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Module 15- Cardiorespiratory And Haemopoietic > Pericardial, pleural and abdominal effusions in SA > Flashcards

Pericardial, pleural and abdominal effusions in SA Flashcards

1
Q

List causes of pericardial effusions

A

Congenital pericardial disease
Idiopathic haemorrhagic effusion
Neoplasia
Congestive heart failure – usually small effusions & not functionally significant
Left atrial rupture - RARE
Haemorrhage – trauma, coagulopathy, haemangiosarcoma
Hypoproteinaemia
Pericarditis – migrating FBs? -RARE

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2
Q

What happens in Pericardio-peritoneal diaphragmatic hernia

A

Abdominal contents are herniated into the pericardial sac because of direct communication between the peritoneal and the pericardial cavities.

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3
Q

Signs and treatment of pericardio peritoneal diaphragmatic hernia

A

None, gastro-intestinal, cough, ascites
Surgery if symptomatic

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4
Q

Pericardio-peritoneal diaphragmatic hernia (PPDH): Diagnostic Imaging

A

Marked cardiomegaly
Intestines, spleen, liver may be in the pericardial space
Frequently an incidental finding

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5
Q

Define cardiac tamponade

A

Compression of the heart by an accumulation of fluid in the pericardial sac

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6
Q

How does cardiac tamponade occur

A

If the pressure of effusion is greater than right atrial/ventricular pressure

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7
Q

Why can tamponade occur at lower volumes when pericardium is thickened

A

Because there is less compliance of the pericardium.

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8
Q

Pathophysiology of pericardial effusion

A
  1. Pericardial effusion
  2. Compresses right heart
  3. Decreases filling of right side
  4. Increased venous pressure causing RCHF
  5. Decreases CO
  6. Forward failure
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9
Q

Clinical presentation of pericardial effusion with tamponade

A

Abdominal distension
Exercise intolerance
Lethargy
Weakness

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10
Q

Breeds of dogs predisposed to pericardial effusion with tamponade

A

Idiopathic: Golden retrievers, Labradors, St. Bernards
Neoplastic: Boxers, German Shepherd

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11
Q

Physical examination findings of pericardial effusion with tamponade

A

Poor cardiac output
- Pallor
- Prolonged capillary refill time
- Weak pulse
- Tachycardia
- Muffled heart sound
Right sided congestive heart failure
- Jugular distension
- Ascites
- Hepatomegaly
Pulsus paradoxus

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12
Q

What is pulsus paradoxus

A

Weaker pulse during inspiration

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13
Q

What is the name of the technique used in pericardiocentesis

A

Seldinger technique

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14
Q

Progonosis of pericardial effusion

A

Recurrence occurs in 50% of case following pericardiocentesis
Pericardiectomy is recommended if the effusion recurs and carries a good prognosis in idiopathic cases
If the effusion recurs quickly, neoplasia is likely and prognosis is guarded
Surgery may be an option in some cases with tumours

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15
Q

Small volume pericardial effusions are seen with what conditions in cats?

A

Congestive heart failure (main cause of pericardial effusions seen on echo in cats)
Hypoproteinemia
Feline infectious peritonitis

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16
Q

T/F Feline Infectious Peritonitis can cause pericardial effusion

A

True!

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17
Q

Difference between Exudates and Transudates

A

Exudates are fluids, CELLS, or other cellular substances that are slowly discharged from BLOOD VESSELS usually from inflamed tissues.

Transudates are fluids that pass through a membrane or squeeze through tissue or into the EXTRACELLULAR SPACE of TISSUES.

18
Q

List some causes of abdominal effusions in dogs

A

Liver disease
Cardiac disease
Neoplastic (Haemangiosarcoma)
Hypoalbuminaemia

19
Q

List some causes of abdominal effusions in cats

A

Infectious disease- Feline infectious peritonitis
Neoplastic (Abdominal carcinomas)
Liver disease
Heart disease (uncommon)
Hypoalbuminemia

20
Q

Physical examination of patient with abdominal effusion

A

Abdominal distension
Abdominal Fluid thrill/wave
Tachypnoea/dyspnoea: If large effusion (pressure on diaphragm)
Abdominal discomfort: Particularly when lifted

21
Q

Differentiate between abdominal effusion from Thoracic vs Non thoracic

A

Look for evidence of cardiac disease and right sided congestive heart failure
Jugular distension
Jugular pulsation
Murmur
Arrhythmias

22
Q

List some causes of pleural effusions in dogs and cats

A

Neoplastic diseases (Lymphoma, Carcinoma, Mesothelioma)
Hypoalbuminaemia
Protein losing enteropathy
Protein losing nephropathy

23
Q

Define carcinoma

A

Carcinoma is a malignancy that develops from epithelial cells.

24
Q

Clinical examination of patient with pleural effusion

A

Dyspnoea
Tachypnoea
Muffled heart sounds
Ventral dullness on thoracic percussion

25
Q

How would transudate look like on ultrasound

A

Hypoechogenic

26
Q

How would exudate look like on ultrasound

A

Hyperechoic

27
Q

Which intercostal space do you perform a thoracocentesis

A

7-9th

28
Q

Pyothorax is a sign of what infection

A

Intrapleural bacterial infection

29
Q

T/F Pyothorax is more common in cats

A

True!

30
Q

Clinical signs of patient with pyothorax

A

Dyspnoea ± acute onset, lethargy, inappetence, pyrexia, anorexia
Ventral thoracic dullness - percussion, auscultation
Haematology ± leucocytosis, ± anaemia

31
Q

Aetiology of pyothorax

A

Consider FeLV/FIV
Penetrating bite
Perforation of respiratory tract or oesophagus
Pneumonia with lung necrosis
Haematogenous/lymphatic spread
Migrating foreign body
Iatrogenic
Unknown/idiopathic

32
Q

FeLV

A

Feline Leukemia virus

33
Q

FIV

A

Feline immunodeficiency virus

34
Q

FIP

A

Feline Infectious peritonitis

35
Q

Chyle

A

Milky bodily fluid formed in the lacteal system of the intestine
High triglycerides
Lymphocytes

36
Q

Difference between Chyle and pseudochyle

A

Chyle: cholesterol: triglyceride in fluid < 1, lymphocytes
Psudochyle: cholesterol: triglyceride in fluid >1, neutrophils, lymphocytes

37
Q

Causes of Chyle

A

Congestive heart failure
Neoplasia
Trauma
Congenital
Idiopathic (Afghans, bull mastiffs)

38
Q

Chylothorax: Management

A

Conservative:
Thoracocentesis
Low fat diet
Diuretics especially if CHF present
Rutin (nutraceutical)- aids fluid absorption

Surgical:
thoracic duct ligation + pericardectomy + cysterna chyli ablation + thoracic omentalization

39
Q

Where does heart worm live

A

Adults live in the pulmonary arteries and right ventricle

40
Q

What can one expect to see on a thoracic radiograph of a dog with heartworm

A

Interstitial lung pattern
Pulmonary artery dilation
Tortuous pulmonary vessels

41
Q

Diagnostic testing for heartworm

A

Blood smear for microfilaraemia
Knott’s/filter test – to concentrate microfilariae
Microfilarial antibody test
Adult female worm antigen test

42
Q

Name of drug to treat heartworm

A

Macrocyclic Lactone (milbemycin, avermectins) and Doxycycline prior to adulticide therapy
Deep intramuscular injection Melarsomine

Module 15- Cardiorespiratory And Haemopoietic (21 decks)

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