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131 Cards in this Set
- Front
- Back
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What scale is body condition score measured on in a dairy cow? beef cow? horse? |
dairy cow = 1-5 beef cow = 1-9 horse = 1-9 |
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Horse TPR |
temp = 99.0 - 100.8 pulse = 32 - 44 RR = 8 - 20 |
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Cow TPR |
temp = 98.0 - 102.4 pulse = 60 - 80 RR = 18 - 28 |
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Sheep TPR |
temp = 100.9 - 103.8 pulse = 70 - 80 RR = 12 - 20 |
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Goat TPR |
temp = 101.7 - 104.5 pulse = 70 - 80 RR = 12 - 20 |
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Camelid TPR |
temp = 100.0 - 102.0 pulse = 60 - 80 RR = 12 - 20 |
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Start horse exams at the _________ Start cow exams at the __________ |
Start horse exams at the front of the animal Start cow exams at the rear of the animal |
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Where is a good place to test hydration status in large animals? |
upper eyelid |
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What lymph nodes can be palpated in horses? in cattle? |
Horses = only submandibular Cows = submandibular, pre scapular, subiliac/prefemoral, mammary (also technically parotid, medial retropharyngeal, iliofemoral, and lymph nodes of the aortic bifurcation) |
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What organs can be palpated rectally in the horse? |
bladder, uterus, ovaries, internal lymph nodes, inguinal rings, left kidney, spleen, medial cecal band, small colon, nephrosplenic ligament |
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What organs can be palpated rectally in the cow? |
bladder, uterus, ovaries, internal lymph nodes, inguinal rings, left kidney, rumen |
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What disease processes might be indicated by jugular vein distension? |
right sided heart failure pericardial effusion chronic severe pleural effusion masses within the thoracic cavity |
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If a cardiac murmur is heard, how would you determine if the murmur is systolic or diastolic? |
palpate facial artery pulse at the same time as murmur = systolic no pulse with murmur = diastolic |
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How can animal age affect your interpretation of the skin tent test for hydration? |
old animals = less elastic skin, skin tent may be falsely longer young animals = highly elastic skin, skin tent may be falsely shorter |
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What factors could cause falsely high or falsely low temperature readings? |
falsely high = exercise, marked excitement, high environmental temperature falsely low = dissension of the rectum with feces, straining, loss of tone of the anal sphincter |
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What is the best artery to palpate for pulse in the horse? in the cow? |
horse = facial artery (along the mandible) cow = coccygeal artery (also external maxillary artery and digital arteries at aortic bifurcation (rectal palpation)) |
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Which heart sounds are loudest? Which additional heart sound is commonly heard in horses? |
S1 and S2 are lowest (lub and dub) S4 is commonly heard in horses (atrial contraction) |
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increased ____ effort = upper respiratory tract dz increased ____ effort = lower respiratory tract dz |
increased inspiratory effort = upper resp increased expiratory effort = lower resp |
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How is the horse GI tract ausculted? What are normal sounds? |
4 quadrants (right and left dorsal and ventral abdomen) all 4 quadrants = continuous small intestinal sounds R side = cecal and colonic sounds every 10-20 seconds |
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How is the cow GI tract ausculted? What are normal sounds? |
rumen evaluated on the L, but ping both sides. normally 2-3 strong contractions in 2 minutes |
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what is the legal requirement for what information is included in medical documentation? |
owner, animal ID, species, breed, age, sex, color, admission and discharge dates, PE findings, diagnosis, treatment, sx and anesthesia reports, progress reports, radiographs, waivers |
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how long do you legally have to keep medical documents retrievable? |
3 years |
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How long do you have to respond to a records request? |
5 days |
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What does SOAP stand for? |
subjective, objective, assessment, plan |
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What is the 1st medical logic axiom? |
Occam's razor the simplest explanation is usually the right one |
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What is the 2nd medical logic axiom? |
common diagnoses occur commonly "when you hear hoof beats, think horses. but still look out the window" |
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What is the 3rd medical logic axiom? |
Hickam's Dictum "a patient can have as many damn diagnoses as they please" |
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What are the three mechanisms of diarrhea? |
secretory malabsorption/maldigestion exudative |
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How much of their body weight do horses drink each day? cows? neonates? |
horses (and dogs) = 4-6% cows = 7 - 10% neonates = 20-25% |
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What percentage of the animal's ECF volume enters the gut each day? How much of this water is absorbed before excretion? |
total daily amount of all fluid entering the gut roughly equally the animals ECF volume. 99% is reabsorbed |
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What part of the gut absorbs the most water? What type of cells are absorptive? |
villus cells of the jejunum and ileum |
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What is the mechanism of secretion in crypt cells? |
Na/K ATPase --> negative electric charge in the cell --> pump Cl- out into the lumen |
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What is the mechanism of absorption in villus cells? |
Na/K ATPase -> negative electric charge in cell --> Na/glucose and amino acid co-transporters, also Na/H exchange |
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What are the two mechanisms by which bacterial toxins cause secretory diarrhea? |
1. stimulate the enteric nervous system --> stimulate crypt cell division --> push off abortive apical epithelium and replace it with immature secretory crypt cells 2. stimulate adenylate cyclase --> increase cAMP --> enhanced Cl secretion |
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what are some diseases that might result in loss of areas of digestive enzyme or acid production (resulting in maldigestion)? |
gastric ulcers parasitic or microbial damage to gastric pits or villus cells liver or pancreatic disease |
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what is the #1 cause of malabsorption? |
loss of surface area |
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How can alterations in intestinal motility cause diarrhea? |
slowed transit (most common) --> poor mixing cycles increased transit --> less time for absorption |
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Which type of diarrhea is usually the most severe? |
exudative: indicates more severe tissue damage and loss of mucosal integrity. typically due to inflammatory processes |
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What are bronchovesicular lung sounds? Bronchial? vesicular? |
bronchovesicular = normal physiologic bronchial = higher airway, usually both inspiration and expiration vesicular = hear better on inspiration. harder to hear in cats and small dogs. peripheral sounds |
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What is the difference between crackles and wheezes? |
crackles = more pronounced on inspiration (due to alveoli popping open) wheezes = more pronounced on expiration (due to thickening of upper airways) |
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What might be seen on a CBC for a respiratory case workup? |
anemia (hemorrhage, coagulopathy) polycythemia (rare, due to chronic hypoxia. may indicate R-L shunt) eosinophilia (parasites, allergies) |
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When is a CT better for respiratory disease workup? When is an MRI better? |
CT for bone, preferred for the thorax MRI for soft tissues |
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What clinical signs are shared by both cardiac and respiratory diseases? What physical exam finding indicates cardiac etiology vs. respiratory? |
Both = lung sounds increased collapse or syncopal episodes cyanosis weak femoral pulses = cardiac |
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What are three ways of evaluating pulmonary function? |
arterial blood gas pulse oximetry capnography |
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what are the two most effective cough suppressants? |
butorphanol and hydrocodone (opiates!) *some people also administer maropitant citrate (NK-1 R antagonist). questionable efficacy |
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What class of drugs would be indicated for treatment of feline asthma or chronic bronchitis? |
bronchodilators (methylxanthines, beta-2 agonists) also steroids (anti-inflammatory) |
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what are the three possible causes of dyspnea? |
hypoxemia (sensed by chemoreceptors in aortic and carotid bodies) hypercapnia (central and peripheral chemoreceptors) acidemia (central and peripheral chemoreceptors) |
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Inspiratory vs. expiratory dyspnea 1. upper airway obstruction 2. polyneuropathy/neuromusuclar disease 3. parenchymal and lower airway disease 4. fixed upper airway obstructions |
1. inspiratory dyspnea 2. inspiratory dyspnea (abdominal effort) 3. expiratory dyspnea (abdominal "push") 4. inspiratory AND expiratory |
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How should dyspnea be treated? |
#1 = oxygen treat underlying condition airway obstruction = sedation CHF = diuretics feline asthma/bronchitis = steroids and bronchodilators pneumothorax/pleural effusion = thoracocentesis if respiratory arrest = intubation, maybe ventilation |
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sneezing indicates disease of what part of the respiratory tract? what disease location is indicated by reverse sneezing? |
sneezing = nasal passages/sinuses reverse sneezing = nasopharynx |
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What is the important difference between the cough reflex and the sneeze reflex? |
inspiration of air --> epiglottis and vocal folds close --> diaphragm and abdominal muscles contract --> epiglottis and vocal folds open --> (tongue pushes up against soft palate, sneeze only) --> air expelled |
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What kind of nasal discharge is seen with: inflammatory diseases? infections? nasal tumors? fungal infections? |
inflammation = serous to mucoid infectious = purulent nasal tumors = mucoid, mucopurulent, sanguineous, epistaxis fungal = common to see epistaxis |
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How would you treat these fungal infections: nasal aspergillosis nasal cryptococcus ocular or CNS involvement cats with severe CNS signs |
aspergillosis = topical anti fungal treatments (clotrimazole or enilconazole) cryptococcus = oral anti fungals (itraconazole) ocular/CNS involvement = fluconazole severe CNS signs = amphotericin B |
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What is normal water intake for an animal? How is polydipsia defined? |
water intake = 20-70 ml/kg/day polydipsia > 100ml/kg/day |
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Normal urine output? How is polyuria defined? |
urine output = 20-45 ml/kg/day polyuria > 50 ml/kg/day |
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At what point is urine considered concentrated for cats? dogs? |
Cats = USG > 1.035 Dogs = USG > 1.030 |
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USG > 1.025 is not consistent with PU/PD except in which rare case? |
syndrome of inappropriate ADH secretion excess ADH --> holding on to free water --> free water overload and concentrating too much |
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What are the 3 most common causes of primary polyuria? |
osmotic diuresis (glucose, urea, amino acids/protein) ADH deficiency (central diabetes insipidus) inability to respond to ADH (nephrogenic diabetes insipidus) |
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What are 5 metabolic disorders that might result in nephrogenic diabetes insipidus? |
hypercalcemia hyperthyroidism hyperadrenocorticism (cushings) hypokalemia hypoadrenocorticism (addison's, due to hypokalemia. less common to present with PU/PD) |
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What are two ways of distinguishing CDI vs. NDI vs. psychogenic polydipsia? |
test plasma osmolality water deprivation test (modified) |
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How does a plasma osmolarity test distinguish between diabetes insipidous and psychogenic polydipsia? |
DI = high plasma osmolarity PP = low plasma osmolarity |
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What are 7 factors affecting core body temperature? |
diurnal rhythm age ambient temperature exertion feeding/metabolic rate reproductive cycle accuracy of measurement |
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How is body heat produced? |
basal metabolic rate muscle activity fat metabolism digestion thyroxine sympathetic stimulation |
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What are two mechanisms of conserving body heat? |
autonomic stimulation (reduces peripheral circulation and causes piloerection) behavioral changes (huddling/grouping, seeking shelter) |
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What are the four main mechanisms of heat loss from a body? |
**evaporation conduction convection radiation (less important) also via: cutaneous vasodilation and behavioral changes |
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In which organs is heat primarily produced? Where is it primarily lost? |
produced in the muscles and liver lost in the skin and respiratory tract |
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What part of the brain controls body temperature? |
anterior hypothalamus |
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activation of warm-sensitive neurons --> |
vasodilation increase in RR sweating decreased activity attempt to find cooler environment |
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activation of cold-sensitive neurons --> |
vasoconstriction piloerection increased muscle activity (voluntary and shivering) postural and behavioral changes hunger |
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hypothermia occurs when the body temperature drops below_______. At this point what happens to cellular heat production? |
hypothermia occurs when the body temperature drops below 95 degrees F Rate of cellular heat production halves for each 10 degree drop in body temp |
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what is the most common cause of hypothermia in small animals? |
anesthesia |
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What are signs of hypothermia? |
low rectal temperature depressed ventilation absence of shivering decreased reflexes depressed cardiac function and decreased intravascular volume (hypoxia, academia, arrhythmias) |
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What is the mechanism of malignant hyperthermia? What exposure may incite this? |
hereditary defect in ryanodine receptor exposure to halogenated anesthetics or muscle relaxants --> excessive Ca release in muscle cells --> uncontrolled contraction and metabolism --> excessive heat production |
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To what degree does cellular O2 consumption increase with increased temperature? |
cellular O2 consumption increases 10% for every degree C increase in body temp |
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At what temperature does oxygen use exceed supply (tissue death begins)? At what temperature do temperature control mechanisms fail completely? |
> 105.8 > 107 |
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What is anhydrous? What species is affected? How is it diagnosed |
*loss of ability to sweat *horses moved from temperate to hot environments *thin, patchy hair coat, decreased performance, increased RR * intradermal injection of epinephrine or terbutaline |
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what is the physiological mechanism of fever? |
exogenous pyrogens or activated immune cells --> activation of endogenous pyrogens (IL-1) --> stimulate anterior hypothalamus --> increased se point --> fever |
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which endogenous pyrogen is the most important (or at least the only one specifically mentioned)? |
IL-1 |
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What are the benefits of fever? |
increased survival reduced duration of infection enhanced host defenses inhibit bacterial access to iron inhibit growth of some bacteria and viruses inhibit growth of some tumors |
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What are the disadvantages of fever? |
increased metabolic rate ( oxygen consumption, water and caloric requirements) suppress appetite weakness protein loss cardiovascular and neurologic damage if severe |
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What are the critical body temperatures in cats/dogs, horses, and cattle? |
cats/dogs > 106 horses > 105 cattle > 107 |
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What are 8 causes of fever? |
infection tissue trauma immune mediated disease neoplasia administration of blood products drugs toxins metabolic causes |
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How do glucocorticoids and NSAIDs treat fever? |
both inhibit prostaglandin synthesis NSAIDs = do NOT block endogenous pyrogens steroids = DO block endogenous pyrogens (reserve for KNOWN causes of fever) |
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what is the difference between intermittent, remittent, and sustained fevers? |
intermittent = diurnal, peaks in late afternoon remittent = cyclical period of days sustained = constant |
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coughing is initiated by contact of irritants with receptors in the airways. Where are these receptors particularly concentrated? |
larynx and carina (but also in the trachea, bronchi, bronchioles, alveoli) |
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In general, receptors in the proximal airway detect what kind of stimulation? What kind of stimulation do receptors in the dial airway detect? |
proximal airway = mechanical distal airway = chemical |
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which species has a much less sensitive trachea? |
horses |
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how might a cough occur without inspiration (solely expiratory reflex)? |
direct stimulation of the larynx (such as with intubation) |
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What is the difference between stertor and stridor? |
stertor = noisy nasal breathing (snorting) stridor = increased noise at the larynx and trachea (wheezing) |
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With pleural disease, what kind of respiratory pattern is typically seen? |
restrictive pattern of tachypnea and decreased depth. (fluid or soft tissue in the chest will result in dull percussion) |
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What is the mechanism of reverse sneezing? |
stimulation of trigeminal nerve endings in nasopharyngeal mucosa --> rapid contraction of inspiratory muscles and muscles of larynx --> vocal fold adduction and narrowing of larynx --> increased air pressure in trachea --> glottis opens --> sudden, rapid inspiration of air --> moves debris from nasopharynx to oropharynx to be swallowed. narrowing of glottis and coughing prevents debris from getting into lower airways. |
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what systemic diseases could present with epistaxis in dogs and cats? |
hypertension vasculitis coagulopathy thrombocytopenia hyperviscosity syndromes multiple myeloma polycythemia |
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What systemic diseases could present with epistaxis in horses? |
purport hemmorhagica exercise induced pulmonary hemorrhage (EIPH) |
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How valuable are nasal discharge culture in cases? What about virus isolation? |
*cultures are of low diagnostic yield, often grow a population of mixed commensals. Bacteria are often secondary *inciting viral infection is often not present at the time of diagnosis |
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What are some of the non-specific treatments used to help clear respiratory secretions?
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humidification saline nasal drops decongestants mucolytics |
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How might a leukotriene antagonist be used to treat an animal with nasal discharge? |
If you suspect allergic rhinitis leukotriene antagonists are antihistamines |
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How would you treat an animal with lymphoplasmacytic rhinitis? |
immunosuppression glucocorticoids (prednisone/prednisolone) topical glucocorticoid drops or sprays additional immunosuppressants to minimize steroids = azathioprine, chlorambucil, cyclosporine some benefit from NSAIDs as well |
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What is Yunnan baiyao used for? |
hemostasis (from patax notoginseng?) for epistaxis: topical powder or oral capsule (internal bleeding) mostly used for epistaxis from nasal tumors |
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What are possible causes of osmotic diuresis?
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excess glucose = diabetes mellitus excess urea = renal insufficiency (can't retain urea --> medullary washout) excess proteins = protein losing glomerulopathy (from chronic inflammation, glomerulonephritis) excess proteins AND amino acids = Fanconi syndrome (rare) |
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What are the most common causes of nephrogenic diabetes insidious? |
chronic kidney disease hypercalcemia (lymphoma, hyperparathyroid) hyperadrenocorticism (cushings) hyperthyroidism |
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Why might a dog with a pyometra present as PU/PD?
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G- endotoxins --> inhibit ADH receptor --> nephrogenic diabetes insipidus --> primary polyuria --> PU/PD |
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What helpful information could you get from imaging in a case of PU/PD? |
renal architecture (form does NOT indicate function) adrenal size hepatic parenchyma |
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How is isosthenuria defined? |
USG 1.008 - 1.012 PU/PD cases usually < 1.025 |
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An animal presents with: PU/PD elevated Alk-Phos stress leukogram What's do you think is wrong? What do you want to do next? |
hyperadrenocorticism (cushings) ACTH stim test, LDDS test |
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An animal presents with: PU/PD no azotemia glycosuria but no hyperglycemia What's your diagnosis? |
Fanconi syndrome |
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An animal presents with: PU/PD azotemia proteinuria What do you suspect? Additional diagnostics? |
protein losing nephropathy urine protein/creatinine ratio (higher than 6 supports diagnosis) |
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What are the three phases of the modified water deprivation test? |
Phase I = restore renal medullary gradient (gradual reduction of water intake to 70%) Phase II = dehydrate animal (monitor urine concentration and body weight. If able to concentrate = psychogenic) Phase III = exogenous administration of ADH (no response = NDI, response = CDI) |
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What electrolytes are high in intracellular fluid? In extracellular fluid? |
ICF = potassium and phosphorus ECF = sodium and chloride |
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What is the difference between ECF-IV (intravascular) and ECF-EV (extravascular) fluid? |
ECF-IV = high albumin, high sodium and chloride ECF-EV = NO albumin, high sodium and chloride *fluid and electrolytes will move freely between these compartments |
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What dictates the ratio of fluids in the IV-ECF and the EV-ECF? |
balance between hydrostatic and osmotic pressure |
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What is the percent of body water found in the ECF in large animals and large animal neonates? |
adult large animals = 0.3 X BW neonate large animals = 0.5 X BW |
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What is the percent of body water found in the ECF in small animals and small animal neonates? |
adult small animal = 0.4 X BW neonates small animals = 0.6 X BW |
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What is the percent BW of blood (IV-ECF) in most adult animals? |
6% - 7% |
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What are the four basic categories of fluids? Which of these can be used for replacement? For maintenance? |
crystalloids colloids blood/blood replacers energy supplements (all can be used for replacement, crystalloids and energy supplements for maintenance) |
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Over what time period are replacement fluids typically administered? Shock fluids? |
Replacement fluids = typically over 2-4 hrs Shock fluids = typically full blood volume over ~20 minutes (25% of total each 5 minutes X 4 times) |
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At what point (%) does dehydration typically become clinical? |
6% (except in neonates) PE will reveal no abnormalities below this |
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Define mild dehydration |
%BW = 6% Skin tent = 1-3 sec mucous membranes = moist/slightly tacky eyes = normal other = decreased urine output |
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Define moderate dehydration |
%BW = 8% Skin tent = 3-5 sec mucous membranes = tacky eyes = normal other = weaker pulse |
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Define severe dehydration |
%BW = 10% Skin tent = 3-5 sec mucous membranes = dry eyes = sunken other = poor jugular fill |
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Define very severe dehydration |
%BW = 12% Skin tent = FOREVER mucous membranes = dry, pale, cold eyes = sunken other = may not be able to feel pulse |
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When might you want to slow fluid administration? |
when fluid overloading is feared ex: heart failure, hypoproteinemia |
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How does goal-directed fluid therapy differ from standard fluid therapy? |
Standard fluid therapy: define % dehydration and replace all of those fluids Goal-directed fluid therapy: look for changes in specific parameters suck as central venous pressure or blood lactate |
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What are the maintenance fluid requirements for adult horses? |
4-6% of BW 40-60 ml/kg/day 2ml/kg/hr |
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What are the maintenance fluid requirements for adult cattle? |
7-10% BW 70-100ml/kg/day 3-4 ml/kg/hr |
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What are the maintenance fluid requirements for adult small animals? |
5-8% BW 50-80 ml/kg/day 2-3 ml/kg/hr *cats on the lower end, big dogs on higher end |
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What are the maintenance fluid requirement of neonatal animals (small and large)? |
10% of BW 100ml/kg/day 4ml/kd/hr |
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What factors might increase maintenance fluid requirements for an animal? How much might maintenance requirement be increased by? |
activity level hyperthermia milk production vomiting/diarrhea polyuria might need 2-4X regular maintenance |
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What type of fluids should NEVER be given SQ? |
hypertonic (these will pull fluid out of vasculature!) |
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How do you assess hydration status? |
body weight loss (if available) clinical pathology (BUN, creatinine, PCV, TP) physical exam (skin tent, mucous membranes) |
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How does lactate help determine hydration status? |
lactate is made by anaerobic glycolysis indicates that not enough O2 is being delivered to tissues |
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How does training improve thermoregulation? |
decreased heat production and storage more rapid sweating improved cardiovascular stability in heat lower sweat Na+ concentration |
