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Clinics! > SA Medicine > Flashcards

SA Medicine Flashcards

1
Q

9yo intermittet cough, inc. effort.
2wk tx abx No Improvement
rads - atelectic R middle lobe, no RM bronchi visualization, pleural effusion.

Differential?

A

lobe torsion

no visualization of the lobe bronchi is key

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2
Q

clinical signs of PRAA

A

regurgitation, high appetite, poor body condition

rads - narrowing esophagus, at the location, and megaesophagus cranial to it.

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3
Q

Differentials for pleural effusion and atelectasis

A

torsion
lobe abscess
trauma

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4
Q

oliguric renal failure, ethylene glycol consumption 2 days ago.
steps? prognosis?

A

guarded to poor prognosis

-> hemodialysis

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5
Q

ovarian remnant syndrome

A

cat goes into estrus (vocalizing, rolling, being mounted) even though previous OVH.
Can be weeks to years after surgery.
You can also confirm with diagnostic tests: estrogen >70 (not super reliable), progesterone >6 (after induced ovulation)

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6
Q

cat with blepharospasm, conjunctival hyperemia, epiphora of right eye..
fluorescein stain showed ulceration.
Cause?

A

Herpes
is the only infectious cause of corneal ulcers in cats (usually secondary infection)
Herpes ulcers are LINEAR (dentritic ulcers) usually UNILATERAL

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7
Q

T. foetus in young cats causes?

tx?

A

diarrhea. outgrow it by 2 years.

Ronidazole.

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8
Q

tx glaucoma in dog

A
  • topical dorzolamide (carbonic anhydrase inhibitor)
  • topical latanoprost (prostaglandin)
  • oral methazolamide (cai)
  • IV mannitol (not topical!)
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9
Q

feature of parvovirus that isn’t common in other enteritis (IBD, Clostridial, campylobacter)

A

leukopenia

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10
Q

Hypervitaminosis D

A

excessive vitamin D intake

- competes with receptors causes inc. intestinal absorption of Ca and P.

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11
Q

Perforated colon

glucose?

A

causes septic abdomen

  • peritoneal fluid is 20mg/dL LESS Than BG.
  • differentiates septic v. nonseptic effusion
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12
Q

8yo poodle with lyme exposure since 4yo. Only lab change is proteinuria.
How do you monitor?

A

Urine protein:Creatinine ratio

Because pt with PLN need monitoring for inc. proteinuria via pro:crea, its better than dipstick bc not affected by specific gravity. Monitoring albumin is also helpful.

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13
Q

How long do you treat deep pyodermas?

A

deep lesions heal on surface first, hard to assess deep tissue level of infection. tx with abx for 7-21 days after tissue is normal (no bacteria on cytology)
- in general need 6-8 weeks of tx vs. superficial need 3-4 wk

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14
Q

Tx demodicosis

A

ivermectin several months

  • prevent bacterial infection with topical tx like benzoyl peroxide shampoo
  • tx secondary infection as needed. (deep infection need 6-8 weeks abx, 7-21 days post negative cytology)
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15
Q

which microfilaria in peripheral blood looks simillar to dirofilaria immitis?

A

Acanthocheilonema reconditum

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16
Q

mucoid ocular discharge is the primary sign of what?

how do you diagnose it?

A

KCS

- shirmer tear test

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17
Q

Prognosis for DCM?

A

poor long term (especially dobbies)

with pimobendan inc. from 3 months to 1y.

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18
Q

Treatment for DCM

A

diuretic - furosemide

ACE inhibitor - enalapril, pimobendan +/- spironolactone

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19
Q

Fluid therapy

A

Main: 30 x BW + 70 (80 (132 if dog)BW^.75
plus deficit %xBW x 1000mL/kg
**(or approximate by 10mL/lb bolus and 1-2 ml/lb /h)
Maintenance for anesthesia:
Routine: 5-10ml/kg/hr
Major procedure: 10-20ml/kg/hr

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20
Q

RER

A

70 x BW ^0.75

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21
Q

Cat lymphoma.

Symptoms, Diagnosis, and prognosis?

A
  • anorexia, lethargy, weight loss. v/d, rarely difficulty breathing
  • dx: lymph node/mass FNA/biopsy
    Prognosis
  • High grade: 2-3 months with pred alone
  • Low grade: 1.5-2 years. 90% respond to chlorambucil/pred.
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22
Q

Puppy Impetigo/Pyoderma
clin signs?
tx?
dx

A
  • pustules in belly/inguinal/axilla in dogs/cats <1 year. Variable Pruritis
  • Usually self limiting
    Treat with topical (Gentamycin spray). Syst. Abx if persistent.
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23
Q

Insulin dosing?

food/weight loss?

A 
- Want BG between 120-300 in cat. (100-250 dog)
1U BID (cat<4kg) 1.5-2U (>4kg)
- if glucose if <350 don't go over 1U at all. 
- low carb, high protein food. 1-2% BW loss per week (AFTER ESTABLISHING INSULIN DOSE)
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24
Q

common cause of insulin disregulation?

A

UTI

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25
Q

Bladder Stones

A

CS: UTI, hematuria
rads: CaOxalate, struvite opaque. AUS better.
- struvite (triple phosphate crystals, basic urine, induced by staph)
- CaOxalate (acidic urine)
Tx: extended abx for UTI
1. Struvite - dietary dissolution(acidify) and drink to dilute urine)
2. CaOxalate - Sx, alkalanize urine (veggies, restrict protein/Ca)
3. Uric Acid (Dalmations/Dog with LIVER SHUNT) - Sx, high quality, low protein, low purine diet

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26
Q

What happens in Lymphangiectasia?

A

classic protein losing enteropathy. characterized by dilation and dysfunction of intestinal lymphatics and leakage of protein rich lymph into the intestinal lumen. As a result, protein, cholesterol, and lymphcytes are ALL LOST. Ca is also frequently low due to low albumin or vitamin D and Ca malabsorption.

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27
Q

Causes of Cardiac tamponade?

A

Pericardial effusion resulting in increased intrapericardial pressure impairing diastolic filling. Heart base tumors, R sided congested heart failure, idiopathic pericardial hemorrhage, peritoneopericardial diaphragmatic hernia, infectious pericarditis, FB, coagulopathy, and hypoalbuminemia.

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28
Q

Ca and P levels with hypervitaminosis D?

A

high Ca, High P
Excessive intake of vitamin D is associated with an increase in 25-hydroxyvitamin D3 levels. At high levels, 25-hydroxyvitamin D3 competes with 1,25-dihydroxyvitamin D3 for its receptors on the intestines and bone causing increased absorption of Ca and P from the intestinal tract and resorption of bone causing increased levels of circulating Ca and P. A common source of confusion is that this is in contrast to PTH which causes high Ca but generally causes unchanged or normal phosphorus because it also enhances renal phosphorus excretion.

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29
Q

Laryngeal Paralysis Examination

What drugs do you use?

A

Treatment: Doxapram is a central nervous stimulant that has effects on respiratory centers. It is thought that it may work by stimulating the reflex activation of carotid and aortic chemoreceptors. At one point, it was used in critical care patients during resuscitation efforts; however, this has fallen out of favor since doxapram results in increased work associated with respiration without an increased amount of arterial oxygenation. When performing a laryngeal exam, the goal is to have the patient just deep enough so you can perform a laryngeal exam. Injectable anesthetics such as thiopental or propofol are used. Overzealous administration of these can result in a false diagnosis of laryngeal paralysis and it is therefore recommended to administer Doxapram to help stimulate respiration and definitively confirm your diagnosis.

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30
Q

Which of these correctly describes the anatomical difference between a dog and cat esophagus?

a. The entire feline esophagus is smooth muscle. The canine esophagus is 2/3 smooth, then 1/3 striated muscle
b. The entire canine esophagus is striated muscle. The feline esophagus is 2/3 striated, then 1/3 smooth muscle
c. The entire canine esophagus is smooth muscle. The feline esophagus is 2/3 smooth, then 1/3 striated muscle
d. The entire canine esophagus is smooth muscle. The feline esophagus is 2/3 striated, then 1/3 smooth muscle
e. The entire feline esophagus is striated muscle. The canine esophagus is 2/3 striated, then 1/3 smooth muscle

A

b. The correct answer is the entire canine esophagus is striated muscle. The feline esophagus is 2/3 striated, then 1/3 smooth muscle. This anatomical fact is important because of the actions of drugs on the esophagus. For example, a drug such as cisapride, which is a smooth muscle prokinetic, would not be useful in dogs with megaesophagus because they have no smooth muscle in the esophagus, but the drug would tighten the lower esophageal sphincter.

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31
Q

Urethral prolapse

A
  • almost exclusive to young English Bulldogs
  • cause not always determined, but may be secondary to excessive masturbation, sexual excitement, or infection
  • examine closely to r/o concurrent neoplasia/infection
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32
Q

Pheochromocytoma tx?

how is it complicated with vena cava invasion?

A

Uncontrolled hypertension is associated with increased mortality. Pre-treatment with phenoxybenzamine for several weeks prior to sx to control hypertension (associated with increased survival time)

There is not increased mortality as long as pheo is removed by skilled surgeon familiar with vascular surgery.
Renal invasion/Nephrectomy is associated with increased mortality.

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33
Q

which ticks cause which diseases?

A

Ixodes pacificus - Lyme
Dermacentor v. and a. - Rocky Mountain Spotted Fever
Ambyomma - canine granulocytic ehrlichiosis (E. ewingii, Anaplasma)
Rhipicephalus - E. canis

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34
Q

when do you treat VPCs?

A

HR >180
over 20 seconds duration
pulse deficits
clinical signs

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35
Q

When will you know if an intestinal resection/anastomosis is successful?

A

5 days post-op

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36
Q

clinical signs of Salmon poisoning disease?

A
  • severe hemorrhagic enteritis, lethargy, anorexia, generalized lymphadenopathy
  • hx of going fishing
  • fluke eggs in feces
  • caused by neoricketsia helminthoeca in the fluke Nanophytes Salmincola
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37
Q

bladder innervation

A

symp - hypogastric n.
parasym - pelvic n.
somatic - pudendal n.

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38
Q

test for von willebrands before taking a doberman to surgery?

A

buccal mucosal bleeding test

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39
Q

treatment of Malassezia

A

ketoconazole (or other azoles)
or Terbinafine
(Griseofulvin is not effective)

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40
Q

key feature of tetanus?

tx?

A

facial contraction and smirk.

tx: wound debridement, sedation, abx, minimize external stimuli. Antitoxin (after initial test dose)

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41
Q

triple pelvic osteotomies should only be done in dogs with ??

A 
No DJD (this is why its performed when 6m-1y old. 
(they will not eliminate progression of arthritis, but degree will be less)
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42
Q

holding layer for hollow viscera (ex. esophagus)

A

submucosa

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43
Q

salter harris fractures

A 
1 - physeal only
2 - p, metaphysis
3 - p,epiphysis
4 - p, met and epi
5 - compression
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44
Q

idiopathic epilepsy

A
  • 1-5 yrs old onset
    tonic-clonic seizures
  • WITHOUT interictal abnormalities
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45
Q

signalment for hypoglycemic and PSS seizures?

associated with neoplasia?

A

hypoglycemic - young (~2m) status epilepticus (esp. if not eating)

PSS- (esp yorkies) after eating, generalized tonic-clonic (may be obtunded between)

older dogs. (focal motor seizures) becoming more frequent.

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46
Q

treatment idiopathic anterior uveitis?

A

reduce inflammation.

  • topical steroids often used (pred, dex not hydro) Systemic steroids if corneal ulcer and if infection ruled out as cause of uveitis.
  • topical NSAIDs (flurbi, voltaren are newer options) or systemic (carprofen, flunixin)
  • topical atropine (may exacerbate glaucoma)
  • *abx are often given anyway bc triple abx ointment with dexamethasone is often cheapest and easiest topical steroid prep.
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47
Q

Diseases that cause severe inflammation can induce?

A

DIC complex

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48
Q

severe inflam from pancreatitis can cause massive endothelial injury, resulting in vasculitis. This starts the ______, which can be so severe it uses up all the _____, and the patient is susceptible to ______ disorders.

A

coagulation cascase
clotting factors
bleeding disorder.

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49
Q

patients with clinical signs and 3 of the 4 which LAB FINDINGS have DIC.

A

inc. PT
inc. PTT
inc. FDP (aka fibrinogen)
decreased PLT.

50
Q

BARF diet associated with?

A

salmonella

water/mucoid hemorrhagic diarrhea

51
Q

pustules are commonly associated with?

A

staph

52
Q

causes of folliculitis

A

bacteria (staph)
dermatophytes
demodex

53
Q

which tumors cause polycythemia?
thrombocytopathy?
hypercalcemia?

A

poly - renal carcinoma
thrombo - hemangio, multiple myeloma
Ca - AGASACA, lymphoma

54
Q

when do you give a blood transfusion?

A

if expected ongoing blood loss

or PCV <20 (with clinical signs, this is subjective)

55
Q

Which tumor is associated with causing GI ulcers, perioperative hypotension, and coagulation abnormalities in dogs?

A

MCT
The correct answer is mast cell tumors. Many of the clinical signs of mast cell tumors are related to the factors released by mast cells including histamine, heparin, and other vasoactive amines. Histamine can cause ulcers via activation of H2 receptors on gastric parietal cells. Heparin can cause coagulopathy. Histamine and other vasoactive amines can lead to vasodilation and hypotension.

56
Q

which is the only mite known to cause pustules/papules?

A

demodex

57
Q

why do you use ACE inhibitors in DCM?

A

blunts the effects of the RAAS, thereby reducing sodium and fluid retention.
REDUCES VENTRICULAR AFTERLOAD.
also blunt aldosterone and other hormones which induce cardiac remodeling.

58
Q

what are the source of the dermatophytes?
m. canis?
m. gypseum?
trichophyton mentagrophytes?

A

canis - cats
gypseum - soil
trichophyton - rodents

59
Q

tests for scabies?

A

superficial scrape
CS
pinnal-pedal reflex (+ in 70% of scabies, or any pruritic dogs)

60
Q
  • nonseasonal waxing waning erythema, scaling, pruritis.
  • ulceration and thickening of oral mucosa, hyperkeratotic foot pads
  • BIOPSY because concerned about which cancer??

(already tried allergic immunotherapy and diet trial, negative on scrape, cytology)

A

cutaneous lymphoma

This is a common presentation for cutaneous lymphoma (mycosis fungoides). Patients with this cancer will often be worked-up for allergies because many are pruritic. However, most cases of allergies will not have lesions affecting the oral mucosa or foot pads. It is important to have cutaneous lymphoma on your list of differentials for older patients with skin disease who are not responding to conventional therapy.

Although, mast cell tumors can cause pruritus through release of histamine, the clinical presentation is not consistent with a mast cell tumor. Mast cell tumors are variable in appearance but usually do not cause generalized exfoliative erythroderma or affect the mucous membranes.

61
Q

which hormone is a perianal adenoma responsive to?

A

testosterone

-common in intact males, they regress with castration

62
Q

most commonly used non-calcium phosphate binder?

A

Aluminum hydroxide

63
Q

lead poisoning CS and tx?

A
  • GI and neuro (seizures) (access to old paint, batteries, fishing weights)
  • blood levels not helpful
  • inc. nRBC WITHOUT ANEMIA, theres also basophilic stippling
    tx: Ca-EDTA chelates the lead or Succimer orally

(D-penacillamine has been used to chelate lead, Cu, Fe, Hg - but used more for Cu)

64
Q

shortest acting, fastest onset barbiturate?

A

thiopental

65
Q

what results in hypocalcemia in Chemistry but doesn’t show clinical signs?

A

hypoproteinemia

66
Q

indication for using Furosemide?

A

heart FAILURE

67
Q

treatment of choice for proptosis?

A

The answer is tarsorrhaphy. Tarsorrhaphy is the treatment of choice for proptosis. In this procedure, the eyelids are pulled in front of the proptosed globe rather than pushing the eye in and then temporarily suturing the lids shut. Exenteration is a procedure used to remove eyes with neoplasia that is infiltrating into the surrounding structures. A conjunctival flap is a procedure usually used to help healing of complicated corneal ulcers. Phacoemulsification is the procedure used to remove cataracts.

68
Q

spinosad should never be used with ?

A

extralabel uses of ivermectin. (ex. treatment of demodex)

69
Q

adultacide vs. IGR

A

laners (nexgard - alfoxolaner) are adultacide

lufenuron, pyriproxfen

70
Q

spaying and chance of getting mammary cancer?

A

incidence of mammary carcinoma:
prior to first heat = 0.5%
after first = 8%
after 2nd = 24%

71
Q

Addisonians often present in __________?

So what do you need to do?

A

hypovolemic shock;

  • restore volume with IV fluids
  • chem panel (extend of dec. Na, inc. K, inc. BUN)
72
Q

administration of what will adversely affect the results of ACTH stim test?

A

pred (or -olone))

cortisone, flucortisone

73
Q

potential effects of chronic anterior uveitis?

A

corneal scarring, cataracts, glaucoma

74
Q

how do beta blockers work?

A

reduce myocardial oxygen demand, thus reducing the frequency of ventricular arrhythmias.

75
Q

Why would you do a urine culture?

A

WBC, bacteria in urine
isosthernuria/hyposthenuria
glucosuria

76
Q

CS of discoid lupus erythematosis

A
  • depigmentation, erythema, scaling and loss of ‘cobblestone’ appearance of the nasal planum.
  • Alopecia, crusting, scaling, and ulceration also seen on face, muzzle, lips, pinnae, and periorbitally
77
Q

causes of Horner’s syndrome?

A

idiopathic
otitis
intrathoracic neoplasia
HypoT/ DM

78
Q

____ of body is water?

ratio of ECF to ICF?

A

2/3

1:2

79
Q

cobalmin (b12) is absorbed in the

A

ileum

80
Q

causes of hyphema

A

hyperthension
rodenticide anticoag
lymphoma
uveodermatologic syndrome

81
Q

ingestion of mothballs

A

heinz body anemia (hemolysis, methemoglobinemia)

82
Q

how to raise PCV 1%

A

2ml/kg

83
Q

what causes insulin resistance in cats?

A

DM
excess GH(acromegaly)
excess glucagon
other (hyperT, Cush /excess cortisol, catecholamines)

84
Q

how to treat cats with heartworm

A

corticosteroids

85
Q

chemosis in cats

A

chlamydophila felis

86
Q

cervical ventroflexion in cats

A

low potassium!
(CKD)
or myasthenia/polymyopathy (toxo, immune, cush, OP toxicity, thiamine def, botulism)

87
Q

Thrombin time (TT)

A

final step of coag

fibrinogen to fibrin

88
Q

Prostatitis tx?

A

chloramphenicol, erythromycin, TMS, floroquinolones (enrofloxacin)

89
Q

Hepatic lipidosis is often seen in obese cats that become anorexic for several days, causing excessive fat stores mobilized to liver.

Causes of anorexia leading to hepatic lipidosis in cats?

A

IBD
Cholangiohepatitis
neoplasia
pancreatitis

90
Q

More common cat blood

A

type B

91
Q

why is it not recommended to cast a distal ulna/radial fracture (in a small dog)

A

decreased blood supply to radius/ulna

impairs healing and predisposes to fractures

92
Q

causes of non-cardiogenic pulmonary edema

A 
upper airway obstruction
PTE
direct trauma
vasculitis
liver ds. 
seizures
toxins, envenomation
DIC
sepsis
93
Q

HGE

A
  • hemorrhagic diarrhea with hemoconcentration
  • vomiting, abdominal pain
  • protein normal (with high PCV bc PLE)

caused by hypersensitivityrxn from clostridium enterotoxcin
(mini schauzers and poodles)

94
Q

soft tissue sarcomas

A 
perif nerve sheath tumors
hemangiopericytomas
fibrosarcomas
liposarcomas
malignant fibrous histiocytomas
myxosarcomas
rhabdomyosarcomas
leiomyosarcomas

(locally invasive, low metastatic rate for low/int grade tumors)

95
Q

Multiple Myeloma needs two of what 4 criteria?

A
  1. monoclonal gammopathy
  2. Radiographic evidence of osteolytic bone lesions (satisfied in this case)
  3. > 5% neoplastic cells or >10-20% plasma cells in the bone marrow
  4. Immunoglobulin light chain proteinuria (Bence-Jones proteinuria)
96
Q

crystals formed in alkaline urine?

A

struvite

Mg Ammonium phosphate

97
Q

differentials for gas in bladder?

A

The radiograph shows emphysematous cystitis, which is caused by the presence of gas forming bacteria. Even if a patient is asymptomatic, emphysematous cystitis typically has an underlying cause that should be determined and treated. The most common rule outs include Cushing’s disease (ACTH stimulation test), diabetes mellitus (urinalysis to look for glucosuria), chronic urinary tract infections (urine culture) and bladder stones. Hypothyroidism, Addison’s disease and tick borne diseases have not been associated with emphysematous cystitis. Once the underlying disease process is treated, the cystitis will typically resolve with antibiotic therapy.

98
Q

canine babesiosis

A

This is a case of Babesia gibsoni. Babesia sp. are protozoa that parasitize erythrocytes, causing anemia. Many different species exist. B. canis and B. gibsoni are two organisms commonly known to infect dogs, both organisms have Ixodid tick vectors. Babesia gibsoni, as seen here, is a small ring shaped parasite. Bites from other dogs during dog fights is also thought to be an important mode of transmission, possibly explaining the increased incidence of the disease in pit bulls and staffordshire terriers.

99
Q

Do dogs get cat scratch disease?

A

Sort of.
Bartonella henselae is the bacterium that causes cat-scratch disease. In cat-scratch disease, the owner is infected with the bacteria from flea feces when the cat bites or scratches the owner. Commonly, the bacteria cause fever, malaise, weight loss and lymphadenopathy. Often, cats show no clinical signs. Dogs can be exposed via tick or flea vector and show signs similar to humans, including possible endocarditis. With the dog and cat being from a southern state, both animals were at risk of exposure from Bartonella species.

100
Q

type 3 collagen is replaced by

A

type 1 (never complete; takes 8-11 months)

101
Q

anesthetic agents that affect the spleen?

A

ace -> enlargement and sequesters RBCs

thiopental -> engorgement

102
Q

signalment tracheal collapse

A

toy/miniature dogs
(chihuahua, pom, toy poodle, shih tzu, lhasa apso, yorkie)
middle-older ago, though can be seen in young animals

103
Q

ringworm

A

m. canis

topical and oral (lyme sulfur dip/shampoo [with miconazole] with itra/fluconazole PO)

104
Q

liver enzymes highly suggestive of hepatic lipidosis

A

high ALP compared to GGT(usually normal)

105
Q

electrolyte changes with uroabdomen

A

hypo Na, Cl

hyper Phosphate, K, azo

106
Q

endocarditis pathogen

A

bartonella

107
Q

phenothiazine side effects

A

sedation (no analgesia)
hypotension
(may decrease hematocrit due to splenic sequestration, decrease sensitivity of myocardium to catecholamine-induced arrhythmias)

108
Q

treatment for Pemphigus

and prognosis?

A

2-4mg/kg pred +/- azathioprine

poor prognosis

109
Q

breed predisposed to acanthosis nigrans?

A

daschund

110
Q

What does vertebral endplate lysis indicate?

A

discospondylitis

look for occult infection somewhere else, perform blood cultures

111
Q

prostatitis treatment?

A

erythromycin, chloramphenicol, TMS, Flouroquinolones (Enro) have good penetration of blood-prostate barrier

(pending culture)

112
Q

What can predispose HOD?

A

weimaraners

recent vaccination -> hyperreactivity of immune system

113
Q

You are working at a small animal clinic performing a cystotomy on a 7 year old male Dalmatian. You glance at your anesthetic monitoring equipment and notice that the oxygen saturation on your pulse oximeter is 90%. Assuming that your equipment is working normally, what does this mean about your patient’s oxygenation status?

a. Arterial oxygen pressure is 60 mm Hg, and oxygen saturation may drop precipitously if it decreases further
b. This is concerning because normally, a patient’s oxygen saturation does not exceed 50%
c. Arterial oxygen pressure is 100 mm Hg, which is normal for this patient
d. Arterial oxygen pressure is 40 mm Hg and will result in potentially serious tissue hypoxia due to inadequate oxygen delivery
e. This oxygen saturation is low for a patient under anesthesia breathing 100% oxygen but would be normal for an animal breathing room air, which is 21% oxygen

A

When assessing an anesthetized patient with pulse oximetry, it is important to realize several things:

The shape of the oxygen saturation curve is sigmoid, and until you reach oxygen pressures of < 60 mm Hg, there is very little change in oxygen saturation. Because an anesthetized patient breathing 100% oxygen should have about 500 mm Hg oxygen in the arterial blood, this can drop a long way before a dramatic change to oxygen saturation occurs.

However, the time to intervene is early when you see saturation percentages decrease because it means that your patient is oxygenating very poorly, especially if they are breathing 100% oxygen, and even a relatively small further decline could dramatically reduce their oxygen saturation, resulting in tissue hypoxia and dangerous consequences.

An oxygen saturation of 98-100% corresponds to > 100 mm Hg oxygen in arterial blood
An oxygen saturation of 95% corresponds to 80 mm Hg
An oxygen saturation of 90% corresponds to 60 mm Hg
An oxygen saturation of 50% corresponds to 30 mm Hg
An oxygen saturation of 10% corresponds to 10 mm Hg

By the way, in room air, arterial oxygen pressure should normally be 80-100 mm Hg and oxygen saturation is 95-100%

114
Q

A 9-year old Cocker Spaniel presents to you for multiple small (3-6 mm) skin masses. The owner describes them as cauliflower-like. Some appear to be ulcerated. What is the most likely diagnosis?

Squamous cell carcinoma
Sebaceous gland tumor Correct Answer
Mast cell tumor
Cutaneous lymphosarcoma

A

The correct answer is sebaceous gland tumor. These are actually the most common skin tumor in the dog. This group of tumors includes sebaceous hyperplasia, sebaceous epithelioma, sebaceous adenoma, and sebaceous adenocarcinoma. They are usually found in older dogs and are especially common in Cockers, Beagles, Poodles, and Miniature Schnauzers. They usual look like wart- or cauliflower-like lesions < 1 cm and can occur anywhere but usually are seen on the limbs, trunk, and eyelids.

115
Q

tx cytaux

A

Cytauxzoon felis is a protozoal organism and transmission to cats is through tick bites. Cats usually show clinical signs 1-3 weeks after infection. Signs can be non specific and include anorexia, lethargy, dyspnea, and icterus. Cats will also commonly have a marked pyrexia. The organism invades the reticuloendothelial cells of the lungs, spleen, liver, lymph nodes, and other organs so cranial organomegaly can often be present. The bone marrow can be affected causing pancytopenias. Thrombocytopenia is likely related to the development of disseminated intravascular coagulation, which can cause spontaneous bleeding. There is no effective therapy and prognosis is poor to grave. Treatment is mainly supportive and involves IV fluids to maintain tissue perfusion and to correct dehydration, blood transfusions to improve the anemia and oxygen carrying capacity of the blood, and heparin therapy for prophylactic treatment of DIC.

Anti-protozoal medications such as imidocarb have been used with varying success. Corticosteroids and antibiotics such as doxycycline, enrofloxacin, and marbofloxacin are commonly used to treat Mycoplasma haemofelis, but they are ineffective against Cytauxzoon. Immune mediated hemolytic anemia, cholangiohepatitis, and FIP should also be considered as differentials.

116
Q

cause of air in bladder?

A

The radiograph shows emphysematous cystitis, which is caused by the presence of gas forming bacteria. Even if a patient is asymptomatic, emphysematous cystitis typically has an underlying cause that should be determined and treated. The most common rule outs include Cushing’s disease (ACTH stimulation test), diabetes mellitus (urinalysis to look for glucosuria), chronic urinary tract infections (urine culture) and bladder stones. Hypothyroidism, Addison’s disease and tick borne diseases have not been associated with emphysematous cystitis. Once the underlying disease process is treated, the cystitis will typically resolve with antibiotic therapy.

117
Q

Lens removal is strongly recommended for several conditions. Which of these conditions necessitates immediate lens removal?

 Incipient cataract
 Anterior lens luxation
 Progressive retinal atrophy
 Anterior uveitis
 Posterior lens luxation
A

The correct answer is anterior lens luxation. Lens removal is indicated in cases of anterior lens luxation because they usually cause discomfort and usually cause uveitis and glaucoma. Posterior lens luxations are usually innocuous and can be left on the floor of the vitreous cavity. An incipient cataract should only have a minor effect on vision and does not necessitate lens removal. Uveitis and retinal atrophy will not be improved by lens removal. Keep in mind that an argument could be made for removal of the lens in both posterior lens luxation and the cataract; however, the best answer choice is still anterior lens luxation.

118
Q

Which of the following can be treated with enalapril?

Protein-losing nephropathy
Acute renal failure
Protein losing enteropathy
Hypotension

A

Enalapril is an angiotensin-converting enzyme (ACE) inhibitor used as a vasodilator, antihypertensive agent, and heart failure treatment. It works by preventing the conversion of angiotensin I to angiotensin II, thus reducing aldosterone concentrations and causing diuresis. Its dilatory effects on the efferent arterioles of glomeruli help to palliate protein losing nephropathies. It is often used in conjunction with diuretics.

119
Q

LV concentric hypertrophy in cats

A

Left ventricular concentric hypertrophy is normally associated with systemic hypertension, hyperthyroidism, or hypertrophic cardiomyopathy (systolic anterior motion of the mitral valve can occur with any of these conditions). Thus, blood pressure measurement, examination of the fundus (for evidence of hemorrhage or retinal detachment in response to systemic hypertension), and thyroid testing can be justified. A urinalysis is also indicated to rule out isosthenuria and/or proteinuria consistent with renal disease and resultant hypertension. Serum and plasma taurine levels are not indicated in this case based on the finding of concentric hypertrophy (taurine deficiency is associated with a dilated cardiomyopathy and eccentric hypertrophy).

120
Q

A male dog is undergoing exploratory surgery for a suspected extrahepatic portosystemic shunt. What are the only veins that should be entering the vena cava between the hepatic veins and renal veins?

Testicular vein
Left circumflex iliac vein
Caudal pancreaticoduodenal vein
Phrenicoabdominal veins

A

The correct answer is the phrenicoabdominal veins. The left circumflex iliac vein and testicular vein are both caudal to the renal veins. The caudal pancreaticoduodenal vein eventually becomes the gastroduodenal vein, which empties into the portal vein. Any vessels other than the phrenicoabdominal veins would be considered anomalous and could be your extrahepatic shunt.

Clinics! (19 decks)

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