Emergency medicine Flashcards
1
Q
If an animal is having Difficulty breathing suggestions would be to:
A
- Minimal restraint and no neck leads
- Keep animal calm
- Keep in cool environment
2
Q
If an animal is Choking suggestions would be to? Bleeding?
A
- Bring in immediately
- May try Heimlich maneuver
3) Clean cloth or towel applied
3
Q
Exposed or ingested toxicant, suggestions:
A
- Bring product container
- Time of exposure
- Determine if vomited
- Immediate departure if < 30’ distance
- Induce emesis if > 30’
- External, give bath
4
Q
Recumbent/shocky, suggestions:
A
Cover and keep warm
5
Q
Seizuring suggestions:
A
- Advise should stop in 2-5 minutes
- Stay calm
- Move animal away from stairs, furniture
- Keep hands away from mouth
- Place cool wet towels on pet for transport
6
Q
Limb fracture suggestions:
A
- Transport with minimal handling
- Possible splint with magazine, pole or other clean material
7
Q
Open or penetrating wound suggestions:
A
Chest: place in lateral recumbency with affected side down
Cover wound with clean, water moistened towels
FB: leave in place and place animal with unaffected side down
8
Q
Burn suggestions:
A
Apply cool water compress
9
Q
Heatstroke suggestions:
A
- Rinse animal with gentle spray
- Do not rinse when transporting
- DO NOT APPLY ICE
10
Q
Ocular injury suggestions
A
- Exposure to irritant-rinse copiously
- Cover with moistened towel
11
Q
Define triage.
A
Defined as the evaluation and allocation of treatment to patients according to a system of priorities designed to maximize the number of survivors
12
Q
Treatment should NEVER be altered due to amount of patients but only by _______
A
approval of the owner.
13
Q
Crash cart should have what inside for breathing?
A
- Airway, Breathing, Circulation
- ET tubes
- Ambu bag
- Laryngoscope
- Stylet
- O2 mask
14
Q
Crash cart should have what inside for circulation?
A
- Stethoscope
- IV catheters: Butterfly catheters
- Tape
- Clippers
- Sx scrub
- Minor/major surgical pack
- Fluid administration sets: Fluid bags
- Balanced electrolyte
- Hypertonic saline, Synthetic colloid
- Infuser bag
15
Q
What drugs are mandatory to have in a crash box?
A
- Atropine*
- Epinephrine*
- 2 % lidocaine without epinephrine*
- Sodium bicarbonate*
- Syringes
- Needles
- Dose chart
16
Q
An advantage of a crash box is?
A
1) More supply space
2) Adapted for specialized equipment (O2 & suction)
17
Q
What are some responsibilities of the technician during an emergency
A
- Prepare emergency & operating room
- Receive phone calls
- Provide first aid instructions
- Secure patient’s airway & manage IPPV if needed
- Secure IV access
- Monitoring devices
- Pain management
- Charts
- Communication with doctors
18
Q
What 3 things should a crash cart be?
A
1) Central Location
2) Easily Accessed
3) Portable
19
Q
Water-based solutions containing electrolytes and nonelectrolyte solutes permeable to capillary membranes, used for rehydration and maintenance
A
Crystalloids
20
Q
1st choice for fluid resuscitation, but not good for shock therapy, renal failure or cerebral injuries
A
Crystalloids
21
Q
Lower osmotic pressure than fluid comparing
A
hypotonic
22
Q
Good replacement for Dehydration and Resuscitation, Not good for maintenance due to higher content of Na and Cl
A
isotonic
23
Q
Draws fluid into vascular spaces, May be prolonged when used with colloids. Used for treating Head injuries, cerebral edema. Prolonged use can lead to hypernatremia, hyperosmolality, increased bleeding. Too fast infusion can cause bradycardia, hypotension, bronchoconstriction, rapid shallow breathing
A
hypertonic
24
Q
Include dextran 70 & hetastarch. Maintains fluid within the vascular space as long as the osmotic pressure greater than the tissue. Usually maintained by albumin.
A
colloids
25
T/F Digital faster than film
true
26
Always obtain caller’s _______ BEFORE placing on hold
name/phone number
27
Questions owners should be able to answer
- Is the animal breathing
- Is the animal conscious
- Is the animal bleeding
- Is the animal able to move
- Are there any open wounds or visible fractures
- When did the accident occur
- How far are the owners from the facility
28
What are the 4 classes of classifying a patient based on triage
```
4 Classes
I: dying before your eyes
II: critical, attention w/i minutes
III: urgent, attention w/i 1 hour
IV: less critical, attention w/i 24 h
```
29
What are the 4 major organ systems assessed for triage
- Respiratory
- Cardiovascular
- Neurologic
- Renal
30
What is the purpose of the primary survey(1st)?
to determine further stability of patient and to identify and treat any life-threatening conditions(vitals, samples, hemorrhage control, shock mgmt)
31
ABCDE’s of emergency
- Airway
- Breathing
- Bleeding
- Cardiovascular
- Circulation
- Disability
- Level of Consciousness
- External assessment
32
_____ is the most common vascular access.
Peripheral
33
What are the 5 levels of consciousness?
```
I. A- alert
II. V- verbally responsive
III. P- pain responsive
IV. U- unresponsive
V any level other than “A” requires immediate attention
```
34
The 2nd survey consists of:
- Complete physical examination (after stabilization, complete physical)
- History of patient;
- Allergies: any known
- Meds: currently
- Past history: medical problems
- Lasts: meals, urination, BM, meds
- Events: details of current problem
35
A CRASH PLAN:
- A: airway, breathing, bleeding
- C: circulation, cardiovascular
- R: respiration
- A: abdomen (analgesics)
- S: spine, skin, scrotum
- H: head (mentation, ears, eyes), hydration, hypo-, hyperthermia
- P: pelvis, perineum penis, prostate, pain
- L: limbs ( wounds, fractures, swelling, pain)
- A: arteries/veins
- N: nerves/neurologic, neck nutritional
36
Best treatment for decubital ulcers is?
prevention
37
A client calls, he suspects that his pet has been exposed or ingested a toxicant. What (4) questions and/or recommendations do you give over the phone?
1) Ask the name and phone number
2) What type of toxin it is (if they know)
3) If they can bring in the bottle of it
4) they need to bring the pet in right away
38
As the receptionist on duty, what advice (3) would you give a caller who describes a dog hit by a car with an open or penetrating wound?
1) Bring in immediately
2) Keep pressure on wound
3) Keep it covered with affected side down
39
What 4 drugs are mandatory in a crash cart?
1) epinephrine
2) sodium bicarbonate
3) atropine
4) 2% lidocane gel
40
T/F During an emergency situation, the purpose of the Primary survey is to determine further stability of patient and to identify and treat any life-threatening conditions
true
41
T/F Bounding pulses can be caused by a hyper-dynamic state or diastolic problem.
True
42
T/f If the CRT=<1, the condition of the patient is consistent with hyper-dynamic state and/or vasodilation
true
43
T/F In obtaining vascular access, the peripheral way is most commonly used, but central venous access using jugular or medial saphenous allows higher drug concentration to be achieved in coronary vessels because it allows placement of larger bore catheter and facilitates more rapid fluid administration
true
44
T/F While evaluating a neurological status, a level of consciousness any level other than "A" requires immediate attention
true
45
T/F Flat jugular veins (long time to refill) indicate hypovolemia
true
46
T/F Survivability depends on appropriate triage, establishment of an organized team who performs the 1st survey. take vitals, samples, control hemorrhage, shock management, followed by a 2nd survey which is a complete physical examination and complete history of the patient after stabilization
true
47
T/F Skull radiographs can be challenging to interpret in even the most straightforward cases due to the intricacy of bones in many overlapping planes
true
48
T/F Whether administered either during anesthesia or to a sick patient, fluid therapy often begins with the maintenance rate, which is the amount of fluid estimated to maintain normal patient fluid balance
true
49
T/f Decisions regarding whether to provide fluids during anesthesia and the type and volume used depend on many factors, including the patient's signalment, physical condition, and the length and type of the procedure.
true
50
Never _____ on the phone, always offer an appointment
diagnose
51
What are some signs of shock? (hypovolemic, cardiogenic)
- cool extremities
- pallor of the mm
- hypotension
- tachycardia
- fall in body temperature (hypothermia)
- mentation
- pulse quality
52
How can you treat cardiogenic shock?
by increasing CO, decreasing pre-load & afterload w/ positive inotropes
53
As shock progresses, the body loses the ability to maintain ______
homeostasis
54
____ needs to be in constant supply for tissues to function
ATP
55
What is the initiating cause of distributive shock?
sepsis
56
What are some monitoring equipment used for shock?
- ECG
- Blood pressure
- Pulse oximetry
- Best:Thorough PE and CONSTANT, frequent patient assessments
57
Well perfused patient has: CVP values of?
5-10 cm H2O dogs
| 2-5 cm H2O cats
58
Immediate concern for managing shock are?
- V-ventilation to ensure patent airway, maximize O2
- I-infusion of fluids to restore volume
- P- maintenance of myocardial pumping function, restore cardiac output and blood flow
59
Pressure measured at the tip of a catheter placed in the jugular vein, usually positioned so the tip is close to the heart, Represents right atrial pressure, Reflects filing pressure of RV
Central venous pressure
60
T/F There is a very low percentage of survival and discharge post resuscitation
true
61
The goal of resuscitation is
Goal to restore tissue perfusion
62
What does CPR stand for?
cardiopulmonary cerebral resuscitation
63
The goal of cardiopulmonary cerebral resuscitation (CPCR) is?
to perform effective thoracic compressions such that an adequate amount of oxygen is delivered to the brain and other vital tissues
64
Grading hear murmurs:
- I:
- II
- III
- IV
- V
- VI
```
I: barely auscultable
II: softer than 1st heart sound
III: sound equal to 1st heart sound
IV: louder than 1st heart sound
v: murmur with palpable thrill
VI: murmur and thrill can be heard with stethoscope off of chest
```
65
The acute onset of bradycardia, change in mucous membrane color and capillary refill time, change in respiratory pattern, and change in mentation are signs of possible deterioration and impending ______
cardiopulmonary arrest.
66
T/F New guidelines for humans emphasize the importance of continuous, uninterrupted compressions
true
67
___ is contraindicated because it decreases cerebral blood flow
Doxapram
68
What is the purpose of the defibulator?
Pass a current through heart to depolarize cardiac cells & repolarize in uniform manner
69
Decision to terminate based on:
Disease process, original prognosis and client’s desires (DNR), Usually 10-20 min
70
IMPORTANT TO KNOW OWNER’S WISHES FOR EXTENT OF RESUSCITATION. MOST SUCCESSFUL CPCR IS THE ONE ___
avoided
71
Common Signs in Cardiac Emergencies
- Cyanosis
- Dyspnea
- Collapse
- Hind limb paresis
- Syncope
72
as the inability of the heart to supply the metabolic needs of the body or provide adequate blood flow only by excessive increases in ventricular filling pressures
heart failure
73
A common clinical sign in a dog with CHF? Auscultation?
moist cough, pulmonary crackles and wheezes w/pulmonary edema
74
1st evidence of L-CHF is _______ that resolves with furosemide
interstitial pattern
75
Initial treatment of heart disease is?
O2 supplementation
76
Acute life threatening situation where large numbers of worms move from pulmonary arteries to RV, RA and +/- vena cava.
Caval Syndrome
77
Classifications:
1) Loss of systemic vascular resistance
2) Decreased circulating blood volume
3) Deranged metabolic machinery
4) Decrease in oxygen content in arterial blood
5) Decreased cardiac output due to heart failure
1) Obstructive/Distributive
2) Hypovolemic
3) Metabolic
4) Hypoxemic
5) Cardiogenic
78
What is the most common form of shock?
hypovolemic
79
Improving SV (stroke volume):
1) Stretch of ventricular walls during diastole
2) Decreases in forces opposing blood flow
1) preload
| 2) afterload
80
O2 content (CaO2) is defined as?
the amount of O2 in arterial blood, function of hemoglobin content, ether dissolved in plasma or attached to Hgb
81
Clinical signs of hypoxia
- cyanosis
- dark colored blood
- tachypnea
- tachycardia
- anxiety
82
T/F It is important to recognize shock in its latest stage for best success.
false-earliest
83
What are some factors affecting oxygen delivery?
- inadequate preload
- increased afterload
- cardiac dysrhythmias
- inadequate hemoglobin
- inadequate oxygen saturation
84
Deficient ATP= cell death=
multiple organ failure
85
What does shock most commonly result from?
reduction in oxygen delivery
86
What 2 things does tissue oxygen delivery depend on?
1) cardiac output
| 2) arterial oxygen concentration
87
Define as a state of inadequate circulating volume and inability to meet cellular oxygen demands or inadequate cellular energy production
shock
88
Treatment:
1) V fibrillation:
2) V tachycardia:
3) Supraventricular tachycardia
1) defibrillator
2) lidocaine, procainamide, quinidine
3) Beta-blockers or calcium channel blockers
89
Most commonly shock results from reduction in oxygen delivery secondary to one of three major mechanisms:
a) loss of intravascular volume
b) maldistribution of intravascular volume
c) failure of the cardiac pump
d) all of the above
d) all of the above
90
T/F Shock is a syndrome characterized by the presence of severe clinical signs, including alterations in mental state, mm color, CRT, HR, pulse quality.
true
91
T/F As a vet tech it is of importance to recognize early stages of shock
true
92
T/F Shock may be any syndrome, disease state or injury that results in a critical increase in effective blood flow.
false
93
```
Hypovolemic shock may result from:
A) 3rd spacing of fluids
b) acute hemorrhage
c) vomiting/diarrhea
d) all of the above
```
all of the above
94
T/F Cool extremeties, pallor of the mm, hypotension, tachycardia, are all signs of distributive shock.
false-hypovolemic, cardiogenic
95
T/F Anaphylactic shock is an antigen-antibody reaction occurring immediately after antigen enters circulation
true
96
T/F Severe pain can interfere with normal vasoconstriction response by inhibiting vasomotor center
true
97
T/F The treatment for shock is to optimize O2 delivery to all organs
true
98
Cardiac preload is define as blood in ventricles at the end of diastole
true
99
Name 2 differences between vomiting and regurgitation.
vomiting: active expulsion of gi contents
regurgitation: food is undigested, esophageal disorder
100
Diarrhea with straining is associate with a disorder of the small/large intestine
large
101
The owner of a dog with vomiting and diarrhea is incapable of bringing him to the clinic until the morning, after consulting with your veterinarian, what recommendations would you give him over the phone?
- no food or water until they can bring the dog in (usually wihthold for 24 hours)
- withhold water for 4 hours
102
The owner of a dog observed him ingesting a toxin 1/2 hour ago, he calls and wants to know how to make him vomit, what advice do you offer?
Bring him into the clinic, don't induce vomiting. Bring the bottle of the toxin as well. Ask the vet first. Find out toxin.
103
Describe a dog that has a foreign body lodged in the oral cavity.
- salivating
- not eating
- cyanosis/not breathing
- pawing at mouth
104
What are three clinical signs of a dog that has a foreign body in the stomach?
- vomiting
- not eating
- show pain on abdominal palpation
105
A cat regurgitates his food, what are 2 possibilities of the cause?
1) FB
| 2) hair ball
106
Name 4 possible causes for pancreatitis in dogs?
1) fatty diet
2) breed dispositions
3) drugs
4) abdominal trauma
107
What are the signs of a possible Gastric Dilation Volvulus.
- Repeated unproductive retching
- Restlessness
- Abdominal distention
- Hypersalivation
- Weakness and sometimes collapse
- Vomiting
108
An emergency GDV is on the way, as a CVT what do you need to prepare?
- stomach tube
- catheters
- fluids
- radiographs
- ultrasounds
- analgesics
109
What are the 2 types of Regular insulin and how can they be administered?
1) Humulin R
2) Novolin R
usually IM
110
Name 4 possible causes of hypocalemia.
1) hypoalbuminemia
- ARF and CRF
- Puerperal tetany (eclampsia)
- Acute pancreatitis
- Hyperphosphatemia
- Intestinal malabsorption
- Ethylene glycol
- Phosphate enemas
- All meat diets
111
These diagnostic tools are useful to diagnose what ocular emergencies:
1) Flourescein stain-
2) Tonometry-
3) Cytology-
4) Conjuncitval scrapings-
5) Flourescein antibody-
1) corneal ulcers
2) glaucoma
3) squamous cell carcinoma
4) conjunctivitis
5) cataracts
112
Overflow of tears
epiphora
113
Posterior displacement of the eye
enophtalmos
114
Blood in the anterior chamber
hyphema
115
Light sensitivity
photophobia
116
Inlfammation of all structures or tissues of eye
panophthalmitis
117
A corneal ulcer
descemetocele
118
Protrusion of the globe from the usual position
proptosis
119
Involuntary closing of the eyelids
blepharospasm
120
What are the 2 common causes of canine corneal ulcers?
1) trauma
| 2) shampoo in the eye
121
```
White: gastric or esophageal origin
Color of fluid:
1) Yellow:
2) Green:
3) Brown:
4) Hematemesis:
5) Coffee grounds:
```
1) gastric mixed with bile
2) bile and duodenal contents-both yellow and green can be associated with pancreatitis
3) reflux of fecal-like material
4) frank blood
5) gastric or duodenal vomitus of digested blood
122
GDV Distention puts pressure on:
Diaphragm and Vena cava
123
What is Obstipation?
Obstructive constipation common in older cats
124
What is an ocular emergency?
any serious condition that causes or threatens to cause severe pain, deformity or loss of vision
125
Questions to ask about an ocular emergency would be
- Any medical techniques attempted by the owner?
- When was the problem first noticed?
- Prior incident of ocular dz?
126
_____ is a common neurological disorder of the eye and facial muscles.
Horner's syndrome
127
_____ is a potentially fatal complication of unregulated insulin deficiency
Diabetic ketoacidosis
128
The most common cause of hypoglycemia is ____
Artifactual
129
For Hypercalcemia treatment what is the fluid of choice?
0.9% NaCl fluid of choice
130
Addison’s or Hypoadrenocorticism clinical signs
- Weight loss
- Abdominal pain
- Inappropriate bradycardia
- Vomiting
- Diarrhea
131
What is hemostasis
the stoppage of bleeding
132
Explain the 4 steps involved with primary hemostasis.
1) vascular constriction
2) exposure of collagen causing pooling of platelets
3) platelets release more factors to enhance aggregation
4) formation of complete but unstable plug
133
What is happening in secondary hemostasis?
larger vessels require coagulation factors to form a stable clot
134
What is the final step to hemostasis?
fibrinolysis
135
Von willebrands is a ____ disorder that is commonly seen in Dobermans
congenital
136
____ is the most common primary hemostatic defect, which one of the most common causes is ____
thrombocytopenia, immune mediated thrombocytopenia
137
___ is the most common hereditary bleedimg defect in dogs
Von Willebrands disease
138
What is Disseminated Intravascular coagulation and how is it treated?
is a rare, life-threatening condition that prevents blood from clotting normally. It may cause excessive clotting (thrombosis) or bleeding (hemorrhage) throughout the body and lead to shock, organ failure, and death. It is treated with FFP, O2, fluids.
139
What are some predisposing factors of DIC?
1) Endothelial damage causing contact activation of the intrinsic pathway
2) Abnormal blood flow activating the extrinsic pathway
3) Hypercoaguable state by activating certain enzymes
140
T/F DIC is a primary disease.
false-not a primary disease just a syndrome
141
What is anemia?
reduction of circulating RBCs
142
Normal animals can tolerate loss of 20%, shock occurs with ___ loss
60-70%
143
What are the 2 categories or neurological emergencies?
1) owner perceived
| 2) true emergency
144
Level of consciousness:
1) vocalization, inappropriate response to external stimuli
2) unconscious but responsive to external stimuli
3) unconscious with no response to noxious stimuli
1) delirium
2) semicoma
3) coma
145
Paroxysmal transitory disturbance of brain function that has sudden onset and ceases spontaneously
seizure
146
What are the 2 categories of seizures?
1) Partial (Reflect a limited set of neurons be affected)
| 2) Generalized (Tonic-clonic movement of all limbs)
147
Time after seizure or group of seizures
Post-ictal period
148
Non-progressive, intracranial disorder causing recurring seizures
epilepsy
149
What are some causes of seizures?
- Trauma
- Hypertension
- Toxin
- Hypoglycemic
- Hyperammonia
150
What are the 2 categories of epilepsy?
Focal vs. generalized
1) Focal= remain localized to one body region
2) Generalized= affect whole body=most common type
151
What are the 3 steps to stopping a seizure?
Step 1: benzodiazipines (diazepam)
Step 2: barbiturates (Phenobarbital)
Step 3: general anesthesia (propofol)
152
A condition characterized by an epileptic seizure that is so frequent or prolonged that it creates a fixed or lasting condition
Status epilepticus
153
What are the 2 types of spinal cord injuries?
1) Extrinsic: HBC, falls, falling objects; projectile wounds
| 2) Intrinsic: IVDD; fibrocartilaginous infarct-pain management
154
What do you monitor for head trauma? Treatment?
- ABCs
- Levels of mentation
- Mannitol decreases ICP, Furosemide to prolong effects
155
What are the 2 types of Vestibular Disease?
1) Idiopathic old dog
| 2) Feline idiopathic peripheral dz
156
Describe the 4 steps of primary hemostasis
1) vessels constrict
2) platelets are activated
3) clots form
157
Name 3 conditions that can cause platelets disorders
1) von willebrans
2) DIC
3) immune mediated hemolytic anemia
158
What happens during DIC?
blood clots form throughout the body
159
What is the most important course of action during a DIC emergency? How is it done?
stabilization of the patient, oxygen and fluids
160
Name 3 causes of hemolysis in dogs
1) immune mediated hemolytic anemia
2) thrombocytopenia
3) liver disease
161
What is the treatment for Rodenticide intoxication?
vitamin k
162
PCV: dehydration, spleic contraction, hemo-dilution, hemolytic anemia, blood loss (increased, decreased or normal)
dehydration: increased
splenic: increased
hemo: decreased
hemolytic: decreased
blood loss: decreased
163
TS: dehydration, spleic contraction, hemo-dilution, hemolytic anemia, blood loss (increased, decreased or normal)
dehydration: increased
splenic: normal
hemo: decreased
hemolytic: normal
blood loss: decreased
164
What are the 5 questions you would ask over the phone to screen for a potential dystocia?
1) hoe long since the last pup was delivered
2) is there any pus
3) has she been in labor longer than an hour
4) is she pushing for more than 30 mins and nothing is coming out
5) is her temperature dropping less than 100 degrees
165
What are 4 indications that we are dealing with an emergency situation
1) labor greater than 30 mins with no delivery
2) yellow or green pus
3) no pups being delivered after constant straining
4) temperature dropping below 100 degrees
166
What are 3 causes of uterine inertia?
- primary: inherited
| - secondary: anxiety, stress
167
When is it not recommended to give oxytocin for a dystocia?
when the cervix is not yet dilated/open
168
What are the reasons to give oxytocin, calcium gluconate, or dextrose for dystocia
- you would give oxy for inducing contractions
- calcium to prevent hypocalcemia
- dextrose to prevent hypoglycemia
169
How are neonates cared for after c-section delivery?
- clean the airway
- stimulate to breahte
- keep them warm
170
Explain an open vs closed pyometra
an open can drain the pus, the closed is a medical emergency
171
In case of a uterine torsion what will surgically happen to the uterus
the uterus will be rotated so it needs to be removed-OVH
172
What is the treatment for a uterine prolapse?
sugar and water and to place it back in
173
Why can death occur 2 days after a prostate abscess rupture?
septicemia
174
T/F A pnemothorax implies a collapsed lung, therefore the density observed in a lung on an xray and that is why we most probably have to insert a chest tube (to inflate the lung), the rest of the lung is over-obscured (super black) because of the extra air free in the thoracic cavity and the heart is elevated from the sternum
true
175
Describe an orthopneic patient
open-mouth breathing, neck extended, elbows abducted
176
Describe a Kussmeaul breath pattern and what makes it occur
slow, deep respirations, metabolic acidosis
177
T/F A cheyen stokes pattern is caused by a defect in central respiratory control center
true
178
How are 4 ways to identify a respiratory emregency
1) dypsnea
2) coughing
3) gagging
4) neck stretched, arms extended
179
Why does dyssynchronous breathing occur?
pleural effusion, pnemothorax, problem with lung expansion
180
Why does cyanosis occur?
1) not an adequate amount of oxygen is getting to the tissues
2) Hgb unable to carry O2
181
When you see an animal with extreme effort to inhale air you suspect an ____
airway obstruction
182
T/F Exercise intolerance, gagging while eating or drinking, laryngeal stridor may present with dypsnea, stridor, hyperthermia in a case of tracheal collapse
false-laryngx
183
T/F A "Goose honk" cough is a good indicator of laryngeal paralysis
false-tracheal collapse
184
When performing chest compressions on an animal that weighs more than 15lb the animal should be placed in a
lateral recumbent position
185
When performing cardiac compressions on a dog that weighs 9 lbs what is the point of compression?
directly over the heart
186
What is the ideal route of drug administration during CPCR in advanced life support
intravenous route with a jugular
187
What drug promotes diuresis and decreases cerebral edema in a patient following cardiac arrest by drawing water from the interstitial space between cells?
mannitol
188
Following initial assessment, the most important system to examine in any kind of emergency situation is
airway
189
The part of signalment is not a factor that helps you to identify the problem in a patient with cardiac problems
reproductive status
190
During the triage process, initial presentations are noted an assessed. What three systems assessed to decide where the patient should be directed, either to an exam room or intensive care?
- respiratory
- cardiac
- neurological
191
When referring to the crash cart, and relating the items found there to teh ABC's of resusitation, name 3 items found on the cart and what aspect of the ABC do they relate
1) laryngoscope and ET tubes: airway
2) ambu bag: breathing
3) IV catheters and syringes: circulation
192
What are 3 tests which can be run on the blood from the hub of the catheter which will be your minimum database for the patient?
1) PCV
2) TS
3) blood glucose
4) BUN
193
Give a brief explanation of the 5 levels of consciousness
```
I. A- alert
II. V- verbally responsive
III. P- pain responsive
IV. U- unresponsive
V any level other than “A” requires immediate attention
```
194
An owner calls stating that she found her bottle of heart medication open with chewed pills on the floor. What 4 important questions would you ask first?
- her name and number
- name of medication
- how many pills did the dog ingest
- any vomiting from the pet
195
What would be 4 instructions to give the owner?
- bring pet in immediately
- bring bottle in
- watch pet's behavior
4) watch pet's mentation
196
After how much time of CPCR should the team stop, if no resuscitation is obtained?
10-20 mins
197
The patient survived after prolonged resuscitation, now what do we need to look out for? Name 4 types of pathology of cellular environment.
- Perfusion failure
- Reperfusion injury
- Post-anoxia toxins affecting brain & heart
- Blood dyscrasias after low perfusion
198
During CPR, large breed k9's compressions are done over the ___, while small breed k9 are done over the ___
widest part, smallest
199
Name 3 diagnostic tools you will need to have available during emergency medicine
EKG, blood pressure machine, pulse oximeter
200
T/F Emesis is preferred over gastric lavage for removal of stomach contents which is more effective early.
true
201
Name the most common agents for emesis
1) syrup of ipecac
2) hydrogen peroxide h2o2
3) liquid dishwashing soap
4) apomorphine
202
When do you not induce vomiting?
animal seizing, comatose, dyspeneic
203
When can you repeat H2O2?
within 10 mins
204
Produces emesis and can be lavaged on the conjunctiva
apomorhpine
205
What agent is used to induce vomiting in cats?
xylazine
206
You use a ____ when emesis is contraindicated or amount is too large
gastric lavage
207
What do cathartics do?
they cause evacuation of the bowels
208
Cats lack enzyme in the liver to biotransform this into glucoronic acid
acetaminophen-tylenol
209
#1 common metal toxicity is ____, the most common signs involve the __ and the ___ systems.
lead, gi, nervous
210
What's the difference between absorbent and adsorbent?
absorbent is the process by which a material absorbs some amount of liquid or gas into it. Adsorbent is a process by which some liquid or gas gets accumulated on the surface of a solid material.
211
Define urinary obstruction
inability of urine to flow normally from the body
212
Urinary obstruction clinical signs:
- Dysuria
- Hematuria
- Distended painful urinary bladder
213
The Primary complaint of a blocked cat is _____
constipation
214
The blocked dog male= ___, female= ___
Uroliths, tumors
215
The use of a catheter and sterile fluid/lubricant to relieve urethral obstruction
Urohydropulsion
216
_____ in dalmations aberrant purine metabolism
Ammonium urate
217
75% or more nonfunctional nephrons
azotemia
218
How do you treat acute renal failure
- Fluid
- Drugs
- Nutrition: Low protein/phosphorus/sodium
219
The doctor is in the middle of a difficult surgery with the other technician on staff and you are the only one to receive patients. A cat presents to the emergency clinic with open-mouth breathing and dilated pupils. At the same time a 6 week old pup presents with vomiting and diarrhea for the past three days. It is up to you to initially triage the patients, which patient should be treated first and why? Both clients are new to the clinic:
A) The cat, airway & shock take priority
B) The puppy, dehydration may cause collapse
C) The puppy, vomiting may be from an obstruction
D) The cat could bite the owner
A) The cat, airway & shock take priority
220
Assuming money is already collected, describe what you would do FIRST for the most critical patient.
Check airway
221
What is the most common form of shock seen?
Hypovolemic
222
When rehydrating a patient, what are three external methods to assess the hydration status of the patient WITHOUT drawing blood.
skin pinch, bp, urine output
223
When a client calls the ER, what is one of the first pieces of information obtained prior to placing the client on hold?
Get the client's phone number
224
What are three signs that the patient will exhibit when presenting with either gastric dilatation or volvulus?
- Repeated unproductive retching
- Abdominal distension
- Hypersalivation
225
There can be many causes for bloody diarrhea in dogs. Name the two most common laboratory tests to be performed to aid in the diagnosis of the problem.
- snap test
| - fecal
226
Pulmonary edema is most commonly a result of what condition?
Congestive Heart Failure
227
The difference between vomiting and regurgitation is that vomiting is:
- Preceded by nausea
- Forceful contractions of abdomen and diaphragm
- Active expulsion of gi contents
228
If you were alone and had to initiate diagnosis for the veterinarian, what would be your 3 choices of preliminary exams for GDV ?
A) Radiographs
C) CBC
D) Chemistry & electrolytes
229
The doctor has just started surgery on a patient with bloat and has told you to triage and treat initially anything that comes through the door until surgery’s finished. Twenty minutes later a 12 y/o Miniature Poodle presents agitated, open mouth breathing, slightly muddy mucus membrane color and refusing to lie or sit down for any length of time. You attempt to auscult the thorax and due to the increased respiratory effort, the heart cannot be easily heard. The poodle has strings of saliva hanging from her mouth and is not swallowing; she will not let you close her mouth. What systems do you suspect is affected?
A) Digestive
B) Circulatory
C) Respiratory
230
When performing thoracic radiographs, what two positions are most commonly used?
VD, lateral
231
A client runs into the clinic with a dog that has just been hit by a car and the dog appears non-responsive in her arms., after assessment, what do you do first?
A) Administer Oxygen
232
Mrs.Pita rushes into the clinic with her Champion Chow-Chow, Ming, complaining of a foul odor and discharge on her face. As she walks across the floor of the lobby you notice Mrs. Pita is guiding the dog. What are three problems that you suspect with regards to the dog’s face ?
C) The dog has miasis
D) The infection is compromising the dog's eyesight
E) A traumatic event may have occurred a few days ago
233
A client comes in with her 2 y/o female Miniature Pinscher who is experiencing generalized involuntary muscle tremors. Her history of whelping four pups two weeks ago clues you into the possible cause of this emergency. What is the possible cause?
hypocalcemia
234
A patient presents to the clinic with moderate respiratory difficulty, but not in overt distress. An exam is performed and after radiographs, pleural effusion is diagnosed by the doctor. What is the best treatment for this condition to alleviate the respiratory distress?
Remove the fluid build-up
235
An 8 y/o M/C Main Coon cat presents in severe pain. The owner said he was out of town for 3 days and returned this morning and found the cat was on the floor straining and growling whenever his abdomen is touched. Radiographically, there are no fractures or dislocations-what do think may be the actual cause of the acute pain?
Urinary blockage
236
Mr. Williams with his 4 y/o M/I Bullmastiff, Hank, come into the ER and Mr. Williams looks very worried. Hank is definitely looking very depressed, head down, very little energy, refuses to stand as you start the record. The dog looks obviously thin, drags his feet while walking into the exam room. You start the PE and the following results are determined: RESULTS INTERPRETATIONBW 116 lbs., BCS 2.5/5 HR 124 RR panting, lungs clear LN’s enlarged Temp 104.6 What two organ systems might be involved in this problem ?
Lymphatic, Muscular
237
```
What treatment may alleviate Hanks's symptoms:
A) Vitamin B
B) Iron
C) Cortisone
D) More food
E) All the above
```
E) All the above
238
A 10 y/o mix M/I mix breed dog presents at the clinic for coughing, lethargy, weight loss and ascites. The owner states the dog lives completely outside and brags his dog has not been to the vet’s since a pup for the rabies vaccination. What organ is primarily affected?
Heart
239
Name two laboratory tests that you can easily prepare for the doctor to assist in the diagnosis of the previous case. (coughing, lethargy, weight loss and ascites.)
Snap test for Dirofilaria, Direct heartworm test on the microscope
240
The most common cause of hypercalcemia is
Malignancy
241
You see a dog with the following presentation below, you suspect : ______________Altered mentation , Seizures, Nystagmus , Wandering-aimless, Head tremors, Anisocoria, Altered balance and Paralysis or paresis
Head trauma
242
What would you do if Diazepan and Phenobarbital were ineffective in stopping a seizure occurring in a dog at your clinic?
Anesthetize
243
What can happen if Diazepam is mixed with LRS ?
Formation of precipitate
244
T/F Onion ingestion, Zinc toxicosis and Ehrlichia canis can all cause hemolysis in dogs.
true
245
T/F Drugs, vaccines, infection, neoplasia can all cause platelet disorders.
true
246
T/F Dobermans are prone to congenital Willebrand’s Disease.
true
247
T/F A bleeding time test that is easily performed is the canine Buccal, although it’s fairly insensitive test of plt function but if > 4min in dogs it is suspicious & > 5min, it’s prolonged.
true
248
T/F DIC is a syndrome resulting from overwhelming systemic activation of the coagulation, fibrinolytic and anti-thrombic systems.
true
249
T/F Perceived seizures occurs to healthy animal 1st for> 3-4 min , while true seizures occur several in short period of < 1 min.
false
250
T/F Bizarre behaviors such as “Fly-biting”, flank sucking or tail biting should be perceived as attention seekers by all animal patients.
false
251
T/F Any time we have a bulging eye, the cornea must be protected from drying as identification of underlying problem completed.
true
