SA13 Medical Nursing Flashcards
1
Q
What is an incision wound?
A
- Clean cut
- Caused by sharp object
- Glass, scalpel blade, etc
- Profuse bleeding, especially in deep/larger wounds
2
Q
What is a laceration wound?
A
- Tearing of tissue
- Uneven edges
- Barbed wire, etc
- Less severe bleeding than incision
- Contaminated
3
Q
What is an abrasion wound?
A
- Superficial wound
- Doesn’t penetrate full skin thickness
- Contamination with dirt and foreign material
4
Q
What is a puncture wound?
A
- Small external wound
- Often with significant deeper damage
- Dog/cat bites
5
Q
What is a contusion wound?
A
- Blunt blow
- Ruptured capillaries below surface
- Can have deeper injuries
6
Q
What is an avulsion wound?
A
- Wound with skin flap
- Skin flap becomes necrotic
- Delays healing if not removed
7
Q
What is a fracture?
A
- Break in bone
- Can be classed as open if wound present
8
Q
What is a rupture wound?
A
- Injured organ
- Causes internal bleeding
- Life threatening
- Liver, spleen, etc
9
Q
What is a haematoma?
A
- Blood filled pocket
- Aural, organ (liver, spleen)
10
Q
What is a clean wound?
A
- Surgical wound
- Made under aseptic conditions
11
Q
What is a clean contaminated wound?
A
- Surgical wound
- Made under aseptic conditions
- With mild contamination
12
Q
What is aetiology?
A
Unknown cause
13
Q
What is a contaminated wound?
A
- Fresh traumatic wound
- Surgical wound with major break in asepsis
14
Q
What is a dirty wound?
A
- Traumatic wound over 6 hours old
- Any wound where ongoing infection is present prior to surgery
15
Q
How can wounds be classified?
A
- Open/closed
- Clean/dirty
16
Q
What is ischaemic?
A
Restriction in blood supply
17
Q
What different degrees of damage are there in wounds?
A
- Resolution
- Regeneration
- Organisation
18
Q
What is resolution in terms of wounds?
A
- No tissue destruction
- Very minor inflammatory phase
- Tissue returns to original state
19
Q
What is regeneration in terms of wounds?
A
- Complete replacement of damaged tissue
- Connective tissue and blood supply must be intact
20
Q
What is organisation in terms of wounds?
A
- Formation of scar tissue
- As unable to heal by regeneration
- Often results in loss of normal function
21
Q
What are the stages of the healing process?
A
- Haemostasis
- Inflammatory
- Proliferative
- Remodelling/maturation
22
Q
What is the haemostasis stage of wound healing?
A
Clots form to stop blood loss
23
Q
What is the inflammatory stage of wound healing?
A
- Blood clot attracts neutrophils
- Clear up bacteria, necrotic tissue, foreign material
- Macrophages (monocytes) perform final debridement
- Exudate, swelling and redness seen
- 24-48 hr for clean surgical wound
24
Q
What is the proliferative stage of healing?
A
- Fibroblasts lay new tissue
- Endothelial cells lay new blood vessels
- Epithelial cells migrate over wound to replace epidermis
- Granulation and wound contraction seen
25
What is the golden period to treat an open wound?
- Optimal time of treatment of open wound
- Within 0 - 6 hours
26
What happens 6 - 12 hours after an open wound is caused?
- Bacteria multiplies
- Early stages of infection
27
What happens 12 hours + after an open wound is caused?
- Tissues will be infected
28
What is granulation tissue?
- Bright red, vascular
- Seen 3-5 days in large wounds
- Can take weeks-months to fully develop
29
What is the remodelling/maturation stage in wound healing?
- Scar formation
- Strengthening and hair regrowth
- 7-10 days in clean surgical wound
30
What are labile cells?
- Epithelial, lymph, etc
- High ability to regenerate
31
What is first intention healing?
- Rapid healing can take place in incised wounds
- Only occurs if edges of wound are held together
- Only happens in clean wounds
32
What is second intention healing?
- Granulation
- Slower healing
- Happens where tissue is lost or presence of foreign material or infection
- Epithelial tissue tissue grows across to close wound
- Speed of this growth determined by wound environment
- Warm, moist environment encourages epitheialisation
33
Do wounds need surgical intervention immediately?
- Some wounds can be managed as open wound
- Once granulation is established can have surgical secondary closure
- Wounds without surgical closure must be dressed and bandaged appropriately until full healing
- Can take weeks-months depending on tissue deficit
34
How long does wound healing take in tendons and muscles?
- Several weeks
- Gradual reintroduction to exercise
35
How long does wound healing take in GI, urinary and reproductive tissues?
- 3-4 days
- Urinary bladder heals fastest
- Colon heals slowest
36
What factors can delay wound healing?
- Movement
- Infection
- Impaired circulation/perfusion
- Patient/client interference
- Poor nutrition
- Systemic disease
- Poor wound management
- Surgical factors
- Drug therapy
37
What is erythema?
Reddening of tissue
38
Where does movement especially delay healing?
Over joints
39
How does infection delay healing?
- Bacteria destroys healing tissue
- Causes inflammation and pus
40
How does impaired circulation and poor perfusion delay healing?
- Tissue dies at wound edges
41
How does poor nutrition delay healing?
- Decreased vitamin K (affects clotting)
- Insufficient protein intake (affects cell growth and repair)
42
What systemic diseases can delay healing?
- Hypothyroidism (Decreased metabolism, slow cells)
- Cushings (Increased cortisol, slows healing)
- Renal (Increased toxins, weakened clotting)
- Hepatic disease (Reduced clotting factors)
- Diabetes mellitus (Increased blood glucose, slows healing)
- Severe cardiovascular disease (Poor perfusion, WBC can't get to wound effectively)
43
How can poor wound management delay healing?
- Inappropriate primary dressing
- Poor bandage technique
- Unprotected bandages
- Infrequent bandage changes
- Patient interference
44
What surgical factors can delay healing?
- Wound infection
- Tight sutures
- Inappropriate suture material
- Poor suturing technique
- Poor aseptic technique
- Lack of drainage
45
What is delayed primary closure?
- Closed after 1 - 3 days
- Contaminated so need to be managed as open wound to begin with
46
What is secondary closure?
- Closed after 3+ days
- Heavily contaminated so needs to be managed as open wound for longer
47
What drugs can delay healing?
- Corticosteroids
- Chemotherapy
- Radiotherapy
48
Fluid build up in surgical wound?
Seroma
49
What is the primary dressing layer?
- In contact with the wound
- Can debride wound, absorb fluid, stimulate granulation tissue, promote epithelialisation, contract wound
50
What are the functions of a wound dressing?
- Absorption of exudate
- Analgesia
- Protection
- Prevention of infection
- Promotion of wound healing
- Maintaining correct humidity for healing
51
What is the secondary dressing layer?
- Wool and conforming bandage
- Absorbant
- Easy to apply
- Apply in spiral with even 50% overlap
- Conforming bandage compresses wool
- Holds primary layer in place
- Provides padding and stability
52
What is the tertiary dressing layer?
- Elastic and cohesive
- Apply in even 50% overlap
- Protection from soiling and mutilation
53
When can casts be used?
- Stable fractures
- Greenstick, simple, spiral fractures
- Fractured bone is close to in-tact bone
- Can be used post operatively
- Arthrodesis, internal fixations, tendon repair
54
What is another name for casts?
External coaptation
55
What are the properties of cast materials?
- Comfortable
- Easy to apply
- Strong/hard wearing
- Radiolucent
- Lightweight, not bulky
- Easy to remove
- Water resistant, breathable
- Economical
56
What are some examples of cast materials?
- Polypropylene impregnated with resin (Dynacast)
- Fibreglass impregnated with resin (Vetcast Plus)
- Thermoplastic polymer mesh (Vet-lite, Runlite SA)
- Plaster of Paris
57
What are some important things to remember when applying a cast?
- Apply in close proximity to bone for optimal support
- Too much padding causes slippage
- Too little padding causes decubital ulcers
- Joints above and below fracture must be included
58
How is a cast applied?
- Cover wounds with non-adherent dressing
- Apply stockinette to avoid creases
- Apply cast padding with 50% overlap
- Pad bony areas with 'doughnuts'
- Immerse one roll of cast into water and squeeze several times
- Squeeze excess water and apply to limb with even pressure and 50% overlap
- Repeat until cast complete
- Leave pads and toes of digits 2 + 3 exposed
- Leave 1-2cm of padding exposed at top and bottom
- Turn stockinette and padding edges over ends of cast once hardened
59
How should a cast be cared for?
- Replace if excessively chewed or damaged
- Replace every week if animal young
- Administer medication as prescribed
- Cover bottom when taking patient outside
60
What should be monitored for when casts are used?
- Swelling of limbs and toes
- Chafing
- Staining with discharges
- Foul odour
- Slippage
- Chewing shows signs of discomfort
- Collapse or bending
- General patient demeanour; appetite, lethargy, depression
61
How should a cast be removed?
- Take radiographs to assess healing
- Sedate or GA if using oscillating saw
- Can use plaster shears to cut cast fro, distal to proximal ends
- Two cuts make a cutting line
- Saw cuts through cast, not padding
- Remove padding once cast removed
- Blade can become hot, caution must be taken
62
What are the aims of managing chronic wounds?
- Prevent further contamination
- Decontaminate as much as possible
- Debridement of necrotic tissue
- Infection control
- Healthy wound bed allows healing
63
What causes congestive heart failure?
- Pooling blood in venous system
- Due to damming back effect
- Due to cardiac disease
64
What does left sided congestive heart failure cause?
- Congestion of vessels in lungs
- Fluid leaking causes pulmonary oedema
65
What does right sided congestive heart failure cause?
- Congestion of venous circulation
- Particularly vessels returning from abdomen and chest cavity
- Results in ascites and pleural effusion
66
What clinical sign can cats show with either side congestive heart failure?
Pleural effusion
67
What are the clinical signs of congestive heart failure?
- Dyspnoea
- Tachypnoea
- Exercise intolerance
- Cough
- Syncope (collapse)
- Weight loss
- Pale/bluish MMs
- Ascites
- Dull breath sounds with effusion
- Increased breath sounds with pulmonary oedema
68
Why can coughing occur in congestive heart failure?
Oedema or cardiomegaly pressing on main stem of bronchi
69
What is a foramen oval?
- Opening in septum between right and left atria and ventricles
- Blood bypasses lungs and passes from right ventricle to left
- Should close shortly after birth
- Seen in neonates
70
What is Ductus Arteriosa?
- Connects pulmonary artery and aorta
- Blood bypasses lungs from right to left
- Closes shortly after birth as lungs expand
- Seen in neonates
71
What is Ductus Venosus?
- Venous shunt within liver
- Connects umbilical vein to caudal vena cava
- Blood bypasses foetal liver
- Mothers liver already metabolised nutrients
- Seen in neonates
72
What differences are seen in neonatal circulation?
- Foramen Ovale
- Ductus Arteriosa
- Ductus Venosus
73
What is PDA?
- Patent Ductus Arteriosus
- Failure of Ductus to close after birth
74
What are the signs of Patent Ductus Arteriosus?
- Often detected as machinery type murmur as first vaccination
- Often no clinical signs at that stage
75
What are the long term effects of Patent Ductus Arteriosus?
- High resistance in systemic circulation
- Blood passes from aorta to pulmonary artery
- Leads to over circulation to lungs and left side of heart
- Ultimately leads to left sided heart failure
76
What is the treatment for Patent Ductus Arteriosus?
- Surgical closure
- Treatment for congestive heart failure if diagnosed late
77
What are artial and ventricular septal defects?
- Failure of foramen ovale to close
78
What are the clinical signs of atrial and ventriculare septal defects?
- Similar to PDA
- Systolic murmur is heard
- Bigger hole = quieter murmur
79
What is the treatment for atrial and ventricular septal defects?
- Symptomatic treatment for congestive heart failure
- Open heart surgery
- Surgery requires heart bypass, is very expensive and not commonly done
80
What is aortic stenosis?
- Narrowing of the outflow (valve) of the left ventricle?
81
What are the signs of aortic stenosis?
- Typically a left sided murmur
- Output failure leads to fainting/collapse
- Congestive heart failure
- Sudden death due to cardiac dysrhythmias
82
What is the treatment for aortic stenosis?
- Symptomatic treatment with anti dysrhythmic drugs and beta blockers
- Mild cases may not require treatment
83
What is pulmonic stenosis?
Narrowing of pulmonary valve or artery leaving the heart
84
What are the signs of pulmonic stenosis?
- Typically right sided murmur
- Congestive heart failure
85
What is the treatment for pulmonic stenosis?
- Severe cases require dilation of artery
- Symptomatic treatment in non-surgical cases
86
What is mitral/tricuspid dysplasia?
Underdevelopment of the mitral or tricuspid valve
87
What is tetralogy of fallot?
- 4 heart defects
- Pulmonic stenosis
- Ventricular septal defect
- Abnormally positioned aorta
- Often have more than one congenital defect
88
What is myocarditis?
Inflammation of heart muscle
89
What causes myocarditis?
- Parvovirus in puppies
90
What are signs of myocarditis?
- Acute heart failure
- Death
91
What is dilated cardiomyopathy (DCM)?
- Thinning of myocardium
- Leads to loss of contractility
- Enlargement of heart chambers
92
What causes dilated cardiomyopathy?
- Common in Dobermans
- Often idiopathic
- Seen in taurine deficiency
- Was common in cats
93
What are the signs of dilated cardiomyopathy?
- L+R congestive heart failure
- Ascites and pulmonary oedema in dogs
- Pleural effusions + pulmonary oedema in cats
94
What is the treatment for dilated cardiomyopathy?
- Symptomatic treatment for congestive heart failure
- Taurine supplementation
94
What is hypertrophic cardiomyopathy (HCM)?
- Thickening of cardiac muscle
- Reduction in heart chamber size
- Most common cardiac disease in cats
95
What does stenosis mean?
Narrowing
96
What are the signs of hypertrophic cardiomyopathy?
- Congestive heart failure
- Sudden death
97
What is the treatment for hypertrophic cardiomyopathy?
- Drugs to slow heart and improve chamber filling
- Congestive heart failure treatment
98
What is myxomatous valvular disease (MVD)?
- Mitral valve disease
- Degeneration of atrio-ventricular valves
- Most common in mitral valve
- Faulty valve function
- Blood leaking through valves when closed
- Common in CKCS
99
What are the signs of myxomatous valvular disease?
- Progressing murmur
- Congestive heart failure
100
What is the treatment for myxomatous valvular disease?
Symptomatic treatment
101
What is pericarditis?
- Inflammation of pericardium
- Causes pericardial effusion
102
What is pericardial effusion?
- Fluid accumulation inside pericardial sac
- Prevents heart filling during diastole
- More often in dogs (Golden retrievers)
103
What are the causes of pericardial effusion?
- Idiopathic
- Secondary to tumours or infection
104
What are the signs of pericardial disease?
- Lethargy
- Dyspnoea
- Muffled heart sounds
- Weak pulses
- Pale MMs
- Jugular distension
- Ascites
105
What is the treatment for pericardial disease?
- Drainage of fluid around the heart (pericardiocentesis)
- Removal of part of the pericardium (pericardectomy)
106
What is auscultation?
LISTEN FOR
- Heart rate and rhythm
- Murmurs
- Dullness
- Respiratory sounds
107
What is ECG?
- Measures electrical conductivity of the heart
- Gives info on rate and rhythm
- Gives crude indications of cardiac chamber size
108
What is the wave in an ECG?
P
- Depolarisation of the atria
- Starting from SA node
QRS WAVE
- Depolarisation of ventricles
- From AV node
T
- Repolarisation of ventricles
109
What positions are the ECG leads attached to the patient?
- RED = Right
- YELLOW = Left
- GREEN = Below sun
- BLACK = Right hind
110
How should the patient be positioned for an ECG?
- Non-conductive table cover (vetbed)
- Dogs in right lateral
- Cats sitting or standing
- Turn off other electrical equipment in room
- Apply conductive gel/spirit to pads/clips
- Don't allow leads to touch
- Reduce patient movement and purring
- Keep patient as calm as possible
- Avoid chemical restraint
111
How can radiography be used to look at the heart?
- Shows size and shape of heart
- Can show congestion signs
- Always take DV view first
- Followed by lateral view (usually right)
- Sedation required
- Forelegs out of way
- Take standard inspiratory views
112
What is the most common haemopoietic disease seen in practise?
Anaemia
113
What is erythropoiesis?
Formation of erythrocytes (RBCs)
114
What is lymphoid tissue?
- Found in lymph nodes and spleen
- Matures agranular leukocytes
- Lymphocytes + monocytes
115
What is myeloid tissue?
- Found in red bone marrow
- Forms erythrocytes and granular leukocytes
- Neutrophils, esinophils, basophils
116
What is serum?
- Plasma minus clotting factors
- Does not have fibrinogen or prothrombin
117
What is anaemia?
- Reduced number of erythrocytes (RBCs)
- Reduced haemaglobin concentration
118
What does anaemia lead to?
- Reduced circulating oxygen
- Causes hypoxia in tissues
119
How is anaemia classified?
REGENERATIVE
- Bone marrow responds to erythropoietin from kidneys
- Releases RBCs and reticulocytes into circulation
NON-REGENERATIVE
- Lack of erythropoietin or bone marrow doesn't respond
- No RBCs or reticulocytes released
120
What causes regenerative anaemia?
HAEMORRHAGE
- Internal/external loss
- Sever trauma
- Organ rupture
- Clotting disorder
- Neoplasia
- Haemorrhagic gastroenteritis
- Sever ectoparasite infection
- Surgery
- Epistaxis
HAEMOLYSIS
- Immune-mediated
- Blood parasites (mycoplasma haemofelis)
121
What causes non-regenerative anaemia?
- Bone marrow hypoplasia
- Iron deficiency
- Renal disease
- Leukaemia
- Lymphosarcoma
- Lead poisoning
122
What are the clinical signs of anaemia?
- Pale/jaundice MMs
- Evident blood loss
- Bounding, weak pulses
- Tachycardia
- Lethargy
- Hypotension (if losing whole blood)
- Inappetence
- Dyspnoea/Tachypnoea
- Exercise intolerance
- Collapse/syncope
123
How is anaemia dianosed?
- Haematology; complete blood count, fresh smear, reticulocyte count
- Biochem to check organ disease; kidney disease
- Agglutination test; check for autoimmune haemolytic anaemia
- FeLV/FIV testing in cats
- Coagulation profile
- Imaging; radiographs of thorax, abdomen, ultrasonography, CT scan
124
What does epistaxis mean?
Nose bleed
125
How is anaemia treated?
TREAT UNDERLYING CAUSE
- Identify + control haemorrhage
- Treat immune mediated diseases (steroids)
- Treat infections (Tetracyclines for mycoplasma haemofelis)
- Erythropoietin if renal disease
- Treat coagulopathy; vitamin K and frozen plasma in rodenticide poisoning
- Treat underlying neoplasia
- Iron supplementation in chronic blood loss (Bleeding tumours into gut)
- Fluids (crystalloids, packed red cells, plasma, less commonly colloids)
- Supplementary oxygen may be indicated
126
What are the nursing considerations for aneamia?
- Monitor vital signs
- Pain scoring
- Monitor hydration status
- Encourage eating
- Monitor fluid intake and output
- Monitor excretions
- Assess exercise tolerance
127
What type of fluids are least likely to be required in anaemia treatment?
Whole blood
128
What are the congenital coagulopathies?
- Von Willebrand's Disease
- Haemophillia A
129
What is Von Willebrand's Disease?
- Inherited disease
- More common in certain breeds (dobermans)
- Lack of certain clotting factor (VW factor)
- Causes impaired platelet function
- Platelets needed for start of clotting process
130
What are the signs of Von Willebrand's Disease?
MILD
- Excessive haemorrhage at spay/castration
SEVERE
- Die young of acute haemorrhage
SIGNS
- Epistaxis
- Bleeding post oestrus
- Petechial/ecchymotic haemorrhage
- Bleeding into pleural/peritoneal cavities
- Signs on anaemia
131
How is Von Willebrand's Disease diagnosed?
- Biochem and haematology
- Clotting profile
- Activated clotting time
- Von Willebrand factor
- Platelet function test
CARE WHEN BLOOD SAMPLING
- Lots of pressure post venepuncture
132
How is Von Willebrand's Disease treated?
- Desmopressin synthetic ADH (DDAVP)
- Leads to increased levels in VW's factor and factor VIII
- Cryoprecipitate from pet blood banks - source of factor VIII, fibrinogen, VW factor
- Mainly used prior to elective surgery
133
How can Von Willebrand's Disease be detected in breeding programs?
- Von Willebrand's factor levels can be measured
- Important in breeding
134
What are the nursing considerations for Von Willebrand's Disease?
Same as anaemia
135
What is Haemophillia A?
- Lack of clotting factor VIII
136
What are the signs of haemophillia A?
- Haemorrhage into joints
- Haematoma formation
137
What is the treatment of haemophillia A?
- Cryoprecipitate from pet blood bank; source of C factor VIII, VW factor and fibrinogen
- Mainly used before elective surgery
- Can be used in mild cases
138
What are the nurse considerations of Haemophillia A?
- Same as anaemia
139
What are the acquired coagulopathies?
- Immune-mediated thrombocytopaenia
- Anticoagulant rodenticide poisoning
- Sever liver disease
140
What is immune-mediated thrombocytopaenia?
- Immune system damages and destroys platelets
- Leads to spontaneous bleeding
- Can be idiopathic, from infection or inflammatory disease
141
What are the signs of immune-mediated thrombocytopaenia?
- Bruising
- Epistaxis
- Haematemesis
- Haematuria
- Pale MMs
- Tachycardia
- Tachypnoea
- Anorexia
- Lethargy
142
How is Immune-mediated thrombocytopaenia diagnosed?
- Biochem and haematology
- Platelet count
- Clotting profile
- Thorax + abdomen radiographs
- Ultrasound
- CT
143
What is the treatment for immune-mediated thrombocytopaenia?
- Immunosupressive therapy (steroids)
- Blood transfusion
- Treat underlying cause
144
What is anticoagulant rodenticide poisoning?
- Rodenticides impair vitamin K production
- Vit K required for some clotting factor functions
145
What are the signs of anticoagulant rodenticide poisoning?
- Severe haemorrhage
- Especially into body cavities
146
How is anticoagulant rodenticide poisoning diagnosed?
- Biochem and haematology
- Clotting profile
- Toxicology
147
What is the treatment for anticoagulant rodenticide poisoning?
- Induction of emesis
- Activated charcoal
- Supplementary vitamin K
- Frozen plasma
- Supportive therapy (packed RBC transfusion)
148
What is sever liver disease?
- Clotting factors reduced
- Lack of production in liver
149
What is the treatment of sever liver disease?
- Supportive + supplementary vitamin K
- Frozen plasma
150
How long does clotting process take in healthy patients?
3-5 minutes
151
What is hypercoagulation?
Abnormal clotting
152
What is IMHA
- Immune-mediated haemolytic anaemia
- Immune system attacks RBCs
153
What is evans syndrome?
IMHA with immune-mediated thrombocytopoenia
154
Why are plasma and transfusions used with vitamin K in treatment for anticoagulant rodenticide poisoning?
- Vitamin K takes time to work
- Plasma gives clotting factors immediately
155
What are the signs of sever liver disease?
Same as anaemia
156
When would coupage be contraindicated?
In patients with lung injury
157
What is dysuria?
Difficulty urinating
158
What is Polyuria?
Increased urination
159
What is Oliguria?
Reduced urination
160
What is Anuria?
Not urinating
161
What is Pollakiuria?
Frequent urination in small amounts
162
What is cystitis?
Inflammation of the bladder
163
What is Tenesmus?
- Straining
- Urine or faecal
164
What is Stranguria?
Small dribbles
165
What is Haematuria?
Blood in urine
166
What is Incontinence?
- Lack of control of urination
- Not aware
167
Feline lower urinary tract disease
168
Where does each endocrine gland sit?
Pituitary gland - base of brain
Thyroid gland - Lateral to trachea
Parathyroid gland - next to TG
Pancreas - along proximal duodenum
Ovaries - next to kidneys
169
What is hyperadrenocorticism?
- Cushsings syndrome
- Production of excessive amounts of cortisol from the adrenal gland
170
What is iatrogenic?
From excessive steroid administration
171
What is cushings disease?
- Hyperadrenocorticism
- Production of excessive amounts of cortisol from adrenal glands
172
What can hyperadrenocorticism be caused by?
PITUITARY TUMOUR
- Usually benign (PDH)
ADRENAL TUMOUR
- Can be benign or melignant
- (ADH)
173
What are the clinical signs of hyperadrenocorticism?
- PU/PD
- Polyphagia
- Pendulous abdomen
- Liver enlargement
- Lethargy/poor exercise tolerance
- Muscle weakness
- Alopecia/skin changes
- Persistent anoestrous
- Testicular atrophy
- Calcinosis cutis
- Hypertension
- Neurological signs
174
What is hepatomegaly?
Enlarged liver
175
What is calcinosis cutis?
Thickened, hard skin from calcium deposits
176
Why can hyperadrenocorticism cause a pendulous abdomen?
- Weakened abdominal muscles
- Redistribution of abdominal fat
177
What skin changes can be seen with hyperadrenocorticism?
- Alopecia
- Comedomes
- Thinning skin
- Lack of elasticity
178
What diagnostic tests should be completed first when testing for hyperadrenocorticism?
- Must have compatible signs and results before specific endocrine tests
- Haematology (neutrophilia + lymphoaenia
- Biochemistry
179
Stress leucogram??
180
What are the 3 parts of the vomiting reflex?
NAUSEA
- Hypersalivation + increased swallowing
- Anti-peristalsis of duodenum and jejunum
- Decrease gastric tone
RETCHING
- Diaphragm, intercostal and abdominal muscle spasms
- Overcome gastroesophagus sphincter pressure
VOMITING
- Food forced out of relaxed stomach by abdominal muscles
181
What is the difference between vomiting and regurgitation?
- Regurgitation is ejection of undigested food from larynx or oesophagus before reaching the stomach
- Vomiting is from the stomach
182
What is regurgitation from the pharynx?
- Immediate
- Undigested, neutral pH
- Multiple swallowing attempts
- Poor ability to drink
- Dysphagia present
- Can see dyspnoea and coughs
- Food consistency can aggravate this
183
What is regurgitation from the oesophagus?
- Few seconds delay after eating
- Undigested, neutral pH, can be tubular
- Multiple swallowing attempts
- Normal to poor ability to drink
- Dysphagia present
- Can see dyspnoea and coughs
- Food consistency and exercise can aggravate this
184
What is vomiting from the stomach and proximal small intestine?
- Minutes to hours delay after eating
- Partially digested, may see bile, pH < 5
- Single swallowing attempts
- Normal ability to drink
- Dysphagia not present
- Hypersalivation, abdominal pressure, excess swallowing
185
What can cause acute vomiting?
- CNS disorders
- Gastric/intestinal disease
- Infections
- Gastric foreign bodies
- Intestinal foreign bodies
- GDV (
- Gastric mobility disorders
- Inflammation
- Haemorrhagic gastroenteritis
- Metabolic disease
- Acute pancreatitis ...
186
What CNS disorders can cause vomiting?
- Vestibular disease
- Epilepsy
187
What gastric and intestinal diseases can cause acute vomiting?
188
What is collitis?
- Inflammation of colon
- Often results in LI D+
- Can confuse tenesmus + increased frequency with constipation
189
What is osmotic diarrhoea?
- Most common
- Unabsorbed solutes increases faecal water
190
What is secretory diarrhoea?
- Increased secretion of fluids and ions
- Or decreased absorption
- Cause by bacteria, toxins, viruses and some laxatives
191
What is permeability diarrhoea?
- Increased permeability of epithelial cells and tight junctions
- Blood / protein loss if severe
- Caused by R sided heart failure, portal hypertension, imflammatory bowel disease, neoplasia, infections and toxins
192
What is constipation?
- Failure to pass faeces
- Resulting in impaction
193
What are the clinical signs of constipation?
- Failure to pass faeces
- Tenesmus
- Hard faeces +/- blood
- V+
- Dyschezia
194
What is Dychezia?
Pain while passing faeces
195
How can constipation be diagnosed?
- Physical/rectal exam
- Radiography
- Ultrasonography
- Proctoscopy
196
What is proctoscopy?
197
What is the treatment for constipation?
- Enemas
- IVFT if dehydrated
- Dietary changes
- Lactulose
- Bulking agents
- Obstruction removal surgery
- Increased exercise
198
What are the causes of collitis?
- Chronic inflammation
- Infections secondary to SI fat maldigestion
- Neoplasia/polyps
- Motility disorders
- Local irritation; prostatitis, peritonitis
199
What are the diagnostic tests for collitis?
- Clinical and rectal exam
- Faecal analysis
- Biochem + haematology
- Radiography/ultrasonography
- Biopsy
- Protoscopy
200
What is the treatment for colitis?
- Hypoallergenic (hydrolysed) diet
- Increased soluble + insoluble fibre
- Dietary omega-3 fatty acids
- Dietary changes often enough to control colitis
201
What is cirrhosis?
Scarring
- Occurs in liver when 70-80% cell damage
202
What is prostatic disease?
- Common in older entire male dogs
- Prostate tends to increase in size as as dog ages
- Due to hormonal stimulation; benign prostatic hyperplasia
- Bacterial infection from urethra
- Cysts, abscesses, tumours may develop
- Prostatitis (inflammation)
203
What are the signs of prostatic disease?
- Faecal + urinary tenesmus/constipation
- Flat faeces
- Haematuria from infection/neoplasia
- Dysuria/incontinence
- Abdominal pain
204
How is prostatic disease diagnosed?
- Rectal examination
- Ultrasonography/radiography
- Prostatic wash + cytology
- Urinalysis
- FNA/biopsy
205
How is prostatic disease treated?
- Ypozane tablets - benign prostatic hyperplasia
- Inhibits testosterone uptake by prostate; 7 day course lasts 6 months
- Suprelorin
- Castration
- Antibiotics and analgesia
- Drainage/removal of cysts
- Palliative care for neoplasia
206
What are the nursing requirements for prostatic disease?
- Prevent urine scalding
- Monitor urine + faecal output
- Pain scoring
- Post op surgical care
207
What are testicular tumours?
- Most common; sertoli cell, interstitial cell (leydig cell)
- Most important; sertoli cell
- Usually related to retained testicle
208
What are the signs of testicular tumours?
- Feminisation; increased oestrogen
- Alopecia
- Gynecomastia; mammary development
- Pendulous prepuce
- Bone marrow suppression
209
How are testicular tumours diagnosed?
- Clinical signs and exam
- Are they castrated?
- Blood test; oestrogen concentration
210
How are testicular tumours treated?
- Surgical removal
- Chest radiographs needed to check for metastases
211
What is pyometra?
- Cystic endometrial hyperplasia
- More common in bitch than queen
- Cause by progesterone staying high post oestrus
- Endometrium thickened and gland numbers increase
- Excess fluid in uterus
- Can be induced by progestogens and oestrogens
- Bacteria leaks into blood stream
- Commonly seen 5-6 weeks post season
212
What are the signs of pyometra?
- More common in middle age/older bitches
- Signs start few weeks post oestrus
- PU/PD
- Lethargy
- Anorexia
- V+
- Vaginal discharge if cervix open
- Abdominal pain
- Shock
213
How is pyometra diagnosed?
- Clinical signs
- Abdomen palpation
- Radiograph/ultrasonography
- Vaginal swab
214
How is pyometra treated?
- Ovariohysterectomy
- May need medical stabilisation
- IVFT and antibiotics
- Aglepristone treats medically to empty uterus if open
- Medical treatment can lead to complications
215
What is false pregnancy?
- Pseudopregnancy/pseudcyesis
- More common in bitches
- Unknown causes
- Usually worse after each season
216
What are the signs of false pregnancy?
- Signs seen 6-8 weeks post oestrus
- Mainly behavioural changes
- Nesting and mothering toys
- Mammary development and mastitis
217
How is false pregnancy diagnosed?
- Easily recognised from signs
- Must rule out pregnancy
218
How is false pregnancy treated?
- Can resolve spontaneously
- Drugs to suppress lactation
- Galastop for dogs, Kelactin for dogs and cats
- May need hormonal treatment
- Spay after clinical signs gone
219
What are mammary tumours?
- More common in bitches
- 50% are benign in bitches
- 80% are malignant in cats
- Mammary carcinoma is malignant
220
What are the signs of mammary tumours?
- Enlarged, lumpy mammary tissue
- Can become large and ulcerated if left
221
How are mammary tumours diagnosed?
FNA/biopsy
221
How are mammary tumours treated?
- Surgery
- Mammectomy; single gland
- Local mastectomy; affected and adjacent gland
- Radical mastectomy/mammary strip; all glands on affected side
- Radiography of chest to check for metastases
222
What is an antiprolactin?
- Cabergoline
- Manages pseudopregnancy
- Stops lactation
223
What is aglepristone?
- Termination of pregnancy
- Used up to 45 days post mating
- Medical treatment of pyometra
224
What is proligesterone?
- Synthetic progesterone
- Used for oestrus control
- Treats false pregnancy
225
What is delmadinone?
- Progesterone injection
- Used as chemical castration
- Reduced libido, not infertility
226
What is deslorelin?
- Chemical castrate implant
- Induced temporary infertility in healthy entire male dogs
- Takes 6 weeks for full effects
- Lasts 6 months
227
What is elbow dysplasia?
- Abnormal development of elbow joint
- Usually inherited
- Affects young giant and large breed dogs
228
What are the clinical signs of elbow dysplasia?
- Lameness
- Lifting head when affected leg put down
- Limping
- Arthritis in older age
229
How is elbow dysplasia diagnosed?
- Radiography
- CT scan
- MRI
- Elbow arthroscopy
230
How is elbow dysplasia treated?
- Weight management
- Physio/hydrotherapy
- Anti-inflammatory medication
- Stem cell treatment
- Total elbow replacement
231
How can cases of elbow dysplasia be reduced?
- BVA/KC elbow scoring scheme
- Assess predisposed breeds before breeding
- Aim to eliminate/reduce occurrence
232
What is patella luxation?
- Dislocation of patella
CONGENITAL
- Anatomical deformities at birth
- Can be inherited
AQUIRED
- Result of trauma
233
What are the clinical signs of patellar luxation?
- Inability to extend stifle joint
- Lameness
- Non-weight baring
- Deformity
- Small fractures
- Pain
- Abnormal gait (skipping)
234
How is patellar luxation diagnosed?
- Radiography
- CT scan
- MRI
235
How is patellar luxation treated?
- Depends on grade (1-4)
- Surgery required for 3-4; tibial tuberosity transposition
- Surgery not needed for 1-2 unless severe clinical signs
- Physio/hydro therapy
- Exercise modification
- Weight management
- Anti-inflammatory medication
236
What is the cruciate ligament?
- Normal stifle joint has 2 cruciate ligaments
- Form a cross to stabilise joint
- Menisci serve as shock absorber
237
How is cruciate rupture caused?
CRANIAL RUPTURE
- With medial meniscus damage
- Usually from trauma/exercise
- Femur slips onto tibia
CRUCIATE DEGENERATION
- Breed conformation
- Upright position of hind limbs make joint become unstable
238
What are the clinical signs of cruciate rupture?
- Acute onset lameness after trauma
- Pain
- Limping
239
How is cruciate rupture diagnosed?
- Manipulating joints to assess cranial draw
- Radiography
- MRI
- Exploratory surgery/arthroscopy
240
How is cruciate rupture treated without surgery?
- Anti-inflammatory medication
- Weight management
- Physio/hydrotherapy
- Dogs <15kg normally stabalise
- Dogs >15kg may require surgery
241
How is cruciate rupture treated with surgery?
EXTRASCAPULAR
- Place non-absorbable suture - Around lateral fabella and through hole in tibial crest
- Knot secured with metal crimps
INTRASCAPULAR
- Place strip of patella ligament through inside of stifle joint
- Secured with sutures
TPLO
- Tibial Plateau Levelling Osteotomy
- Change tibial plateau angle
- Allows movement without pain
- Ligament remains damaged
- Bone stabilised with TPLO plate and screws
242
What are the clinical signs of conjunctivitis?
- Uni/bilateral inflammation of conjunctiva
- Blephrospasm
- Increased lacrimation
- Oedema/swelling
- Ocular discharge
243
What is the treatment for conjunctivitis?
- Visually diagnosed
- Antibiotic, antiinflammatory or antiviral eyedrops
- Remove foreign bodies
- Surgical correction of eyelids
244
What are the clinical signs of entropion?
- Inward turning of eyelids
- Blephrospasm
- Squinting
- Increased lacrimation
- Ocular discharge
245
What are the clinical signs of ectropion?
- Outward turning eyelids
- Blephrospasm
- Squinting
- Increased lacrimation
- Ocular discharge
246
What are the clinical signs of distichiasis?
- Extra rows of eyelashes
- Blephrospasm
- Squinting
- Increased lacrimation
- Ocular discharge
247
What is the treatment for entropion, ectropion and distichiasis?
-Visually diagnosed
- Anti-inflammatory or antibiotic eyedrops
- Surgical correction
248
What are the clinical signs of a corneal ulcer?
- Ocular pain
- Ocular discharge
- Blephrospasm
- Increased lacrimation
249
How are corneal ulcers diagnosed?
- Visual diagnosis
- Fluorescein dye to expose epithelial erosion
250
What are the treatments for corneal ulcers?
- Remove cause
- Antibiotics
- Analgesia
- Contact lens placement
Surgery; debridement, grid kerarectomy
251
What are the clinical signs of cataracts?
- Lens clouding
- Poor vision
- Blindness
- Common with diabetes mellitus
252
What is the treatment for cataracts?
- Visually diagnosed
- Surgical treatment
253
What are the clinical signs of glaucoma?
- Increased intra-ocular pressure
- Painful red eyes
- Corneal oedema
- Globe swelling
- Dilated pupil
- Retinal damage
254
How is glaucoma diagnosed?
- Ophthalmoscopy
- Measure intra-ocular pressure
255
How is glaucoma treated?
- Emergency; IV mannitol to draw out fluid
- Carbonic anhydrase inhibitors reduces aqueous + vitreous humour production
- Miotics increase aqueous outflow
- Analgesia
- Enucleation
256
What nursing considerations are there for eye condtions?
- Pain scoring
- Analgesia
- Bathe eyes
- Apply barrier cream under eyes
- Avoid cross-contamination
- Minimise environmental dust
- Prevent patient interference
257
What are the nursing considerations for patients with impaired vision?
- Avoid hazards
- Always keep on lead
- Avoid moving furniture
- Reassure patient of presence
258
What are the clinical signs for otitis externa?
- Head shaking
- Scratching
- Pain
- Smell
- Aural haematoma
- Head tilt
- Heat
- Redness
259
How is otitis externa diagosed?
- Otoscopic examination
- Swabs; cytology culture + sensitivity, microscopy of discharge
260
What is the treatment for otitis externa?
- Topical antibiotics
- Anti-inflammatories
- Antifungals
- Cleaning
- Surgery; lateral wall resection, total ear canal ablation
261
What are the clinical signs of otitis media?
- Head shaking
- Horners syndrome; miosis, upper eyelid droop
- Extension of otitis externa
262
How is otitis media diagnosed?
- Radiography of tympanic bullae
- Aspiration of bullae contents
263
How is otitis media treated?
- Systemic antibiotics
- Severe cases may require bullae ostotomy
264
What are the clinical signs of otitis interna?
- Head tilt
- Nystagmus
265
What is meosis?
Constricted pupil
266
How is otitis interna diagnosed?
- Radiography of tympanic bullae
- Aspiration of tympanic bullae
- MRI/CT scan
267
What is the treatment for otitis interna?
- Antibiotics
- Steroids
- Surgery
268
What are the clinical signs for vestibular syndrome?
- Nystagmus
- Strabismus
- Ataxia
- Mental depression
- Neurological signs
- Horners syndrome
- Nausea
- Signs of external ear disease
269
What is Horners syndrome?
- Upper eyelid droop
270
How is vestibular syndrome diagnosed?
- Neurological assessment
- MRI/CT scan
- Cerebral spinal fluid analysis
271
How is vestibular syndrome treated?
- Treat underlying cause
- Comfortable environment
- IVFT
- Assisted feeding
272
What nursing consideration is important when treating patients with ear conditions?
- May not hear clearly or be deaf
- Always approach so they can see
273
How is contact dermatitis caused?
- Commonly by soaps
- Any detergent or chemicals
274
What are the clinical signs of contact dermititis?
- Pruritic erythematous lesions on feet, ventral abdomen, neck and face
- Often have secondary bacterial infection from self trauma
- Intolerance develops 4-6 weeks after exposure
275
How is contact dermatitis treated?
- Avoid contact with identified allergens
276
How is contact dermatitis diagnosed?
- Patch testing to check for reactions
- Contact elimination to see if resolves then reintroduce and observe for reaction
277
How is food hypersensitivity caused?
-
278
What is pruritis?
- Itching
279
What is alopecia?
- Hair loss
- Can be symmetrical, patchy, partial, complete, diffuse or focal
- Can be associated with hormonal disease
280
What is atopy?
- Allergic skin disease
281
What is erythema?
- Redness
282
What is pyoderma?
Bacterial skin infection
283
What is seborrhoea?
- Excessive sebum production
284
How do tumours grow in different stages?
- Early, rapid growth
- Slow down and reach plateau
- Growth normally slowed when clinically detectable
285
What is tumour doubling time?
Time takes for tumour to double in size
286
What is tumour growth fraction?
- Cell Cycle time
- Time for dividing cells to complete process of cell division
287
What is the difference of rate of growth between benign and malignant tumours?
BENIGN
- Relatively slow
- Growth can stop in some cases
MALIGNANT
- Often rapid
- Rarely stops growth
288
What is the difference in manner of growth between benign and malignant tumours?
BENIGN
- Expansive
- Usually well defined boundary between neoplastic and normal tissue
- Can be encapsulated
MALIGNANT
- Invasive
- Poorly defined boundaries
- Tumour cells extend into normal tissue
289
What is the difference in effects on surrounding tissue between benign and malignant tumours?
BENIGN
- Often minimal
- Can cause pressure/anatomical deformity
MALIGNANT
- Often serious
- Invasive and destructive to surrounding tissues
- Ulceration of superficial tissue
- Lysis of bones
290
What is the difference in metastasis between benign and malignant tumours?
BENIGN
- Does not occur
MALIGNANT
- Spread through lymph and blood
- Can spread throughout body cavities
291
What is the difference in effect on host between benign and malignant tumours?
BENIGN
- Often minimal
- Life threatening if develops in a vital organ
MALIGNANT
- Often life threatening
- Destructive nature of growth
- Metastasis to other vital organs
292
What is the difference between malignant tumours metastasising via lymph and blood?
LYMPH
- To local and regional lymph nodes
BLOOD
- Secondary tumours can develop in any body organ
293
Where are secondary tumours most commonly found in small animals?
- Most common in lungs
- Liver, spleen, kidneys, skin, bone
- None should be ignored
294
What is the most life threatening characteristic of malignant tumours?
Ability to spread and grow in distant organs
295
What is a mast cell tumour?
- Malignant
- Found on skin
- Histamine release causes acute inflammation in skin
296
What is a squamous cell carcinoma?
- Malignant
- Found in squamous epithelium
- Found in oral cavity
297
What is a histiocytoma?
- Benign
- Found in skin
- Formed from histiocytes
- Immune cells in skin
298
What is a lipoma?
- Benign
- Made of adipose tissue
- Common in older, overweight animals
299
What is a liposarcoma?
- Malignant
- Made of adipose tissue
- Rare
300
What is an osteosarcoma?
- Malignant
- Found in bone
- Tumour of osteoblasts
- Usually in limb bones
301
What is a haemangiosarcoma?
- Malignant
- Found in vessels
- Tumours can develop anywhere
302
What is a lymphoma?
- Benign
- Found in lymphocytes
- Can be called benign lymphoid hyperplasia
303
What is a transitional cell carcinoma?
- Malignant
- Found in the bladder
304
What is a thyroid adenoma?
- Benign
- Found on thyroid gland
- May present as hyperthyroidism
305
What is a thyroid adenocarcinoma?
- Malignant
- Found in mammary glands
- Common in older entire females
306
How can true diagnosis of tumours be made?
- Microscopic examination of cells collected from tumour
HISTOLOGY
- Biopsy
- Most accurate
CYTOLOGY
- Fine needle aspirate
- Not definitive diagnosis
- Useful for neoplasia investigation
307
What is needed before starting therapy for tumours?
Vital to diagnose before starting treatment
308
How can tumours be treated?
- Surgery
- Radiation
- Antinroplastic/cytotoxic chemotherapy
- Must be tailored to suit individual cases
309
What is the most effective treatment for majority of solid neoplasms in animals?
- Surgery
- Best chance for curing
310
What is the primary objective of surgery on tumours?
- Physically remove tumour cells
- Requires margins of normal tissue to ensure complete removal
- If metastasised to other organs, primary mass does not need removing
311
What are the different types of surgical excision of tumours?
LOCAL
- Benign can be cured by local surgical resection with minimal margins
WIDE LOCAL
- Effective for locally invasive tumours extending into tissue
- Requires more aggressive approach with 1-2cm margins in all plains
- Can include removal of mandible
COMPARTMENTAL
- Some solid tumours infiltrate more than 1-2cm
- Required full thickness resection of affected area
312
Which tumour treatment is often restricted to larger referral institutes for animals?
- Radiation therapy
- Due to lack of equipment facilities
313
What is radiation therapy for tumours?
- Form of energy
- When absorbed by living tissue, causes excitation and ionisation of atoms and molecules
- Subsequent chemical reactions break molecular bonds and cause cell death
314
What types of radiation are used in radiation therapy?
- X rays
- Gamma rays
- Electrons
- Can be applied via external beam or implanted into tumour
315
What is chemotherapy?
- Become accepted method of treatment in small animals
- Many drugs have anti-cancer activity
- Can be divided into groups of modes of action, anti-tumour activity and toxicity
316
What do all chemotherapy agents act upon?
- Process of cell growth and division
- Most effective against growing and dividing cells
317
What important factors need to be considered when administering chemotherapy?
- Always be used at highest possible dose to affect highest fractional kill
- Even highly effective drugs are unlikely to eradicate tumour population in one dose
- Should be started when tumour burden is at lowest
- Unlikely to be effective if used as last resort with extensive/advanced tumours
318
What are the stages and grades of tumours?
- Stages 1-4
1; Small, contained in one organ
2; Larger, still contained
3; Large, spread to surrounding tissue and lymph nodes
4; Metastasised, likely palliative care
319
What levels do chemotherapy normally consist of?
INDUCTION THERAPY
- Aim to reduce tumour burden to minimal level below limits of detection (remission)
MAINTENANCE THERAPY
- Less intense dosing
- Maintains remission
RESCUE THERAPY
- If relapse, more aggressive therapy for remission
METRONOMIC CHEMOTHERAPY
- Lower doses once or twice daily
- Aim to stop mass growing
- Lower chance of side effects
320
What are the complications of chemotherapy?
- Tissues other than tumours also have rapidly dividing cells
- Bone marrow toxicity (myelosuppression, neutropenia, thrombocytopenia)
- Gastrointestinal toxicity (anorexia, nausea, V+, D+)
- Hypersensitivity (anaphylaxis)
- Phelbitis and tissue necrosis (Many cyto drugs are irritant, can cause sever local tissue necrosis after perivascular injection)
321
What chemotherapy toxicity is associated with cyclophosphamide?
- Haemorrhagic cystitis
- Can be seen after single dose
- Usually seen after very high or repeated doses
- No treatment
- Sever cases take long to resolve
322
What chemotherapy toxicity is associated with doxorubicin?
- Cardiotoxicity
- Chronic changed with cumulative doses
- Can lead to irreversible cardiomyopathy
323
What chemotherapy toxicity is associated with cisplatin?
- Nephrotoxicity
- Can cause acute tubular necrosis
- Can effect renal blood flow
- IVFT must be given with this
324
Why are safety precautions are needed for safely handing cytotoxic drugs?
- Carcinogenic and mutagenic
- Some are teratogenic
- Some extremely irritant
- Produce harmful local effects after direct contact with skin or eyes
325
How are cytotoxic drugs available?
- Tablets / Capsules
- Powders
- Solutions for injection
326
What factors must be considered for tablets/capsules of cytotoxic drugs?
- Never break, crush or open capsules
- Disposable latex gloves should be worn to handle
- If tablets provided in individual packaging, should be dispensed in these
- Must have clear warning labels
- Must be instructed on how to give
- Hands must be washed after handling, even with gloves
- Excess/unwanted drugs must be disposed of high temperature incineration by licensed authority
327
When is the main risk of exposure to injectable cytotoxic drugs?
During preparation and administration
328
What are the minimum PPE requirements for injectable cytotoxic drugs?
- 2 pairs of drugs
- Top layer can be removed if spillage
- Long sleeve gown
- Protective visor or goggles
- FP3 grade masks to prevent splashes to face
329
How should injectable cytocoxic drugs be reconstituted?
- Only by trained personnel
- In designated area free from drafts, away from throughfares and food
- Certain drugs should be reconstituted in fume cupboards
- Careful technique to prevent pressure in vials and aerosols produced
- Excess air expelled into absorbent pad, not atmosphere
- Chemopet make up specific doses of chemotherapy for patients
- PhaSeal device from CAVE referrals
330
How should injecable cytotoxic drugs be administered?
- Luer lock preferred over push connections
- Patients must be restrained effectively by trained staff with full PPE
331
What should be done in the case of a spillage of injectable solution of chemotherapy?
- Mopped up using absorbent towel
- If powder, towel should be damp
- Contaminated surfaces should be washed with lots of water
332
How should waste be disposed of following administration of cytotoxic waste?
- Sharps placed in impenetrable container
- Solid waste placed in double sealed polythene bags
- Disposed of by high temperature incineration
- Specific cytotoxic waste bins can be used
333
What does carcinogenic mean?
Cancer causing
334
What does mutogenic mean?
Includes mutations
335
What does teratogenic mean?
Malformation of embryo / phoetus
336
What is the menace response check?
- Tests cranial nerve II, VI, VII
- Optic, Abducens, Facial nerve
- Move hand towards eye without touching face or blowing air into the eye
- Thalamus, cerebrum and cerebellum involved in response pathway
337
What is the central nervous system?
- Brain and spinal cord
338
What is the peripheral nervous system?
- All nerves off from the CNS
- Cranial nerves
- Spinal nerves
- Autonomic nervous system; nerve fibres from brain and spinal cord
339
What is a seizure?
- Altered electrical activity in brain
- Symptom of disease
- Not a diagnosis
340
How are the signs of seizures divided into phases?
PREICTAL
- Senses something will happen
- Smells
- Restless
- Anxious
ICTAL
- Seizure
POSTICTAL
- Period after seizure
- Exhaustion
- Disoriented
- Anxious
- Can be short or hours or days
341
What is epilepsy?
- Multiple seizures
- Metabolic disorder in brain cells
- More common in dogs than cats
- Can be inherited
- Young animals normally effected (1-5 years)
342
What are the clinical signs of epilepsy?
- True seizure
- Loss of consciousness
- Bowel and bladder evacuation
- Collapse
- Clonic (twitches)/Tonic (rigid)
- Vocalisation
- Jaw chomping
343
How is epilepsy diagnosed?
- Ruling out other causes
- MRI/CT scan
344
How is epilepsy treated?
-
345
What is passive physiotherapy?
- Coupage
- Petrissage
- Friction
- Efflurage
- Passive joint movement
346
What is coupage?
Striking the chest with cupped hands
347
What is Petrissage?
- Chinese burn/twisting skin
- Aids lymph return
348
What is Friction physiotherapy?
- Circular massage movements
349
What is efflurage?
- Massage distal to proximal
- Aids lymph return
350
What is passive joint movement?
- Moving joint through normal ranges
351
What is active physiotherapy?
- Animal has to perform the movements
- Therapeutic exercises
- Apparatus
- Hydrotherapy
352
What are therapeutic exercises?
- Harness controlled lead walks
- Walking up and down slopes
- Walking over different surfaces
- Weave poles
353
What apparatus can be used in active physiotherapy?
354
What is hydrotherapy?
355
What is the primary aim of a neurological examination?
Determine the location of any pathological process
356
What should be the first part of a neurological examination?
- Hands off examination
- Watch how the patient moves on their own
357
What spinal reflexes can be tested in a neurological examination?
- Patellar reflex
- Cranial tibial reflex
- Extensor carpi radialis
- Perinneal reflex
358
