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Flashcards in osce 2016 Deck (113)
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1
Q

catheter locations equine

A
lateral thoracic v.
jugular v 
cephalic 
saphenous
(needle toward heart)
2
Q

catheter locations SA

A

lateral saphenous (dog)
Medial saphenous (cat)
Jugular
auricular

3
Q

arterial access SA

A

dorsal metatarsal a.

4
Q

abdomniocentesis - sa

A

1 cm cranial the umbilicus off midline. 22G needle

5
Q

abdominocentesis- equine

A

1-2 in caudal to xyphoid process right of midline. 18 G 1.5’’

6
Q

Core Vaccinations- canine

A

Canine Distemper V (every 3-4 wks; between 6-16wk)
Canine parvovirus -2
Canine Adeno virus
Rabies (no earlier than 12wk)

7
Q

Core Vx- Feline

A

Feline Panleukopenia
Feline Herpes
Feline Calicivirus
(every 3-4 wks; between 6-16wk)

8
Q

Canine/ Feline Parasiticide

A

Heartworm; Flea; Tick; Round worms; Tape worms; whip worms; hook worms.
Puppies: Every 2 weeks until 3 months of age.
• Once/month from 3 to 6 months of age.
• Four time/year after 6 months of age.
Adults: Treat regularly considering potential exposure to parasites and prepatent periods.

9
Q

Tapetal reflex using transilluminator

A

Stand 5-6 feet away from the dog’s eyes
Move eyes slightly lower than patient/ put dog on table; Shine transilluminator/penlight at dog’s pupil. Moving light from one pupil to another allows you to assess pupil size and symmetry.

10
Q

a + tapetal reflex indicates

A

cornea, anterior chamber and lens are clear and that the retina is likely intact. DO IN DIM LIGHT!

11
Q

if a dog has assymetric pupils how do you determine which is normal

A

if a miotic pupil does not dilate in darkness, it is abnormal
if a dilated pupil does not constrict under light stimulation it is abnormal

12
Q

Menace Response

A

(CN II & VII; orbicularis oculi muscle) Blink is considered positive

13
Q

Palpebral reflex

A

(CN V & VII)

14
Q

Vestibulo-ocular (oculocephalic) reflex

A

(CN III, IV, VI, & VIII) move the head from side to side until you see nystagmus; when the motion stops the nystagmus stops. Then move head upwards and downwards to elicit veritical nystagmus

15
Q

Pupillary Light Reflex: direct & consensual

A

(CN II & parasympathetic fibers of CN III; retina, iris constrictor/sphincter muscle, mid-brain)
Direct:in the eye the light is shown
indirect: the other eye

16
Q

Dazzle Reflex

A

(CN II, VII, retina, rostral colliculus)
Shine a bright light in the eye- An involuntary aversion such as a blink, head/neck turn, or globe retraction is considered positive and
normal response in the visual patient

17
Q

Maze Test

A

To asses blindness. Do in light and dark; tape over one eye

18
Q

Schimer Tear Test

A

measurement of aqueous tear production

normal >15mm/min

19
Q

Normal IOP

A

10-25 mm Hg

20
Q

> 25mm Hg intraocular pressure

A

excessive restraint (pressure around head/neck), jugular occlusion, pushing on globe, glaucoma

21
Q
A

uveitis. Decreased aqueous production due to inflammation

22
Q

Equine physical exam: distance exam be sure to _____.

A

Observe respiratory patterns from a distance prior to interacting with the horse.

23
Q

Never stand ______ of a horse

A

directly in front or behind of. Exc: equine stocks

24
Q

Equine: evaluating head

A

Start at nares; asses color; moisture; airflow;
MM/CRT; (dentition- leave for end of exam)
Sinus evaluation: maxillary; left and right frontal
Eyes: determine lid tone by opening eyes; cornea; conjunctiva etc. menace; PLRs are slow in equine.
Ears: palpate external and internal pinna

25
Q

Pupil in the horse

A

horizontal oval

26
Q

corpora nigrins

A

dorsal or ventral proliferations of the iris into the pupil

27
Q

palpable arteries of the face (equine)

A

transverse facial a.
facial a.
(also good loc for arterial blood draws)

28
Q

HR equine

A

28-44 beat/min

29
Q

palapable LN (equine)

A

submandibular (intermandibular surface mid mandible) Should be

30
Q

Equine: evaluation of neck

A
  1. laryngeal palpation (hold both hands straight up 6in apart in throat latch region) “box like” feel. Dorsal surface / finger tips can evaluate arytenoids. Looking for laryngeal symmetry. squeezing may elicit cough.
  2. Palpate and squeeze trachea
  3. evaluate Jugular furrow
  4. asses dehydration (skin tent
31
Q

Jugular vein assesment; normal filling time

A

Hold off in distal 1/3 of neck; less than 30-60 sec

Strum vein to asses wall

32
Q

Causes of jugular pulse

A

physiologic- no proximal than middle/ distal 1/3 of neck.

pathologic

33
Q

Heart auscultation Horse; audible heart sounds; most common physiologic arrythmia; most common physiologic MUMUR

A

PAM; 3rd, 4th, 5th (left side) Apex beat (5th lower than mitral valve) Tricuspid 4th ICS (right side)

2-4 audible (bah-lub-dub-ah) S4-S1-S2-S3

mobitz 1 2nd degree av block (wenkebach)

grade 3 left heart base systolic ejection murmur

34
Q

equine RR

A

8-20 bpm

35
Q

equine: upper airway sounds can be heard

A

at nostril; over trachea

36
Q

types of breath sounds

A

bronchiol: generated at trachea/large broncus loud/harsh. Insp louder (hilus/ trachea)
bronchovesicular: softer; softer exp (hilus)
vesicular: softer (lung periphery)

In general: greater sounds more ventrally than dorsally, more cranially than caudally

37
Q

When releasing horse in the stall NEVER

A

have the horse between you and the door

38
Q

what is auscultated in the RD quadrant of the horse

A

Cecum (2-3 contraction/1-2 min)

39
Q

Left Dorsal Quadrant?

A

small colon; small intestine

40
Q

Ventral Quadrants?

A

Large Colon

41
Q

Equine Normal Temp

A

99-101 F

42
Q

Clinical evaluation of the respiratory tract involves

A

depth (ventilation), frequency (rate) , character (effort)

43
Q

Thoracocentesis Location

A

pnuemothorax- 7th and 9th ICS dorsal 1/3
Fluid- 7th and 8th ICS ventral 1/3

AVOID: Internal thoracic artery (near costo chondral junc)

44
Q

S1 is asso with

A

closure of AV valves

45
Q

S2

A

end of systole- closure of aortic and pulmonic valves

46
Q

S3

A

rapid filling of ventricles

47
Q

S4

A

atrial contraction (actually blood rushing into the atrium immidietly following atrial systole)

48
Q

3 things that promote blood turbulence

A

decreased viscosity; high velocity; large vessels

49
Q

CPR compression rates for small animals

A

100-120 cpm

50
Q

Limit compression pauses to _____.

A

1 every 2 min for no longer than 10 sec

51
Q

Ventilation rate for emergency cases

A

ventilation rate of 10 breaths/min, with an inspiratory
time of 1 second and a peak pressure of 20 cm
H2O

52
Q

What End-tidal partial pressure of carbon dioxide needs to be obtained for Return of spontaneous circulation

A

if Petco2 does not increase to ≥ 15 mm Hg in dogs or cats despite optimal CPR technique after 2 to 3 minutes, consider a different CPR method, such as open-chest CPR (depending upon the clinical situation); and if Petco2 remains ≤ 10 mm Hg despite maximal effort and the ECG is not showing electrical activity, discontinuation of the resuscitation attempt can be considered.

53
Q

Cardio pulmonary arrest drug tx

A

low-dose epinephrine, followed by vasopressin
and then another low dose of epinephrine, with 2 minutes of CPR in between drug administrations.
atropine can be administered at initiation of CPR and
repeated every 3 to 5 minutes in small animals with
pulseless electrical activity or asystole arrest rhythms

54
Q

tx ventricular tachycardia

A

lidocaine

55
Q

tx ventricular fibbrillation

A

defibrillation (CLEAR)

56
Q

tx asystole

A

CCPR+ epinephrine +/- vasopressin; +/- atropine every other cycle (2min)

57
Q

chest compression depth in dogs and cats

A

between 1/3 and 1/2 the width of the

chest

58
Q

Shock fluid dose cat

A

40-60 ml/kg/

59
Q

Shock fluid dose dog

A

60-90 ml/kg

60
Q

Superficial Skin Scraping for

A
Sarcoptes mites (ears/ ventrum) 
dorsum is often scraped for Cheyletiella mites. 
Scrape lightly
61
Q

Deep Skin Scraping

A

Demodex - live in the hair follicle. areas of alopecia

scrape until bleeding observed

62
Q

Wood’s Lamp procedure

A

In 50% of all infections with the dermatophyte, Microsporum canis, apple-green fluorescences is seen on the hair shafts.

63
Q

TRICHOGRAM

A

is the microscopic examination of plucked hairs
If arthrospores and hyphae are found, dermatophytosis is likely; Demodex; if alopecia is caused by pruritic(broken hairs) vs. non-pruritic etiologies.

64
Q

Cytology of Skin (Acetate tape preparation)

A
bacterial (often Staphylococcus sp).
and yeast (Malassezia sp.) infections of the skin and ears
65
Q

When applying a bandage always push the digital flexor tendons _____.

A

medially (lateral to medial , right limb clockwise)

66
Q

Sheep PE - Temp

A

102-104

67
Q

ruminal contractions (sheep pe)

A

1-2/min

68
Q

Pulse Sheep

A

70-90 bpm

69
Q

RR Sheep

A

12-20 pm

70
Q

Sheep PE: Why examine lips/ gums

A

Look for vesicles, pustules or scabs on the lips, nostrils, face and eyelids which are common sites for contagious ecthyma.

71
Q

unilateral nasal discharge in a sheep?

A

Nasal Bot

72
Q

SHeep Pe: Lung Auscultation

A

Cranial ventral border at 6th rib, mid thorax at 7th rib, caudal border at 11th rib. Sounds heard best in the
trachea and at the base of the lungs. Inspiratory breath sounds are normally louder than expiratory
sounds.

73
Q

SHeep Pe: Heart Auscultation

A

Heart sounds best heard in axilla between 2nd and sixth rib. Heart Sounds: S1 and S2.

74
Q

Take pulse in sheep?

A

femoral artery on the medial aspect of the thigh

75
Q

MM/ CRT eval in sheep

A

buccal, conjunctival or vaginal membranes

76
Q

Palpable LN Sheep

A

Sub-mandibular, pre-scapular and pre-femoral nodes should be palpated

77
Q

Why do you smell Sheep feet

A

Foot Rot - Fusobacterium necrophorum

78
Q

Bovine Venipuncture sites

A

coccygeal v. 1/2 inch deep and perpendicular to the tail
at the underside, midline and at about 3 to 6 inches from the base of
the tail.

79
Q

Small animal Venipuncture sites

A

Jugular v.

Cephalic v.

80
Q

Small Animal IM Location

A
Lumbar muscles (caudal to last rib cranial to wing of ilium, lateral to dorsal spinus processes.) 
Thigh (SemiMembranosus/ semitendinosus) Behind femur; needle pointed CAUDALLY to avoid sciatic.
81
Q

Small Animal SQ inj

A

Tent btwn shoulder blades (needle perpindicular to tent)

82
Q

Ovine IM inj

A

Neck - triangle. Cranial to shoulder ventral to nuchal lig dorsal to cerv vert. Remove needle from syringe when inserting.

83
Q

Ovine SQ inj

A

over triangle, or just behind triceps/ elbow

84
Q

Equine IM inj

A

Neck (jus like sheepy) Caudal Thigh (semimemand semi tend) Ventral to tuber ischia, dorsal to gastroc tendon, axial to lateral thigh. (remove needle while placing)

85
Q

Bovine IM inj

A

triangle of neck (remove needle)

86
Q

Bovine SQ inj

A

Neck, or just behind elbow

87
Q

Normal canine temperature

A

100.4 – 102.2°F

88
Q

Normal feline temp

A

101.3‐102.2°F

89
Q

Pulse Canine

A

60-120

90
Q

RR Canine

A

10-30

91
Q

Palpable structures canine mandible

A

mandibular lymph nodes and the parotid salivary glands. There are a chain of mandibular lymph nodes (2‐5) which are 4 pea‐sized and lose in the skin at the angle of the mandible. They are freely moveable
structures

92
Q

LN canine caudal to ear

A

the submandibular or parotid salivary glands found caudal to the ear and firmly fixed / lobulated

93
Q

LN canine at point of shoulder

A

The superficial cervical (prescapular) lymph nodes are palpated between the thumb and index finger

94
Q

The _______ is palpated on the caudal surface of

the gastrocnemius muscle

A

popliteal lymph node

95
Q

Max fluid rate for potassium

A

.5meq/kg/hr or body weight in kg/2 =meq max

96
Q

maintenance rate for fluids dog and cat

A

40-60 ml/ kg/ day (cat 40, dog 60)

97
Q

5 types of shock

A

Hypovolemic: loss of 3 ‘types’ of fluid:
• Hemorrhagic: loss of blood
• Non-hemorrhagic: loss of plasma from dehydration
• Redistribution of fluid: edema, third-spacing
• Cardiogenic: failure of pump
• Vasodilatory or distributive: failure of ‘tubing’ because of
inflammatory substances in ‘tubing’ like bacteria/sepsis.
• Obstructive: Flow is obstructed. Ex: Gastric dilation
volvulus, pericardial effusion, venous thrombosis, tension
pneumothorax.
• Combination of above

98
Q

3 Classifications of shock

A

Hypovolemic
Cardiogenic
Septic/ Vasodilatory

99
Q

How to correct fluid DEFICITS in dehydrated patient

A

%dehydrated * kg (10% dehydrated in 20 kg dog = 2000 ml deficit)

100
Q

3 factors to consider when calculating fluid plan

A

Deficit
Maintenance
On going losses

101
Q

isotonic crystalloids - how much will remain in vasculature after equilibration?

A

They are freely permeable to cell membranes
– After about ½ hr of equilibration, only about 1/3 will still be within intravascular space.
LARGE VOL CAN LEAD TO EDEMA

102
Q

Examples of Replacement Crystalloids

A

Ringers, LRS, Normosol R, 0.9 % saline, PlasmaLyte A
• Designed to replace fluid loss.
• Can give rapidly (shock, dehydration)!
• Have K conc similar to that of plasma
• If used for maintenance fluid therapy, must monitor serum Na as patient can become hypernatremic. Must also add K if used as maintenance.

103
Q

Exammples of Maintenance crystalloids

A

Normosol M, 0.45 % NaCl + 2.5 % dextrose, PlasmaLyte
56
• Designed to replace daily Na losses without Na overload.
• Don’t give rapidly!
• Some do not have K, so have to add it.
• Used for maintenance fluid therapy. Lower-Na fluids do not stay in vascular space & are poor at expanding blood vol., so often combined with colloids in patients with low albumin

104
Q

When do I use hypertonic saline & what are potential

side effects?

A

• Indications:
– Cases of hypovolemic shock that do not have dehydration or hypernatremia
– Head trauma cases
• Contraindications
– Dehydration
– Hypernatremia
• Side effects
– Rapid administration may cause bronchoconstriction,
bradycardia & hypotension
• Dose: Over a 20-minute period, dogs should receive 4
to 7 ml/kg; cats ½ this dose.

105
Q

When are colloids used?

A

used when goal is to restore RBCs, clotting factors, AT III, or albumin
Bolus: 5-10 ml/kg over 5-10 min for hypovolemia
(CRI): 10-20 ml/kg/day. This is maximum daily dose.

REMEMBER:Colloids are not used to replace dehydration deficits. Colloids are helpful to keep fluids in intravascular space so they are used in cases with low albumin or vasculitis or those with peripheral edema or ascites

106
Q

How do I determine how much K+ to give?

A
  1. Look at the patient’s K Meq/L
  2. Compare to Sliding Scale of Scott to determine how much would be desired
  3. Calculate patient’s K max. (1/2 BW in kg)
  4. If Kmax
107
Q

Perfusion parameters

A

HR, CRT, MM, Pulse pressure, temperature, blood pressure

108
Q

Dog Abdominal Palpation…what can you feel?

A

Normal animal​ - liver, stomach portion of spleen in rib cage, not palpated. Normal spleen not palpated beyond ribs
● Small intestines​ - thin walled, flattened, slip easily through fingers as indistinct structures w/omentum, mesentery, associated vessels & lymph nodes
● Colon​- presence of feces will make it palpable in caudal dorsal abdomen
● Kidney​ - not routinely palpable. (are in cats, have “floating kidneys”)- Left kidney more caudal than right. In dorso-cranial abdomen. Just ventral
● Bladder​- palpable in caudal abdomen, size varies w/amount of urine (duh). Palpate in cranial to caudal fashion, allow bladder to slip between fingers to epaxial muscles behind ribs, apply pressure dorsally

109
Q

Indirect vs direct optho exam

A

Indirect​- w/focal light & lens, ● View at arm’s length, Inverted view, compare regions of fundus

Direct​- use ophthalmoscope head, View close to dog’s eye● Highly magnified, upright image of one small region of fundus.Peripheral retina not examined

110
Q

Gram + Cocci

A

Streptococcus, Staphalococcus

111
Q

Gram + rods

A

Cornybacterium, clostridium

112
Q

Gram - coccobaccilla

A

brucella, pasturella

113
Q

gram - rods

A

Escherichia, Pseudomonas , Proteus, Salmonella