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clinical exam and diagnosis > Pre-midterm > Flashcards

Pre-midterm Flashcards

1
Q

why take a history?

A
  1. part of examination
  2. establish relationship
  3. information
  4. avoid mistakes
  5. client expectation
  6. practice building
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2
Q

what are problems with history taking?

A
  1. completeness
  2. bias
  3. inexperience/misinterpretation
  4. guilt
  5. fear
  6. ownership issues
  7. management differences
  8. owner diagnosis
  9. owner treatment
  10. language
  11. herd problem?
  12. definition of disease
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3
Q

what are special physical examination cases (LA)

A
  1. prepurchase
  2. breeding soundness
  3. foal health check
  4. health certificate
  5. insurance exams
  6. export paper
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4
Q

what should be assessed on distance exam? (11)`

A
  1. attitude
  2. physical condition
  3. general body shape
  4. conformation
  5. hair coat
  6. stance
  7. posture
  8. environment
  9. resp rate
  10. evidence of defecation/urination
  11. behavior
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5
Q

what is the normal temp of a horse?

A

37.5-38.5

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6
Q

what is the normal temp of cow

A

38-39

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7
Q

What is the normal pulse of a horse

A

28-44

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8
Q

What is the normal pulse of a horse

A

28-44

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9
Q

What is the normal pulse of a cow?

A

60-80

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10
Q

What is the normal resp rate of a horse?

A

8-16

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11
Q

what is the normal resp rate of a cow?

A

10-30

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12
Q

What is Q, R and S in an ECG?

A

Q is depolarization of septum, R is deplarization of wall and S is depolarization of upper areas

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13
Q

What is Q, R and S in an ECG?

A

Q is depolarization of septum, R is depolarization of wall and S is depolarization of upper areas

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14
Q

What is pimobendan?

A

a postiive inotrope and a vasodilator

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15
Q

what are the main determinants of blood pressure?

A

CO and systemic vascular resistance

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16
Q

what are two diseases that can increase blood pressure?

A
  1. cushings (increased sensitivity to adrenergic hormones so vasoconstriction)
  2. hyperthyroidism (increased CO)
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17
Q

what is heart failure/cardiac insufficiency?

A

when the heart cannot meet the demands of the body

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18
Q

what is forward heart failure common in

A

dilated cardiomyopathy, sometimes in chronic heart failure

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19
Q

What are the signs of forward heart failure

A
  1. pulse poor
  2. hypothermic
  3. weak
    4, hypotensive
  4. prolonged CRT
    6 may have syncope
  5. progression to cardiogenic shock
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20
Q

what is the most common congestive heart failure?

A

left

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21
Q

what are the clinical signs of left sided congestive heart failure?

A

left atrial enlargement and pulmonary edema

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22
Q

What are the signs of right sided congestive heart failure?

A
  1. pleural effusion (cat)

2. ascites (dog)

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23
Q

What are three mechanisms of compensation in cardiovascular physiology?

A
  1. frank-starling mechanism
  2. ventricular hypertrophy
  3. neurohemoral mechanism
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24
Q

What is the RAAS sstem

A

Renin is released from the kidney and converts angiotensinogen to angiotensin I, that is converted by ACT to ATII. ATII causes aldosterone release, increased thirst, increased GFR, myocardial hypertrophy, vasoconstriction

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25
Q

What is the RAAS sstem

A

Renin is released from the kidney and converts angiotensinogen to angiotensin I, that is converted by ACT to ATII. ATII causes aldosterone release, increased thirst, increased GFR, myocardial hypertrophy, vasoconstriction

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26
Q

What are 4 neurohumoral mechanisms that work in compensation (heart)

A
  1. RAAS
  2. adrenergic nervous system
  3. ADH
  4. atrial naturetic peptide
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27
Q

Combatting what prolongs lifespan?

A

neurohumoral activation

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28
Q

what is spironolactone?

A

aldosterone antagonist

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29
Q

What does the adrenergic nervous system do to the heart?

A

increase HR, contactility, afterload (vasoconstriction), oxygen demand

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30
Q

What are three examples of diastolic dysfunction? Why is it an issue?

A
  1. hypertrophic cardiomyopathy, restrictive cardiomyopathy
  2. pericardial disease
  3. tachycardias
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31
Q

What is an issue with pimobendan?

A

only oral

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32
Q

What is an issue with pimobendan?

A

only oral

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33
Q

why is important to be thorough with a physical exam? (heart)

A

There may be something compromizing the ability to treat the heart (renal dz) or something may mimic cardio dz (resp dz)

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34
Q

Why can there be cachexia with heart disease?

A

underperfusion of the intestines can result in endotoxin, bacteremia, inflammation)–TNF alpha production–cachexia (omega 3 decreases TNF alpha and cachexia)

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35
Q

what on retinal exam can indicates cardio dz?

A

retinal detachment or hemorrhage (hypertension)

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36
Q

What can change apex beat?

A
  1. heart shift
  2. reduced with effusion
  3. pneumothorax
  4. obesity
  5. DCM
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37
Q

what is a pulse deficit?

A

a heart beat that was not accompanied by a pulse (premature beat or pulse wave not big)

38
Q

what are physiologic murmurs?

A

anemia, athletes, young animals

39
Q

What can only the ECG diagnose?

A
  1. rhythm/conduction defects
  2. adverse effects of anesthesia on impulse generation, conduction
  3. drug monitoring for drugs that influence rhythm, conduction
40
Q

What can ECG HELP detect?

A
  1. cardiomegaly
  2. emergency test for hyperkalemia
  3. helpful for pericardial effusion–aspiration
41
Q

What can the ECG not do

A
  1. give definitive diagnosis of heart size
  2. determine mechanical strength of contraction
  3. determine if congestive heart failure is present
42
Q

what position is ECG done in?

A

right lateral recumbancy

43
Q

what position is ECG done in?

A

right lateral recumbancy

44
Q

what is nitroglycerin?

A

venodilator. blod to abdomen rather than lungs. good for emergency

45
Q

What drugs decrease preload?

A

furosemide, spironolactone, thiazides, ACE inhibitors, nitroglycerin

46
Q

what drugs reduce afterload and improve CO?

A

ACE inhibitors (decrease ATII so less vasoconstriction)–may negatively affect GFR

hydralazine–arterial dilator

amlodipine: calcium channel blocker used for hypertension in cat

47
Q

what drugs can improve contractility?

A

dobutamine (CRI only)
dopamine cheaper, can cause arrhythmias, vasoconstriction

pimovendan–inodilateor (positive inotrope and dilation)

48
Q

when does cyanosis occur?

A

when hemoglobin

49
Q

what is stridor?

A

abnormal sound that can hear without stethoscope, usually URT

50
Q

what is a horse resp rate?

A

12-20

51
Q

what is a cow resp rate?

A

26-50

52
Q

what is a dog resp rate?

A

18-34

53
Q

what is a cat resp rate

A

16-40

54
Q

what is a cat resp rate

A

16-40

55
Q

what is the normal ratio of inspiration to expiration?

A

1.0:1.2

56
Q

which is louder, inspiratory or edxpiratory sound?

A

inspiratory (if reversed dealing with resp dz)

57
Q

what are vesicular sounds from?

A

segmental bronchi

58
Q

what are vesicular sounds from?

A

segmental bronchi

59
Q

what are crackles?

A

collapsed airwaas snapping open, esp end expiratory

60
Q

what are wheezes

A

longer musical sounds due to vibration of airway walls before closing (expiration), usually due to bronchoconstriction

61
Q

what occurs with upper resp tract disease?

A

inpiratory dyspnea and noisy inspiration heard from distance away

62
Q

what occurs with lower resp tract dz?

A

expiratory dysnpean and noise best heard with stethoscope

63
Q

what is a nasal swab for?

A

URT-bacterial/viral infection

64
Q

what is nasal lavage for?

A

culture, immunoglobulins, foreign body, parasitic ova

65
Q

what is tracheal lavage for?

A

–best one for pneumonia

for bacteria and cytology

66
Q

what are the two types of tracheal lavage?

A

transtracheal wash, transendoscopic sampling

67
Q

what is bronchoalveolar lavage used for?

A
  1. RAO, IAD, EIPH
68
Q

a go

A

e

69
Q

a good bronchoalveolar lavage sample is what?

A

foamy because of surfactant

70
Q

what is bronchoalveolar lavage not good for?

A

focal disease like neoplasia or pneumonia

71
Q

what is the technique of choice for studying pleural space and pleural surface?

A

ultrasonography

72
Q

where do you go for pleurocentesis/thoracocentesis

A

6-7 intercostal space, 10cm dorsal to olecanon, cranial border of rib

73
Q

what are thoracocentesis samples submitted for?

A
  1. cytology
  2. bacterial culture
  3. sensitivity
74
Q

What should you submit with a thoracocentesis sample?

A

TW sample to see if there is a common association with pleuritis and parenchymal disease

75
Q

what should you submit pleural fluid in?

A

EDTA for cell count and protein determination

76
Q

what serology samples should be submitted?

A

2 sampless 10-14 days apart

77
Q

how should a bacteriology sample be submitted?

A

sterile culture swab on ice and get fast. have appropriate transport media for aerobic, anerobic

78
Q

what should be collected for virology?

A

swabs early in disease during days 1-3 of pyrexia–nasopharyngeal swab good. DON’T freeze

79
Q

What should be sent for blood gas?

A

only arterial

80
Q

What is PaO2 an indicator of? what is PaCO2 an indicator of?

A
  1. gas exchange

2. ventilation

81
Q

what can cause hypoxia?

A

ventilation perfusion mismatch
diffusion impairment
shunts
hypoventilation

82
Q

what can cause hypoxia?

A

ventilation perfusion mismatch
diffusion impairment
shunts
hypoventilation

83
Q

4 factors of pulmonary edema

A

endothelial permeability
alveolar epithelial permeability
hydrostatic pressure
colloid osmotic pressure

84
Q

what is classic finding of pneumothorax?

A

pleura not moving–static

85
Q

laryngeal paresis/paralysis causes what?

A
  1. inspiratory dyspnea
  2. exercise intolerance
  3. roaring
86
Q

what is treatment for laryngeal paresis/paralysis?

A

prosthetic laryngoplasty

87
Q

what does dorsal displacement of soft palate cause?

A

stridor-noise during exhalation

88
Q

what is metoclopramide?

A

antiemetic (dopamine antagonist) and stimulates GI motility

89
Q

what are phenothiazines, maropitant, metoclopramide?

A

antiemetics

90
Q

what should use of gi protectants be restricted to?

A

pateints with ulers, potential for ulcer (although more use omeprazole)

91
Q

what coudl you give dog with esophageitis?

A

sulcralfate

92
Q

what is misoprostol?

A

synthetic prostaglandin

clinical exam and diagnosis (10 decks)

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