Emergency and Critical Care Flashcards
A 6yr old dog is brought into the clinic with anisocoria, loss of conscioussness, and involuntary urination. Which of the following is the most likely cause?
- warfarin poisoning
- urethral obstruction
- epileptic seizure
- organophosphate poisoning
epileptic seizure
Which of the following can be used to check MM color except:
- sclera
- inside vulva
- gingiva
- inside prepuce
sclera
Which of the following is not an immediate consideration in CPR?
- airway
- analgesia
- circulation
- breathing
analgesia
Central venous pressure is used in monitoring.
- temperature
- pulse quality
- hydration status
- heart rate
hydration status
The mucous membranes of a dog in septic shock are?
- pale
- icteric
- cyanotic
- brick red
brick red
You have a new position at a veterinary ICU and are familiarizing yourself with the crash cart. You find a 60 cc syringe with a 3-way stopcock, extension set and 22 gauge needle attached. What might this equipment be used for?
- thoracocentesis
- tracheal drug administration
- jugular catheter placement
- decreasing intracranial pressure
thoracocentesis
Vitamin K is used to treat which poison?
- brodifacoum
- malathion
- snail bait
- theobromine
brodifacoum
Fluids given SQ are
- isotonic
- hypotonic
- hypertonic
- colloids
isotonic
A 10 year old domestic shorthair cat presents with a history of vomiting and inappetance and is severely dehydrated. His CBC shows a hematocrit of 22%. What can be said about this cat?
- the cat is actively losing blood
- his true hematocrit is likely higher than 22%
- the cat is in renal failure
- his true hematocrit is likely lower than 22%
his true hematocrit is likely lower than 22%
The first step in controlling active external bleeding is:
- electrocautery
- tourniquet
- pressure bandage
- direct pressure
direct pressure
Which of the following is used in the treatment of antifreeze toxicity?
- sucralfate
- fomepizole
- enemas
- methocarbamol
fomepizole
A patient that is apneic and cyanotic comes to your clinic. You find a hard ball lodged in the glottal opening. You should
- place the patient in an oxygen cage
- attempt to pass an ET tube
- attempt to pass a nasal oxygen catheter
- perform the Heimlich maneuver, if unsuccessful, prep the patient for a tracheotomy
perform the Heimlich maneuver, if unsuccessful, prep the patient for a tracheotomy
Placement of a jugular catheter is contraindicated in which of the following situations?
- pancreatitis
- thrombocytopenia
- vomiting
- renal failure
thrombocytopenia
What is the isotonic crystalloid one hour “shock dose” of fluids for a cat?
- 40-50 ml/kg
- 180 ml/kg
- 90 ml/kg
- 120-150 ml/kg
40-50 ml/kg
What procedure is not routinely performed to resuscitate neonates following cesarean section?
- clean the nose and mouth using a bulb syringe
- vigorously rub them with a towel
- ligate the umbilical cord using unwaxed dental floss
- administer a drop of oxytocin to stimulate breathing
administer a drop of oxytocin to stimulate breathing
Which of the following is a colloid?
- Sodium chloride 0.9%
- Lactated ringers solution
- Norm-R solution
- Pentastarch
Pentastarch
Which of the following is a colloid?
- hypertonic saline
- dextrose
- LRS
- hetastarch
hetastarch
A three week old kitten is found twitching and non-responsive. What home treatment is most likely to improve the condition?
- Karo syrup
- urinary catheter
- tylenol
- enema
Karo syrup
Which of these is not a sign of traumatic shock?
- white MM
- cool extremeties
- weak femoral pulses
- CRT less than 2 seconds
CRT less than 2 seconds
A stray dog is brought in for listlessness and dyspnea. When drawing blood, you notice it takes a long time to clot. The animal may have ingested
- strychnine
- warfarin-based rodentacide
- ethylene glycol
- organophosphate insecticide
warfarin-based rodentacide
Knuckling is
- a neurologic abnormality
- a respiratory abnormality
- swelling of the carpus or tarsus
- normal in some dogs and cats
a neurologic abnormality
Which of the following is a colloid solution?
- blood
- Plasmalyte
- Norm/R
- LRS
Blood
The four patients described below present to your clinic at the same time. In what order should these patients be triaged?
a: 2 year old male Siamese cat with complete urethral obstruction of 2 days duration
b: 4 year old ferret with a tracheal foreign body and cyanosis
c: 8 year old poodle with a laceration on the forelimb
What order?
- b, c, d, a
- a, c, b, d
- d, a, c, b
- b, a, c, d
b, a, c, d
Emesis should not be induced in a dog that has consumed which toxin?
- bromethalin
- chocolate
- gasoline
- arsenic
gasoline
Which of these has the lowest priority when preparing to treat a critical patient
- O2 source
- ET tubes
- IV catheters
- heating pad
heating pad
Initial first aid treatment of a dog with an open fracture includes all of the following except:
- clean and copious amounts of lavage solution
- take radiographs
- apply a temporary splint
- cover the wound
take radiographs
You have to give fluids to a critically ill 0.25 kg puppy and cannot get a catheter into the jugular or cephalic vein. Which would be your best alternative route?
- carotid artery
- lingual vein
- medullary cavity of the femur
- ear vein
medullary cavity of the femur
What is the first consideration in cardiac arrest?
- IVC placement
- airway
- ventilation
- cardiac compressions
cardiac compressions
The first drug of choice for a cat that experiences status epilepticus is
- potassium bromide
- propofol
- pentobarbital
- diazepam
diazepam
During CPA, what route is the least effective for drug administration?
- intramuscular
- intratracheal
- intravenous
- intaosseous
intramuscular
A patient with multiple pelvic fractures has not urinated in over 24 hours, you suspect he may:
- has a urethral obstruction
- has a diaphragmatic hernia
- has a ruptured urinary bladder
- be too painful to urinate
has a ruptured urinary bladder
Which of the following is not used in the treatment of snail bait toxicity?
- emesis or gastric lavage
- methocarbamol
- enemas
- atropine
atropine
To place a nasal oxygenation catheter in a dog, you would:
- measure at the beginning of the ear
- measure a standard .5” of catheter length
- measure to the medial canthus of the eye
- measure to the pharynx
measure to the medial canthus of the eye
Which of the following is a clinical sign that you would see in a dog with chocolate toxicosis?
- swollen tongue
- paralysis
- tachycardia
- petechia
tachycardia
In emergencies when it is not possible to deliver large amounts of desired fluids, it may be beneficial to administer
- isotonic saline
- hypotonic saline
- D5W (dextrose in water)
- hypertonic saline
hypertonic saline
All of the following are signs of shock, except?
- vasodilation
- weak and thready pulse
- prolonged CRT
- tachycardia
Vasodilation; shock causes vasoconstriction
How much time does it take before cardiac arrest causes irreversible brain damage?
- seven minutes
- thirteen minutes
- three minutes
- ten minutes
3 minutes
Which of the following signs is not an indication of dystocia?
- green or black vulvar discharge
- profuse vulvar hemorrhage
- pup or kitten in birth canal for 5 minutes
- more than 1 hour of vigorous contractions with no pup or kitten produced
pup or kitten in birth canal for 5 minutes
Cardiac compressions are applied to which location?
- second to third ribs
- third to sixth ribs
- first to second ribs
- eighth to tenth ribs
third to sixth ribs
Whole blood is indicated over packed red cells in what case?
- acute blood loss in surgery
–acute blood loss by trauma
- autoimmune hemolytic anemia
- disseminated intravascular coagulation
Electrical activity that serves as the pacemaker in the heart originates from what specific area?
- sinoatrial node in the right atrium
- atrioventricular node in the right ventricle
- bundle of His in the left ventricle
- sinoatrial node in the left atrium
sinoatrial node in the right atrium
What is usually not a sign of acute GDV?
- abdominal distention
- profuse diarrhea
- unproductive attempts to vomit
- hypersalivation
profuse diarrhea
Hypoglycemia is most common in patients that experience
- cardiogenic shock
- anaphlyctic shock
- septic shock
- neurogenic shock
septic shock
A client with a diabetic cat called saying that her cat had a seizure and collapesed. She gave insulin that morning but the cat has not eaten throughout the day. You should advise
- another dose of insulin with home observation
- some sugar solution on the gums, then observe the cat at home
- another dose of insulin, then see DVM today
- some sugar solution on the gums, then see DVM today
some sugar solution on the gums, then see DVM today
Which of the following may not be used in the treatment of status epilepticus?
- Diazepam
- Keppra
- Methocarbamol
- Phenobarbital
Methocarbamol
Gastric dilatation/volvulus (GDV) is a life-threatening emergency. Its main damaging effect is obstruction of the:
- coronary veins
- caudal vena cava
- femoral vein
- renal veins
caudal vena cava
The volume of 1:10,000 epinephrine for intravenous administration to a dog is calculated to be 2.0 ml. What volume of epinephrine should be drawn up for intratracheal administration to the same patient?
- 1.0 ml
- 4.0 ml
- 20.0 ml
- 2.0 ml
4.0 ml
Oxygen can be administered to a patient through all of the following except:
- endotracheal tube
- chest tube
- tracheostomy tube
- nasal catheter
chest tube
Normal urine output for dogs and cats is
- 3-4ml/kg/hr
- 1-2ml/kg/hr
- 0.5ml/kg/hr
- 10ml/kg/hr
1-2ml/kg/hr
First aid for a dog with paraphimosis includes all of the following except
- apply hypertonic solutions to the penis
- lubricate the penis
- apply ice packs to the penis
- apply warm compresses to the penis
apply warm compresses to the penis
What is the normal reading for central venous pressure?
- 10-20 cm H2O
- 0-10 cm H2O
- 20-30 cm H2O
- 30-40 cm H2O
0-10 cm H2O
A patient with pneumothorax is most likely to exhibit which symptoms?
- bloat
- hypertension
- dyspnea
- severe tremors
Dyspnea
A patient with IVDD should be on the following treatment plan:
- strict confinement, steroids and opiates
- minimal confinement and NSAIDs
- strict confinement, and NSAIDs
- allowed to roam freely
strict confinement, steroids and opiates
Petichial hemorrhages on the MMs can indicate
- trauma
- methomoglobinemia
- anemia
- thrombocytopenia
thrombocytopenia
What part of the eye can be used to indicate fluid overload
- lens
- pupil
- conjunctiva
- nictitating membrane
conjunctiva
The normal pH for a dog is
- 7.0
- 8.0
- 6.4
- 7.4
7.4
A tension pneumothorax occurs when
- pressure in the thoracic cavity is less than atmospheric pressure
- pressure in the thoracic cavity is equal to atmospheric pressure
- pressure in the thoracic cavity is constant as the animal breathes in and out
- pressure in the thoracic cavity is greater than atmospheric pressure
pressure in the thoracic cavity is less than atmospheric pressure
Crackles on thoracic auscultation indicate:
- upper airway obstruction
- pleural space disease
- asthma
- fluid in the lungs
fluid in the lungs
Constant rate infusion of dopamine or dobutamine is used to achieve what desired effect?
- increase heart contractility
- emesis
- decrease urinary output
- control seizures
increase heart contractility
What is the rate of cardiac compressions applied to a large dog during cardiopulmonary resuscitation?
- 80-100 per minute
- once every three seconds
- 120-150 per minute
- 12-20 per minute
80-100 per minute
Mucous membranes in animals suffering from hypovolemic shock are:
- cyanotic
- pink
- pale
- brick red
pale
A dog experiencing shock needs fluids. Which of the following is least desireable?
- hypertonic saline
- crystalloids
- colloids
- dextrose
dextrose
All of the following are ways to monitor the heart rate in an unanesthetized animal except
- pulse rate
- esophageal stethoscope
- electrocardiographic monitor
- stethoscope
esophageal stethoscope
Which statement concerning emergency treatment of cats with a UO is least accurate?
- Cats with slow, irregular HR probably suffer from hyperkalemia
- Sometimes the obstruction can be relieved by massaging the tip of the penis
- Cats must always be sedated to have a urinary catheter placed
- If the obstruction is not relieved the cat with die
Cats must always be sedated to have a urinary catheter placed
A dog has a lacerated paw pad. The owner has placed a small bandage over the wound but the blood is soaking through. The appropriate treatment is:
- remove the bandage and apply direct pressure
- -apply a pressure bandage over the existing bandage
- remove the bandage, cauterize the wound and put a new bandage on.
- remove the bandage and apply a tourniquet
What procedure is not routinely performed to resuscitate neonates following cesarean section?
- clean the nose and mouth using a bulb syringe
- vigorously rub them with a towel
- ligate the umbilical cord using unwaxed dental floss
- administer a drop of oxytocin to stimulate breathing
administer a drop of oxytocin to stimulate breathing
Which heart rhythm shows occasional bizarre shaped QRS complexes at random intervals?
- sinus arrhythmia
- ventricular premature contractions
- atrial fibrillation
- asystole
ventricular premature contractions
A small breed dog is considered tachycardic if the heart rate is:
- <180
- <100
- > 180
- > 100
> 180
Central venous pressure is used in monitoring
- heart rate
- hydration status
- temperature
- pulse quality
hydration status
When performing CPR on a neonatal calf, which are the two most critical procedures to begin?
- establish an airway and cardiac compressions
- establish venous access and cardiac compressions
- cardiac compressions and administration of drugs
- establish an airway and venous access
establish an airway and cardiac compressions
To reduce intracranial pressure that results from trauma, which of the following may be administered?
- diazepam
- solu-delta
- atropine
- mannitol
mannitol
A large dog was hit by a car and presented for mild shock and respiratory distress. On physical exam, you notice that when the dog inhales, part of the chest wall sinks into the chest. What is the condition?
- flail chest
- cardiac tamponade
- diaphragmatic hernia
- gastric dilatation/volvulus
flail chest
Which of the following is not a contraindication for fluid therapy?
- swollen soft tissues and bruising from trauma
- pulmonary edema
- pitting of the soft tissues
- cerebral edema
swollen soft tissues and bruising from trauma
Dehydration is assessed by all of the following except
- skin turgor
- nasal discharge
- moistness of mucous membranes
- pcv/tp
nasal discharge
A tension pneumothorax occurs when
- pressure in the thoracic cavity is constant as the animal breathes in and out
- pressure in the thoracic cavity is less than atmospheric pressure
- pressure in the thoracic cavity is equal to atmospheric pressure
- pressure in the thoracic cavity is greater than atmospheric pressure
pressure in the thoracic cavity is greater than atmospheric pressure
Hyperthermic patient should be treated immediately with:
- ice packs
- an alcohol bath
- Cool water bath
- corticosteroid injection to reduce inflammation
Cool water bath
A toy poodle presents for muscle tremors, stiff gait, and reluctance to walk. Her history shows that her vaccines are up to date and that she is currently nursing five 3 week old puppies. You run a CBC and serum chemistry. What is the most likely abnormal result?
- hyperkalemia
- thrombocytopenia
- hypocalcemia
- anemia
hypocalcemia
Which of the following should be treated first?
- linear foreign body
- GDV
- dystocia
- dog with laceration on the pinna
GDV
Dystocia in the dog or cat may be defined as active straining without delivery of a fetus for:
- more than 20 minutes
- more than 30 minutes
- more than 60 minutes
- more than 40 minutes
more than 60 minutes
Which of the following is not usually a sign of a blood transfusion reaction?
- seizures
- tachycardia
- fever
- vomiting
seizures
All of the following would be first aid for a GDV except
- induce emesis
- trocarize the stomach
- treat for shock
- attempt to pass a stomach tube
induce emesis
The Schiff-Sherrington motor posture is indicative of:
- Injury to cerebellum
- Injury to brainstem
- Injury to T2 to L4
- Injury to C1 to T6
Injury to T2 to L4
NSAIDs are also referred to as
– Prostaglandoids
- Neo-prostaglandins
- Anti-prostaglandins
– Pro-prostaglandins
Vomiting should not be induced in patients that have ingested
- organophosphates
- salicylates
- ethylene glycol
- kerosene
kerosene
Which of the following is used to monitor fluid therapy?
- appetite
- bowel movements
- temperature
- UOP
UOP
When monitoring patients on fluids and/or patients that undergo diuresis, UOP is an important consideration. The normal UOP for a healthy dog or cat is approximately:
- 1-2 ml/kg/hr
- 25-30 ml/kg/hr
- 15-20 ml/kg/hr
- 5-10 ml/kg/hr
1-2 ml/kg/hr
Nutritional support can be given in several ways. What is the preferred method?
- PPN
- per rectum
- TPN
- per os
per os
A patient with pneumothorax is most likely to exhibit which symptoms?
- severe tremors
- bloat
- dyspnea
- hypertension
dyspnea
A client calls saying there is a string under his cat’s tongue. You should advise him to
- bring the cat in for an exam
- cut the sting and give oral laxatives
- induce emesis
- gently pull the string out
bring the cat in for an exam
Inducing emesis after ingestion of a solid toxin is probably no longer of value after how much time has elapsed since ingestion?
- 10 minutes
- 24 hours
- 1 to 4 hours
- 30 minutes
1 to 4 hours
Initial first aid treatment of a dog with an open fracture includes all of the following except:
- cover the wound
- apply a temporary splint
- clean and copious amounts of lavage solution
- take radiographs
take radiographs
What is given to treat an animal with eclampsia?
- Calcium
- Insulin
- Glucose
- Potassium
Calcium
Which of the following should be treated first?
- respiratory arrest
- penetrating abdominal wound
- GI foreign body
- GDV
respiratory arrest
Patients in shock have:
- An initial increase in HR that then decreases as the animal nears death
- a decrease in HR
- an initial decrease in HR that then increases as the animal nears death
- an increased HR
An initial increase in HR that then decreases as the animal nears death
The underlying disease for most cases of feline aortic thromboembolism is
- hepatic disease
- diabetes mellitus
- renal failure
- myocardial disease
myocardial disease
Hyperpnea means
- excessively high RR
- excessively high HR
- excessively high temperatures
- excessive amounts of muscular contractions
excessively high RR
Which of the following is not used as part of physical therapy of the respiratory tract:
– coupage
–rotation changes
- tracheal pinch
- nebulize
A 3yr old female cat is brought in with petechiae on her abdomen, bleeding gums, and lethargy. What is the most likely cause?
- seizure
- heatstroke
- warfarin poisoning
- head trauma
warfarin poisoning
What is the most common vessel used to assess the pulse in a dog?
- aorta
- femoral artery
- dorsal pedal artery
- sublingual vein
femoral artery
If a dog that receives parenteral fluids is pyrexic, how much additional fluid should be added to the maintenance fluid dose?
- 25%
- 20%
- 15%
- 10%
10 %
A pulse deficit is when the pulse is
- lagging behind the heartbeat
- covering up the heartbeat, making it difficult to hear
- totally absent, including the heartbeat
- aligned with the heartbeat at all times
lagging behind the heartbeat
Which of the following is not a sign of shock?
- increase respiratory rate and effort
- tachycardia
- elevated body temperature
- pale mucous membranes
pale mucous membranes
