Applied Diagnostic Midterm Flashcards by Julie Broomell

WhWhat is the most commonly isolated bacteria from sinusitis?

Streptococcus equi zooepidemicus
-This is also the most common agent for pneumonia in horses

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Describe the distribution and pattern for each
Suppurative bronchopneumonia
Fibrinous bronchopneumonia
Interstitial pneumonia
Embolic pneumonia
Granulamatous pneumonia

-cranioventral and firm
-cranioventral and firm
-diffuse and elastic
-multifocal and nodular
-multifocal and nodular

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What is triage?

to sort

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How do you triage a dog or cat?

Assess the cardiovascular, respiratory, and brain systmes

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If you do a blood smear and you see a morula within a neutrophil, what are two things it could be?

Erlichia ewingii and A. phagocytophilium

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E. ewingii only causes _ disease
What is a main sign?

acute
polyarthritis

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What does Anaplasma cause?

granulocytic anaplasmosis

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Where does ricketsiia replicate and what can it cause?

vasculature
thrombosis and hemorrahge

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How do we treat H.americanum?

TMS treatment for 2 weeks then deconquinate for 2 years

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What can anemia be due to?

Loss
-Induced (trauma, parasites)
-Spontaneous (thrombocytopenia, DIC, coagulopathies

Destruction (infection, immune mediated, drugs, DIC)

Hypoplasia
-Refractory (anemia of chronic disease, renal failure)
-Bone marrow (aplastic anemia, pancytopenia, drugs, immune, neoplasia, idiopathic)

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A dog walks into your clinic. You notice on physical exam he is lethargic and hasnt been eating. He has pale MM, is tachycardic, and has strong bounding pulses, what do you think could be a strong differential?N

Anemia

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Can you confirm rapid blood loss with blood work?

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What patterns would we see on PCV and TS with loss? desctruction? hypoplasia?

Loss ->early on normal PCV and slightly increase TS or increased
Late -> Low PCV, low TS

Desctruction ->TS can be increased or normal, low PCV

Hypoplasia ->PCV decreased, normal or increased TS

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CBC results for loss? destruction? hypoplasia?

Loss -> higher reticulocyte count
Destruction ->Regenerative anemia, hyperchromic macrocytic
Hypoplasia ->Non regenerative anemia (normocytic normochromic)

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What are prazosin and phenoxybanamine?

-alpha adrenergic antagonists
-used to treat pheochromocytomas

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What are ace-inhibitors used for?

-first line of treatment in dogs except when they have severe hypertension

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When do we treat hypertension?

-severe hypertension
-evidence of Tod with moderate hypertension
-persistent elevated blood pressure with disease associated with hypertension

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What are common underlying causes of hypertension in dogs?

-kidney disease
-hyperadrenocorticism
-diabetes mellitus
-pheochromocytoma

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What are common underlying causes of hypertension in cats?

-chronic kidney disease
-hyperthryoidism
-drugs
-adrenal disorders

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What are common organs that are affected by hypertension

brain, kidneys, eyes, and heart

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What does oscillometric work well for vs doppler?

doppler -> small dogs and cats
oscillometric -> medium to large breed dogs

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What is the spectrum of action metronidazole?

-anerobes and protozoa

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What are phenicols good for?

abscess and intracellular bacteria

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What is the spectrum of activity for macrolides and licosamides?

-gram positive aerobes
-anaerobes

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What are the spectrum of activity potentiated sulfonamides

-gram positive, gram negative , protozoa

What is the spectrum of activity for tetracyclines

-gram positive, gram negative, anaerobes, ricketssia

What is the spectrum of activiity for fluroquinolones

-gram negative -staphylococci -ricketsia mycoplasma

What drugs are fluorquinolones?

-enrofloxacin, marbofloxacin, orbifloxacin, pradofloxacin,

How can you differentiate between adrenal or pituitary Cushings?

endogenous ACTh or ultrasound

How can you assess that an animal is controlling their cushings

ACTH stim test

With monitoring a patient with Cushings what is our goal?

post ACTH cortisol of 1.5-5.5 ug/DL with control of CS

You have a patient with cushings come in for a follow up exam. You run an ACTH stim test to determine if the cushings is being controlled well. You notice the post ACTH cortisol is greater than 5.5. Should you increase the dose?

No. It can take longer to see a complete response at the starting dose

What fluids can you not bolus?

hypotonic fluids

what fluids are isotonic?

LRS, normal saline, normosol R, plasmalyte A

Are dehydration and hypovolemia the same?

Hyponatremia =

excess water

You have a patient that you have been giving fluids for the last 4 hours. You come to monitor and reassess his hydration status. You notice he has clear nasal discharge and his heart rate and RR seem elevated. He seems to be regurging as well. What do you suspect?n

Fluid overload

Do pack red cells have clotting factors?

What are the ddx for petechiation?

-thrombocytopenia -thrombocytopathia -endothelial dysfunction -

What drug groups are not absorbed orally in dogs and cats?

-benzylpenicillins and aminoglycosides

What drug groups are not widely distributed?

-penicllins, cephalosporins, aminoglycosides

What group of drugs are time-dependent?

beta lactams

what group of drugs are concentration dependent?

-fluorquionolones and aminoglycosides

What can HCM be due to?

-primary or secondary to hyperthyroidism

what are neoplastic diseases of the heart

-hemangiosarcoma -chemodectoma -lymphosarcoma

what are congenital malformations of the heart

-ventricular septal defect -pda -tetraology of falot -asd persistent aortic arch

How do we rule out liver failure with blood work?

would expect glucose, urea, and cholesterole to be decreased

Why would only albumin be low on cbc and not globulins?

-hepatic failure -inflammation -PLN

Why can globulins be increased in blood work?

-dehydration -inflammation

How can we rule out PLN on bloodwork

Urine would have protein in it

How do we know if its not renal azotemia with bloodwork

USG being above 1.30

How can we rule out post-renal azotemia?

would have imbalances of electrolyte, distended urinary bladder, hyponatremia, chloremia, phosphatemia

What is the most likely cause of erythrocytosis?

dehydration

Why can we have elevated phosphurus?

-decrease GFR diffuse intestinal disease rhabdomolysis

What pattern on blood work would we expect to see with cholestasis?

both indirect and direct bilirubin to be elevated, or just direct

Why woul djust indirect bilirubin be elevated

fasting/anorexia

What are 3 key features that you should recognize to do CPR?

-loss of consciousness, loss of normal spontaneous breathing, loss of palpable pulses

How many breaths per minute do you want when performing CPR?

8-12 breaths per minute

What is the best way to replenish all components of blood being lost?

whole blood

What are differentials for chronic vomiting?

-IBD -> steroid responsive, food responsive -neoplasia (lymphoma, adenocarcinoma) -parasitism -idiopathic gastritis -chronic foreign body -hyperhtyroidism, chronic pancreatitis,heaptobiliary disease, chronic kidney disease, hypercalcemia -

What marks day 1 of gestation in rats and mice?

Presence of the sperm plug

What is the most common type of mammary tumors rodents get?

fibroadenoma?

What drug groups have renal adverse effects?

aminoglycosides tetracyclines

What drug groups have GI side affects

-all- macrolides lincosamides

What drug groups have bone marrow adverse effects

chloramphenicol potentiated sulfonamides

What are examples of hypovolemic shock?

hemorrhage severe dehydration loss of fluid in third space severe burns

What are examples of distributive shock

-anaphylatic shock -septic shock -neurogenic shock -pheochromocytom

what are examples of obstrutive shock

-GDV -obstruction of vena cava -tension pneumonthorax -cardiac tamponade with pericardial effusion -positive pressure ventilation

What is the shock bolus

-use isotonic crystalloids such as LRS, normosol R, plasmalyte A 5-20ml/kg IV over 10-20 minutes

How do we treat septic shock? Anaphylatic shock?

-norepinephrine and broad spectrum antibiotics -epinephrine and anti-histamines

What does pyogranulamatous means?

macrophages and neutrophils

Small bowel vs large bowel diarrhea

small bowel -> large volume of feces, normal or increase frequency to defecate, flatulence, melena, weight loss, vomiting Large bowel-> small volume of feces, inrease frequency of defecation, mucus in feces, hematochezia, tenesmes, pain or urgency to go

Worry about using steroids with what conditions?

-diabetes mellitus -infections -cushings -nsaid therapy washout

How do we taper steroid

-make sure their clinical signs have been controlled for 2 weeks -decrease by 25% every 2-4 weeks for the next 4-6 months

NSAIDS?

-excellent analgesia for severe, chronic, and or orthopedic pain -contraindicated in dehydrated or hypovolemic patients -risk of GI ulcers/upset

Opiods?

-good analgesic option for acute severe pain

What are upper airway diseases?

-laryngeal paralysis, tracheal collaspe, foreignbodies, polyps, BAS

What are differentials for a titrational acidosis?

KLUE Ketones lactate uremia ethylene glycole

Categorize the liver enzymes

Hepatocellular injury -> ALT, AST Cholestasis -> ALP, GGT Indication impaired funciton -> bilirubin, BUN, cholesterol, albumin, glucose

When do we investigate liver enzymes increased further?

-ALT greater than 2x normal over several months -Unexplained liver enzymes elevation persisiting over 6-8 weeks -non-hepatic cases have been ruled out

What is the gold standard in dogs for detecting heart worm?

-antigen test

What is the most common neoplasm in the spleen of a cat?

-mast cell tumor

What CS do we see with hypothryoidism?

pitting face edema -weight gain -alopecial -hyperpigmented skin

How do we treat and monitor hypothyroidism?

-leovthyroixine once a day -post pill monitoring -> T4 peaks at 4-6 hours after giving meds -should be high to normal T4