Q3 Exam 2 Flashcards
lobes of the liver
left (lateral and medial), quadrate, right (medial and lateral), caudate (papillary and caudate process)
how much of the liver can you remove?
70%
when is U/S vs CT useful in liver diagnostics
US: focal or multifocal hepatic disease
CT: vascular anomalies and surgical planning
punch biopsy depth in liver
no more than 50% thickness of lobe
most common primary liver tumors in dogs vs cats
hepatocellular carcinoma, massive, left lobe
bile duct tumors (often more benign)
most common metastases in the liver
lymphosarcoma, carcinomas, sarcomas (like HGS)
why is the left lobes easiest to resect
pedunculated, no association with gall bladder or CVC
ideal hepatic surgical candidate
left, one lobe, less than 50% of liver mass, not diffuse or nodular
hepatic cysts
usually incidental, only treat if large enough to interfere with other organs, r/out abscess
cats extrahepatic biliary anatomy
common bile duct and pancreatic duct JOIN before entering duodenum
common biochemistry changes with hepatobiliary disease in dogs vs cats
dogs- cholestatic (ALP,GGT)
cats- any elevation in one of the 4 liver enzymes worrying
when to treat biliary sludge
secondary disease, more than grade 3, biliary sludge not gravity dependent, or at risk for a mucocele
most likely cause of gallbladder issues
hypomotility and hydrophobic bile acid overproduction
gallbladder mucocele in cats
not a thing
medical therapy for mild signs of gallbladder mucocele
ursodiol, SAMe, antibiotics, supportive care, low fat diet, search for endocrinopathy
cholecystitis dx
histo gold standard, usually assumptive on U/S and clinical signs, can do bile culture too!
cholecystitis tx
medical therapy for mild cases, still likely hospitalize (antibiotics, ursodiol, hepatoprotectants, low fat diet), medical and surgery for mod to severe cases
neutrophilic cholangitis
leading cause ascending bacterial infection (E coli, enterococcus, clostridium), will see fever often! make sure to feed cats!!! penicillin vs penicillin and fluoroquinolone
lymphocytic cholangitis
cats with episodic signs, immune mediated, liver biopsies (weird), need immune suppression and hepatoprotectants
hepatic lipidosis biochemical changes
increased ALP, hyperbilirubinemia, take to U/S!
ALT
hepatocellular injury
most sensitive hepatic function test
bile acids (not necessary if jaundiced), detects CH only 50%
breeds predisposed to chronic hepatitis
cocker spaniels, dobermans, dalmations, westies
infectious diseases causing hepatitis
lepto, leishmaniasis, histoplasmosis, protozoal
copper-associated CH breeds and tx
westies, labs (+ dobies and dalmations), tx low Cu diets with protein supplement, D-penicillamine (chelator but expensive)
zone of liver most susceptible to injury
centrilobular zone 3, high CYP, low GSH and O2
quantitative Cu assessment in liver
atomic absorption spectroscopy
vacuolar hepatopathy
hepatocytes distended with cytosolic glycogen, “swiss cheese liver”, scottish terriers, higher risk of cancer
parameters for blood transfusion in hemoabdomen
20% and not responsive to fluid, treat the patient, do not autotransfuse if neoplastic!!!!
common location of gastric necrosis with GDV
usually dorsal greater curvature, most serious if cardia
fluid analysis of uroabdomen
ratio creatinine fluid:periphery > 2:1
ratio K fluid:periphery >1.4:1
correct hyperkalemia
Ca gluconate if severe, need to follow with insulin and dextrose, maybe be able to dilute with fluids if mild
transfusion trigger for anesthesia
22% PCV
shock bolus for cat and dog
90 mL/lg dog and 60 mL/kg cat, 1/4 at a time
treat regurg during anesthesia
suction and flush protocol, promotility agents
4 drugs commonly used in emergency anesthesia
opioids, benzos, lidocaine, alfoxalone, ketamine (controversial)
CPP =
MAP - ICP
how can inhalants increase ICP
more than 1MAC of any inhalant
cushings reflex
increased ICP leading to bradycardia and severe hypertension
treatment for brain herniation
patient positioning, controlled ventilation, hypertonic saline and later mannitol, consider steroids
postop cognitive dysfunction
likely happen with older dogs, lidocaine and vitamin C may help??
opioid drug of choice for neurologic patients
methadone
safest induction drug for neuro patients
etomidate (myoclonus tho?)
FIV
cat bites, acute to asymptomatic to terminal/clinical, CD4+ long term affected, develop B cell lymphoma, serology detects ANTIBODIES
FIP
starts with FECV then mutates to affinity for monocytes/ macrophages, wet and dry form, gold standard is IHC on histopath from explore, not common lol, tx GS-441524 now conditionally FDA approved!!!
FeLV
just from saliva, abortive, regressive or infective, serology usually tests for ANTIGEN, T cell lymphoma very likely
papules vs pustules
smol solid elevation of skin, elevation of skin containing pus, BOTH primary lesions
rivaltas test
can only prove high protein effusion, effusion drop into water and acetic acid
what if I get a sterile pustule?
likely PF!!!
reasons for primary crusts
seborrhea, zinc responsive dermatitis, SND
zinc responsive dermatosis
husky and boston terriers, young puppies
superficial necrolytic dermatitis
old age, liver not producing things to create good skin in places that turn over often (paw pads and elbows)
5 layers of epidermis
basale, spinosum, lucidum , graulosum, corneum
4 allergy mimics
parasites, dermatophytosis, immune disease, neoplasia
atopy
most common allergic skin disease, a diagnosis of exclusion, treat by checking IDAT and allergy shots, frequent baths, good flea control, stop itchiness, no cure
CAFR
almost always to protein, non-seasonal pruritis, ridgeback, GSD, shar pei, dx with elimination diet trial
dermatophytosis tx
topical with antifungal product, maybe itraconazole or terbinafine, clean house
sebaceous adenitis
poodles, loss of curls or color change, oil soaks and baths + atopica
pemphigus foliaceus
acantholytic keratinocytes, pustules, start immune suppression (steroids to start), hard to treat
cutaneous lymphoma
T cell better (weird), exfoliative erythroderma and depigmentation, not great prognosis
pyoderma treatment
start with topical therapies, maybe move to oral antibiotics (but not fluoroquinolone)
hair growth phases
anagen, catagen, telogen, exogen
demodex tx
amitraz dips licensed, most treat with isoxazolines
vaccine induced alopecia
ischemic damage and vasculitis, rabies in small breeds, tx with pentoxifylline
dorsal thermal necrosis
bad sun burn, coag necrosis on histo
causes of paraneoplastic alopecia in dogs
nodular dermatofibrosis, feminization syndrome, SND, paraneoplastic pemphigus
causes of paraneoplastic alopecia in cats
paraneoplastic alopecia, thymoma associated
dermatomyositis
collies and shelties, asymptomatic atrophy of muscles months after skin lesions, double punch biopsy, pentoxifylline and immunosuppression
erythema multiforme
keratinocyte apoptosis and lymphocyte satellitosis
how does thyroid hormone act in the hair cycle
initiates anagen
calcinosis cutis
secondary to hyperadrenocorticism, will eventually turn very red, can help fix with slow administration of DMSO maybe
alopecia x
hair cycle arrest in plush coated breeds, diagnosis of exclusion, flax seed oil and melatonin, microneedling, neuter?
topical hormone replacement alopecia
feminization maybe, preputial linear dermatopathy
color dilution alopecia
abnormal melanin transfer and storage, trichogram, gently brush and bath
canine flank alopecia
unknown cause, bilateral, short day months, jelly fish follicle on histopath, flax seed and melatonin?
pattern baldness
pinna, ventrum, caudal thighs, miniaturization of follicles on biopsy, flax seed and melatonin
three parts to the tympanic membrane
pars flaccida (dorsal weird ridge), pars tensa (classic membrane), and stria mallearis
primary secretory otitis media
CKCS, bulging ear drums and deafness
what size ear cone?
4mm on EVERY PATIENT
which antibiotic to use if ruptured ear drum?
fluoroguinolone
three layers of the eye
fibrous outer layer (sclera and cornea), vascular middle layer (iris, ciliary body, and choroid), neural inner layer (retina and optic nerve)
jones eye test
evaluates nasolacriminal drainage patency, ~5min
seidel test
leakage of aqueous humor
meibomian gland
role in lipid tear film, in upper eyelid
third eyelid accessory tear gland
30-40% of tears
conjunctiva normal flora
mostly gram+ aerobes, gram- in few dogs, 65% cat eyes culture neg
where does tear film mucus come from?
conjunctiva goblet cells
entropion
spastic don’t have to fix, some dogs grow out after 1 year, can do temporary tacking sutures
eyelid agenesis
lateral third of upper eyelid doesn’t form, dumpster cats
eyelid neoplasia in dogs
most benign, majority from meibomian glands
eyelid neoplasia in cats
less common, mostly SCC (adenocarcinoma, PNS, and lymphoma also bad)
common causes of feline conjunctivitis
M felis, C felis, FHV-1
corneal reactions to disease (6)
edema, vascular, fibrosis, pigment, cellular infiltrate, accumulates substances
