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AAAASpring 2025 > SAM Final > Flashcards

SAM Final Flashcards

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1
Q

Culprit of feline idiopathic cystitis

A

1 = stress

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2
Q

4 common causes of feline house soiling

A
  1. Stress (environmental or social)
  2. Marking (NOT out of stress or retaliation)
  3. Medical illness (FIC, OA, urinary dz, HT4, DM)
  4. Feline idiopathic cystitis (dx of exclusion)
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3
Q

5 pillars of healthy feline environment

A
  1. Safe place
  2. Multiple, separate litter boxes & e/d area
  3. Exhibit natural play/predatory behavior
  4. Positive & consistent human-cat social interactions
  5. Respect importance of cats’ keen sense of smell
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4
Q

Common pharmaceutical options for behavioral urinary tract problems (3)

A
  1. Fluoxetine (SSRI) – #1 choice
    - works immediately in stressed cats
    - do NOT give with amtriptyline (TCA)
  2. Buspirone (anxiolytic)
    - give to aggressive cat
  3. Alprazolam (benzodiazepine)
    - AVOID in aggressive cats
    - give to scared cat
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5
Q

What conditions should prazosin be avoided in when treating FIC?

A

Cats with cardiac conditions
- Prazosin = alpha adrenergic antagonist (helps relax urethral muscles)

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6
Q

Hematuria, vocalizing in/around litter box, digging frantically, exhibiting ambivalence regarding litter box = signs of what?

A

FIC (multi-factorial condition w/ ≥1 FLUTD sign) that led to urethral obstruction (blocked cat)

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7
Q

FIV pathogenesis, common signalment

A
  • Retrovirus + Lentivirus
  • Bite wound -> APCs -> lymph nodes. 60d incubation period
  • Free-ranging male cats
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8
Q

FeLV pathogenesis, common signalment

A
  • Retrovirus + oncogenic (lymphoma)
  • Close contact w/ bodily secretions (oronasal++) -> replicates in tonsillar + pharyngeal lymphoid tissue -> monocytes + lymphocytes -> viremia. 30d incubation period
  • Kittens > adults
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9
Q

3 possible outcomes of FeLV infections

A

1. Progressive
- WORST prognosis b/c of persistent viremia

2. Regressive
- No persistent viremia -> most cats DO WELL
- Can cause immunosuppression/comprised cat

3. Abortive
- Immune system ELIMINATES BEFORE viremia can occur
- May never know if a cat has an abortive leukemia

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10
Q
  • Recurrent infections (respiratory, ocular, derm, urinary bladder)
  • Transient fevers.
  • Neutro/lymphoPENIA; hyPERglobulinemia
A

FIV

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11
Q
  • Severe macrocytic, non-regenerative anemia
  • Depressed, hyporexic
  • Lymphadenopathy
A

FeLV

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12
Q

Interpret (+) FeLV SNAP test

A

Tests for p27 antigen
- (+) = cat is in early viremia (within 4 weeks of inoculation. Regressive cat should be (-) within 16 weeks of inoculation.
- ALWAYS re-SNAP a (+) test

p27 = viral core protein produced by infected cells

gp70: envelope glycoprotein important for inducing immunity//target for vaccine production

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13
Q

Interpret (-) FeLV SNAP test

A

Either truly negative, OR cat suffering from the oncogenic effects of FeLV (lymphoma)
- 10% of cats develop neoplasia from FeLV
- If suspect, retest in 30 days

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14
Q

Interpret (+) FIV SNAP test

A

FIV SNAP tests antibody
- can only tell you that the cat has been infected with FIV before (cannot differentiate b/w historically or currently)
- can also be maternal Ab (esp. if ≤ 6months old)
- consider recent vaccination

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15
Q

Interpret (-) FIV SNAP test

A

Not infected (no antibodies)
- If suspect, retest in 60 days

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16
Q

Viremia in cats w/ lymphoma from FeLV is mostly associated with what tumor location?

A

Mediastinal
- lowly associated w/ alimentary

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17
Q

What is the best confirmatory test for FeLV and why?

A

IFA - detects p27 antigen in cells
- Only PROGRESSIVE INFECTIONS test positive!!
- Can be detected by 30d of infection

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18
Q

Prognosis for FeLV

A

80-90% FATALITY within 3-4 years of infection due to potent immunosuppression

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19
Q

Preventive + screening measures for FeLV

A
  • Test ALL kittens/newly acquired cats, cats w/ known exposure, sick cats, outdoor cats, blood donors
  • Keep cats indoors
  • Vaccinate ALL kittens!!
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20
Q

Preventive meausres for FIV

A
  • Test ALL kittens
  • Keep indoors
  • Transmission in households where cats get along = unlikely
  • Vaccination is INEFFECTIVE!!
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21
Q

Vaccine-associated sarcomas

A
  • Rabies & FeLV vaccines
  • Every 1 in 10,000 cats (very rare)
  • Sarcoma = invasive w/ high met rate
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22
Q

Signs that localize RT infection to nasal/nasopharynx in dog v. cat

A

Dog: Unilateral epistaxis, stertor, nasal d/c

Cat: stertor, decr. airflow bilaterally, hx sneezing

Stertor = low freq. inspiratory sound (ESP, BOAS)

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23
Q

Stertor vs. stridor

A

Stertor = low-frequency/snoring INSPIRATORY sound
- ESP, BOAS

Stridor = impaired airflow thru larynx or trachea, inspiratory OR expiratory
- Laryngeal paralysis

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24
Q

Most common cause of epistaxis in dogs

A

Neoplasia; signs often unilateral

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25
What fungal pathogen causes primary nasal disease in dog vs. cat
**Aspergillosis - dogs** - unilateral but can progress to bilateral if crosses cribiform plate - young to middle-aged **Cryptococcus- cats**
26
What teeth typically cause tooth root abscesses or oralnasal fistulas?
Carnassial and canine teeth
27
Diagnostics for primary nasal disease
Skull rads, head CT (cribiform plate visualization), rhinoscopy +/- biopsies for histopath
28
Tx for lymphoplasmacytic rhinitis
Prednisone - is a chronic rhinitis w/ unknown causes - epistaxis is typically infrequent
29
Common clinical signs of nasal lymphoma in cats
Nasal discharge w/ loss of nasal airflow
30
Feline inflammatory polyps - what are they - signlament - tx - recurrence rate
- Benign growths in epithelium of tympanic bulla or auditory tube - Young to middle-aged cats - Tx = traction-avulsion - HIGH recurrence rate | Horner's syndrome, CN VII paralysis, otitis = temp. complications of tx
31
Where are cough receptors located
Throughout URT, extd. into bronchioles - larynx, tracheal bifurcation, main bronchi
31
32
Anatomical categories for ddx of chronic cough (3)
1. Airways (large & small) 2. Pulmonary parenchyma 3. Pleural space
33
Clues that chronic cough is localized in the pulmonary parenchyma and NOT the pleural space? (2)
**1. Increased bronchovesicular sounds** - expect decreased lung sounds w/ pleural space **2. Crackles**
34
3 diagnostic criteria for chronic bronchitis + signalment
1. chronic cough 2. evidence of excessive mucus production 3. exclusion of other chronic cardiopulmonary diseases Signalment: middle to older-aged breeds ## Footnote Persistent, sonorous cough, with paroxysms of coughing often followed by a terminal retch - *Think Lou Lou* Cytology typically reveals excess mucus, possibly with hyperplasia of epithelial cells, and increased numbers of neutrophils, goblet cells, and macrophages Prednisone Doses: * anti-inflammatory = 0.5-1mg/kg * immunosuppressive = 2mg/kg Other considerations * Elimination of environmental irritants * Control of body weight * Use of harness in place of collar
35
ID the pleural effusion transudate: - Low protein, low nCC - Colorless, transparent
**Pure transudate** - Increased venous pressure, lymphatic hypertension, low oncotic pressure
36
ID the pleural effusion transudate: - nCC 1,000-7,000/uL - Mostly MØs and neuts - Light yellow, slightly cloudy +/- blood-tinged - Speckling in FF on abd u/s
**Modified Transudate** - Increased venous or lymphatic pressure, inflammation of pleural vasculature
37
ID the pleural effusion transudate: - Neuts predominate - Purulent +/- foul odor
**Exudate** (septic v. sterile) - Multiple infectious causes | high protein + high cell count ## Footnote Septic: pleuraal pneum., GI perfo, esophageal perf, Sterile: pancreatitis, enteritis/colitis, rupturued urinary bladder, FIP, neoplasia
38
ID the pleural effusion transudate: - 0.5-1 million/uL RBCs w/ measurable PCV
**Hemorrhage** - Coagulopathy, bleeding neoplasia, trauma
39
ID the pleural effusion transudate: - small lymphocytes predominate - grossly white to pink - opaque - high triglycerides (2x serum)
**Chyle** - Cardiac dz, neoplasia, HW, cranial vena cava thrombus or mass, idiopathic
40
Best tx for idiopathic chylothorax
**Surgery that ligates thoracic duct** 1. Pericardectomy with ligation of thoracic duct or 2. Cisterna chyli ablation with ligation of thoracic duct | medical mgmt has limited success
41
Pleural space disease DDX (4)
1. Pleural effusion 2. Pleural space/mediastinal mass 3. Diaphragmatic hernia 4. Pneumothorax
42
42
Pitting edema
Most common form of peripheral edema. Caused by displacement of fluid within interstitial space
43
4 common causes of **peripheral edema**
Pitting edema = most common form **1. Incr. hydrostatic pressure** - Generalized (incr. plasma voume) v. Localized (venous obstruction from mass) **2. Decr. plasma oncotic pressure** - PLE; reduced albumin synthesis **3. Incr. capillary perm.** - Hypersensitivity rxn **4. Lymphatic dysfunction** - LN hypoplasia, aplasia, destruction
44
Which abdominal effusion do these cause: portal vein thrombosis, liver dz, right-sided HF, cardiac tamponade, extra/intraluminal caudal VC neoplasia
Pure Transudate (aka protein-poor) - ALL are causes of increased hydrostatic pressure | Modified transudate = protein-rich
45
Septic vs. non-septic exudate in abdominal effusion (ascites)
Septic = GI perf, abscess rupture, FB migration Non-septic = pancreatitis; neoplasia | Bile and urine = other causes of exudative effusions
46
How to treat lymphangiecstasia + IBD
LF diet + immunosuprpessive dose of corticosteroids (IBD = autoimmune etiology)
47
Blastomycosis - region - risk factors - Predilection sites - Definitive Dx - Tx options + duration
- MS, MO, OH river valleys, mid-Atlantic states - Outdoor activity + close proximities to bodies of water - Sporting dog breeds - BELLS: Bone, Eyes, Lungs, Lymph nodes, Skin - Cytology or histology ID of Blastomyces organisms - TX options: PO = Itraconazole, PO = Fluconazole (excellent penetration into CNS/ocular tissue), Inj. = Amphotericin B (nephrotox!!) Tx = ≥ 5-6 months in dogs!
48
Dermal lesions on the **nasal planum, face, and nail beds** + radiographic evidence of **pulmonary lesions** are consistent with what fungal infection?
Blasto | Radiographic lesions present in **85%** of dogs
49
**True or False**: All dogs with Blasto have radiographic pulm lesion pattern of diffuse nodular pattern, AND exhibit respiratory signs.
**FALSE** - May NOT have resp signs - Only 40% of dogs have the classic pattern
50
Describe musculoskeletal of Blasto
Osteolyic + periosteal proliferation, DISTAL to stifle + elbow
51
MiraVista Quantitive antigen test for Blasto
- 90-95% sensitivity in URINE for dogs - Nearly 99% cross-reactivity with Histoplasmosis ## Footnote Histoplasmosis: Quantitative antigen test (MiraVista Laboratory) * Sensitivity: * Urine: 94% in cats and 89% in dogs * Potential for false negatives with ocular histoplasmosis in cats * Cross-reacts with Blastomyces
52
How many negative Blastomyces urine antigen tests are obtained **prior to discontinuing tx**? What about after?
Prior: Two (-) tests one month apart After: Retest one month after d/c
53
Histoplasmosis - region - risk factors - Predilection sites
- Central + eastern U.S. - Cats < 4 years old, indoor & outdoor - **B**E**L**LS: **Bone (infiltration into marrow)**, Eyes, **Lungs (50% will have resp. signs)**, Lymph nodes, Skin | dx/tx similar to blasto
54
HX: acute onset of lameness affecting multiple limbs, non-blanching abdominal rash, relapse of signs every time pred tapered. BW: azotemia, proteinuria, granular casts Arthrocentesis: neutrophilic synovitis **DX and why??**
1. Systemic Lupus Erythematosus (SLE) + Lupus Nephritis - German Shepherds!! 2. DX b/c of 3 criteria: cutaneous lesions, arthritis, and renal disorders (glomnephr//proteinuria)
55
HX = chronic shifting leg lameness, wax/wane lethargy, severe carpal valgus, joint effusion, (+) drawer, stiff/short gait BW = inflammatory. Neg 4dx Rads: bony lysis/erosive changes around joints (lucensies) Arthrocentesis: moderate suppurative arthropathy **Likely dx + tx**
Erosive Polyarthritis (bony lysis of jts -> instability, luxation) - Young Greyhounds - TX = lifestyle modifcations, NSAIDs, Galliprant
56
Idiopathic Immune-Mediated Polyarthritis - how common is it - dx - Signalment - what joints affected - tx
- 50-65% of cases - Dx = exclusion of other causes of PA - Sporting & large breed dogs - Multiple jts involved: small, distal joints - Tx = pred +/- mycphenolate mofetil
57
Tick-borne causes of morulae in neutrophils (2)
1. Ehrlichia ewingii 2. Anaplasma phagocytophilum
58
For RMSF, IgG titer needs to be greater than __?__ to be considered a (+) infection
IgG >1024 - other (+) indications: increased IgM or 4x increase in IgG | IgG increases 2-3 weeks post infection
59
Gold standard for dx lepto
Acute and convalescent titers via Microscopic Agglutination Test (MAT - test for **antibodies**) | Can confirm via urine PCR PRIOR to starting abx
60
Witness IgM Lepto test is less likely to be affected by vaccination when?
After 3-4 months
61
Large-breed dogs get __?__ shunts, and small-breed dogs get __?__ shunts.
**Large**-breed dogs get __**intrahepatic**__ shunts, and **small**-breed dogs get __**extrahepatic**__ shunts. | Esp. yorkies!!
62
Portal vein provides __?__% of blood flow and __?__% of O2 to the liver
**80%** of blood flow **50%** of O2 to liver
63
What are the effects of hepatic encephalopathy?
- Imbalance of **GABA** > Glutamate (**inhibitory** > excitatory) neurotransmission - Edema - Pro-inflamm. cytokines | Ammonia = #1 toxin
64
When do acquired extrahepatic shunts tend to develop?
Sequela of end-stage liver failure --> portal hypertension --> shunt formation
65
Portal vein hypopalsia (microvascular dysplasia) occurs where? Prognosis?
Intrahepatic vascular shunting w/ a better long-term prognosis than PSS
66
Classic BW findings for PSS
Anemia, hypoBG, hypoalb, hypochol, low BUN, mild incr. liver enzymes, **increased bile acids, increased fasting ammonia**
67
Do you expect low or high protein C when dx PSS
LOW b/c the shunt prevents bile acids from absorbing Vitamin K in the SI | Protein C = vitK-dependent
68
Protein C levels in: 1. PSS 2. PVH
**Protein C** 1. **PSS** = **<** 70% 2. **PVH** = **≥** 70% ## Footnote Protein C is an anticoagulant * Vitamin K-dependent protein, synthesized in the liver
69
How to **medically** vs **surgically** treat hepatic encephalopathy
**Medically** 1. Lactulose (traps ammonium in colon) 2. Decr. ammonia-producing bacteria (ABX, enemas) 3. Decrease substrate for ammonia production (low protein diet) **Surgically** 1. Ameroid constriction- gradual occlusion of shunt vessel to decr. risk of portal hypertension | neomycin, metronidazole, amoxicillin
70
FIP replicates in__?__ by what gene mutation?
Monocytes/macrophages - Spike gene mutation allows for entrance into them | FeCV replicates in enterocytes
71
Purpose of Rivalta Test in FIP
to differentiate b/w transudate and exudate effusion (wet FIP) | positive = exudate; non-specific
72
FIP gold standard dx test
Direct detection via **Histo + IHC** | is invasive, usually done post mortem ## Footnote Other direct = PCR, where (+) with high viral loads strongly suggests FIP
73
Remdesivir vs. Molnupiravir
1. **Remdesivir**: IV or SQ. RNA Chain terminator - Remdesivir if severe neurological signs, inability to swallow or tolerate oral meds, extremely dehydrated/unwell - Minimum 84 days of treatment 2. **Molnupiravir**: PO. Lethal mutagenesis/"error catastrophe" - 2nd line for cats not responding to GS-441524, relapsed or cost constraints ## Footnote - Remdesivir pro-drug > metabolized to GS-441524 - Molnupiravir prodrug > metabolized to EIDD-1931
74
The __?__ form of FIP has a ***partial*** cell-mediated response, while the __?__ form has a ***poor*** one.
- **Dry = partial** - **Wet = poor**
75
Dry vs Wet FIP histo lesions
**Dry** = pyogranulomatous lesions around vasculature **Wet** = vasculitis w/ perivascular necrosis | Pyogranulomatous = predominance of macrophages and neutrophils
76
Prognosis for cats treated with nucleoside analogues | Remdesivir; Molnupiravir
85% long-term survival
77
Nadir
**Nadir**: Lowest point of blood glucose levels @ **6 hours** post administration (during BG curve) **80-150 mg/dL**
78
Ideal BG range for DM animals throughout day for dog v. cat
**Dog**: 80-200 mg/dL **Cat**: 80-300 mg/dL | Goal is to resolve clinical signs, not achieve euglycemia!!!
79
Somogyi effect + how to treat
Rebound hyperglycemia that occurs when BG drops below 60 OR drops rapidly - tx = lower insulin dose
80
DM canine signalment + ratio
Females > males (2:1)
81
Dogs get which type of DM?
Type 1 // absolute insulin deficiency
82
What two things MUST be present to dx DM in dogs?
Persistent fasting hyperBG AND glucosuria | other: PU/PD/polyphagia
83
Vetsulin
- intermediate acting (porcine) - U-40 - Relies on zinc crystal size to slow rate of absorption (larger crystals) - SHAKE BOTTLE | last 6-16h
84
Novalin N/Humilin N (NPH)
- intermediate acting - U-100 - Don't use in cats - GENTLY ROLL bottle, do NOT shake! | last 6-16h
85
Goals of treating DM + insulin therapy
- Prevent hypoglycemia - Resolve clinical signs
86
Insulin resistance occurs when what dose per injection is needed?
>1.5 U/kg per injection | However, POOR O COMPLIANCE usually cause for POOR DM CONTROL
87
3 most common co-morbidities in DM dogs
Cushing's, acute pancreatitis, UTI,
88
When should BG curve be performed? (5 scenarios)
1. After the 1st dose of a new kind of insulin 2. 7–14 days after an insulin dose change 3. At least every 3 months even in well-controlled diabetics 4. If clinical signs recur in a controlled patient 5. When hypoglycemia is suspected
89
Most common acromegaly signalment
neutered male cats, > 10 y/o
90
IGF - what is it/how it relates to acromegaly/dx of acromegaly
Insulin-like growth factor - released from liver from GH from pituitary - Hypersomatotropism = excessive GH secretion --> excessive IGF release => **acromegaly** - Dx of acromegaly = IGF-1 levels!!
91
Most common pituitary tumor in cats for cushing's
Macroadenomas (50%) - tx = trilostane (PDH only) | Dogs = microadenomas
92
What two endocrine diseases lead to insulin resistance in DM cats?
1. Cushing's (pit or adr tumor) --> PU/PD, fragile skin 2. Acromegaly (pit tumor) --> weight gain
93
Cervical ventroflexion associated w/ what feline endocrine dz
1º hyp**er**aldosteronism | from hyPOK+
94
Two forms of 1º hyperaldosteronism + signalment
1. Tumor+++ (unilat. adrenal gland) -> tx w/ unilat. adrenalectomy 2. Idiopathic hyperplasia (bilat. AGs) avg. 11 y/o cats
95
Feline Cushing's biochem findings
HyperBG, hyperCholesterolemia, increased ALT | dx = LDDST
96
Feline ADH cushing's tx
Surgery

AAAASpring 2025 (6 decks)

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