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;
94 Cards in this Set
- Front
- Back
|
What is the most common cause of hepatic encephalopathy?
|
portosystemic shunts
|
|
|
What is the cause of hepatic encephalopathy?
|
liver dysfunction leads to increased blood ammonia levels
|
|
|
Do you often see systemic signs with liver dysfunction?
|
yes
|
|
|
Do you see prosencephalic dysfunction resulting in seizures?
|
yes
|
|
|
Do you see cranial nerve dysfunction?
|
no
|
|
|
How do you treat hepatic encephalopathty?
|
antibiotics
protein restriction lactulose |
|
|
What do you want to avoid in treating hepatic encephalopathy?
|
diazepam and phenobarbital if seizures
|
|
|
What are the characteristics of hepatic encephalopathy?
|
chronic progressive symmetrical (waxing and waning)
|
|
|
What is the cause of acquired hydrocephalus?
|
obstruction
|
|
|
What type of dogs are predisposed to congenital hydrocephalus?
|
young, toy, brachycephalic dogs
|
|
|
What type of signs are seen with hydrocephalus?
|
chronic progressive prosencephalic signs
|
|
|
Are radiographs sensitive for hydrocephalus?
|
no they are insensitive
|
|
|
What can you use to diagnose hydrocephalus?
|
CT, MRI, US
|
|
|
How do you treat hydrocephalus?
|
steroids and diuretics
w or wo surgery |
|
|
What type of strabismus do you see with hydrocephalus?
|
venrolateral
|
|
|
What disease is syringohydromelia often associated with?
|
chiari malformation
|
|
|
What is syringo(hydro)myelia?
|
condition where fluid filled cavities (syrinx or cyst) develop within the spinal cord
|
|
|
What is are the most common signs associated with syringohydromyelia?
|
scratching and neck pain
|
|
|
What types of dogs do you see GME in?
|
toy and small breeds
|
|
|
What breeds do you see necrotizing disease in?
|
pugs, maltese, yorkshire terrier, chihuahuas
|
|
|
Do you see evidence of infections in sterile CNS inflammation?
|
no
|
|
|
What type of CNS signs do you see in sterile CNS inflammation?
|
multifocal
|
|
|
What type of pain might the multifocal signs seen with sterile CNS inflammation include?
|
neck pain
|
|
|
In the case of sterile CNS inflammations what will the cell count and protein look like?
|
The cell count and protein will be up in all
|
|
|
When will the CNS be mixed with sterile CNS inflammations?
|
GME/NLE
|
|
|
What is the treatment for sterile CNS inflammations?
|
long term immunosuppresion
|
|
|
Will just steroids be enough for immunosuppression in the case of sterile CNS inflammations?
|
NO
|
|
|
In infectious inflammatory disease is it often typically difficult to make a single neuroanatomic localization?
|
yes it is multifocal
|
|
|
What is the work up for infectious inflammatory brain disease that is similar in all cases?
|
systemic testing/CSF/MRI/paired titers/PCR/culture
|
|
|
Do you use electrodiagnostics in the diagnosis of infectious inflammatory brain disease?
|
no
|
|
|
Can you use paired serum and CSF titers to aid you in the diagnosis of infectious inflammatory brain disease?
|
yes
|
|
|
What does IgG indicate in the case of infectious inflammatory brain disease?
|
It just indicates exposure
|
|
|
What type of infectious inflammatory brain disease has an antigen test?
|
cryptococcus
|
|
|
What type of the feline infectious peritonitis virus is often associated with cns disease?
|
dry form --> vasculitis/pyogranulomatous inflammation of the CNS
|
|
|
What type of hypersensitivity is the cause of feline infectious peritonitis virus?
|
type III
|
|
|
Do you often see systemic signs with FIP?
|
yes --> liver/kidney
|
|
|
Do you see diffuse CNS signs with FIP?
|
yes --> seizures, blindness, dementia, cranial nerve signs
|
|
|
Do you see seizures with FIP?
|
yes
|
|
|
Might you see obstructive hydrocephalus with feline infectious peritonitis virus?
|
yes
|
|
|
Is there a definitive antemortem test for feline infectious peritonitis virus?
|
no
|
|
|
What might the CSF be like in early stages of feline infectious peritonitis virus?
|
neutrophilic
|
|
|
What might the MRI reveal in the case of FIP?
|
ventricular dilation and inflammation around the ventricles
|
|
|
Is there a cure for FIP?
|
no
|
|
|
What do you do to evaluate and assess the severity of head trauma injury?
|
evaluate the a, b, c's of the patient
evaluate neurological status (MGCS) evaluate BP HR PO2 PCO2 oxygen stauration TP BUN PCV , glucose, urine output, urea, creatinine and temperature |
|
|
What is the treatment for head trauma?
|
restore substrate delivery
-oxygenation -fluids (crystalloids and colloids) -mannitol is the third choice -with or without surgery -NOT steroids |
|
|
When do you use osmotic diuretics for head trauma?
|
if oxygen and fluids are unsuccessful
|
|
|
What are the effects of mannitol?
|
-can reduce ICP and cerebral edema
-can increase vascular volume |
|
|
What do you need before administering mannitol?
|
euvolemia
|
|
|
Why is mannitol effective?
|
it improves cerebral perfusion, causing cerebral dehydration and scavenging oxygen free radicals
|
|
|
What is the general approach to toxin exposure treatment?
|
-if dermal exposure use warm water and washing up liquid
-if confirmed oral exposure - activated charcoal -muscle relaxants -keep normothermic -seizure therapy -fluid therapy -reduce stimulation |
|
|
What are the most common mycotoxins?
|
penitrem A and roquefortine
|
|
|
What is the mechanism of action of mycotoxins?
|
the toxin inhibits glycine release and function in the CNS
|
|
|
What is the treatment for exposure to mycotoxins?
|
symptomatic treatment
|
|
|
What is the prognosis for exposure to mycotoxins?
|
it is good but can take 2-3 days
|
|
|
What type of toxicity is associated with ivermectin?
|
GABAergic
|
|
|
Might you get ivermectin toxicity if given a normal dose of ivermectin?
|
yes if you have an ineffective p-glycoprotein pump
|
|
|
What are the clinical signs associated with ivermectin toxicity?
|
depression and disorientation
-stupor, coma -seizures (rare) -respiratory failure |
|
|
What is the treatment for ivermectin toxicity?
|
There is no specific treatment
|
|
|
What is the mechanism of action of organophosphates and carbamates?
|
overstimulation of the CNS --> seizures and depression
|
|
|
What do you treat the overstimulation of parasympathetic muscarinic acetylcholine receptors by organophosphates and carbamates with?
|
atropine
|
|
|
What do you treat the overstimulation of skeletal muscles due to the nicotinic aceytlcholine receptor stimulation by organophosphates and carbamates?
|
-treat with pralidoxime / 2-PAM
|
|
|
What is the age of patients with brain tumors?
|
greater than 7 years old
|
|
|
What type of signs are seen with brain tumors? (characteristics)?
|
Often chronic progressive, asymmetrical signs
|
|
|
Are MRI and CT definitive when it comes to brain tumor diagnosis?
|
No they document mass lesions but they are not definitive
|
|
|
What is the conservative/palliative treatment for brain tumors?
|
steroids for edema
anticonvulsants |
|
|
What is the definitive therapy for brain tumors?
|
surgical debulking
radiotherapy |
|
|
What are the characteristics of cerebrovascular disease?
|
Acute non-progressive asymmetrical
|
|
|
What cranial nerve syndromes are important to remember because they may be central or peripheral?
|
5 - dropped Jaw
7- facial paralysis 8 - head tilt 10 - megaesophagus and laryngeal paralysis |
|
|
With a CNS lesion might they have postural reactions deficits as well as motor dysfunction?
|
yes
|
|
|
If the eye is too dilated and won't constrict in the light what is the problem?
|
It is either CN 2 or 3 if vision is present then it is cranial nerve 3 lesion
|
|
|
What if the eye is too constricted and it won't dilate in the dark?
|
It is a sympathetic lesion
|
|
|
Is there usually a visual deficit with horner's?
|
no there is usually not a visual deficit
|
|
|
Is horner's usually peripheral or central?
|
peripheral
|
|
|
What percentage of animals with Horner's are idiopathic?
|
50%
|
|
|
What can Horner's be due to?
|
trauma/ear disease/ tumor
|
|
|
If you have unilateral masticatory muscle atrophy with a cranialnerve 5 lesion what might you also see?
|
may also lose sensation to the face and have a dry ee
|
|
|
What are your peripheral differentials for masticatory muscle atrophy?
|
peripheral nerve sheath tumor --> by far the most common
-inflammation of the nerve |
|
|
What do you have to rule out with masticatory muscle atrophy?
|
muscle disease
-with CK, EMG, biopsy |
|
|
What is vertical nystagmus an indication of?
|
central disease
|
|
|
Do you see weakness or postural deficits if you have peripheral vestibular disease?
|
no
|
|
|
What are the two big things you think about if you have peripheral vestibular disease?
|
Otitis media interna
idiopathic |
|
|
What are the two big things you think about if you have central vestibular disease?
|
neoplasia - mengioma/choroid plexus tumor/lymphoma
inflammatory - infectious vs. sterile |
|
|
How long does it take the nystagmus to resolve with idiopathic peripheral vestibular disease?
|
72 hours
|
|
|
How long does it take the ataxia to resolve with idiopathic peripheral vestibular disease?
|
2 weeks
|
|
|
How long does it take the head tilt to resolve with peripheral vestibular disease?
|
2 months
|
|
|
Might some head tilt be residual with peripheral idiopathic vestibular disease?
|
yes
|
|
|
What is the improvement due to with idiopathic peripheral vestibular disease?
|
compensation
|
|
|
What are your differentials for acute dropped jaw?
|
-trauma
-IDIOPATHIC TRIGEMINAL NEUROPATHY -lymphoma -inflammation |
|
|
What does your work up include in the case of acute dropped jaw?
|
- you need to exclude other causes
---> CSF/MRI |
|
|
What is the prognosis of acute dropped jaw if it is idiopathic?
|
It is good with supportive care
|
|
|
What are your peripheral differential diagnosis for facial nerve paralyis?
|
otitis media interna
trauma idiopathic part of polyneuropathy |
|
|
Could facial nerve paralysis also be due to CNS disease?
|
yes
|
|
|
Could facial nerve paralysis be permanent?
|
yes
|
|
|
might you do a schirmer tear test and give artificial tears if needed with facial nerve paralysis?
|
yes
|
