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CD General subjects > Computer test - ECG, US, endoscopy,BP measurement > Flashcards

Computer test - ECG, US, endoscopy,BP measurement Flashcards

1
Q

Central venous pressure measurement

A

Direct (catheterization or accurate invasive fluid replacement)
Indirect (examination of peripheral veins OR in DOGS : lateral recumbence collapse of v. saphena about 5cm aboce zero point)

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2
Q

Systemic arterial pressure indications in small animal practice ?

A

To reveal secondary hypertension in case of known predisposing factors, diseases
To find the cause of ocular, central nervous or cardiac alterations, signs
In case of using ACE-inhibitors or hypertensive drugs
In case of severe diseases, shock
Anaesthesia monitoring Thrombosus
To reveal essential hypertension

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3
Q

Blood pressure formula ?

A

Cardiac output x peripheral resistance Peripheral resistance depends on vessel diameter, wall elasticity, blood viscosity
From 120/80 mmHg in Aorta to 2-5 in vena cava.
Systolic/diastolic value
Pulse pressure = systolic minus diastolic pressure
Arterial mmean pressure : diastolic pressure + (pulse pressure / 3)

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4
Q

Causes of hypertension ?

A 
Renal diseases (50% of cases) 
Endocrine diseases (Cushing, Hypo-/hyperthyroidism, diabetes mellitus) 
Pheochromocytoma 
Obesitas 
Essential 
Acromegaly
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5
Q

Consequences of hypertension ?

A

Ocular
Central nervous
Cardiac
Renal

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6
Q

Arterial BP measurement different methods ?

A

Direct (arterial puncture by inserting pressure KT) = accurate but invasive & painful

Indirect :
Automatic (oscillometric method) → systolic, diastolic, arterial mean pressure measurement
Doppler method → systolic, (diastolic) pressure
Dog, cat: a. sacralis mediana, a. radialis

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7
Q

Arterial BP measurement by Doppler method ?

A

Forelimb behind the paw, tail, (hind limb behind the paw) → aa. digitales palmares communes, a. caudalis mediana
Only systolic value
At any animal size
Needs training (technically more difficult than oscillometry)

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8
Q

Arterial BP measurement by oscillometric method ?

A

Systolic, diastolic (mean) blood pressures
Dog: Forelimb (a. radialis), tail (a. caud. med.), hind limb (a. saphena)
Cat: Forelimb (a.radialis)
Automatic
Technically simpler but easily produces false measurements
Not reliable in animals smaller than 8kg

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9
Q

Principles and parts of ECG

A

Measures amplitude and time of potential differences of electric current generated trhough depolarization and repolarization of cardiac structures’
Can be recorded intracardially, epicardially or on surface of body

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10
Q

Small animals electrical conduction system ?

A

Sub-endocardial (fibres superficial on muscles)

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11
Q

Large animals electrical conduction system ?

A

Sub-epicardial (fibres deep in muscles)

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12
Q

P wave and correspondance in the cardiac cycle ?

A

Start of Atrial depolarization – diastole

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13
Q

PQ phase and correspondance in the cardiac cycle ?

A

Total atrial depolarization – every cell ‘isoelectric’

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14
Q

QRS complex and correspondance in the cardiac cycle ?

A

Start of ventricular depolarization – systole starts – o Atria repolarise but not detectable

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15
Q

Q wave and correspondance in the cardiac cycle ?

A

Signal runs to apex of heart

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16
Q

R wave and correspondance in the cardiac cycle ?

A

point of max ventricular depolarization

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17
Q

S wave and correspondance in the cardiac cycle ?

A

Depolarization of right ventricle

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18
Q

ST phase and correspondance in the cardiac cycle ?

A

Ventricles totally depolarized – ‘isoelectric line’

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19
Q

T wave and correspondance in the cardiac cycle ?

A

Start of ventricular repolarization
o Small animals – down
o Large animals – up

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20
Q

TP phase and correspondance in the cardiac cycle ?

A

Resting phase after repolarization – ‘isoelectric line’

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21
Q

Diagnostic value of ECG

A

Only a part of systemic clinical examination, which is to us by proper indivation and in experienced hands
Exact diagnosis and evaluation of cardiac arrhythmias – best method
Detects enlarged cardiac chambers – but echocardiography better
Shows cardiac disturbances of electrolytes and systemic diseases – Ca2+. K+
Aids some cardiac disease diagnosis/prognosis
Monitors anaesthesia & surgery → deepness of narcosis, hypoxia, arrhythmias, danger of cardiac arrest
Evaluates effectiveness of cardiac drugs (Digitalis glycosides , antiarrhythmic medication, electrolyte substitution, pericardial puncture, etc.)

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22
Q

Calculate HR on ECG ?

A

R/R interval, average of 3-4 beats

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23
Q

ECG leads systems ?

A
  • Einthoven - bipolar = difference of potential between two points
    First vector right to left forelimb,
    2nd vector left forelimb to left hindlimb,
    3rd vector left hindlimb to righ forelimb
    1st electrode = Right forelimb = Red / 2nd = Left forelimb = Yellow / 3rd = Left Hindlimb = Green
  • Goldberger - unipolar (same as Einthoven but higher voltage)
  • Wilson’s - unipolar precordial
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24
Q

Position for ECG ?

A 
Right lateral recumbency
Sternal recumbency 
Standing 
Attaching the leads (wetting, alligator clips) :
 Red = Right Foreleg, 
Yellow = Left Foreleg, 
Green = Left Hindleg, 
Black = Right Hindleg
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25
Q

Standard speed of ECG ?

A

Paper speed – 25mm/sec (or 50 mm/sec)
25mm/sec – each square is 0.04 sec
50mm/sec – each square is 0.02/sec

26
Q

Different cardiac arrhytmias ?

A
  • Normotop : impulse formation dist.
    o Sinus node
  • Sinus tachycardia or bradycardia
  • Sinus arrhythmia
* Heterotop : sick sinus syndrome 
o Atrium
- Atrial  extra systole (premature escape)
- Atrial  tachycardia 
- Atrial fluttern
- Atrial fibrillation

o AV node

  • Nodal extra systole (premature escape)
  • Nodal tachycardia

o Supra-ventricular
- Ventricular extra systole (premature escape) F

o Ventricle

  • Ventricular tachycardia - Ventricular fluttern
  • Ventricular fibrillation
27
Q

Impulse formation disturbances ?

A
  • Normotop
  • Sinustachycardia
  • Respiratory (sinus) arrhythmia)
  • Ectopic beats : 1. escape beats, 2. premature beats, supraventricular extrasystole, premature ventricular contraction, ventricular extrasystole
  • Heterotrop
  • ventricular premature beats/extrasystoles, bigeminal rhythm
  • atrial fibrillation
  • paroxysmal ventricular tachycardia,
  • ventricular fluttern
28
Q

Impulse conduction disturbances ?

A

µ Normotrop

  • SA block
  • I, II, III degree AV block
  • Complete block of the bundle of His
  • Right bundle branch blockage
  • Left bundle branch block
  • Sinus arrest
  • Wandering pacemaker
  • Heterotop
  • 1stdegree AV block → Prolonged AV conduction time (PQ interval longer than usual)
  • 2nd degree AV block → P waves but no ventricular complex (QRS)
  • 3rd degree AV block → Isolated P waves and ventricular complexes (QRS)
  • His bundle
    → Complete block
    → Right block
    → Left block
29
Q

Signs of enlarged cardiac chambers ?

A
  • Left Atrium – wide, notched P – P mitrale
  • Right Atrium – tall, peaked P – P pulmonale, atrial T
  • LA + RA – P biatriale
  • Left Ventricle – wide, tall QRS, ST changes, left axis shift of vector
  • Right Ventricle – S1, S2, S3, right axis shift of vector
  • Both ventricles – wide tall QRS, deep Q wave, P changes, normal axis of vector
  • Example – LA and LV enlargement – e.g. in DCM
30
Q

ECG changes in case of hyperkaliemia ?

A 
Tall, peaked T 
Flattened P
 Bradycardia 
Prolonged P-R and Q-T
 Wide QRS
 Atrial standstill
 Sino-ventricular rhythm
 3rd degree AV block
 Cardiac arrest
31
Q

ECG changes in case of hypoK ?

A

Prolonged Q-T
Small biphasic T
Bradycardia

32
Q

ECG changes in case of Hyper Ca ?

A

Elevated S-T
Bradycardia
Altered T
Short S-T

33
Q

ECG changes in case of hypo Ca ?

A

Prolonged Q-T

Tachycardia

34
Q

ECG changes in case of myocardial hypoxia ?

A

Changing HR – decrease then increase
Abnormally large T – may shift polarity (up/down)
ST elevation or depression
Cardiac arrhythmias

35
Q

Technique of echocardiography ?

A

Only sector transducers can be used
Numbers of echocardiographic windows are limited
Examination planes, transducer orientations and nomenclature differ from those of abdominal ultrasonography

36
Q

Diagnostic possibilites of echocardiography ?

A

Examination of cardiac chambers (wall, cavity)
Recognition of valvular disorders
Detection of shunts with contrast echocardiography (septal defects, PDA)
Quantitative and functional examination: e.g. fractional shortening
Detection of blood flow disorders (Doppler echocardiography)
Detection of pericardial fluid : free fluid (even 15 mL), pericardial mass, paradoxical wall movement, collapsed “right heart”

37
Q

Echocardiography M mode ?

A

Unidirectional M-mode echocardiography (M: motion) or “duplex” mode
→ used for measurements of the left ventricle
One-directional ultrasonography: the moving cardiac structures are depicted only along one ultrasound line emitted from the probe. Depth is plotted on the vertical and time on the horizontal axis

38
Q

Echocardiography B-mode ?

A

Two-dimensional B-mode echocardiography

DCM: dilated cardiac myopathy
HCM: hypertrophic cardiac myopathy

39
Q

Left ventricle dimension evaluation ?

A

Bi-dimensional mode

La = max 17 mm in cats

40
Q

Transducer used in abdominal US ?

A

1.12 MHz Transducers
For large animals we have to use low frequency transducers. These produce higher waves which have a poorer resolution (old technique) nowadays they are better.

41
Q

Indications for Abdominal US ?

A

Palpable alterations in the abdomen
Laboratory alterations (haematological changes, inflammation, etc.)
Clinical signs without palpable or laboratory alterations
Screening exam (congenital diseases, elderly patients)
Only after a proper clinical examination to answer questions about morphology

42
Q

US of abdominal cavity - visible things ?

A 
Fluid accumulation (black) →  bladder, close to it there’s usually some free abdominal fluid 
Abdominal mass 
Free air

Enlarged lymph nodes (lymphoma)
Hypoechoid because filled with a lot of blood
Especially seen when enlarged due to some cancer

US of the kidney
Normal
Diffuse kidney changes in a young dog

Pyometra in dog - Fluid filled uterus

Intestinal invagination
Younger dogs with diarrhoea, elderly dogs

Stones

43
Q

For which examination are rigid endoscopes used ?

A

Rhinoscopy (pharynx, larynx, trachea)

44
Q

For which examination are felxible endoscopes used ?

A

Oesophagoscopy, gastroscopy (Diameter: 5mm)

Bronchoscope only up/down movements possible

45
Q

Dimensions of flexible endoscope ?

A

Diameter: 6-10 mm, (5mm for oesophago/gastroscopy)
length: 103-140 cm

46
Q

Avantages of endoscopy ?

A 
Diagnostic imaging 
Culture and biopsy sample collection 
Semi-invasive diagnostic method 
Cheaper  than  diagnostic  laparotomy 
Sometimes the only option / Possibility 
Therapeutic application
47
Q

Indications for rhinoscopy ?

A 
Sneezing, reverse sneezing 
Epistaxis 
Facial or nasal pain/sensitivity Knowledge of foreign body
Nasal discharge 
Difficult or noisy breathing 
Facial swelling or distorsion 
Ulceration of the rhinarium
48
Q

Indications for laryngo/pharyngoscopy ?

A 
sLaryngeal dysfunction (Exercise intolerance, respiratory distress, increased respiratory effort, prolonged inspiratory time, voice change, cyanosis, coughing after feeding or drinking, inspiratory noise / Stridor)
Difficulty in swallowing Regurgitation
49
Q

Indications for tracehobronchoscopy ?

A

Acute cough if an inhaled body is suspected
Chronic cough (unknown cause or does not respond to therapy)
Unexplained abnormal breathing pattern/lung infiltrate
Removal of mucoid obstruction in atelectatic lung lobes
Tracheal collapse (confirmation and staging)
Chronic bronchitis (staging and sample collection)
Stridor (not explained by laryngoscopy evaluation)

50
Q

Indications for oesophagoscopy ?

A

Dysphagia
Retrieval of oesophageal foreign bodies
Regurgitation
Balloon catheter dilation of oesophageal structures

51
Q

Indications for gastroscopy ?

A 
Evaluation of dysphagia 
Regurgitation 
Chronic vomiting
Hematemesis, melena 
Gastric foreign bodies 
Placement of percutaneous gastronomy (PEG) tubes
52
Q

Indications for duodenoscopy ?

A

Chronic vomiting
Chronic diarrhoea
Melena
Haematosis

53
Q

Indications for colonoscopy ?

A 
Large bowel diarrhoea 
Tenesmus
Haematochezia (blood in faeces) 
Increased faecal mucous
Dyschezia (pain during defecation) 
Palpable rectal masse
54
Q

Diseases diagnosed by rhinoscopy ?

A

Rhinitis (viral, bacterial, fungal, Polyp, neurogenic, allergic)
Foreign body
Neoplasia (Adenocarcinoma, squamous cell

55
Q

Diseases diagnosed by laryngo/pharyngoscopy ?

A 
Foreign bodies (bones) 
Elongated soft palate Tonsillitis, laryngitis
Laryngeal paralysis/collapse 
Neoplasm, polype 
Nasopharyngeal stenosis
56
Q

Diseases diagnosed by tracheobronchoscopy ?

A

Tracheal collapse/hypoplasia/segmental stenosis
Tracheobronchitis (viral, bacterial, fungal)
Obstructive tracheal mass
Trauma
Neoplasia
Canine chronic bronchitis
Eosinophilic bronchitis
Pulmonary parasites
Feline asthma
Foreign body
Bronchopneumonia (Distemper, Bordetella bronchiseptica, etc.)

57
Q

Diseases diagnosed by oesophagoscopy ?

A 
Megaoesphagus 
Foreign bodies 
Persistent right aortic 
arch
 Hiatus hernia
Oesophagitis Oesophageal stricture Spirocercosis/Neoplasia
58
Q

Diseases diagnosed by gastroscopy ?

A 
Chronic gastritis 
Ulcers 
Neoplasia 
Gastric motility disorder
Foreign bodies 
Hiatal hernia 
Pyloric obstruction
59
Q

Diseases diagnosed by duodenoscopy ?

A

Inflammatory bowel disease (eosinophilic enteritis, lymphocytic-plasmacytic enteritis)
Lymphangiectasia
Duoedenal ulcer
Lymphoma

60
Q

Diseases diagnosed by colonoscopy ?

A 
Colitis (Inflammatory bowel d.; Hitiocytic ulcerative colitis, trichuris vulpis, bacterial colitis)
Lymphoma 
Cecal inversion 
Adenocarcinoma 
Ileocolic intussusception

CD General subjects (14 decks)

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