CS - Collapse Flashcards
What is the definition of collapse?
unintentional prostration arrived at due to pathological mechanisms
aka won’t get up because something is wrong
What are potential neurological disorders of consciousness that cause collapse?
seizures, narcolepsy, brainstem dz
diffuse cerebral dysfunction
metabolic (lowBG)
encephalopathy, toxins
What are hypoxic disorders of consciousness that cause collapse?
shock: hypovolaemia, cardiogenic, obstructive, etc
respiratory condition
What are skeletal/joint disorders that could cause collapse?
arthritis, panosteitis, patellar luxation, discospondylitis, spinal fracture
What are lower motor unit disorders that can cause collapse?
polyneuropathy
endocrine neuropathy
neoplasia
What are upper motor unit disorders causing collapse?
vestibular dz
cerebellar dz
spinal
What are nm junction disorders causing collapse?
myasthenia
botulism
What are myopathy disorders causing collapse?
hypokalaemia
exertional
muscula dystrophy
How do we decide what to investigate during a collapse?
life threatening/major body system problems first
What is the main tx during an addisonian crisis?
dexamethasone
IVF
What is the tx options during a supraventricular or ventricular tachycardia?
lidocaine
vagal maneuver
dilitiazem
What are classic signs of feline aortic thromboembolism?
cyanotic nails and pads
not being able to feel a pulse in the affected limb
What are the CS of textbook hypoadrenocorticism cases?
middle aged female dogs
history of chronic GI signs
hyperkalaemic and hyponatraemic
lack ability to secrete aldosterone and cortisol from their adrenals
How does lack of cortisol and lack of aldosterone affect the body?
lack of cortisol: GI signs and signs of shock
lack of aldosterone: inability to excrete potassium and retain sodium at the level of the kidneys
What are the signs of hypovolaemic shock?
vasoconstriction
pale mucous membranes
prolonged crt
tachycardia
poor pulses
What are the risks of a puppy going off their food when they feel unwell?
don’t have any fat reserves to maintain normoglycaemia
become at risk of becoming hypoglycemic which can cause collapse
What are potential CS of portosystemic shunts?
small liter mate
polydipsia
neuro signs
evidence of hepatic insufficiency
- hypoglycaemia
- hypoalbuminaemia
- hypocholesterolaemia
- elevated ammonia
- abnormal bile acid stimulation test
ammonium biurate crystals sometimes seen
How can hyperkalaemia affect an ECG?
elevated potassium prevents myocytes from contracting because they are unable to conduct their action potential
changes on the ecg depend on which myocytes are affected
What electrolyte imbalance can most likely cause bradycardia?
hyperkalaemia
How does insulin reduce potassium levels in the blood?
it allows for potassium to move into the intracellular space
insulin binds to a specific membrane receptor and stimulates the sodium-potassium ATP pump resulting in intracellular uptake of K.
intracellular content of potassium increases, the interstitial and intravascular concentration of potassium decreases. total body potassium does not change, it is effectively hiding the potassium away from the body inside the cells
Why is dexamethasone a good tx to get a patient out of an addisionian crisis?
improves BP and GI signs
controls both the mineralocorticoid deficiency and the cortisol deficiency
What are catecholamines and how do they affect blood glucose levels especially during shock?
hormone released by adrenal glands in response to stress: dopamine, norepinephrine, epinephrine
it antagonises insulin causing an increased level of blood glucose
a ptx in severe shock can have high levels of catecholamines causing them to sometimes have hyperglycaemia
How is a vagal manoeuvre performed?
massaging the carotids in the cervical region
