FM1 Pt3-8 Physical Exam & History taking

Question 1

Why is a thorough physical examination important in cats?

Answer 1

It can detect minor abnormalities before they become serious and identify major organ dysfunction without expensive tests.

Question 2

What are the key principles of physical examination?

Answer 2

Be consistent and thorough, record all findings, back off to observe the cat from a distance, and learn from each experience.

Question 3

What are some findings that should prompt further evaluation before surgery?

Answer 3

Abnormal TPR values, age under 12 weeks or over 6 years, underweight or overweight, history of trauma or systemic disease, significant abnormalities on exam.

Question 4

What does “Signalment” include in a cat’s examination?

Answer 4

Species, breed, age, sex, reproductive status, and other distinguishing characteristics.

Question 5

How should you ask owners questions about their cat’s history?

Answer 5

Use open-ended questions to obtain accurate information, e.g., “Have you seen the cat’s stool recently?”

Question 6

What should be observed during the general appearance and initial observations?

Answer 6

Symmetry, body condition, mental status, posture, gait, and hydration status.

Question 7

What are the normal heart rate range in cats?

Answer 7

Heart rate: 110-180 bpm (up to 240 bpm if stressed)

Question 8

What is the normal respiratory rate range in cats?

Answer 8

Respiratory rate: 20-40 breaths per minute (up to 60 bpm if stressed).

Question 9

What is Capillary Refill Time (CRT) and what does it indicate?

Answer 9

CRT reflects perfusion of peripheral tissues; normal is <2 seconds, longer may indicate compromised circulation.

Question 10

What are some key areas to examine in the “Head to Toe” systems examination?

Answer 10

Head and neck (eyes, ears, nose, mouth, throat), trunk and limbs, thorax, abdomen, external genitalia, and perineum.

Question 11

What are the different mucous membrane colors and their possible interpretations?

Answer 11

Pink: Normal; Pale/White: Anaemia or poor perfusion; Blue: Hypoxemia; Brick red: Early shock or sepsis; Yellow: Bilirubin accumulation; Petechiae: Coagulation disorder.

Question 12

Pink mucous membranes indicate?

Answer 12

Normal
Caused by:
Adequate perfusion/oxygenation of peripheral tissues

Question 13

Pale/White mucous membranes indicate?

Answer 13

Anaemia, poor perfusion, vasoconstriction.
Possible causes:
Blood loss, shock, decreased peripheral blood flow

Question 14

Blue (cyanotic) mucous membranes indicate?

Answer 14

Inadequate oxygenation.
Possible causes:
Hypoxemia

Question 15

Brick red mucous membrane indicate?

Answer 15

Increased perfusion, vasodilation
Possible causes:
Early shock, sepsis, fever, systemic inflammatory response syndrome (SIRS)

Question 16

Yellow (jaundiced) mucous membranes indicate?

Answer 16

Bilirubin accumulation
Possible causes:
Hepatic or biliary disorder and/or haemolysis

Question 17

Petechiae on mucous membranes indicates?

Answer 17

Coagulation disorder.
Possible causes:
Platelet disorder, DIC, coagulation factor deficiencies

Question 18

How are heart murmurs graded and what does it indicate?

Answer 18

Graded from 1/6 (very soft) to 6/6 (very loud with palpable thrill); the grade reflects loudness but not necessarily the degree of cardiac dysfunction.

Question 19

What is evaluated when listening to heart murmurs?

Answer 19

Location, Timing, Duration, Character & Grade (loudness).

Question 20

Evaluating location of heart murmur.

Answer 20

Usually the valve area over which the murmur is loudest = aortic, mitral, tricuspid, pulmonic.
Because of their small size, it is often difficult to allocate a precise location to feline heart murmurs, so they are often classified as being loudest on the left or right side (or on the sternum) and being loudest at the base or apex of the heart (rather than at a specific valve).

Question 21

Evaluating timing of heart murmur.

Answer 21

The part of the cardiac cycle during which the murmur is heard = systole, diastole or continuous

Question 22

Evaluating duration of heart murmur.

Answer 22

Refers to the duration within systole or diastole murmur is heard = early systole, holosystolic, diastole

Question 23

Evaluating character of heart murmur.

Answer 23

The quality of the murmur
o Plateau or regurgitant type (same sound for the duration of murmur)
o Decrescendo, crescendo, crescendo-decrescendo or ejection type (intensity changes throughout duration of murmur)
o Machinery (heard throughout systole and diastole)
o Decrescendo or blowing

Question 24

Evaluating grade of heart murmur.

Answer 24

Loudness. Subjective assessment, does not necessarily indicate degree of cardiac dysfunction

Question 25

Grade 1/6 Heart Murmur

Answer 25

Can only be heard in quiet room after several minutes of listening

Question 26

Grade 2/6 Heart Murmur

Answer 26

Can be heard immediately, but is very soft

Question 27

Grade 3/6 Heart Murmur

Answer 27

Low to moderately intense

Question 28

Grade 4/6 Heart Murmur

Answer 28

Loud, but without a palpable thrill

Question 29

Grade 5/6 Heart Murmur

Answer 29

Loud, with a palpable thrill

Question 30

Grade 6/6 Heart Murmur

Answer 30

Can be heard with the stethoscope slightly off the thoracic wall