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84 Cards in this Set
- Front
- Back
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What conditions comprise diabetic ketoacidosis?
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Hyperglycemia
Metabolic acidosis Ketonuria Dehydration Electrolyte abnormalities |
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What are some common concurrent issues with DKA?
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Pancreatitis, infection, estrus, Cushing's, pregnancy, obesity, exogenous steroids
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How is DKA treated?
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Fluid therapy (intravascular then dehydration)
K and P supplementation Insulin therapy |
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What are MAJOR clinical signs of hypoglycemia?
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Seizures, ataxia, blindness (also weakness, stupor, coma, etc)
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Blood glucose below what value gives hypoglycemia clinical signs?
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<40 mg/dL
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Which of the following are NOT common causes of hypoglycemia?
a) Cushing's b) Sepsis c) Severe liver dz d) Addison's dz |
ALL can cause hypoglycemia!
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What is the normal Na:K ratio? Below what value is Addison's a consideration?
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Normal >32;
Addison's <27 (often 21) |
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What can cause a Na:K ratio <27?
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Addison's
Parvo GI dz |
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Which of the following are NOT common signs of Addison's?
a) Hypotension b) Hypoglycemia c) Hypocalcemia d) Hyponatremia e) Metabolic alkalosis |
c) Hypocalcemia
e) Metabolic alkalosis |
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What might you see on radiography in a patient with Addison's? On ECG?
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Rads (microcardia, small CVC)
ECG (Tented T, disappearing P, wide, bizarre QRS) |
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What is the treatment plan for an Addisonian crisis?
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Shock doses of isotonic crystalloids
Dexamethasone Treat hypoglycemia Treat hyperkalemia |
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What are some signs of acute liver failure?
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Anorexia, vomiting, icterus, CNS signs, coagulopathies
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What three things comprise triaditis? In which species does this occur?
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Pancreatitis, Cholangiohepatitis, and IBD in cats
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What do the following hepatic ultrasound values indicate?
Hypoechoic Hyperechoic Mixed echogenecity |
Hypo (necrosis)
Hyper (infiltrative dz) Mixed (chronic dz) |
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What are good ancillary therapies in treating hepatic disease?
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Taurine
Carnitine Thiamine Milk Thistle, SAM-E, Vit. E |
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What is a weird sign of hepatic encephalopathy in a cat?
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Discolored iris
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How is hepatic encephalopathy treated?
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Lactulose and/or oral abx
Fluid therapy High carb/low protein diet |
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Which of the following is NOT a systemic complication of pancreatitis?
a) hypertension b) edema c) pleural effusion d) chronic renal failure e) DIC |
a) hypertension (should be HYPO)
d) chronic renal failure (should be ACUTE) |
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What is the best test for pancreatitis?
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cPLI or fPLI
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Which of the following are NOT lab results in pancreatitis?
a) lipemia b) azotemia c) hypoproteinemia d) hypercalcemia e) mature leukocytosis |
d) hypercalcemia (should be HYPO)
e) mature leukocytosis (would have a LEFT SHIFT) |
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How is pancreatitis treated?
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Pain meds!
Fluid therapy Nutrition Maybe antibiotics??? |
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Which of the following are NOT important historical events in a case of dystocia?
a) the bitch in pain and biting her vulva b) there is green discharge with no whelping c) there are strong contractions for 20 minutes with no birth d) a cat has failed to deliver all offspring within 12 hours e) more than 1 week overdue |
c) there are strong contractions for 20 minutes with no birth
d) a cat has failed to deliver all offspring within 12 hours (should be 50-60 minutes; and a cat can take all day) |
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Fetal skeletons should be visible by radiography by _______.
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45d
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What are indications for using oxytocin in canine parturition?
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Cervix is DILATED
Fetal position is NORMAL NO birth canal obstructions weak/absent contractions |
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What are indications for a c-section?
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narrow pelvis/oversized fetus
uterine torsion dystocia with no response to medical therapy |
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What are indications for an en-bloc OVH with a dystocia that doesn't respond to medical therapy?
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Dead/necrotic fetus
Uterine rupture Unwanted future pregnancies |
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What drugs should you have handy during neonatal resuscitation post c-section?
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Naloxone/naltrexone (anti-opiate)
Flumazenil (anti-benzodiazepine) |
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What are some lab values for a bitch with pyometra?
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Pyuria, proteinuria, w/low USG
Azotemia Left-shift leukocytosis |
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Who prolapses their uterus more, bitches or queens? When does it occur?
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CATS>DOGS; follows parturition
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What are common isolates grown from a dog with acute prostatitis? What are good abx for these?
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E. coli, Staph/Strept, Mycoplasma
(TMS, Enro, Clavamox, Chloramphenicol) |
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How is prostatitis treated?
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antibiotics
fluids stool softeners castration |
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How are prostatic cysts or abscesses treated?
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Surgical drainage
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Testicular torsion is common in ________.
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cryptorchids
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What commonly causes paraphimosis?
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Hair around the penis
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How is paraphimosis treated?
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sedation/anesthesia
remove any constricting hair hyperosmotic solutions or preputial incision RARELY amputation, castration, and scrotal urethrostomy |
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T or F:
Patients with uremia are not necessarily azotemic. |
False!
Uremia = clinical signs + azotemia |
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What are signs of uremia?
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Vomiting, azotemia, anorexia, oral ulcers, melena, cachexia, diarrhea, etc...
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When should contrast studies of the urinary system be performed?
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Undiagnosed dysuria, pollakuria or hematuria
Cystic opacities Abnormal bladder shape Caudal abdominal masses Assess bladder/urethra integrity |
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Which of the following are NOT urinary emergencies?
a) pollakiuria b) anuria c) urolithiasis d) trauma e) pyelonephritis |
a) pollakiuria
e) pyelonephritis |
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What are common causes of acute renal failure?
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Renal hypertension d/t sepsis
Nephrotoxins Other infection Obstruction Hyper Ca |
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T or F:
Potassium and Phosphorus may be normal or high in acute renal failure. |
True!
|
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What are the three things necessary to diagnose anuria or oliguria?
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1) patent urinary collection system
2) adequate hydration 3) MAP>60mmHg |
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What are the treatments for oliguria/anuria?
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Furosemide first!
Try mannitol (once) Maybe dopamine? Dialysis or CRRT as a last resort... |
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What is the next step in a urolith-obstructed patient where the blockage cannot be retropulsed?
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Surgery! (urethrotomy or prepubic cystostomy)
|
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T or F:
Treating UTIs in partially obstructed cats is an important aspect of urolith therapy. |
False!
Cats rarely get UTIs...this is more for DOGS |
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What are common historical and physical exam findings in a blocked cat?
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Stranguria, pain, vomiting, collapse
Large, firm, painful bladder Discolored penis |
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What are the bad sequelae to urinary blockage in cats?
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Hyperkalemia
Azotemia and acidosis BAD ANESTHESIA CANDIDATE |
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How are blocked cats treated?
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Pain meds
IV cath & start crystalloids Treat hyper K Urethral cath (under anesthesia) and flush bladder |
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Put the following in order from most to least likely to rupture.
Kidney Bladder Urethra Ureter |
Bladder
Kidney Urethra Ureter |
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What are some possible causes of hydronephrosis?
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Urolith
Trauma Neoplasia Iatrogenic (spay) |
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How is hydronephrosis treated?
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Restore fluid/electrolyte balance
Unilateral nephrectomy Maybe a stent |
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What are the four aspects of a physical exam of a patient with possible abdominal/GI emergency?
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Inspect/observe
Auscultate Palpate Percuss |
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Which of the following are abdominal radiographs unable to ascertain?
a) organomegaly b) ileus c) foreign bodies d) obstruction e) pancreatitis |
rads can do it all in the abdomen!!
|
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When should you think about performing an abdominocentesis?
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Loss of serosal detail on rads
Penetrating abdominal injury Persistant abdominal pain Blunt trauma w/abdominal signs Post-op complications |
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When should you NOT perform an abdominocentesis?
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Coagulopathy
Dyspnea Diaphragmatic hernia Ileus Organomegaly Previous abdominal surgery |
|
T or F:
Peritoneal lavage increases the diagnostic power of abdominocentesis nearly 2-fold. |
True!
Abdominocentesis is only 50% diagnostic; lavage increases it to 93-98%. |
|
What would cause changes in each of the following abdominocentesis parameters?
High bilirubin High amylase High creatinine/K High lactate Low pH or glucose |
High bilirubin (gall bladder rupture)
High amylase (pancreatitis) High creatinine/K (bladder rupture) High lactate (sepsis) Low pH or glucose (sepsis) |
|
What would cause changes in each of the following gross abdominal fluid values?
Turbulent/flocculent Green Pink w/PCV<1% Red w/PCV>2.5% |
Turbulent/flocculent (peritonitis)
Green (biliary leakage) Pink w/PCV<1% (mild hemorrhage) Red w/PCV>2.5% (significant hemorrhage) |
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Septic peritonitis is diagnosed when WBCs exceed ___________.
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>1000 cells/uL
|
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Which of the following are NOT always indications for GI surgery?
a) non-responsive pain b) bile in abdomen c) abdominal free gas d) GDV e) Mesenteric volvulus |
c) abdominal free gas
(often an indication but may be a post surgical issue too...) |
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Regarding GI emergencies, an animal with regurgitation, dysphagia, hypersalivation, and anorexia likely has...
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...esophageal foreign body
|
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Regarding GI emergencies, an animal with projectile vomiting likely has...
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...Gastric foreign body
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Regarding GI emergencies, an animal with vomiting, electrolyte imbalances, and foci of gas-filled intestines likely has...
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...intestinal obstruction
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Regarding GI emergencies, an animal with hematemesis, melena, anemia, and abdominal pain likely has...
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Gastric erosions/ulcers
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Regarding GI emergencies, a young dog with hematemesis, melena, and a high PCV likely has...
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Hemorrhagic gastroenteritis
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What are the 3 types of shock sequelae to GDV?
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Hypovolemic
Cardiogenic Septic |
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How are most gastric diseases treated?
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Analgesia, fluids
Histamine blockers Sucralfate or other gastroprotectants Promotility drugs Anti-emetics |
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How is rectal prolapse treated?
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Stuff the sucker back in
Use hypertonic dextrose Pursestring suture Lactulose stool softener Deworm |
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What are the 2 types of external cardiac compressions and indications for each?
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Heart pump (small animals)
Thoracic pump (larger animals) |
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T or F:
There is a better prognosis with internal cardiac compressions. |
True!
|
|
Which drugs are appropriate to give during asystole?
a) epinephrine b) dopamine c) vasopressin d) atropine e) Na bicarb |
a) epinephrine
c) vasopressin |
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T or F:
Ca should never be given in times of cardiac arrest. |
False!
Give Ca with hypocalcemia, hyperkalemia, or Ca-blocker toxicity |
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If an arrthymia is refractory to everything, what mineral should be given?
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Mg
|
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What are common arrthymias in cardiac arrest?
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Asystole
Pulseless electrical activity V-fib Bradycardia |
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Which arrthymia is treated by defibrillation?
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v-fib
|
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Which arrthymia is treated by epinephrine or vasopressin?
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Asystole or PEA
|
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Which arrthymia is treated by atropine?
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Bradycardia
|
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What are some ways to assess the efficacy of CPCR?
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Femoral pulse
Blood gas Capnography |
|
T or F:
Low EtCO2 during CPCR has a good prognosis because it indicates good oxygenation. |
False! You want 18-24 EtCO2 which indicates good circulation (gas exchange)!!
|
|
What is monitored post CPCR to check for tissue perfusion? What drugs can help with perfusion?
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Monitor BP, urine output, blood gas, maybe echo
(use DA or Dobutamine) |
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What are major categories to address after CPCR?
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Tissue perfusion
Cerebral perfusion Myocardial care Prevent/treat reperfusion injury Prevent/treat pulmonary trauma |
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Cerebral damage is assumed when...
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...there is no consciousness 15-20 minutes post CPCR.
|
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Which of the following are NOT important to interdict when preventing cerebral trauma post CPCR?
a) hypotension b) hypervolemia c) hypocapnia d) hypothermia e) hyperthermia |
d) hypothermia
(hypothermia isn't a big deal) Wanna prevent hyper/hypotension, hyper/hypovolemia, hyper/hypocapnia, and hypoxia too |
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What drugs are thought to help with cerebral injury post CPCR?
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Mannitol
Furosemide |
