Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
98 Cards in this Set
- Front
- Back
|
What conditions comprise diabetic ketoacidosis?
|
Hyperglycemia
Metabolic acidosis Ketonuria Dehydration Electrolyte abnormalities |
|
|
What are some common concurrent issues with DKA?
|
Pancreatitis, infection, estrus, Cushing's, pregnancy, obesity, exogenous steroids
|
|
|
PE findings with DKA
|
plantigrade stance
rear limb weakness scruffy, scaly coat |
|
|
What needs to be present to make a dx of DKA?
|
hyperglycemia
glucosuria ketoniuria |
|
|
How is DKA treated?
|
Fluid therapy (intravascular then dehydration)
K and P supplementation Insulin therapy 3-4 hours after fluids |
|
|
How often does BG need to be monitored in DKA patients
|
every 2 hours
|
|
|
When should DKA patients return for a 24 hour BG curve
|
5-7 days
|
|
|
What are MAJOR clinical signs of hypoglycemia?
|
Seizures, ataxia, blindness (also weakness, stupor, coma, etc)
|
|
|
Blood glucose below what value gives hypoglycemia clinical signs?
|
<40 mg/dL
|
|
|
Which of the following are NOT common causes of hypoglycemia?
a) Cushing's (paraneoplastic syndrome) b) Sepsis c) Severe liver dz d) Addison's dz e) insulinoma |
ALL can cause hypoglycemia!
|
|
|
How often does BG need to be checked in hypoglycemic patients?
|
Immediately after initial IV bolus of dextrose
in an hour in 2 hours then q 4-8 hours |
|
|
Causes of primary addisons
|
iatrogenic
fungal infections hemorrhagic infarctions neoplasia amyloidosis trauma |
|
|
Causes of secondary addisons
|
inflammation
neoplasia trauma congenital defects of hypothalamus exogenous steroid admin |
|
|
What is the normal Na:K ratio? Below what value is Addison's a consideration?
|
Normal >32;
Addison's <27 (often 21) |
|
|
What can cause a Na:K ratio <27?
|
Addison's
Parvo GI dz |
|
|
Which of the following are NOT common signs of Addison's?
a) Hypotension b) Hypoglycemia c) Hypocalcemia d) Hyponatremia e) Metabolic alkalosis |
c) Hypocalcemia
e) Metabolic alkalosis |
|
|
What might you see on radiography in a patient with Addison's? On ECG?
|
Rads (microcardia, small CVC)
ECG (Tented T, disappearing P, wide, bizarre QRS) |
|
|
What is the treatment plan for an Addisonian crisis?
|
Shock doses of isotonic crystalloids
Dexamethasone Treat hypoglycemia Treat hyperkalemia |
|
|
What are some signs of acute liver failure?
|
Anorexia, vomiting, icterus, CNS signs, coagulopathies
|
|
|
Clinical signs of feline hepatic lipidosis
|
icterus
vomiting hypersalivation |
|
|
Tx for hepatic lipidosis
|
Fluids
Correct acid/base disturbances Nutrition |
|
|
Feeding regimen for hepatic lipidosis
|
Feed 1/3 of caloric requirements on day 1
2/3 on day 2 full amount day 3 |
|
|
What drugs should be avoided in hepatic lipidosis
|
benzos
corticosteroids |
|
|
What three things comprise triaditis? In which species does this occur?
|
Pancreatitis, Cholangiohepatitis, and IBD in cats
|
|
|
What do the following hepatic ultrasound values indicate?
Hypoechoic Hyperechoic Mixed echogenecity |
Hypo (necrosis)
Hyper (infiltrative dz) Mixed (chronic dz) |
|
|
What are good ancillary therapies in treating hepatic disease?
|
Taurine
Carnitine Thiamine Milk Thistle, SAM-E, Vit. E |
|
|
What is a weird sign of hepatic encephalopathy in a cat?
|
Discolored iris
|
|
|
T or F?
Hyperbilirubinemia is common with hepatic encephalopathy |
False!
|
|
|
How is hepatic encephalopathy treated?
|
Lactulose and/or oral abx
Fluid therapy High carb/low protein diet |
|
|
Does hypo or hyperkalemia increase renal production of ammonia?
|
Hypokalemia
|
|
|
Which of the following is NOT a systemic complication of pancreatitis?
a) hypertension b) edema c) pleural effusion d) chronic renal failure e) DIC |
a) hypertension (should be HYPO)
d) chronic renal failure (should be ACUTE) |
|
|
What is the best test for pancreatitis?
|
cPLI or fPLI
|
|
|
Which of the following are NOT lab results in pancreatitis?
a) lipemia b) azotemia c) hypoproteinemia d) hypercalcemia e) mature leukocytosis |
d) hypercalcemia (should be HYPO)
e) mature leukocytosis (would have a LEFT SHIFT) |
|
|
How is pancreatitis treated?
|
Pain meds!
Fluid therapy Nutrition Maybe antibiotics??? |
|
|
What is the refeeding diet for pancreatitis?
|
soft
low in fiber highly digestible high in carbs low in fat low in protein |
|
|
Which of the following are NOT important historical events in a case of dystocia?
a) the ***** in pain and biting her vulva b) there is green discharge with no whelping c) there are strong contractions for 20 minutes with no birth d) a cat has failed to deliver all offspring within 12 hours e) more than 1 week overdue |
c) there are strong contractions for 20 minutes with no birth
d) a cat has failed to deliver all offspring within 12 hours (should be 50-60 minutes; and a cat can take all day) |
|
|
Fetal skeletons should be visible by radiography by _______.
|
45d
|
|
|
What are indications for using oxytocin in canine parturition?
|
Cervix is DILATED
Fetal position is NORMAL NO birth canal obstructions weak/absent contractions |
|
|
What are indications for a c-section?
|
narrow pelvis/oversized fetus
uterine torsion dystocia with no response to medical therapy |
|
|
What are indications for an en-bloc OVH with a dystocia that doesn't respond to medical therapy?
|
Dead/necrotic fetus
Uterine rupture Unwanted future pregnancies |
|
|
What drugs should you have handy during neonatal resuscitation post c-section?
|
Naloxone/naltrexone (anti-opiate)
Flumazenil (anti-benzodiazepine) |
|
|
What are some lab values for a ***** with pyometra?
|
Pyuria, proteinuria, w/low USG
Azotemia Left-shift leukocytosis |
|
|
Who prolapses their uterus more, ******* or queens? When does it occur?
|
CATS>DOGS; follows parturition
|
|
|
What are common isolates grown from a dog with acute prostatitis? What are good abx for these?
|
E. coli, Staph/Strept, Mycoplasma
(TMS, Enro, Clavamox, Chloramphenicol) |
|
|
How is prostatitis treated?
|
antibiotics
fluids stool softeners castration |
|
|
How are prostatic cysts or abscesses treated?
|
Surgical drainage
|
|
|
Testicular torsion is common in ________.
|
cryptorchids
|
|
|
What commonly causes paraphimosis?
|
Hair around the penis
|
|
|
How is paraphimosis treated?
|
sedation/anesthesia
remove any constricting hair hyperosmotic solutions or preputial incision RARELY amputation, castration, and scrotal urethrostomy |
|
|
T or F:
Patients with uremia are not necessarily azotemic. |
False!
Uremia = clinical signs + azotemia |
|
|
What are signs of uremia?
|
Vomiting, azotemia, anorexia, oral ulcers, melena, cachexia, diarrhea, etc...
|
|
|
When should contrast studies of the urinary system be performed?
|
Undiagnosed dysuria, pollakuria or hematuria
Cystic opacities Abnormal bladder shape Caudal abdominal masses Assess bladder/urethra integrity |
|
|
Which of the following are NOT urinary emergencies?
a) pollakiuria b) anuria c) urolithiasis d) trauma e) pyelonephritis |
a) pollakiuria
e) pyelonephritis |
|
|
What are common causes of acute renal failure?
|
Systemic/renal hypotension
Nephrotoxins Other infection Obstruction Hyper Ca |
|
|
T or F:
Potassium and Phosphorus may be normal or high in acute renal failure. |
True!
|
|
|
What are the three things necessary to diagnose anuria or oliguria?
|
1) patent urinary collection system
2) adequate hydration 3) MAP>60mmHg |
|
|
What are the treatments for oliguria/anuria?
|
Furosemide first!
Try mannitol (once) Maybe dopamine? Dialysis or CRRT as a last resort... |
|
|
What is the next step in a urolith-obstructed patient where the blockage cannot be retropulsed?
|
Surgery! (urethrotomy or prepubic cystostomy)
|
|
|
T or F:
Treating UTIs in partially obstructed cats is an important aspect of urolith therapy. |
False!
Cats rarely get UTIs...this is more for DOGS |
|
|
What are common historical and physical exam findings in a blocked cat?
|
Stranguria, pain, vomiting, collapse
Large, firm, painful bladder Discolored penis |
|
|
What are the bad sequelae to urinary blockage in cats?
|
Hyperkalemia
Azotemia and acidosis BAD ANESTHESIA CANDIDATE |
|
|
How are blocked cats treated?
|
Pain meds
IV cath & start crystalloids Treat hyper K Urethral cath (under anesthesia) and flush bladder |
|
|
Put the following in order from most to least likely to rupture.
Kidney Bladder Urethra Ureter |
Bladder
Kidney Urethra Ureter |
|
|
What are some possible causes of hydronephrosis?
|
Urolith
Trauma Neoplasia Iatrogenic (spay) |
|
|
How is hydronephrosis treated?
|
Restore fluid/electrolyte balance
Unilateral nephrectomy Maybe a stent |
|
|
What are the four aspects of a physical exam of a patient with possible abdominal/GI emergency?
|
Inspect/observe
Auscultate Palpate Percuss |
|
|
Which of the following are abdominal radiographs unable to ascertain?
a) organomegaly b) ileus c) foreign bodies d) obstruction e) pancreatitis |
rads can do it all in the abdomen!!
|
|
|
When should you think about performing an abdominocentesis?
|
Loss of serosal detail on rads
Penetrating abdominal injury Persistant abdominal pain Blunt trauma w/abdominal signs Post-op complications |
|
|
When should you NOT perform an abdominocentesis?
|
Coagulopathy
Dyspnea Diaphragmatic hernia Ileus Organomegaly Previous abdominal surgery |
|
|
T or F:
Peritoneal lavage increases the diagnostic power of abdominocentesis nearly 2-fold. |
True!
Abdominocentesis is only 50% diagnostic; lavage increases it to 93-98%. |
|
|
What would cause changes in each of the following abdominocentesis parameters?
High bilirubin High amylase High creatinine/K High lactate Low pH or glucose |
High bilirubin (gall bladder rupture)
High amylase (pancreatitis) High creatinine/K (bladder rupture) High lactate (sepsis) Low pH or glucose (sepsis) |
|
|
What would cause changes in each of the following gross abdominal fluid values?
Turbulent/flocculent Green Pink w/PCV<1% Red w/PCV>2.5% |
Turbulent/flocculent (peritonitis)
Green (biliary leakage) Pink w/PCV<1% (mild hemorrhage) Red w/PCV>2.5% (significant hemorrhage) |
|
|
Septic peritonitis is diagnosed when WBCs exceed ___________.
|
>1000 cells/uL
|
|
|
Which of the following are NOT always indications for GI surgery?
a) non-responsive pain b) bile in abdomen c) abdominal free gas d) GDV e) Mesenteric volvulus |
c) abdominal free gas
(often an indication but may be a post surgical issue too...) |
|
|
Regarding GI emergencies, an animal with regurgitation, dysphagia, hypersalivation, and anorexia likely has...
|
...esophageal foreign body
|
|
|
Regarding GI emergencies, an animal with projectile vomiting likely has...
|
...Gastric foreign body
|
|
|
Regarding GI emergencies, an animal with vomiting, electrolyte imbalances, and foci of gas-filled intestines likely has...
|
...intestinal obstruction
|
|
|
Regarding GI emergencies, an animal with hematemesis, melena, anemia, and abdominal pain likely has...
|
Gastric erosions/ulcers
|
|
|
Regarding GI emergencies, a young dog with hematemesis, melena, and a high PCV likely has...
|
Hemorrhagic gastroenteritis
|
|
|
What are the 3 types of shock sequelae to GDV?
|
Hypovolemic
Cardiogenic Septic |
|
|
How are most gastric diseases treated?
|
Analgesia, fluids
Histamine blockers Sucralfate or other gastroprotectants Promotility drugs Anti-emetics |
|
|
How is rectal prolapse treated?
|
Stuff the sucker back in
Use hypertonic dextrose Pursestring suture Lactulose stool softener Deworm |
|
|
What are the 2 types of external cardiac compressions and indications for each?
|
Heart pump (small animals)
Thoracic pump (larger animals) |
|
|
T or F:
There is a better prognosis with internal cardiac compressions. |
True!
|
|
|
Which drugs are appropriate to give during asystole?
a) epinephrine b) dopamine c) vasopressin d) atropine e) Na bicarb |
a) epinephrine
c) vasopressin |
|
|
T or F:
Ca should never be given in times of cardiac arrest. |
False!
Give Ca with hypocalcemia, hyperkalemia, or Ca-blocker toxicity |
|
|
If an arrthymia is refractory to everything, what mineral should be given?
|
Mg
|
|
|
What are common arrthymias in cardiac arrest?
|
Asystole
Pulseless electrical activity V-fib Bradycardia |
|
|
Which arrthymia is treated by defibrillation?
|
v-fib
|
|
|
Which arrthymia is treated by epinephrine or vasopressin?
|
Asystole or PEA
|
|
|
Which arrthymia is treated by atropine?
|
Bradycardia
|
|
|
What are some ways to assess the efficacy of CPCR?
|
Femoral pulse
Blood gas Capnography |
|
|
T or F:
Low EtCO2 during CPCR has a good prognosis because it indicates good oxygenation. |
False! You want 18-24 EtCO2 which indicates good circulation (gas exchange)!!
|
|
|
What is monitored post CPCR to check for tissue perfusion? What drugs can help with perfusion?
|
Monitor BP, urine output, blood gas, maybe echo
(use DA or Dobutamine) |
|
|
What are major categories to address after CPCR?
|
Tissue perfusion
Cerebral perfusion Myocardial care Prevent/treat reperfusion injury Prevent/treat pulmonary trauma |
|
|
Cerebral damage is assumed when...
|
...there is no consciousness 15-20 minutes post CPCR.
|
|
|
Which of the following are NOT important to interdict when preventing cerebral trauma post CPCR?
a) hypotension b) hypervolemia c) hypocapnia d) hypothermia e) hyperthermia |
d) hypothermia
(hypothermia isn't a big deal) Wanna prevent hyper/hypotension, hyper/hypovolemia, hyper/hypocapnia, and hypoxia too |
|
|
What drugs are thought to help with cerebral injury post CPCR?
|
Mannitol
Furosemide |
