Clinical Flashcards
What is not a mark?
• Tattoo
What is not part of the Nationale?
History
What are the Principles of Mareks’ sound percussion: (MC)
- Crackling sound of tapping the hammer and plessimeter.
- Sound of thoracic wall or wall of any organ.
- Resonant sound of gas containing tissue or other organs.
How is the induced cough in the horse? (SC)
Intensive, sharp, high, short, dry, painless, snapping, does not recur.
What are the characteristics of the Pulse pressure:
- Difference between systolic and diastolic blood pressure.
* Determined by heart rate, stroke volume, and peripheral resistance.
What are the indications of an ECG:
- Evaluation of cardiac arrhythmias
- Detect enlarged cardiac chambers (Echocardiography is better)
- Show cardiac disturbances of electrolytes and systemic diseases
- Aid cardiac diseases diagnosis
- Monitor anaesthesia
- Evaluate effectiveness of cardiac drugs (Digitalis glycosides, etc.)
What is the dental formaula in the dog?
3i, 1c, 4p, 2m/3i, 1c, 4p, 3m
Indication of Oesophagosocpy (x9)
- Dysphagia
- Regurgitation
- foreign bodies
- esophageal structure
- megaoesophagus (D)
- eosophagitis (D)
- patent ductus arteriosus (D)
- hiatal hernia (D)
- worms
Indications of gastroscopy (x10)
- dysphagia
- regurgitation
- chronic vomiting
- foreign bodies
- hematemesis
- melena
- gastritis (D)
- ulcers(D)
- neoplasia(D)
- pyloric obstruction (D)
Indications of duodenoscopy (x6)
- chronic vomiting
- hematemesis
- melena
- chronic diarrhea
- IBS
- lymphengiectesa
Indications for colonoscopy (x9)
- Tenesmus
- Haematochezia
- Dyschezia
- Rectal masses
- Faecal mucus
- Lymphoma (D)
- Adenocarcinoma (D)
- Cecal inversion (D)
- Colitis ( D)
Which are not the indications for a GI endoscope?
Ascites
In dogs, right sided heart failure can lead to?
Ascites
Pulmonary edema
Distended jugular
What sound do you hear in case of pulmonary edema?
Non musical ronchi (crepitation & crackling)
What type of stones can be seen with an ultrasound?
Inorganic
organic
struvit and oxalate
Nystagmus
Involuntary eye mouvements
Horner’s syndrome
Myosis
ptiasis
enopthalmos
prolapse of the third eyelid
Post prandial lipaemia, after how many hours?
12
history is part of the general impression?
not true
True about ataxia
- Incoordination
- Muscle weakness
- Vestibular malfunction
Incoordination
Pre cordial thrill?
Pathological. Grade 5 murmur (Very loud murmur with pre-cordial thrill)
Cat’s abdomen organs palpated?
- Right kidney • Left kidney • Urinary bladder • Small intestine • Colon (faeces) • Liver
LN in cattle which physiological?
- Mandibular ln. • Praescpaular ln. • Superficial inguinal lnn. • Sub-iliac lnn. (in lower third between tuber coxae and flank fold) • Mammary lnn.
Not kidney evaluation parameters
creatinine kinase
BM not performed
- Xray
- Biopsy
- Scintigraphy (check for malignancies)
- ALKP (osteolysis)
- CBC (septic disease)
- US
Skin biopsy
- Hereditary skin diseases
- Auto-immune diseases
- Neoplasms
Heart can be plapated
Between the 3rd and 6th ic space.
• All species on both sides except Ru, pig -> Only on the left.
true about kidney
Acute nephritis -> Enlarged, painful.
Chronic nephritis -> Smaller
What Ancillary methods can be used to test muscles? (MC x9)
- EMG (electromyography)
- Biopsy (muscle, endplate)
- CK
- LDH
- AST
- ALT
- US
- MRI
- Urinanalysis (! myoglibinuria)
Which are Anticoagulants? (MC)
- Heparin. (Added to plasma before centrifugation.)
- EDTA
- Citrate
Where is the apical beat located on the dog?
over the edge of the sternum. Left 3-6 ICS, Right 3-5 ICS
Which are ‘Connected’ skin lesions?
Vesicle and bulla
What can be heard in the upper region in the case of hydrothorax?
louder sound, forced loud breathing, increase dullness
What are the lung borders in the horse?
16,14,10
How to examine the spleen?
- Palpation, percussion, rectal examination. In LA!
* Additional: CBC, US!, radiography, FNA/cytology, biopsy
Vesicle
- Circumscribed elevation filled with fluid (>1cm = bulla, blister). Often viral or auto-immune origin.
- Skin lesion less than 1cm and filled with clear fluid.
Narrowing of the upper airway occurs mostly in held expiration?
Not true
What is not palpable in Horse rectal examination?
- Stomach
- Right K
- Liver
UMN
Hyperactive reflexes. Increased tone.
Which additional method for examining the bone marrow is NOT correct?
- Abdominal US
- X ray
Which is the Most important way to examine the urinary tract?
Urinalysis
BMBT
Buccal Mucosal Bleeding Test: Capillary refill time (<2secs). Also, tests platelet function.
Percussion air standpoint
- Volume/Loudness
- Pitch/Frequency
- Tone/Resonance
- Duration
- Special sounds
Expired air standpoint
- Odour
- Strength
- Temperature
- Symmetry
What clinical signs are seen in case of pericardial effusion?
Elevation of the caudo-ventral border: Increase of cardiac dullness (enlargement)
Why do we use Valsalva probe?
Rubbing of pleural surfaces -> stop breathing: Rubbing disappears = pleuropericardial/pleuropleural
Bone clinical examination:
Physical examination -> General inspection, palpation (pain, consistency, crepitation, movement, temperature), percussion.
Symptoms of a generalised seizure:
Diffused origin within cortex, thalamus, brainstem -> So all muscles effected and ‘general’ symptoms seen -> Excitation or loss of consciousness
Thorax normal percussion sounds
- Small animals: Sharp, high or low, sonorous (resonant) and long percussion sound.
- Large animals: Sharp, low, non-sonorous, non-resonant and short percussion sound.
adrenal glands examination
- CBC (stress leukogram)
- Biochemistry (ALP, SIALP, NA/L ratio)
- ACTH stimulation test, LDDS test
- US, CT
locomotor system examination
- History
- Physical examination
- General impression
- Inspection, palpation, percussion of the given organ
- Compare symmetrical parts of the body
Part of general impression
- Body size • Body shape and development state • Nutritional condition • General condition, grooming • Consciousness and behaviour • Posture • Locomotion • Obvious abnormalities
Pulse in cow
- A. Facialis
- A. transversa faciei
- A. coccygea
Where can the pulse be measured on the Horse? (MC
- A. Facialis
- A. transversa faciei
- A. digitalis lat and med
What is true about endoscopy?
Can be done in awake patients (TRUE – in large animals)
What is M-mode in echocardiography?
Uni-directional M-mode echocardiography (M:motion). Used for the measurement of the left ventricle.
Different % in Ruminants:
- Rumen -> 80% on LEFT LHS
• Reticulum -> 50% in middle of abdomen and to the Left 6-9th ics near xiphoid process
• Omasum -> 7-8% on RIGHT RHS and ventral -> Difficult to reach -> 6-9th ics
• Abomasum -> 8% in contact with abdominal wall -> On ventral part of abdomen
What to check when suspecting locomotion problems?
• Physical examination history
• General impression -> Observation of the standing , moving and recumbent animal
• Inspection, palpation, percussion of the given organ -> Functional unit of BAM
• Compare symmetrical parts of the body -> Differentiate musculoskeletal signs of systemic diseases
• Further examinations -> Rectal palpation, X-ray, CT, MRI, Arthroscopy, US, EMG (Electromyography), Scintigraphy = Nuclear
imaging, Biopsy, Aspiration cytology, CBC, Serum biochemistry, Serology
Lab test performed if suspecting bone illness in Horse?
• CT, X-ray, scintilligraphy • Ca, P, • ALKP (increased osteoclast activity), PTH, PTHUrelated protein, vit. D metabolites • CBC • Kidney function • Haematology – Acute osteomyelitis • Biopsy, Histopathology • Cytology, Fluids, Exudates • Microbiology Different mixed answers
Pericardial tamponade in Cow. Signs:
Pulse changes with respiration
Positive venous stasis test -> No emptying below the compression point
What is grade 5/6 of cardiac murmum?
very loud murmur with precordial thrill
What is the procedure of the nervous system exam?
ASK, WATCH, TOUCH, PAIN
Which are US types?
M-model, B-model, Doppler
Which Lymph nodes can be palpated in the healthy Horse?
- Mandibular ln.
* Superficial inguinal lnn.
Noises heard upon pericardial effusion:
- Increase of cardiac dullness
* Crepitation/crackling
Slap test:
hit the wither of the horse: Slap test on arytenoids –> N. vagus recurrens
Examination of the prostate gland:
- Palpation -> Abdominal / Rectal-digital
- Visualisation -> X-ray, US
- Urinalysis
- Examination of prostatic fluid # Prostatic massage
- Examination of semen
- Cytology, biopsy
Describing lymph nodes:
- Shape
- Size -> Measure. Compare to something.
- Consistency
- Structure
- Painfulness
- Movability
- Temperature compared with other
- Surface
- Intactness of covered skin
What is the consequence If the transducer frequency is higher?
Higher resolution and less penetration depth.
Where is the Diernhofer triangle?
- At the cardiac area
* Normal filled with air
Adrenal gland function:
- CBC (stress leukogram)
- Biochemistry -> ALP, SIALP, NA/K ratio
- ACTH stimulation test, LDDS test
- US, CT
Reasons why there might be bleeding from the penis:
Blood dripping from penis, but clear urine: Injury to penis e.g. wound or a prostate problem.
How is the epidermal collarette formed
remainder of the covering of a ruptured vesicle or pustule, but also seen in epidermal necrosis. Can be caused by bacteria or dermatophites.
What is true about the horse? (MC)
- Right colon attached. Stomach does not touch the wall
• Left colon is free
• Long soft palate
• Acute angle of oesophagus into stomach
Which species has physiological palpable ovarian glands?
• Cattle
Respiratory sounds over abdomen (MC)
• Stronger in dog than horse
Which is a Pathological behaviour?
Auto-mutilation
What indicates consciousness?
- Ability to learn
- Eat
- Walk
- Ability to remember
Puncta maximum of the dog on the left side?
for heart apex: 3-6
for murmur: 3P-4A-5M
What causes an enlarged P wave?
Atrial enlargment
2 different labs have measured creatine but got different results, Lab 1 higher than lab 2. What can be the reason?
- One used spectrophotometer
- One used specific enzymes
- Incorrect measurement
- Wrong equipement
What is incorrect about sampling of a spinal cord?
- Blood sample
- Biopsy
- US of abdominal cavity
Which nerves are responsible for the Panniculus reflex?
Afferent: Spinal segments, centre: C7-T1 Efferent: m. cutaneous trunci
In which animals is the percussion of the hemithorax absolute?
horse and dogs
What is the caudal border of lungs in cattle?
11, -, 8
In which species can you feel the heart on the right side?
Cat
Dog
Horse
In which species can’t you palpate the heart on the right side?
- Ruminants
* Swine
Symptoms of vestibular ataxia?
- Head tilt
- Nystagmus
- Animal lean and fall to affected side
Splashing sound characteristics:
Sounds like water in a bottle
Which is the most important part of urinary diagnostics?
Laboratory examinations of urine and blood
Indications to do a skin biopsy? (MC)
- Auto-immune dermatopathies
- Tumours
- Congenital skin diseases
What can the mucous membrane look like if there is cardiac failure?
- Cyanotic
- Livid
- Pale, whitish
What can be examined on the teeth? (x6)
- Stones (cremor dentis)
- Surface
- Closure
- Tartar
- Movability
- Percussion sound
In which species can the uterus be palpated physiologically?
- Horse
* Cattle
What do you examine with the ‘swinging light test’?
• N. opticus + n. oculomotor
Apical beat location in the dog and cat?
Left 3-6 and Right 3-5 ics
Pick the true statement about synovial fluid:
Clear, light-straw in colour, sticky, viscous-feel, strand forming (between fingers / glass slide)
Joint’s motion:
Joints are easily movable according to the given joint’s range of motion. Passive movement is free of pain and no constant crepitation is felt.
Where does the nasal discharge come out from, when it originates from the guttural pouch?
• Bilateral nasal discharge (behind the choanae)
Cause of iron deficiency anaemia?
GI bleeding
How to check the Pancreas?
Check amylase and lipase biochemical parameters
Nerves involved in the perineal and anal reflex:
- N. pudendus (afferent and efferent)
* N. rectalis caud. (efferent)
Signs of a damaged trigeminal nerve?
- Sagging lower jaw
- Trismus
- Tic
What can be seen on inspection of the thorax?
- Repiratory rate
- Chest size
- Deformities
Arterial palpation:
- Rhythm
- Symmetric
- Rate
- Quality -> Size, strength, duration of pulse wave, and fullness of artery
What are the signs of kidney failure?
Chronic: smaller size.
What is the percussion sound of the horse thorax?
Sharp, low, sonorous, short
What is a rhythmic oscillating muscle twitch?
tremor
Which of the following is permanent data of the animal?
- Species
- Breed
- Sex
- Colour
- Colour pattern
- Nose or muzzle impression
- Blood groups
- Marks ->Chestnut, whorl, permanent blemishes or defects
What colour is the mucous membrane in case of hypo-volaemic shock?
• Dirty red
What to check for when you inspect the testes?
- Location
- Size
- Shape
- Structure
- Surface
- Painfulness
- Symmetry
- Movability
- Consistency
- Cryptorchidism -> testes should have descended by 6 months of age -> Sertoli cell tumour can cause hyper-oestrogenism
LMN lesion signs:
- Diminished or absent reflexes
- Decreased or absent tone
What is false about the physical exam of kidney?
Decreased kidney size is always associated with chronic renal diseases in dogs
There are three common causes of kidney shrinkage: congenital renal dysplasia, end stage kidney disease and chronic pyelonephritis.
Rhythmic oscillating muscle twitch:
Tremor
What is B-mode in echocardiography:
2D, Can show DCM and HCM.
Part of rumen with mild tympanic sound?
Upper 1/3rd
What is a Pathognomic symptom?
Specific. Characteristic for a particular disease. Sign whose presence means that the disease is present without any doubt.
month-old calf:
Full capacity = 135-180 liters
Instruments needed for a neurological exam?
- Reflex hammer
- Penlight
- Arterial clamp
- Needle
What is anisocoria?
Unequal pupil size.
What can be examined by inspection of joints?
• Angle • Swelling • Deformities • Symmetry - Skin
Which are Methods of neurological examination?
- X-ray
- EEG (ElectroEncephalography)
- CT (Computed Tomography)
- MRI (Magnetic Resonance Imaging)
- MIR
- Blood count
- Pathogen detection
- Cerebrospinal fluid analysis
Type of exam commonly carried out, together with ECG?
PhonoCardioGraphy PCG
There was a picture of an ECG reading, and a reading from the other test. Has to say what is was.
Choose the correct statement:
CT is an X-ray tube that rotates around the patient to obtain multiple images that are then relayed to a computer that reconstruct the image
What is an elevaton of the skin with fluid and volume under 1cm without epithelial surrounding?
• Vesicle
What is true about the systolic heart murmur in horses:
- Can be physiologic
- Graded 1-3/6
- Can be heard on the left side of the thorax
- Localized and brief
- Intensity may change with exercise
False
- Due to ventricular filling (FALSE – it is Caused by blood flow in aorta and pulmonary artery)
- Happens in late systole (FALSE B it happens in earlyBmid systole)
- It is crescendo (FALSE – it is crescendoBdecrescendo or decrescendo)
What is not part of status praesens?
• History
Indications for a tracheobronchoscopy?
- Acute cough if an inhaled body is suspected
- Chronic cough -> Unknown cause or does not respond to therapy
- Unexplained abnormal breathing pattern / Lung infiltrate
- Tracheal collapse -> Confirmation and staging
- Chronic bronchitis -> Staging and sample collection
- Stridor -> Not explained by larygoscopy evaluation
- Removal of mucoid obstruction in atelectatic lung lobes
Signs of conscious pain perception in dog? (MC)
- Crying
* Biting towards the examiner
Indications for colonoscopy:
- Large bowel diarrhoea
- Haematochezia
- Blood in faeces
- Increased faecal mucosa
- Tenesmus
- Dyschezia -> Pain during defecation
- Palpable rectal masses
What is true about abomasal displacement? (SC)
• Splashing with ballottement
How to examine if there is free fluid and gas in right abdomen of Ruminants?
” Inspection -> Size, presence and grade of bloat.
“ Palpation -> Ruminal contraction at left flank.
“ Percussion -> Normal: upper 1/3- mild tympanic, ventral 2/3 –dull and in froathy bloat we here moderately tympanic “ Auscultation
“ Additional exams- Rumen fluid, rumenotomy, rectal examination
Where does the basic clinical value belong to?
Status preasens
What could cause a cardiac beat dislocation?
- Pneumothorax
- Hydrothorax
- Abcess
- Tumour
What is not transcient data? (MC)
- Type of coat
* Cropped/docked tail
What can be heard in the upper region, in case of hydrothorax?
Splashing sound
Transient data:
- Age
- Body weight
- Brand marks
- Tattoos
- Ear tags
- Micro-chip
What are the reduced mental states?
- Dementia
- Stupor
- Indolentia
- Somnolentia
- Delirium
- Coma
In which cases would you perform a biopsy?
- Hereditary skin diseases
- Autoimmune diseases
- Neoplasm
Which part of the rumen is tympanic?
Upper 1/3rd -> Tympanic Lower 2/3rd -> Dull
What sound is hear during pulmonary odema?
Non-musical rhonchi: Crepitation and crackling
ECG, asked to calculate the heart rate:
155
Cause of epidermal colarette?
Ruptured vesicle
In dogs, left-sided heart failure can lead to:
- Dyspnoea
- Coughing
- tachypnoe
When is RDW (Red cell Distribution Width) elevated?
Regenerative anaemia
A papule is:
Small, solid elevation <1cm
Acoustic impedance:
Density of product x Acoustic velocity
In case of hepatopathy, AST is:
Useless (AST used only for muscle and tendon lab work.)
In what kind of conditions would you hear a stronger heartbeat?
Thin thoracic wall
