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Cat & Dog > Cardiology (1-9) > Flashcards

Cardiology (1-9) Flashcards

1
Q

in canine cardiac cases, what is a cough commonly due to?

A

left atrial enlargement

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2
Q

is it common for cats to cough with cardiac disease?

A

no

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3
Q

what clinical sign is commonly seen with congestive heart failure (CHF) in cats and dogs

A

dyspnoea

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4
Q

dyspnoea is commonly seen in left congestive heart failure (CHF) due to what?

A

pulmonary oedema

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5
Q

dyspnoea is commonly seen in right congestive heart failure (CHF) due to what?

A

pleural effusion

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6
Q

what is pleural effusion in cats commonly caused by?

A

left congestive heart failure (CHF)

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7
Q

what type of activity can prolonged hypoxia cause?

A

seizure-like activity

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8
Q

what blood test assesses myocardial damage?

A

troponin-1

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9
Q

what blood test assesses myocardial stretch?

A

Pro-BNP

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10
Q

name 6 factors that affect the quality of thoracic radiographs

A
  1. phase of respiration
  2. view
  3. rotation
  4. exposure factors
  5. developing
  6. obesity
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11
Q

what vertebrae do you measure the vertebral heart score (VHS) from?

A

T4

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12
Q

what should the vertebral heart score be?

A

less than or equal to 10.5

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13
Q

name 3 types of blood pressure measurements

A
  1. direct
  2. oscillometric
  3. doppler
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14
Q

name the heart disease

chronic activation of the compensatory systems (RAAS, sympathetic system, vasopressin, endothelin, etc) leads to fluid retention and cardiac remodelling

A

congestive heart failure (CHF)

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15
Q

name the stage of heart failure - MMVD (myxomatous mitral valve disease)

genetic predisposition but no structural changes

A

stage A

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16
Q

name the stage of heart failure - MMVD (myxomatous mitral valve disease)

no clinical signs, murmur, no clinically significant cardiomegaly

A

Stage B1

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17
Q

name the stage of heart failure - MMVD (myxomatous mitral valve disease)

no clinical signs, murmur, cardiomegaly (EPIC)

A

Stage B2

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18
Q

name the stage of heart failure - MMVD (myxomatous mitral valve disease)

past or current clinical signs of congestive heart failure (CHF)

A

Stage C

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19
Q

name the stage of heart failure - MMVD (myxomatous mitral valve disease)

severe refractory CHF

A

Stage D

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20
Q

what drugs can be used to treat heart failure by decreasing preload?

A

diuretics

(furosemide, torasemide, spironolactone)

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21
Q

name 3 diuretics that can be used to decrease preload

A
  1. Furosemide
  2. Torasemide
  3. Spironolactone
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22
Q

what drugs can be used to treat heart failure by decreasing afterload?

A

vasodilators

(ACEi, pimobendan)

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23
Q

name 4 types of vasodilators that can be used to decrease afterload

A
  1. ACEi
  2. inodilators
  3. nitric oxide donors
  4. Ca2+ channel blockers
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24
Q

name the 5 step approach to an acute case of left-sided CHF (congestive heart failure)

A
  1. oxygen and cage rest
  2. IV furosemide
  3. IV pimobendan (licensed for dogs only)
  4. sedation if distressed
  5. thoracocentesis (cats)
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25
Q

name the 3 step approach to an acute case of right-sided CHF (congestive heart failure)

A
  1. thoracocentesis (dog) if dyspnoeic
  2. abdominocentesis
  3. treat underlying cause
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26
Q

what is the standard treatment for a chronic case of congestive heart failure (CHF) in dogs
(4 drugs)

A
  1. furosemide
  2. pimobendan
  3. ACEi
  4. Spirinolactone
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27
Q

what is the standard treatment for a chronic case of congestive heart failure (CHF) in cats
(3 parts)

A
  1. furosemide
  2. clopidogrel
  3. +/- thoracocentesis
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28
Q

name the 3 categories of diuretics

A
  1. loop diuretics
  2. K+ sparing
  3. hydrochlorthiazies
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29
Q

name the diuretic

potent diuretic;
fast onset of action;
inhibits K+/Na+/2Cl- pump in thick ascending loop of Henle;
highly protein-bound, NOT filtered! needs to be secreted into tubule for its action

A

furosemide

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30
Q

what drug should be used with furosemide due to side effect of activating RAAS further

A

ACEi

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31
Q

name 6 side effects of furosemide

A
  1. hypokalaemia, hyponatraemia
  2. activates RAAS further
  3. hypocalcaemia, hypomagnesaemia
  4. metabolic alkalosis
  5. excessive dehydration
  6. can aggravate azotaemia
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32
Q

name the diuretic

weak diuretic, end DCT;
competitive antagonist of aldosterone R;
slow onset of action (days);
improved absorption with food;
effects on myocardial fibrosis

A

spironolactone

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33
Q

name the diuretic

weak diuretic, end DCT;
inhibits Na+ channel in DCT;
combined with hydrochlorthiazide

A

amiloride

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34
Q

name the diuretic

inhibit the Na+/Cl- cotransporter in DCT;
better diuretic than K+ sparing;
oral formulation (8-12h duration);
slow onset of action (12h);
side effects: hypokalaemia, hyponatraemia, hypochloraemia

A

hydrochlorothiazide

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35
Q

name the vasodilator

blocks conversion to Angiotensin II
(RAAS activated in CHF)

A

ACEi

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36
Q

name 2 ACEi drugs that can be used to decrease afterload in CHF

A
  1. Benazepril
  2. Enalapril
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37
Q

name the vasodilator

inodilator - positive inotrope (calcium sensitiser);
phosphodiesterase III inhibitor (peripheral vasodilation);
phosphodiesterase V inhibitor (pulmonary hypertension)

A

pimobendan

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38
Q

name the vasodilator

acute management of LCHF in dogs;
glyceryl trinitrate (Percutol cream) & Sodium Nitroprusside;
mediates vasodilation through cGMP

A

nitric oxide donors

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39
Q

name the drug

used for inotropic support in patients with acute HF, septic shock;
used to support myocardial function during GA;
synthetic beta1 adrenergic agonist;
can induce arrhythmias caused by intracellular calcium overload

A

Dobutamine

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40
Q

name the drug

weak positive inotropy (use in DCM in dogs);
negative chronotropy (antiarrhythmic in dogs);
from Digitalis purpurea (foxglove);
blocks Na+/K+ ATPase leading to incr. intracellular Na+

A

Digoxin

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41
Q

name the 3 most common congenital cardiac diseases in dogs

A
  1. subaortic stenosis
  2. pulmonic stenosis
  3. patent ductus arteriosus
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42
Q

name the 2 more common congenital cadiac diseases in cats

A
  1. ventricular septal defects
  2. atrioventricular valve dysplasia
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43
Q

name 5 dog breeds that are predisposed to subaortic stenosis

A
  1. boxers
  2. newfoundland
  3. GSD
  4. golden retrievers
  5. rottweiler
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44
Q

name 3 clinical findings on physical exam that indicate subaortic stenosis

A
  1. sytolic murmur
  2. PMI left heart base
  3. poor pulse quality
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45
Q

what should be used to diagnose subaortic stenosis

A

echocardiography

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46
Q

what breed is most commonly predisposed to pulmonic stenosis

A

bull dogs

(but also several breeds)

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47
Q

name 1 clinical finding on physical exam that may indicate pulmonic stenosis

A
  1. systolic murmur (left heart base)
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48
Q

what should be used to diagnose pulmonic stenosis in a dog

A

echocardiography

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49
Q

what 2 signs of pulmonic stenosis may be seen on radiographs

A
  1. right-sided enlargement
  2. post-stenotic dilatation
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50
Q

what direction of shunting is the most common in patent ductus arteriosus (PDA)

A

left to right shunting

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51
Q

name 3 clinical findings on physical examination that may indicate a PDA

A
  1. continuous “machinery” murmur
  2. “water-hammer”/bounding pulse
  3. PMI left base
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52
Q

what 2 signs of PDA are usually seen on radiographs

A
  1. left-sided enlargement
  2. pulmonary overcirculation
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53
Q

what is the treatment for a PDA

A

closure of the PDA

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54
Q

what dog breed is most predisposed to mitral valve dysplasia

A

english bull terriers

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55
Q

what sign of mitral valve dysplasia may be seen on radiographs

A

left-sided enlargement

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56
Q

name 2 signs of mitral valve dysplasia that may be seen on electrocardiography

A
  1. left atrial enlargement
  2. left ventricular enlargement
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57
Q

what does mitral valve dysplasia lead to

A

left-sided congestive heart failure

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58
Q

what does tricuspid valve dysplasia lead to

A

right-sided congestive heart failure

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59
Q

what breed is the mose predisposed to tricuspid valve dysplasia

A

labradors

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60
Q

what sign of tricuspid valve dysplasia may be seen on radiographs

A

right-sided enlargement

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61
Q

name 2 signs of tricuspid valve dysplasia that may be shown on electrocardiography

A
  1. right-sided enlargement
  2. splintered QRS
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62
Q

what direction of shunting is most common in a ventricular septal defect

A

left to right shunting

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63
Q

what breed is the most predisposed to ventricular septal defect

A

english springer spaniel
(and cats!)

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64
Q

name 2 signs of ventricular septal defect that may be seen on radiographs

A
  1. left (+/- right) enlargement
  2. pulmonary overcirculation
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65
Q

is the systolic murmur louder with a smaller or bigger ventricular septal defect

A

louder with smaller hole

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66
Q

what 3 things does stenisus cause

A
  1. pressure overload
  2. concentric hypertrophy
  3. forward and backward failure
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67
Q

what 3 things do leaks and holes in the heart cause?

A
  1. volume overload
  2. eccentric hypertrophy
  3. backward failure
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68
Q

what is the most common cardiac disease in dogs?

A

myxomatous mitral valve disease (MMVD)

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69
Q

name the cardiac disease

the basic, thin, mitral valve structure is disrupted and distorted by expansion of the matrix of the spongiosa;
the valve leaks leading to a systolic murmur

A

myxomatous mitral valve disease (MMVD)

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70
Q

how does age affect myxomatous mitral valve disease (MMVD)

A

severity and leak increases with age

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71
Q

as preload increases, which part of the heart enlarges?

A

left atrium

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72
Q

which part of the heart enlarges with eccentric hypertrophy?

A

left ventricle

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73
Q

a leakly mitral valve causes volume overload which eventually leads to what kind of heart failure?

A

left-sided congestive heart failure

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74
Q

backward or forward heart failure signs?

  1. cough
  2. dyspnoea
  3. abdominal distension
A

backward failure signs

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75
Q

backward or forward heart failure signs?

  1. exercise intolerance
  2. lethargy
  3. syncope
A

forward failure signs

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76
Q

which comes first in myxomatous mitral valve disease (MMVD), backward or forward failure signs?

A

backward failure signs

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77
Q

name 2 biomarkers from blood samples that can aid management and diagnosis of congestive heart failure

A
  1. Troponin-I
  2. NT-proBNP
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78
Q

name the biomarker

released according to atrial stretch and ventricular wall stress

A

pro-BNP

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79
Q

what diagnostic is required in order to diagnose left-sided congestive heart failure?

A

chest radiograph

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80
Q

acute presentations of congestive heart failure in a dog with MMVD is often due to the rupture of what structure?

A

chordae tendinae rupture

(less likely: left atrial rupture)

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81
Q

name the 4 drugs/therapies used to treat acute congestive heart failure

A
  1. Furosemide IV
  2. Oxygen
  3. Nitroglycerine ointment
  4. Pimobendan

(reach for phone, then have a pee)

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82
Q

if you have to choose, what are the 2 most important drugs for treating congestive heart failure

A

furosemide + pimobendan

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83
Q

name two predictors of congestive heart failure;
increase in the 4 months before stage C of failure

A
  1. incr. HR
  2. incr. RR

(BW decreases by 3%)

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84
Q

the valves on which side of the heart are affected by bacterial endocarditis?

A

left side

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85
Q

name the 2 commonest sites of bacterial endocarditis in dogs & cats

A
  1. mitral valve
  2. aortic valve

(left side of heart)

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86
Q

name 4 non-specific signs of malaise that dogs with bacterial endocarditis typically present with

A
  1. pyrexia
  2. joint stiffness
  3. new murmur
  4. diastolic murmure over left heart base
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87
Q

what is the treatment for bacterial endocarditis?

A

supportive care and antibiotics

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88
Q

what 3 signs should be seen in a chest radiograph to diagnose CHF (congestive heart failure) in dogs with MMVD (myxomatous mitral valve disease)?

A
  1. left atrial/auricular enlargement
  2. pulmonary venous congestion
  3. peri-hilar pulmonary oedema
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89
Q

what chemotherapy drug can cause secondary DCM (dilated cardiomyopathy)

A

Doxorubicin

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90
Q

name 3 nutritional causes of secondary DCM (dilated cardiomyopathy)

A
  1. taurine deficiency
  2. carnitine deficiency
  3. “BEG” diets
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91
Q

what is the main histopathological feature of DCM (dilated cardiomyopathy)

A

wavy myocardial fibres

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92
Q

what value should always be measured to aid in diagnosis, prognosis and management of DCM (dilated cardiomyopathy)

A

T4/TSH

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93
Q

what makes the definitive diagnosis of DCM (dilated cardiomyopathy)

A

echocardiography

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94
Q

is echocardiography necessary to diagnose myxomatous mitral valve disease (MMVD)?

A

no, can diagnose with just stethoscope

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95
Q

what drug can be used to incr. contractility and prolong pre-clinical period of DCM (dilated cardiomyopathy)

(does not cure it)

A

Pimobendan

(PROTECT study)

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96
Q

what drug can be used to treat atrial fibrillation?

A

digoxin

97
Q

name 2 postitive inotropes that can be used in acute management of DCM (dilated cardiomyopathy)

A
  1. pimobendan
  2. dobutamine
98
Q

name the 4 drugs that should be used for chronic management of DCM (dilated cardiomyopathy) with congestion

A
  1. furosemide
  2. pimobendan
  3. ACE inhibitor
  4. Spironolactone
99
Q

name 3 dog breeds that must be warned of sudden death with DCM (dilated cardiomyopathy)

A
  1. Dobermans
  2. Boxers
  3. Great Danes
100
Q

what is the most common cardiac disease in cats?

A

hypertrophic cardiomyopathy (HCM)

101
Q

name the subtye of HCM

when dynamic left ventricular outflow tract obstruction occurs with HCM (hypertrophic cardiomyopathy)

A

HOCM (hypertrophic obstructive cardiomyopathy)

102
Q

what type of heart failure does HCM (hypertrophic cardiomyopathy) in cats lead to?

A

left-sided congestive heart failure

103
Q

what heart sound in a cat usually suggests cardiac disease?

A

gallop sound

(murmur does not always mean cardiac disease in cats)

104
Q

what diagnostic exam is superior to radiography in dyspnoeic cats?

A

T-POCUS

(stress can cause sudden death in cats with heart disease)

105
Q

name the 2 drugs used to treat HCM (hypertrophic cardiomyopathy) in cats with chronic congestive heart failure

A
  1. furosemide/torasemide
  2. clopidogrel
106
Q

name the form of restrictive cardiomyopathy

normal LV wall thickness;
fibrosis of myocardium

A

myocardial form

107
Q

name the form of restrictive cardiomyopathy

thick endocardial scar that may bridge LV lumen

A

endomyocardial form

108
Q

name the feline emergency

Presentation:
acute onset, severe pain;
paresis of hindlimbs, cyanotic pads, cold limbs, no pulse;
up to 66% CHF - dyspnoea

A

feline aortic thromboembolism

109
Q

what type of pain relief should be given to a cat with feline aortic thromboembolism

A

IV opioids

110
Q

in the FAT cat study, what drug was able to outperform aspirin as an anti-thrombotic agent?

A

clopidogrel

111
Q

name the disease

inflammation of the heart muscle

A

myocarditis

112
Q

name 4 causes of myocarditis

A
  1. infectious
  2. neoplasia
  3. toxins
  4. immune-mediated
113
Q

what value will be highly elevated in a patient with myocarditis

A

troponin (cTnl)

114
Q

is heart failure typically systolic or diastolic in dogs?

A

systolic

115
Q

is heart failure typically systolic or diastolic in cats?

A

diastolic

116
Q

name the 2 main causes of pericardial disease

A
  1. idiopathic
  2. neoplastic
117
Q

what breeds commonly have idiopathic pericardial disease?

A
  1. golden retrievers
  2. giant breeds
118
Q

name 5 neoplastic causes of pericardial disease

A
  1. right atrial haemangiosarcoma
  2. chemodectoma
  3. thyroid carcinoma
  4. mesothelioma
  5. lymphoma
119
Q

what diagnostic gives the definitive diagnosis of pericardial disease?

A

echocardiography

120
Q

name 5 key diagnostic findings of pericardial disease that can be seen with echocardiography

A
  1. black fluid stopping at heart base
  2. pleural effusion
  3. neoplasm
  4. ascites
  5. distended caudal vc & hepatic vv
121
Q

why is congestive heart failure (CHF) therapy contra-indicated in pericardial disease treatment?

A

filling is already compromised

122
Q

name 3 treatment options for pericardial disease

A
  1. pericardiocentesis
  2. sub-total pericardiectomy
  3. balloon pericardiotomy (palliative)
123
Q

what side of heart failure does pericardial effusion cause

A

right-sided heart failure

124
Q

what is the best therapy for canine pericardial disease

A

pericardiocentesis

125
Q

where do adult Angiostrongylus vasorum live in dogs?

A

in pulmonary arteries

126
Q

name 3 respiratory signs in a dog with Angiostrongylus vasorum

A
  1. coughing
  2. haemoptysis
  3. dyspnoea
127
Q

name 3 post mortem findings that diagnose Angiostrongylus vasorum

A
  1. nematodes in airways and vessels
  2. R ventricular hypertrophy
  3. thromboembolic lesion
128
Q

name 2 definitive diagnostic tests for Angiostrongylus vasorum

A
  1. ELISA antigen test (Angio Detect test)
  2. Baermann analysis (faecal test)
129
Q

name 3 haematology signs of Angiostrongylus vasorum

A
  1. eosinophilia
  2. thrombocytopenia
  3. anaemia
130
Q

name 4 treatment options for Angiostrongylus vasorum

A
  1. Fenbendazole
  2. Milbemycin
  3. Moxidectin spot-on
  4. Selamectin spot-on
131
Q

which lungworm is more common in north UK

A

Crenosoma vulpis

132
Q

name the parasite

the spaghetti worm;
large, white-ish worm;
females 30cm, males 23cm w/ spirally coiled tail;
mosquito is intermediate host

A

Dirofilaria immitis

133
Q

what is the primary clinical sign of Dirofilaria immitis

A

coughing

134
Q

name 5 haematology signs of Dirofilaria immitis

A
  1. eosinophilia
  2. neutrophilia
  3. basophilia
  4. anaemia
  5. lymphopenia
135
Q

what is the definitive diagnostic test for Dirofilaria immitis

A

Heartworm antigen test
(female only antigen)

136
Q

name 3 treatments for Dirofilaria immitis in dogs

A
  1. doxycycline
  2. larvaicidal
  3. melarsomine hydrochloride
137
Q

in what case is direct removal of Dirofilaria immitis (heartworm) performed?

A

caval syndrome

138
Q

what treatment for Dirofilaria immitis can be used in dogs but is toxic to cats

A

melarsomine

139
Q

name 4 preventative treatments for Dirofilaria immitis

A
  1. ivermectin
  2. selamectin
  3. milbemycin oxime
  4. moxidectin
140
Q

what is the preventative protocol for Dirofilaria after a trip duration <1 month

A

single treatment when back in UK

141
Q

what is the preventative protocol for Dirofilaria after a trip duration >1 month

A

first treatment w/in 30 days of arrival at destination, then monthly thereafter & for 30 days after return to UK

142
Q

list the 3 types of cells of the heart in order of most to least automaticity

A
  1. SA node (60-160/min)
  2. AV node (40-60/min)
  3. Perkinje cells (20-40/min)
143
Q

where is electrical activity of the heart generated?

A

sinoatrial node

144
Q

name the 6 parts of the conduction system of the heart in order

A
  1. sino-atrial node (SA)
  2. special tracts (ST)
  3. Atrial ventricular node (AV)
  4. bundle of His (H)
  5. Purkinje fibres (PF)
  6. ventricular muscle (VM)
145
Q

name the 6 key anatomical elements that contriibute to the ECG

A
  1. spontaneous SA node
  2. atrial myocardiu
  3. insulating annulus fibrosus
  4. slowly conducting atrioventricular (AV) node
  5. rapidly conducting purkinje fibres
  6. ventricular myocardium
146
Q

what is a normal beat on an ECG called?

A

sinus beat

147
Q

what does the P wave represent on an ECG?

A

atrial depolarisation

148
Q

what does the PQ interval represent on an ECG?

A

delay at AV node

149
Q

what does the QRS complex represent on an ECG?

A

ventricalar depolarisation

150
Q

what does the T wave represent on an ECG?

A

ventricular repolarisation

151
Q

what 3 things soes an ECG tell you about?

A
  1. rate
  2. rhythm
  3. conduction
152
Q

how should the animal be positioned to record an ECG?

A

R lateral recumbency

153
Q

what 4 things should be labelled on ECG tracings

A
  1. name/number
  2. date
  3. paper speeds
  4. callibration mark
154
Q

where does the red lead of an ECG go?

(UK)

A

Right fore (above point of elbow)

155
Q

where does the yellow lead of an ECG go?

(UK)

A

Left fore (above point of elbow)

156
Q

where does the green lead of an ECG go?

(UK)

A

Left hind (above the stifle)

157
Q

where does the black lead of an ECG go?

(UK)

A

Right hind (above the stife)

158
Q

this causes regular baseline oscillations at 50Hz on an ECG

A

AC interference

159
Q

what type of oscillations do muscle tremors cause on an ECG?

A

coarse, disorganised oscillations

160
Q

what does limb movement cause on an ECG?

A

single, well-defined deflections

161
Q

how to determine the heart rate from an ECG at 25 mm/s

A
  1. count number of QRS complexes in 15cm
  2. multiply by 6 (6 seconds at 25mm/s)
162
Q

how to determine the heart rate from an ECG at 50 mm/s

A
  1. count the number of QRS complexes in 15cm
  2. multiply by 20 (3 seconds at 50 mm/s)
163
Q

if the impulse generating the QRS starts off above the annulus, how will the QRS complex look on ECG

A

tall and narrow

164
Q

if the impulse generating the QRS starts off below the annulus, how will the QRS complex look on ECG?

A

wide and bizarre

165
Q

what does a wide P wave on ECG indicate?

A

LA enlargement

166
Q

what does a tall P wave on ECG indicate?

A

RA enlargement

167
Q

what does a wide QRS complex on ECG indicate?

A

LV enlargment or LVBBB

168
Q

what does a tall QRS complex on ECG indicate?

A

LV dilation/hypertrophy

169
Q

what does a small QRS complex on ECG indicate?

A

effusions, obesity, hypothyroidism

170
Q

what does alternating R waves in QRS complex on ECG indicate?

A

pericardial effusion

171
Q

what does a deep S wave on ECG indicate?

A

RV enlargement or left anterior fascicular block

172
Q

what does a wide S wave on ECG indicate?

A

RBBB

173
Q

what does a prolonged QT on ECG indicate?

A

electrolyte disturbances, hypothermia

174
Q

what does an elevated/depressed ST on ECG indicate?

A

hypoxial, artifacts

175
Q

where does supraventricular premature complex start off?

A

above annulus
(tall & narrow QRS)

176
Q

name the type of arrhythmia

4 or more consecutive SVPCs;
the R-R interval is regular

A

supraventricular tachycardia

177
Q

name the type of arrhythmia

results from multiple re-entrant circuits above the annulus;
narrow QRS tachycardia with no P waves and irregular R-R intervals

A

atrial fibrillation

178
Q

where do ventricular premature complexes (VPCs) start off from?
they are wide, bizarre and appear earlier than expected

A

below annulus

179
Q

what is R-on-T on an ECG a risk factor for?
(when there is no flat baseline between 2 complexes)

A

ventricular fibrillation

180
Q

name the type of arrhythmia

4 or more consecutive VPCs and is life-threatening

A

ventricular tachycardia

181
Q

name the type of arrhythmia

quick, but not fast enough to be a ventricular tachycardia

A

accelerated idioventricular rhythm

182
Q

name the type of arrhythmia

the PQ interval is long but the AV still conducts

A

1st degree AV block

183
Q

name the type of arrhythmia

some P wavs are conducted, some are not

A

2nd degree AV block

184
Q

what is Mobitz type 1 (2nd degree AV block) mediated by?

A

vagally mediated

185
Q

what is Mobitz type 2 (2nd degree AV block) due to?

A

pathology

186
Q

name the type of 2nd degree AV block

the PQ varies or lengthens before the block

A

Mobitz type 1

187
Q

name the type of 2nd degree AV block

the PQ interval is constant when a P wave conducts

A

Mobitz type 2

188
Q

name the type of arrhythmia

no P waves are conducted, and escape beats come from below the annulus;
P waves are superimposed on QRS complexes

A

3rd degree AV block

189
Q

name the type of arrhythmia

there is a pause in the P waves greater than 2 R-R intervals, but there are still P waves

A

sinus arrest

190
Q

name the type of arrhythmia

there are no P waves at any point on the ECG tracing

A

atrial standstill

191
Q

name the type of arrhythmia

a sinus rhythm with beat-to-beat variation in the height of the R waves;
often due to pericardial effusion

A

electrical alternans

192
Q

name the type of arrhythmia

sinus rhythm with a deep S wave on leads 1, 2, and 3

A

right ventricular enlargement pattern

193
Q

name the type of arrhythmia

a sinus rhythm with a deep S wave on leads 2 and 3 but not lead 1 (usually in cats only)

A

left anterior fascicular block

194
Q

name the type of arrhythmia

combines supraventricular tachyarrhythmias with bradydysrhythmias

A

sick sinus syndrome

195
Q

name the type of arrhythmia

uncoordinated, incessant ventricular activity;
looks like a scrawl and requires DC cardioversion

A

ventricular fibrillation

196
Q

name the 2 reasons for treating an arrhythmia

A
  1. haemodynamically significant
  2. life threatening
197
Q

name 5 drugs to treat tachyarrhythmias

A
  1. lidocaine
  2. beta blockade
  3. sotalol
  4. Ca channel blockers
  5. Digoxin
198
Q

name 3 ways to treat bradyarrhythmias

A
  1. pacemaker
  2. sympathomimetics
  3. anti-cholinergics
199
Q

name the Vaughan William classification

blocks Na+ channel;
prolongs AP;
ex: Quinidine, Procainamide;
for ventricular arrhythmias

A

Class 1A

200
Q

name the Vaughan William classification

blocks Na+ channel;
shortens AP;
ex: Lidocaine, Mexiletine;
for ventricular arrhythmias

A

Class 1B

201
Q

name the Vaughan William classification

blocks Na+ channels;
no effect on AP;
ex: Flecainamide;
for ventricular arrhythmias

A

Class 1C

202
Q

name the Vaughan William classification

beta-blockers;
no effect on AP;
ex: Atenolol, Propanolol, esmolol

A

Class II

203
Q

name the Vaughan William classification

blocks K+ channels;
marked prolongation of AP;
ex: amiodorone solatol

A

Class III

204
Q

name the Vaughan William classification

blocks Ca2+ channels;
no effect on AP;
ex: diltiazem, verapamil;
for supraventricular arrhythmias

A

Class IV

205
Q

name the arrhythmic class

membrane stabilising drugs;
Na+ channel blockers;
inhibit Na+ influx;
needs normal K+ for activity

A

Class 1

206
Q

name the antiarrhythmic

class 1B;
affects phase 0, primarily in diseased tissue;
used as local anaesthetic;
rapid action;
IV use;
first choice for ventricular tachycardia!

A

lidocaine

207
Q

name the antiarrhythmic

similar properties and effects to lidocaine, but ORAL;
indicated for ventricular arrhythmias;
difficult to obtain;
good in combo with Solatol and Atenolol

A

Mexiletine

208
Q

name the antiarrhythmic class

adrenergic beta-R blocker;
negative chronotrope;
negative ionotrope;
indications:
1. pheochromocytoma
2. hyperthyroidism
3. pressure overload
4. arrhythmias (V and SV)

A

Class 2

209
Q

name 2 selective beta1-blockers;
for patients with asthma, diabetes

A
  1. Atenolol
  2. Esmolol
210
Q

name 3 conditions where you must be careful using beta-blockers

A
  1. risk of CHF
  2. diabetes
  3. asthma
211
Q

name the antiarrhythmic

class III;
half a beta-blocker + K+ blocker;
for V and SV arrhythmias;
prolongs action potential duration;
can lead to QT prolongation at high doses;
1st choice for ARVC (boxers)

A

sotalol

212
Q

name the antiarrhythmic

class III;
K+ blocker but also effects class I, II, IV;
for V and SV arrhythmias;
very long half-life

A

amiodarone

213
Q

name 4 possible side effects of amiodarone

A
  1. hepatotoxic
  2. hypothyroidism
  3. pulmonary fibrosis
  4. QT prolongation
214
Q

name the antiarrhythmic class

Ca2+ channel blockers;
mainly for SV arrhythmias;
can induce vasodilation, bradycardia

A

Class IV

215
Q

name the antiarrhythmic

class IV;
well absorbed but first pass metabolism;
oral form (admin TID, modified release BID);
for acute SVT and atrial fibrillation

A

Diltiazem

216
Q

name the antiarrhythmic

narrow therapeutic index;
weak positive inotrope;
parasympathomimetic activity;
useful in atrial fibrillation;
careful if V arrhythmias;
long half life

A

Digoxin

217
Q

name 5 reasons to reduce digoxin dose

A
  1. hypoalbuminaemic
  2. hypokalaemic
  3. azotemic
  4. cachexic
  5. Doberman
218
Q

name 3 GI signs that can be caused by digoxin toxicity

A
  1. nausea
  2. vomiting
  3. anorexia
219
Q

name 4 ECG signs of malignancy that indicate risk of ventricular fibrillation

A
  1. Ron T
  2. multifocal VPCs
  3. very premature
  4. couplets, triplets
220
Q

name 3 criteria for a haemodynamically significant arrhythmia

A
  1. HR > 180-200 bpm
  2. hypotension
  3. clinical signs
221
Q

name the 4 parts of treatment for sustained ventricular tachycardia in order
(emergency)

A
  1. lidocaine IV
  2. class III
  3. beta blockers
  4. cardiversion
222
Q

name 3 types of effective drugs for management of narrow QRS tachycardia

A
  1. beta-blockers (class III)
  2. calcium blockers (class IV)
  3. class III
223
Q

what 2 drugs should be used to treat atrial fibrillation

A

Diltiazem + Digoxin

224
Q

name 3 options for medical treatment of bradyarrhythmias

A
  1. parasympatholytics
  2. sympathomimetics
  3. adenosine R
225
Q

name 3 things that affect stroke volume

A
  1. preload
  2. afterload
  3. contractility
226
Q

the lower the cardiac reserve, the (lower or greater?) the exercise intolerance

A

greater

227
Q

what is the relationship between oxygen delivery (DO2) & oxygen uptake (VO2) when cardiac reserve is exhausted?

A

DO2 < VO2

228
Q

name 4 reasons that animals with cardiovascular disease are at increased risk from anaethesia

A
  1. anaesthetics impair cardiopulmonary function
  2. CV disease causes multiple secondary organ effects
  3. CV disease alters drug pharmacokinetics
  4. treatment may interact with anaesthetics
229
Q

what 2 organs are most commonly secondarily affected by CV disease?

A
  1. renal dysfunction
  2. liver dysfunction
230
Q

name 3 signs of renal dysfunction secondary to CV disease

A
  1. hyperkalaemia
  2. azotaemia
  3. hypoalbuminaemia
231
Q

name 3 signs of liver dysfunction secondary to CV disease

A
  1. coagulation abnormalities
  2. hypoglycaemia
  3. delayed drug metabolism
232
Q

name 9 ways to reduce anaesthetic risk in a dog/cat with CV disease

A
  1. make an accurate diagnosis
  2. understand pathophysiology
  3. recognise secondary complication
  4. recruit cardiovascular reserve
  5. choose anesthetics that offset primary haemodynamic effects
  6. reduce adverse haemodynamic effects of surgery
  7. use adjunct drugs
  8. titrate against clinical effect
  9. adequate monitoring
233
Q

name 3 ways to decr. cardiac work preoperatively for an animal with CV disease

A
  1. vasodilators
  2. rest
  3. anxiolytics
234
Q

name 3 ways to remove fluids preoperatively for an animal with CV disease

A
  1. diuretics
  2. pericardiocentesis
  3. diets
235
Q

which is safer for an animal with CV disease:
gen. anaesthesia OR sedation?

A

gen. anaesthesia

(monitoring!)

236
Q

name 5 negative effects of hypothermia during anaethesia in a patient with CV disease

A
  1. depressed ventilation
  2. incr. blood viscosity
  3. ‘left shift’ OxyHb dissociation curve
  4. arrhythmogenic
  5. causes shivering
237
Q

why should a patient with CV disease not be positioned in a severe ‘head-up’ position during anaesthesia?

A

reduces venous return

238
Q

why should a patient with CV disease not be positioned in a severe ‘head-down’ position during anaesthesia?

A
  1. impairs breathing
  2. decr. cerebral perfusion

Cat & Dog (19 decks)

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