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ABVP ECM Boards > Emergency medicine > Flashcards

Emergency medicine Flashcards

1
Q

An animal presenting with an English “H” or Spanish “J” airway sound is indicative of which type of obstruction?

A

Laryngeal or tracheal

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1
Q

What does the absence of the menace reflex indicate in rabbits and rodents?

A

Not necessarily anything, often absent in normal animals

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2
Q

If you are bitten by a ferret during exam, this is the best way to get them to release:

A

Hold them under a running faucet

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3
Q

What is the most common zoonotic risk associated with chinchillas?

A

Giardia

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4
Q

What condition can result after handling an aggressive/stressed rat that causes recurrent fever, vomiting, muscle ache and enlarged lymph nodes 6-10 days after handling?

A

Rat bite fever - caused by Streptobacillus moniliformis and/or Spirillum minus

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5
Q

What can occur when gerbils and mice are picked up too caudally?

A

Tail slip

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6
Q

How is tail slip in gerbils and mice treated?

A

Amputation at the level where the skin ends

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7
Q

What virus carried by rats, mice, and Syrian hamsters can result in mild symptoms that can progress to meningitis, especially in prenatal and immunocompromised people?

A

Lymphocytic choriomeningitis virus

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8
Q

What two factors does oxygen delivery to tissues depend on?

A

Arterial oxygen content and cardiac output

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9
Q

Why is the oxygen-hemoglobin dissociation curve shifted to the right in ECMs relative to larger mammals?

A

They have higher oxygen consumption per gram of tissue (so diffusion gradient must be higher)

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10
Q

What direction should a tube be advanced for nasotracheal intubation?

A

Ventrally and medially into the ventral nasal meatus

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11
Q

List 3 contraindications for nasotracheal intubation:

A
  1. UR disease
  2. Edema of the nasal passages
  3. Narrowing of the nasal passages (s/a from apical elongation from the teeth)
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12
Q

A guinea pig housed with a rabbit is presenting with anorexia, oculonasal discharge, dyspnea, and other LRT signs. What are two most possible etiologic agents that may be causing the clinical signs?

A

Bordetella bronchiseptica or Streptococcus pneumoniae

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13
Q

What non-respiratory disease should be considered in prairie dogs with respiratory distress?

A

Pseudo-odontoma causing obstructive respiratory disease

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14
Q

Sedation with this agent will decrease hematocrit 15 minutes after induction in ferrets, so is not ideal to use prior to blood collection for transfusion.

A

Isoflurane

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15
Q

List 3 sites that are suitable for IO placement in most ECMs:

A

Proximal humerus, tibia and femur

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16
Q

Urethral catheters in guinea pig males should be placed where?

A

In the external urethral opening dorsal of the glans, avoiding the ventral intromittent sac

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17
Q

What is the normal PCV of ferrets?

A

45-65%

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18
Q

If rodenticide toxicity is suspected, what medication can be administered?

A

Vitamin K

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19
Q

If acetaminophen toxicity is suspected in ferrets, what medication can be administered?

A

N-acetylcysteine

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20
Q

If NSAID toxicity is suspected in ferrets, what medication can be administered?

A

Misoprostol

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21
Q

Why are ferrets more prone to heat stress?

A

They don’t have sweat glands and can’t tolerate temps above 86* >~10 minutes

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22
Q

Ingestion of ibuprofen in ferrets will result in what clinical signs?

A

GI - Anorexia, vomiting, diarrhea, melena
Neuro - tremors, ataxia, depression coma
Renal - Anuria or oliguria

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23
Q

What course of action should be taken with a ferret with ibuprofen ingestion 1 hr ago?

A
  1. Induce emesis/gastric lavage and charcoal
  2. IV fluids
  3. Sucralfate, Misoprostol, Metoclopramide +/- anticonvulsants to treat GI ulcerations, renal failure, hepatic/CNS effects
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24
Q

A recently vaccinated 1 yr old ferret presenting with a 106* fever, pain, anorexia and muscle wasting is likely suffering from what disease?

A

Disseminated idiopathic myositis

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25
Q

If a jill presents with dystocia, after ensuring kits are positioned appropriately, what should be administered to induce labor?

A

Prostaglandin F2 alpha, then oxytocin if labor is not induced within 3 hours. C-section if no kits w/in 8 hours

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26
Q

Name the stages of wound healing in order:

A
  1. Inflammatory phase
  2. Debridement phase
  3. Repair phase
  4. Maturation phase
27
Q

How do neutrophils contribute to wound debridement and prevention of infections?

A

They phagocytose bacteria and cellular debris. They release enzymes and growth factors that facilitate the breakdown of necrotic material and stimulate monocytes to turn to macrophages

28
Q

What do macrophages do in a wound during the debridement stage?

A

They help remove necrotic tissue, bacteria and foreign material. They secrete chemotactic/growth factors that recruit mesenchymal cells, stimulate angiogenesis and modulate matrix formation leading to granulation tissue formation

29
Q

What cells migrate into wound along fibrin strands to deposit collagen, elastin and proteoglycans during the repair phase?

A

Fibroblasts

30
Q

Following fibrin deposition, what is released from endothelial cells of new capillaries that invade the wound bed and clears the path for granulation tissue?

A

Plasminogen activator

31
Q

What role does granulation tissue play in wound healing?

A

Provides a surface for epithelium to migrate across and helps with wound contraction

32
Q

When does the maturation phase of wound healing occur?

A

2.5-3 weeks after the initial injury

33
Q

What are factors that can affect wound healing?

A
  1. Infections/inflammation from foreign debris
  2. Seroma formation
  3. Excessive use of antiseptics in/around wounds
  4. Impaired blood supply
  5. Type of injury/instrument used (ie scissors vs. scalpel)
  6. Condition/age of patient
  7. Concurrent illness
  8. Stress/pain causing endogenous steroid release or iatrogenic steroids
  9. Radiation/chemotherapy
34
Q

Scrubbing of wounds and flushing antiseptic agents into wounds is discouraged because:

A

It damages tissue and potentially promotes infection; Antiseptics can have cytotoxic effects that may delay wound healing

35
Q

For wound lavage, which antiseptic is preferred and why?

A

Chlorhexidine 0.05% (over povidone-iodine 1%) because it least affects the healing process and has higher bactericidal activity and long residual effects

36
Q

What three techniques can be used for wound debridement?

A

Surgical, enzymatic (trypsin and Castor oil) and mechanical (adherent bandages, calcium alginate)

37
Q

How long can demarcation of viable tissue take to determine?

A

24 hours to 5 days

38
Q

When is primary closure utilized?

A

With clean wounds less than 6 hrs old that can be closed w/out tension or dead space

39
Q

If a wound is older than 8 hours but has minimal contamination or trauma present and has not reached the granulation phase, what type of closure can be utilized?

A

Delayed primary closure

40
Q

When and how is secondary closure performed?

A

When wounds do not close by second intent; granulation tissue is removed and fresh skin margins are created and the wound is closed following apposition of skin edges

41
Q

What are potential disadvantages of second intent wound closure?

A

Scarring and/or incomplete healing, especially in high movement/tension areas

42
Q

What type of bandages could be utilized for an exudate-producing wound that is not clean?

A

Wet-to-dry or dry-to-dry bandages

43
Q

What is the most common cause for blood transfusion besides acute trauma in: a. intact female rabbit, b. intact female ferret, c. ferret with GI signs

A

a. uterine pathology
b. hyperestrogenism causing pancytopenia
c. Helicobacter-associated gastric ulcers

44
Q

List 3 indications for blood transfusions.

A

An increased need for albumin, coagulation factors and/or red blood cells

45
Q

When should hypertonic crystalloids be avoided?

A

In dehydrated patients as they already have a volume-depleted extravascular fluid component

46
Q

What is often the first clinical sign of dehydration in hindgut fermenters?

A

Decreased fecal production and gastrointestinal hypomotility

47
Q

What is happening when a rabbit receiving a transfusion shows signs of DIC, bronchospasm and vascular collapse? How is this treated?

A

An acute hemolytic transfusion reaction due to a donor-recipient mismatch. Transfusion should be stopped and corticosteroids, fluids and bronchodilators should be administered

48
Q

If ferret or rabbit blood is not available, what can be used for a xenotransfusion as a last resort?

A

Feline red blood cells

49
Q

How should a patient in severe hypovolemic shock be approached?

A

Bolus hypertonic saline, then colloids. Follow with isotonic crystalloids and bolus of colloids until systolic BP >90 mmHg; Continue crystalloids. Rewarm concurrently

50
Q

If overhydration is suspected, how should it be treated?

A

Discontinue IV/IO fluid therapy, provide supplemental oxygen and admin diuretics IV

51
Q

What sedatives should be avoided in critical patients?

A

Alpha 2 agonists because they reduce cardiac output and tissue perfusion

52
Q

What method of induction should be avoided in critically ill exotics and why?

A

Inhalant induction; leads to physical struggle and prolonged period of apnea, hypoxemia, hypercapnia, and bradycardia

53
Q

The following are clinical signs of what type of coagulation issue?
- Reduced or absent tissue perfusion
- Necrotic extremities
- Absent pulses
- Regional pain / loss of nociception

A

Thrombosis

54
Q

Disorders of primary hemostasis cause ____ , while secondary hemostatic disorders cause _____ .

A

Petechial or mucosal hemorrhage; Hematomas and large body cavity bleeds

55
Q

What 3 tests should a patient presenting with anemia and abnormal bruising have performed?

A
  1. CBC w/sequential platelet assessment
  2. Biochemistry
  3. Coagulation factors if species appropriate
56
Q

What are potential causes of thrombocytopenia in ECM?

A
  1. Hyperestrogenemia in ferrets
  2. Benzimidazole administration
  3. Neoplasia/chemo agents
  4. Infectious agents (Eimeria, Histoplasmosis
  5. DIC
  6. Venomous snake bites
57
Q

How does Vitamin C deficiency cause hemorrhage?

A

Abnormal collagen synthesis caused ultrastructural changes to blood vessel walls

58
Q

While DIC is difficult to diagnose in ECM, what is indicative of overt DIC?

A

Severe thrombocytopenia with prolonged clotting times and elevated fibrin-related markers (d-dimer)

59
Q

What type of cells does RHD target and what does it cause?

A

Hepatocytes, phagocytic and endothelial cells
Hepatocellular necrosis, DIC, and death

60
Q

What species does not need to be cross matched for the first transfusion as they do not have blood types?

A

Ferrets

61
Q

What are the acute effects of fluid overload?

A

Interstitial or pulmonary edema, body cavity effusions, especially when accompanied by body weight increases of 5-10%

62
Q

What is the best way to assess hydration level in ECM patients?

A

Measure changes in body weight and measure weight of all fluid outputs

63
Q

What 2 monitoring tools most effectively assess quality and patient response to CPR?

A

ETCO2 and ECG

64
Q

What is the best first initial step in veterinary CPR?

A

Chest compressions

65
Q
A

ABVP ECM Boards (10 decks)

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