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Flashcards in Pre-midterm Deck (92):
1

why take a history?

1. part of examination
2. establish relationship
3. information
4. avoid mistakes
5. client expectation
6. practice building

2

what are problems with history taking?

1. completeness
2. bias
3. inexperience/misinterpretation
4. guilt
5. fear
6. ownership issues
7. management differences
8. owner diagnosis
9. owner treatment
10. language
11. herd problem?
12. definition of disease

3

what are special physical examination cases (LA)

1. prepurchase
2. breeding soundness
3. foal health check
4. health certificate
5. insurance exams
6. export paper

4

what should be assessed on distance exam? (11)`

1. attitude
2. physical condition
3. general body shape
4. conformation
5. hair coat
6. stance
7. posture
8. environment
9. resp rate
10. evidence of defecation/urination
11. behavior

5

what is the normal temp of a horse?

37.5-38.5

6

what is the normal temp of cow

38-39

7

What is the normal pulse of a horse

28-44

8

What is the normal pulse of a horse

28-44

9

What is the normal pulse of a cow?

60-80

10

What is the normal resp rate of a horse?

8-16

11

what is the normal resp rate of a cow?

10-30

12

What is Q, R and S in an ECG?

Q is depolarization of septum, R is deplarization of wall and S is depolarization of upper areas

13

What is Q, R and S in an ECG?

Q is depolarization of septum, R is depolarization of wall and S is depolarization of upper areas

14

What is pimobendan?

a postiive inotrope and a vasodilator

15

what are the main determinants of blood pressure?

CO and systemic vascular resistance

16

what are two diseases that can increase blood pressure?

1. cushings (increased sensitivity to adrenergic hormones so vasoconstriction)
2. hyperthyroidism (increased CO)

17

what is heart failure/cardiac insufficiency?

when the heart cannot meet the demands of the body

18

what is forward heart failure common in

dilated cardiomyopathy, sometimes in chronic heart failure

19

What are the signs of forward heart failure

1. pulse poor
2. hypothermic
3. weak
4, hypotensive
5. prolonged CRT
6 may have syncope
7. progression to cardiogenic shock

20

what is the most common congestive heart failure?

left

21

what are the clinical signs of left sided congestive heart failure?

left atrial enlargement and pulmonary edema

22

What are the signs of right sided congestive heart failure?

1. pleural effusion (cat)
2. ascites (dog)

23

What are three mechanisms of compensation in cardiovascular physiology?

1. frank-starling mechanism
2. ventricular hypertrophy
3. neurohemoral mechanism

24

What is the RAAS sstem

Renin is released from the kidney and converts angiotensinogen to angiotensin I, that is converted by ACT to ATII. ATII causes aldosterone release, increased thirst, increased GFR, myocardial hypertrophy, vasoconstriction

25

What is the RAAS sstem

Renin is released from the kidney and converts angiotensinogen to angiotensin I, that is converted by ACT to ATII. ATII causes aldosterone release, increased thirst, increased GFR, myocardial hypertrophy, vasoconstriction

26

What are 4 neurohumoral mechanisms that work in compensation (heart)

1. RAAS
2. adrenergic nervous system
3. ADH
4. atrial naturetic peptide

27

Combatting what prolongs lifespan?

neurohumoral activation

28

what is spironolactone?

aldosterone antagonist

29

What does the adrenergic nervous system do to the heart?

increase HR, contactility, afterload (vasoconstriction), oxygen demand

30

What are three examples of diastolic dysfunction? Why is it an issue?

1. hypertrophic cardiomyopathy, restrictive cardiomyopathy
2. pericardial disease
3. tachycardias

31

What is an issue with pimobendan?

only oral

32

What is an issue with pimobendan?

only oral

33

why is important to be thorough with a physical exam? (heart)

There may be something compromizing the ability to treat the heart (renal dz) or something may mimic cardio dz (resp dz)

34

Why can there be cachexia with heart disease?

underperfusion of the intestines can result in endotoxin, bacteremia, inflammation)--TNF alpha production--cachexia (omega 3 decreases TNF alpha and cachexia)

35

what on retinal exam can indicates cardio dz?

retinal detachment or hemorrhage (hypertension)

36

What can change apex beat?

1. heart shift
2. reduced with effusion
3. pneumothorax
4. obesity
5. DCM

37

what is a pulse deficit?

a heart beat that was not accompanied by a pulse (premature beat or pulse wave not big)

38

what are physiologic murmurs?

anemia, athletes, young animals

39

What can only the ECG diagnose?

1. rhythm/conduction defects
2. adverse effects of anesthesia on impulse generation, conduction
3. drug monitoring for drugs that influence rhythm, conduction

40

What can ECG HELP detect?

1. cardiomegaly
2. emergency test for hyperkalemia
3. helpful for pericardial effusion--aspiration

41

What can the ECG not do

1. give definitive diagnosis of heart size
2. determine mechanical strength of contraction
3. determine if congestive heart failure is present

42

what position is ECG done in?

right lateral recumbancy

43

what position is ECG done in?

right lateral recumbancy

44

what is nitroglycerin?

venodilator. blod to abdomen rather than lungs. good for emergency

45

What drugs decrease preload?

furosemide, spironolactone, thiazides, ACE inhibitors, nitroglycerin

46

what drugs reduce afterload and improve CO?

ACE inhibitors (decrease ATII so less vasoconstriction)--may negatively affect GFR

hydralazine--arterial dilator

amlodipine: calcium channel blocker used for hypertension in cat

47

what drugs can improve contractility?

dobutamine (CRI only)
dopamine cheaper, can cause arrhythmias, vasoconstriction

pimovendan--inodilateor (positive inotrope and dilation)

48

when does cyanosis occur?

when hemoglobin

49

what is stridor?

abnormal sound that can hear without stethoscope, usually URT

50

what is a horse resp rate?

12-20

51

what is a cow resp rate?

26-50

52

what is a dog resp rate?

18-34

53

what is a cat resp rate

16-40

54

what is a cat resp rate

16-40

55

what is the normal ratio of inspiration to expiration?

1.0:1.2

56

which is louder, inspiratory or edxpiratory sound?

inspiratory (if reversed dealing with resp dz)

57

what are vesicular sounds from?

segmental bronchi

58

what are vesicular sounds from?

segmental bronchi

59

what are crackles?

collapsed airwaas snapping open, esp end expiratory

60

what are wheezes

longer musical sounds due to vibration of airway walls before closing (expiration), usually due to bronchoconstriction

61

what occurs with upper resp tract disease?

inpiratory dyspnea and noisy inspiration heard from distance away

62

what occurs with lower resp tract dz?

expiratory dysnpean and noise best heard with stethoscope

63

what is a nasal swab for?

URT-bacterial/viral infection

64

what is nasal lavage for?

culture, immunoglobulins, foreign body, parasitic ova

65

what is tracheal lavage for?

--best one for pneumonia
for bacteria and cytology

66

what are the two types of tracheal lavage?

transtracheal wash, transendoscopic sampling

67

what is bronchoalveolar lavage used for?

1. RAO, IAD, EIPH

68

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69

a good bronchoalveolar lavage sample is what?

foamy because of surfactant

70

what is bronchoalveolar lavage not good for?

focal disease like neoplasia or pneumonia

71

what is the technique of choice for studying pleural space and pleural surface?

ultrasonography

72

where do you go for pleurocentesis/thoracocentesis

6-7 intercostal space, 10cm dorsal to olecanon, cranial border of rib

73

what are thoracocentesis samples submitted for?

1. cytology
2. bacterial culture
3. sensitivity

74

What should you submit with a thoracocentesis sample?

TW sample to see if there is a common association with pleuritis and parenchymal disease

75

what should you submit pleural fluid in?

EDTA for cell count and protein determination

76

what serology samples should be submitted?

2 sampless 10-14 days apart

77

how should a bacteriology sample be submitted?

sterile culture swab on ice and get fast. have appropriate transport media for aerobic, anerobic

78

what should be collected for virology?

swabs early in disease during days 1-3 of pyrexia--nasopharyngeal swab good. DON'T freeze

79

What should be sent for blood gas?

only arterial

80

What is PaO2 an indicator of? what is PaCO2 an indicator of?

1. gas exchange
2. ventilation

81

what can cause hypoxia?

ventilation perfusion mismatch
diffusion impairment
shunts
hypoventilation

82

what can cause hypoxia?

ventilation perfusion mismatch
diffusion impairment
shunts
hypoventilation

83

4 factors of pulmonary edema

endothelial permeability
alveolar epithelial permeability
hydrostatic pressure
colloid osmotic pressure

84

what is classic finding of pneumothorax?

pleura not moving--static

85

laryngeal paresis/paralysis causes what?

1. inspiratory dyspnea
2. exercise intolerance
3. roaring

86

what is treatment for laryngeal paresis/paralysis?

prosthetic laryngoplasty

87

what does dorsal displacement of soft palate cause?

stridor-noise during exhalation

88

what is metoclopramide?

antiemetic (dopamine antagonist) and stimulates GI motility

89

what are phenothiazines, maropitant, metoclopramide?

antiemetics

90

what should use of gi protectants be restricted to?

pateints with ulers, potential for ulcer (although more use omeprazole)

91

what coudl you give dog with esophageitis?

sulcralfate

92

what is misoprostol?

synthetic prostaglandin