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Misc Flashcards

1
Q

What recumbency should you record an ECG in?
How many leads should you use?

A

Right lateral
Minimum 6 can use 12

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2
Q

Aldosterone

A

Made be the adrenal cortex
Causes sodium and water retention
Causes potassium loss

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3
Q

How does hypothermia cause bradycardia?

A

Causes decreased cardiac depolarisation
Decreases HR
Decreases CO

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4
Q

What does RAAS stand for?
What are the steps?

A

Renin angiotensin aldosterone system
1. Drop in BP sensed
2. JG cells in the kidney produce Renin
3. Angiotensinogen released from the Liver
4. Angiotensin I created
5. Converted via ACE to angiotensin II
6. Angiotensin II causes vasoconstriction and promotes the release of Aldosterone and ADH

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5
Q

Cells in the Pancreas and what they produce

A

Alpha cells - Glucagon
Beta - Insulin
Delta - Somatostatin
F Cells - Pancreatic polypeptide

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6
Q

Main electrolyte abnormalities with DKA

A

Hypokalaemia
Hyponatraemia
Hypophosphataemia
Hypomagnaesaemia

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7
Q

Calculation of free water deficit

A

BW x 0.6 x (Measured Na/140)

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8
Q

Information about Magnesium

A

2nd most abundant cation
Intracellular, less than 1% found in serum
Difficult to measure as only the ionised is active
Can be supplemented if refractory hypokalaemia
0.25-1mEg/kg/24hrs iv

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9
Q

Drugs that cause/ worsen hyperkalaemia

A

Ace inhibitors (enalapril or benazepril Fortekor)
Angiotensin receptor blockers (losartan and telmisartan Semintra)
Heparin
Cyclosporin
Tacrolimus
NSAIDS
Trimethoprim
Non-specific beta blockers
Cardiac glycosides

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10
Q

Renal threshold for glucose

A

Dogs 200 mg/dL (11)
Cats 220 mg/dL (12)

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11
Q

Difference between PvCo2 and PaCo2

A

PvCo2 is 5-10mmHg higher

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12
Q

Receptors in the CRTZ

A

Nk1
Dopamine
Serotonin
Histamine
Muscarine
Enkephalin
Alpha-2 Adrenergic

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13
Q

What receptors does maropitant act on

A

Nk-1 in the CRTZ

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14
Q

Why do severely anaemic patients not become cyanotic?

A

To become cyanotic you must have a haemoglobin level of above 5 (HTC 15%)

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15
Q

What temperature should you start active cooling?

A

Above 105.8 (41)

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16
Q

Plasma osmolality equation and normal

A

(2xNa) + BUN/2.8 + Glu/18
Normal 300

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17
Q

What is glyconeogenesis?

A

When the liver converts glucose to glycogen for sugar storage

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18
Q

Difference between endocrine and exocrine

A

endocrine - hormones
exocrine - enzymes

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19
Q

Normal blood lactate?
Indication of survival

A

Less than 2-2.5
How quickly it reduces

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20
Q

When performing abdominocentesis on a GDV which side should if be performed on and why?

A

Left lateral, perform from the right, to avoid the spleen

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21
Q

ARDS diagnosis
Berlin criteria

A

Acute onset - less than 72hrs
Prescence of a primary dx process that causes enough inflammation to set up a reaction in the lungs
Evidence of pulmonary oedema without heart failure or fluid overload
Evidence of inefficient gas exchange (P/F ratio >300)

P/F ratio >100 severe
100-200 moderate
200-300 mild

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22
Q

6 Organs involved in the SOFA score and Parameters measured

A

Respiratory
Liver
Cardiovascular
Renal
Coagulation
CNS

P/F ratio
Platelet count
Total bilirubin
Crea
MAP BP
GCS

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23
Q

3/4 Stages of ARDS

A
  1. Exudative
    Type 1 pneumocystis are damaged- they are in charge of gas exchange, they cannot multiply
  2. Proliferative
    Type 2 pneumocytes multiply- secrete surfactant
  3. Fibrotic
  4. Recovery
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24
Q

Types of fluid found in the pleural space

Disease processes associated with them

A

Transudate
Clear, low cell count, low protein count
Associated with decreased oncotic pressure- hypoalbuminaemia

Modified transudate
Most common, higher cell count
Associated with increased hydrostatic pressure- Heart failure

Exudate
High cell count, bacteria, lymphocytes
Pyothorax, chylothorax

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25
What is MDR-1 Implications of genetic predisposition and not having it
Multi-Drug resistant protein - 1 Removes foreign substances out of cells in the GI tract, kidney, liver. Cannot stop drugs crossing the blood brain barrier drugs have a larger effect, animals more sensitive
26
Things that affect absorption of drugs administered PO
Stomach, gastric motility Lack of small intestinal motility. Drug can be reabsorbed + build up to toxic doses Food in the stomach Gastric pH Increased permeability of the GI tract-more absorption
27
What is pharmacokinetics? What is ADME?
The study of how drugs pass through the body Absorption Distribution Metabolisation Excretion
28
Drugs that activate the P450 system and increase metabolism
Phenobarbitone St johns wort Phenylbutazone
29
Drugs that decrease the metabolism of other drugs
Erythromycin Grapefruit juice Omeprazole Cimetidine Chloramphenicol
30
What causes the oxyhemoglobin curve to shift to the right?
decreased pH Increased temperature
31
What causes the oxyhemoglobin curve to shift to the left
Increased pH Decreased temperature
32
What causes the oxyhemoglobin curve to shift to the left
33
Normal circulating blood volume
90ml/kg dogs 55ml/kg cats
34
How much FFP does it take to increase albumin by 1g/L (10g/L UK)
45ml/kg
35
Units for albumin and the difference? Normal range
US g/Dl Uk g/l x10 3.2-4.1
36
4 types of hypoxia
Hypoxic Hypaemic Histiotoxic Metabolic
37
5 causes of hypoxaemia
V/Q mismatch Low partial pressure of inspired O2 Diffusion impairment Anatomical shunting Hypoventilation
38
What is shock
A severe imbalance between oxygen supply and demand. Leading to inadequate cellular energy production, cellular death and multi-organ failure
39
Units for creatinine and how to convert
x88 US mg/dL UK mol/L
40
Differences between abdominal fluid and peripheral blood that can show uroperitoneum
Potassium x1.4 more Creatinine x2 more
41
What vitamin helps with the absorption of calcuim
Vitamin D3 Cholecalciferol
42
What are kupffer cells and were are they found?
Macrophages found in the liver Remove bacteria from the blood
43
Definition of sepsis
A life threatening organ dysfunction caused by a dis-regulated host response to infection
44
Metabolic deficits seen with hepatic lipidosis
Glutathione Taurine Vitamin K Vitamin B
45
Definition of septic shock
A subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality Inability to maintain BP abouve 65MAP despite adequate fluid resuscitation without vasopressors Lactate will not go below 2
46
Where is glucagon produced? What does it do?
In the pancreas Stimulates the liver to convert stored glycogen to glucose for energy
47
Which vitamin is needed for the production of haemoglobin? Where is it stored?
B12 Liver
48
Drugs you wouldn't give to patients with kidney problems
NSAIDS Some diuretics Some antibiotics Tetracyclines and Sulphomimides Corticosteroids Decreased clearance, narrow safety margins
49
Differences between abdominal fluids and peripheral blood that can show septic effusion
Glucose lower in effusion (20) Lactate higher (2)
50
Effects of metabolic acidosis on the body
Shifts oxyheam curve to the right Decreases cardiac contractility Decreased CO Tachycardia Decreased arrhythmia threshold Catecholamine resistance Peripheral arteriolar vasodilation Venoconstrication of peripheral veins Pulmonary arteries vasoconstrict Insulin resistance Hyperkalaemia (K swapped from cells with H)
51
Risks associated with administration of sodium bicarbonate Calculation for the amount needed
Paradoxical cerebral acidosis Increased Co2 production Hypercapnia Increased sodium and osmole concentration Circulatory system overload Iatrogenic metabolic alkalosis Changes to oxyhemoglobin curve Hypocalcaemia Hypokalaemia mEg of bicarbonate needed = 0.3xBWxbase excess
52
2 major stimuli for ADH release
Elevated plasma osmolality Decreased effective circulating volume
53
Effects of alkalosis on the body
Muscle spasms Stuporous mentation Hypocalcaemia Hypokalaemia
54
Difference between anions and cations and examples of both
cations are positively charged K+ Na+ Mg+ Ca+ Cl- HCO3- P-
55
How to convert glucose and the units?
UK mmol/l US mg/dL /18
56
What is apheresis
When the blood is removed from the patient and separated into its components One or more components id removed or processed and the blood is returned to the patient Therapeutic plasma exchange
57
What type or reaction is anaphylaxis?
IgE mediated hypersensitivity reaction
58
Stages of hypovolemic shock and clinical signs associated
Compensatory Vasoconstriction Splenic contraction Tachycardia Rapid CRT Injected mm's Early decompensatory Tachycardia Hypotension Weak pulses Pale mm's Prolonged CRT Cool extremities Increase in resp rate and effort Decreased mentation Late decompensatory Bradycardia Severe refractory hypotension Pale/cyanotic mm's Undetectable CRT Weak/absent pulses Hypothermia Decreased mentation Prolonged and severe tissue hype-perfusion causes ATP deplation, anaerobic respiration and cellular death
59
What is cardiac afterload
The force that the ventricles must overcome to open the semi-lunar valves
60
What is cardia preload
The volume in the ventricles at the end of diastole
61
Nasal oxygen dose
50-150 ml/kg/min
62
A-a Gradient and normal limits
PAO2-PaO2 PAO2= (FiO2x713)-(PaCo2/0.8) Normal = 5-15
63
How to calculate MAP
((Diastole x 2)+ Systole) / 3
64
What is released during anaphylaxis
Histamine Cytokines Heparin Tryptase Prostaglandins Platelet activating factor
65
What receptors does histamine bind to? What effects are seen due to this?
H1-H4 (GI, CV and resp systems) Respiratory signs, smooth muscle contraction, bronchospasm, mucus secretion, oedema formation Cardiogenic shock Dysrythmias Cardiac ischaemia Gastric acid production Puritis Increased vascular permeability Vasodilation
66
Normal level of lactate
>2.5

VTS ECC (1 decks)

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