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Year 2 > Nursing > Flashcards

Nursing Flashcards

1
Q

Dehydration

A

Fluid lost slowly from extravascular compartment. Patient unable to keep up with ‘ins’ and ‘outs’.
Water loss equal from all compartments.

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2
Q

Intravascular volume assessment

A 
Heart rate
Pulse quality
CRT and mucous membranes colour 
Blood pressure 
Mentation 
Temp
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3
Q

Extravascular volume assessment

A 
Moistness of MM
Skin turgor 
Weight
Globe position
Urine output
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4
Q

What clinicopathological features will be affected by patients hydration status

A

PCV / Total solids
Urea and creatinine
Urine specific gravity

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5
Q

Hypovolaemia fluid administration

A

Rapid fluid resuscitation

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6
Q

Dehydration fluid recovery

A

Correct slowly

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7
Q

What are fluids trying to achieve

A

Change in volume status
Change in content
Change in distribution

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8
Q

Crystalloids

A

Solutions containing solutes
Solutes and water move freely between membranes
Distributed through all body compartments by 1hour
Cheap
Isotonic / Hypertonic / Hypotonic

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9
Q

Isotonic crystalloids

A

Mostly used
Same tonicity as plasma
Treatment of hypovolaemia and dehydration
Replacement fluids
Mimic intravascular electrolyte conc (high sodium and low potassium)
0.9% NaCl and Hartmanns

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10
Q

Hypertonic crystalloids

A

More common in large animals
Tonicity larger than plasma
Prolongs intravascular volume expansion

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11
Q

Hypotonic crystalloids

A 
Very rarely used 
Tonicity lower than plasma 
0.18% saline and 4% glucose
Glucose metabolised 
Monitor fir electrolyte disturbances
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12
Q

What co morbidities need to be considered when prescribing fluid therapy

A 
Cardiac disease and heart failure 
Renal disease
Respiratory disease 
Those that can balance ins and outs as suffer from volume overload 
Be more cautious
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13
Q

Signs of volume overload

A

Pulmonary Odense
Venous engorgment
Peripheral Odema formation
Cagily effusions

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14
Q

Per os

A

Fluid by mouth

Absorption in intestinal tract, relatively slow and body can be selective

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15
Q

Subcut fluids

A

Injected under skin

Slowly absorbed into regional capillaries and distributed equally beteeen fluid compartments

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16
Q

IV fluids

A

Into intravascular compartment

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17
Q

Central venous access fluids

A

Common in large animals

Catheters directly into larger vessels usually jugular vein

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18
Q

Intra Osseus fluids

A

Into medullary cavity of long bone. This is highly vascularised so rapidly absorbed.

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19
Q

Pain

A

Unpleasant sensory and emotional experience associated with actual or potential tissue damage

How patient interprets nociception

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20
Q

Nociception

A

The neural process of encoding noxious stimuli

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21
Q

Nociceptive pain

A

Pain that arises from actual or threatened damage to non neural tissue and is due to the activation of nociceptors.

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22
Q

Neuropathic pain

A

Pain caused by a lesion or disease of the somatosensory nervous system
Harder to treat

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23
Q

Hyperalgesia

A

Increased pain from a stimulus that normally provokes pain

Reduced pain threshold

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24
Q

Allodynia

A

Pain due to stimulus that doesn’t normally provoke pain

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25
Q

Acute pain

A

Short period of time
Miniutes / hours / weeks

Can be protective at first
Can be one chronic if not treated

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26
Q

Chronic pain

A

Pain that lasts longer than a few weeks

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27
Q

Physiological signs associated with pain

A

Increased heart rate blood pressure abs temp
Altered resp
Stress hormones

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28
Q

NRS
VAS
SDS
CSOM

A

Numerical rating scale
Visual analogue scale
Simple descriptive Scale
Client specific outcome measures

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29
Q

Pharmacokinetics

A

What the body does to the drug

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30
Q

Pharmacodynamics

A

What the drug does to the body

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31
Q

What are the targets for drug action

A

Receptors
Enzymes
Transporters
Ion channels

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32
Q

Full agonist

A

Able to generate a maximal response after binding to receptor
High affinity and high intrinsic activity

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33
Q

Affinity

A

How well drug binds ti receptor

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34
Q

Intrinsic activity / efficacy

A

Magnitude of effect once bound

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35
Q

Partial agonist

A

Drug that has an intrinsic activity of less than 1

Receptor occupancy produces submaximal effect

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36
Q

Inverse agonist

A

Drug binds and has opposite effec to agonist

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37
Q

Antagonist

A

Exhibits affinity but no intrinsic activity

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38
Q

Therapeutic index

A

Maximum non toxic dose / minimum effective dose

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39
Q

ADME

A

Absorption
Distribution
Metabolism
Excretion

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40
Q

Bioavailability

A

The fraction of a dose reaching the systemic circulation after administration compared to the dose administer iv

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41
Q

Factors determining drug distribution

A 
Protien binding 
Tissue binding 
Organ blood flow 
Membrane permeability 
Brig solubility
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42
Q

Preventive analgesia

A

Administration of analgesia before during and after procedure to prevent in regulation of the nervous system. Should reduce intensity and duration of acute pain and reduce chronic pain.

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43
Q

Multi modal analgesia

A

Uses different classes of analgesic agents to overcome pain. More effective abs often can use lower doses.
Lower doses = less side effects.

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44
Q

Types of analgesic agents

A

Opioids
NSAIDs
LA

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45
Q

NSAID

A

Non steroidal anti inflammatory drug

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46
Q

Opioids

A

Controlled drug.
Act at the endogenous opioid receptors primarily in brain and spinal cord.
Usually administered IV ( not pethidine)
Some administered buccally.
Side effects - resp depression sedation bradycardia nausea decrease in GI motility

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47
Q

NSAIDs

A

Prostaglandins are an inflammatory mediator.
Metabolised in liver.
Can’t use two of these at once.
Side effects - GI ulceration renal ischhemia

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48
Q

Local anaesthetics

A

Enter nerve fibres abs block the voltage operated Na+ channel. This blocks nerve conduction.
Metabolism depends on if it’s an ester or amide.

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49
Q

Epidural

A

Anaesthetic injected into epidural space via catheter

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50
Q

Spinal anaesthesia

A

Aesthetic is injected directly into cerebrospinal fluid with small needle.

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51
Q

Baricity

A

Is the weight of one substance compared with the weight of an equal volume of another substance.
Glucose can be added to make solutions heavier.

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52
Q

Addition of vasconstructors

A

Reduces speed of systemic absorption abs therefore prolong duration of action.

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53
Q

General anaesthesia

A

State of unconsciousness produced by anaesthetic agents. No pain across body.

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54
Q

Regional anaesthetic

A

Insensibility caused by interruption of sensory in region

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55
Q

Local anaesthetic

A

Lack of sensation in localised part if body.

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56
Q

Sedation

A

Allaying if irritability or excitement

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57
Q

Anxidysis

A

Reduces anxiety

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58
Q

Analgesia

A

Reduced sensibility to pain

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59
Q

Narcosis

A

Sleep like state

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60
Q

Hypnosis

A

Artificially induced state of passivity

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61
Q

What is premedication

A

A drug combination given prior to induction of GA.
Calms patient and aids restraint.
Provides preemptive analgesia.
Allows reduction of induction drugs and maintenance drugs. MAC sparing.
Helps smooth induction and recovery.

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62
Q

Preoperative phase

A 
Owner conversation and informed consent. 
Full history. 
ASA classification.
Getting ready. 
Set up machine / equipment. 
Prep drugs / IV catheter. 
Premed.
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63
Q

Induction phase

A 
Takes patient from conscious to anaesthetised. 
IV catheter. 
Pre oxygenation. 
Premed IM. 
Admin of induction agent. 
Securing of airway.
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64
Q

Order of admission phases

A

Preoperative
Induction
Maintenance
Recovery

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65
Q

Maintenance phase

A

Maintain anaesthesia.
Placement of local or regional blocks.
Surgery / diagnostic procedure.

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66
Q

Recovery phase

A

Cessation of gas.
Remove airway device.
Recovery area.

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67
Q

Anaesthetic triad

A

Analgesia

Narcosis. Muscle relaxation

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68
Q

Reasons for anaesthesia

A

Facilitate surgery etc
Prevention of pain
Research
Immobility

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69
Q

The CEPSAF inquiry

A

Overal risk of an animal not waking from sedation

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70
Q

Brachycephalic problems

A

Airways GOR ocular skin skeletal

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71
Q

What drug can boxers not have

A

ACP - Acepromazine

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72
Q

MDR1

A

Collies sheepdog shepherd.

Can’t remove drugs and toxins from brain when this gene is present

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73
Q

Greyhounds problem

A

Lack of body fat = slow recovery and keep warm.

P4SO clearance mechanism.

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74
Q

Doberman problems

A

Dialysed cardiomyopathy can be asymptomatic

Von willerbrand factor - BMBT , blood clotting issues

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75
Q

The female dog of what breed is effected with sick sinus syndrome

A

Mini Schnauzer

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76
Q

Preventative analgesia

A

Prevent unregulation of nervous system in the face of noxious stimuli.
Should reduce intensity and duration of acute pain and reduce chronic pain.

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77
Q

Muti modal analgesia

A

Use several agents abs techniques to be effective.

This means lower dose which is less side effects.

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78
Q

Analgesic agents in practice

A 
Opioids 
Non steroidal anti inflammatory drugs 
Local anaesthetics 
Alpha-2 agonists 
Ketamine
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79
Q

NSAIDs

A

Non steroidal anti inflammatory drugs

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80
Q

Alpha -2 agonists

A

Sedatives that are analgesic

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81
Q

Ketamine

A

Anaesthetic that is analgesic

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82
Q

Opioids factoids

A 
Controlled drugs in UK
Schedule 2
Act at the endogenous opioid receptors
Can be IV 
Well absorbed orally subcut im 
Can cause resp depression sedation bradycardia nausea
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83
Q

NSAIDs

A

Prostaglandins are inflammatory mediators.
Metabolised in liver. Effective for acute abs chronic pain.
Can’t use two non steroidal as a multi modal anaesthetic regimen.
Can cause GI ulceration renal ischaemia.
GI side effects very common - vomiting diarrhoea.

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84
Q

Local anaesthetics

A

Enter nerve fibre and block voltage operated Na+ channel which blocks nerve conduction.
Membrane stabilising effect.
Can be esters or amides.

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85
Q

What analgesic is toxic to cats

A

Paracetamol

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86
Q

Tramadol

A

Centrally acting analgesic

More evidence in dogs than cats

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87
Q

Metabolism of esters

A

Metabolised in plasma

Hydrolysis if ester link

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88
Q

Metabolism if amides

A

Broken down in liver

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89
Q

Baricity

A

Weight of one substance compared to the weight of equal volume of another substance.
Glucose can be added to make solution heavier

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90
Q

Why would adrenaline be added to a solution

A

Added as a vasoconstrictor to local anaesthetics to reduce speed of systemic absorption and therefore prolong duration of action

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91
Q

Balanced anaesthesia

A

Premed
Induction
Maintenance
Recovery

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92
Q

Sedation factoids

A

Dose dependant up to plateau dose.
Improved by combination with opioid.
Improved when animal left in quiet environment.

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93
Q

Petechia

A

Blood clots in mouth or stomach

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94
Q

ASA classification

A 
I normal healthy animal 
II mild systemic disease 
III systemic disease we’ll controlled by treatment 
IV severe systemic disease 
V unlikely to survive 24 hours 
E emergency
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95
Q

Pre op fasting

A

Reduce volume of stomach contents
Prevent GOR regurgitation aspiration

Feeding a small canned food 3 hours pre op reduced incidence of GOR.
Prolonged starvation may actually caused an increased of GOR.

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96
Q

What is shock

A

An imbalance between oxygen delivery to the tissues and oxygen consumption by the tissues.

Cells respire anaerobicly = less oxygen = less energy = more lactate = acidic environment

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97
Q

Types of circulatory shock

A

Hypovolaemic
Cardiogenic
Obstructive
Distributive

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98
Q

Hypovolaemic shock

A

Resulting in decreased blood volume.
Result of fluid losses or decreased intake.
Usually due to haemorrhage

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99
Q

Cardiogenic shock

A

Reduced cardiac output.

Heart failing as pump.

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100
Q

Obstructive shock

A

Due to physical obstructions in blood flow to or from the heart through the great vessels.

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101
Q

Distributive shock

A

Due to maldistribution of blood flow.

Usually due to inappropriate or widespread vasodilation.

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102
Q

The minimum database

A 
PCV
TS
Urea
Glucose
Lactate 
Blood smear examination
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103
Q

Main electrolytes we check

A

Potassium
Sodium
Chloride

104
Q

Potassium disturbance

A

Most common
Needs to be maintained in narrow range
Hyper or hypo kalaemia

105
Q

Hyperkalaemia

A

Life threatening effects upon myocardial conduction.

Managed with fluids and monitoring

106
Q

Hypokalaemia

A

Less life threatening

Managed with potassium supplementing

107
Q

Sodium disturbance

A

Use fluids to correct both 24-48 hours

108
Q

Chloride disturbance

A

Should be 1:1 ratio with sodium

109
Q

Anion gap

A

Imbalance between anions and cations.

Helps to narrow down list of differentials that may explain patient state

110
Q

Acidaemia

A

Blood pH < 7.35

111
Q

Alkalaemia

A

Blood pH > 7.45

112
Q

Main types of acid / base disturbance

A

Metabolic acidosis
Metabolic alkalosis
Resp acidosis
Resp alkalosis

113
Q

Metabolic acidosis

A

Loss of base from body / failure to excrete acid / accumulation of acid.

The body will try to increase pH back to normal. Does this by ‘blowing off’ Co2 - hyperventilating.

Patients will have low pH and PCO2

114
Q

Metabolic alkalosis

A

Relative increase in hydrogen / loss of acid in body.

Body will attempt to lower pH. Does this not increasing Co2 hypoventulating.

Patient will have high pH and PCO2

115
Q

Resp acidosis

A

Rise in blood Co2

To compensate the kidneys will retain more bicarbonate and excrete more hydrogen ions.

Patient will have low pH and high PCO2

116
Q

Resp alkalosis

A

Fall in blood Co2. Caused by any disease / condition that results in hyperventilating.

Body attempts to lower pH. Kidneys increase bicarbonate elimination.

Patient has high pH and low PCO2

117
Q

Sedation vs Premedication

A

Sedation - patient is sedated but not under GA (still conscious)
Premed - administered prior to GA

118
Q

Problem with sedation for minor things

A

No control over airway

No option of deepening sedation of it’s not working

119
Q

When to use injectable anaesthetic agents

A

Induction of anaesthesia before administration of an inhalant agent.
Adjunct to inhalational anaesthesia.
Short term anaesthesia.
TIVA

120
Q

Injectable anaesthetic agents

A

Propofol ( dogs abs cats)
Alfaxalone ( dogs cats pet rabbits)
Ketamine ( horses dogs cats)
Tiletamine / zolazepam ( dogs and cats)

121
Q

Drugs for euthanasia

A

Pentobarbital - large number of species

122
Q

Anaesthetic agents exert their effects on the brain so …

A

… they have to cross from thr systemic circulation through the blood brain barrier to the brain

123
Q

Factors effecting the effects of drugs

A 
Blood flow to brain 
Amount of non ionised drug 
Lipid solubility 
Molecular size 
Concentration gradient 
Protien binding 
Distribution 
Metabolism 
Excretion
124
Q

Propofol

A

Highly plasma protien bound and lipid soluble
Post induction apnoea common
Hypotension myocardial depression and peripheral vasodilation
Pain on injection

Can be stored for 28 days after opening and can repierve the lid.

125
Q

Anflaxalone

A 
Steroid anaesthetic 
Clear solution 
High therapeutic index 
20% plasma protien bound 
Some resp depression 
Preserved baroreceptor tone
126
Q

Ketamine

A

Reflexes maintained
Sympathetic stimulation
Maintains CV and resp function
50% plasma protien bound

127
Q

Tiletamine / Zolazepam

A

Repeated doseing = poor recovery
IM or IV
Recent MA in uk dogs cats but not rabbits

128
Q

Thiopental

A 
Powder mace up to 2.5/5%
Alkaline 
Peru vascular tissue necrosis - make sure to secure IV access 
Rapid onset 
Highly plasma protien bound - 80%
Predictable
129
Q

IV injectable anaesthetic

A

Propofol

Alfaxalone

130
Q

IM injectable anaesthetic

A

Sedation

GA comb

131
Q

Inhalant anaesthesia induction

A

Face mask

Gas chamber

132
Q

Injectables main points

A

IV - quickest 2-10 min, reliable, expected efficacy, less stres for animal, relies on catheter placement.

IM - fairly quick 10-20 min, reliable but can be painful and slower.

SC - easy to administer, less painful than IM but can cause pain, 30-40 min, lower efficacy.

133
Q

Airway management

A

Mask
Laryngeal mask
Supraglottic device V gel
Endotracheal tube ETT

134
Q

Low volume / high pressure

High volume / low pressure

A

Circle vs rectangle cuffs put different pressure on airway

135
Q

What is the Murphy eye

A

Safety feature of ET tubes incsse if blockages

136
Q

Placing a tube

A 
Visualise 
Positioning 
Secure tube 
Inflate cuff 
Confirmation of correct placement
137
Q

Providing oxygen when under GA

A

Cylinder

Pipeline

138
Q

What oxygen cylinders should be stored vertically

A

FGJ

139
Q

What oxygen cylinders should be stored horizontally

A

CDE

140
Q

What is the cylinder yolk

A

Supports cylinder and provides gas tight seal.

Prevents wrong attachments.

141
Q

What is the pin index

A

Yoke on the machine had 2 protruding parts which are aligned with the 2 holes in corresponding gas cylinder

142
Q

Piped gas is supplied from a main source and feeds into colour coded pipes which are corresponded to schrader sockets. What are the colours?

A

Oxygen white
Nitrous blue
Medical air black with white collar

143
Q

What does the pressure regulator on the anaesthetic machine do

A

Regulates gas from cylinder to anaesthetic machine because pressure needs to be reduced to prevent damage. Also smooths any fluctuations of gas.

144
Q

Safety features of anaesthetic machine

A

O2 failure alarm - sound or light. Should cut out delivery of nitrous oxide.

Nitrous oxide cut off- it’s dependent on oxygen pressure as can’t be administered alive. Prevents hypoxic mixture being delivered.

Hypoxic guard - not in all machines, makes sure oxygen is sufficient before releasing nitrous.

Flow meter - gas specific, flow control valve , tapered transparent tube , bobbin or ball to read.

Vaporisers - contains volatile liquid anaesthif agent.

Scavenging - removal of environmental contaminants.

Oxygen exposure - takes in air and purifies it

145
Q

Active vs passive scavenging

A

Active - waste gases and anaesthetic agents are drawn outside the building by a fan and vent system. Requires an air break.

Passive scavenging - not suitable for nitrous oxide. Gas is pushed by patients resp efforts.

146
Q

Dead space

A

Volume of gas that does not eliminate carbon dioxide

147
Q

Tidal volume

A

Volume of gas entering the king with each inspiration

148
Q

Minute volume

A

Volume of gas entering the lungs in each minute

149
Q

Metabolic oxygen requirements

A

Amount of oxygen required each minute for metabolic processes

150
Q

Rebreathing

A

Occurs when the inspired gases reaching alveoli contain more carbon dioxide than can be accounted for by more reinhalation from the patients dead soacs

151
Q

Rebreathing vs non rebreathing system

A

Rebreathing - soda lime removes carbon Dioxide

Non rebreathing - t piece Bain and lack fresh gas flow removed expired co2

152
Q

Fluid requirements

A

Extravascular deficit + maintenance + ongoing losses

153
Q

SSI

A

Surgical site infection

154
Q

Sterilisation

A

Heat - auto clave and dry heat

Cold - ethylene oxide, commercial solution and gamma radiation

155
Q

Vacuums assisted autoclave

A 
Steam penetration 
Dries the load 
Fully automatic 
Packaging 
Maintenance
156
Q

Isofluarane used with

A

Cats and dogs primarily

157
Q

Sevoflurane used primarily with

A

Dogs abs cats

158
Q

MAC

A

Minimum alveolar concentration

159
Q

What does MAC do

A

Conc required to prevent purposeful movement in response to a supramaximal noxious stimulus

160
Q

Partial pressure

A

Pressure that gas exerts in a mixture of gases

161
Q

Partition coefficient

A

Ratio of the concentration of a compound in two solvents at equilibrium

162
Q

Balanced anaesthesia technique

A 
Inhalant anaesthetics 
Balanced anaesthesia 
Anaesthetic triad 
Monitoring 
Supportive therapy
163
Q

Stage 1

A

Time of induction ti unconsciousness. Pulse abs resp often elevated. Breath holding can occur.

164
Q

Stage 2

A

From unconsciousness to rhythmic breathing. All crainial nerve reflexes present. Eye will soon rotate yo vebtromedial position

165
Q

Stage 3 plane 1

A

Resp regular abs deep. Spontaneous limb movement is absent. Pinch reflex response. Nystagmus if present will slow abs disappear. Ventromedial eye.
Suitable for minor procedures.

166
Q

Stage 3 plane 2

A

Eyelids partially separated. Palprebral reflex is sluggish or gone. Corneal reflex still. Muscles relaxed.
Adequate for most procedures

167
Q

Stage 3 plane 3

A

Eyeball is central and eyelids begin to open. Pulpillary diameter increases. Abdominal muscles relax.
Good for all procedures

168
Q

Stage 4

A

Overdose.
Characterised by progressive heart failure.
Pulse rapid or very slow. No oalprebral reflex.

169
Q

Monitoring anaesthesia without equipment

A 
Pulse palpitations. 
Resp rate. 
Eye position. 
Temperature. 
Mm and crt 
Oesophageal stethoscope
170
Q

What can hypothermia result in

A

CNS depression
Hypotension
Bradycardia
Decreased urine output

171
Q

Reducing risk of hypothermia

A 
Keep anaesthetic minimal 
Minimise wetting fur
Maintain high ambient temp 
Heat and moisture exchanges 
Use correct breathing system 
Warm fluids 
Keep patient warm
172
Q

Capnograph results

A

Carbon dioxide abs how it moves in the resp system

Ins and exp co2 abd resp rate show as numbers
Capnogrwoh shows as wave form

173
Q

Side stream capnography

A

Endotracheal tube and connector. Breathing system. Adapter abs sample line.
Patient has fresh gas going into the lungs, this takes sample for machine tk analyse.

Cheap. Harder to break. Easy to replace.

Almost real tome. Sample line easily damaged. Must be changed regularly.

174
Q

Mainstream capnography

A

No sample line. One fret connector. Light source and connector - where analysis happens.

Real time results. No need for sample line.

Expensive. Damaged easily. Adds drag to system.

175
Q

Oxyhaemoglobin dissociation curve

A

Sigmoid curve shows relationship between arterial partial pressure of oxygen PaCo2 and the % of haemoglobin saturation (SPo2)

176
Q

Difference between oxyhaemoglobin and de oxyhaemoglobin

A

Saturated with oxygen vs not carrying oxygen.

177
Q

Where to place pulse ox probe

A

Tongue interdigital ear preoucd etc

178
Q

Blood pressure

A

Indirect indicator of blood flow

Measurement of pressure on walls of blood vessels by blood

179
Q

Direct / indirect blood pressure

A

Non invasive = Doppler / oscillometric

Invasive = placement of arterial line

180
Q

What should the cuff width be

A

40% of limb circumference

181
Q

Stages of removing tube

A 
Loosen / untie 
Depends on situation (species)
Deflate cuff a minute before extubation 
- dogs and rabbits remove when signs of laryngeal reflex 
- cats extubate when ear or eye reflex
- brachy can leave 
Remove tube smoothly 
Late extubstion depending on situation
182
Q

Hypothermic

A 
Bradycardia 
Cardiac arrhythmia 
Impaired coagulation and sound healing 
Decreased oxygen delivery to tissues 
Shivering increases oxygen requirements
183
Q

Hyperthermia

A

Decreased heat loss
Excessive external heat
Increase metabolic production of heat.
Increased oxygen requirement

184
Q

ECG

A

Not diagnostic

Looking for normal / reporting abnormal

185
Q

When would you investigate SpO2

A

When at 95%. Ideally should be higher. Worry at 90%

186
Q

Volatile anaesthetic

A

A liquid that at room temperature changes fo a vapour that’s can be inhaled for GA

187
Q

Isoflurane

A 
MAC 1.4-1.6
Irritant to mucous membranes 
Causes peripheral vasodilation 
No analgesia 
Dogs abs cats
188
Q

Sevoflurane

A 
Dogs and cats
MAC 2 .1-2.6
Low blood solubility 
Non irritant to mm
Poor analgesic
189
Q

Nitrous

A 
Administered as gas
MAC >100%
Supplement to analgesia 
Rapid uptake and elimination 
Insoluble
190
Q

Azotemia

A

Elevation of urea +/- creatinine in blood stream

191
Q

Uraemia

A

Clinical signs associated with azotemia

192
Q

Pre renal, renal or post renal azotemia

A

Pre renal - inadequate renal perfusion
Renal azotemia - reduced functional mass of the kidneys due to underlying kidney disease
Post renal - kidneys are functional but waste products are not excreted.

193
Q

Acute vs chronic kidney injury

A

AKI - acute nephron damage / dysfunction. Affects worse as very abrupt over hours / days
CKD - chronic nephron loss. Gradual process.

194
Q

Clinical findings of AKD

A 
Lethargic 
Depressed 
Inappetant
Nauseas 
Cardiac arrhythmias
195
Q

CKD - functional vs structural

A

Functional - lab measurable
Structural - visually seen on scan

Management aimed at protecting remaining nephrons and managing clinical consequences

196
Q

Historical and clinical findings of CKD

A 
Subtle non specific 
Pupd
Weight loss
Lethargy weakness 
Inappetance

Typically dehydrated
Kidneys small and itrehular
Rubber Jaw
Reduced muscle condition

197
Q

Incontinance

A

Congenital or aquired

Most common in females due to anatomy but less so in cats

198
Q

Urethral sphincter mechanism incontinence

A

USMI
Most managed with oestrogen
Can be treated surgically
Common after spaying

199
Q

feline lower urinary tract disease

A

FLUTD
Secondary to some kind of bladder disease
Leads to urethral obstruction in some male cats.
If males suffer repeatedly it becomes surgical disease

200
Q

Urethrotomy

A

Incision into urethra

Last resort for stones that cannot be flushed back into bladder

201
Q

Urethrostomy

A

Creation of new opening
Used as last resort for recurrent obstruction
Must be made upstream from diseased urethra

202
Q

Prostatic disease

A 
Prostate surrounds urethra of the male 
Rare in cats 
Dogs 
- benign hyperplasia 
- prostatis 
- abscessstion
- cysts 
- neoplasia
203
Q

Benign prostatic hyperplasia

A 
BPH
Caused dischezia/ dysuria 
Seen in older entire males 
Managed medically with anti androgens 
Often castration is preferred as definitive treatment
204
Q

Prostatitis

A

Bacterial infection often with BPH
Disease in entire males
Dysuria, pyrexia,
Antibiotics

205
Q

Prostatic abscess

A

Usually with prostatitis in entire males

Variable systemic signs

206
Q

Prostatic cyst

A

Entire males

Often associated with BPH

207
Q

Prostatic neoplasia

A

Disease in elderly dogs
Usually very painful
More common in castrsted

208
Q

CPCR

A

Cardiopulmonary cerebral resuscitation

209
Q

Horses at lowest risk going under anaesthesia

A

Ages 2-7

210
Q

Are surgical diseases more common in the upper or lower urinary tract

A

Lower

211
Q

White blood cells =

A

Inflammation / infection

212
Q

Renal neoplasia

A

Carcinomas are most common in dogs
Vague clinical signs, palpable abdominal mass, haematuria
Pulmonary metastasis is present in half of dogs and bilateral neoplasia is common. Surgery not indicated.
Lymphoma is most common renal tumour in cats. Chemotherapy.

213
Q

Renal trauma

A

May follow RTA or bite injury.

Uncontrolled haemorrhage may require nephrecotomy.

214
Q

Renal stones

A 
Renoliths
Aetiology similar to other uroliths
Often seen in animals with chronic kidney failure. 
Surgery not recommended
Diet and antibiotic therapy.
215
Q

Nephrotomy

A

Surgical incision into kidney

216
Q

Nephrectomy

A

Surgical removal of kidney

217
Q

Bladder stones

A

Struvite and urate uroliths can be medically dissolved. All others or those causing obstruction can be removed by cystomy.
Haematuria.
Frequency / urgency to urinate.

218
Q

Bladder neoplasia

A 
Not uncommon in elderly. 
Haematuria 
Frequency / urgency urinate
Malignant 
Partial cystomy
219
Q

Bladder trauma

A

Blunt abdominal trauma can cause rupture.

Uroabdomen and post renal failure.

220
Q

Why provide fluid therapy

A

Maintain hydration or perfusion

221
Q

Lower urinary tract disease

A

LUTD

Diseases of the bladder and urethra

222
Q

Urolith

A

Urinary stone

Macroscopic

223
Q

Crystal

A

Microscopic mineral precipitate

Can make up stone

224
Q

Crystalluria

A

Crystals in urine

225
Q

Whst type of urine is at less risk of Crystal and stone formation

A

Dilute

226
Q

Nephroliths

A

Upper urinary
Kidney stones
Abdominal pain = anorexia inappetance lethargy haematuria

227
Q

Urethroliths

A

Lower urinary
Urethral stones
Obstruction
Cystoliths signs

228
Q

Can crystals predict stones present

A

No

229
Q

Feline idiopathic cystitis

A 
Young to middle aged 
Overweight, inactive 
Indoor litter tray users 
Multi animal household 
Nervous disposition 
Dry diet 
Stressors 
Autumn winter

Manage with opioids, NSAIDs

230
Q

Urethral sphincter mechanism incompetence

A

USMI
Larger breed spay bitches
Leak during recumbency

231
Q

When and why do we castrate horses

A 
Behaviour modification 
Control breeding 
Can turn out with mares 
Medical reasons 
6months - 2 tests when both tested are descended
232
Q

What to check before horse castration

A 
Age 
Tetanus status 
Weather it’s been used for breeding 
Facilities at yard 
Both testicles
233
Q

Post op monitoring of open castration

A

Bleeding- drips okay for first 12 hours. Can’t count call asap. Pulsing / arterial requires immediate attention.

Sedation / analgesia.

Swelling expected but excessive contact.

Monitor

234
Q

ACP clinical effects

A

Sedation and anxiolytic

Not analgesic so combine with opioids

235
Q

Clinical effects of alpha 2 agonists

A

Sedation analgesia and muscle relaxation

236
Q

Clinical effects benzodiazepines

A

Minor tranquilisers, muscle relaxation, anticonvulsant

237
Q

What electrolytes do we typically check

A

Potassium
Sodium
Chloride

238
Q

Sodium and clinical signs

A

It is the rate that the abnormalities develop opposed to the absolute value which determines the severity of the clinical signs.

239
Q

How to prevent hypoxia

A

Give 5-10 mints of pure oxygen to counteract nitrous

240
Q

What does Doppler measure

A

Systolic bp only

241
Q

What does oscillometric measure

A

Systolic diastolic abs mean

242
Q

Systolic

A

Measure if force the heart exerts on the walls of arteries

243
Q

Diastolic

A

Pressure in the arteries when the heart is between contractions

244
Q

Acoustic impedance

A

Density of tissue X speed of sound in tissue

245
Q

Speculate reflection

A

Beam hits large smooth surface

246
Q

Non speculative reflection

A

Beam hits small structures

‘Texture’ to organs

247
Q

Brightness of sound waves

A

Depends on amplitude of signal

248
Q

Transducers

A

Electronic

Either phased or linear arrays

249
Q

Difference between phased array and linear array

A

Phased - beam is stewed electronically
Linear - multiple elements, triggered in groups
Micro convex / convex - elements arranged in curve

250
Q

Phased array / micro convex

A

Easy to manipulate
Small contact area
Wide field at depth

251
Q

Linear

A

Large contact area

Large view near skin - good for superficial structures

252
Q

High frequency

A

Superficial structures in large animals
All structures in small animals
Good resolution
Can’t image deeper structures

253
Q

Low frequency

A

Deeper structures
Larger animals
Poorer resolution
Can image deeper structures

254
Q

Patent prep for untraslund

A

Starve overnight
Empty stomach preferable
Improves ability to examine organs
Cab safety sedate / GA if needed

255
Q

Tissue appearance ultrasound

A

Fluid = anechoic / black
Fat = echogenic /white
Soft tissues = variable

256
Q

What will Doppler ultrasound show

A

Direction of blood flow
Velocity of blood flow
Weather flow is laminar or turbulent

Year 2 (3 decks)

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