Internal medicine of small animals Flashcards

Question

Non-regenerative anaemia

Answer 1

Lowered production in RBC's - BM suppression - Lack of precursors (vitamins, Fe, Mins, protein) Compensation can take time (things may look non-regen at first) Chronic disease - inflammation - renal failure - reduced EPO - infection - FeLV, FIP, Leishmania - Hepatic disease - Hypothyroidism + Addison's Chronic blood loss --> this exhausts precursors like Fe, proteins, folate Auto-immune (maternal) BM suppression - hyperestrogenism, neoplasia Compensatory mechanisms - Tachycardia - Redistribution away from GIT - More EPO from kidneys - Less Hb affinity for O2 = faster tissue perfusion ``` Dx Bloods -decreased PCV + MCHC -Macrocytic (imature RBC's) -Polychromasia (nucleated RBC) -Serum --Yellow - EV Haemolysis --Red - IV Haemloysis ``` BBT Treatment - Fix underlying cause - Severe anaemia transfusion - -DEA 1-8 (dog types) - -A,B, AB (cat types) Mix blood to see types = agglutination (no match) Adverse reactions usually occur with cats if recipient is B and donor is A

Answer 2

HYPOCOAGULATION Thrombocytopathies -Lowered production (Vit K, BM, neoplasia) -Increased sequestration (Splenomegaly) -Destruction (AI, toxins, drugs, oestrogen) -Over utilisation (DIC, haemorrhage) Thrombobastaenia -Normal number with altered function Coagulopathies -Congenital: Von Willebrands + chediak-higashi syndrome + Heamophillia A + B -Acquired: Liver disease, warfarin, decreased Vit K, DIC, Heam diathesis Vasopathies (defects or damage to vessels) HYPERCOAGULATION DIC Protein loss --> anti-thrombin III Hypercholesterolaemia --> thrombus Systemic disease --> sepsis, burns, heamolysis Thrombocytosis --> Bleeding or adrenaline (physiological) Cs: haematuria, petechiae, epistaxis, melana, splenomegaly ``` Dx: CBC (thrombocytopenia) Platelet counts clotting factors prothrombin times BBT Activated clotting time ``` T: Transfusion (PRP, Blood, warfarin)

Answer 3

Leukosis Proliferation of leukocyte producing tissue Causes malignant neoplasia of R/WBC's Leukaemia Acute - BM infiltration = displacement of cells and lowered immune system Chronic - mature neoplastic lymphocytes in blood Dx: Bloods: leukopenia, anaemia, thrombocytopenia, monoclonal IgM spikes Marrow cytology: lymphocyte proliferation Bence jones protein (in urine) T: prednisolone, vincristne, chlorambucil ``` Feline leukaemia virus (FeLV) Saliva + urine, replicates in tonsils Good immunity - Latent Bad immunity - progressive infection Forms -thymic -multi-centric -alimentary Immunosuppression Dx: ELISA, IFAT, LN FNA ``` ``` Lymphoma/lymphosarcoma Proliferation of LN + BM Classification -Multi-centric -Mediastinal -Alimentary -Extra-nodal ``` ``` Staging I - Single LN II - Multiple LN in one region III - Lymphadenopathy IV - Liver and splenic involvement V - Blood or BM involvement ``` Dx: FNA of LN, X-Ray, USG T: preds, vincristine, doxorubicin ``` Polycythemia Increased RBC production Primary/Secondary Causes bleeding disorders T: lower PCV, chemotherapy ```

Answer 4

Lymphadenopathies -Reactive hyperplasia - Ag stimulation causes LN enlargement but LN's themselves are no affected Lymphadenitis - Neutrophils + macrophages invade LN's ``` Causes: B: rickettsia, brucella, pasturella, fuscobact F: Sporotrichosis Non-Inf: allergies, immune mediated Dx:bloods, LN FNA ``` Splenomegaly Primary - torsion Secondary - disease ``` Types Congestive - hypertension Hyperplasia - chronic anaemia Inflammation - SLE Infection - -P: babesia, ehrlichiosis, toxoplasma -B: salmonella, mycobacteria -V: canine hepatitis, FIP -Neo: heamangiosarcoma ``` Localisation - Diffuse (increased splenic work) - Asymmetrical (tumour) Hypersplenism - increased removal of RBC's Hyposplenism - decreased removal and presence of more reticulocytes Heamangiosarcoma Common splenic tumour Rupture --> internal bleeding

Answer 5

``` Oral cavity Stomatitis Primary -Peridontal disease -trauma -chemical -nocardia ulcerative stomatitis Secondary -AI (pemphigus, SLE) -Metabolic (cushings) -Immunosupressive -eosinophilic complexes -FOR lesions ``` Oral Neoplasia - Benign: epulis, papilloma - Malignant: Melanoma Oropharyngeal dysphagia Oral or pharyngeal Structural - teeth, gums, tongue or palate, stricture Functional - nerve damage, myasthena gravis Cs: Halitosis, bruxism and hypersalivation Dx: Oral x-ray ``` Salivary glands Sub-mandibular zygomatic parotid sub-lingual ``` ``` Mucoceles -Sublingual = Ranula FB or stomatitis = obstruction Sialolith is calculi in the duct T: marsupialised the gland ```

Answer 6

Megaoesophagus - Segmental or diffuse - Inherited or acquired - Regurgitation - prokinetics (only in cats as dogs is striated not smooth) Oesophageal FB -Thoracic inlet, apex cordis, hiatus oesophagi Oesophageal perforation -contrast x-ray Oesophagitis -Iatrogenic, acid reflux T: cimetidine (H2 inhib), omeprazole, prokinetic, anti-emetic (cerinia) Stricture Diverticulum -Traction/pulsion Hiatal hernia GIT in thorax Vascular ring anomalies Entrapment by aorta resect and ligate Neoplasia Spirocercosis (Spirocerca lupi) Red worms found in oesophagus

Answer 7

``` Acute gastritis >1 week V+ contaminated food dietary changes FB viral - parvo, distemper Parasites ``` ``` V+ characteristics Gastric - milky acidic Duodenal - yellow alkaline FB/ulceration - Red Bile - reflux, pancreatitis ``` Chronic gastritis recurrence of acute Reflux or Ulceration T: novel proteins or hypoallergenic food Gastric ulcers -V with blood GDV twisting, stops outflow and can obstruct VCCau presence of air or gorging a large meal --> GDV X-Ray: compartmentalisation Gastropexy Gastric outflow obstruction -Pylorus (usually stenosis) Gastric motility disorders -delayed emptying due to weak contractions Neoplasia DDx in vomiting - Vomit vs Regurgitation - Timing - -fast (gastritis, overfeeding) - -Hours post (outflow obstruction, gastric motility disorder) ``` T: Anti-emetic (metoclopramide) PPI (omeprazole) H2 blocker (cerenia) Mucoprotectants (sucralfate) Probiotics (Promax) withhold food (48hrs) + try bland food (elimination) ATB + anti-parasitic ```

Answer 8

Acute D+ <3wks Chronic D+ >3wks D+ Secretory - increased fluid from mucosa osmotic - poor digestion --> large particles = osmolarity malabsorptive - lack of absorption Acute B - salmonella, shigella, campylobacter, e.coli toxin V - Parvo, distemper, adeno P - isospora, giardia, toxo, crypto, eimeria, tenia, ancylostoma Chronic D+ (acute that lasts >3 wks) IBD Protein loss enteropathy Food allergy, D+, lymphatic rupture Villous atrophy Predisposition in setters + german shepherds Bacterial overgrowth + GI stasis -Absence of digestive enzymes (gall bladder stasis) Dx: contrast X-Ray can show slow movement T: promote gall bladder emptying pancreatic enzymes surgical ileocaecal valve correction ProMax Ileus (Intestinal obstruction) Mechanical - intra/extra luminal Functional - Spastic/paralytic

Answer 9

COLON IBD -Hypersensitivity (Ag to mucosa) T: Diet, hypoallergenic, chlorambucil Acute colitis -Giardia, campylobacter, parvo, histoplasma Irritable bowel syndrome -Stress + irritability often in large working dogs high fibre and sedatives Ulcerative colitis Typhlitis -inflammation of cecum Primary/secondary (typhlocolitis) Megacolon - congenital - acquired (colon inertia - neuro, metabolic, endocrine) Obstruction Neoplasia Intussusception Hypomotility + constipation Extra-intestinal (dehydration, endocrine, neuromuscular function alteration Intra-intestinal (obstruction, inhibition of defecation reflex) Perforation RECTUM Prostatitis -prostate hyperplasia (leydig cell neoplasia) Proctatitis -inflammation of anus Anal/rectal prolapse -complete/incomplete T:Hypertonic solution Anal sac disease - clogging or inflammation - obese dogs, poor muscle tone

Answer 10

Malabsorptive syndrome Disruption of degradation or absorption of food ``` Malabsorption (SI disease) fewer enterocytes or impaired function -Inflammatory damage -Bacterial interference with micelle formation -SIBO local immunodeficiency Biliary obstruction - bile acids ``` Maldigestion (exocrine pancreatic insufficnecy) - Acinar atrophy, pancreatitis - bile duct stasis Digestion pancreas secretes most digestive enzymes + Bile duct secretes bile acid for fat digestion Cs: weight loss even if polyphagic, abdominal distention (hypoprotein) T: diet, pancreatic enzyme supps, PPI (omeprazlole), H2 blocker (cimetidine)

Answer 11

Pancreas - endocrine - exocrine -->pancreatic juices Pancreatitis - chronic inf - trypsinogen --> trypsin (in SI is normal, in pancreas results in auto lysis) - Billiary tract stasis, toxaemia - Poor diet (fatty/sugary) Cs: steatorrhea + heamatorrhea ``` Exocrine pancreatic insufficiency Synthesis or secretion of enzymes -Acini atrophy -chronic pancreatitis -Masses - obstruction of duct Dx: serum trypsin ``` Pancreatic neoplasia - Adenoma/adenosarcoma - Insulinoma --> hypoglycaemia - duct obstruction

Answer 12

Function - Protein metabolism - detoxification - produces bile - coagulation factors Acute hepatitis - Primary = CAV-1, toxoplasma, leptospira - Secondary = GIT infections, toxins, fungi, drugs Inflammation --> fibrous islets (cirrhosis) Cs: >60% destruction results in Cs Bloods: ALP, ALT, GGT, Glu Dehy Increase: NH4, Cholesterol,, billirubin Decreased: CF's, albumin, glucose Liver function tests - Serum bile acids - Ammonia tolerance test

Answer 13

Chronic hepatitis - Proliferation and dysfunction - Lepto, CAV - AI, chemicals, drugs - Cholangitis prequel Chronic active hepatitis -still inflammed ``` Hepatosis dietica (yellow liver) -Vit E + sel deficiency ``` Dx: shrunken nodular liver Biopsy: parenchymal cirhosis or depositis of Fe, Cu, Vit A Amyloidosis - AL + SAA - steroids or nsaids Steatosis hepatis (fatty liver) 2ndry to anorexia in obese animals --> fatty deposits Can be caused by DM, lack of insulin --> glucose into cells --> lipid metabolism for energy -Pre - increased FA's hepatic - impaired function post - inability to conjugate with apoproteins --> lipoproteins Hepatic glycogenesis - steroid induced hepatopathy - steroids = hyperglycaemia Cirrhosis parenchyma --> fibrous tissue shunting and blockage Feline cholangitis/cholangiohepatitis syndrome (CAHS) -2nd to GIT or pancreas T: Metaclopromide (anti sickness) Hepatoprotectants (milk thistle) Vit K supplement

Answer 14

Obstruction Inflammation of pancreas, SI, gall bladder or duct itself (complete) Extrahepatic cholestasis --> rupture --> bile leaks --> peritonitis Jaundice + steatorrhea Cholelithiasis (gall stones) Cholesterol, salts, protein related to chronic cholecystitis full obstruction = Cs Inflammation Cholangitis - large bile duct Cholangiolitis - small intrahepatic ducts Cholecystitis - gall bladder itself Reflux of bacteria from SI or haematogenous Feline progressive lymphocytic cholangiohepatitis --> fibrosis and proliferation Bile duct hyperplasia Insults --> proliferation formation of new irregular channels Neoplasia Cholangiomas cholangiocarcinoma

Answer 15

Icterus - presence of billirubin in tissues turning them yellow commonly collects in: -sclera, Kidney tubules Forms Pre-hepatic heamolysis (increased serum Br) ``` Hepatic Hepatocyte damage (increased serum Br) ``` Post-hepatic IntraHepatic - bile caniculi inside liver Extrahepatic - main bile duct (increased serum cBr) Van den Berg test - differentiate Br and cBr - Prehepatic: normal liver enzymes + increased Br - Hepatic: Increased liver enzymes + increased Br - Posthepatic: Liver enzymes + increased cBr Dx - Enzymes - Van de Berg test - USG T: underlying cause

Answer 16

PSS, cirrhosis, liver failure --> NH4+ --> CNS - disrupts neurotransmitters - cerebral oedema (mannitol) - oxidative stress ``` Portal hypertension Pre - portal vein obstruction Hepatic - sinusoid disruption Post - disruption between liver and heart/VCCau (hepatic vein) -Can cause PSS, ascites or peritonitis ``` PSS Congenital - extrahepatic or intrahepatic Acquired - 2nd to liver disease cirrhosis + portal hypertension Reduced blood to liver --> impaired detoxification ability NH4+ increased flow through oesophageal vein (oes varicies) (prone to rupture) Ligation of shunts Perilobular hepatic artery supplies hepatocytes as such central lobe area is most sensitive to hypoxia and the perilobular area is most sensitive to toxins

Answer 17

Kidney failure - >75% nephrons damaged Pre-renal - hypovolemia Renal - Direct damage to nephrons or interstitium - -Glomerulonephritis - GFR - -interstitial - lepto - -nephrotoxic - drugs, metals - -ischemic - emboli Post-renal - Urinary tract obstruction or cystorrhexis ``` Consequences -lowered excretion --> Hyperk+ --> Acidosis + bradycardia HyperP --> increase PTH --> hyperCa2+ Creatinine + BUN ``` Dx: uremic breath, bradycardia Bloods - BUN, Cr, P, K, H+, Ca2+ Urinalysis - SG 1.015-1.045, pH 6-6.5 T: fluids, charcoal, bicarb, diuretics

Answer 18

Occurs over months/years - retained toxins - loss of endocrine function Acquired -AI (SLE), nephrotoxins, infections (lepto), obstruction (calculi) Congenital -cystic kidneys Impaired renal function Decreased GFR Buffering ability (acidosis) Toxicosis P --> PTH --> Ca2+ Decreased excretion Na + H2O --> oedema + ascites Urea --> oral ulcers + melana impaired insulin degeneration Decreased calcitriol --> cannot bind Ca2+ in SI --> lower Ca --> PTH activated --> secondary hyperparathyroidism Decreased EPO --> anaemia Grading 1 - Non-azotemic 2 - Azotemia 3 + 4 - Azotemia, PU/PD, V+ Mild - PU/PD Moderate - oral ulcers, uermic breath, V+ Severe - Seizures, blindess, fatigue Uremic syndrome - anaemia, D+, V+, CNS, osteodystrophy, acidosis Dx: Non-regen anaemia PTH, K, Na, H2O, EPO, Ca Cre + BUN T: Acidosis (Bicarb) K - KCl fluids ACE inhibitors (vasodilator)

Answer 19

Obstruction Any obstruction --> post-renal azotemia Intraluminal - uroliths, emboli Intramural - neoplasia, fibrosis Other - ectopic ureters, neurological Hydronephrosis/urolithiasis Obstruction of bladder or urethra --> build up of fluid in the kidney --> dilation and loss of function --> uremic syndrome Uremia High levels of uremia in the blood --> uremic syndrome Uremic syndrome - P - PTH --> Ca2+ - K (bradycardia) --> H+ - Na + H20 --> dehydration - Ca2+ --> osteoporosis - calcitriol --> reduced Ca abs - EPO --> anaemia - Uremia --> ulcerative mouth and enteritis - Pulmonary + pericardial oedema Urethral prolapse Trauma, urethritis pea-sized mass Feline idiopathic cystitis Sterile cystitis stress related issue Feline lower urinary tract disease multifactoral - FIC, neoplasia, UTI, obstruction, uroliths

Answer 20

Crystals formed of various materials High levels of salt Retention of salts (inability to concentrate urine) pH change that favours crystalisation (alkaline) A scaffold exists to help form crystals Citrate acts as a crystal formation inhibitor Stones usually occur in urethra damage --> inflammation + rupture Obstruction --> hydronephrosis --> renal failure and uremic syndrome Cs depend on location - Ureteral: discomfort + heamaturia - Bladder: Stranguria, abdo pain - Urethral: straining with no urination T: dietary (acidification of urine + citrate) Retrograde hydropulsion cystotomy, urethrotomy Spec grav - <1.045 Types of stones Calcium oxolate (cats mostly) -Higher efficacy of citrate to inhibit -hypercalcaemia, Vit D, protein, P (PTH) Cystine -Protein + low pH Struvite (dogs mostly) -MO's --> urease --> alkaline urine Urate - uric acid - occurs in dalmations with PSS - Allopurinol --> metabolises urate in the bladder

Answer 21

``` urinary retention Incomplete retention without obstruction Hypocontractility -bladder distention -neurogenic -electrolyte imbalance (Na) ``` Functional obstruction -Sacral lesions, urethrospasm Dx: cystoretrography T: metaclopromide (increases muscle tone in bladder detruser muscles) Diazepam + acepromazine (functional obstruction - anxietolytic) Dysautonomia (Key-Gaskell syndrome) Dysfunction of autonomic NS Dx: STT (<5mm), Megaesophagus, histopathology of ganglia Parasympathomimetics Urinary incontinence Failure of voluntary control of micuration -constant / intermittent Neurological Bladder storage dysfunction - overfilling urethral disorders - hypoplasia anatomical - patent urachus, ectopic ureters ``` Cs: urine scalding Dx: double contrast uroscopy T: Acidifying agents E2 --> spayed females A2 - agonists Urethrostomy ```

Answer 22

Seizures alteration of neuronal excitability --> prolonged depolarisation - Insufficient inhibition of excitement (GABA) - excessive excitement (glutamate) Localisation - Extracranial: Metabolic, toxic - Intracranial: tumour, haemorrhage Types -Focal: Motor, autonomic, behavioural General - Tonic (stiffness + opsitonus) - clonic (paddling + chewing) - Tonic-clonic - Atonic (brief absence of muscle tone) - Absence (transient loss of conciousness) Stages of seizures: Prodromal - salivation, weakness Aura - induction of seizure, odd ECG activity Ictal - seizure itself Postictal - memory loss, disorientation, ataxia Dx: Neuro exam - menace, pupillary, cornal, placing/postural, walking, tracking Imaging - CT, MRI Status epilepticus; Continuous seizure for >5mins 2 Phases; Compensatory -Tries to compensate for increased O2 and glucose demands in the brain by increasing blood flow --> lactic acidosis and hypoglycaemia Decompensatory -Compensation fails --> cerebral oedema --> decreased blood flow >60 mins --> organ failure

Answer 23

>2 seizures in 1 month Types Provoked - systemic disorder causing a brain insult (heavy metals) Idiopathic (primary) - Recurrent seizures with no lesions -Usually genetic, with an onset of appox. 6 months Symptomatic (secondary) - with ID'able cause; -Intracranial: degenerative (storage disease), hydrocephalus, ischemia -Extracranial: hepatic encephalopathy, nutritional (B1), infectious (rabies) Juvenile epilepsy - <1 year onset ``` Exam Time of day? Type? duration? Neuro exam -proprioception, posture, gait, behaviour ``` T: Diazepam (0.5 - 2mg/kg) Phenobarbital (2 - 4mg/kg) Bromide - DOGS ONLY!

Answer 24

Brain Cerebrum - higher functions cerebellum - muscles, posture, movement brain stem - automatic function ``` Congenital Hydrocephalus Toy or brachycephalic breeds Lack of drainage or overproduction Diuretics + mannitol ``` Caudal occipital malformation syndrome (COMS) Presses on the skull --> abnormal fluid dynamics Intracranial arachnoid cysts Pseudocyst formed of fluid in the arachnoid space Neuronal migration disorders Improper migration of neurones during development leading to underdeveloped areas of the brain Cs: scizencephaly (odd clefts) Dandy-walker syndrome (cerebellar hypoplasia) Toy breeds Cs: tremors, ataxia, odd posture, behavioural changes, seizures

Answer 25

Degenerative Metabolite overloading Lysosomal storage disease Accumulation of lysosomal byproducts Genetic/acquired Dementia (congenital dysfunction syndrome) Age changes in the brain increased amyloid deposition causing nerve degeneration T: Anipryl Spongy degeneration Inherited Aquired - hepatic enceph, rabies, TSE, intoxication Neuronal vacuolisation Familial disease --> intracytoplasmic vacuolation Multi-sytemic neuronal degeneration Hereditary in terriers progressive from 3-6 months Neoplastic Arise from neuroectoderm Glia, ganglia, myelin sheaths ``` Primary tumours Glioma - common CNS in dogs -astrocytomas -oligodendromas -ependymomas -medulloblastomas ``` Meningiomas gangliomas schwannomas (neurofibroma) Secondary Pituitary adenoma Lymphoma

Answer 26

Neurological exam Localise lesions ``` 1 - Mentation Behaviour + consciousness Normal - BAR Excitation Depression -Obtunded (somnolece) -stupor -coma ``` ``` 2 - posture + gait Posture -kyph, lord, scoli -Torticollis, opsitonus - Goose step, schiff-sherington (FL - tonic, HL -paralysis) ``` Gait - Paralysis - Ataxia - Spasm - Tremors - Forced movements ``` 3 - CN exam CN 2 --> 8 -pupillary: 2+3 -menace: 2+3+6+7 -dazzle: avoidance is normal -palpebral: 5+6+7 ``` ``` 4 - postural reaction Abnormality in proprioception -Overknuckling -Placing (visual, tactile) -Hopping (initiate) -Wheelbarrowing -Hemi-walking ``` ``` 5 - Spinal reflexes Lateral recumbency -Bicep - Cervical -Tricep - C/T -Panniculus - Thoracic -Patellar - Lumbar -Gastrocnemius - Lumbar -Withdrawal - L/S -Peri-anal - Sacral ``` Reflexes are either - Hyperreflexive - UMN - Hyporeflexive - LMN Important to differentiate neurological and muscular 6 Palpation swelling or atrophy of muscle assessment of pain 7 Nociception Superficial - cutaneous pain Deep - periosteal nociception --> interdigital pressure Imaging methods USG MRI CT

Answer 27

Vestibular syndrome Maintains balance - includes brain stem and middle/inner ear Vestibular syndrome Central vestibular disease - encephalitis Vestibular nerve - Inflammation Peripheral vestibular disease - Otitis, ototoxicity, polyps ``` Cs: CVD (brain lesion) -Head tilt -Circling -Nystagmus (H, R, V) -Rolling ``` PVD (Vestibulocochlear nerve CN8); - CVD Cs's (Nystagmus is only H + R) -Horner's syndrome - Facial paralysis (facial n. CN7) Dx: Otoscopy, neuroexam, Brainstem auditory evocation test Horner's syndrome Loss of innervation to the eye Central lesion - BS, SC, Hypothalamus Pre-ganglionic - nerves going to ear (FL or neck trauma) Post-ganglionic - Nerves going fro middle ear to eye (otitis, vestibular syndrome) Damage to sympathetic neurons --> dominance of parasympathetic system - 3rd eyelid prolapse - Miosis - Ptosis - Enophthalmos Dx: Cyclopentolate eye drop --> mydriasis --> if successful = postganglionic lesion)

Answer 28

``` MYOSITIS Infectious myositis Suppurative myositis (C. septicum) Bites --> haematogenous Abscesses and pus ``` Parasitic myositis - Toxoplasma (cats) - Neospora (dogs) Immune mediated myositis Polymyositis -Large breeds at risk -muscle atrophy, exopthalamus, strabismus Masticatory muscle myositis Acute - swelling and lymphadenitis Chronic - bilateral atrophy Dermatomyositis Hereditary disease of skin and muscle atrophy and megaoesophagus ``` MYOPATHIES Non-inflammatory degeneration Metabolic myopathies -Hyperadrenocorticism -Hypothyroidism ``` HypoCa2+ polymyopathy - Feline hypoCa2+ often 2ndary to hypoK - hypoK = increased Na sensitivity of nerves = hyporeflexivity --> weakness Inherited myopathies X-Linked muscular dystrophy -Lack of dystropin eventually fatal to male puppies Labrador retriver myopathy Inherited myopathy especially in temporal muscles Myotonia Defective muscle membrane (Cl- channel dysfunction) Constant contraction delayed relaxation ``` NEUROMUSCULAR DISORDERS Myasthena gravis Dysfunction of NM junctions acquired or inherited Ab --> ACh receptors Weakness + megaoesophagus IFAT - Ab's Tensilon test - ACh responce test (tension inhibits ACh hydrolysis) ``` Dysautonomia Degeneration of autonomic NS V+, D+, decreased anal tone, absent pupillary light reflex, fewer tears, mydriasis, 3rd eyelid prolapse

Answer 29

``` Rodenticides Warfarin -Prevents prothrombin formation Warfarin - chronic Superwarfarin - 1 dose Dx: MBBT ``` ``` Ethylene glycol (anti freeze) 1 Tbsp severe acidosis + renal failure ``` FOOD Chocolate -Theobromide -T: Warm milk Alcohol (ethanol) - Hypothermia, glycaemia, volemia - Respiratory collapse Grapes + raisins -Acute kidney failure Garlic + onions -haemolysis Tea + coffee caffeine in hepatotoxic Chewing gum -Xylitol --> hypoglycaemic crisis due to insulin spikes with no glucose administration DRUGS ACE inhibitors -Hypovolemic shock -T: Cola Anti-depressants - Hyperthermia + tachycardia - Neurological issues Weed (THC) -Inhibits neurotransmitters Paracetamol -Cats + G.Pigs --> liver failure ``` PLANTS Tulips Lily's Rhododendrons Foxglove Daffodil Azalea Iris ``` MO's + Mycotoxins - Botulism - Aflatoxin - Ergot - Tricenethens - ochratoxin - zearalenone T: Neutralise - lemon juice (if alkalic), soda (if acidic) Remove - Inhibit absorption (charcoal) - emetics (apomorphine/xylazine) - Lavage, Oil - Laxative, enema Increase excretion -Diuretics Supportive - fluids (10ml/kg/hr) - Benzo's (seizures) - liver protectants - Acidosis (bicarbonate) ABC - Airways (clear/tracheostomy) - Breathing (CPR) - Circulation (Prevent shock)

Answer 30

General Contact - wash with soda (acidic), lemon juice (alkaline) Occular - eye flush 20-30 mins Ingestions -Empty stomach (<2 hr ingestion) --> gastric lavage + emetics -reduce absorption (charcoal, oil, laxatives, milk) ``` Supportive Seizures - benzos acidosis - bicarb volemia - fluids cardia - adrenaline or K ``` ABC therapy Airways - open mouth, extend neck, pull tongue forward Breathing - No breath? --> cpr (12-24 BPM) - Check for air/fluid --> thoracentesis Circulation - HR, MM, CRT, Pulse intensity - chest beneath elbow (80-120bpm) - Resp rate: 15-25/min Signs of shock Tachycardia Pale Low BP --> weak pulses EMERGENCY DRUGS Adrenaline - 0.01mg/kg initial then 0.1mg/kg after 5 mins -Myocardial contraction -Vasoconstriction Atropine (0.05mg/kg) -Parasympatholytic effect --> increases HR Fluids - For correction of hypovolemia - crystaloids/colloids Sodium bicarbonate -Correction of acidosis

Internal medicine of small animals Flashcards

(54 cards)