CFC Flashcards

Question

What is a bronchial pulmonary pattern?

Answer 1

Increased opacity of the bronchial walls, abnormal shape and diameter of bronchi, thickening of bronchial walls, tramlines (side on bronchi) and doughnuts (end on bronchi). ddx - bronchitis, bronchopnuemonia, feline asthma, mineralisation of bronchial walls.

Answer 2

fluffy, ill defined infiltrate + confluence of abnormal areas. focal - lobar - perihilar - generalised, air bronchograms. ddx - pneumonia, pulmonary oedema, pulmonary haemorrhage, neoplasia

Answer 3

``` Displaced ung margins collapsed lung lobes defined lobar edge Radiolucency - no lung markings elevated cardiac shadow signs of trauma ```

Answer 4

Low to medium Kv and high MAs maximises abdominal contrast expose during expiration Use a grid if abdominal diameter >10cm

Answer 5

Pancreas may be measurably swollen, hypoechoic, may contain solid or cystic masses, mesenteric fat inflamed and hyperechoic.

Answer 6

It is a consequence of deregulation of homeostatic mechanisms between parathyroid hormone, calcitonin and active vitamin D. Most common causes of hypercalcaemia are; Malignancy and hypoadrenocorticism in dogs Malignancy, renal failure or idiopathic in cats. In non skeletal solid tumours as a result of tumour derived parathyroid hormone related protein and cytokines such as transforming growth factors, tumour necrosis factor and oestrogen functioning as osteoclast activating factors . e.g t cell lymphoma, anal gland adenocarcinoma, thyroid carcinoma, thymoma, malignant melanoma Increased plasma PTH-rp concentration in a hypercalcaemic patient in the absence of renal failure gives a strong index of suspision for neoplasia. Sometimes hypercalcaemia results from direct bone destruction in primary or metastatic tumours e.g myeloma, leukaemia, bone tumours, thyroid carcinomas.

Answer 7

In dogs - pupd in cats - lethargy/anorexia The severity of signs depennds on the absolute magnitude, rate of rise, underlying cause, duration.

Answer 8

IVFT 0.9% Nacl Frusemide - causes decreased tubular calcium reabsorption at loop of henle Corticosteroid - decreases gut absorption, bone resorption and increases renal excretion of calcium. Calcitonin - decreases bone resorption Bisphosphonates such as pamidronate, zoledronate and clodronate - bind ca2+ to hydroxyappetite crystals, decrease bone resorption Sodium bicarbonate - promotes alalosis, increases protein bound calcium fraction

Answer 9

Bone marrow suppression anorexia sterile haemorrhagic cystitis vomiting/diarrhoea

Answer 10

Chronic lymphocytic leukaemia.

Answer 11

treat immune mediated disease Bone marrow suppression Pancreatitis

Answer 12

Phlebitis Bone marrow suppression anaphylaxis cardiotoxicity

Answer 13

Phlebitis, peripheral neuropathy | vinblastine is myelosuppressive

Answer 14

It is lymphotoxic and anti inflammatory which allows tumour shrinkage

Answer 15

Osteosarcoma nephrotoxic should never be given to cats - pulmonary oedema vomiting after infusion

Answer 16

anaphylaxis

Answer 17

I - a single node II - two or more nodes in an affected regional area III - generalised lymph node involvement IV - stage III plus liver and spleen involvement V - bone marrow and non lymphoid organ involvement such as eye, CNS, lung

Answer 18

Oral prednisone and chlorambucil

Answer 19

Hyperviscosity of the blood can occur when there are vastly elevated numbers of cells in the circulation or due to hypergammaglobulinaemia, which results from aberrant production of immunoglobulins by neoplastic B cells. IgA and IgM producing tumours cause more severe hyperviscosity than igG as the former are multimeric molecules. Clinical consequences of hyperviscosity include; bleeding diathesis ocular changes - retinal detachment & haemorrhage Neurological signs PUPD due to renal tubular and glomerular damage.

Answer 20

Mephalan and prednisone. If poor response - cyclophosphamide may be added. 85% of patients respond, MST 18 months. bisphosphonates may alleviate discomfort with osteolytic lesions.

Answer 21

Primary erythrocytosis. Rule out any secondary cause of polycythaemia before a diagnosis of primary polycythaemia can be made. EPO levels are low in case of primary polycythaemia. The clinical signs are often due to an increased PCV and resulting hyperviscosity - neurological deficits, visual defects, lethargy and dullness.

Answer 22

Polychromasia, ypochromasia, reticulocytosis, schistocytes, nucleated RBCs on blood smears.

Answer 23

Rare in most breeds but very common in bernese mountain dogs and flat coated retrievers also at increased risk.

Answer 24

``` Aseptic technique Sharp anatomic dissection Gentle tissue handling Careful haemostasis Avoid tension Obliteration of dead space - accurate tissue apposition ```

Answer 25

Polydioxanone Monofilament synthetic absorbable 80% strength at 2 weeks 60% at 6 weeks

Answer 26

Poliglecaprone 25 Monofilament synthetic absorbable 50-60% strength at 7 days 20-30% at 14 days

Answer 27

Polyglactin 910 Braided synthetic absorbable 50% strength at 50 days

Answer 28

Braided synthetic absorbable. polyglactin 910. | Retention of 75% strength at 14 days, 50% at 21 days.

Answer 29

Polyglyconate Monofilament synthetic absorbable . 50% stronger out of pack than PDS and remains stronger at 5 weeks. 90% strength at 1 week.

Answer 30

Mersilk (silk) - braided natural permanent, provides prolonged tensile strength retention in tissues up to 3 months. ethilon - monofilament, synthetic, permanent. Prolene - monofilament, synthetic, permanent

Answer 31

Catgut, monocyrl, vicryl rapide

Answer 32

Vicryl, dexon, biosyn

Answer 33

PDs, maxon | non absorbables

Answer 34

A non depolarizing neuromuscular blocking agent. This would not only stop the dog moving but would prevent ocular movement during very light ga.

Answer 35

Metabolic oxygen consumption - LArge animals 5ml.kg-1min-1 In small animals 10ml.kg-1min-1 .

Answer 36

A higher fresh gas flow is required to flush the expired co2 away during the expiratory phase and prevent it being re inspired, so the fresh gas flow required is calculate dbased on the animals minute volume - 200ml/kg/min For systems with the reservoir bag on the inspiratory limb the fresh gas flow is calculated as 1x minute volume eg magill system, lack, parallel lack. for systems with the reservoir bag on the expiratory limb fresh gas flows are caalculated as 2 or 3x minute volume ayres T piece - 2 or 3x minute vol Bain 2 or 3x minute vol

Answer 37

rebreathed gas is wamer, moist, lower in o2 and anaesthetic as it has been mixed with the expired breath. o2 and anaesthetic must be replenished and co2 must be removed.

Answer 38

At the start of anaesthesia higher gas flows are required (30ml/kgmin) to maintain the concentration of anaesthetic agent within the breathing system. this is necessary because of the rapid uptake of anaesthetic into the animal at the start of anaesthesia, and the expired breath contains a much lower concentration of anaesthetic and will reduce the anaesthetic concentration within the breathing system. Also at the onset of anaesthesia, patients expire nitrogen, which may lower cicuit oxygen to hypoxic levels unless purged througha pressure relif valve. Denitrogenation is achieved using high flows for the first 10-15 minutes of anaesthesia or regular dumping of the bag.

Answer 39

The filled soda lime canister used to absorb co2 contains approximately 50% absorbent granules and 50% airspace. efficient absorption requires an airspace volume in excess of tidal volume, i.e minimum working soda lime volume is 2xvt.

Answer 40

Efficient general purpose, but mechanical dead space, inertia and expiratory resistance preclude its usefull ness in cats or dogs under 5kg. The system should not be used for prolonged IPPV.

Answer 41

Outer inspiratory limb surrounds an inner expiratory tube . lightweight and has less drag than a magill. Inner hose damage has been reported. Parallel lack has largely replaced coaxial system due to potential risks resulting from damage to inner tubing. Mini lack available for use in small dogs and cats.

Answer 42

Inspiratory hose connects to et tube and open ended expiratory limb at a t shaped connector. Gas flow 2 or 3 mv will avoid rebreathing, a rapid respiratory rate with a short expiratory pause - shoter time for expired gas to be flushed away may require higher flows. there is minimal dead space and low resistance, so this is ideal for cats, small dogs, neonates and birds. Can be used for IPPV but risk of barotrauma. With jackson rees modification is an open ended reservoir bag on the expiratory limb. this facilitates IPPV.

Answer 43

This has an inner inspiratory limb and an outer expiratory limb. A valve may or may not be present on the expiratory limb. flow rates vary 2 or 3 x mv, used in animals > 5kg, used for IPPV. low drag and mechanical dead space.

Answer 44

Dose dependent respiratory depression post induction apnoea Post induction cyanosis Dose dependent cardiovascular depression Not arrythmogenic & does not sensitise heart to catecholamines Good muscle relaxation but ocasional muscle twitching Decreases intracranial pressure, causes bronchodilation Anticonvulsant

Answer 45

Cyclohexanone It has analgesic effects - NMDA receptor antagonist, has anti hyperalgesic properties, good for chronic pain, reduces MAC. It causes unconsciousness- dissociative anaesthesia. cranial nerve reflexes are maintained. It increases ICP, IOP. Causes increased HR and contractility, increased mvo2, transient respiratory depression, apneustic pattern, incraesed salivation, muscle rigidity and spontaneous muscle movements common. Use with caution in : hyperthyroidism, hypertrophic cardiomyopathy, glaucoma, epilepsy, increased ICP.

Answer 46

A steroid anaesthetic - 'saffan' used to be with cremophor EL - dogs have anaphylactic reactions to. Not anymore. Can be topped up or used for TIVa as is non cummulative. Now no cremaphor so no histamine release (oedema & flushing of paws, pinnae)

Answer 47

It is a muscle relaxant/neuro muscular blocker. It is not an anaesthetic and has no analgesic properties. It relaxes skeletal muscles. Licensed in horses.

Answer 48

The minimum alveolar concentration of inhalational anaesthetic agent is the concentration that prevents movement in response to a supramaximal stimulus in 50% of unpremedicated subjects. ``` In the dog - Halothane - 0.87 Isoflurane - 1.28 Sevo flurane - 2.36 Desflurane 7.20 ``` ``` In the cat - Halothane 1.14 Isoflurane 1.63 Sevoflurane 2.58 Desflurane 9.79 ```

Answer 49

During induction N2o very rapidly diffuses from alveolus to capillaries. Fractional concentrations of remaining gases in alveolus are increased. higher concentrations of volatile gasses in alveolus results in faster induction.

Answer 50

N2o diffuses into gas filled spaces faster than n2 diffuses out > worsens pneumothorax , gdv, vascular air emboli, dont use if enclosed gas filled space.

Answer 51

Edrophonium or neostigmine.

Answer 52

Eye position in dogs and cats becomes ventromedial, then central with deepening anaesthesia. NB ketamine is associated with a brisk palpebral reflex and central eye position.

Answer 53

Lidocaine - onset 10 mins, duration 60-90 Mepivicaine - onset 10 min, duration 90-180 Bupivicaine - onset 20 min, duration 4-8h

Answer 54

Done most commonly to provide analgesia for abdominal surgery. local injected in proximity to the thirteenth thoracic and first two lumbar nerves. Inject just above the cranial edge of the transverse process of L1. Local infiltration of the injection reduces reaction to needle insertion. L5 is immediately cranial to tuber coxae.

Answer 55

T12, l1 and l2 are also blocked - the ends of the transverse processes of first, second and fourth lumbar vertebrae are identified. The needle is inserted parallel to and just ventral to the transverse process of L1. It is injected in a fan shaped pattern. hen the needle is withdrawn and re inserted just dorsal to the transverse process with another 15 ml injected as before. this blocks dorsal and ventral branches.

Answer 56

branch of the facial nerve - supplies motor fibre to the eyelids. the block producess eyelid akinesia that facilitates ocular examination and provides relaxation for ocular surgery. does not produce corneal or palpebral analgesia.

Answer 57

Upper incisors, gums, upper lip and nostril. Injecting into the canal will desensitise the maxillary bone and many of the maxillary teeth on that side.

Answer 58

Lower lip, if injected into the foramen also produces analgesia of lower incisors and gums.

Answer 59

Long needle inserted through eyelid either dorsal or ventral to the globe, the globe is deflected by digital pressure as the needle is inserted.

Answer 60

This is useful for any surgery involving mandible and teeth - the foramen is palpated just caudoventral to the last tooth. A mixture of lidocaine and bupivicaine can be injected. Another approach is medial to the horizontal ramus, advancing it parallel to the horizontal ramus until the tip is closed to the palpated foramen.

Answer 61

Fergusons reflex is abolished s- eliminates straining of uterus/rectum. Allows tail amputations, caslicks operation, epiziotomy etc. In cattle and horses the site for injection is done by pumping the tail which reveals the first intercoccygeal space as the most mobile. A 21 swg needle is then inserted approx 15 to the vertical.

Answer 62

An area centred on midline lying over most dorsal palpable points of the tuber xocae is prepared - Just caudal to the dorsal process of the last lumbar vertebrae is the lumbosacral space. the needle should be inserted perpendicular to the skin and passed vertically towards spinal column.

Answer 63

Hypoglycaemia - dimished glycogen levels may predispose to gypoglycaemia Hypoalbuminaemia - may alter drug binding and lower plasma oncotic pressure. This is of particular concern if protal hypertension follows attempted resolution of porto systemic shunts. Hepatomegaly - may reduce FRC and limit lung inflation during breathing, predisposing to hypercapnia/hypoxia.

Answer 64

post pyloric vomiting - Metabolic acidosis, hypovolaemia, hypochloraemia, hypernatraemia, hypokalaemia. Pre pyloric vomiting - metabolic alkalosis, hypovolaemia, hypokalaemia, hypochloraemia, hypernatraemia.

Answer 65

``` Metabolic acidosis hypovolaemia hypokalaemia hypochloraemia hypernatraemia ```

Answer 66

Intra gastric pressure in creases, gastric circulation, caudal vena cava blood flow and portal venous flow are obstructed, venous return to the heart and cardiac output are subsequently reduced resulting in cardiogenic shock. Respiratory pathophysiology associated with gdv includes tachypnoea, lower FRC, lower tidal volume. Relive by paracentesis/gastrotomy. Increase in plasma pH due to sequestration of gastric contents within the stomach lumen > respiratory acidosis.

Answer 67

Any condition causing coagulopathy may manifest as epistaxis, as can hypertension and hyperviscosity syndrome such as multiple myeloma. Profound bleeding may also be seen if neoplasms or fungal plaques erode a major vessel.

Answer 68

Chronic fibrotic lung disease and secondary to left sided congestive heart failure. Standard drug treatment is sildenafil and pimobendan .

Answer 69

Aluminium salts Calcium salts Sevelamer hydrochloride Lanthanum carbonate. Dont use calcium salts in animals with hypercalcaemia.

Answer 70

Dilation of teh efferent renal arteriole - reduces glomerular hypertension Reduction of angiotensin II - this has an effect on systemic hypertension, may reduce podocyte hypertrophy and reduce renal fibrosis, may increase appetite and feeling of well being, may cause an increase in azotaemia as a result of reduction in GFR.

Answer 71

ACE inhibitors in dogs | Calcium channel blocker amlodipine in cats.

Answer 72

oral piroxicam for palliation.

Answer 73

Reduced volume of distribution will decrease the required dose of IVa. Increased circulation time will increase the time to effect of IV induction agants. Reduced cardiac output will decrease the induction time of inhaled anaesthetics. increased v/q discrepancy will increase induction time with inhaled anaesthetics. reduced peripheral perfusion will prolong redistribution and clearance. reduced renal blood flow will prolong redistribution and clearance.

Answer 74

Wide P wave - left atrial enlargement Tall P wave - right atrial enlargement. Wide QRS - left ventricular enlargement Tall r - left ventricular enlargement Small r - pericardial/pleural effusion Alternate R waves of different height - pericardial effusion. Deep S wave- RV enlargement

Answer 75

A harmless subcutaneous parasite that also produces microfilaria.

Answer 76

Ace inhibitors (eg enalepril), diuretics eg frusemide, pimobendan, (positive inotrope) +- digoxin (controls ventricular rate in atrial fibrillation), +/- spironolactone depending on how bad it is. May add in dobutamine if end stage.

Answer 77

The early DCt, they prevent sodium and chloride ion reabsorption. Increase the loss of K+ since more sodium is presented in the collecting tubule and more urine flow due to increased volume.

Answer 78

B blockers or calcium channel antagonists - they act as negative chronotropes and negative inotropes resulting in improved diastolic filling. B blocker - atenolol Calcium channel antagonists - diltiazem amlodipine if hypertension (calcium channel antagonist)

Answer 79

they act at the thick ascending loop of henle. They inhibit the co transport of Na / K / 2cl form the lumen into the tubule cell which reduces the hypertonicity of the medulla.

Answer 80

They cause loss of sodium and water in the DCt which leads to hypovolaemia, more sodima nd water is reabsorbed in the PCt, and less urine is in the loop of helne therefore less urine presented to the collecting tubule.

Answer 81

``` Canine haemangiosarcoma canine appendicular osteosarcoma canine and feline mmmary carcinomas canine oral and naillbed melanomas tonsillar squamous cell carcinomas undifferentiated sarcomas and carciinomas of any origin. ```

Answer 82

splitting of s1 is caused by discordant closure of the mitral and tricuspid valves, which can occur when there is asynchronous contraction of the ventricles as in left or right bundle-branch block, cardiac pacing, and ectopic premature ventricular beats. Abnormal splitting of S2 has been associated with pulmonary hypertension, as in pulmonary emphysema of horses and severe heartworm disease in dogs. Other possible causes include a large atrial septal defect, right bundle-branch block, or premature ventricular ectopic beats of left ventricular origin.