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133 Cards in this Set

  • Front
  • Back
Which is the compensatory mechanism, polyuria or polydipsia?
Polydipsia
What is the normal, small animal water intake per day? What is the normal urine output per day?
20-70 ml/kg (up to 100ml/kg if hot);
20-45 ml/kg
What is the normal specific gravity for dogs and cats?
Dog >1.030
Cat > 1.035
Define polydipsia and polyuria in terms of normal intake and output (give numbers)!
Polyuria = >50ml/kg/day urine production
Polydipsia = >100ml/kg/day water intake
What are triggers for ADH release? What does ADH do?
Decreased atrial stretch, increased osmolality, sympathetic stimulation, and angiotensin II trigger ADH;
ADH causes VASOCONSTRICTION and renal fluid RESORPTION
What are the types of primary polyuria? Which is most common?
Osmotic diuresis (most common)
Diabetes insipidus (central and nephrogenic)
What are the types of primary polydipsia?
Psychogenic ONLY
What is the general cause of osmotic diuresis?
Caused by lost osmotically active particles.
What are some specific losses that lead to osmotic diuresis? What condition is associated with each?
Glucose (D. mellitus)
Urea (Renal insufficiency)
Amino acids/Proteins (Glomerulonephritis; Fanconi's Syndrome)
What are the three most common metabolic disorders leading to diabetes insipidus?
Hypercalcemia
Hyperthyroidism
Hyperadrenocorticism
What are three main differentials for isothenuria in a PU/PD case?
Renal insufficiency
Partial central D.I.
Nephrogenic DI
T or F:
Isothenuria is nearly always a finding in PU/PD patients.
False!
Usually SG will be <1.025 but not necessarily isothenuric (but it can be sometimes)
How can hyperthyroidism be ruled-out in cats in a PU/PD workup?
Total T4 in adult/older cats.
Differentiate plasma osmolality in Central DI, nephrogenic DI, and psychogenic polydipsia.
CDI - high osmolality
NDI - high
Psychogenic - low osmolality
What are the two goals of a modified water deprivation test?
Assess ADH release
Assess kidney's response to ADH
Describe how to perform a modified water deprivation test.
Phase 1 - accurately measure water consumption for a couple days then reduce intake by ~30% over a few more days.
Phase 2 - Dehydrate animal over 8h.
Phase 3 - exogenous administration of ADH
Which phase of the modified water deprivation test will rule-out psychogenic PD and why?
Phase 2; dehydrated animal will concentrate urine.
What are some examples of fallacies of equine pain management?
Animals don't sense pain
Animals may perceive pain differently.
Pain is beneficial in limiting animal movement
What are benefits to acute pain? To chronic pain? To surgical pain?
Acute - protective (removal from negative stimulus), sign of something wrong
Chronic & surgical - NO POSITIVE PURPOSE
Which parameters are better in assessing pain, objective (HR, RR, etc) or subjective (behavioral) signs.
Behavioral signs
What are the three components of analgesia best practices?
Preemptive analgesia
Multimodal therapy
Post-op/discharge analgesia
What condition must be considered when using NSAIDs in horses?
right dorsal colitis
What are general indications for NSAID use?
Whenever inflammation is present or will be created.
Which drug prevents wind-up in equines when used preemptively?
Ketamine
What are major side-effects of alpha-2 agonists?
Hyper/hypotension
CV/Resp depression
Ileus
Tissue swelling due to excess/accumulation of fluid describes...
EDEMA
Rapid edema of the skin, mucosa, or submucosa describes...
ANGIOEDEMA
Define effusion. Where do effusions occur?
Accumulation of fluid in a body cavity. Pleural, pericardial, abdominal, retroperitoneal, peritoneal
OK, for the upteenth time, what are the major factors that influence edema formation?
Hydrostatic pressure
Oncotic pressure
Lymphatic drainage
Vascular integrity
What are radiographic characteristics of pulmonary edema?
dorso-caudal (perihilar) alveolar pattern
What are radiographic characteristics of a pleural effusion?
lungs retracted dorsally (floating); fissure lines around lobes, increased rounding of lung tips
What is the best diagnostic tool for ascites?
Ultrasound
A fluid with a SG 1.015-1.025 and <7000 cells/ul describes...
a MODIFIED TRANSUDATE
A fluid with a SG 1.010 and <1500 cells/ul describes...
a TRANSUDATE (transudates have SG <1.015)
What are two major conditions where a transudate is seen?
Hypoalbuminemia (protein losing glomerulopathy/nephropathy, liver dz)
Liver dz w/portal hypertension
Which of the following conditions may result in a modified transudate?
a) liver disease w/portal hypertension
b) Neoplasia
c) Heart Failure
d) Coagulopathy
e) Thoracic trauma
a) liver disease w/portal hypertension
b) Neoplasia
c) Heart Failure

Can also be seen w/pericardial dz, lung lobe torsion, diaphragmatic hernia
Left atrial pressure above which level results in pulmonary edema?
a) 5mm Hg
b) 10mm Hg
c) 15mm Hg
d) 20mm Hg
e) 25mm Hg
> 25mm Hg = pulmonary edema
Right atrial pressure above what level causes ascites?
a) 5mm Hg
b) 10mm Hg
c) 15mm Hg
d) 20mm Hg
e) 25mm Hg
c) 15mm Hg
Increased venous pressures in which two regions leads to pleural effusion?
Right and left atria
How is left atrial pressure measured?
Pulmonary Capillary Wedge Pressure (PCWP)
What are some differentials for pleural effusion? Which species is it seen more in?
Myocardial/pericardial disease
AV valve insufficiency
Severe R or L CHF
...seen more in CATS
A lymphatic leakage from the small intestine results in...
Chylous effusion
What are differentials for a blood effusion?
coagulopathy
neoplasia (eg: HSA)
Trauma
lung lobe torsion
Fluids with SG > 1.025 and >7000 cells/ul describes...
Where are these fluids commonly found?
Exudate; can present as an Inflammatory Effusion;
Common in abdomen and thorax
Which tumors may result in a pericardial effusion? Which is the worst?
Hemangiosarcoma (worst)
Heart base tumor
Mesothelioma
What are the types of heart base tumors? Which dogs are predisposed to these?
Chemodectoma
Thyroid/parathyroid tumors
Brachycephalic dogs predisposed
What are three findings in a physical exam that may indicate a pericardial effusion?
Muffled heart sounds (acoustic dampening)
Weak femoral pulse
Venous congestion
T or F:
Tracheal reflex is an easy way to elicit a cough in a horse.
False!
Horses have a low density of tracheal receptors.
What is another name for loud nasal breathing?
Stertor
What is another name for loud throaty breathing (roaring)?
Stridor
What are treatment options for cough?
Antitussives (opioids)
Bronchodilators (Beta 2 agonists; methylxanthenes)
What three factors can trigger chemoreceptors resulting in dyspnea?
Low O2
High CO2
Low pH
Raising the head to breathe is known as...
Orthopnea
What are some treatments for dyspnea?
Treat underlying dz
Administer O2
Sedate
Glucocorticoids
Furosemide
Brochodilators
Thoracocentesis
Tracheostomy
Mechanical ventilation
Sneezing protects (choose one) lower/upper airways.
Sneezing protects the LOWER airways.
Which two cranial nerves are primarily involved in the sneeze reflex? In the reverse sneeze reflex?
Sneeze - CNV and X
same for reverse sneeze
What are some systemic causes of epistaxis?
Hypertension
Clotting disorders
Vasculitis
Hyperviscosity
Which of the following can cause epistaxis?
a) trauma
b) coagulopathy
c) renal failure
d) neoplasia
e) hypoadrenocorticism
a) trauma
b) coagulopathy
c) renal failure
d) neoplasia

lots of others. Also HYPERadrenocorticism
Which antibiotic drug classes are commonly used to treat nasal infections?
Sulfas, lincosamides, fluoroquinolones, macrolides, doxycycline
When should antihistimines be used to treat upper airway diseases?
When it is an allergic process
Which drug destroys mucoproteins?
Acetylcysteine
Which drugs can be used as decongestants?
Alpha agonists
Antihistimines
What are the most common nerves injured in a brachial plexus injury?
Musculocutaneous
Axillary
Radial nn.
Which nerves innervate the autonomous zones of the distal-medial aspect of the canine pelvic limb? The plantar aspect? The cranial-lateral aspect?
Distal-medial (Saphenous)
Plantar (Tibial)
Cranial-lateral (Peroneal)
Which nerves provide autonomous cutaneous innervation to the dorsal aspect of the canine forelimb? The lateral aspect? The medial aspect?
Dorsal (Radial)
Lateral (Ulnar)
Medial (Musculocutaneous)
What are the signs of Horner's syndrome?
Sunken eye
Visible 3rd eyelid
Miosis
What are three lesion locations that could result in Horner's syndrome?
Inner ear lesion
Spinal cord issue (T1/T2)
Mass in neck
In which part of the brain are seizures initiated?
Prosencephelon
Which of the following will affect seizure threshold?
a) Length of nerve axon
b) Electrolyte availability
c) Nerve lipoprotein membrane
d) Neurotransmitter concentration
b) Electrolyte availability
c) Nerve lipoprotein membrane
d) Neurotransmitter concentration
Increases in which neurotransmitters will reduce the seizure threshold? Decreases in which NTs will do the same thing?
Increased glutamate, aspartate, Ach
Decreased GABA, glycine, taurine, NE
What are the 4 seizure classifications?
Focal
Simple partial
Complex partial
Generalized (Grand Mal)
What is the difference between cluster seizures and status epilepticus?
Cluster seizures is having 2-3 generalized seizures in one day. Status epilepticus is continuous seizures (or multiple cluster seizures)
What are some extracranial causes of seizures?
Hypoglycemia
Hepatic encephalopathy
Chronic uremia
Hypoxia
Hyperlipidemia
Hyperthermia
Intestinal parasites
Electrolyte disorders
Japanese cartoons
What are some intracranial causes of seizures?
Space filling lesions (neoplasia, inflammation, infection)
Trauma
Malformation
Degeneration (stroke, neonatal ecephalopathy)
Describe common signalments (age/breed) of an animal with idiopathic epilepsy.
6mo to 6yr dog
(Lab, Golden, Ger Shep, Springer, Std Poodle)
What are some neurological causes of syncope?
HYPP
Polyneuropathies (coonhound paralysis)
stroke
narcolepsy
Neuromuscular disorders (botulism/tick paralysis)
myasthenia gravis
What is a visual method for differentiating an UMN neuropathy from a LMN neuropathy?
LMN neuropathy will have muscle atrophy
When should EMG abnormalities manifest in a neuropathy?
a) immediately
b) 1 day
c) 3 days
d) 5 days
e) never
d) 5 days
Focal myositis usualy affects which muscle group?
Masticatory muscles
What are some infectious differentials for myositis?
Toxoplasmosis
Neosporosis
Leptospirosis
When should NCV abnormalities manifest in a myopathy?
a) immediately
b) 1 day
c) 3 days
d) 5 days
e) never
e) NEVER! NCV should remain normal!
What is the normal value for a NCV test?
NCV = nerve conduction velocity; should be > 50m/s
What is a unique feature of Horner's syndrome in a horse?
they SWEAT
What is reported to be the first indicator that a post back surgery dog will walk again?
Tail wagging!
Choose peripheral, central, or paradoxical vestibular lesion...
...ipsilateral head tilt.
Peripheral or central
Choose peripheral, central, or paradoxical vestibular lesion...
...falling away from the lesion.
Paradoxical
Choose peripheral, central, or paradoxical vestibular lesion...
...ipsilateral postural & CP deficits.
Central or peripheral
Choose peripheral, central, or paradoxical vestibular lesion...
...may have CN IX - XII deficits.
Central or paradoxical
Fill in the blank:
A paradoxical vestibular lesion has a head tilt _________ the lesion and postural deficits___________ the lesion while central vestibular has head tilt ____________ the lesion and postural deficits ___________ the lesion.
A paradoxical vestibular lesion has a head tilt AWAY FROM the lesion and postural deficits on the SAME SIDE as the lesion while central vestibular has head tilt TOWARD the lesion and postural deficits on the SAME SIDE as the lesion.
How can vestibular vs. cerebral cortex induced circling be differentiated?
Menace response will be absent in contralateral eye of cerebral circling.
Which of the following lack a gallbladder?
a) Horse
b) Cow
c) Pig
d) Camelid
e) Javelina
Horse, Camelid, and Javelina
T or F:
Bile acids, bilirubin, and urobilinogen all undergo hepatic recycling.
Tru dat!
What are the 6 major hepatic functions?
Carbohydrate metabolism
Protein metabolism/synthesis
Fat metabolism
Urea synthesis
Bile Acid Synthesis
Detoxification
Put these in the correct order:
Biliverdin
Hemoglobin
Heme
Urobilinogen
Conjugated bilirubin
Unconjugated bilirubin
Hemoglobin
Heme
Biliverdin
Unconjugated bilirubin
Conjugated bilirubin
Urobilinogen
Which are common findings with hemolytic disease?
a) Myoglobinuria
b) Icterus
c) Anemia
d) Hemoglobinuria
e) Hematuria
b) Icterus
c) Anemia
d) Hemoglobinuria
Predict the following values in a case of obstructive hepatic disease:
Serum conjugated bilirubin
Urine conjugated bilirubin
Urine uribilinogen
GGT
ALP
INCREASED Serum conjugated bilirubin
INCREASED Urine conjugated bilirubin
DECREASED Urine uribilinogen
INCREASED GGT
INCREASED ALP
Describe the prevalence of icterus in the horse and ruminant.
Horse (normal in 10-15%)
Rare in ruminants
There are 9 clinical signs of liver failure...NAME THEM ALL OR DIE!!!
Icterus
Hepatic Encephalopathy
Weight Loss
Photosensitization
Pruritis
Ventral edema/ascites
Hemorrhage
Diarrhea
Abdominal pain
What are the liver leakage enzymes? Which are more common for large animal?
ALT
AST (LA)
LDH
SDH (LA)
GLDH
Which leakage enzyme is SPECIFIC for hepatocellular damage?
SDH
What are the induced liver enzymes? Elevation of these is generally indicative of what condition?
GGT and ALP elevations are indicative of cholestasis
Which liver enzyme is commonly elevated in young training racehorses? Why?
GGT; unknown!
Ruminant colostrum is rich in which hepatic enzyme?
GGT
What are the two most useful SPECIFIC tests of hepatic function? What is a major issue with each?
Serum bile acids (not very specific; wide range in ruminants)
Blood ammonia (very labile)
Which of the following are NOT poor prognosticators of hepatic disease?
a) Hypoalbuminemia
b) Hypoglobulinemia
c) High GGT and SDH
d) Fibrosis
e) Prolonged PT
b) Hypoglobulinemia (should be HYPER)
c) High GGT and SDH (should be high GGT & ALP with low/normal SDH)
Sudden transient loss of consciousness resulting in collapse w/spontaneous recovery describes...
Syncope
What are the 5 general causes of syncope?
Neurological
Cardiogenic
Metabolic
Tussive/cough
Autonomic dysfunction
T or F:
Cardiac syncope can occur due to bradycardia or tachycardia.
True!
What are some causes of bradycardia that result in syncope?
AV block
Sick sinus syndrome
Atrial standstill (springer spaniel)
Hyperkalemia (cat)
What are the major cardiac causes of syncope?
Arrthymia
Flow obstruction
Low output
Cyanotic heart disease
Cardiac tamponade
What are some obstructive causes of cardiac syncope? Some low output causes?
Pulmonic/aortic stenosis (obstructive)
Dilated cardiomyopathy, Mitral regurg (low output)
What must always be ruled-out when diagnosing a possible syncope case?
sEiZurEzzZzz
Describe the mechanism of tussive syncope.
Coughing increases intrathoracic pressure which decreases venous return
What are some factors that can influence accurate rectal temperature measurement?
Farts (air in rectum)
Decreased anal tone
insertion of thermometer into feces
Which of the following factors has the least impact on thermal regulation in adult animals?
a) Metabolic activity
b) Muscle activity
c) Digestion/Fermentation
d) Brown fat metabolism
d) brown fat metabolism; this is important in NEONATES
Give some examples of autonomic conservation of body heat.
Piloerection
Reduction of peripheral circulation
What are the 4 major methods of heat loss? Which is the most important/effective?
Conduction
Convection
Evaporation (most important)
Radiation
What is the location of the body's "internal thermostat"? What are the 3 sensors that this center uses for monitoring?
Anterior hypothalamus uses warmth/cool sensitive neurons in skin/mucous membranes and blood temp sensors
What are some signs of hypothermia?
Low rectal temp (duh)
depressed ventilation
absence of shivering
depressed reflexes
depressed cardiac fxn
decreased intravascular volume
hypoxia, acidemia, cardic arrthymia
What is the difference between fever and hyperthermia?
Fever is a hypothalamic response to pyrogens while hyperthermia is an elevation of core body temp
Below which temperature is thermoregulation severely impaired?
<94 F
Which of the following never results in true hyperthermia?
a) anesthesia
b) Bacterial infection
c) loss in plasma volume
d) Excessive environmental temperatures
b) Bacterial infection (CAUSES FEVER)

anesthesia can cause MALIGNANT HYPERTHERMIA; loss in plasma volume (dehydration) can HUGELY affect thermoregulation
T or F:
Core temperatures of 70-75 F can be tolerated with no permanent ill effects.
True!
This is hibernation!
Briefly explain the mechanism of malignant hyperthermia. Which drug is protective?
Hereditary ryanodine receptor defect causes excessive Ca in muscle cells leading to uncontrolled contraction and HEAT.
Dantrolene is protective!
For every 1 degree Celsius increase in core body temperature, cellular oxygen consumption increases by what proportion?
10%
Which of the following are signs of heat stroke?
a) DIC
b) loss of shivering
c) myocardial damage
d) lethargy and shock
e) profuse sweating
a) DIC
c) myocardial damage
d) lethargy and shock
Moving a horse from a temperate to a hot and humid climate could run the risk of developing what thermoregulatory condition?
Anhydrosis
What thermoregulatory disorder is characterized by the following signs:
Resistance to anti-pyretics
Excessive response to external cooling
Loss of diurnal variation
Nervous system disease!
Which mediator is chiefly responsible for fever?
IL-1
What are some benefits of fever?
Greater antibody production
Hypoferremia
Inhibits tumor and microbe growth
Proliferation of leukocytes
What are some disadvantages of fever?
Temp increases of >5 F are of no benefit
Protein loss
anorexia
CV and neuro damage
What are the critical body temps for a cat or dog? A horse? A cow?
Cat/dog 106 F
Horse 105 F
Cow 107 F
What are some general causes of fever?
Infectious disease
Neoplasia
Noninfectious inflammation (trauma)
Drug fever/Toxins
Metabolic disorders