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Treatment > Block 3 More > Flashcards

Block 3 More Flashcards

1
Q

How do you treat metabolic shock/

A

Dextrose

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2
Q

How do you treat anemic shock?

A

Red blood cell transfusion

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3
Q

What is an additional concern with GI of shock?

A

Sepsis
Bacteria can enter bloodstream through GI

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4
Q

How does sepsis from shock initially present?

A

Bloody diarrhea

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5
Q

What are the 3 components of the feline lethal triad of shock?

A

Hypothermia
Hypotension
Bradycardia

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6
Q

What is a downside to warming you patient?

A

Warmth makes vasodilation worse

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7
Q

Should you give steroids to shock patients?

A

NO!

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8
Q

How do you not want to administer fluids in a patient that is likely actively bleeding?

A

Bolus

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9
Q

What is a drug that has major cardiovascular effects during analgesia?

A

Dex, dont use dex

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10
Q

What does the doxy for treating HW attack?

A

Wolbachia

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11
Q

What is wolbachia?

A

Endo-symbiotic bacteria inside HW

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12
Q

What should you consider when treating HW with melarsomine?

A

Sedation and analgesia

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13
Q

What is really important to do during the treatment protocol at home?

A

Exercise restriction

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14
Q

What are the 4 things beginning at day 0 of diagnosis of HW?

A

Exercise restriction
Prednisone if symptomatic
HW preventative
Day 0-28 of doxy

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15
Q

When is first melarsamine injection give?

A

Day 61

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16
Q

When are 2nd and 3rd melarsamine injections given

A

90 and 91

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17
Q

What is the susceptibility gap?

A

Period when juveniles are present that are not killed by preventative nor melarsomine

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18
Q

How do you fix the susceptibility gap?

A

2 month lag
Allows juveniles to become adults

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19
Q

What is contraindicated in cats with HW?

A

Adultacide therapy

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20
Q

What can be given with HW that are severe and symptomatic?

A

Sildenafil as pulmonary vasodilator

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21
Q

What is caval syndrome

A

Large worm burden causing retrograde movement of worms into tricuspid valve orifice

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22
Q

What can caval syndrome cause?

A

Right CHF

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23
Q

What is often seen with caval syndrome?

A

Hemoglobinuria

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24
Q

With caval syndrome, you will likely need to do surgery, mortality is still 40% and need to go through melamine protocol

A
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25
Q

What is the slow kill method for HW?

A

Administer macrocyclic lactones and doxy only

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26
Q

How long does slow kill method take?

A

> 2 years for 95% to die

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27
Q

When can you consider slow kill method?

A

Anaphylaxis to melarsomine, older patient that can’t go through procedure

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28
Q

“You must test for HW prior to prescribing HWP because giving HWP to an infected dog could be dangerous”

A

The potential danger depends on the microfilaria load and the type of preventative used

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29
Q

What are the 2 reasons for dogs on preventatives still getting infected?

A

Susceptibility gap
Macrocyclic lactone lack of efficiency
Owner compliance
Resistant strains

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30
Q

Where are most of the resistant strains?

A

Mississippi River Valley

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31
Q

What is the ML-resistance strain called?

A

MP3 (Miss Piggy)

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32
Q

What is Cheyne-Stoker respiration?

A

Occurs with heart failure and end of life

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33
Q

Biot’s respiration?

A

Sequence of gasps, apnea, and several deep gasps

Trauma, stroke, opioids

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34
Q

Kussmaul’s Respiration?

A

Regular deep respirations without pause
Metabolic acidosis

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35
Q

Apneustic respiration?

A

Holding an inspired breath at the end of inhalation for a short period before exhaling
Brain trauma and ketamine

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36
Q

What is number for failure to ventilate?

A

PaCO2 > 60

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37
Q

What is number for failure to oxygenate?

A

PaO2 <60

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38
Q

First step in treating failure to oxygenate?

A

Supplemental oxygen

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39
Q

What is the rule of thumb to prevent oxygen toxicity?

A

Maintain PaO2<250mmHg
Generaly is FiO2<0.5

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40
Q

What is objective of PEEP?

A

Recruit all lung units to stay open

PEEP helps keep lung lobes oxygenating

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41
Q

What does positive pressure require?

A

Intubation

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42
Q

What does positive pressure decrease?

A

FRC (area of lung left after a deep breath)

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43
Q

What are ascending bellows?

A

Bellow ascends during exhalation phase

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44
Q

What type of ventilator is an anesthesia ventilator?

A

Descending

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45
Q

Does descending ventilator have PEEP?

A

No

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46
Q

What are the 3 types of ventilator types?

A

Controlled (machine does all work)
Assisted (patient triggers)
Assist/Controlled (combination of both)

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47
Q

What is the I:E ration?

A

Time spent on respiratory cycle
Inhaled = 1 sec
Exhale = 2 sec
1:2 is normal

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48
Q

What are the 4 types of ventilator induced lung injury?

A

Barotrauma
Volutrauma
Atelectrauma
Biotrauma

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49
Q

What is barotrauma?

A

Regional lung distention due to increased pressure in SOME areas of the lung

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50
Q

What is volutrauma?

A

Over distention associated with high peak airway pressure. Lung stretch causing diffuse alveolar damage

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51
Q

What is atelectrauma?

A

Ventilation at low volumes related to opening and closing of lung units

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52
Q

What is biotrauma?

A

Inflammatory injury due to any of the previous 3

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53
Q

What does capnogrpahy look like with hypoventilation?

A

Increased plateaus

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54
Q

What does capnogrpahy look like with hyperventilation??

A

Decreased plateaus

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55
Q

What does capnogrpahy look like with cardiac arrest?

A

waves going down

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56
Q

Notches occur in spontaneous breathing during PPV

A

Cardiogenic oscillations are common causing decreasing wave in small steps

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57
Q

What does partial obstruction look like?

A

Prolonged slope with fall at end

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58
Q

Equation to remember:

A

Hb = 1/3PCV

59
Q

What is normal pH?

A

7.4

60
Q

What is normal PaCO2?

A

40

61
Q

What is normal PaO2?

A

5 x inspired O2 level

62
Q

What mutation causes a decreased response to a drug?

A

MDR1

63
Q

How long does it take for a HW to get to L5?

A

45-60 days

64
Q

How long does it take to get to adult phase of microfilaria?

A

6-7m

65
Q

With non compliance, how often do you have to test to ensure the patient is HW free?

A

Day 0
Day 180
Day 360

66
Q

If a HW is resistant to one ML is it likely to be resistant to all ML?

A

Yes

67
Q

What is the formula for swine and water consumption?

A

About 1 gallon per 100lbs

68
Q

Extra-label use of drugs in animal feed is not permitted

A
69
Q

How is mycoplasma mostly controlled (antibiotic)

A

Lincosamide

70
Q

What can’t you do with tilmicosin?

A

INJECT IT!

71
Q

What is the most common cause of polyp?

A

Inflammation

72
Q

How do you visualize a polyp?

A

Retract soft palate

73
Q

How do you treat a eustachian tube polyp?

A

Traction and pull
Steroids post op

74
Q

What is stage 1 laryngeal collapse?

A

Everted saccules

75
Q

What is stage II laryngeal collapse?

A

Medial displacement of cuneiform process

76
Q

What is stage III of laryngeal collapse?

A

All plus airway obstruction

77
Q

How do you treat a dog with car par?

A

“Arytenoid lateralization” aka tie back

78
Q

What do you do for dogs that have failed the tie back?

A

Permanent tracheostomy

79
Q

What is the most common tumor of the nasal planum?

A

SCC for cats and dogs

80
Q

What is treatment for nasal planum disease?

A

Nasal planectomy

81
Q

What is a QOL complication of nasal planectomy?

A

Stricture

82
Q

What normally causes stricture?

A

Dehiscence then stricture

83
Q

What is the most common lung tumor in cats?

A

Adenocarcinoma

84
Q

What is the most common lung tumor in dogs?

A

Bronchoalveolar carcinoma

85
Q

What is seen in metastasis of lung cancers?

A

Lung digit syndrome

86
Q

What is treatment for lung cancer?

A

Lung lobectomy
(chemotherapy not great)

87
Q

What is the volume of each lunch?

A

L: 42%
R: 58%

88
Q

Which species has a better prognosis after lung lobectomy?

A

Dogs

89
Q

Does size matter for lung cancers?

A

Yes!

90
Q

What are the 4 respiratory diseases to rule out?

A

Newcastle
Infectious bronchitis
Infectious larygnotracheitis
Avian influenze

91
Q

How can you treat infectious larygotracheitis?

A

Can vaccinate because it spreads slow

92
Q

What is something noteworthy about infectious coryza?

A

Recovered birds can be carriers

93
Q

What is the parasite in chickens?

A

Syngamus trachea

94
Q

Can you vaccinate for EHM in horses?

A

NO!!! (Only EHV1 but doesn’t prevent EHM)

95
Q

What is a hallmark for EHV1 neurological disease?

A

Urinary incontinece

96
Q

What is the most common respiratory infection in horses?

A

Equine influenza

97
Q

What is the treatment for influenza?

A

Supportive care

98
Q

What “breed” is more susceptible to influenza?

A

Foals and donkeys - high mortality

99
Q

When should you vaccinate a foal with influenza?

A

9-11 months of age
Too early may impair future responses

100
Q

What type of bacteria is strep equi equi?

A

Gram (+)

101
Q

How is strangles spread?

A

nose to nose

102
Q

What can be done in complicated cases of strangles?

A

Tracheostomy and penicillin

103
Q

How can you treat purpura hemorrhagica?

A

Penecillin and immunosurppressive Dex

104
Q

What should you not do after a strangles outbreak?

A

Vaccinate for strangles

105
Q

When do foals pick up R. equi and when do they become symptomatic?

A

Within first 7 days
At weaning

106
Q

What is treatment for R. equi?

A

“mycin” antibiotic
Clarithromycin is given 2x a day and if you need to add rifampin, it is also given 2x a day. Easiest

107
Q

What are the adverse effects of treatment of R. equi?

A

Diarrhea
Hyperthermia (anergy?)
Usually aligns with August too

108
Q

How to treat pleuropneumonia in horses?

A

Broad spectrum antibiotic

109
Q

What is a strong signal of equine asmthma?

A

expiratory wheezes

110
Q

What pattern is seen on thoracic ultrasound of equine asthma?

A

Bronchial pattern

111
Q

What is seen on cytology of BAL for equine asthma?

A

Kirshman’s spirals

phospholipids on top too of tap

112
Q

What is #1 clinical sign in equine asthma?

A

Cough

113
Q

What is considered diagnostic on BAL cytology?

A

> 20% non-regenerative neutrophils

114
Q

How should you first treat equine asthma?

A

Management (outside all the time)

115
Q

What is the medical treatment of equine asthma?

A

Steroid (dex)
Bronchodilator (Albuterol)

116
Q

What is #1 nasal tumor in dogs?

A

Carcinomas

117
Q

What is T1 classification of Adam’s modified system?

A

Confined to one nasal passage with no bony involvement

118
Q

What is T2 classification of Adam’s modified system?

A

Bony involvement

119
Q

What is T3 classification of Adam’s modified system?

A

Involvement of bone, orbit, or nasopharynx

120
Q

What is T4 classification of Adam’s modified system?

A

Tumor through cribriform plate

121
Q

Does addition of NSAIDs help prolong survival time with nasal tumors?

A

No

122
Q

What is #1 cause of nasal tumor in cats?

A

lymphoma

123
Q

Are most malignant

A

Yes!!

124
Q

Are most canine nasal tumors malignant?

A

No

125
Q

Is radiation therapy helpful in dogs?

A

No

126
Q

Is radiation therapy helpful in cats?

A

Yes!

127
Q

Do all PDAs need closed?

A

No

128
Q

What is medical therapy for PDAs?

A

Pimo
Enalpril
Furosemide

129
Q

Is surgical ligation a valid treatment option for PDAs?

A

yeah

130
Q

What percent of dogs die from PDA within 3 years of PDA?

A

90%

131
Q

What is the best option for dogs with a right to left VSD?

A

Surgery

132
Q

What should you do with an ASD without evidence of cardiac chamber enlargement?

A

No therapy, monitor

133
Q

What is the most common cause of atrial standstill?

A

Hyperkalemia

134
Q

What is treatment for first degree AV block?

A

Nothing

135
Q

What do you treat with 3rd degree AV block that is fainting

A

Pacemaker

136
Q

What type of drug is telmisartan?

A

ARB

137
Q

Is amlodipine used with pulmonary hypertension?

A

No

138
Q

What can you add to SAS prophylactically?

A

Antibiotics

139
Q

Do you do balloon valvuloplasty for SAS?

A

No

140
Q

What do you treat with any stenotic disease?

A

ATENOLOL

141
Q

*** Atenolol reduces heart rate and contractility and thus myocardial oxygen consumption. It has anti-ischemic effects and anti arrhythmic effects

A
142
Q

Is PS ever cured?

A

No!

143
Q

In a dog with a history of syncope and weakness due to severe mitral valve stenosis, what therapy should not be considered?

A

Amlodipine

144
Q
A

Treatment (10 decks)

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