Principles Of Medicine Final

Front 1

What are the criteria for meeting humane euthanasia?

Back 1

- Rapid death or loss of consciousness followed by immediate death
- No pain or distress
- Esthetic
- Safe
- Reliable and irreversible

Front 2

Name 3 methods of humane euthanasia.

Back 2

- IV admin of penobarbitol overdose
- Physical methods: captive bolt (No country for old men), gunshot, 2x4 to the head (not really)
- Adjunct methods: succinyl choline for prevention of muscle spasm, anesthesia or sedation prior, etc

Front 3

Name the 4 primary causes of peripheral edema.

Back 3

- Increased hydrostatic pressure
- Increased vascular permeability
- Decreased lymphatic drainage
- Decreased plasma colloid osmotic pressure.

Front 4

What is Nigel doing right now?

Back 4

Annoying me.

Front 5

What are the most common causes of generalized edema?

Back 5

Heart failure and hypoproteinemia

Front 6

If you have an area of edema that is very firm, non-pitting and painful, what is the likely cause?

Back 6

Increased vascular permeability (VERY firm, non-pitting, painful)

Front 7

If you have an area of edema that is firm, pits and non-painful, what is the likely cause?

Back 7

Decreased lymphatic drainage and increased hydrostatic pressure.

Front 8

If you have an area of edema that easily pits but resolves in <1min and non-painful, what is the likely cause?

Back 8

Decreased plasma colloid osmotic pressure

Front 9

The cells in the area of edema are deprived of what, therefore resulting in necrosis?

How would you treat edema?

Back 9

Deprived of O2 and nutrients.

Trt: bandaging, exercise, hydrotherapy

Front 10

Ascites characteristics (fluid composition, etc)?

Back 10

Non-inflammatory, transudate, modified transudate, (low protein and cell). See with generalized edema in dogs.

Front 11

Pleural effusions/Hydrothorax characteristics?

Back 11

Non-inflammatory, transudate/modified transudate (low protein and cell levels). Seen with generalized edema in cats.

Front 12

Pleuritis/Peritonitis fluid composition?

Back 12

Inflammatory, exudates. Caused by increased vasc perm, decreased lymphatic drainage, etc. Perforating wounds, rupture of GIT or extension of bronchopneumonia, neoplasia, trauma, bacti or viral.

Front 13

T/F. Abdominal adhesions never result in peritonitis.

Back 13

False

Front 14

What components of the bacterial cell wall result in Endotoxemia?

Back 14

LPS components of the Gram Neg Cell wall.

(confronted by macrophages that then elicit inflammatory response, release arachidonic acid from cell walls and a plethora of inflam mediators)

Front 15

What are some signs you will see with an animal in endotoxic shock?

Back 15

Neutrophil Margination
DIC
Leukopenia (Shelly would love that shit)
Lactic acidosis
Tachycardia, hypotension, increased CRT, dark MM, cold extremities (hmm, maybe I have endotoxemia)

Front 16

Define Trophism.

Back 16

Predilections for organisms to be attracted to certain tissues because of nutrient content, rapid cell turn over, certain cell wall receptors.

Front 17

What is Parker doing right now?

Back 17

Licking the floor. Like a fucking weirdo.

Front 18

With cardiac disease, what are some physical abnormalities that you might see? (specifically related to the heart)

Back 18

- Arrhythmias
- extra heart sounds
- heart murmur

Front 19

If an animal is presenting with CS including dyspnea, cough, abdominal enlargement, syncope, lameness, what disease process might it be manifesting?

Back 19

Cardiac Disease

Front 20

Pulmonary congestion and edema are typically seen with (R/L) heart failure?

Back 20

Left Heart Failure

Front 21

Ascites, pleural effusion, venous distention and abnormal jugular pulses are commonly seen with (R or L) heart failure?

Back 21

Right Heart Failure

Front 22

Decrease cerebral perfusion leading to weakness, ataxia, loss of consciousness, absence of tonic-clonic activity and rapid and complete recovery are noted with what condition?

Back 22

Syncope. AKA fainting.

AKA what happens to Rebecca when she stands up after sitting on her ass all day studying.

Front 23

T/F Thromboembolism can sometimes be mistaken for neuro or ortho disorder?

Back 23

True dat. Also see atrial enlargement

Front 24

Hear murmur is defined as?

Back 24

Abnormal turbulent flow of blood through the heart.

Front 25

With bradycardia, the problem is typically due to what?

Back 25

Formation or conduction problem - too few beats.

Front 26

Old Greg has got the ___.

Back 26

Funk.

Front 27

Karen Teft is a ___.

Back 27

Troll.

Front 28

Tachycardia is commonly due to what?

Back 28

Ectopic pacemaker tissue, primary cardiac disease, systemic illness.

Front 29

What is the bottom line of weight loss?

Back 29

Metabolic needs are not being met.

Front 30

What are the four main kinds of weight loss?

Back 30

- Insufficient intake with appetite present.
- Insufficient intake with appetite diminished
- Decreased utilization
- Increased demand

Front 31

What are some causes of insufficient food intake with normal appetite in wieght loss?

Back 31

- low on the pecking order/competition
- No access to feed/insufficient quantity
- poor dentition
- Dysphagia

Front 32

What are some causes of insufficient intake with decreased appetite?

Back 32

- Pain, lameness, systemic disease
- Vices
- Oral meds (eg. Metronidazole)

Front 33

What are some caused of increased demand in relation to wt loss?

Back 33

- Prego/lactation
- increased work/growth
- Parasitism
- Winter
- Disease

Front 34

What are some causes of decreased utilization with respect to wt loss?

Back 34

- Parasites
- Poor quality feed
- malabs/maldigestion
- organ failure

Front 35

Define pseudoanorexia.

Back 35

- cannot grasp, chew or swallow

Front 36

T/F Inflammation or disease of the lower urinary tract all produce similar signs

Back 36

True

Front 37

T/F Trace - 1+ Bili in urine of a "kitty cat" is prefectly normal.

Back 37

FALSE!!!!!!!!

Front 38

What are the two forms of abnormal urination and describe them.

Back 38

- Incontinence: loss of voluntary control of micturition (can be neurogenic or non-neurogenic)

- Inappropriate urination: peeing in places ppl don't like - behavioral, etc

Front 39

Define micturition.

Back 39

The process of voiding urine where the bladder and urethra form a functional unit for storage and outlet.

Front 40

The Storage phase of micturition is controlled by the ___ via the ___ nerve.

Back 40

SNS, hypogaStric nerve

Front 41

The voiding phase of micturition is controlled by the ___ via the ___ nerve.

Back 41

PNS, Pelvic nerve.

Front 42

What is reflex dyssynergia?

Back 42

Animal initiates urination and the sphincter suddenly slams shut and animal strains - high residual volume and functional bladder outlet obstruction.

Front 43

What are the 2 forms of neurogenic incontinence with respect to the motor neurons? Describe them.

Back 43

UMN - lesion cr to S1. Loss of voluntary control, manual expression is difficult.

LMN - Lesion b/w S1 and S3. Easy to express manually.

Front 44

What are 3 kinds of non-neurogenic incontinence?

Back 44

Ectopic ureter, reflex dyssnergia, bladder distention/obstruction

Front 45

Primary Thirst is due to?

Back 45

Hypovolemia
Increased plasma osmolality

Front 46

Secondary Thirst is due to?

Back 46

Oropharyngeal stimuli
Anticipation of water requirements

Major mechanism!

Front 47

Urinary Concentration depends on?

Back 47

Composition & volume of fluid entering distal tubule
Integrity of medullary interstial conc gradient
Action of ADH

Front 48

Polyuria is defined as?

Back 48

Excessive urination. >50ml/kg/day - dilute

Front 49

Polydipsia is defined as?

Back 49

Excessive drinking
>100ml/kg/day for dogs
>50ml/kg/day for "kitty cats"

Front 50

And increase in nitrogenous compounds in the blood is called what?

Back 50

Azotemia

Front 51

Azotemia + a constellation of clinical signs (feeling sick) is called what?

Back 51

Uremia

Front 52

What are the 3 stages of renal failure?

Back 52

1) Decreased renal reserve (50% loss in renal function capacity or GFR)
2) Renal insufficiency (50-75% loss/GFR; will see PU/PD, ill animal. No azotemia yet)
3) Renal Failure: >75%, mild to severe azotemia, PU/PD, electrolyte abnormalities, extrarenal manifestations

Front 53

What are some extrarenal manifestations of renal failure

Back 53

PU/PD, anorexia, anemia, weight loss, osteodystrophy, diarrhea, oral lesions, pale mm, etc

Front 54

What are the 3 kinds of uremic toxins?

Back 54

1) Products of pr- catabolism
2) Product of bacterial metabolism
3) Endocrine disorders (e.g HyperPTism)

Front 55

Anemia in chronic renal failure is due to the deficiency in what hormone?

Back 55

EPO

Front 56

What are the metabolic and physiological sequelae of diarrhea in calves?

Back 56

1) Dehydration and hypovolemia
2) Loss of electrolytes from ECF
3) Metabolic acidosis

Front 57

Metabolic acidosis in calves with diarrhea is due to what?

Back 57

- Loss of bicarb
- increased production of lactic acid by anaerobic glycolosis
- decrease H+ excretion by the kidneys
- Organic acid production through fermentation of milk (mmm, delicious milk)

Front 58

If a calf is 5-6% dehydrated, will they respond to oral fluids?

Back 58

Yes

Front 59

What range of % dehydration requires IV fluid admin to a calf with the shits?

Back 59

8-10%

Front 60

What are the major carriers stimulating the movement of H2O in oral replacement solutions?

Back 60

Na and Glucose

Front 61

If a calf is unable to suckle, should you administer oral fluids?
What about if it has ileus?
What if the dehydration is progressing rapidly?

Back 61

NOPE

Front 62

What is the primary advantage of using ORS over IV fluids?

Back 62

Economy ($$$$$$$$)

Front 63

If a calf has villus atropy due to a GIT infection that I cannot currently think of that results in this, will ORS be as effective?

Back 63

No sir

Front 64

Is the Glucose present in ORS sufficient to provide an energy source to the calf?

Back 64

No ma'am

Front 65

What is one of the most important components of ORS?

Back 65

ALKALINIZING AGENTS

Front 66

What are the main components of ORS?

Back 66

- Cotransporters - Na/Glu
- Alkalinizing agents
- Energy source
- Gelling agents
- Amino acids
- Ion replacement

Front 67

Because most ORS don't meet 100% of the calf's maintenance reqm'ts, when should milk be administered?

Back 67

After sucking drive has been restored by electrolyte therapy and given in frequent small feedings.

Front 68

What is the most antigenic canine blood type?

If this is the first transfusion, is it likely to result in a immediate transfusion reaction?

Back 68

DEA 1.1

No immediate rxn but will sensitize therefore see rxn on subsequent transfusions.

Front 69

When will you see a transfusion rxn in cats and why?

Back 69

On the first transfusion because naturally occurring Antibodies are present against A, B and AB blood types.

Front 70

What is the most common feline blood type?

Back 70

A

Front 71

Using donor RBC and recipient plasma describes what type of cross match?

Back 71

Major cross match

Front 72

Using donor Plasma and recipient RBC described what type of cross match?

Back 72

Minor cross match - less deliterious

Front 73

When should you preform a cross match?

Back 73

- Hx of previous transfusions
- Previously prego
- Multiple transfusions anticipated

Front 74

In order to be classified as fresh whole blood, it must be drawn from the donor and transfused into a recipient w/in __ Hours.

Back 74

6

Front 75

Kim Jung Il says...

Back 75

Herro Hans.

Front 76

How long can stored whole blood be stored in a fridge?

Back 76

28 days

Front 77

T/F It is ok to take a bit of blood out of the bag during storage and save the rest for later, AKA a little blood snack prior Liz's blood meal?

Back 77

NO!!!!!!!

Front 78

Packed RBC can be stored for how long?

Back 78

28 days

Front 79

What would you use packed blood for?

Back 79

Anemia, RBC destruction w/o hypovolemia, deficits in other blood components

Front 80

When are plasma products indicated?

Back 80

Any inflammatory process with significant cytokine release

Front 81

How is platelet rich plasma processed differently?

Back 81

Lighter centrifugation, 75% platelets remain - good for thromocytic patients

Front 82

Quick Rules of thumb:
For every 1% rise in PCV you need:
__ mL of whole blood/kg
__ mL of packed RBC/kg

Back 82

2ml
1ml

Front 83

What time frame do you usually give transfusions in?

What if it is an emergent situation?

Back 83

4 hours

Squeeze the transfusion in fast

Front 84

What are the 2 types of Transfusion Rxns?

Back 84

- Immunoglogic - antigens to RBC, plasma proteins, WBC or platelets

- Non-immunologic - circulatory overload, sepsis, citrate toxicitiy.

Front 85

What is the most important thing to do when managing transfusion reactions?

Back 85

STOP THE F'ING TRANSFUSION, YA DUMB BITCH.

Front 86

T/F MM are usually cyantic in both central and peripheral cyanosis.

Back 86

FALSE. Peripheral cyanosis usually see normall MM because is a slowing of blood to the extremities and increased extraction of O2 from normally saturated blood.

Front 87

Define Cyanosis.

Back 87

Abnormal blue discoloration to the skin, sclerae and visible MM because of increase in the amount of absolute Hgb (NOT carrying O2)

Front 88

What are two causes in the definition of central cyanosis?

Back 88

- Inadequate oxygenation of the arterial blood (impaired pulmonary function, R-L shunts eg Tetralogy of Fallot)
- Presence of an abnormal Hgb derivative (Methemoglobin, sulfhemoglobin)

Front 89

Cyanosis due to impaired pulmonary function can be due to what processes?

Back 89

- Ventilation perfusion mismatch
- Alveolar hypoventilation
- Decreased gas transfer across B-G barrier
- Pulmonary arteriovenosis shunts

Front 90

If your HgB is unable to bind O2 due to abnormal products bound to it, will it be a normal color?

Back 90

No, darker.

Front 91

Define Cough.

Back 91

sudden, noisy explusion of air through the epiglottis - clears mucus and foreign material

Front 92

What are some stimuli that can result in cough?

Back 92

- Mechanical deformation
- Chemically innnert dusts
- Pollutant gases
- Inflammatory conditions
- Chemical mediators (histamines)
- Esophageal irritation (choking)

Front 93

What are the consequences of cough?

Back 93

- further irritation
- Pneumothorax
- emphysema
- weakness
- exhaustion

Front 94

T/F an infrequent cough is seen at later stages of disease.

Back 94

False. Infrequent cough seen at early stages of disease

Front 95

Paroxysmal cough are described as..

Back 95

numerous coughs in close succession, seen in advanced disease

Front 96

Protracted deep coughs are usually due to...

Back 96

Alveolar emphysema
Inflam of URT

Front 97

Shallow short cough are usually seen with...

Back 97

Acute painful conditions
Conditions causing reduced volume of expired air

Front 98

What are the manifestations of dyspnea?

Back 98

- tachypnea
- extended head and neck
- stridor
- cyanosis
- mouth breathing
- exaggerated abdominal effort
- heave lines
- double expiratory lift

Front 99

Pathologic tachypnea occurs due to:

Back 99

- need for additional O2 (decreased O2 in environment, decreased O2 carrying capacity of the blood, compensation for metabolic acidosis, excessive environmental heat, etc

Front 100

With an intrathoracic airway obstruction you see ---- distress?

Back 100

Expiratory

Front 101

With an extrathoracic airway obstruction you see ____ distress?

Back 101

Inspiratory

Front 102

With fixed airway obstruction you see ___ distress

Back 102

Inspiratory and Expiratory

Front 103

If a dog has a nasal tumor you will likely see

Back 103

Inspiratory distress

Front 104

What is Ozena?

Back 104

Foul odor to nasal discharge - indicates anaerobic infection, necrotizing conditions, FB, connection b/w oral and nasal cavities

Front 105

What can result in epistaxis?

Back 105

- Trauma (punch you in the face)
- Coagulopathies
- Erosive or invasive disease of URT
- Guttural pouch mycosis

Front 106

Hemoptysis is the hallmark of pulmonary hemorrhage - how can it result?

Back 106

- damage to pulmonary vessels
- severe pulmonary hypertension
- clotting or bleeding disorders

Front 107

Abnormal breath sounds can be due to what 4 things?

Back 107

- Increased ventilation
- Increased airflow resistance
- Hyperinflation/emphysema
- Pleural space disease

Front 108

Crackles are a ___ sound.

Back 108

DISCONTINUOUS

Front 109

Wheezes are a ___ sound.

Back 109

CONTINUOUS

Front 110

Polyphonic wheezes high single or multiple notes? What do they indicate?

Back 110

Mulitple notes - widespread airway narrowing

Front 111

Monophonic wheezes are a single continous note - what do they indicate?

Back 111

Airway obstruction

Front 112

Regurgitation is a PASSIVE or ACTIVE process.

Back 112

Passive

Front 113

What is the major risk with regurgitation?

Back 113

Aspiration pneumonia - because it is a passive process the airway is not protected.

Front 114

How can you manage regurgitation?

Back 114

- Frequent small meals
- Elevate the food
- Hold animal upright for 10-15 min
- Treat underlying process

Front 115

What are common causes of regurgitation?

Back 115

- Megaesophagus
- Esophageal obstruction/inflammation
- Hypothyroidism
- Hypoadrenocorticism

Front 116

Do you get much warning when an animal is going to regurgitate their food?

Back 116

NOPE

Front 117

T/F Vomiting is a passive process.

Back 117

False

Front 118

What two centers in the CNS are involved in vomiting and why did they develop?

Back 118

Emetic Center
CRTZ

Evolved to prevent further absorption of toxins after it has entered the blood stream.

Front 119

What are some characteristics of vomit?

Back 119

Partially digested
Bile stained
Acidic
Abdominal heaving/retching AKA NIGEL

Front 120

What are the 3 stages of vomiting?

Back 120

1) Nausea
2) Retching - forceful abdominal contractions, expansion of thoracic wall with glottis CLOSED, gastric contents move up esophagus
3) Actual Vomiting: gastric contents are forcefully expelled from the mouth, contraction of abdominal wall and simultaneious inhibition of respiration to prevent asipiration.

Front 121

What can cause vomiting?

Back 121

- Primary GI Disease (Gastric, Sm Intest, Lrg Intest)
- Exra GI: metabolic, endocrine, toxins, drugs, abdominal disorder, CNS disease. EXAMS.

Front 122

Describe the steps involved in treating vomiting?

Back 122

1) Treat the underlying cause
2) Supportive care - MAINTAIN HYDRATION
3) Symptomatic care - antiemetics - metaclopramide (CRTZ & increased GI motility), Maropitant (Cerenia (CRTZ and Emetic Center))

Front 123

T/F - Cerenia can be used in all species.

Back 123

FALSE. Only Dogs.