Equine Med Surg Ii Test 2

Front 1

List the differences between the Gastric Squamous and Glandular mucosa.

Back 1

Squamous: no secretion and absorption, highly susceptible to peptic injury, large proliferative and healing capacity
Glandular: highly resistant to injury, mucus-bicarb layer, NO and PGE in mucosa

Front 2

T/F: milk and roughage both decrease gastric acidity.

Back 2

True

Front 3

T/F: carbs stimulate gastric acid secretion.

Back 3

True

Front 4

EGUS: Squamous lesions are the result of _________________, where as glandular lesions are the result of _________________.

Back 4

squamous lesions are due to increased exposure to acid.

glandular lesions are due to impaired mucosal protection.

Front 5

Where do lesions form in the equine stomach when feed is deprived intermittently?

Back 5

Squamous.

Front 6

T/F: stall confinement does not cause ulcers if horses have free choice hay available at all times.

Back 6

False. any stress can result in ulcers even if feed is available.

(30% of stalled horses, 60% of show horses, 90% of race horses-half of which are moderate/severe)

Front 7

Why do NSAID induced ulcers occur in the glandular mucosa?

Back 7

because they alter blood flow (the protective mechanism of this region)

Front 8

T/F: helicobacter is not an important factor in EGUS.

Back 8

true.

Front 9

Why might you want to do gastroscopy for a simple ulcer?

Back 9

Just treatment with gastroguard is expensive (35$/d for 28d)-->$1000

Gastroscopy 300-500$

Front 10

concerning EGUS, in general...Adults get ____ lesions whereas foals get _____ lesions.

Back 10

Adults: linear lesions
foals: punctate lesions (also usually get squamous lesions)

Front 11

T/F: gastric desquamation is normal in the foal for the first 5 days.

Back 11

false: only first 1-2days

Front 12

If omeprazole is a permanent inhibitor of the proton pump in cells why do you have to dose it daily?

Back 12

Permanent proton pump inhibitor of CELLS- the Cells turnover every 24hours.

Front 13

T/F: Cimetidine is effective in racehorses.

Back 13

false

Front 14

When might you want to use sucralfate?

Back 14

binds to ulcerated GLANDULAR mucosa

(does NOT work for squamous lesions)

Front 15

What is your top differential:
4mo old female foal
chronic weight loss
intermittent colic
dependent edema
fever
hypoproteinemia
thickened intestine

Back 15

Proliferative enteropathy: Lawsonia intracellularis

(Rx: macrolides, erythromycin)

Front 16

describe a classic case of DPJ.

Back 16

acute colic followed by diminishing abdominal discomfort
lots of reflux
tachycardia
FEVER + Hemorrhagic reflux

Front 17

T/F: surgery is contraindicated in cases of DPJ

Back 17

false

surgery is a good option especiall if you cannot rule out obstruction

Front 18

What tests can be done to help diagnose IBD?

Back 18

Glucose absorption test
Biopsy

Front 19

Why would you choose a D-xylose test or a glucose test? (what is the difference in what they tell you?)

Back 19

D-xylose is more precise value- but it is hard to find labs to run them

Glucose gives trends over time which is better than a precise value- and all labs run it.

Front 20

Name 3 causes of acute colitis.

Back 20

salmonella
c. difficile
c. perfringens
neorickettsia risticii
parasitic (rare)
antimicrovial associated
NSAID tox

Front 21

What is the most common cause of infectious colitis in adult horses?

Back 21

Salmonella
* no host adapted salmonella species in horses so no chonic carriers for life

Front 22

Concerning the pathophysiology of salmonella:
___ causes active fluid secretion
___ causes cellular damage
____ causes activation of inflammatory response.

Back 22

enterotoxin: fluid secretion
cytotoxin: cellular damage
LPS: inflammatory response

Front 23

What is the common name of Equine monocytic ehrlichiosis?

Back 23

Potomac Horse fever

*neorickettsia risticii: obligate intracellular

Front 24

What is the most common sequelae of PHF?

Back 24

laminitis--> death

Front 25

Describe a classic case of PHF.

Back 25

2-3d post infx: low grade fever usually missed

10d post infx: fever up to 105, diarrhea, increased IgG (so look for falling titers on pairs)

Front 26

T/F: Equines can develop into clostridium carriers.

Back 26

True
*asymptomatic

Front 27

What is responsible for causing disease associated with Clostridium enterocolitis?

Back 27

Toxin A: causes intestinal inflammation leading to fluid secretion and injury of cells
Toxin B: injures of Kills intestinal cells
Enzymes: damage intestinal cells and breakdown intestinal wall

Front 28

How do you diagnose C. difficile?

Back 28

ELISA for Toxin A and B

Front 29

T/F: C. perfringens can kill a foal without causing diarrhea.

Back 29

True.

*per Dr. McKenzie's notes: Some cases progress so quickly that diarrhea does not occur

Front 30

Where wouuld your window be for ultrasounding the right dorsal colon?

Back 30

Right side
11th-13th ICS
ventral to lung

Front 31

___% of plasma colloid osmotic pressure is due to protein. ____% of protein is albumin.

Back 31

66% protein
75% of that protein is albumin

Front 32

What is the Reflection Coefficient (Rc)?

Back 32

a factor of permeability

Rc 1: 100% resistant
Rc 0: 0 resistance (anything can pass)

Front 33

What are the PE findings that correlate with 7-9% dehydration?

Back 33

skin tent 3-5 seconds
sticky MM
2-4 CRT
50-60 PCV
7.5-8.5 TP

Front 34

What is the difference between fluids and rates for foals and horses (general)?

Back 34

Foals get double rate (100ml/kg/d)
and do not handle lactate well (so avoid LRS)

Front 35

What factors affect Total body water?

Back 35

body condition: lower BCS= higher water
high muscle density= higher Body water
pregnancy= higher body water
(decrease: obesity, high altitude)

Front 36

How do you determine the following?
Replacement fluids:
Losses:
Maintenance:

Back 36

Replacement: %dehydration x BW(kg) =L
Losses: estimate x 2
Maintenance: 50 ml/kg/d

Front 37

What is a standard fluid rate?
Shock rate?

Back 37

standard: 10-20 ml/kg/hour (5-10L/500kg)
shock: 20-45 ml/ kg/ hour (10-22.5L/500kg)

Front 38

Urine production should be...?

Back 38

4-8 ml/kg/hr in foals

~ 1ml/kg/hr in adults

>/= 66% of input

Front 39

What is the definition of Mean Arterial pressure?

Back 39

average arterial pressure during a single cardiac cycle

Front 40

What factors cause hypotension?

Back 40

hypovolemia
SIRS
Acute hemorrhage
Sepsis
Cardiac failure
Anaphylaxis

Front 41

What are the pros and cons of direct and indirect measurement of arterial pressure?

Back 41

direct: much more sensitive, but high risk of thrombosis the longer it is iin

indirect: less sensitive, but noninvasive

Front 42

When should you intervene to adjust the blood pressure?

Back 42

MAP< 60mmHg

Front 43

What are the causes of edema?

Back 43

volume overload
vasculitis
renal dysfunction
hypoproteinemia

Front 44

what can cause vasculitis?

Back 44

fever
endotoxemia
reperfusion injury
acidemia

*CS: petechia

Front 45

how can you monitor blood protein without running chem's constantly?

Back 45

refractometer

Front 46

What makes up plasma protein?

Back 46

albumin 3g/dl
globulins 3 g/dl
fibrinogen 300 mg/dl

* complement, antibodies, energy source

Front 47

At what point should you intervene to adjust the TP?

Back 47

<4g/dl
albumin < 2g/dl
edema
suspect vasculitis

Front 48

What is the calculation for determining plasma replacement?

Back 48

Replacement amount (L) = {(desired [6g/dl]-measured)(0.05 * BW)}/ Donor plasma concentration

* short cut: increase 1g/dl for every 4L plasma admin (for 500kg horse)

Front 49

How would you monitor a plasma transfusion?

Back 49

0.5ml/kg for 30min
monitor heart rate, rr, T every 5 min

gradually increase to 40 ml.kg.hr

Front 50

What is an alternative to plasma?

Back 50

hetastarch

Front 51

What are the electrolytes in bw%?

Back 51

bicarb 50%
Na 30%
K 40%
Ca 30%

Front 52

How do you calculate the bicarb deficit?

Back 52

Deficit (mEQ)= (normal-patient) (50%)(BW kg)

Normal is 25 mEq
1g NaHCO3= 12 mEq

Front 53

What % is isotonic?

Back 53

1.3%

*usually just put 1 500ml 5% bottle in 1 L of distilled water

Front 54

How would you administer a bicarb fluid?

Back 54

1/2 over 2-4 hours

If improved: remaining over 12 hours
if not: remainder over 3-4 hours

Front 55

what's a quick easy way to admin oral bicarb?

Potassium?

Back 55

(4 oz) 1/4 box arm & hammer to 5 gallons water

(4 oz) 1/3 box lite salt to 5 gallons water

Front 56

What is the dental formula of a horse with all of its teeth?

Back 56

3143/3143

44 teeth- full mouth

Front 57

What ages do the incisors erupt?

Back 57

2.5, 3.5, 4.5 (I1-2-3, resp)

Front 58

What are the 3 phases of chewing?

Back 58

opening
closing
poswer stroke

Front 59

Where do the upper and lower arcades tend to develop points?

Back 59

upper: buccal
lower: lingual

Front 60

T/F: hay causes more lateral excursion of the chewing pattern than grass.

Back 60

false

grass is more

*grain promotes more up and down motion

Front 61

What are the consequences of overlong incisors?

Back 61

inefficient mastication--> weight loss
TMJ pain

Front 62

What will a mouth look like that preferentially uses one side?

Back 62

diagonal bite

Front 63

Why is it important to take the least amount of crown possible?

Back 63

promote longevity of arcade
keep them from being sore

Front 64

What is a bit seat?

Back 64

rolled rostral side of upper and lower 6s

Front 65

T/F: mandible position changes with head position.

Back 65

true

*raised head: parrot mouth, lowered head: sow mouth

Front 66

What teeth are in the Maxillary sinuses?

Back 66

08s and 09s- rostral sinus
10s and 11s - caudal sinus

Front 67

Maxillary teeth genearlly have __ roots (some have __).

Mandibular teeth generally have ___ roots with the exception of the 11's which have ___.

Back 67

Maxillary teeth: 3 roots (some have 4)

Madibular teeth: 2 roots (11s have 3)

Front 68

What are indications for tooth extraction?

Back 68

teeth with apical infection
fractured teeth
severe periodontal disease (diastema)

Front 69

anachoresis is a type of ____ infection of the tooth.

Back 69

primary apical infection: d/t bacteremia

*others are open pulp horn d/t excessive pulp reduction or caries

Front 70

what are the options for cheek tooth removal?

Back 70

oral extraction
repulsion
buccotomy

Front 71

____: inadequate tissue oxygenation most often due to decreased tissue perfusion.

(hypovolemia + hypoxia)

Back 71

shock

Front 72

____: usually results from bacteremia or endotoxemia. triggers cascade of mediators resulting in CV changes.

(hypovolemia, hypoxia, and bacteria w/ associated toxins)

Back 72

septic shock

Front 73

Common causes of septic shock?

Back 73

enterocolitis
metritis
pleuropneumonia
clostridial or staph infections
neonatal septicemia

Front 74

____: systemic response associated with release of vasoactive and inflammatory mediators that cause shock.... changes in vascular tone, vascular leakage, and coagulopathies

Back 74

systemic inflammatory response syndrome (SIRS)

Front 75

What is MODS?

Back 75

Multiple Organ dysfunction syndrome

* spetic shock or SIRS that causes dysfunction of one or more organs such that this becomes clinically evident: Renal, intestinal, lung, coagulopathies, feet

Front 76

What is going on with SIRS and Septic Shock-- when they have hypotension and maldistribution of blood flow?

Back 76

hyperdynamic phase of shock-- treatment is most effective during this time

Front 77

What are the clinical signs of the late stages of shock?

Back 77

Cold extremities
weak peripheral pulse
dark MM
slow CRT
diminished mental alertness
petechiation
decreased or absent urine production

Front 78

Insect hypersensitivity is due to ____ antigens.

Back 78

salivary

Front 79

Insect hypersensitivity:
immediate reaction is due to ___
late reaction is due to ____ and ____.

Back 79

immediate: IgE
Late: IgE and CMI

Front 80

What are the pruritic hypersensitivies?

Back 80

insects
atopic dermatitis
food allergy
drug reactions

Front 81

dorsal lesions over the face, pinnae, head, mane, withers and tail head are associated with dorsal feeding insects such as ___.

Back 81

culicoides

Front 82

What insect tends to feed on ventral parts of the horse?

Back 82

haematoba irritans: horn fly

Front 83

IDT and IgE specific serology can be used to confirm the diagnosis and determine ____.

Back 83

allergens to be included in allergen specific immunotherapy

Front 84

what time range for IDT reactions is abnormal?

Back 84

24-48 hours

Front 85

T/F: fatty acids should not be administered with antihistamines and glucocorticoids because they have an antagonistic effect.

Back 85

false

they have a syndergistic effect

Front 86

how long should you administer antihistamines before evaluating response?

Back 86

2 weeks

Front 87

ASIT- what is it and how long before you see a response?

Back 87

Allergen specific immunotherapy

up to 9 months

Front 88

Weird clinical sign associated with atopic dermatitis in horses...

Back 88

head tossing... and laminitis

Front 89

What is the most common clinical signs of food allergy?

Back 89

non-seasonal pruritis and urticaria

Front 90

describe a diet trial for food allergy in horses.

Back 90

4-6 weeks of avoidance

challenge adding back 1 item every 5-7d

Front 91

this disease is an autoimmune skin disease associated with production of antibodies against surface proteins of keratinocytes.

Back 91

pemphigus foliaceus

Front 92

Most common clinical presentation of skin for pemphigus foliaceus?

Back 92

edema and crusting

*can localize on the coronary band

Front 93

What are the differentials for pemphigus?

Back 93

dermatophytosis
dermatophilosis
systemic granulomatous disease
primary keratinization disorder

Front 94

Most cases are dermatophytosis are seen during what seasons?

Back 94

fall winter

Front 95

What are the most common species identified in cases of dermatophytosis in horses?

Back 95

trichophyton and microsporum

*zoonotic and contagious

Front 96

Is treatment required for dermatophytosis?

Back 96

usually self-limiting: 1-3 months

Front 97

How do you diagnose dermatophytosis?

Back 97

trichogram
fungal culture
hitopath

Front 98

What are the topical and systemic treatment options for dermatophytosis in horses?

Back 98

topical: eniconazole, lime sulfur, povidone iodine

systemic: griseofulvine, itraconazole

Front 99

What is the technical name for rain scald?

Back 99

dermatophilosis

Front 100

What is the key lesion for dermatophilosis? Agent?

Back 100

paint brush crust

*actinomycete- dermatophilus congolensis (gram + branching)

Front 101

what are predisposing factors for dermatophilosis?

Back 101

moisture
skin trauma
contact- environment, infected animals, fomites, insects

Front 102

T/F: dermatophilosis cannot survive in the environment more than a couple months.

Back 102

false. it can survive years

Front 103

What is the name for saddle sores or summer rash due to bacterial infection?

Back 103

saphylococcal folliculitis

*Rx: antimicrobial shampoo

systemic therapy for severe cases-- TMS

Front 104

What is azotemia?

Back 104

decreased GFR

serum CRT >/= 2 mg/dl

Front 105

Urea is produced by the hepatic metabolism of ____.

Back 105

amino acids

Front 106

What are nonrenal causes of increased BUN?

Back 106

hemorrhage into GIT
increased catabolism (muscle breakdown)
drugs (glucocorticoids, azathioprine, tetracycline)

Front 107

why do we like to measure CRT as an indicator of azotemia?

Back 107

freely permeable and distrubed throughout total body water

freely filtered at the glomerulus

not reabsorbed or metabolized by the kidney

less affected by non-renal variables

Front 108

Whats the different between BUN/CRT changes that occur in early and late renal disease?

Back 108

early: large changes in GFR= small changes in BUN/CRT

late: small changes in GFR = large changes in BUN/CRT

Front 109

T/F: magnitude of azotemia can tell you pre-renal, renal, and post-renal.

Back 109

false

Front 110

What can elevated GGT indicate in relation to the kidney?

Back 110

renal tubular epithelial injury

(primary utility: aminoglycoside toxicity dertermination)

Front 111

Types of Fluid therapy?
Hypertonic fluids:
Isotonic fluids:
Hypotonic fluids:

Back 111

hypertonic: hypertonic saline, NaHCO3
Isotonic: LRS, Normosol, 0.9%saline
Hypotonic: 0.45% saline, 2.5% dextrose, water

Front 112

What effect does alkalinzing fluid have on an acidotic hyperkalemic patient?

Back 112

correct acidosis--> drives potassium into cells

Front 113

What is the purpose of diuretic therapy in renal patients?

Back 113

increases GFR by increasing blood flow
flush out tubular casts
decreases oxygen/blood requirement--> by decreasing "work", may decrease nephrotoxicity

Front 114

What is peritoneal dialysis?

Back 114

fluids in the abdomen for absorption

*10-20 mg/kg LRS for 1 hours with 1000units heparin/ L fluid