Flashcards Preview

Veterinary Technician > Emergency medicine > Flashcards

Flashcards in Emergency medicine Deck (251):
1

If an animal is having Difficulty breathing suggestions would be to:

-Minimal restraint and no neck leads
-Keep animal calm
-Keep in cool environment

2

If an animal is Choking suggestions would be to? Bleeding?

-Bring in immediately
-May try Heimlich maneuver
3) Clean cloth or towel applied

3

Exposed or ingested toxicant, suggestions:

-Bring product container
-Time of exposure
-Determine if vomited
-Immediate departure if < 30’ distance
-Induce emesis if > 30’
-External, give bath

4

Recumbent/shocky, suggestions:

Cover and keep warm

5

Seizuring suggestions:

-Advise should stop in 2-5 minutes
-Stay calm
-Move animal away from stairs, furniture
-Keep hands away from mouth
-Place cool wet towels on pet for transport

6

Limb fracture suggestions:

-Transport with minimal handling
-Possible splint with magazine, pole or other clean material

7

Open or penetrating wound suggestions:

Chest: place in lateral recumbency with affected side down
Cover wound with clean, water moistened towels
FB: leave in place and place animal with unaffected side down

8

Burn suggestions:

Apply cool water compress

9

Heatstroke suggestions:

-Rinse animal with gentle spray
-Do not rinse when transporting
-DO NOT APPLY ICE

10

Ocular injury suggestions

-Exposure to irritant-rinse copiously
-Cover with moistened towel

11

Define triage.

Defined as the evaluation and allocation of treatment to patients according to a system of priorities designed to maximize the number of survivors

12

Treatment should NEVER be altered due to amount of patients but only by _______

approval of the owner.

13

Crash cart should have what inside for breathing?

-Airway, Breathing, Circulation
-ET tubes
-Ambu bag
-Laryngoscope
-Stylet
-O2 mask

14

Crash cart should have what inside for circulation?

-Stethoscope
-IV catheters: Butterfly catheters
-Tape
-Clippers
-Sx scrub
-Minor/major surgical pack
-Fluid administration sets: Fluid bags
-Balanced electrolyte
-Hypertonic saline, Synthetic colloid
-Infuser bag

15

What drugs are mandatory to have in a crash box?

-Atropine*
-Epinephrine*
-2 % lidocaine without epinephrine*
-Sodium bicarbonate*
-Syringes
-Needles
-Dose chart

16

An advantage of a crash box is?

1) More supply space
2) Adapted for specialized equipment (O2 & suction)

17

What are some responsibilities of the technician during an emergency

-Prepare emergency & operating room
-Receive phone calls
-Provide first aid instructions
-Secure patient’s airway & manage IPPV if needed
-Secure IV access
-Monitoring devices
-Pain management
-Charts
-Communication with doctors

18

What 3 things should a crash cart be?

1) Central Location
2) Easily Accessed
3) Portable

19

Water-based solutions containing electrolytes and nonelectrolyte solutes permeable to capillary membranes, used for rehydration and maintenance

Crystalloids

20

1st choice for fluid resuscitation, but not good for shock therapy, renal failure or cerebral injuries

Crystalloids

21

Lower osmotic pressure than fluid comparing

hypotonic

22

Good replacement for Dehydration and Resuscitation, Not good for maintenance due to higher content of Na and Cl

isotonic

23

Draws fluid into vascular spaces, May be prolonged when used with colloids. Used for treating Head injuries, cerebral edema. Prolonged use can lead to hypernatremia, hyperosmolality, increased bleeding. Too fast infusion can cause bradycardia, hypotension, bronchoconstriction, rapid shallow breathing

hypertonic

24

Include dextran 70 & hetastarch. Maintains fluid within the vascular space as long as the osmotic pressure greater than the tissue. Usually maintained by albumin.

colloids

25

T/F Digital faster than film

true

26

Always obtain caller’s _______ BEFORE placing on hold

name/phone number

27

Questions owners should be able to answer

-Is the animal breathing
-Is the animal conscious
-Is the animal bleeding
-Is the animal able to move
-Are there any open wounds or visible fractures
-When did the accident occur
-How far are the owners from the facility

28

What are the 4 classes of classifying a patient based on triage

4 Classes
I: dying before your eyes
II: critical, attention w/i minutes
III: urgent, attention w/i 1 hour
IV: less critical, attention w/i 24 h

29

What are the 4 major organ systems assessed for triage

-Respiratory
-Cardiovascular
-Neurologic
-Renal

30

What is the purpose of the primary survey(1st)?

to determine further stability of patient and to identify and treat any life-threatening conditions(vitals, samples, hemorrhage control, shock mgmt)

31

ABCDE’s of emergency

-Airway
-Breathing
-Bleeding
-Cardiovascular
-Circulation
-Disability
-Level of Consciousness
-External assessment

32

_____ is the most common vascular access.

Peripheral

33

What are the 5 levels of consciousness?

I. A- alert
II. V- verbally responsive
III. P- pain responsive
IV. U- unresponsive
V any level other than “A” requires immediate attention

34

The 2nd survey consists of:

-Complete physical examination (after stabilization, complete physical)
-History of patient;
-Allergies: any known
-Meds: currently
-Past history: medical problems
-Lasts: meals, urination, BM, meds
-Events: details of current problem

35

A CRASH PLAN:

-A: airway, breathing, bleeding
-C: circulation, cardiovascular
-R: respiration
-A: abdomen (analgesics)
-S: spine, skin, scrotum
-H: head (mentation, ears, eyes), hydration, hypo-, hyperthermia
-P: pelvis, perineum penis, prostate, pain
-L: limbs ( wounds, fractures, swelling, pain)
-A: arteries/veins
-N: nerves/neurologic, neck nutritional

36

Best treatment for decubital ulcers is?

prevention

37

A client calls, he suspects that his pet has been exposed or ingested a toxicant. What (4) questions and/or recommendations do you give over the phone?

1) Ask the name and phone number
2) What type of toxin it is (if they know)
3) If they can bring in the bottle of it
4) they need to bring the pet in right away

38

As the receptionist on duty, what advice (3) would you give a caller who describes a dog hit by a car with an open or penetrating wound?

1) Bring in immediately
2) Keep pressure on wound
3) Keep it covered with affected side down

39

What 4 drugs are mandatory in a crash cart?

1) epinephrine
2) sodium bicarbonate
3) atropine
4) 2% lidocane gel

40

T/F During an emergency situation, the purpose of the Primary survey is to determine further stability of patient and to identify and treat any life-threatening conditions

true

41

T/F Bounding pulses can be caused by a hyper-dynamic state or diastolic problem.

True

42

T/f If the CRT=<1, the condition of the patient is consistent with hyper-dynamic state and/or vasodilation

true

43

T/F In obtaining vascular access, the peripheral way is most commonly used, but central venous access using jugular or medial saphenous allows higher drug concentration to be achieved in coronary vessels because it allows placement of larger bore catheter and facilitates more rapid fluid administration

true

44

T/F While evaluating a neurological status, a level of consciousness any level other than "A" requires immediate attention

true

45

T/F Flat jugular veins (long time to refill) indicate hypovolemia

true

46

T/F Survivability depends on appropriate triage, establishment of an organized team who performs the 1st survey. take vitals, samples, control hemorrhage, shock management, followed by a 2nd survey which is a complete physical examination and complete history of the patient after stabilization

true

47

T/F Skull radiographs can be challenging to interpret in even the most straightforward cases due to the intricacy of bones in many overlapping planes

true

48

T/F Whether administered either during anesthesia or to a sick patient, fluid therapy often begins with the maintenance rate, which is the amount of fluid estimated to maintain normal patient fluid balance

true

49

T/f Decisions regarding whether to provide fluids during anesthesia and the type and volume used depend on many factors, including the patient's signalment, physical condition, and the length and type of the procedure.

true

50

Never _____ on the phone, always offer an appointment

diagnose

51

Define as a state of inadequate circulating volume and inability to meet cellular oxygen demands or inadequate cellular energy production

shock

51

What 2 things does tissue oxygen delivery depend on?

1) cardiac output
2) arterial oxygen concentration

51

What does shock most commonly result from?

reduction in oxygen delivery

51

Deficient ATP= cell death=

multiple organ failure

51

What are some factors affecting oxygen delivery?

-inadequate preload
-increased afterload
-cardiac dysrhythmias
-inadequate hemoglobin
-inadequate oxygen saturation

51

T/F It is important to recognize shock in its latest stage for best success.

false-earliest

51

What are some signs of shock? (hypovolemic, cardiogenic)

-cool extremities
-pallor of the mm
-hypotension
-tachycardia
-fall in body temperature (hypothermia)
-mentation
-pulse quality

52

Clinical signs of hypoxia

-cyanosis
-dark colored blood
-tachypnea
-tachycardia
-anxiety

52

O2 content (CaO2) is defined as?

the amount of O2 in arterial blood, function of hemoglobin content, ether dissolved in plasma or attached to Hgb

52

How can you treat cardiogenic shock?

by increasing CO, decreasing pre-load & afterload w/ positive inotropes

53

Improving SV (stroke volume):
1) Stretch of ventricular walls during diastole
2) Decreases in forces opposing blood flow

1) preload
2) afterload

53

What is the most common form of shock?

hypovolemic

53

Classifications:
1) Loss of systemic vascular resistance
2) Decreased circulating blood volume
3) Deranged metabolic machinery
4) Decrease in oxygen content in arterial blood
5) Decreased cardiac output due to heart failure

1) Obstructive/Distributive
2) Hypovolemic
3) Metabolic
4) Hypoxemic
5) Cardiogenic

53

As shock progresses, the body loses the ability to maintain ______

homeostasis

54

____ needs to be in constant supply for tissues to function

ATP

55

What is the initiating cause of distributive shock?

sepsis

56

What are some monitoring equipment used for shock?

-ECG
-Blood pressure
-Pulse oximetry
-Best:Thorough PE and CONSTANT, frequent patient assessments

57

Well perfused patient has: CVP values of?

5-10 cm H2O dogs
2-5 cm H2O cats

58

Immediate concern for managing shock are?

-V-ventilation to ensure patent airway, maximize O2
-I-infusion of fluids to restore volume
-P- maintenance of myocardial pumping function, restore cardiac output and blood flow

59

Pressure measured at the tip of a catheter placed in the jugular vein, usually positioned so the tip is close to the heart, Represents right atrial pressure, Reflects filing pressure of RV

Central venous pressure

60

T/F There is a very low percentage of survival and discharge post resuscitation

true

61

The goal of resuscitation is

Goal to restore tissue perfusion

62

What does CPR stand for?

cardiopulmonary cerebral resuscitation

63

The goal of cardiopulmonary cerebral resuscitation (CPCR) is?

to perform effective thoracic compressions such that an adequate amount of oxygen is delivered to the brain and other vital tissues

64

Grading hear murmurs:
-I:
-II
-III
-IV
-V
-VI

I: barely auscultable
II: softer than 1st heart sound
III: sound equal to 1st heart sound
IV: louder than 1st heart sound
v: murmur with palpable thrill
VI: murmur and thrill can be heard with stethoscope off of chest

65

The acute onset of bradycardia, change in mucous membrane color and capillary refill time, change in respiratory pattern, and change in mentation are signs of possible deterioration and impending ______

cardiopulmonary arrest.

66

T/F New guidelines for humans emphasize the importance of continuous, uninterrupted compressions

true

67

___ is contraindicated because it decreases cerebral blood flow

Doxapram

68

What is the purpose of the defibulator?

Pass a current through heart to depolarize cardiac cells & repolarize in uniform manner

69

Decision to terminate based on:

Disease process, original prognosis and client’s desires (DNR), Usually 10-20 min

70

IMPORTANT TO KNOW OWNER’S WISHES FOR EXTENT OF RESUSCITATION . MOST SUCCESSFUL CPCR IS THE ONE ___

avoided

71

Common Signs in Cardiac Emergencies

-Cyanosis
-Dyspnea
-Collapse
-Hind limb paresis
-Syncope

72

as the inability of the heart to supply the metabolic needs of the body or provide adequate blood flow only by excessive increases in ventricular filling pressures

heart failure

73

A common clinical sign in a dog with CHF? Auscultation?

moist cough, pulmonary crackles and wheezes w/pulmonary edema

74

1st evidence of L-CHF is _______ that resolves with furosemide

interstitial pattern

75

Initial treatment of heart disease is?

O2 supplementation

76

Acute life threatening situation where large numbers of worms move from pulmonary arteries to RV, RA and +/- vena cava.

Caval Syndrome

88

Treatment:
1) V fibrillation:
2) V tachycardia:
3) Supraventricular tachycardia

1) defibrillator
2) lidocaine, procainamide, quinidine
3) Beta-blockers or calcium channel blockers

89

Most commonly shock results from reduction in oxygen delivery secondary to one of three major mechanisms:
a) loss of intravascular volume
b) maldistribution of intravascular volume
c) failure of the cardiac pump
d) all of the above

d) all of the above

90

T/F Shock is a syndrome characterized by the presence of severe clinical signs, including alterations in mental state, mm color, CRT, HR, pulse quality.

true

91

T/F As a vet tech it is of importance to recognize early stages of shock

true

92

T/F Shock may be any syndrome, disease state or injury that results in a critical increase in effective blood flow.

false

93

Hypovolemic shock may result from:
A) 3rd spacing of fluids
b) acute hemorrhage
c) vomiting/diarrhea
d) all of the above

all of the above

94

T/F Cool extremeties, pallor of the mm, hypotension, tachycardia, are all signs of distributive shock.

false-hypovolemic, cardiogenic

95

T/F Anaphylactic shock is an antigen-antibody reaction occurring immediately after antigen enters circulation

true

96

T/F Severe pain can interfere with normal vasoconstriction response by inhibiting vasomotor center

true

97

T/F The treatment for shock is to optimize O2 delivery to all organs

true

98

Cardiac preload is define as blood in ventricles at the end of diastole

true

99

Name 2 differences between vomiting and regurgitation.

vomiting: active expulsion of gi contents
regurgitation: food is undigested, esophageal disorder

100

Diarrhea with straining is associate with a disorder of the small/large intestine

large

101

The owner of a dog with vomiting and diarrhea is incapable of bringing him to the clinic until the morning, after consulting with your veterinarian, what recommendations would you give him over the phone?

-no food or water until they can bring the dog in (usually wihthold for 24 hours)
-withhold water for 4 hours

102

The owner of a dog observed him ingesting a toxin 1/2 hour ago, he calls and wants to know how to make him vomit, what advice do you offer?

Bring him into the clinic, don't induce vomiting. Bring the bottle of the toxin as well. Ask the vet first. Find out toxin.

103

Describe a dog that has a foreign body lodged in the oral cavity.

-salivating
-not eating
-cyanosis/not breathing
-pawing at mouth

104

What are three clinical signs of a dog that has a foreign body in the stomach?

-vomiting
-not eating
-show pain on abdominal palpation

105

A cat regurgitates his food, what are 2 possibilities of the cause?

1) FB
2) hair ball

106

Name 4 possible causes for pancreatitis in dogs?

1) fatty diet
2) breed dispositions
3) drugs
4) abdominal trauma

107

What are the signs of a possible Gastric Dilation Volvulus.

-Repeated unproductive retching
-Restlessness
-Abdominal distention
-Hypersalivation
-Weakness and sometimes collapse
-Vomiting

108

An emergency GDV is on the way, as a CVT what do you need to prepare?

-stomach tube
-catheters
-fluids
-radiographs
-ultrasounds
-analgesics

109

What are the 2 types of Regular insulin and how can they be administered?

1) Humulin R
2) Novolin R
usually IM

110

Name 4 possible causes of hypocalemia.

1) hypoalbuminemia
-ARF and CRF
-Puerperal tetany (eclampsia)
-Acute pancreatitis
-Hyperphosphatemia
-Intestinal malabsorption
-Ethylene glycol
-Phosphate enemas
-All meat diets

111

These diagnostic tools are useful to diagnose what ocular emergencies:
1) Flourescein stain-
2) Tonometry-
3) Cytology-
4) Conjuncitval scrapings-
5) Flourescein antibody-

1) corneal ulcers
2) glaucoma
3) squamous cell carcinoma
4) conjunctivitis
5) cataracts

112

Overflow of tears

epiphora

113

Posterior displacement of the eye

enophtalmos

114

Blood in the anterior chamber

hyphema

115

Light sensitivity

photophobia

116

Inlfammation of all structures or tissues of eye

panophthalmitis

117

A corneal ulcer

descemetocele

118

Protrusion of the globe from the usual position

proptosis

119

Involuntary closing of the eyelids

blepharospasm

120

What are the 2 common causes of canine corneal ulcers?

1) trauma
2) shampoo in the eye

121

White: gastric or esophageal origin
Color of fluid:
1) Yellow:
2) Green:
3) Brown:
4) Hematemesis:
5) Coffee grounds:

1) gastric mixed with bile
2) bile and duodenal contents-both yellow and green can be associated with pancreatitis
3) reflux of fecal-like material
4) frank blood
5) gastric or duodenal vomitus of digested blood

122

GDV Distention puts pressure on:

Diaphragm and Vena cava

123

What is Obstipation?

Obstructive constipation common in older cats

124

What is an ocular emergency?

any serious condition that causes or threatens to cause severe pain, deformity or loss of vision

125

Questions to ask about an ocular emergency would be

-Any medical techniques attempted by the owner?
-When was the problem first noticed?
-Prior incident of ocular dz?

126

_____ is a common neurological disorder of the eye and facial muscles.

Horner's syndrome

127

_____ is a potentially fatal complication of unregulated insulin deficiency

Diabetic ketoacidosis

128

The most common cause of hypoglycemia is ____

Artifactual

129

For Hypercalcemia treatment what is the fluid of choice?

0.9% NaCl fluid of choice

130

Addison’s or Hypoadrenocorticism clinical signs

-Weight loss
-Abdominal pain
-Inappropriate bradycardia
-Vomiting
-Diarrhea

131

What is hemostasis

the stoppage of bleeding

132

Explain the 4 steps involved with primary hemostasis.

1) vascular constriction
2) exposure of collagen causing pooling of platelets
3) platelets release more factors to enhance aggregation
4) formation of complete but unstable plug

133

What is happening in secondary hemostasis?

larger vessels require coagulation factors to form a stable clot

134

What is the final step to hemostasis?

fibrinolysis

135

Von willebrands is a ____ disorder that is commonly seen in Dobermans

congenital

136

____ is the most common primary hemostatic defect, which one of the most common causes is ____

thrombocytopenia, immune mediated thrombocytopenia

137

___ is the most common hereditary bleedimg defect in dogs

Von Willebrands disease

138

What is Disseminated Intravascular coagulation and how is it treated?

is a rare, life-threatening condition that prevents blood from clotting normally. It may cause excessive clotting (thrombosis) or bleeding (hemorrhage) throughout the body and lead to shock, organ failure, and death. It is treated with FFP, O2, fluids.

139

What are some predisposing factors of DIC?

1) Endothelial damage causing contact activation of the intrinsic pathway
2) Abnormal blood flow activating the extrinsic pathway
3) Hypercoaguable state by activating certain enzymes

140

T/F DIC is a primary disease.

false-not a primary disease just a syndrome

141

What is anemia?

reduction of circulating RBCs

142

Normal animals can tolerate loss of 20%, shock occurs with ___ loss

60-70%

143

What are the 2 categories or neurological emergencies?

1) owner perceived
2) true emergency

144

Level of consciousness:
1) vocalization, inappropriate response to external stimuli
2) unconscious but responsive to external stimuli
3) unconscious with no response to noxious stimuli

1) delirium
2) semicoma
3) coma

145

Paroxysmal transitory disturbance of brain function that has sudden onset and ceases spontaneously

seizure

146

What are the 2 categories of seizures?

1) Partial (Reflect a limited set of neurons be affected)
2) Generalized (Tonic-clonic movement of all limbs)

147

Time after seizure or group of seizures

Post-ictal period

148

Non-progressive, intracranial disorder causing recurring seizures

epilepsy

149

What are some causes of seizures?

-Trauma
-Hypertension
-Toxin
-Hypoglycemic
-Hyperammonia

150

What are the 2 categories of epilepsy?

Focal vs. generalized
1) Focal= remain localized to one body region
2) Generalized= affect whole body=most common type

151

What are the 3 steps to stopping a seizure?

Step 1: benzodiazipines (diazepam)
Step 2: barbiturates (Phenobarbital)
Step 3: general anesthesia (propofol)

152

A condition characterized by an epileptic seizure that is so frequent or prolonged that it creates a fixed or lasting condition

Status epilepticus

153

What are the 2 types of spinal cord injuries?

1) Extrinsic: HBC, falls, falling objects; projectile wounds
2) Intrinsic: IVDD; fibrocartilaginous infarct-pain management

154

What do you monitor for head trauma? Treatment?

-ABCs
-Levels of mentation
-Mannitol decreases ICP, Furosemide to prolong effects

155

What are the 2 types of Vestibular Disease?

1) Idiopathic old dog
2) Feline idiopathic peripheral dz

156

Describe the 4 steps of primary hemostasis

1) vessels constrict
2) platelets are activated
3) clots form

157

Name 3 conditions that can cause platelets disorders

1) von willebrans
2) DIC
3) immune mediated hemolytic anemia

158

What happens during DIC?

blood clots form throughout the body

159

What is the most important course of action during a DIC emergency? How is it done?

stabilization of the patient, oxygen and fluids

160

Name 3 causes of hemolysis in dogs

1) immune mediated hemolytic anemia
2) thrombocytopenia
3) liver disease

161

What is the treatment for Rodenticide intoxication?

vitamin k

162

PCV: dehydration, spleic contraction, hemo-dilution, hemolytic anemia, blood loss (increased, decreased or normal)

dehydration: increased
splenic: increased
hemo: decreased
hemolytic: decreased
blood loss: decreased

163

TS: dehydration, spleic contraction, hemo-dilution, hemolytic anemia, blood loss (increased, decreased or normal)

dehydration: increased
splenic: normal
hemo: decreased
hemolytic: normal
blood loss: decreased

164

What are the 5 questions you would ask over the phone to screen for a potential dystocia?

1) hoe long since the last pup was delivered
2) is there any pus
3) has she been in labor longer than an hour
4) is she pushing for more than 30 mins and nothing is coming out
5) is her temperature dropping less than 100 degrees

165

What are 4 indications that we are dealing with an emergency situation

1) labor greater than 30 mins with no delivery
2) yellow or green pus
3) no pups being delivered after constant straining
4) temperature dropping below 100 degrees

166

What are 3 causes of uterine inertia?

-primary: inherited
-secondary: anxiety, stress

167

When is it not recommended to give oxytocin for a dystocia?

when the cervix is not yet dilated/open

168

What are the reasons to give oxytocin, calcium gluconate, or dextrose for dystocia

-you would give oxy for inducing contractions
-calcium to prevent hypocalcemia
-dextrose to prevent hypoglycemia

169

How are neonates cared for after c-section delivery?

-clean the airway
-stimulate to breahte
-keep them warm

170

Explain an open vs closed pyometra

an open can drain the pus, the closed is a medical emergency

171

In case of a uterine torsion what will surgically happen to the uterus

the uterus will be rotated so it needs to be removed-OVH

172

What is the treatment for a uterine prolapse?

sugar and water and to place it back in

173

Why can death occur 2 days after a prostate abscess rupture?

septicemia

174

T/F A pnemothorax implies a collapsed lung, therefore the density observed in a lung on an xray and that is why we most probably have to insert a chest tube (to inflate the lung), the rest of the lung is over-obscured (super black) because of the extra air free in the thoracic cavity and the heart is elevated from the sternum

true

175

Describe an orthopneic patient

open-mouth breathing, neck extended, elbows abducted

176

Describe a Kussmeaul breath pattern and what makes it occur

slow, deep respirations, metabolic acidosis

177

T/F A cheyen stokes pattern is caused by a defect in central respiratory control center

true

178

How are 4 ways to identify a respiratory emregency

1) dypsnea
2) coughing
3) gagging
4) neck stretched, arms extended

179

Why does dyssynchronous breathing occur?

pleural effusion, pnemothorax, problem with lung expansion

180

Why does cyanosis occur?

1) not an adequate amount of oxygen is getting to the tissues
2) Hgb unable to carry O2

181

When you see an animal with extreme effort to inhale air you suspect an ____

airway obstruction

182

T/F Exercise intolerance, gagging while eating or drinking, laryngeal stridor may present with dypsnea, stridor, hyperthermia in a case of tracheal collapse

false-laryngx

183

T/F A "Goose honk" cough is a good indicator of laryngeal paralysis

false-tracheal collapse

184

When performing chest compressions on an animal that weighs more than 15lb the animal should be placed in a

lateral recumbent position

185

When performing cardiac compressions on a dog that weighs 9 lbs what is the point of compression?

directly over the heart

186

What is the ideal route of drug administration during CPCR in advanced life support

intravenous route with a jugular

187

What drug promotes diuresis and decreases cerebral edema in a patient following cardiac arrest by drawing water from the interstitial space between cells?

mannitol

188

Following initial assessment, the most important system to examine in any kind of emergency situation is

airway

189

The part of signalment is not a factor that helps you to identify the problem in a patient with cardiac problems

reproductive status

190

During the triage process, initial presentations are noted an assessed. What three systems assessed to decide where the patient should be directed, either to an exam room or intensive care?

-respiratory
-cardiac
-neurological

191

When referring to the crash cart, and relating the items found there to teh ABC's of resusitation, name 3 items found on the cart and what aspect of the ABC do they relate

1) laryngoscope and ET tubes: airway
2) ambu bag: breathing
3) IV catheters and syringes: circulation

192

What are 3 tests which can be run on the blood from the hub of the catheter which will be your minimum database for the patient?

1) PCV
2) TS
3) blood glucose
4) BUN

193

Give a brief explanation of the 5 levels of consciousness

I. A- alert
II. V- verbally responsive
III. P- pain responsive
IV. U- unresponsive
V any level other than “A” requires immediate attention

194

An owner calls stating that she found her bottle of heart medication open with chewed pills on the floor. What 4 important questions would you ask first?

-her name and number
-name of medication
-how many pills did the dog ingest
-any vomiting from the pet

195

What would be 4 instructions to give the owner?

-bring pet in immediately
-bring bottle in
-watch pet's behavior
4) watch pet's mentation

196

After how much time of CPCR should the team stop, if no resuscitation is obtained?

10-20 mins

197

The patient survived after prolonged resuscitation, now what do we need to look out for? Name 4 types of pathology of cellular environment.

-Perfusion failure
-Reperfusion injury
-Post-anoxia toxins affecting brain & heart
-Blood dyscrasias after low perfusion

198

During CPR, large breed k9's compressions are done over the ___, while small breed k9 are done over the ___

widest part, smallest

199

Name 3 diagnostic tools you will need to have available during emergency medicine

EKG, blood pressure machine, pulse oximeter

200

T/F Emesis is preferred over gastric lavage for removal of stomach contents which is more effective early.

true

201

Name the most common agents for emesis

1) syrup of ipecac
2) hydrogen peroxide h2o2
3) liquid dishwashing soap
4) apomorphine

202

When do you not induce vomiting?

animal seizing, comatose, dyspeneic

203

When can you repeat H2O2?

within 10 mins

204

Produces emesis and can be lavaged on the conjunctiva

apomorhpine

205

What agent is used to induce vomiting in cats?

xylazine

206

You use a ____ when emesis is contraindicated or amount is too large

gastric lavage

207

What do cathartics do?

they cause evacuation of the bowels

208

Cats lack enzyme in the liver to biotransform this into glucoronic acid

acetaminophen-tylenol

209

#1 common metal toxicity is ____, the most common signs involve the __ and the ___ systems.

lead, gi, nervous

210

What's the difference between absorbent and adsorbent?

absorbent is the process by which a material absorbs some amount of liquid or gas into it. Adsorbent is a process by which some liquid or gas gets accumulated on the surface of a solid material.

211

Define urinary obstruction

inability of urine to flow normally from the body

212

Urinary obstruction clinical signs:

-Dysuria
-Hematuria
-Distended painful urinary bladder

213

The Primary complaint of a blocked cat is _____

constipation

214

The blocked dog male= ___, female= ___

Uroliths, tumors

215

The use of a catheter and sterile fluid/lubricant to relieve urethral obstruction

Urohydropulsion

216

_____ in dalmations aberrant purine metabolism

Ammonium urate

217

75% or more nonfunctional nephrons

azotemia

218

How do you treat acute renal failure

-Fluid
-Drugs
-Nutrition: Low protein/phosphorus/sodium

219

The doctor is in the middle of a difficult surgery with the other technician on staff and you are the only one to receive patients. A cat presents to the emergency clinic with open-mouth breathing and dilated pupils. At the same time a 6 week old pup presents with vomiting and diarrhea for the past three days. It is up to you to initially triage the patients, which patient should be treated first and why? Both clients are new to the clinic:
A) The cat, airway & shock take priority
B) The puppy, dehydration may cause collapse
C) The puppy, vomiting may be from an obstruction
D) The cat could bite the owner

A) The cat, airway & shock take priority

220

Assuming money is already collected, describe what you would do FIRST for the most critical patient.

Check airway

221

What is the most common form of shock seen?

Hypovolemic

222

When rehydrating a patient, what are three external methods to assess the hydration status of the patient WITHOUT drawing blood.

skin pinch, bp, urine output

223

When a client calls the ER, what is one of the first pieces of information obtained prior to placing the client on hold?

Get the client's phone number

224

What are three signs that the patient will exhibit when presenting with either gastric dilatation or volvulus?

-Repeated unproductive retching
-Abdominal distension
-Hypersalivation

225

There can be many causes for bloody diarrhea in dogs. Name the two most common laboratory tests to be performed to aid in the diagnosis of the problem.

-snap test
-fecal

226

Pulmonary edema is most commonly a result of what condition?

Congestive Heart Failure

227

The difference between vomiting and regurgitation is that vomiting is:

-Preceded by nausea
-Forceful contractions of abdomen and diaphragm
-Active expulsion of gi contents

228

If you were alone and had to initiate diagnosis for the veterinarian, what would be your 3 choices of preliminary exams for GDV ?

A) Radiographs
C) CBC
D) Chemistry & electrolytes

229

The doctor has just started surgery on a patient with bloat and has told you to triage and treat initially anything that comes through the door until surgery’s finished. Twenty minutes later a 12 y/o Miniature Poodle presents agitated, open mouth breathing, slightly muddy mucus membrane color and refusing to lie or sit down for any length of time. You attempt to auscult the thorax and due to the increased respiratory effort, the heart cannot be easily heard. The poodle has strings of saliva hanging from her mouth and is not swallowing; she will not let you close her mouth. What systems do you suspect is affected?

A) Digestive
B) Circulatory
C) Respiratory

230

When performing thoracic radiographs, what two positions are most commonly used?

VD, lateral

231

A client runs into the clinic with a dog that has just been hit by a car and the dog appears non-responsive in her arms., after assessment, what do you do first?

A) Administer Oxygen

232

Mrs.Pita rushes into the clinic with her Champion Chow-Chow, Ming, complaining of a foul odor and discharge on her face. As she walks across the floor of the lobby you notice Mrs. Pita is guiding the dog. What are three problems that you suspect with regards to the dog’s face ?

C) The dog has miasis
D) The infection is compromising the dog's eyesight
E) A traumatic event may have occurred a few days ago

233

A client comes in with her 2 y/o female Miniature Pinscher who is experiencing generalized involuntary muscle tremors. Her history of whelping four pups two weeks ago clues you into the possible cause of this emergency. What is the possible cause?

hypocalcemia

234

A patient presents to the clinic with moderate respiratory difficulty, but not in overt distress. An exam is performed and after radiographs, pleural effusion is diagnosed by the doctor. What is the best treatment for this condition to alleviate the respiratory distress?

Remove the fluid build-up

235

An 8 y/o M/C Main Coon cat presents in severe pain. The owner said he was out of town for 3 days and returned this morning and found the cat was on the floor straining and growling whenever his abdomen is touched. Radiographically, there are no fractures or dislocations-what do think may be the actual cause of the acute pain?

Urinary blockage

236

Mr. Williams with his 4 y/o M/I Bullmastiff, Hank, come into the ER and Mr. Williams looks very worried. Hank is definitely looking very depressed, head down, very little energy, refuses to stand as you start the record. The dog looks obviously thin, drags his feet while walking into the exam room. You start the PE and the following results are determined: RESULTS INTERPRETATIONBW 116 lbs., BCS 2.5/5 HR 124 RR panting, lungs clear LN’s enlarged Temp 104.6 What two organ systems might be involved in this problem ?

Lymphatic, Muscular

237

What treatment may alleviate Hanks's symptoms:
A) Vitamin B
B) Iron
C) Cortisone
D) More food
E) All the above

E) All the above

238

A 10 y/o mix M/I mix breed dog presents at the clinic for coughing, lethargy, weight loss and ascites. The owner states the dog lives completely outside and brags his dog has not been to the vet’s since a pup for the rabies vaccination. What organ is primarily affected?

Heart

239

Name two laboratory tests that you can easily prepare for the doctor to assist in the diagnosis of the previous case. (coughing, lethargy, weight loss and ascites.)

Snap test for Dirofilaria, Direct heartworm test on the microscope

240

The most common cause of hypercalcemia is

Malignancy

241

You see a dog with the following presentation below, you suspect : ______________Altered mentation , Seizures, Nystagmus , Wandering-aimless, Head tremors, Anisocoria, Altered balance and Paralysis or paresis

Head trauma

242

What would you do if Diazepan and Phenobarbital were ineffective in stopping a seizure occurring in a dog at your clinic?

Anesthetize

243

What can happen if Diazepam is mixed with LRS ?

Formation of precipitate

244

T/F Onion ingestion, Zinc toxicosis and Ehrlichia canis can all cause hemolysis in dogs.

true

245

T/F Drugs, vaccines, infection, neoplasia can all cause platelet disorders.

true

246

T/F Dobermans are prone to congenital Willebrand’s Disease.

true

247

T/F A bleeding time test that is easily performed is the canine Buccal, although it’s fairly insensitive test of plt function but if > 4min in dogs it is suspicious & > 5min, it’s prolonged.

true

248

T/F DIC is a syndrome resulting from overwhelming systemic activation of the coagulation, fibrinolytic and anti-thrombic systems.

true

249

T/F Perceived seizures occurs to healthy animal 1st for> 3-4 min , while true seizures occur several in short period of < 1 min.

false

250

T/F Bizarre behaviors such as “Fly-biting”, flank sucking or tail biting should be perceived as attention seekers by all animal patients.

false

251

T/F Any time we have a bulging eye, the cornea must be protected from drying as identification of underlying problem completed.

true