Cardio Exam 2

Front 1

T/F: Primary Valvular disease is common in the Cat.

Back 1

False

*primary and secondary cardiomyopathies are the most common acquired cardiac disease in the cat

Front 2

In Hypertrophic Cardiomyopathy, ___ pressures in the ventricle may rise abnormally high.

Back 2

diastolic

*even when the diastolic volume is normal or small

Front 3

HCM refers to ____ or ____ myocardial hypertrophy.

Back 3

primary or idiopathic

Front 4

hypertrophy of the myocardium causes __________ to be compromised which further slows myocardial relaxation.

Back 4

coronary perfusion

Front 5

T/F: in most cases of HCM, systolic ventricular performance is normal.

Back 5

True

Front 6

What species and gender is most commonly effected by HCM?

Back 6

Male Cats

Front 7

_____ is the most common clinical sign associated with feline HCM. It results from ____ or ____.

Back 7

dyspnea

pleural effusion or pulmonary edema

Front 8

How do you diagnose HCM?

Back 8

echo

Front 9

What is SAM and what is it associated with?

Back 9

Systolic Anterior Motion of the Mitral Valve

causes dynamic outflow tract obstruction (70% of cats with HCM have this)

Front 10

Why is the lowest effect dose of furosemide used to treat feline patients with pleural effusion? What else might you use instead?

Back 10

Feline patients do not tolerate overly aggressive diuretic therapy well.

pleurocentesis

Front 11

Therapeutic drugs for patients with diastolic dysfunction has been directed towards the objectives of improving ventricular filling. What specific effect would these drugs have on the heart?

Back 11

slow heart rate
speed myocardial relaxation

= longer stronger contraction = better ventricular emptying= more space to "fill" with incoming blood flow= increased stroke volume

Front 12

This drug is sometimes used as an adjunct to diuresis when CHF results from HCM. It is a Calcium channel blocker that has a slowing effect on the sinus node.

Back 12

Diltiazem

Front 13

These drugs are beta-blockers. They slow heart rate and decrease dynamic outflow tract obstruction.

Back 13

Propranolol
atenolol

Front 14

____ are vasodilators that have far-reaching neuroendocrine effects.

Back 14

ACE inhibitors

Front 15

If a cat has subclinical HCM, do you treat it?

Back 15

if it shows left atrial dilation on echo

Front 16

Most patients with restrictive cardiomyopathy have normal ventricular wall thickness and normal systolic ventricular performance. So what is abnormal that is causing diastolic dysfunction?

Back 16

left atrial or biatrial dilation

Front 17

Why don't cats get DCM much anymore?

Back 17

We know that taurine is an essential AA for cats-- which was causing the high incidence of DCM along with many other problems.

Front 18

Cats often develop "flow murmurs" in the absence of structural cardiac disease, but if you hear ____ then the patient likely has myocardial disease.

Back 18

a gallop

Front 19

Cats with myocardial disease are predisposed to thromboemboli. Will heparin help treat this complicaiton?

Back 19

- may be used 24-72 hours post embolization, may prevent the thrombus from enlarging, but does NOT have a thrombolytic effect

Front 20

Hyperthyroidism is a high cardiac output state that can cause hypertrophy of the heart. Is this reversible?

Back 20

yes

Front 21

What is the main difference between hypertrophic cardiomyopathy and restrictive cardiomyopathy?

Back 21

restrictive-- there is no hypertrophy

both--diastolic dysfunction

Front 22

Concerning canine dilated cardiomyopathy: Loss of a critical mass of cardiomyoctes and maladaptive hypertrophic responses can result in irreversible _____ myocardial dysfunction.

Back 22

systolic

Front 23

_____ occurs when the walls of the heart appear thin relative to chamber size, but the absolute heart weight has increased.

Back 23

eccentric hypertrophy

Front 24

What breeds of dogs are more commonly diagnosed with DCM?

Back 24

large-giant breeds
cocker spaniels
dalmations

Front 25

Dogs with DCM generally have a ___ sound, related to reduced ventricular compliance and high atrial pressures

Back 25

gallop (s3)

Front 26

You are examining a dog's ECG. It has a higher than normal R wave and a wider than normal P wave. What might this indicate?

Back 26

Tall R--> LV enlargement
wide P--> LA enlargment

Front 27

What rhythm is most commonly demonstarted in dogs with DCM?

Back 27

atrial fibrillation

Front 28

T/F: on Echo, low fractional shortening in the absence of ventricular dilation does NOT constitue a diagnosis of DCM.

Back 28

true

Front 29

Canine DCM:
These breeds usually present with VTAC.

These breeds usually develop ascites and Atrial fibrillation.

This is the only SMALL breed that commonly gets DCM.

Back 29

VTac: dobies, boxers

Ascites + AF: Giants

Small: cocker

Front 30

measurement of N-terminal pro-B-type natriuretic peptide may aid in identifying dogs with ____.

Back 30

occult DCM

Front 31

What is the conventional therapy for congestive heart failure due to SYSTOLIC dysfunction?

Back 31

1- furosemide
2- ACE inhibitor
3- Pimobendan

Front 32

What is Pimobendan?

Back 32

phospodiesterase inhibitor
positive ionotrope
vasodilator

Front 33

What can you manage VTac with?
elevated HR?
refractory edema?

Back 33

IV lidocaine
beta-blocker
furosemide/nitroprusside

Front 34

How long does it take to see a response to taurine supplementation?

Back 34

3-4 months

Front 35

This is an inherited disorder that is characterized by fatty or fibrofatty replacement of the right and sometimes left ventricular myocardium.

Back 35

Arrhythmogenic right ventricular cardiomyopathy

(boxer dog cardiomyopathy)

Front 36

How do you diagnose ARVC?

Back 36

DNA swab test to WSU

- genetic history
- left apical systolic murmur
- VTac
- syncope
-PM: fibrofatty infiltrated myocardium

Front 37

>100 PVCs over 24 hours in an Adult Boxer is strongly suggestive of ____.

Back 37

Arrhythmogenic Right Ventricular Cardiomyopathy

Front 38

If you treat syncope that you think is due to VTac (and is really due to neurocardiogenic bradycardia) what will happen?

Back 38

syncope gets worse

Front 39

T/F:

L-carnitine
Fish Oil Omega-3s
Sotalol
mexiletine + atenolol

are all treatment options for ARVC.

Back 39

true

Front 40

English Springer Spaniels and Old English Sheepdogs are commonly affected by ____, noted on the ECG as an escape complex with no P wave.

Back 40

Atrioventricular myopathy
(silent atria, persistent atrial standstill)

Front 41

You do a necropsy on an Old English Sheepdog that had progressive severe muscle atrophy. You examine the heart and find dilated, thin, almost transparent atria with no visible muscle. What is your tentative diagnosis?

Back 41

Atrioventricular myopathy

Front 42

Chagas, Parvo, and Lyme can cause what myocardial disease?

Back 42

myocarditis

*also distemper, systemic fungal infections, bartonella

Front 43

_____ is, by far, the most commonly encountered acquired cardiac disease in adult dogs, and the condition is caused by a progressive myxomatous degeneration of AV valves.

Back 43

Degenerative mitral valve disease

Front 44

What breed commonly gets Chronic Degenerative Valvular disease?

Back 44

Cavalier King Charles Spaniels

*Male- slightly more common

Front 45

What are the 6 structures of the mitral valve apparatus?

Back 45

valve leaflets
annulus fibrosus
chordae tendinae
papillary muscles
left atrium
left ventricular muscle

Front 46

What 2 factors determine the severity and volume of regurgitation of the mitral valve?

Back 46

Regurgitation orifice area

Left ventricular or left atrial pressure gradient

Front 47

What physical findings can be directly correlated to the severity of the regurgitation/ NYHA classes of heart failure?

Back 47

murmur intensity
heart size

Front 48

In dogs, determining whether the main underlying problem is cardiac or respiratory in origin can be difficult. What are some differences?

Back 48

Cardiac:
BCS thin,
HR rapid,
Rhythm regular,
Murmur loud

Respiratory:
BCS obese,
HR normal,
Rhythm respiratory arrhythmia,
Murmur soft

Front 49

Diagnostic evaluation of Mitral regurgitation can be done with Radiographs. What are some of the signs you might see?

Back 49

enlarged left auricle: bulge from 1-3
enlarged cardiac silhouette
obtuse angle/ dorsal deviation of the mainstem bronchi
LA: dense mass superimposed

Front 50

T/F: Echo is essential to diagnosis of Chronic Degenerative Valvular Disease in Dogs.

Back 50

false

*thoracic rads are essential, echo can be helpful if radiographic signs are not obvious

Front 51

T/F: ECG of dogs with Mitral valve regurgitation is generally Normal.

Back 51

True

Front 52

What does FONSE stand for and when is it used?

Back 52

Furosemide
Oxygen
Nitroglycerine
Sedation
Enalapril

standard of care of ACUTE heart failure management

Front 53

Why is the aggressive use of furosemide in the presence of cardiac tamponage but absence of pulmonary edema contraindicated?

Back 53

patients with LA rupture resulting in cardiac tamponade often require IV fluid therapy due to circulatory collapse

Front 54

____ is the most common degenerative valve abnormality identified in older horses.

Back 54

aortic valve insufficiency

Front 55

What is the difference between endocarditis, vegetative endocarditis, and infective endocarditis?

Back 55

endocarditis: inflammation of hte endocardial surface

vegetative:platelets, fibrin, microorganisms, inflammatory cells adhere to heart valves, septal defects, chordae tendinae, mural endocardium

infective:microbial infection of the endocardial surface

Front 56

What are the most common reported isolates from infective endocarditis?

Back 56

Staphy, Strep, E. coli, Corynebact, Bartonella, (others: AB resistant: Pseudomonas, proteus)

Front 57

As wall stress___ there is a ___ in myocardial oxygen demand.

Back 57

stress increases
O2 demand increases

Front 58

Law of Laplace explains _____. This is represented by the equation:

____ = P x r/h

Back 58

wall stress

Front 59

T/F: embolization of the spleen can be catastrophic.

Back 59

False

clinically silent
* kidneys, CNS are catastrophic

Front 60

You have a critically ill puppy you are treating for parvo. He has been receiving IV fluids for 3 days, and just as his fever has diminished and you think you can send puppy home-- he presents with a sudden fever spike and a new cardiac murmur. What do you think is going on?

Back 60

Acute infective endocarditis-- get the catheter Ouuuuut

Front 61

What do you expect the pulse to feel like in Aortic valve insufficiency?

Back 61

bounding/ hyperkinetic

Front 62

Of the tests listed, which is absolutely diagnostic for acute infective endocarditis:

thoracic rads
ECG
Echo
Blood culture
CBC/Chem/UA

Back 62

blood cultures

Front 63

What is the "modified Duke Criteria"?

Back 63

major and minor criteria used to diagnose infective endocarditis

Major: 2 + blood cultures, Echo evidence of oscillating mass

Front 64

What is different about the development of endocarditis in ruminants versus other species?

Back 64

Ruminants tend to develop lesions of the RIGHT side of the heart (tricuspid and pulmonary) whereas other species always develop lesions on the left.

*corynebact is the most common

Front 65

What are the 2 forms of pericardial disease and which is most common?

Back 65

effusive* common
constrictive

Front 66

Most pericaridal effusinos in cats are due to ____ where as in dogs they are primary resulting from the presence of neoplasia or idiopathic pericarditis.

Back 66

CHF

Front 67

____ is present when intrapericardial pressures and diastolic pressures of the ventricles are equal

Back 67

tamponade

Front 68

What are the clinical signs of tamponade resulting from?

Back 68

low cardiac output and systmic (right) congestion

Front 69

What is the rhythm of tamponade usually?

Back 69

tachycardia

*may be muffled by the pericardial effusion

Front 70

What are the characteristic changes in the pulse associated with tamponade?

Back 70

weakening of the arterial pulse with respiration--> pulsus paradoxus

jugular distension

Front 71

Physical findings of tachycardia, muffled heart sounds, jugular vein distension, and ascites are HIGHLY suggestive of ____.

Back 71

cardiac tamponade

Front 72

T/F: pulmonary edema usualy accompanies cardiac tamponade.

Back 72

false

Front 73

___ is the diagnostic test for cases of cardiac tamponade for its prognostic and diagnostic information.

Back 73

echo

Front 74

almost all Pericardial effusions in dogs are ___.

Back 74

hemorrhagic

Front 75

Treatment of pericardial effusion with diuretics is ineffective and potentially harmful. What should you do instead?

Back 75

pericardiocentesis

Front 76

Normal pulmonary circulation is ___-flow, ___-resistance circuit capable of accomodating the entire right ventricular output at ____ the pressure of systemic circulation.

Back 76

high flow
low resistance

1/5 systemic pressure

Front 77

Secondary Pulmonary Hypertension develops as a result of: (3 things)

Back 77

impedance of pulmonary venous drainage
pulmonary overcirculation
increased pulmonary vascular resistance

Front 78

Pulmonary Hypertension imposes a ____ load on the ____ ventricle which hypertrophies with ______ hypertrophy.

Back 78

pressure load
right ventricle
concentric hypertrophy

Front 79

You are presented with a dog that has respiratory distress and right apical murmur. What should you suspect?

Back 79

Pulmonary Hypertension

Front 80

How could you determine the velocity of a tricuspid regurgitant jet?

Back 80

modified Bernoulli equation

delta P = 4Vsquared

where delta p is the change in pressure from the right atrium to the right ventricle

Front 81

What are Phosphodiesterase-V inhibitors used to treat?

Back 81

Pulmonary Arterial Hypertension

- great distribution of PDE-V in the lung tissue

Front 82

In pulmonary hypertensive cases that also have left heart disease, what are your treatment options?

Back 82

reduce afterload, increase contractility
reduce afterload:
nitroprusside
ACE-inhibitors
hydralazine
amlodipine

positive ionotrope:
Pimobendan

Front 83

Pulmonary hypertension due to lung disease or hypoxemia can be treated with...

Back 83

ambulatory oxygen
+
prednisone
bronchodilators
PDEinhibitors

Front 84

What is the general pathogenesis of Cor Pulmonale in Ruminants?

Back 84

high altitude hypoxia leads to pulmonary vasoconstriction which causes Right Heart hypertrophy, dilation and eventually CHF

Front 85

What would cause Cor pulmonale in the horse?

Back 85

Chronic COPD

Front 86

T/F: The # of circulating microfilaria in the peripheral blood correlate well with the number of adult heartworms and therefore can be used to determine the severity of infection.

Back 86

FALSE

Front 87

What does the ELISA Heartworm test detect?

Back 87

circulating heartworm antigen shed form the cuticle of female worms (therefore infections with all male worms may produce a false negative)

*high sensitivity and specificity

Front 88

What view is best view to evaluate the caudal lobar pulmonary vessels for heartworms?

Back 88

D/V

Front 89

If you suspect the caval syndrome what diagnostics should you run?

Back 89

PCV- anemia
UA- HGBuria

* do NOT treat with Melarsomine: a HW extraction is required

Front 90

What are the differences in:
circulatory failure
heart failure
myocardial failure
Congestive heart failure

Back 90

Circulatory Failure- delivery of O2 is insufficient ( can be d/t many different things)

Heart Failure- injured heart = inability to pump enough blood for metabolic needs and BV pressures

Myocardial failure=defect in contractility

Congestive Heart Failure= abnormal heart function results in congestion and edema

Front 91

*increased blood volume
*hypoproteinemia
*azotemia
*hyponatremia w/ severe CHF
*Effusion

these are systemic alterations that may be associated with ___.

Back 91

heart failure

Front 92

What is the difference in the presentation of patients with acute versus chronic heart failure?

Back 92

acute: CS associated with Low Cardiac output

chronic: CS associated with Congestion

Front 93

What are the determinants of Cardiac Output?

Back 93

Preload
Afterload
Heart rate
Contractility
Synergy

Front 94

Increased diastolic wall stress stimulates ____ hypertrophy while increased systolic wall stress stimulates _____ hypertrophy.

Back 94

diastolic: eccentric

systolic: concentric

Front 95

the rate of myocardial relaxation is an active, energy requireing rocess that depends on the rate at which systolic ______ ions are re-sequestered by the ____.

Back 95

ca++ : sarcoplasmic reticulum

Front 96

in chronic heart conditions such as volume overload, the heart cannot keep up with the demands. hypoxia signals a neurohormonal reponse causing ______________ and __________ which increases afterload and preoload. However this only exacerbates the condition.

Back 96

peripheral vasoconstriction and fluid retention

Front 97

concerning chronic pressure overloads: If concentric hypertrophy returns wall stress and end systolic volume to normal, why is there still a problem?

Back 97

capilarry density and myocardial perfusion does not increase in proportion to the increase in muscle mass. = myocardial hypoxia = arrhythmias and sudden death

Front 98

What is the relationship between backward failure, forward failure, and the modern concept of heart failure?

Back 98

the modern concept of heart failure incorporates both concepts of backward and forward failure.

forward: inadequate tissue perfursion = RAAS

backward: ventricular failure causes back up of blood

Front 99

Frank-Starling Mechanism operates mainly to equalize outputs betwen _____.

Back 99

the ventricles

Front 100

Cardiac Response to the SNS results in increasd ___ and ___.

Back 100

heart rate and contractility

Front 101

What is ANP? Where does it come from and what does it do?

Back 101

Atrial Natriuretic Peptide

Released from the atria when there is distension results in increased Na+ and water excretion by the kidney and vasodilates.

Front 102

Plasma ___ levles often correlate well with the severity of heart failure because the SNS is activated when CO is depressed.

Back 102

Norepinephrine

Front 103

drugs to treat diastolic heart failure aime to improve____ while drugs that treate systolic heart failure aim to improve ____ and decrease ____.

Back 103

diastolic--- improve ventricular filling

systolic-- improve contractiliy and decrease congestion

Front 104

Digitalis is a positive ionotrope. How does it work?

Back 104

makes more Ca++ available

*narrow MOS, toxicity = GI, arrhythmias

Front 105

What drug is known as an "Inodilator"?

Back 105

Pimobendan

Front 106

Pimobendan is particularly effective for use in what breed of dogs?

Back 106

Dobies

* often used in conjunction with furosemide, ACE inhibitors (and possibly even digoxin, spironolactone, or beta blockers)

Front 107

Name 2 bipyridines. How do they work?

Back 107

Amrinone, Milrinone

* increase Ca++ availability by increasing cAMP by phosphodiesterase inhibition and other mechanisms

Front 108

What kind of diuretic is furosemide?

Back 108

loop

Front 109

how do thiazide diuretics (hydrochlorothiiazide, chlorothiazide) work?

Back 109

inhibit the reabsorption of sodium and chloride in the distal tubule

Front 110

What kind of diuretic is spironolactone?

Back 110

potassium sparing

Front 111

systemic arterial vasodilators are used to reduce _____ and increase ____.

Back 111

reduce myocardial oxygen consumption (decreasing the volume load decreases the wall stress)

increase cardiac output

*they also reduce regurgitant volume and increase forward output

Front 112

Whats the main difference between nitroprussied and nitroglycerin?

Back 112

nitroprusside-- arteriolar vasodilator

nitroglycerine-- venous vasodilator

Front 113

Name 3 drugs that counter the neurohormonal dysfunction associated with CHF.

Back 113

Beta-blockers (sometimes)
Digoxin (increases PS tone and decreases adrenergic tone)
spironolactone (aldosterone antagonist)

Front 114

Ohm's Law:

BP = ___ x ___

Back 114

blood pressure = cardiac output x systemic vascular resistance

Front 115

Enalapril has proven efficacy in dogs with heart failure resulting from ____ or ____.

Back 115

degenerative mitral valve disease

dilated cardiomyopathy

Front 116

The cardiotoxic effects of digitalis are related to the serum _____ concentration. What is usually the first sign of digoxin toxicosis?

Back 116

potassium

inappetance

Front 117

What drugs are standard management for Systolic failure? diastolic failure?

Back 117

systolic: furosemide, Ace inhibitor, pimobendan, +/- digoxin

diastolic: furosemide, enalapril?

Front 118

T/F: most dogs with HF are tachycardic.

Back 118

true

Front 119

Large dogs usually get ____ while small elderly breeds usually get ___.

Back 119

large-- DCM

small-- degenerative mitral valve disease

Front 120

If mitral valve disease is severe enough to cause HF, what will you hear on auscultation?

Back 120

loud murmur

Front 121

What is the urgent therapy protocol for Cats in Acute CHF?

Back 121

Furosemide
+/- nitroglycerine

ECHO!!!

Front 122

When herat failure is the cuase of dyspnea, the response to diuretic therapy is usually ___ and ____. Failure to respond to empirical therapy for HF should prompt reevaluation of the diagnosis.

Back 122

rapid and dramatic

Front 123

Arrhythmias resulting from disorders of impulse formation include: (4)

Back 123

depressed normal automatacity
enhanced normal automatacity
abnormal automatacity (ectopic tac)
triggered activity (preceded by normal cardiac depolarization)

Front 124

concerning arrhythmias due to disorders of impulse conduction: blockages of impulse conduction commonly result in ____ while rerouting of impulses usually results in _____.

Back 124

block: bradycardia

reroute: tachycardia

Front 125

Successful treatment of arrhythmias requires:

Back 125

ACCURATE ECG diagnosis


*consideration of underlying mechanisms, heart disease, prevent progression

Front 126

T/F: administration of antiarrhythmics has the possibility to induce more dangerous arrhythmias.

Back 126

true

Front 127

To be successful, antiarrhythmics must selectively target the abnormal cells without supressing normal cardiac pacemaker cells in the sinus node. How do they do this?

Back 127

- suppress abnormal automatacity
- lower RMP
- raising the threshold potential of diseased cells

Front 128

Increases in adrenergic stimulation, temperature and hypoxia have what effect on diastolic depolarization?

Back 128

increased

Front 129

What is the manifestation of Triggered activity arrhthmias?

Back 129

abnormal calcium fluxes or imbalanced autonomic tone =

Premature beats or ectopic tachycardias

Front 130

__________ is one of the most common and importatn causes of tachyarrhythmias.

Back 130

re-entry

Front 131

What classes of antiarrhythmics primarily affect working myocytes?
conduction system?

Back 131

working myocytes: I & III

conduction: II & IV

Front 132

arrhythmias arrising from ectopic myocardial locations should be treated with what class of antiarrhythmics?

Back 132

class 1 or 3

Front 133

Class 1 Antiarrhytmics are ____ blockers. They act to decrease the __________________.

Back 133

1: Sodium Channel Blockers

decrease slope of phase 4

Front 134

Class 1a are _____. (general class)
Class 1c are_____.

Back 134

1a: anticholinergic

1c: beta-blockers

Front 135

Propranolol, Atenolol, and esmolol are class II antiarrhythmics. Their mechanism of action is____.

Back 135

beta-blockade

Front 136

What class of antiarrhythmic is sotalol?

Back 136

Class III: potassium channel blockers


*also has class 2 properties

Front 137

What is unique about amiodarone? Does this add to or distract from its toxicity potential?

Back 137

it is an antiarrhythmic that has class 1,2,3 and 4 properties.

Lots of Toxicities-- indicated for use in life threatening ventricular arrhytmias

Front 138

T/F: potassium channel blockers (class 3 antiarrhytmics) have little effect on ABNORMAL automaticity.

Back 138

true

Front 139

Calcium channel blockers are class ___ antiarrhythmics. They interrupt reentry pathways by increasing ____ refractoriness.

Back 139

CCB: Class 4

increase AV node refractoriness

Front 140

If you could choose between quinidine or procainamide, which would you use in a small animal setting if there were no specific indications for the use of one over the other?

Back 140

procainamide has less side effects

Front 141

Disopyramide
sotalol
verapamil

All of these have something in common.

Back 141

negative ionotropes

Front 142

What would you use to treat bradyarrhythmia?

Back 142

atropine, glycopyrrolate (PSM)

isoproterenol, theophylline (SM)

Front 143

When APCs are observed in patients with CHF, ____ treatment is indicated as APCs may be a precursor for ____.

Back 143

digitaliis

atrial fibrillation

Front 144

What is a vagal maneuver?
When is it used?

Back 144

ocular or carotid sinus compression can intiate a reflex that results in vagal discharge

may terminate an SVT or induce AV block in pathologic SVT

Front 145

describe an ideal candidate for DC cardioversion.

Back 145

AF with structurally normal hearts

*generally occurs in giant breeds

Front 146

Equine hearts have many weird but normal variations. Name 2

Back 146

Sinus arrhytmia
wandering pacemaker
first degree AV block
sinus arrest
SA block

Front 147

What population of horses tends to develop idiopathic atrial fibrillation?

Back 147

young horses-- sudden unexplained loss of stamina

-- if no heart disease: conversion of AF to sinus rhythm is attempted with quinidine

Front 148

T/F: Most arrhythmias in ruminants are due to GI disturbances (bloat, vagal indigestion, DA) electrolyte disorder, acid base disturbances.

Back 148

true

Front 149

Hypocalcemia in cows results in a ________ QT interval, where as hypercalcemia is characterized by a ____ QT interval.

Back 149

hypocalcemia: prolonged QT
(initial bradycardia followed by an INCREASED HR)

hypercalcemia: shortened QT (bradycardia)