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Breathing and Cir. Exam 3 > Monday Lectures > Flashcards

Monday Lectures Flashcards

1
Q

What is pressure?

A

Force applied to a surface per unit area

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2
Q

What two things does blood pressure rely on?

A

Location and phase of cardiac cycle

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3
Q

What are the two components of blood pressure?

A

Cardiac output/flow and resistance

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4
Q

What are the two components of cardiac output/flow?

A

Stroke volume and heart rate

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5
Q

What is the formula for resistance in a blood vessel?

A

Resistance = 8(length of the vessel)(viscosity of the blood)/3.14…(radius of the blood vessel)^4)

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6
Q

What is the most important factor that resistance depends on?

A

Radius of the vessel

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7
Q

What is the minimum systolic blood pressure necessary to be considered systemic hypertension?

A

Systolic BP > 160mmHg

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8
Q

What are the three different types of systemic hypertension?

A

Situational, secondary, and idiopathic

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9
Q

What is situational hypertension?

A

White coat syndrome → increased BP as a consequence of in-clinic measurement process

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10
Q

What is the main body system that is activated in relation to white coat syndrome?

A

Autonomic nervous system

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11
Q

Are animals with situational hypertension normotensive?

A

Yes

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12
Q

What can the persistent and pathologically increased blood pressure that defines secondary hypertension be due to? Three answers.

A

Disease/condition, therapeutic agent, and toxic agent

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13
Q

What two diseases are the most commonly found diseases to be affecting blood pressure and therefore causing secondary hypertension?

A

Renal and endocrine diseases

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14
Q

Listed below are the 4 mechanisms through which renal disease can cause secondary hypertension, give the blood pressure component (cardiac output and resistance) that will be affected:
- Sodium and fluid retention

  • RAAS hyperactivation → increased sodium retention and vasoconstriction
A
  • Sodium and fluid retention (Increased cardiac output)
  • RAAS hyperactivation → increased sodium retention and vasoconstriction (Increased cardiac output and resistance)
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15
Q

Listed below are the 4 mechanisms through which renal disease can cause secondary hypertension, give the blood pressure component (cardiac output and resistance) that will be affected:
- SNS hyperactivation → increased sodium retention and vasoconstriction

  • Vascular endothelial dysfunction → impaired NO production
A
  • SNS hyperactivation → increased sodium retention and vasoconstriction (Increased cardiac output and resistance)
  • Vascular endothelial dysfunction → impaired NO production (Increased resistance)
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16
Q

What are the two mechanisms of action that endocrine disease can cause secondary hypertension?

A

RAAS activation and increased sensitivity to aldosterone?

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17
Q

Is the systemic hypertension found related to hyperadrenocorticism/Cushing’s disease reversible?

A

Can be also cannot be

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18
Q

What organ system does diabetes affect that leads to increased blood pressure?

A

Renal

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19
Q

Why do pheochromocytomas cause episodic systemic hypertension, making it hard to diagnose?

A

The catecholamine release due to pheochromocytomas is episodic and the systemic hypertension is related to the catecholamine release

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20
Q

What are the two mechanisms by which hyperthyroidism causes secondary hypertension, especially in cats?

A

Increase cardiac output and increase sensitivity to sympathetic activation

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21
Q

Is the increase in blood pressure related to hyperthyroidism in cats mild or severe?

A

Mild

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22
Q

What two therapeutic agents can cause hypertension?

A

Corticosteroids and alpha agonists

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23
Q

What is the persistent and pathologically increase in blood pressure in absence of an identifiable underlying cause?

A

Idiopathic hypertension

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24
Q

Do cardiac diseases cause systemic hypertension?

A

No

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25
Q

Can systemic hypertension cause cardiac disease?

A

Yes

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26
Q

Why does systemic hypertension cause cardiac disease?

A

It increased afterload of the heart

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27
Q

What type of overload and hypertrophy does systemic hypertension cause?

A

Pressure overload → concentric hypertrophy

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28
Q

Is the heart disease due to systemic hypertension mild or severe?

A

Mild

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29
Q

What are the four organs that are particularly sensitive to systemic hypertension?

A

Kidney, eye, brain, and heart/vessels

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30
Q

What are the two renal sequela of systemic hypertension?

A

Decrease in renal function and early renal death

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31
Q

What would indicate the above renal issues that you could monitor in your patient?
- Above question: What are the two renal sequela of systemic hypertension? (Decrease in renal function and early renal death)

A

Increased renal values → BUN, creatinine; proteinuria

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32
Q

What is the ocular sequelae of systemic hypertension?

A

Retinal detachment

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33
Q

How would a patient with the above ocular systemic hypertension sequelae present to you?
(Retinal detachment)

A

With acute onset of blindness

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34
Q

Is systemic hypertension a frequent sole cause of congestive heart failure?

A

No, infrequent

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35
Q

What blood pressure does the doppler cuff method give you?

A

Systolic

36
Q

Will a narrow blood pressure cuff over or underestimate blood pressure?

A

Overestimate

37
Q

What is the first line choice of drug for severe hypertension (>200mmHg)?

A

Calcium channel blocker → amlodipine

38
Q

What drug would you choose for cats with uncontrolled hyperthyroidism and that is contraindicated in dogs with pheochromocytomas?

A

Beta blockers → atenolol

39
Q

If you are treating a cat for systemic hypertension and it also has proteinuria, what drugs would you use to treat this cat?

A

ACE inhibitor and calcium channel blockers → benazepril and amlodipine

40
Q

Which of the drugs chosen above would you remove if the cat does not have proteinuria?

A

Benazepril

41
Q

What abnormalities of the heart give it a ‘reverse D’ appearance on radiography?

A

Right heart and main pulmonary artery enlargement

42
Q

Why do R → L shunt patients not respond to oxygen supplementation?

A

Because blood is skipping systemic circulation so higher levels of oxygen in systemic circulation isn’t going to help

43
Q

What are the four cyanotic heart diseases?

A

rPDA, R to L VSD, R to L ASD/PFO, and tetralogy of fallot

44
Q

Why are animals with cyanotic heart diseases at a higher risk of ventricular arrhythmias?

A

They will have concentric hypertrophy of the right ventricle d/t PH and PS + decreased oxygen content of blood = myocardium not getting enough oxygen → myocardium dies off → ventricular arrhythmias

45
Q

If you see a GSD patient with a bad ventricular arrhythmia, what disease do they have?

A

Inherited ventricular arrhythmia

46
Q

What are the breeds associated with juvenile dilated cardiomyopathy?

A

Portuguese water dog, doberman, and toy terriers

47
Q

What is the term for transient loss of consciousness resulting from a decrease in cerebral perfusion?

A

Syncope

48
Q

What are the three causes of syncope?

A

Cardiovascular, reflex mediated, and orthostatic hypotension

49
Q

What do all cardiovascular abnormalities/diseases/conditions do that cause syncope?

A

Reduce cardiac output

50
Q

What are the two groups of cardiovascular abnormalities that cause cardiovascular syncope?

A

Arrhythmias and others → structural obstructive heart diseases, pulmonary hypertension/PTE, pericardial effusion and congestive heart failure

51
Q

What about the patient history would be more highly indicative of arrhythmic cardiovascular syncope?

A

If they animal is normal between episodes → arrhythmic

52
Q

You auscultate a left sided diastolic murmur that is readily heard and of equal intensity to the S1 and S2 sounds, what grade and type of cardiac disease is this indicative of?

A

Grade 3, aortic valve regurgitation

53
Q

(T/F) Horses may have normal performance and life-span with mild to moderate valvular regurgitation.

A

T

54
Q

What three things would indicate the necessity of a cardiac work-up including echo, resting and exercise ECG?

A

Grade 3/6 murmur or higher, arrhythmias, and cardiac murmur with unexplained exercise intolerance

55
Q

What are the two predisposing conditions for endocarditis?

A

IV injection and jugular vein thrombophlebitis

56
Q

What is the most commonly endocarditis affected valve in cattle?

A

Tricuspid

57
Q

What are the most commonly endocarditis affected valves in horses?

A

Aortic and mitral

58
Q

What can occur secondary to tricuspid endocarditis or lymphoma in cattle?

A

Ruptured chordae tendineae

59
Q

What are the two causes of mitral valve ruptured chordae tendineae in horses?

A

Idiopathic or secondary to endocarditis

60
Q

What three locations can the aorta rupture into?

A

Pulmonary artery, pericardium or right of the heart

61
Q

Would the murmur associated with aortic rupture be diastolic, systolic, or continuous?

A

Continuous

62
Q

Though ventricular septal defects are typically associated with right sided systolic murmurs, they can also present with left sided systolic murmurs as a result of what two things?

A

Radiating sound or relative pulmonary stenosis

63
Q

What does the impact on lifespan and athleticism depend on with ventricular septal defects? Two answers.

A

Size of the defect and direction of the shunted blood

64
Q

What is cor pulmonale?

A

Pulmonary hypertension leading to right ventricular dilation/hypertrophy and right sided heart failure

65
Q

What is the term for the disease that is due to relatively low oxygen concentrations at high altitude leading to hypoxic vasoconstriction of the pulmonary artery as well as hyperplasia and reduced diameter of pulmonary arterioles, resulting in pulmonary hypertension?

A

Ruminant high altitude disease aka brisket or high mountain disease

66
Q

What is the treatment for high altitude disease, although prevention truly is the best strategy? Two answers.

A

Thoracocentesis to remove pleural effusion and remove to lower altitude

67
Q

What is the ideal pulmonary arterial pressure when cattle are at higher altitudes?

A

< 41 mmHg

68
Q

What should you not do with a cattle that has a pulmonary arterial pressure > 48 mmHg at higher altitudes?

A

Breed them → susceptibility is heritable

69
Q

What are the three types of pericarditis?

A

Effusive, fibrinous, and constrictive

70
Q

What is the most common cause of pericarditis in cattle?

A

Traumatic reticulopericarditis

71
Q

What is the most common cause of pericarditis in equine patients?

A

Idiopathic

72
Q

What is the suspected etiology of Actinobacillus spp. inoculation in the pericardium?

A

Ingestion of Eastern tent caterpillars

73
Q

What are the common locations for lymphoma in large animal species?

A

Right atrium, mediastinum, and pericardium

74
Q

What is the transmissible virus that causes lymphoma in cattle?

A

BLV, bovine leukemia virus

75
Q

What is the arrhythmia that is typically normal, non-pathologic in equine patients?

A

2nd degree AV block

76
Q

What are bradyarrhythmias, which are often detected in health horses, associated with?

A

High parasympathetic tone

77
Q

What is an important characteristic of non-pathologic arrhythmias in horses?

A

The are present at rest and disappear with an increase in sympathetic tone such as exercise

78
Q

What is the term for the irregularly irregular arrhythmia characterized by lack of p waves and normal, irregular QRS complexes?

A

Atrial fibrillation

79
Q

A treatment option for atrial fibrillations is administration of quinidine which is a sodium channel blocker that also affects potassium channels to have what effect on refractory period and action potential conduction?

A

Prolongs the refractory period and slows AP conduction

80
Q

(T/F) All arrhythmias are pathologic and abnormal in cattle.

A

True

81
Q

When do arrhythmias most commonly occur in cattle?

A

When the animal is off feed and/or with GI disease

82
Q

What do urinary tract obstructions or uroabdomens increase that can cause bradycardia, atrial arrest, and death in small ruminants and camelids?

A

Hyperkalemia

83
Q

What does the resulting change in excitation potentials of cardiac myocytes due to inflammation, necrosis, and/or fibrosis result in? Three answers.

A

Arrhythmias, brady/tachycardia, and poor cardiac contractility

84
Q

Nutritional myodegeneration is caused by the deficiency of what two substances/minerals?

A

Vitamin E and selenium

85
Q

What species is very susceptible to ionophore intoxication?

A

Horses

86
Q

Why are ionophores often added to livestock feed?

A

To treat coccidiosis

87
Q

Will horses with ionophore toxicity have decreased or increased left ventricular fractional shortening?

A

Poor cardiac contractility → decreased left ventricular fractional shortening

Breathing and Cir. Exam 3 (7 decks)

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