Medical Emergencies Flashcards by Jazmine Hawdon

What is expected in a patient presenting in Chronic heart failure (CHF)

Dyspnoea
Abdominal Effort 
Pale/Cyanotic MM 
Cough 
Syncope 
Exercise intolerance

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What is drug is recommended as a sedative for a patient with CHF

Butorphanol

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What are causes of CHF

Mitral endocardiosis
DCM
Feline myocardial disease

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What are 6 historical features of a patient with CHF

Weigh loss 
coughing 
exercise intolerance 
Lethargy and fatigue 
Inappetence

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What is the most common sign of dogs presenting with acute CHF

respiratory distress

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What are 4 things you can do as a treatment for a patient presenting in CHF

oxygen therapy
cage rest
sedative - relieve distress
Diuresis

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What are the three stages of an AKI

pre renal
renal
post renal

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What is a pre renal AKI

Includes those which affect the blood flow to the kidneys

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What is a renal AKI

Effects the kidneys directly e.g nephrotoxins

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what is a post renal AKI

Due to urinary obstructions

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What are clinical signs of AKI’s

Azotemia ( elevated BUN and CREA) 
Fluid retention 
Acid base abnormalities 
Tachypnoea 
tacky MM 
Bradycardia 
Hypothermia

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How are AKI’s graded

graded in kidney filtration rate - characterised by the increase of creatinine and changes in UOP.

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What is an example of a pre renal AKI

Hypovolemia
Dehydration
Hypotension

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What is an example of the ‘renal AKI’ and the two types

infections - lepto,

non infectious - Toxins , NSAIDS

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What is the creatinine level in a grade 1 AKI

under 1.6 mg/dL

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What is the creatinine level in a grade 2 AKI

1.7-2.5 mg/dL

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What is the creatinine level in a grade 3 AKI

2.6-5.0 mg/dL

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What is the creatinine level in a grade 4 AKI

5.1 - 10 mg/dL

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What is the creatinine level in a grade 5AKI

over 10 mg/dL

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What is an example of post renal AKI

Bladder stone
Prostatic disease
Urethral/bladder perforation

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What are 6 form of treatment you could use on a patient with an AKI

IVFT 
correction of electrolyte imbalance 
Diuresis - mannitol/Fruosemide 
Antidote for toxin? 
Manage oliuria/anuria 
U-cath or surgery (post renal)

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What are the main 6 endocrine glands

thyroid
Parathyroid
Pituratory gland
Adrenal glands
Pancreas
Ovaries
Testes

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What is the role of the endocrine system

To release and produce hormones delivered by the bloodstream

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What is a DKA

Diabetic Ketoacidosis
Low insulin stops glucose being taken up by cells. Causing the metabolism of fats and proteins releasing KETONES making an acidosis and high glucose

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What is the most common endocrine emergency

DKA

What are the two types of diabetes mellitus in dogs

``` Insulin deficiency (absolute) Insulin insensitivity (relative) ```

What are 4 clinical signs of a DKA

Vomiting Depression Tachycardia dehydration

What are the 3 steps for the treatment of a DKA

1. Correction of dehydration and intravascular volume 2. Normalise glucose - insulin 3. Correct electrolyte and acid-base imbalance

What is hypoadrenocorticism

Addison's disease Malfunction of adrenal glands decreasing cortisol and aldosterone production

Addison's disease is a reflection of what

low circulating steroids (cortisol and aldosterone due to malfunction of adrenal glands

What are the 2 main steroids

Glucocortic acid - Cortisol and aldosterone | Mineralcorticoid - Aldosterone

What is Aldosterone (mineralcorticoid) responsible for

Reabsorption of sodium and the excretion of potassium

What does low Aldosterone (mineralcorticoid) result in

hyponatraemia and hyperkalaemia

What are some clinical signs of a cortisol (Glucocortic) deficiency

GI signs | Vomiting diarrhoea

What are some clinical signs of a patient in Addisonian crisis

``` Diarrhoea Vomiting PU/PD Lethargy Bradycardia Dehydration Hyperkalaemia Hyponatraemia ```

What is the treatment for a patient in What are some clinical signs of a patient in Addisonian crisis

- Aggressive IVFT (NaCl) - Dexamethasone ( doesnt affect ACTH stim) - Insulin - hyperkalaemia - Dextrose - hypoglycemia

What are the 5 stages of treatment when dealing with a poisoned patient?

1. Stabilise and support 2. Reduce and minimise absorption of the toxin 3. Working diagnosis 4. Antidote? 5. Increase elimination of toxin

How do you induce emesis in a dog

Apomorphine

How do you induce emesis in a cats

soda crystals

What is recommended if emesis is contraindicated?

Gastric lavage

In gastric lavage what rib should the gastric tube go measuring from the nose

13th rib

what 4 toxins are poorly absorbed by charcoal?

Ethanol, Methanol, Nitrates and Lead.

What is the antidote for Paracetamol?

N-Acetylcysteine

What is the antidote for anticoags (Rodenticides) ?

Vitamin K

What is the antidote for Ethylene ?

Atropine

What is the antidote for Opioids?

Naloxone

What is the antidote for Vitamin D ?

Calcitronin

How do you increase the elimination of a toxin

IVFT - Diuresis | Laxatives

What are the clinical signs if a patient has present with chocolate toxicity

Vomiting Diarrhoea Tachycardia Tremors/Seizures

What is the treatment for a patient has present with chocolate toxicity

``` Eliminate the toxin Charcoal Induce emesis IVFT Benzodiazepines if seizure ```

What are the clinical signs of a patient presenting with an NSAID toxicity

``` Vomiting Diarrhoea Gastric ulcer Renal failure Hypotension ```

What is the treatment for a a patient presenting with an NSAID toxicity

IVFT | Gastro protectants

What is the treatment for a a patient presenting with an Grape toxicity

IVFT Emesis Charcoal

What are the clinical signs for a a patient presenting with an Grape toxicity

Vomiting Diarrhoea Renal failure Lethargy

What are the clinical signs for a patient with lily toxicity

``` GI irritation Vomiting Diarrhoea Anorexia Renal toxicity ```

What is the treatment for a a patient presenting with an lily toxicity

IVFT

What does xylitol do to the cells if they are ingested?

Glucose is driven into the cells

What are the clinical signs of xylitol toxicity

Neurological signs Vomiting Ataxia seizures

What are mycotoxins

Moulds (blue cheese, bin, compost)

What are some clinical signs of a patient with mycotoxin toxicity

twitching seizures vomiting AKI

What is parvo virus

A highly infection pathogen that causes rapid onset of dividing cells.

What cells are affected from parvo virus ??

Gastrointestinal cells myocardial cells bone marrow cells

What are the clinical signs of a patient presenting with parvo virus

``` Vomiting Diarrhoea Lethargy poor appetite poor demeanour pyrexia weight loss ```

What is the treatment for a patient with parvo virus

Antibiotics - treat neutropenia, GI protectant, stop bacterial translocation, help fever and sepsis. IVFT - 50ml/kg/day + ongoing losses Nutritional support -12-24 hours vomiting has stopped antiemetics Vit B Antiparasitic Probiotics

What clotting factors are affected with rodenticide toxicity

II VII IX X (2,7,9,10)

What factors are tested pT and ApTT

pT: VIII X V II (8 10 5 2) aPPT : XII XI IX VIII (12,11,9,8)

What's the toxic dose of chocolate

Dark 3.5g/kg Milk 13g/kg White check for xylitol nuts of raisins.

What are 3 stages of seizures

Prodromal (lasts hours to days) procedures to seizure leading up Aura (pre ictal) localised signs indicating a seizure is coming (restlessness) Ictal - actual seizure event

Types of seizures

Generalised - both cerebral hemispheres (consciousness lost) Tonic clonic - tonic phase (stiffness) then clonic phase (jerking) Focal (partial) only on cerebral hemisphere involved

Best test to diagnose Addison's

ACTH stim

Treatment for Addisons

Steroids (glucocorticoids)