History, physical exam, restraint

Question 1

Signalment (7)

Answer 1

information collected at the start of/before the visit.

Name
Species
Breed
Age
Gender
Neutered/intact
Weight

Question 2

BAR
QAR

Answer 2

BAR – bright, alert responsive
QAR – quiet, alert, responsive

Question 3

hemi- & paraparesis

Answer 3

weakness or paralysis of one side of the body is a hemiparesis or hemiplegia;

weakness or paralysis of both legs is a paraparesis or paraplegia

Question 4

kyphosis

Answer 4

hunched back

opposite to lordosis

Question 5

BCS scale

Answer 5

Scale 1-5 or 1-9

Question 6

Muscle condition score (MCS) - what do you palpate (4) and how do you rate (4).

Answer 6

Spine, scapulae, skull, wings of the ilia

Normal, mild loss, moderate loss, severe loss

Bilateral or unilateral loss in limbs

Question 7

Counting Respiratory rate: how and norm. for dogs and cats.

Answer 7

Resting state; count during 10 or 15 seconds, multiply by 6 or 4.

Normal rate:
Dogs - 10-40/min (consider the size of the dog)
Cats - 20-40/min

Try and localize whether increased effort on inspiration or expiration.

Question 8

Stridor indicates ?

Answer 8

rigid tissue vibrations (larynx, trachea)

Question 9

Stertor indicates?

Answer 9

soft tissue vibrations (soft palate/upper airways)

Question 10

Pathological Breathing patterns are often described as 1 of 3:

Answer 10

Obstructive
Restrictive
Asynchronous (paradoxical)

Question 11

Obstructive breathing pattern =

Answer 11

Increased inspiratory effort (+/- respiratory noise) → upper airway disease.

Increased expiratory effort → lower airway disease.

Question 12

Restrictive breathing pattern =

Answer 12

Mixed respiratory pattern in which you see both increased inspiratory and expiratory effort → primary lung disease (parenchymal disease).

Question 13

Asynchronous (paradoxical) breathing pattern =

Answer 13

Abdomen moves inward during inspiration → pleural disease.

Question 14

Dogs
Deciduous teeth

Answer 14

Deciduous teeth 2x (I3/3:C1/1:P3/3) = 28

Question 15

Dogs
Permanent teeth

Answer 15

2 x (I3/3:C1/1:P4/4:M2/3) = 42

Question 16

Cats
Deciduous teeth

Answer 16

2x (I3/3:C1/1:P3/2) = 26

Question 17

Cats
Permanent teeth

Answer 17

2x (I3/3:C1/1:P3/2:M1/1) = 30

Question 18

ptyalism

Answer 18

excessive salivation

Question 19

A prolonged CRT indicates?

Answer 19

peripheral perfusion is Normal at 1-2 sec

Prolonged = dehydration, hypovolemia, shock

Question 20

A decreased CRT can indicate?

Answer 20

Decreased – early shock, fever, hyperthermia

peripheral perfusion is Normal at 1-2 sec

Question 21

pale white mucous membranes can indicate (3)

Answer 21

anemia
poor perfusion
vasoconstriction

Question 22

possible causes of red mucous membranes (4)

Answer 22

sepsis
early shock
SIRS (Systemic inflammatory response syndrome)
fever

Question 23

brownish mucous membranes can indicate?

Answer 23

not when its not pigment!

methemoglobulinemia/ intravascular hemolysis

Question 24

enophtalmia

Answer 24

sunken eyes

Question 25

skin turgor is normally reduced in what types of healthy patient? (2)

Answer 25

geriatric or underweight patients and vice versa, overweight patients normally have increased turgor

Question 26

estimate dehydration percentage when history of few episodes vomiting and/ diarrhea, clinical exam normal.

Answer 26

<5%

Question 27

estimate dehydration percentage when history of episodes vomiting and/ diarrhea, clinical exam finds increased turgor, dry mm, enophtalmia.

Answer 27

6-8%

Question 28

estimate dehydration percentage when history of excessive episodes vomiting and/ diarrhea, clinical exam finds marked degree turgor, dry mm, enophtalmia, slow CRT, rapid pulse.

Answer 28

9-11%

Question 29

estimate dehydration percentage when hypovolemic shock.

Answer 29

12-15%

Question 30

A Normal thyroid gland can’t be

Answer 30

palpated

Question 31

An Overfilled, pulsating Jugular vein can indicate?

Answer 31

Right-sided heart failure

Question 32

Palpable lymph nodes (5)

Answer 32

Submandibular lnn Prescapular lnn Axillary lnn Inguinal lnn Popliteal lnn

Question 33

Normal rate heart rate Dogs Cats

Answer 33

Dogs - 60-140/min (consider the size) Cats – 140 (180) -200/min

Question 34

sinus arrhythmia

Answer 34

HR faster during inspiration and slower during expiration is normal for dogs but not cats

Question 35

what is a cardiac gallop?

Answer 35

Cardiac gallop is a mechanical hemodynamic event associated with a relatively rapid rate of ven- tricular filling and accompanied by a ventricular bulge and a low-frequency sound. It includes three or four sounds, thus resembling the sounds of a gallop. Gallop rhythms may be associated with the following: Ventricular overload.

Question 36

grading heart murmurs

Answer 36

Auscultate all valve areas Murmurs are graded I-VI Sound caused by turbulent blood flow Assess where the murmur is the loudest (PMI) Systolic vs diastolic vs continuous Feel the femoral pulse at the same time!

Question 37

On the left side of the thorax you can auscultate which valves?

Answer 37

P - pulmonary valve, most cranial A - aortic valve, most dorsal M - mitral valve, towards apex most caudal

Question 38

On the right side of the thorax you can auscultate which valves?

Answer 38

T - tricuspid valve

Question 39

Thoracic auscultation for respiratory sounds.

Answer 39

Divide the thorax into 4 areas each side. Pathological sounds: - Increased lung sounds - Wheezes - Crackles - Decreased lung sounds: Dorsally → pneumothorax Ventrally → pleural effusions Assess whether sounds on inspiratory or expiratory phase. Larynx - isolate upper airway sounds.

Question 40

Abdominal palpation.

Answer 40

Use gentle but firm pressure, both hands, move dorsal to ventral and cranial to caudal. Avoid the spine - back pain vs abdominal pain. Pain/discomfort + localization. Is the abdomen soft, firm/tense, hard.

Question 41

Palpable abdominal organs vs. Non-palpable organs (when normal/healthy):

Answer 41

Palpable organs: - Intestines with Fecal matter, foreign bodies, neoplasia. - Bladder (if full) - Kidneys (cats) Non-palpable organs when normal: Liver, pancreas, stomach, spleen, adrenal glands, uterus.

Question 42

Normal temps in Dogs Cats

Answer 42

Dogs - 37,5 – 39,1℃ Cats - 37,8 – 39,1℃ Take into consideration fear, anxiety, stress. And Hyperthermia vs pyrexia.

Question 43

Rectal palpation for what types of patients? (3)

Answer 43

Older intact males, males with urinary problems, all patients with defecation problems.

Question 44

A normal Prostate on palpation:

Answer 44

Normal - symmetrical, two lobes, nonpainful. In Large dogs they may be non-palpable.