exam 1 - CV emergencies

Question 1

2 types of heart failure

Answer 1

congestion/backward failure
low output/forward failure

Question 2

when does HF happen

Answer 2

when heart is unable to meet metabolic demands of peripheral tissues or can only do so in the presence of increased venous filling pressures

Question 3

causes of heart failure

Answer 3

valvular dz, myocardial dz, congenital heart dz, arrhythmias, endocarditis, sepsis

Question 4

history with CHF

Answer 4

increase respiration and effort
cough
exercise intolerance
syncope
abdominal distension

Question 5

history with forward failure

Answer 5

weakeness
depression
exervise intolerance
lethargy
syncope

Question 6

PE with dogs with CHF

Answer 6

increased RR/RE
tachycardia
murmur
increased lung sounds
can have - crackles, hypothermia, arrhythmias, ascites

Question 7

PE for dogs with forward failure

Answer 7

tachycardia
murmur
poor pulses
cool extremities
prolonged CRT
dull
may have - hypothermia, arrhythmias

Question 8

PE cats

Answer 8

tachypnea
increased resp effort
tachy or bradycardia
hypothermia
may have - mumur, gallop, increased lung sounds, muffled lung sounds, arrhythmias

Question 9

Dx for heart failure

Answer 9

POCUS, thoracic rads, ECG, BP, SpO2, bloodowrk, echo

Question 10

what does POCUS measure

Answer 10

LA enlargement
LA:aorta
1.6-2 = significant

Question 11

what else can POCUS find

Answer 11

effusions, B-lines

Question 12

does POCUS replace echo

Answer 12

no

Question 13

HF tx goal

Answer 13

improve oxygen delivery
reduce preload, control edema and effusions, improve pump function, reduce afterload

Question 14

Tx for HF in all patients

Answer 14

furosemide - loop diuretic
oxygen
pimobendan - Ca sensitizer and PDE3 inhibitor

Question 15

tx for HF in decompensated pt

Answer 15

furosemide, oxygen,
nitro - mixed vasodilator/venodilator
dobutamine - beta agonist

Question 16

1 DDx for feline arterial thromboembolism

Answer 16

cardiomyopathy

Question 17

other DDx for feline arterial thromboembolism

Answer 17

neoplasia, FB, idiopathic

Question 18

feline ATE locations

Answer 18

90% hindlimbs - 69-80% bilateral
10% brachial - R more common
renal, splanchnic, cerebral

Question 19

history for feline ATE

Answer 19

+/- history of cardiac disease
acute onset paresis or plegia
lameness
vocalization
+/- respiratory signs

Question 20

PE for feline ATE

Answer 20

5 Ps
pain, pulseless, pallor, polar, paralysis

Question 21

diagnostics for feline ATE

Answer 21

doppler
paired blood glucose - lower in affected limbs
paired lactate - higher in affected limbs
US

Question 22

tx for feline ATE

Answer 22

PAIN MANAGEMENT
anticoagulants, antithrombotics, +/- CHF management

Question 23

prognosis feline ATE

Answer 23

negative indicators
>1 limb, hypothermia, lack of motor function, CHF

Question 24

survival for feline ATE

Answer 24

27-39%

Question 25

outcomes for feline ATE

Answer 25

25-35% euth, 28-40% natural death
50% cats regain motor function over 4-6 wks

Question 26

whats more common, thrombosis or thromboembolism in dogs

Answer 26

thrombosis

Question 27

causes of pericardial effusion

Answer 27

neoplasia, idiopathic, LA rupture, infectious, coagulopathy, CHF

Question 28

what collapses first in pericardial effusion - R or L heart

Answer 28

R heart

Question 29

acute history for pericardial effusion

Answer 29

collapse, weakness, sudden death, vomiting, lethargy

Question 30

chronic history for pericardial effusion

Answer 30

abdominal distension, exercise intolerance, latheragy, decreased appetite, may be asymptomatic

Question 31

PE findings in pericardial effusion

Answer 31

shock - obstructive
muffled heart
jugular distension
pulsus paradoxus
tachycardia

Question 32

diagnostics for pericardial effusion

Answer 32

POCUS, ECG, BP, echo, rads, cbc/chem/coag

Question 33

tx for pericardial effusion

Answer 33

pericardiocentesis, IV fluid bolus, NO LASIX (decreases preload)
overnight in hospital for observation