CS - Collapse

Question 1

What is the definition of collapse?

Answer 1

unintentional prostration arrived at due to pathological mechanisms
aka won’t get up because something is wrong

Question 2

What are potential neurological disorders of consciousness that cause collapse?

Answer 2

seizures, narcolepsy, brainstem dz
diffuse cerebral dysfunction
metabolic (lowBG)
encephalopathy, toxins

Question 3

What are hypoxic disorders of consciousness that cause collapse?

Answer 3

shock: hypovolaemia, cardiogenic, obstructive, etc
respiratory condition

Question 4

What are skeletal/joint disorders that could cause collapse?

Answer 4

arthritis, panosteitis, patellar luxation, discospondylitis, spinal fracture

Question 5

What are lower motor unit disorders that can cause collapse?

Answer 5

polyneuropathy
endocrine neuropathy
neoplasia

Question 6

What are upper motor unit disorders causing collapse?

Answer 6

vestibular dz
cerebellar dz
spinal

Question 7

What are nm junction disorders causing collapse?

Answer 7

myasthenia
botulism

Question 8

What are myopathy disorders causing collapse?

Answer 8

hypokalaemia
exertional
muscula dystrophy

Question 9

How do we decide what to investigate during a collapse?

Answer 9

life threatening/major body system problems first

Question 10

What is the main tx during an addisonian crisis?

Answer 10

dexamethasone
IVF

Question 11

What is the tx options during a supraventricular or ventricular tachycardia?

Answer 11

lidocaine
vagal maneuver
dilitiazem

Question 12

What are classic signs of feline aortic thromboembolism?

Answer 12

cyanotic nails and pads
not being able to feel a pulse in the affected limb

Question 13

What are the CS of textbook hypoadrenocorticism cases?

Answer 13

middle aged female dogs
history of chronic GI signs
hyperkalaemic and hyponatraemic
lack ability to secrete aldosterone and cortisol from their adrenals

Question 14

How does lack of cortisol and lack of aldosterone affect the body?

Answer 14

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

Question 15

What are the signs of hypovolaemic shock?

Answer 15

vasoconstriction
pale mucous membranes
prolonged crt
tachycardia
poor pulses

Question 16

What are the risks of a puppy going off their food when they feel unwell?

Answer 16

don’t have any fat reserves to maintain normoglycaemia
become at risk of becoming hypoglycemic which can cause collapse

Question 17

What are potential CS of portosystemic shunts?

Answer 17

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

Question 18

How can hyperkalaemia affect an ECG?

Answer 18

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

Question 19

What electrolyte imbalance can most likely cause bradycardia?

Answer 19

hyperkalaemia

Question 20

How does insulin reduce potassium levels in the blood?

Answer 20

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

Question 21

Why is dexamethasone a good tx to get a patient out of an addisionian crisis?

Answer 21

improves BP and GI signs
controls both the mineralocorticoid deficiency and the cortisol deficiency

Question 22

What are catecholamines and how do they affect blood glucose levels especially during shock?

Answer 22

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

Question 23

How is a vagal manoeuvre performed?

Answer 23

massaging the carotids in the cervical region