Miscellaneous Flashcards

1
Q

what is the purpose of RVCS professional code of conduct for vet nurses?

A

sets out nurses professional responsibilities and standards of practice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

list the 5 principles of practice according to the RCVS code of conduct

A
professional competence
honesty and integrity
independence and impartiality
client confidentiality and trust
professional accountability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

list some nursing interventions that can be done to help encourage inappetant patients to eat

A
avoid lots of food in kennel
avoid unpalatable prescription diets
anti-emetics
appetite stimulants
analgesia
provide options for different foods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when are feeding tubes placed in patients?

A

anorexic for 48 hours
anticipate anorexia after a procedure
head, neck, mouth trauma
provide oral rehydration and medication if AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

list equipment needed to place NO tube

A
surgical stapler
feeding tube
syringes
LA
sterile lube
gloves
sterile water
tape
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe how NO tubes are placed

A

measure tube from 7th rib in cats and 9th in dogs to end of snout and mark on tube
give LA to one nares
apply sterile lube to end of tube and hold against muzzle
direct tube in medio-ventral-caudal direction and quickly insert up to the mark
patient should swallow when at pharynx so goes to oesophagus
check negative pressure with syringe
administer 10mls water slowly and check no respiratory distress
tape to nares and face and place collar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe the process of feeding through NO or oesophageal feeding tube

A

draw food into syringe and leave in warm water bath
check for negative pressure
preflush 10ml water
feed over 10-15 minutes watching for nausea or regurgitation
follow with 10ml flush

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are considerations when feeding through NO tube?

A

keep face clean

tempt with food before tube feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how long can NO tubes be left in?

A

7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how are NO tubes removed?

A

gently pulling out of nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when are NO tubes contraindicated?

A
cat flu
congestion
epistaxis 
head trauma
oesophageal disease
vomiting
impaired gastric outflow
comatose patients, no gag reflex
need support longer than 7 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

list complications of NO tube

A
removal by patient
displacement
infection
irritation preventing eating
aspiration
blockage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

list advantages of NO tube

A

no GA
easy to place and remove
well tolerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

list disadvantages of NO tubes

A

short term
aspiration risk
not secured inside patient
time consuming feeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

list equipment for oesophageal feeding tube

A
sterile and non-sterile gloves
curved artery forceps
surgical prep equipment
scalpel
bandage material
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is nursing care for oesophageal tube?

A

check stoma site 2x daily
tempt food before feeding
no neck collar or lead
give medication through tube when possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how is oesophageal tube stoma site checked?

A
remove dressing
clean with 1:10 iodine
assess if normal appearance
check negative pressure
flush with water
redress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how long can oesophageal feeding tubes be left in place?

A

months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how are oesophageal feeding tubes removed?

A

cut suture holding in place
gently pull out
dressing over stoma site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

list contraindications for placing oesophageal feeding tube

A

persistent vomiting
impaired gastric outflow
patients at risk of aspiration
oesophageal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

list complications of oesophageal tubes

A

infection
displacement
suture failure
blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

state advantages of oesophageal feeding tubes

A

larger volumes and medications can be given easier

can be managed at home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

list disadvantages of oesophageal feeding tube

A

GA needed
infection at stoma site
time consuming feeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

list equipment needed for percutaneous endoscopic gastrotomy/PEG tube

A
PEG tube kit
endoscope
endoscope forceps
suture material
surgical prep equipment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

describe how PEG tubes are placed?

A

clip in right lateral from costal arch, lateral edges of transverse processes to ventral 13th rib
use light from endoscope in stomach to see where to place needle through to stomach
introduce guide wire through needle
put loop of PEG tube through guide wire
feed through mushroom tip through PEG tube
guidewire pulled away so mushroom tip against stomach wall
peg tube secured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

how do you feed through PEG tube?

A
wait 24 hours after placement
preheat food in syringe
aspirate stomach contents through tube, measure volume and replace
feed over 20-25 minutes
give medication
flush with 10ml water
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are nursing considerations for patients with PEG tubes?

A

check stoma site 2x daily

tempt to eat before tube feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are advantages of PEG tube?

A

large lumen for admin
can leave for months
owner can manage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

list disadvantages of PEG tube

A

GA needed
needs to be in at least 7 days
cant use first 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

describe how much patients are fed when feeding tube placed

A

24hrs- 1/3 RER
48hrs- 2/3RER
72hrs- full RER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the veterinary poisons information service?

A

24 hour helpline to give guidance regarding treatment of poisons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the benefit of the tox box service?

A

contains antibodies for uncommon poisons around the country so vets dont have to keep in stock when rarely used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what suggests intoxication?

A

acute onset signs usually towards an organ system

known or suspected accidental or rarely malicious exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

list what is included in phone triage for poison victims

A

what
when
dose
current BW
call VIPS if asymptomatic, unknown poison or low risk
bring for immediate vet attention if symptomatic or known high risk ingestion
bring label and or sample
if dermal prevent self grooming and other contact with pet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

how can you prepare for triaging poison patients?

A
inform vet
hospital sheet
IV catheter
IVFT
oxygen
sample tubes
decontaminants
emetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what history should be taken for poison patients?

A
patient signalment
pre-existing conditions
onset of problem
progression of signs
information of toxin
signed consent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is included in primary survey of poison patients?

A
respiratory rate, effort, lung sounds
MM
CRT
pulses
temperature
mentation
neuro exam
bladder size
pain
haemorrhage
trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is initial care for poison patients after primary survey?

A
oxygen
airway
IVFT
treat any cardiac abnormalities
manage neuro issues
secondary head to toe exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

how is poisoning diagnosed in patients?

A

history of exposure
acute onset signs
toxin panel potentially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what are the ways of managing intoxications?

A

remove toxin
reduce ongoing absorption
dilute toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what does inducing emesis in poison patients do?

A

empties 50% gastric contents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

when is induced emesis indicated in poison patients?

A

2-3 hours after oral ingestion of non-corrosive intoxicant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

when is induced emesis contraindicated in poison patients?

A

corrosive intoxicant

pre-existing aspiration risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what emetics can be used for poison patients?

A

dogs- apomorphine

cats- xylazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

when is gastric lavage considered in poison patients?

A

intoxication within an hour

contraindicated to induce emesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what are complications of gastric lavage in poison patients?

A

anaesthesia
aspiration
GO perforation or trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

how is gastric lavage performed?

A
anaesthetised and intubated, placed in lateral
measure nares to last rib
lavage with 10-30ml water
kink tube before removal
suction oropharynx before recovery
extubate after swallow reflex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

how can you cutaneously decontaminate patients?

A

PPE
clip long haired patients in area
warm water and mild shampoo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what is haemodialysis used for for poison patients?

A

renal replacement
toxin removal
rarely used due to expense and availability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what is the purpose of enteric adsorbents in poison patients?

A

reduce absorption

facilitate excretion of toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

name an example of an enteric adsorbent

A

activated charcoal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what is intralipid enteric adsorbent used for?

A

lipophilic toxins

when other treatment failed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what are complications of intralipid enteric adsorbents?

A

fat embolism

pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

state some supportive management for intoxication patients

A
antidote
specific therapy
organ care
hydration and nutrition
analgesia
anti-emetics
recumbency care
eye lube
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what are the effects of nephrotoxins?

A

AKI causing azotaemia, olig, an, polyuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

list clinical signs of nephrotoxication

A
sudden onset
inappetence
lethargy
vomiting 
diarrhoea
signs related to AKI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

how is nephrotoxicity diagnosed?

A

azotaemia
submaximally concentrated urine
specific findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

list common nephrotoxins

A

NSAIDs
lillies in cats
grapes and raisins in dogs
ethylene glycol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

how is nephrotoxicity managed?

A

decontamination by emesis, activated charcoal, dermal

specific antidotes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

list nursing considerations for nephrotoxicity

A

maintain euhydration and euvolaemia
anti-emetics
analgesia
monitor for hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what is prognosis for nephrotoxicity?

A

depends on toxin and extent of injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

list signs of neurotoxicity

A
hyper-excitability
agitation
tachycardia
arrhythmia
muscle tremor
seizure
coma
low mentation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

list common neurotoxins

A
theobromine, chocolate
permethrin on cats
metaldehyde, slug pellets
tremorgenic mycotoxins
cannabis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

how are neurotoxins managed?

A
GI decontamination
dermal decontamination
muscle relaxants
anti-epileptic therapy
intralipids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

list nursing considerations for neurotoxin patients

A

recumbency care
manage seizures
monitor respiration
if lack gag reflex IVFT, feeding tubes etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

list common hepatotoxins

A
xylitol
mushrooms
blue green algae
alfatoxins
penobarbitone
paracetamol
doxycycline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

list general considerations for hepatotoxins

A
antioxidant support
give lactulose if encephalopathic
monitor electrolytes
manage glucose levels
plasma if coagulopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what is the effects of xylitol on pets?

A

stimulates endogenous insulin release

lethargic, weak, seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

how is xylitol intoxication managed?

A

emesis
activated charcoal
manage hypoglycaemia
feed little and often of high fibre complex carbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

how do anticoagulant rodenticides affect the body when ingested?

A

prevent activation of clotting factors in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

how does anticoagulant rodenticide poisoning present?

A
symptoms after 2-5 days
severe coagulopathy
haemoabdomen
haemothorax
collapse
hypovolaemic
anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

what is advice for patients ingested who have anticoagulant rodenticides but are pre-symptomatic?

A

emesis
activated charcoal
measure clotting times at presentation and 48 hours after decontamination, base for diagnosis
treat with vitamin K if abnormal clotting times

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

what is advice for symptomatic cases of anticoagulant rodenticide poisoning?

A

urgent vet care
coagulopathic so care with blood sampling
vitamin K therapy
plasma if life threatening bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what is the effect of paracetamol toxicity in cats and dogs?

A

cats- methaemoglobinemia

dogs- hepatic injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what causes methaemoglobinemia?

A

RBC oxidative damage causes Fe3+, Hb can only bind to Fe2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

what are signs and diagnosis of methaemoglobinemia?

A

chocolate, dark cyanotic MM

diagnosed by drop of blood with brown discoloration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

why are cats susceptible to paracetamol toxicity?

A

lack pathways for its metabolism

accumulate high oxidative metabolites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

what is the effect of methaemoglobinemia?

A
reduced oxygen delivery
shock
CV distress
neuro signs
death
oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

how is paracetamol toxicity treated?

A

induce emesis
activated charcoal
anti-oxidants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

what is prognosis for paracetamol toxicity?

A

guarded as highly toxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

what effects does adder venom have?

A

cytotoxic
cytolytic
CV effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

list clinical signs of adder bites

A
usually within 2 hours
puncture wounds
swelling to bite
depression
panting
pyrexia
cardiac arrhythmia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

how are adder bites treated?

A
keep calm and quiet
leave area alone to not distribute toxins further
antivenom
analgesia
IVFT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

what is prognosis for adder bites?

A

good with treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

list examples of caustic substances

A

alkali
batteries
benzalkonium chloride
washing tablets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

list clinical signs of caustic substance intoxication

A
oral, oesophageal, gastric ulceration
pain
hypersalivation
anorexia
regurgitation
vomiting
dermal alopecia, burns, ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

how is caustic intoxication treated?

A

dermal decontamination with warm water
analgesia
IVFT
tube feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

what is prognosis for caustic intoxication?

A

depends on burn severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

what is respiratory arrest?

A

apnoea

90
Q

what is cardiac arrest?

A

no CO

91
Q

what is CPA?

A

no CO and apnoea

92
Q

list risks for CPA

A
trauma
systemic illness
paediatrics
geriatrics
iatrogenic causes
recent arrest
93
Q

what are the aims of CPCR?

A

prefusion of heart lungs and brain

return of spontaneous circulation

94
Q

how should you be prepared for CPCR?

A

regular training

crash box ready and accessible

95
Q

what is considered basic life support?

A

CPCR

oxygen

96
Q

what is considered advanced life support?

A

drugs
IVFT
cardioversion

97
Q

list examples of the equipment in each drawer of the crash trolley

A

airway access
IV and IO access
ventilation
drugs

98
Q

what drugs are included in the crash trolley?

A
adrenaline
atropine
50% dextrose
propofol
naloxone
99
Q

what equipment other than standard for life support can be used in CPCR?

A
capnography
crash record chart
ECG
defib
pulse oximetry
BP monitor
100
Q

what are the 2 types of compressions?

A

cardiac pump directly over heart in cats and small dogs

thoracic pump at widest part of thorax in large dogs

101
Q

how are compressions carried out?

A

100-120/min
at least 50% depth of thorax
can do interthoracic direct compressions

102
Q

when and how is IPPV done in CPCR?

A

as soon as suspect respiratory arrest

20brpm inflating thorax normal amount

103
Q

what should happen after CPCR?

A

monitor for rearrest
treat underlying cause
consult owner
debrief

104
Q

list blood products available for dogs

A
whole blood
packed RBC
fresh frozen or frozen plasma
cyroprecipitate
cyroprecipitate poor plasma
105
Q

how do cats get access to blood?

A

local donation as no blood banks

106
Q

who is whole blood broken down?

A

spun to produce packed RBC and fresh frozen plasma

107
Q

how is cryoprecipitate produced?

A

partially thawing and spinning fresh frozen plasma

108
Q

what are the components of fresh whole blood?

A

physiological concentrations of RBC, platelets, proteins, coagulation factors

109
Q

what is meant by stored whole blood?

A

over 8 hours post collection up to 21 days at 2-6 degrees

no functional platelets, lots of clotting factors

110
Q

how are packed RBC stored and what is its composition?

A

same as whole blood up to 42 days

PCV 70-80%

111
Q

what is fresh frozen plasma?

A

stored less than a year at -18

contains coagulation factors and plasma proteins

112
Q

what is frozen plasma?

A

FFP thawed and refrozen or over 1 year, up to 5 years

stable coagulation factors only

113
Q

what is the composition of cyroprecipitate?

A

rich in fibrinogen. VII and vWF

114
Q

state some diseases that can be treated with blood products

A

hypovolaemic anaemia
euvolemic anaemia
coagulopathy
thrombocytopenia

115
Q

what are clinical signs that help determine whether to use blood to treat anaemia?

A
acute onset
PCV
weakness
tachycardia
tachypnoea
high blood lactate
116
Q

what is the best way to give blood products?

A

replace with whats most similar to whats missing

117
Q

what determines blood type?

A

antigens on RBC surface

118
Q

what causes transfusion reactions?

A

naturally occurring antibodies in recipients blood against donor antibodies

119
Q

list signs of transfusion reaction

A
fever
tachycardia
dyspnoea
muscle tremors
vomiting
collapse
hemoglobinemia
haemoglobinuria
death
120
Q

what as the most antigenic DEA?

A

DEA 1

no naturally occurring antibodies for DEA 1

121
Q

why should dalmations only be give blood from other dalmations?

A

they are Dal negative but most other dogs are Dal positive

122
Q

what blood can you give to dogs that are DEA 1 neg, DEA 1 pos?

A

neg- only DEA 1 neg

pos- DEA 1 neg or pos

123
Q

why can you give the first transfusion in dogs untyped?

A

no naturally occurring antibodies so unlikely to get transfusion reaction

124
Q

what blood should be given to dogs in emergency?

A

DEA 1 neg

125
Q

what is the effect of DEA 1 neg being exposed to pos blood?

A

produce antibodies against DEA 1 antigens so future exposure will cause transfusion reaction

126
Q

what are the blood types on cats?

A

A
B
AB

127
Q

why do cats have to be typed and cross matched for blood transfusions?

A

have naturally occurring antibodies in plasma

128
Q

what are the levels of antibodies in plasma of A and B blood in cats?

A

A- few anti-B antibodies

B- lots of anti-A antibodies

129
Q

what blood type should be given in cats?

A

own blood type

if AB and cant because rare give A as low numbers of antibodies

130
Q

how is cross matching of blood carried out?

A

determine serological compatibility, incompatible if agglutination
recipient serum and donor RBC for major cross match as most severe reactions from this
recipient RBC and donor serum for minor cross match

131
Q

when is blood cross matching done?

A
recieved transfusion over 4 days ago
history of transfusion reaction
transfusion history unknown
previously pregnant
all females
dalmatians
132
Q

how are blood products obtained?

A

canine blood banks

local donors

133
Q

what makes a pet a suitable donor for blood?

A
healthy
1-8 years old
no travel history
routine healthcare
never received transfusion
clear health screening
good jugular veins
large dogs over 25kg
large cats over 4.5kg
134
Q

what needs to be done to patients before donating blood?

A
clinical history
full physical exam
PVC
TS
haematology
biochemistry
blood typing
infectious disease screening
135
Q

describe the process of blood donation

A

place catheter for IVFT
clip and prepare jugular vein and apply EMLA
sedate if needed
anticoagulant at correct ratio to blood

136
Q

what are the maximum amounts of blood that animals can donate?

A

15ml/kg for dogs

10-12ml/kg for cats

137
Q

how are animals cared for after blood donation?

A

IVFT, volume of blood taken over 1-2 hours
give food and water
restrict activity for 24 hours

138
Q

what are negatives to open blood donation?

A

more sites of bacterial contamination

need anticoagulant

139
Q

what are negatives to closed blood donation?

A

only use for large dogs

need anticoagulant

140
Q

what are benefits to closed blood donation?

A

needle uncapping is only exposure for contamination so has longer shelf life

141
Q

what needs to be done before giving blood products?

A

inspect bag for contamination and abnormalities
thaw frozen products to body temperature
record and monitor patient

142
Q

how is blood given to patients?

A

IV blood giving set
10-20ml/kg given
1ml/kg over 20 minutes monitoring for reactions, rest over 4-6 hours

143
Q

what is monitored for recipients of blood?

A
mentation
temperature
PR
RR
MM
CRT
plasma and urine colour
PVC and TS
144
Q

when do blood recipients need to be monitored?

A

every 15-30 minutes during transfusion

1, 12 and 24 hours after transfusion

145
Q

what are signs of antigen-antibody sensitivity reactions in blood transfusion?

A
fever
tachycardia
dyspnoea
muscle tremors
weakness
haemolysis
146
Q

list immunologic reactions to blood products

A

antigen-antibody sensitivity reaction
cytokines and leukocytes
allergic reaction

147
Q

what are signs of allergic reaction to blood products?

A
pruritus
erythema
urticaria
angioedema
vomiting
dyspnoea
anaphylaxis
148
Q

list examples of non-immunologic transfusion reactions

A
volume overload
citrate intoxications
coagulopathy
ammonia intoxication
bacterial contamination
pre-transfusion haemolysis
149
Q

what are signs of volume overload reaction to blood?

A

pulmonary oedema
jugular distention
chemosis
effusions

150
Q

what is sign of citrate intoxication from blood?

A

hypocalcaemia

151
Q

list signs of coagulopathy as a reaction to blood

A

petechia
ecchymoses
bruising
thrombocytopenia

152
Q

list signs of blood infection

A

fever
distributive shock
vomiting
haemolysis

153
Q

how do you manage transfusion reactions?

A
stop transfusion
fluid resus for distributive shock
antibiotics for contamination
oxygen for dyspnoea
monitor haemolysis, renal function
slow infusion if volume overload
154
Q

what causes periodontal disease?

A

inflammatory response to plaque

gingivitis left untreated progressing to periodontitis

155
Q

describe the aetiology of periodontal disease

A

accumulation of plaque

156
Q

what is plaque?

A

biofilm on all mouth surfaces

made up of mucopolysaccharides, glycoproteins, bacteria, oral debris

157
Q

what is calculus?

A

mineralised plaque covered in plaque

158
Q

what is gingivitis?

A

reversible plaque induced inflammation limited to gingiva

159
Q

list clinical signs of gingivitis

A

inflammation
reddening
bleeding gums
halitosis

160
Q

define halitosis

A

bad breath

161
Q

what is mild, grade 1 gingivitis?

A

redness
swelling
no bleeding on probing

162
Q

what is moderate, grade 2 gingivitis?

A

grade 1 with bleeding on probing

163
Q

what is grade 3 severe gingivitis?

A

grade 2 with ulceration and spontaneous bleeding

164
Q

how is gingivitis treated?

A

removal of calculus
improve oral hygiene
daily oral hygiene

165
Q

what is periodontitis?

A

inflammation involving gingiva and surrounding periodontal ligament, alveolar bones and cementum

166
Q

how does periodontitis develop?

A

untreated gingivitis

167
Q

what are clinical signs of periodontitis?

A
dental deposits
halitosis
mucosal and glossal ulcers
gingiva recession
bleeding 
dysphagia
pain 
teeth falling out
168
Q

what are components of clinical dental exam?

A
halitosis
dysphagia
hypersalivation
gingival health
number of teeth
GA exam of head, occlusions, individual teeth, oral cavity
169
Q

how are patients prepped for dental exam under GA?

A
GA prep
throat pack to prevent aspiration
IVFT
temperature regulation
analgesia
170
Q

what is the modified tridan system?

A

used on dental charts to number teeth with first number quadrant and second and third is tooth position

171
Q

state normal number of adult teeth in dogs and cats

A

dogs- 42

cats- 30

172
Q

what is examined in dental exam under GA?

A

calculus score
gingivitis score
periodontal probe depth
sulcus

173
Q

define sulcus

A

gap between tooth and gingiva

174
Q

what are causes of dental attachment loss?

A

periodontal pockets
gingival rescission
furcation exposure
tooth motility

175
Q

what is dental caries?

A

softening and loss of enamel resulting in formation of pit in tooth

176
Q

how is dental caries managed?

A

filling

extractions

177
Q

what teeth are most commonly affected by crown fractures?

A

canines
carnassials
incisors

178
Q

how are crown fractures managed?

A

polishing small chips

extraction

179
Q

what is crown attrition?

A

wearing of crown leading to exposed pulp or fracture of tooth

180
Q

how is crown attrition treated?

A

usually extraction

181
Q

what are feline dental neck lesions?

A

pits affecting enamel, dentine and cementum

active destruction of unknown cause

182
Q

how are feline dental neck lesions treated?

A

extractions

183
Q

which deciduous teeth are most commonly retained?

A

incisors

upper canines

184
Q

why do retained deciduous teeth need to be extracted?

A

malerruption and malocclusion of retained teeth

185
Q

what is the problem of malocclusion?

A

abnormal wear

injury to mouth

186
Q

how is malocclusion treated?

A

conservative management
extraction
orthodontics

187
Q

what is the purpose of scaling teeth?

A

removal of plaque and calculus from tooth above and below gingival margin

188
Q

what are the types of tooth scalers available?

A

manual
ultrasonic
sonic

189
Q

what are considerations for ultrasonic scalers?

A

use flat surface on tooth, never tip
maximum each tooth 15 seconds at a time
water flowing before contact

190
Q

why are sonic and rotosonic scales less commonly used for dentals?

A

potentially damage teeth and adjacent structures

191
Q

describe the process of scaling teeth

A
remove gross deposits of calculus
irrigate mouth
examine teeth
remove loose teeth
probe sulcus
remove calculus below gingival surface
polish after scaling
192
Q

what is the purpose of polishing after scaling teeth?

A

damage from scaling allows faster build up of calculus so polishing prevents this

193
Q

list instruments used for dental surgery

A
curettes
scalers
periodontal probe
extraction forceps
dental mirror
root elevators
194
Q

what are indications for tooth extractions?

A
advanced periodontal disease
caries or feline neck lesions
retained deciduous teeth
tooth trauma with exposed pulp
malocclusion damaging soft tissues
195
Q

list instruments for dental exam

A
mouth mirror
periodontal probe
mouth props
gags
retractors
196
Q

list equipment for calculus removal

A

calculus removing forceps
subgingival curette
hand scaler
polishing cups and paste

197
Q

list aftercare for dental surgery

A
tooth brushing once healed
mouth washes
soft food while healing
no hard chews
soft toys
198
Q

how can owners be educated to prevent dental disease?

A

promote dental care from first visit
tooth brushing daily advised
nurse clinics or consults focused on prevention

199
Q

list examples of conditions affecting pinnae

A

trauma
aural haematoma
neoplasia

200
Q

what increases risk of aural neoplasia?

A

sun exposure
white fur
hairless
unpigmented skin

201
Q

how is aural haematoma caused?

A

head shaking damages capillaries so bleed into ear

202
Q

what causes otitis externa?

A

immune mediated
parasites
poor aeration
obstruction by fur, neoplasia, inflammation

203
Q

what are common neoplasias of the ear?

A

squamous cell carcinoma
ceruminous gland adenoma
melanoma
basal cell carcinoma

204
Q

what causes otitis media?

A

chronic otitis externa

205
Q

list middle ear diseases

A

bacterial otitis media
tympanic membrane trauma allowing bacterial infection
tumours
polyps

206
Q

how is pinnae trauma treated?

A
treat underlying cause
clip pinnae
place in lateral
bandage
buster collar
consider contamination
207
Q

how is aural haematoma treated?

A
drainage
stitches to limit swelling
massage 
flushing
prevent further accumulation
208
Q

what can pinnectomy be used for?

A

removal of invasive tumours

209
Q

what is lateral wall resection?

A

removal of secretory epithelium, lateral cartilage of vertical ear canal

210
Q

what is the purpose of lateral wall resection?

A

increase drainage and ventilation of ear

211
Q

how is lateral wall resection prepared for?

A

clip whole pinnae and side of head
flush ear to remove debris
lateral with head elevated

212
Q

what are indications for lateral wall resection?

A

non responsive to other treatment

external ear canal disease

213
Q

what is vertical canal ablation?

A

excision of whole auricular cartilage

formation of stoma at level of horizontal canal

214
Q

what are indications for vertical canal ablation?

A

disease affecting whole vertical canal

neoplasia

215
Q

how do you prep for vertical canal ablation?

A

same as LWR

prep histology samples

216
Q

what is total ear canal ablation and lateral bulla osteotomy?

A

removal of all epithelial lining and vertical and horizontal canal cartilage

217
Q

what is the purpose of total ear canal ablation and lateral bulla osteotomy?

A

salvage procedure for chronic otitis externa, trauma and neoplasia

218
Q

list potential complications for total ear canal ablation and lateral bulla osteotomy

A
hearing and facial nerve paralysis
infection
cosmetic affects
haemorrhage
vestibular issues
trauma to deep structures
fistula formation
219
Q

describe prep for total ear canal ablation and lateral bulla osteotomy

A

clip whole pinnae, caudal border of eyelid, lateral neck

prep whole pinnae

220
Q

when is ventral bulla osteotomy performed?

A

cats with middle ear disease

middle ear polyps

221
Q

list complications for ventral bulla osteotomy

A

vestibular disease
haemorrhage
infection