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SAM I > Cardio > Flashcards

Cardio Flashcards

1
Q

King Charles spaniel presents to your clinic. Upon auscultation you hear a murmur. What is the best diagnostic test(s)?

a. Electrocardiogram & Echocardiograph of the heart
b. Echocardiograph of the heart & x-ray of the chest
c. Auscultation & PE
d. Cardiac Catheterization & angiocardiography

A

b. Echocardiograph of the heart & x-ray of the chest

Explanation:

Radiographs of the heart and thorax should be taken in ALL CASES where cardiac abnormalities are detected on PE. Lateral & VD or DV or necessary.

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2
Q

Atrial fibrillation is characterized by:

a. Very slow heart rate
b. Steady heart rhythm
c. Machinery murmur
d. S4 gallop
e. Pulses and heart sounds with irregular rhythm and intensity

A

e. Pulses and heart sounds with irregular rhythm and intensity

Explanation: Many foci are firing independently and so there is rapid chaotic electrical activity. Auscultation sounds like a 5 year old playing the drums - chaotic!

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3
Q

Which of the following is true with regards to LEFT atrial enlargement?

a. Increased duration of p wave
b. Increased amplitude of p wave
c. Decreased duration of p wave
d. Decreased amplitude of p wave

A

a. Increased duration of p wave

Explanation: PEAKS and MOUNDS
Peaks = High Voltage = P Pulmonale = Right Atrial Enalargment
Mound = Increased Duration = P mitrale = Left Atrial Enlargment

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4
Q

Which is not part of the PE auscultation of the heart?

a. Make the dog sit
b. Auscultate in a quiet room
c. Occlude the nares for short periods if the patient is panting
d. Exert firm pressure on the thoracic wall to prevent sound artifacts from hair rubbing together which may resemble crackles.
e. All of the choices are correct

A

a. Make the dog sit

Explanation: the patient should be standing

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5
Q

Which are the typical signs of left sided heart failure?

a. Dyspnea, cough, orthopnea
b. Dyspnea, cough, tachycardia, weak pulse, weakness and syncope
c. Distension of jugular and peripheral veins, ascites, hepato- and splenomegaly, pleural effusion, and peripheral edema
d. Continuous machinery murmer, cyanosis, erythrocytosis

A

b. Dyspnea, cough, tachycardia, weak pulse, weakness and syncope

Explanation:
C = signs of R-sided heart failure
D = CS of Patent Ductus arteriosus

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6
Q

Which of the following is correct?

a. Lidocaine is the drug of choice to treat 3rd degree AV block
b. Furosemide is used to treat pulmonary edema
c. ACE inhibitors act as agonists to Ag II, causing vasoconstriction and hypertension.
d. If a dog is in cardiogenic shock, digoxin is the drug of choice to improve cardiac contractility.

A

b. Furosemide is used to treat pulmonary edema

Explanation:

A= NO. You will kill your patient.
C = ACE inhibitors prevent the formation of Ag II and cause vasodilation and hypotension.
D = Dobutamine is used for cardiogenic shock as it is a better positive inotrope.
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7
Q

Which of the following is incorrect?

a. An enlarged left atrium will show a P wave with greater amplitude
b. Sick sinus syndrome is characterized bradycardia, intermittent periods of sinus arrest or AV block, long periods of asystole & escape beats.
c. T waves become tall and spiked with hyperkalemia
d. Right Ventricular enlargement is identified by the appearance of an S wave in leads I, II, III and aVF.

A

a. An enlarged left atrium will show a P wave with greater amplitude

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8
Q

Which of the following is not associated with prolonged QRS?

a. Supraventricular predepolarization
b. Left bundle branch block
c. Right bundle branch block
d. VPD
e. Ventricular escape beat

A

a. Supraventricular predepolarization

Explanation:

SVPD are coming in early but there is a P wave for every normal QRS complex. Everything is normal, just faster.

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9
Q

Which of the following is most likely to cause tachycardia?

a. Sinus bradycardia
b. First degree AV block
c. Sinus arrest
d. Atrial Fibrillation

A

d. Atrial Fibrillation

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10
Q

5 yr old irish wolfhound presents with decreased contractility, atrial fibrillation and a ventricular response rate of 280 bpm. what drugs do you give?

a. Lidocaine
b. Beta blockers
c. Digoxin and Diliatizem
d. ACE inhibitors
e. None- Atrial fibrillation doesn’t respond to treatment

A

c. Digoxin and Diliatizem

Explanation:

The dog has a high ventricular response rate with decreased function. The response rate is best achieved with Diltiazem & Digoxin.
(p. 26 notes)

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11
Q

What is the best way of detecting pulmonary edema from congestive heart failure?

a. Radiographs
b. Stethescope
c. PCO2
d. Ultrasound

A

a. Radiographs

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12
Q

Which of the following can be diagnosed on the physical exam?

a. Supraventricular tachycardia
b. AV block
c. Hyperkalemia
d. Atrial fibrillation

A

D. Atrial fibrillation

Explanation:

This can be heard on auscultation. The heart rate is irregularly irregular (5 year old playing the drums)

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13
Q

Which one of the following statements about Patent Ductus arteriosus is correct?

a. The hallmark of PDA is a continuous machinery murmur.
b. The treatment of choice is beta blockers.
c. The prognosis of PDA without treatment is excellent.
d. PDA always starts as a R-L shunt.

A

a. The hallmark of PDA is a continuous machinery murmur.

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14
Q

What would be the initial treatment for a dog with mild heart failure due to dilated cardiomyopathy?

a. Furosemide and Pimobendan
b. Furosemide and Oxygen
c. Furosemide and Dobutamine
d. Furosemide and Ace Inhibitors

A

a. Furosemide and Pimobendan

Explanation:

This combo allows for treatment at home and avoiding the stress of the hospital.

Only severe CHF would need hospitalization w/ monitoring where you can treat with oxygen, dobutimine CRI (if hypotention and decreased contractility).

ACE inhibitors are used after the initial treatment to control preload and deleterious effects of RAAS system.

(pg. 50 notes)

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15
Q

Which of the following is true of cats with HCM?

a. The gold standard test for diagnosis are biomarkers in the blood.
b. Aspirin is the most effect treatment for control of aortic thromboembolism
c. This is a very rare cardiomyopathy in cats.
d. Clinical signs may include systolic murmur, irregular pulses with dysrhythimas, dyspnea and/or hind limb paralysis

A

d. Clinical signs may include systolic murmur, irregular pulses with dysrhythimas, dyspnea and/or hind limb paralysis

Explanation:

A = no. usefulness of these test has not been determined. Better off with Rads and ECG. HCM is an exclusion diagnosis.

B = there is little evidence of the effectiveness of aspirin.

C = HCM is the most common cardiomyopathy.

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16
Q

Which of the following is true of HCM in cats?

a. it can remain subclinical for years and many achieve near-normal life expectancies.
b. Warfarin is the treatment of choice for prevention of aortic thromboembolism
c. Prognosis of cats with aortic thromboembolism and heart failure is excellent if treated early on.
d. Cats that present with aortic thromboembolism are non-painful.

A

a. it can remain subclinical for years and many achieve near-normal life expectancies.

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17
Q

Which of the following is true of aortic stenosis?

a. Aortic stenosis is transmitted genetically and most commonly affects chihuahuas and WHWT
b. Surgical correction (transventricular myectomy or balloon valvuloplasty) is the best treatment option and increases survival.
c. Echocardiogram w/ Doppler is used to diagose the severity
d. Aortic stenosis is characterized by hyperkinetic pulses

A

c. Echocardiogram w/ Doppler is used to diagose the severity

Explanation:

A = these breeds are not affected

B = Survival does NOT increase with surgery

D = hyperkinetic pulses are only seen if there is aortic insufficiency and regurgitation is also present.

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18
Q

Which of the following statements about endocardiosis is correct?

a. Endocardiosis affects mainly large and giant breed dogs.
b. Left atrial enlargement can exasperate or cause coughing, especially those with chronic airway disease
c. The most common radiographic sign is Right Atrial enlargment
d. A systolic click on auscultation is diagnostic.

A

b. Left atrial enlargement can exasperate or cause coughing, especially those with chronic airway disease

Explanation:

As regurgitation increases, there is left atrial enlargement that compresses the left main bronchus against the aorta.

A = Mostly small/medium sized dogs

C = The most common radiographic sign is LEFT atrial enlargement

D = Systolic clicks are an early sign but they are often insidental

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19
Q

Which of the following statements about L-R shunting in PDAs is correct?

a. Erythrocytosis
b. Continuous murmur & waterhammer pulses
c. Cyanosis caudally (vulva/penis) but not in the mucous membranes of the head.
d. Cases of L-R cannot be corrected surgically as this will result in acute Right heart failure.

A

b. Continuous murmur & waterhammer pulses

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20
Q

Standard treatment for endocardiosis (MVD) Stage C is?

a. Ace inhibitors
b. Pimobendan
c. Lasix
d. All of the above

A

D. All of the above

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21
Q

What causes DCM in cats?

A

Taurine deficiency

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22
Q

DCM in dobermans can cause?

A

VPDs

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23
Q

Which of the following is the LEAST likely in hypertrophic cardiomyopathy?

a. Volume overload left ventricle
b. ECG may be normal or show signs of left heart enlargement
c. Murmur is typically an incidental finding at routine visits

A

a. Volume overload left ventricle

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24
Q

Which of the following is the LEAST likely in myxomatous atrioventricular valvular degeneration?
Decreased diastolic filling

A
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25
Q

What is the best/most likely treatment of a Grade III AV Block?

a. Defibrillation
b. Pacemaker
c. Lidocaine
d. Furosemide

A

b. Pacemaker

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26
Q

You treated 9yo SF Toy Poodle for left congestive heart failure due to myxomatous valve disease and then sent it home. A week later it experiences weakness and starts vomiting. You do a blood panel and the BUN and Crea(i think) were increased. What do you do?

a. Euthanize it because of the very grave prognosis
b. Further decrease the Na in the diet
c. Decrease the Furosemide dose
d. Decrease the ACE inhibitor
e. Add Sildenafil to treatment protocol

A

c. Decrease the Furosemide dose

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27
Q

What is the BEST way to diagnose HCM?

a. Hear a murmur upon auscultation
b. Hear a gallop rhythm upon auscultation
c. Radiographs
d. Echocardiogram

A

d. Echocardiogram

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28
Q

True/False: ARVC is best treated with Sotalol.

A

TRUE.

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29
Q

Murmurs in cats, which is incorrect?

a. Tx with beta blocker and ace inhibitors
b. In cats, murmurs are more common on the left side
c. Physiological are rare
d. HCM can occur with or without a murmur

A

c. Physiological are rare

Explanation: they’re common

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30
Q

Which of the following is correct?

a. Pulmonic stenosis can be treated with balloon valvuloplasty
b. characterized by degrees of Right ventricular concentric hypertrophy
c. tetralogy of fallot rarely results in cyanosis
d. Atrial septal defects often cause hypertrophy and fatal arryhthmias
e. Persistant right aotic arch present with Left heart failure

A

a. Pulmonic stenosis can be treated with balloon valvuloplasty

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31
Q

What is the treatment of choice for aortic stenosis?

A

Sotalol

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32
Q

T/F: When clinical signs appear in a cat suffering from HCM, they can have sudden death, weakness and rear limb paresis/paralysis.

A

TRUE

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33
Q

A Boxer presents with Ventricular Premature Depolarizations, what should you do next?

A

Holter Monitor to determine the frequency

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34
Q

An dog presents with coughing. You suspect endocardiosis (Myxomatous AV degeneration). What should you do to confirm your diagnosis?

A

Radiograph

Echocardiogram

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35
Q

True/False:
Ace inhibitors with help slow the progression of endocardiosis.

A

FALSE.

This disease cannot be slowed down. No Chill.

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36
Q

Which of the following is correct in regards to DCM?

a. Great danes usually get VPDs
b. Usually die suddenly from arrhythmias or develop heart failure
c. Once VPDs are seen, patients must be put on beta blockers immediately.
d. Characterized by diastolic dysfunction and thickening of ventricular walls (pressure overload)

A

b. Usually die suddenly from arrhythmias or develop heart failure

Explanation:

a. Seen in doberman pinschers/boxers
c. up to 50 vpds/day are ok for dobermans
d. there is SYSTOLIC dysfunction, thickening of ventricular walls and volume overload.

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37
Q

Which of the following commonly causes L-CHF?

a. Pulmonic stenosis
b. Aortic stenosis
c. PDA
d. ASD

A

c. PDA

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38
Q

LN enlargement, lameness, and an ulcerative lesion on the ventrum. Best test?

a. Joint aspirate and cytology
b. Hepatozoon titer
c. Lepto titer
d. Impression of the ulcerative lesion

A

d. Impression of the ulcerative lesion – bc you’re always supposed to start with the least invasive test

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39
Q

True/False:
Pericardial effusion is best treated with diuretics

A

FALSE.

Diuretics are contraindicated (decrease blood volume, further collapse chambers).

Perform pericardiocenteiss with cardiac tamponade.

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40
Q

True/False
Use Na+ supplementation to treat heart disease

A

FALSE

You want to reduce serum sodium levels to decrease water retention.

Caution: Severe sodium restriction ccan cause hypotension & renal dysfunction, esp if ACE inhibitors are being used.

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41
Q

Which of the following would you not use for heart failure treatment? (CHF = FONS)

a. Furosemide
b. Oxygen supplementation
c. Nitroprusside
d. Amlodipine

A

d. Amlodipine

42
Q

True/False:
Warfarin is a safe and effective drug for treatment of ATE secondary to HCM in a cat.

A

FALSE.

There is no demonstrated survival benefit. May actually cause fatal hemorrhage.

Aspirin is used for chronic control.

43
Q

True/False:

Endocardiosis causes decreased contractility.

A

FALSE.

It is Normal to increased. The pump is working, the valve is broken.

44
Q

TRUE/FALSE
Treat DCM w/ Nitroglycerine bc it’s a bronchodilator

A

FALSE

Nitroglycerine is a venodilator

45
Q

How do ACE inhibitors work?

A

a. Block myocardial damage from the RAAS system
i. Blocks conversion of Angiotensin I → II to help protect the heart from the damaging effects of
the SNS

46
Q

True/False
Treatment of choice is Pimobendan for cats with HCM.

A

FALSE

– NO, its ACE inhibitors. There is no contractility issue w/ HCM so
wouldn’t use pimobendan (which improves contractility by sensitizing the heart to Ca2+). Do use
pimobendan w/ DCM bc there’s decreased contractility w/ DCM.

47
Q

True/False:

Diagnostic tool of choice is rads for Myxomatous AV degeneration (Endocardiosis)

A

FALSE

it’s U/S. Unless coughing. then add rads.

48
Q

TRUE/FALSE:

Furosemide Can be given IV, IM, IO in the treatment of pulmonary edema.

A

TRUE

49
Q

TRUE/FALSE

ACE inhibitors are more effective in the acute phase of heart failure

A

FALSE

They are very effective as chronic maintenance therapy

50
Q

TRUE/FALSE:

HCM can remain subclinical for years.

A

TRUE

51
Q

TRUE/FALSE

Arrhythmogenic right ventricular cardiomyopathy commonly causes left heart failure.

A

FALSE

Signs of right CHF may be seen. Occasional left.

52
Q

Which one of the following is indication for treatment of VPDs?

A. When there are too many
B.ventricular tachycardia is present
C. R on T is present.
D. All of the above

A

D. All of the above

53
Q

TRUE/FALSE:

T waves are always negative.

A

FALSE

54
Q

Which of the following statements is incorrect?

  1. Dilated cardiomyopathy is seen principally in large and giant breeds of dogs.
  2. Dilated cardiomyopathy in cats may be caused by a deficiency of taurine in the diet
  3. In dilated cardiomyopathy echocardiography usually reveals the atria and ventricles to be enlarged and “flabby”. Contractility is reduced.
  4. In dogs with dilated cardiomyopathy, lone atrial fibrillation is best controlled with propranolol or diltiazem. If these are ineffective alone then digoxin should be added to the treatment.
  5. Dogs with dilated cardiomyopathy have a guarded to very poor prognosis.
A
  1. In dogs with dilated cardiomyopathy, atrial fibrillation is best controlled with propranolol or diltiazem. If these are ineffective alone then digoxin should be added to the treatment.

This is the treatment for severe DCM afib. Digoxin is not effect for lone-AF. Also, sotalol is better.

55
Q

. Which statement from the following about hypertrophic cardiomyopathy in cats is incorrect?

  1. It is characterized by moderate to severe left ventricular concentric hypertrophy.
  2. It is generally idiopathic but may be secondary to genetic factors, endocrine abnormalities, hypertension or congenital heart defects.
  3. It often presents clinically as acute dyspnea, syncope/collapse and/or rear limb paresis.
  4. The most effective treatment is dobutamine infusions. Oral digoxin to improve cardiac contractility.
  5. Cats with hypertrophic cardiomyopathy have a poorer prognosis if thromboembolism is also present.
A
  1. The most effective treatment is dobutamine infusions. Oral digoxin to improve cardiac contractility.– tx with beta blocker / ace inhibitor
56
Q

Which of the following statements about chronic valve disease is incorrect?

  1. It is the most common cause of coughing in older dogs.
  2. No therapy will halt or delay the progression of the disease.
  3. It results in volume overload of the heart and eccentric hypertrophy
  4. Furosemide, ACE inhibitors and a reduced salt diet are the mainstays of therapy.
  5. Acute exacerbation of signs with chronic valve disease may occur if there is rupture of the chordae tendinae.
A
  1. It is the commonest cause of coughing in older dogs.
    - No. The most common cause is small airway disease. Cough results from bronchial compression from L atrial enlargement.
57
Q

Which of the following statements about chronic valve disease in dogs is incorrect?

  1. It occurs most commonly in small and medium sized dogs.
  2. In the early stages of the disease the heart compensates adequately and there are no clinical signs.
  3. As the heart begins to decompensate there is a night-time cough.
  4. With further decompensation the cough occurs in the day-time as well.
  5. Finally the dog usually shows signs of right-sided congestive heart failure with hepatosplenomegally and ascites.
A
  1. Finally the dog usually shows signs of right-sided congestive heart failure with hepatosplenomegally and ascites.

Explanation: mitral valve is more commonly affected. this is LEFT CHF

58
Q

Which of the following statements is incorrect?

  1. In dogs with chronic valve disease and chronic bronchitis, coughing can be decreased by the administration of arteriodilators which decrease left atrial compression on the left mainstem bronchus.
  2. In boxer myocarditis there is no ventricular dilation or loss of contractility but ventricular arrhythmias are common.
  3. Pericardial effusion is commonly due to metastasis of hemangiosarcomas to the right atrium.
  4. Dogs with valvular endocarditis commonly have fever, anorexia, weight loss and the sudden and rapid development of a murmur.
  5. Cardiac tamponade is best treated by the intravenous administration of furosemide to decrease intrapericardial pressure.
A
  1. Cardiac tamponade is best treated by the intravenous administration of furosemide to decrease intrapericardial pressure.
59
Q

The most sensitive test for the diagnosis of heart worm infection in dogs is:

  1. a concentration test
  2. Radiography
  3. echocardiograph
  4. an antibody detection test
  5. an antigen detection test
A
  1. an antigen detection test
60
Q

Which of the following statements about heartworm disease is incorrect?

  1. the disease may result in right heart failure
  2. radiographs are useful to characterize the severity of the disease
  3. Thrombocytopenia is a common finding in infected dogs.
  4. In echocardiography the worms may be invisible as parallel hyperechoic lines.
  5. Indoor dogs are more likely to develop the disease than outdoor dogs.
A
  1. Indoor dogs are more likely to develop the disease than outdoor dogs.
61
Q

. Which of the following statements about the prophylaxis of heartworm is incorrect?

  1. From the age of 6-8 weeks, all dogs at risk of heartworm should be placed on prophylaxis.
  2. If unprotected dogs/cats are diagnosed with occult heartworm they should be placed on prophylaxis immediately to prevent further infection.
  3. Ivermectin and other macrolides are administered for prophylaxis of heartworm on a monthly basis.
  4. Ivermectin (heartguard) cannot be given as a heartworm prophylaxis to Collies.
  5. If milbemycin prophylaxis is started in a microfilaremic dog there might be mast cell degranulation and a shock-like reaction
A

3. Ivermectin (heartguard) cannot be given as a heartworm prophylaxis to Collies.

62
Q

Which of the following statements about the treatment of heartworm disease is incorrect?

  1. worms die within a few hours of melarsomine therapy
  2. dyspnea in a dog post adulticide therapy is an emergency and requires cage rest, oxygen therapy, predisolone and perhaps bronchodilators
  3. in severe infections,a graded kill of heartworms can be carried out by giving melarsomine once and then again (two injections 24 hours apart) a month later
  4. A heartworm antigen test should be carried out four months after adulticide therapy to ensure all adult heartworms have been killed.
  5. Dithiazanine, ivermectin and milbemycin are effective microfilaricides.
A
  1. worms die within a few hours of melarsomine therapy
63
Q

. Which statement about feline heartworm disease is incorrect?

  1. In endemic areas heartworms are less common in cats than in dogs.
  2. Heartworm adulticide therapy will result in a life-threatening crisis in 30% of cats
  3. Common sign of heartworm infections are very rare in cats
  4. Occult heartworm infections are very rare in cats
  5. Outdoor and indoor cats should be placed on prophylaxis
A
  1. Occult heartworm infections are very rare in cats
64
Q

. Which statement about hypertrophic cardiomyopathy in cats is incorrect?

  1. it is characterized by left ventricular concentric hypertrophy
  2. clinical signs include dyspnea, syncope/collapse and/or rear limb paresis
  3. the primary treatments given are furosemide to relieve pulmonary edema and a beta-blocker to improve diastolic filling
  4. thrombi present in the femoral arteries should be removed surgically
  5. subsequent thromboembolism may be prevented with aspirin or coumarin
A
  1. thrombi present in the femoral arteries should be removed surgically
65
Q

Which of the following statements about chronic valve disease is incorrect?

  1. it occurs most commonly on older, small breed dogs
  2. it is most often subclinical
  3. the abnormality is best diagnosed by ultrasound
  4. the mitral valve is most commonly involved
  5. therapy with corticosteroids will halt or delay the progression of the disease
A
  1. therapy with corticosteroids will halt or delay the progression of the disease
66
Q

Which of the following statements about chronic valve disease is incorrect?

  1. it is usually associated with a murmur which is loudest over the apex of the heart on the left
  2. the murmur is due to regurgitation of blood from the ventricle to the atrium in diastole
  3. left atrial enlargement can exacerbate coughing caused by concurrent collapsing trachea
  4. acute heart failure can develop if there is rupture of the chordae tendinae
  5. most dogs with chronic valve disease die from some other condition
A
  1. the murmur is due to regurgitation of blood from the ventricle to the atrium in diastole
67
Q

Which of the following statements about canine heartworm disease is incorrect?

  1. outdoor dogs are more likely to be infected than indoor dogs
  2. symptomatic dogs may show progressive weight loss, chronic non-productive cough, labored respiration, exercise intolerance and exertional dyspnea
  3. the most sensitive diagnostic test is an ELISA for heartworm antigen
  4. radiographs are useful to characterize the severity of the vascular lesions
  5. left ventricular enlargement is common in dogs with heartworm
A
  1. left ventricular enlargement is common in dogs with heartworm
68
Q

Which of the following statements about prophylaxis of heartworm is incorrect?

  1. from the age of 6-8 weeks, all dogs at risk of heartworm should be placed on prophylaxis
  2. some puppies placed on prophylaxis at 6-8 weeks may develop adult heartworm infections later because they may have been infected with microfilariae in utero
  3. Ivermectin (heartguard) can be given as a heartworm prophylaxis to Collies.
  4. Milbemycin should only be given as a prophylactic if the dog is confirmed to be free of microfilaria
  5. “filaribits” (diethylcarbamazine) are now seldom used for prophylaxis because of the problems associated with daily dosing
A
  1. some puppies placed on prophylaxis at 6-8 weeks may develop adult heartworm infections later because they may have been infected with microfilariae in utero (doesn’t happen)
69
Q

Which of the following statements about the treatment of dogs with heartworm is incorrect?

  1. dogs with moderate to severe lung lesions are generally given aspirin and prednisolone before adulticide therapy
  2. graded kills of adult worms may be achieved by administering a single dose of “immiticide” (melarsomine) followed by two doses a month later
  3. dogs should be cage rested for 1-2 weeks after the adulticide treatment
  4. dyspnea following adulticide therapy is an emergency and should be treated with oxygen, cage rest, prednisolone and possibly bronchodilators
  5. although not FDA approved, milbemycin or ivermectin may be used as microfiaricides
A
  1. dogs should be cage rested for 1-2 weeks after the adulticide treatment
70
Q

Which statement about feline heartworm disease is incorrect?

  1. compared to the situation in dogs, in cats prepatent periods are longer and there are usually fewer adult worms which have shorter life-spans
  2. most cats with heartworm have occult infections
  3. many infections in cats are asymptomatic
  4. when signs occur there is usually coughing, dyspnea and vomiting
  5. cats are less likely to have life threatening crises post adulticide therapy than dogs
A

5. cats are less likely to have life threatening crises post adulticide therapy than dogs

71
Q
  1. The EKG lead most commonly used to measure the amplitude and duration of depolarizations and repolarizations of the heart is:
  2. lead I
  3. lead II
  4. lead III
  5. V10
  6. aVr
A
  1. lead II
72
Q

Which of the following statements about murmurs is correct?

  1. diastolic murmurs are more common than systolic murmurs in dogs
  2. the first and second heart sounds are audible with a holosytolic murmur
  3. murmurs only occur with heart disease
  4. the second heart sound is caused by the closure of the aortic and mitral valves
  5. an s4 gallop is common in dogs with atrial fibrillation
A
  1. the first and second heart sounds are audible with a holosytolic murmur
73
Q

Treatment for ventricular premature contraction (VPCs) is indicated when:

  1. over 10% of the total heart beats are VPCs
  2. the R-on-T phenomenon is present
  3. there is evidence of myocardial failure
  4. any of the above are present
  5. only a and c above are present
A
  1. any of the above are present
74
Q

The choice of therapy for VPCs is:

  1. intravenous digoxin
  2. intravenous lidocaine
  3. oral lidocaine
  4. continuous infusions of dobutamine
  5. intracardiac epinephrine
A
  1. intravenous lidocaine
75
Q

Which statement about dogs with aortic stenosis is incorrect?

  1. it is a congenital condition, occurring commonly in Newfoundlands and boxers
  2. there is usually a systolic murmur loudest on the left over the heart base and radiating along the carotid arteries in the neck
  3. left-sided congestive heart failure usually develops and this must be treated with digoxin and furosemide
  4. the severity of the lesion (gradient across the valve) is usually determined by Doppler
  5. fatal ventricular arrhythmias usually develop before heart failure occurs
A
  1. left-sided congestive heart failure usually develops and this must be treated with digoxin and furosemide
76
Q

Which statement about a patient with a patent ductus arteriosus that is shunting left-to-right (L-R) is incorrect:

  1. there is usually a continuous murmur and “waterhammer” pulse
  2. radiographs may show a ductus diverticulum and prominent blood vessels in the lungs
  3. there is no polycythemia
  4. signs of right heart failure usually develop
  5. surgery is the treatment of choice
A
  1. signs of right heart failure usually develop
77
Q

Typical signs of heart failure are:

  1. ventral, edema, dyspnea, tachycardia
  2. dyspnea, cough, tachycardia, weak pulses, weakness and syncope
  3. tachypnea, epistaxis, hemoptysis
  4. ascites and weakness
  5. dyspnea, cough, murmur, ascites and pleural effusion
A
  1. dyspnea, cough, tachycardia, weak pulses, weakness and syncope
78
Q

Initial therapy for a dog in severe left heart failure should include:

  1. oxygen, furosemide and nitroglycerine ointment
  2. oxygen, digoxin and an ACE inhibitor
  3. dobutamine infusion and a low sodium diet
  4. dopamine infusion with parenteral oxygen and nitroprusside
  5. spironolactone, an ACE inhibitor and digoxin
A
  1. oxygen, furosemide and nitroglycerine ointment
79
Q

A transudate is characterized by having a:

  1. large number of cells, mainly neutrophils and a high protein content
  2. small number of cells, mainly neutrophils and a high protein content
  3. large number of cells, mainly macrophages and a low protein content
  4. small number of cells, mainly macrophages/mesothelial cells and a low protein content
  5. large number of cells, mainly eosinophils and a low protein content
A
  1. small number of cells, mainly macrophages/mesothelial cells and a low protein content
80
Q

A Holter monitor is useful for investigating:

a. the relative sizes of the heart chambers
b. arrhythmias
c. electrolyte disturbances
d. murmurs
e. gallop rhythms

A

b. arrhythmias

81
Q

Which statement about hypertrophic cardiomyopathy in cats is incorrect?

  1. it is characterized by left ventricular concentric hypertrophy
  2. in most cases it is idiopathic but sometimes it is secondary to hyperthyroidism, hypertension or aortic stenosis
  3. clinical signs include acute dyspnea, syncope/collapse and or rear limb paresis
  4. the primary treatments to be given are furosemide to relieve pulmonary edema and dobutamine infusions/oral digoxin to improve cardiac contractility
  5. thromboembolism may be controlled with aspirin or coumarin
A
  1. the primary treatments to be given are furosemide to relieve pulmonary edema and dobutamine infusions/oral digoxin to improve cardiac contractility
82
Q

Which of the following statements about chronic valve disease is incorrect?

  1. it is the commonest cause of coughing in older dogs
  2. it occurs most commonly in older, small breed dogs
  3. ACE inhibitors and furosemide are the mainstays of therapy
  4. If heart heartfailure is present, antitussives are contradicted and the use of digoxin and bronchodilators questionable
  5. No therapy will halt or delay the progression of the disease
A
  1. it is the commonest cause of coughing in older dogs
83
Q

Which statement about feline heartworm disease is incorrect?

  1. the prevalence of heartworms in cats is lower than in dogs
  2. cats react to dead worms more severely than dogs
  3. common signs of heartworm in cats are coughing, dyspnea and vomiting
  4. most cats with heartworm have occult infections
  5. only outdoor cats should be placed on prophylaxis
A
  1. only outdoor cats should be placed on prophylaxis
84
Q

Which of the following statements about heartworm disease is incorrect?

  1. the disease usually results in left heart failure
  2. radiographs are useful to characterize the severity of the disease
  3. the most sensitive diagnostic test is an ELISA test for heartworm antigen
  4. by echocardiography, the worms may be visible as parallel hyper echoic lines
  5. outdoor dogs are more likely to develop the disease than indoor dogs
A
  1. the disease usually results in left heart failure
85
Q

Which of the following statements about prophylaxis of heartworm is incorrect?

  1. from the age of 6-8 weeks, all dogs at risk of heartworm should be placed on prophylaxis
  2. melarsomine can give a graded kill of heartworms in severely effected dogs if it is administered once and then again a month later
  3. Ivermectin cannot be given as a heartworm prophylaxis to Collies
  4. Dyspnea in a dog post adulticide therapy is an emergency and requires cage rest, oxygen therapy, prednisolone and perhaps bronchodilators
  5. Microfilaria therapy is given 3-6 weeks after adulticide therapy.
A
  1. Ivermectin cannot be given as a heartworm prophylaxis to Collies
86
Q

Which of the following indicates Left ventricular enlargement

a. ↑ P wave
b. ↑ Q wave
c. ↑ R wave
d. ↑ S wave
e. ↑ T wave

A

c. ↑ R wave

87
Q

Which of the following arryhthmias is most likely to cause no clinical signs?

a. Sick Sinus Syndrome
b. Wandering Atrial Pacemaker
c. Grade III AV blk
d. Vent tachycardia
e. Supraventricular tachycardia

A

b. Wandering Atrial Pacemaker

There are no hemodynamic consequences.

88
Q

Which of the following treatments is the most likely to control the clinical signs of Grade III AV block?

a. Defibrillator
b. pacemaker
c. medical therapy w/ digoxin
d. medical therapy w/ propranol
e. none of the above

A

b. pacemaker

89
Q

7yr old male boxer with history of collapsing, irregular heart rhythm. Which diagnostic test would you do?

a. measure blood pressure
b. electrocardiogram
c. xray heart
d. Ultrasound heart
e. cardiac catherization

A

b. electrocardiogram

90
Q

Which of the following statements is true about murmurs?

a. diastolic murmors are more common than systolic murmurs
b. None of the normal heart sounds can be heard with holosystolic murmur
c. 1st and 2nd heart sounds are audible with pansystolic
d. murmur only heard when heart is diseased
e. murmurs with L-R shunts are louder than R-L

A

e. murmurs with L-R shunts are louder than R-L

91
Q

12 yr old CKCS with chronic cough, you detect grade III AV block w/ midsystolic murmur loudest over mitral valve. What are the next 2 diagnostic tests?

a. Echo of heart and xray chest
b. EKG and echo of heart
c. Measure serum electolytes and echo of heart
d. measure blood pressure and xray chest
e. EKG and xray chest

A

a. Echo of heart and xray chest

92
Q

Which statement is correct?

a. pericardial effusion usually results in Right Heart failure
b. pericardial effusion is best treated medically w/ diuretics
c. bacterial endocarditis most commonly affects papillary muscle
d. a week of antibiotic therapy is usually sufficient to tx bacterial endocarditis
e. hypertension in K9/Fe is most often idiopathic

A

a. pericardial effusion usually results in Right Heart failure

93
Q
  1. Which of the following is the best initial therapy for K9 in severe Left heart failure?
    a. beta blocker and digoxin
    b. O2 and furosemide
    c. Pimobendan and ↓Na diet
    d. O2 and ACE inhibitor
    e. Calcium channel blocker and lasix
A

b. O2 and furosemide

94
Q

With regards to cardiac hypertrophy

a. eccentric with pressure overload
b. concentric with pressure overload
c. concentric with volume overload
d. eccentric with volume overload
e. both b and d

A

b. concentric with pressure overload

95
Q

Furosemide for pulmonary edema, which is correct?

a. usually results in mild dehydration, ↓K and ↓Na
b. oral administration of ? is as effective as IV administration in animals with

severe heart failure

c. Na supplimentation is needed in animals on chronic therapy
d. should be given limited access to water while on lasix as this will counter act

effects of the drug

e. maintanence dose of lasix in 90% of dogs is 1mg/kg every other day

A

a. usually results in mild dehydration, ↓K and ↓Na

96
Q

What does a Holter moniter investigate?

a. murmurs
b. gallop murmurs
c. relative size of heart
d. arryhthmias
e. electrolyte distubance

A

d. arryhthmias

97
Q

Which of the following treatments of CHF with ACE inhibitors is correct?

a. arterial dilators do not cause vasodilation
b. block remodeling of myocardium induced by RAAS
c. potent and very rapid onset of action
d. most common side effect is ↓ liver enzymes
e. if BUN and creatinine ↑, dose should be ↓

A

b. block remodeling of myocardium induced by RAAS

98
Q

Which of the following about abnormal myxomatous AV valves is correct?

a. frequency in small breed
b. commonly progresses to CHF
c. pulmonary edema resulting from CHF is most common in old dogs w/ a cough
d. Right atrial enlargement can exacerbate coughing due to small airways
e. Rt atrial enlargement can be ↓ by administration of a + inotrope like digoxin

A

a. frequency in small breed

99
Q

Which of the following about Myxomatous AV valves is correct?

a. commonly on tricuspid valve
b. prssure overload of ventricle and concenric hypertrophy
c. use of ACE inhibitors early in course of disease will slow degeneration and prolong life
d. ACE inhib and lasix are mainstays of therapy if heart failure occurs

A

d. ACE inhib and lasix are mainstays of therapy if heart failure occurs

100
Q
A

SAM I (6 decks)

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