Cardio - Unit 2 Tophat

Question 1

What is the origin of the complex in image A?

Answer 1

ventricular origin

Question 2

What is the calculated heart rate in ECG strip A?

Answer 2

8 complexes in 30 big boxes

8*20 = 160 bpm

Question 3

What is the pathophysiologic etiology of heart failure in a dog with DCM?

A) Too much afterload

B) Too much preload (volume overload)

C) Not enough contractility (decreased inotropy)

D) Not enough relaxation/fillinf (decreased lusitropy)

Answer 3

C

Question 4

What is the GOLD STANDARD diagnostic test for screening dogs for ventricular arrhythmias associated with DCM?

Answer 4

Holter monitor

Question 5

What 2 medications have been shown to slow progression of DCM in Dobermans during the asymptomatic phase?

(i.e. prolong time to development of CHF)

Answer 5

Pimobendan

ACE inhibitor (enalapril/benazepril)

Question 6

Name 2 ORAL medications that can be used to treat ventricular arrhythmias in dogs with DCM.

Answer 6

Sotalol

Mexiletine

Question 7

In patients with pericardial effusion and cardiac tamponade, diastolic filling of the ___ side of the heart is impaired.

Answer 7

right

Question 8

What are the hallmarks of pericardial effusion on a thoracic radiograph?

Answer 8

Enlarged & rounded cardiac silhouette, dilated caudal vena cava, small pulmonary arteries and veins

Question 9

What is normal pulmonary artery systolic pressure?

Answer 9

25 mmHg

Question 10

Is left-sided heart disease pre- or post-capillary?

Answer 10

Postcapillary

Question 11

Is chronic bronchopulmonary disease pre- or post-capillary?

Answer 11

Precapillary

Question 12

What drug is used for treatment of pulmonary hypertension (direct pulmonary vasodilator)?

Answer 12

Sildenafil

Question 13

If an asymptomatic dog tests positive for heartworm disease (positive HW antigen test), what 2 medications should be started IMMEDIATELY (on the day of diagnosis)?

Answer 13

1. HW preventative
2. Doxycycline

Question 14

You are examining a patient that presented to you for a recent onset of lethargy and weakness. On examination you note that the patient is obese and it is difficult to hear the heart sounds, he has a rapid hear rate at 180 bpm, and you do not appreciate a heart murmur. The patient has jugular venous distension, a palpable abdominal fluid wave, and normokinetic to hypokinetic femoral pulses that vary with the patient’s respiratory cycle. What is the most likely cause of the patient’s physical exam findings.

Answer 14

Pericardial effusion with tamponade

Question 15

You are working as an emergency clinician on a busy night in the ER. You have two dogs that present for collapse and you confirm that they both have pericardial effusion. You want to start treatments on the least stable patient first.

What diagnostic test do you recommend for the patients to compare their hemodynamic stability?

Answer 15

Blood pressure

Question 16

A 7-year-old male castrated Boxer presents for an episode of collapse. On physical examination, you auscult frequent premature beats with pulse deficits, but no heart murmur. An ECG shows frequent monomorphic ventricular premature complexes (VPCs) of right ventricular origin. Thoracic radiographs are unremarkable. Which of the following is the most appropriate treatment?

A) Furosemide

B) Pimobendan

C) Sotalol

D) Diltiazem

E) No treatment

Answer 16

C

Question 17

Sildenafil exerts which of the following hemodynamic effects on the right ventricle?

A) Increases contractility

B) Decreases preload

C) Decreases afterload

D) Increases HR

Answer 17

C