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62 Cards in this Set
- Front
- Back
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How is acepromazine SQ (.05-.1 mg/kg) helpful with heart failure with cardiac emergencies. |
anxiolytic that dose not depress respiration alpha adrenergic blocker that decreases peripheral vascular resisitance which may also be helpful. |
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What composes reperfusion syndrome |
hyperkalemia metabolic acidosis |
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For CPR what is the # of chest compression per minuet |
80-100 |
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Where is CPR performed on smaller dogs? bigger dogs? |
lateral recumbancy dorsal recumancy |
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How is the dose changed for IT administration of drugs? |
doubling of the IV dose |
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What type of drug is atropine
What is it indicated for with CPR |
vagolytic
sinus bradycardia asystole PEA - pulseless electrical activity |
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Epinephrine is what type of drug used with CPR
TX of choice for |
adrenergic vasopressor
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What is the treatment of choice for ventricular fibrilation |
electrical defibrillation |
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What RX is an alpha 2 adrenergic reversal? |
atipamezole |
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What is a benzodiazepime reversal |
flumazenil |
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What is the opiod reversal |
naloxone |
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What are good prognostic signs after CPR |
coughing ocular reflexes rapid return of consciousness |
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What are some poor prognostic factors following CPR? |
prolonged unconsciousness absence of the oculocephalic reflex (Doll's eye) any detioration of mental neurological status |
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What is common following cardiopulmonary arrest? |
blindness often reversable |
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What are the three categories to focus on for evaluating traumatic brain injury |
level of consciousness brain stem reflexes motor activity/posture |
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What does an altered level of consciousness indicate for traumatic brain injury |
cerebral cortex or brain stem (RAS) |
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What tests help to evaluate for brain stem reflex for a patient with traumatic brain injury? |
puils - size, symmetry, and position PLR physiologic nystagums |
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Where do miotic pupils indicate a lesion |
above the brain stem leaving the oculomotor nerve and pupillary constrictor intact and unopposed from higher centers |
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Where do mydriatic pupils indicate a lesion |
brain stem lesions affecting the oculomotor nerve on the side of the injury |
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What does abscence of PLR (unilateral or bilaterally) indicate |
disruption or compression of the oculomotor nerve tracts ipsilateral to the injury. |
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Where would an injury occur that might cause ventrolateral strabismus |
oculomotor nerve dammage |
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What CN does physiologica nystagmus test |
III VIII |
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Where is a lesion is the Doll's eye reflex is absent |
brain stem |
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What do pupils of normal size that are not light responsive indicate? |
significant brain stem dysfucntion |
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What type of pupils indicate severe brainstem dysfunction |
fixed and dilated pupils |
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What is decerebrate rigidity |
extension of all four limbs and opisthonotonus |
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Where is the lesion if decerebrate rigidity is present |
rostral brain stem leiosn |
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Where is the lesion if decerebellate rigidity is present |
cerebellar lesion |
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What is the term for a dog with Opisthotonus and extention of all 4 legs
where is the lesion |
Decerebrate rigidity
rostral brain stem |
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What is the term for a dog with extention of the front legs with hind limb flexion
where is the lesion |
Decerebellate rigidity
cerebellar lesion (herniation) |
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What is the Cushing response AKA |
CNS ischemic response |
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What is the Cushing Response |
compensatory mechanism that can be seen with markedly elevated ICP. |
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What occurs physciologically with the Cushing's response |
- Increased intracranial hypertension - decreases cerebral blood flow - detected by the vasomotor center of the brain - emits a sympathetic discharge causing peripheral vasoconstriction - results in elevation in MAP to maintain cerebral perfusion pressure - baroreceptor cause a reflex bradycardia |
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What signs clinically should alert clinican to possibility of Cushing response/increased ICP |
hypertension and bradycardia |
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THese fluids replace and maintain extracellular volme |
crystalloids |
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What is oxyglobin |
hemoglobin based oxygen carriers made of polymerized bovine hemoglobin suspeneded in LRS |
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What is the buffer in LRS |
lactate |
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What is the buffer in Plasmalyte |
acetate gluconate |
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What is the buffer in Normosol R |
acetate gluconate |
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If serum potassium is in the range of:
4.0-5.0 (mEq/L) How much potassium supplementation should be added to fludis |
5 mEq/250 mls fluids |
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If serum potassium is in the range of:
3.0-3.9 (mEq/L) How much potassium supplementation should be added to fludis |
7 mEq/250 mls fluids |
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If serum potassium is in the range of:
2.5-2.9 (mEq/L) How much potassium supplementation should be added to fludis |
8 mEq/250 mls fluids |
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If serum potassium is in the range of:
< 2.5 (mEq/L) How much potassium supplementation should be added to fludis |
10 mEq/250 mls fluids |
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sticky MM with a history of vomiting/diarhea and lack of water intake is est % dehydration |
4-6% |
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Loss of skin moisture dry MM is est % dehydration |
6-8% |
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Loss of skin moisture, dry MM, and sunken eyes is est % dehydration |
8-10% |
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loss of skin moisture, dry MM, dull mentation, dull corneas, perfusion deficit present is est at % dehydration |
>12% |
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What test is used to detect and semiquantiate plasma, serum and urinary ketones? |
nitroprusside reaction |
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What is the nitroprusside reaction detecting and not reacting with? |
detects acetone and acetoacetate but does not reactio with beta hydroxybutyrate |
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Why can you still get a ketoneuria despite improvment of C/S with DKA |
delayed clearance of acetone still have ketones 3-4 days into hospilization |
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What is the most common electrolyte disturbance with DKA |
hypokalemia |
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What is the maximum rate of potassium ion administration |
0.5 mEq/kg/hr |
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How is an insulin CRI prepaired |
5U of regular insulin to a 500 ml of LRS/0.9% NaCL that provides 0.01 U/kg/hr |
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How is insulin CRI administered? |
separate IV line |
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On a CRI, what level of decline of the BG should not exceeded? |
75-100 mg/dL/hr |
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When should an insulin CRI be decreased to half the dosage (0.05 U/kg/hr)? |
when BG hits 250 mg/dL and dextrose should be added to the fluids |
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What BG range should the CRI target to acheinve? |
150-250 mg/dL |
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What is the protocol for IM insulin for DKA? |
2U regular insulin for dogs <10 kg and cats >10 kg is 0.25 U/kg
hourly injection 1 U per cat/small dog hourly injection 0.1U/kg for dogs
till BG 250 mg/dL then move to SQ insulin q 6 hours
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What is the hyperglycemia hyperosmolar syndrome? |
characterized by: - extreme dehydration - renal dysfunction - abnormal brain dysfunction - marked hyperglycemia - lack of significant ketoacidosis
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What is hyperglycemic hyperosmolar syndrome attributed to (3) |
- decreased insulin utilization and glucose transport - increased hepatic glycogenesis/glycogenolysis - impaired renal exretion of glucose |
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What are the two concepts that have been postulated as a pathophysiological causes of hyperglycemic hyperosmolar syndrome. |
1) an insulinized liver (still B cell activity) along with a peripheral diabetic state results in no ketones. 2) enhansed glucogenesis in the liver due to elevated portal vein ration of glucagon to insulin along with dehydration cause marked hyperglycemia |
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TX objectives for hyperglycemic hyperosmolar syndrome |
establishing normal hydration judicious use of insulin ample potassium supplementation - Treat as for DKA
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