Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CAEM Pt. 2 > Systemic Hypertension, Pericardial Effusion, HW Disease > Flashcards

Systemic Hypertension, Pericardial Effusion, HW Disease Flashcards

(59 cards)

Start Studying
1
Q

What two factors determine MAP?

A

CO (SV & HR) and SVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What BP value is considered hypertensive?

A

Systolic > 160 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What BP value is dangerous and can lead to target organ damage?

A

Systolic > 180 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Top 5 diseases associated with hypertension in dogs

A

1) Renal disease - esp protein-losing nephropathies
2) Hyperadrenocorticism
3) Diabetes mellitus
4) Pheochromocytoma
5) Hyperaldosteronism

  • Others = acromegaly, hypertensive meds (PPA, palladia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Top 3 diseases associated with hypertension in cats

A

1) Renal disease of any variety
2) Hyperthyroidism
3) Diabetes mellitus

*Age is no a risk factor for HT, but it is a risk factor for the above diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is idiopathic hypertension common in dogs and cats

A

No - more common in people, usually suspected in cat and dogs because the underlying disease hasn’t been found

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the target organs that can be damaged with hypertension? (4)

A
  • Brain = HT encephalopathy
  • Eye = HT choroidopathy
  • Kidney = functional decline
  • Heart = adaptation like hypertrophy and diastolic dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What clinical signs do we see because of target organ damage (4)?

A

1) Eye = hemorrhage, retinal detachment, photophobia, acute onset blindness
2) Brain = intracranial signs (with very severe HT)
3) Kidney = proteinuria
4) Heart = new mitral murmurs, new gallop rhythms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which patients do we measure BP and perform a fundic exam in? (2)

A

1) Presenting clinical signs of hypertension

2) Confirmed compatible and causative disease, Ex: diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

At what age, in cats, do we start to worry about hypertension?

A

> 10 years - risk factor for diseases that cause HT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What things should we ensure when measuring BP of our patients? (5)

A
  • Ensure the animal is as unstressed as possible
  • Utilize the same measurement method for every patient
  • Patient should be conscious, unsedated, sitting/recumbent
  • Measure after a period of acclimation
  • Measure before any stressful procedures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do we treat hypertension in general?

A

1) Treat any underlying diseases
2) Medications that modify the RAAS and vasodilate
a) RAAS = ACE-i
b) Vasodilator = amlodipine
3) Discontinue any BP elevating meds
4) Monitor fluid administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do we use to prevent proteinuria with renal disease?

A

ACE-inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do we use to treat the cardiac abnormalities with hyperthryoidism?

A

Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What drug do we use to modify the RAAS system to control hypertension?

A

> ACE inhibitor

  • Blocks formation of AG II = blocks vasoconstriction and formation of aldosterone
  • Returns vasoconstriction to normal tone = less proteinuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of patient do we never want to use ACE inhibitors in?

A

Dehydrated patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the hypertensive drug of choice in cats?

A

> Amlodipine = Ca++ channel blocker
- Vasodilator

+/- Add ACE-I if proteinuric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the hypertensive drug of choice in dogs?

A

> ACE-inhibitor

- Add on amlodipine if needed after one week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical signs of pericardial effusion

A 
\+ Hypotension
\+ Weakness
\+ Cough
\+ Vomiting
\+ Dyspnea
\+ Collapse
\+ Death

+ Chronic = lethargy, weakness, exercise intolerance, weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

PE findings of pericardial effusion

A 
\+ Muffled heart sounds
\+ Muffled lung sounds
\+ Ascites
\+ Jugular vein distension
\+ Weak pulses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Diagnostics for pericardial effusion

A
  • History and PE
  • ECG
  • Echocardiograph to visualize the effusion
  • Thoracic radiographs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Abnormalities seen on ECG with pericardial effusion (4)

A
  • Tachycardia
  • Ventricular arrhythmias
  • Attenuated QRS complexes
  • Electrical alternans
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Abnormalities seen on chest rads, with pericardial effusion (4)

A
  • Large globoid cardiac silhouette
  • Enlarged vena cava
  • Pleural effusion
  • Loss of abdominal detail
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Abnormalities seen on echo with pericardial effusion (2)

Study These Flashcards
A

+/- Masses, esp in the right atrium or heart base

- Right atrial tamponade

25
What is troponin I and what does it tell you?
Cardio-specific biomarker that is released from the myocardium - elevated in dogs with pericardial effusion
26
What do you always want to submit along with performing thoracocentesis?
CYTOLOGY - often non-diagnostic, but may lead exfoliated cells
27
What is the most common cause of pericardial effusion in cats?
FIP (exudative) - Other = CHF (transudate)
28
What are the most common causes of pericardial effusion in dogs?
1) Idiopathic (hemorrhagic) | 2) Neoplasia - HSA, heart base tumors, mesotheliomas
29
How do we treat first time pericardial effusion?
Pericardiocentesis
30
What do we recommend with repeat pericardial effusion?
Pericardectomy - subtotal or window
31
Life cycle (L1 to L5) of heartworm
- L1-infected dog is bit by a mosquito - Microfilaria infect the mosquito and spread in the bloodstream, mature to L3 - L3-infected mosquito bites a dog - Matures through juvenile L4 to adult L5 in the dog (migrates from blood > pulmonary artery right heart) - Adult HW's produce infective L1 microfilaria - Mosquito bites infected dog...
32
Lesions seen with heartworm (4)
> Vascular = endothelial cell hypertrophy, pulmonary artery endarteritis from worm byproducts, produce thromboemboli > Pulmonary = (eosinophilic) pulmonitis, granulomas > Heart = right ventricular hypertrophy (pulmonary hypertension), caval syndrome > Renal = immune mediated glomerulonephritis, glomerulosclerosis from microfilaria > Aberrant migration systemically
33
What is caval syndrome?
> High worm burden that the worms overwhelm the right atrium and cause tricuspid regurgitation - Hemolysis due to blood flowing through the worms, acting as a sieve - Blood backs up systemicaly due to high right atrial/ventricular pressures +/- Renal and hepatic failure due to hemolysis
34
What pathogen accompanies the heartworm and what problems can it cause?
> Wolbachia - Surface antigen induces IgG response, thought to contribute to pulmonary and renal inflammation * Released when you kill the HW
35
True or false - infected and asymptomatic dogs will not have microfilaria in their blood
False - need to examine blood smears at low power
36
Clinical signs of HW disease in dogs
+ Cough + Exercise intolerance = pulmonary HT and lung lesions + Weight loss + R-CHF = ascites, etc. + Severe = dyspnea, syncope (pulmonary HT), hemoptysis, ascites (caval syndrome)
37
Findings on blood smear, CBC, and chem panel with HW positive animals
- Microfilaria in the blood - Hyperproteinemia = hyperglobulinemia - Eosinophilia and basophilia - Anemia from chronic disease - U/A = proteinuria from glomerulonephritis, casts, RBC's +/- Abnormal renal and liver values
38
Findings on chest rads with HW disease
- Right caudal lung lobe interstitial to alveolar infiltrates - Lung granulomas - Tortuous or blunted pulmonary vessels +/- SEVERE = enlarged pulmonary arteries +/- Right sided heart failure
39
ECG findings with HW disease
Right axis deviation from right ventricular enlargement
40
Why is ID of microfilaria a poor choice for HW diagnosis? (5)
- Seasonality and daily periodicity complications - Dogs may or may not be shedding microfilaria if on tx - Dogs with pneumonitis may not have microfilaria (may be concentrated in lung parenchyma) - Need to differentiate D. immitis from Dipetalonema reconditum - Unisex infection may create an amicrofilaremia
41
What is the number one diagnostic tool for HW in dogs?
> Antigen testing - Good sensitivity after 6 months of infection (don't test puppies < 6 mo) * Should still confirm positives with blood smears, thoracic rads, CBC (eosino/basophils), or Ab test
42
Why might an antigen test be negative (falsely)?
- Worms aren't mature enough to shed microfilaria (too early) - Too low of worm burden - Unisex infection of only male worms
43
Treatment of canine HW (4)
- Melaromine, 3 doses = adulticide, kills L4-L5, deep lumbar injection *Strict cage rest for 6-8 weeks - Monthly avermectin microfilariacide to kill L1 - Doxycycline = against Wolbachia to reduce arterial lesions +/- Surgical worm removal with caval syndrome + heparin therapy +/- Steroids - Sildenafil for hypertension
44
How do we prevent HW?
Monthly preventative, starting at 8 weeks of age (kill L1, L3, and L4) *Test prior to using preventative
45
How does cat HW infection differ from dogs?
- Cats = infected with only 1-4 worms - Worse arteritis - Longer pre-patent period - Cat HW's live longer
46
What do we suspect with coughing cats?
Respiratory disease - ddx = HW or asthma
47
Clinical signs of feline HW
``` + Coughing + Gagging + Dyspnea + Tachypnea *Looks like asthma *Can die suddenly due to HW embolization ```
48
Is caval syndrome common in cats?
No - don't have high worm burdens
49
PE findings of feline HW
- Abnormal lung sounds - Cough - Open mouth breathing +/- Murmur +/- Jugular distension with right CHF
50
Findings on CBC, blood smear, and chem with feline HW
- Microfilaremia - Hyperproteinemia, high globulins - Eosinophilia - Basophilia - Anemia from chronic disease - U/A = proteinuria, casts, RBC's +/- Renal and hepatic values
51
What might you see on tracheal washes in feline and canine HW?
Eosinophils
52
Radiological findings of feline HW
- Peribronchial cuffing - Diffuse or focal interstitial infiltrates - Focal alveolar infiltrates - Pleural effusion - Enlarged caudal pulmonary arteries and pruning of pulmonary arteries
53
Do we use ID of microfilaria to diagnose feline HW?
No - few cats are persistently microfilaria
54
Do we use antigen testing to diagnose HW in cats?
No - high rate of false negatives
55
Reason for false negatives in antigen testing with feline HW (4)
1) Worms are not mature enough to shed microfilaria 2) Low worm burdens = difficult to detect Ag 3) Only male worms present 4) May take up to 170 days for cats to test Ag-positive post-infection
56
What is the first line diagnostic for feline HW?
> Antibody testing - Negative Ab test rules it out but - Positive Ab test only confers exposure * Highly sensitive for detecing HW Ab's 3 months post-infection - Use Ag testing in conjunction
57
Treatment of feline HW
*Assess each cat as an individual +/- Tx with subclinical animals > Prednisone (clinical signs are due to inflammatory reactions) +/- Doxycycline for Wolbachia
58
Do we use melarsomine in cats?
NO - really only a last ditch effort
59
How do we prevent feline HW?
Monthly prophylactics for cats in endemic areas

CAEM Pt. 2 (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions