b) w/c 23-Sept-14 ALIMENTARY WEEK 1 Flashcards
What leukogram would you expect from a regenerative left shift?
Regenerative Segmented > Band
i.e. more mature than immature
What leukogram would you expect from a degenerative left shift?
Band > Segemented
i.e. more immature than mature
Problem associated with platelet count?
Clumping. Manuel count is better
Normal heart rate ranges for cats and dogs
Cats: 160-200bpm
Dog: 80-120bpm
Pain on eating is known as _____ and is more common in vominiting OR regurgitation?
Odynophagia and is more common in regurgitation than vomiting
Main problem associated with regurgitation?
Aspiration pneumonia ‘cloudiness on the lungs’
Treatment is difficult but involves raising food bowlq
What aluminium hydroxide based compound binds to the exudate at ulcer sites and acts as a protective barrier?
Sucralfate
Which anti-emetic stops substance p binding and is the most potent and acts on the final stage receptor.
Marcopitant
also Omepraxole is a proton pump inhibitor
Increased bilbrubin and ALP are consistant with cholestasis. What is this and why might it cause the increase?
Cholestasis is the blockage of the bile duct. It causes a rise in ALP and Bilrubin due to pancreatitis due to closely apposed pancreatic duct/ bile duct
What would the clinical presentation of a horse with laminitis be?
Bounding digital pulse in affected hoof.
‘Pottery gait’ - hindlimb bias
Laminitis is define as as compromise between the interaction of the hoof wall with the pedal (coffin) bone.
What is the term used to describe increased nitrogenous waste
Azotemia (Creatinine and Urea)
DDx for Azotemia
Pre-renal (dehydration), renal, post-renal. USE SPECIFIC GRAVITY.
What are the normal specific gravity values for Dog, Cow/Horse and Cat.
Cow/Horse: 1.025
Dog: 1.030
Cat: 1.035
If lower cannot concentrate = renal disease
In what species should urea not be used as a reliable indicator, what should be used?
In COWS urea should not be used and it can be recycled into the rumen. Creatinine should be used instead.
What can cause hypernatremia?
Too much sodium. Main extracellular ion.
Can be caused from decreased water intake or increased water loss.
What can cause a decrease in potassium levels?
Potassium is main intracellular ion. Affected by acid/base balance. Vomiting can cause a decrease.
Chloride moves in parallel to ________. Changes in Cl- without changes to this parallel ion could be caused by….
chloride moves in parallel to SODIUM. Acid/Base balance changes K- but not Na+ e.g. vomiting
If albumin is low, what ion will also be low?
Calcium.
What methods can be used to decrease bacterial contamination when incising the gut?
Prophylactic antibiotics if incising gut (not normally required for stomach due to acidic environment).
Lavage GI wound after closure, change gloves, lavage abdo with sterile saline, seperate set of instruments for contaminated part of surgury, isolate site of entry (i.e. exteriorise then use swabs)
Which layer must sutures pass through to reduce the risk of wound breakdown? Why this layer?
Submucosa as it had the highest collagen content
What are the two phases involved in wound repair?
Lag phase (1-4 days). No increase in wound strength just platelet clot, fibrin clot, inflammation Proliferative phase (3-14days). Fibroblast proliferative, increased collagen and INCREASED wound strength.
Which part of the GIT is at the greatest risk of wound breakdown?
Risk of wound breakdown increases along the GIT. The large intestine is therefore most likely to breakdown (regained 50% by day 14)
Three factors that will impact negatively on wound healing
- Hypoproteinemia
- Chemotherapy/Radiotherpay (not for 3 weeks post surgery)
- Steroids (discontinue use post surgery)
Two types of monofilament suture and their respective strengths
Monocryl (33% in 7 days) and PDS (26% in 14 days)
Therefore PDS II is preferable
If an Ex-Lap is performed and nothing of significance is found, what MUST you do
Take biopsies of stomach, small intestine, liver, pancreas. DO NOT BIOPSY THE LARGE INTENSINE UNLESS A LESION IS SPECIFICIALLY IDENTIFIED DUE TO RISK OF BREAKDOWN
Where is the gall bladder found?
In between right medial and quadrate lobes of liver
What should you do before biopsying the liver?
- Consider FNA under ultrasound guidance
- Check coagulation factors (as produced by liver)
Example of a gastric protectant you could administer following gastrotomy
Sucralfate. Also consider using an anti-acid e.g. Omeprazole
Which parts of the stomach cannot be resected? i.e. gastrectomy
Cardia must be preserved. Common bile duct and Pancreatic duct. If not= Supplement pancreatic enzymes for life
When doing an enterotomy where do you place the first suture?
Mesenteric side then second suture on the anti-mesenteric side. (Spatulate smaller side)
REPAIR MESENTERIC DEFICIT otherwise trapped intestine. The omentilise
What would you expect to see on a radiograph for a dog that has eaten string?
‘Stacking up’ of intestine
Difference between leiomyoma and leiomyosarcoma?
Both tumours of the smooth muscle. Leiomyoma is a BENIGN tumour.
Leiomyosarcoma is a MALIGNANT tumour
pronounc: “lie-o-myo-sarcoma”
Would would you expect to see on ultrasound in a dog with intussusception? What treatment options are there??
Parallel lines or consentric rings.
Treatment = reduction or resection.
Reduction = push rather than pull.
If reoccurs could do enteroplication
Prognosis and pathogensis of septic peritonitis.
HOW would you diagnose this?
EXTREMELY GUARDED - 50% MORTALITY
Bacteria- Infllamm cells entry peritoneal cavity, cytokines enter, increased capillary permeability, increased fluid and protein, decreased oncotic pressure, hypovolemic shock.
Diagnosis by abdominocentesis
What drugs should not be given following an enterotomy, why?
Steroids = impairs wound breakdown Anti-emetics = hides 'warning' clinical sign of septic peritonitis
What pH does the rumen digest cellulose best at?
Between 6.2 and 7.
Main VFA at this pH = acetate (=milk fat)
Even lower pH i.e. sugar/ starch = butyrate/ proprinate/ lactate= ruminal acidosis.
Why is rumination in cows so important?
Rumination = salivation. Cows required saliva for its bicarbonate content (150L/day including 3.5 kg of bicarbonate). Need to be comfortable to ruminate.
A high producing dairy cow presents with Haemoptysis and epistasis. What could be causing this?
Sub-acute respir acidosis (SARA).
Ruminitis causes bacteria to get to liver- then lungs.
Also can present with thrombosis of vena cava, laminitis, decreased milk fat and decreased milk yields.
Low milk fat can be indicative of SARA
What position might result in bloat (and why)
Lateral recumbancy can block the cardia resulting in free gas bloat.
Move into sternal recumbancy
How do you treat frothy bloat?
Can lead to sudden death and affect SEVERAL cows (c.f. with free gas bloat; normally single cases).
Treat orally with antifoaming agent/ sufactant e.g. mineral oil 500ml.
How do you diagnose between free gas bloat and frothy bloat?
- Take grazing history; pass stomach tube; if nothing then frothy bloat (treat orally)
- If single animal more likely to be free gas bloat; use rumen trocar or pass stomach tube.
Why might animals with milk fever be at risk from free gas bloat?
Lateral recumbancy due to hypocalcemia might block the cardia.
Sit in sternal recumbancy
When is left displaced abomasum most likely to occur? What are the clinical signs?
High producing dairy cows. Within 6 weeks of calving. Diet changes made too quickly, insufficient fibre; poor management over dry period to post-calving period
Clinical signs include a drop in milk yield, raised ketones in blood/urine
Why are RDA’s more serious than LDA’s?
RDA’s can twist to become an abomasal torsion or volvulus. Blood supply can be compromised and lead to ischemic necrosis. Slaughter or surgery WITHIN hours.
How would you distinguish between caecal dilation and LDA?
Similar clinical signs but rectal examination reveals ‘sausage pointing towards you’
There might also be a ping in the right paralumber fossa. If volvulus; drain surgically
If dilation; high fibre diet then surgery if persistant
Where would you expect to hear a ping if a cow had a caecal dilation?
Right caudal abdomen, extending forward no further than the first three caudal rub spaces. Rectal examination reveals a gas filled sausage
Why do cows with LDA/RDA’s present with hypochloremia and hypokamemia?
Hypocholremia is present because of continued excretion into the abomasum but its not reabsorbed in the small intestine.
Hypokalemeia is due to the alkalosis driving K+ into the cells
What numbers are the wolf teeth?
105 and 205 i.e. top arcade/ Maxillary teeth
105 (top right) 205 (top left)
In horses, what number tooth is most commonly affected by tooth route infections?
109 and 209 (i.e.first molars) as they erupt at 1 yr old.
Therefore they are the oldest teeth
What nunber is the maxillary right quadrant of the horses mouth?
100
Draw a diagram of the 4 quadrants of the horses mouth and the eruption times for all perm teeth
a
How can the infundibulum be used to identify teeth?
2 present in each maxillary cheek teeth
None in mandibular cheek tetth
1 in each incisor
What are the cheek teeth?
Premolars 2 to 3 and Molars 1-3.
i.e. 07-11. Maxillary cheek teeth have 2 infundibuli
What age are the deciduous pre molars shed?
06,07,08. Shed respectively at 2.5,3 and 4 years. If retained can lead to anorexia, poor performance/ malocculusion.
What is the most painful equine dental disease, which teeth does it most commonly affect?
Peridontal disease. Most commonly affects Mandibular cheek teeth (pre molars/ molars)
