Misc Flashcards by olivia walesby

3 phases of cardiac ischaemia

Electrical phase, circulatory phase, metabolic phase

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What is the starting dose for a biphasic defibrillator and what is the maximum dose?

Start 2-4J/Kg
Maximum dose 10J/Kg

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What 3 parts make up Virchow’s triad?

Altered blood flow
Endothelial damage
Hypercoagulability

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What is the ratio to diagnose Chylothorax

Fluid >3:1 x blood triglycerides
> or equal to 100mg/dL

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What troponin value make haemangiosarcoma more like!?

Check Chun 0.25ng/ml?

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Name endogenous pyrogens involved in pyrexia?

Cachectin (TNF-alpha)
Lymphotoxin (TNF-beta)
IL-1alpha
IL-1 beta
Interferon alpha
Interferon beta
Interferon gamma
IL-6
Macrophage inflammatory protein 1 alpha
Macrophage inflammatory protein 1 beta
IL-8

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Benefits of high flow nasal O2 as per SACCM 2023

Heated and humidified
Inspiratory flows demands
Functional reserve capacity
Lighter
Oxygen
Washout dead space

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As per SACCM what are the recommended initial high flow nasal oxygen settings

Flow rate = patients minute volume= respiratory rate x tidal volume (10-15ml/kg)
Fi02 = 100%
Temperature= 32-37 degrees Celsius

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Name the categorises of necrotising soft tissue infections

Type 1- polymicrobial
• mixed anaerobes and aerobes
• usually isolate four or more organisms

Type 2 - monomicrobial
• commonly beta-haemolytic streptococcus

Type 3- gram neg monomicrobials
• clostridia infections
• included marine organisms

Type IV- fungal
• Candida infections

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What does snap 4dx plus snap test for?

Dirofilaria immitis
Ehrlichia canis
Ehrlichia ewingii
Ehrlichia Chaffeensis
Anaplasma phagocytophilum
Anaplasma platys
Borrelia burgdorferi

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What receptor is involved with anaphylaxis?

FC epsilon R1

Transmembrane with alpha, beta and gamma subunits

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What type of reaction is anaphylaxis?

Type 1 hypersensitivity reaction involving IgE, mast cells, basophils

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What type of reaction is serum sickness?

Delayed reaction Type III hypersensitivity reaction

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What May cause a high anion gap metabolic acidosis?

HAGMA
DUEL
D= diabetes
U= uremic
E= ethylene glycol
L= lactate
S= salicylates

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What May cause a normal anion gap metabolic acidosis

NAGMA

A=Addisons
B= bicarbonate loss (GI or renal)
C= chloride excess
D= Diuretics (acetazolomide)

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Anion gap equation

(Na+ K)- (bicarbonate + chloride)

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What are the 5 phases of AKI?

5 phases

Insult
Initiation
Extension
Maintenance
Recovery

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Half life of synthetic canabinoids

72-96 hours

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Name the methods of heat loss

Convection
Conduction
Radiation
Evaporation

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What type of hypersensitivity reaction is anaphylaxis?

Type I and IgE predominates

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Name the 3 forms of dyshemoglobin

Methemoglobin
Carboxyhemoglobin
Sulfhemoglobin

How many sulfhydrl groups do cats have on their red blood cells and when damaged what do you see on cytology

8
This is why more likely to have oxidative damage and form Heinz bodies ( a few normal in cats)

What is the normal level of methemoglobin in the blood

<3%

Name three ways paracetamol/acetaminophen is metabolised

Glucuronidation (dogs)
Sulfation (cats)
Or
Oxidation by CYP2E1 and CYP1A2 to NAPQI which is toxic

What enzyme(s) is thiamine a cofactor for?

Pyruvate dehydrogenase Alpha ketoglutarate dehydrogenase Transkeletase

What does bradykinin cause and which enzyme breaks it down

Causes hypotension Angiotensin converting enzyme (ACE)

Hypertension classification and TOD risk

Normal <140mmHg Minimal risk of TOD Prehypertensive 140-159mmHg Low risk of TOD Hypertensive 160-179mmHg Moderate TOD risk Severely hypertensive > or equal to 180mmHg High risk of TOD

Which organs are at risk of TOD

Eyes Kidneys Brain Heart

Define sepsis

Life-threatening organ dysfunction cause by dysregulated host response to infection

How many plasma volumes would be needed of TPE?

1-1.5 plasma volumes

Name some adverse reactions from TPE

Hypocalcaemia Plasma reactions Alkalosis secondary to citrate AKI because of colloids Blood loss because of circuit Hypoproteinaemia Haemorrhage

In humans what categories are there for TPE to help guide tx?

Category 1 -1st line (myasthenia gravis) Category 2-2nd line tx (IMHA) Category 3- limited trials (IMTP and sepsis) Category 4- ineffective or harmful

For what toxins does TPE work best for?

Small volume of distribution and intravascular (<1L/kg) E.g NSAIDs as highly protein bound

Sodium concentration in hartmanns

130mmol/L

Fractional excretion of Sodium

Urine sodium x serum creatinine divided by urine creatinine x serum sodium

Name 4 factors that determine diffusion rate (Ficks law) of a substance from blood to interstitium

Gradient concentration Surface area for exchange Diffusion distance Permeability of capillary wall to the diffusing substance

Name 4 functions of the endothelial cell

1. Enzymatic conversion of circulating hormones 2. Production of substances that lead to blood clot formation 3. Key roles in abiogenesis and remodelling of vasculature 4. Production of vasoactive substances

What does an inotrope do?

Increases strength of heart beat

What does a chronotropic drug do?

Increases heart rate

What does a dromotropic drug do?

Increases speed of conduction

What would a high peak pressure mean?

Airway issue/resistance E.g ET tube blockage Retained secretions Mucous plug

What does a high plateau pressure mean?

Compliance issue Pneumothorax ARDS

What defines a massive transfusion?

Transfusion of Blood products totalling estimated blood volume in 24 hours 50% of blood volume in 3-4 hours Admin 1.5ml/kg/min for 20mins

Cholinergic crisis signs

SLUDGE MUDDLES Salivation, lacrimation, urination, defecation, GI motility, emesis, miosis Excess of acetylcholine Drug side effect or toxin with organophosphate?

Naloxone 1. MOA 2. length of action

1. Binds with great affinity to mu, kappa, delta opioid receptors, competitively displacing agonists with lesser affinity and so reversing actions of agonist agents 2. Short acting whereas nalmefene and naltrexone are longer acting

What are the diagnostic criteria of syndrome of inappropriate anti diuretic hormone secretion

1. Hypoosmolar hyponatremia 2. Euvolemia 3. Inappropriate concentrated urine-urine osmolarity >100mOsm/L 4. Urine sodium concentration>30mmol/L 5. Hypoadrenocorticism excluded

What are risk factors for acute pancreatitis increased morbidity and mortality

Older age, obesity, hypertriglyceridemia, biliary reflux, drug reactions, pancreatic trauma, recent Sx, concurrent endocrinopathies dogs, current GI dz and/or cholestatic disease

Pathophysiology of pancreatitis

Premature activation of proteases within pancreatic acinar cells Abnormal fusion of lysosomes and zymogen granules leads to premature activation of trypsinogen to trypsin Local cascade from trypsin activating other pro enzymes Pancreatic secretory trypsin inhibitor overwhelmed

What two major enzymatic reactions are cobalamin needed for

Methionine synthase Methylmalonyl-CoA-mutase

What are the potential effects associated with sodium bicarbonate administration? As per SACCM