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Vet Nurse Small Animal Diploma CQ > SA13 Medical Nursing > Flashcards

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
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2
Q

What is a laceration wound?

A
  • Tearing of tissue
  • Uneven edges
  • Barbed wire, etc
  • Less sever bleeding than incision
  • Contaminated
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3
Q

What is an abrasion wound?

A
  • Superficial wound
  • Doesn’t penetrate full skin thickness
  • Contamination with dirt and foreign material
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4
Q

What is a puncture wound?

A
  • Small external wound
  • Often with significant deeper damage
  • Dog/cat bites
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5
Q

What is a contusion wound?

A
  • Blunt blow
  • Ruptured capillaries below surface
  • Can have deeper injuries
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6
Q

What is an avulsion wound?

A
  • Wound with skin flap
  • Skin flap becomes necrotic
  • Delays healing if not removed
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7
Q

What is a fracture?

A
  • Break in bone
  • Can be classed as open if wound present
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8
Q

What is a rupture wound?

A
  • Injured organ
  • Causes internal bleeding
  • Life threatening
  • Liver, spleen, etc
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9
Q

What is a haematoma?

A
  • Blood filled pocket
  • Aural, organ (liver, spleen)
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10
Q

What is a clean wound?

A
  • Surgical wound
  • Made under aseptic conditions
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11
Q

What is a clean contaminated wound?

A
  • Surgical wound
  • Made under aseptic conditions
  • With mild contamination
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12
Q

What is aetiology?

A

Unknown cause

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13
Q

What is a contaminated wound?

A
  • Fresh traumatic wound
  • Surgical wound with major break in asepsis
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14
Q

What is a dirty wound?

A
  • Traumatic wound over 6 hours old
  • Any wound where ongoing infection in present prior to surgery
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15
Q

How can wounds be classified?

A
  • Open/closed
  • Clean/dirty
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16
Q

What is ischaemic?

A

Restriction in blood supply

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17
Q

What different degrees of damage are there in wounds?

A
  • Resolution
  • Regeneration
  • Organisation
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18
Q

What is resolution in terms of wounds?

A
  • No tissue destruction
  • Very minor inflammatory phase
  • Tissue returns to original state
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19
Q

What is regeneration in terms of wounds?

A
  • Complete replacement of damaged tissue
  • Connective tissue and blood supply must be intact
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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
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21
Q

What are the stages of the healing process?

A
  • Haemostasis
  • Inflammatory
  • Proliferative
  • Remodelling/maturation
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22
Q

What is the haemostasis stage of wound healing?

A

Clots form to stop blood loss

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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
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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
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25
Q

What is the golden period to treat an open wound?

A
  • Optimal time of treatment of open wound
  • Within 0 - 6 hours
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26
Q

What happens 6 - 12 hours after an open wound is caused?

A
  • Bacteria multiplies
  • Early stages of infection
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27
Q

What happens 12 hours + after an open wound is caused?

A
  • Tissues will be infected
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28
Q

What is granulation tissue?

A
  • Bright red, vascular
  • Seen 3-5 days in large wounds
  • Can take weeks-months to fully develop
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29
Q

What is the remodelling/maturation stage in wound healing?

A
  • Scar formation
  • Strengthening and hair regrowth
  • 7-10 days in clean surgical wound
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30
Q

What are labile cells?

A
  • Epithelial, lymph, etc
  • High ability to regenerate
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31
Q

What is first intention healing?

A
  • Rapid healing can take place in incised wounds
  • Only occurs if edges of wound are held together
  • Only happens in clean wounds
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32
Q

What is second intention healing?

A
  • 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
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33
Q

Do wounds need surgical intervention immediately?

A
  • 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
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34
Q

How long does wound healing take in tendons and muscles?

A
  • Several weeks
  • Gradual reintroduction to exercise
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35
Q

How long does wound healing take in GI, urinary and reproductive tissues?

A
  • 3-4 days
  • Urinary bladder heals fastest
  • Colon heals slowest
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36
Q

What factors can delay wound healing?

A
  • Movement
  • Infection
  • Impaired circulation/perfusion
  • Patient/client interference
  • Poor nutrition
  • Systemic disease
  • Poor wound management
  • Surgical factors
  • Drug therapy
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37
Q

What is erythema?

A

Reddening of tissue

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38
Q

Where does movement especially delay healing?

A

Over joints

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39
Q

How does infection delay healing?

A
  • Bacteria destroys healing tissue
  • Causes inflammation and pus
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40
Q

How does impaired circulation and poor perfusion delay healing?

A
  • Tissue dies at wound edges
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41
Q

How does poor nutrition delay healing?

A
  • Decreased vitamin K (affects clotting)
  • Insufficient protein intake (affects cell growth and repair)
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42
Q

What systemic diseases can delay healing?

A
  • 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)
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43
Q

How can poor wound management delay healing?

A
  • Inappropriate primary dressing
  • Poor bandage technique
  • Unprotected bandages
  • Infrequent bandage changes
  • Patient interference
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44
Q

What surgical factors can delay healing?

A
  • Wound infection
  • Tight sutures
  • Inappropriate suture material
  • Poor suturing technique
  • Poor aseptic technique
  • Lack of drainage
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45
Q

What is delayed primary closure?

A
  • Closed after 1 - 3 days
  • Contaminated so need to be managed as open wound to begin with
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46
Q

What is secondary closure?

A
  • Closed after 3+ days
  • Heavily contaminated so needs to be managed as open wound for longer
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47
Q

What drugs can delay healing?

A
  • Corticosteroids
  • Chemotherapy
  • Radiotherapy
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48
Q

Fluid build up in surgical wound?

A

Seroma

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49
Q

What is the primary dressing layer?

A
  • In contact with the wound
  • Can debride wound, absorb fluid, stimulate granulation tissue, promote epithelialisation, contract wound
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50
Q

What are the functions of a wound dressing?

A
  • Absorption of exudate
  • Analgesia
  • Protection
  • Prevention of infection
  • Promotion of wound healing
  • Maintaining correct humidity for healing
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51
Q

What is the secondary dressing layer?

A
  • 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
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52
Q

What is the tertiary dressing layer?

A
  • Elastic and cohesive
  • Apply in even 50% overlap
  • Protection from soiling and mutilation
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53
Q

When can casts be used?

A
  • Stable fractures
  • Greenstick, simple, spiral fractures
  • Fractured bone is close to in-tact bone
  • Can be used post operatively
  • Arthrodesis, internal fixations, tendon repair
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54
Q

What is another name for casts?

A

External coaptation

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55
Q

What are the properties of cast materials?

A
  • Comfortable
  • Easy to apply
  • Strong/hard wearing
  • Radiolucent
  • Lightweight, not bulky
  • Easy to remove
  • Water resistant, breathable
  • Economical
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56
Q

What are some examples of cast materials?

A
  • Polypropylene impregnated with resin (Dynacast)
  • Fibreglass impregnated with resin (Vetcast Plus)
  • Thermoplastic polymer mesh (Vet-lite, Runlite SA)
  • Plaster of Paris
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57
Q

What are some important things to remember when applying a cast?

A
  • 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
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58
Q

How is a cast applied?

A
  • 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
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59
Q

How should a cast be cared for?

A
  • Replace if excessively chewed or damaged
  • Replace every week if animal young
  • Administer medication as prescribed
  • Cover bottom when taking patient outside
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60
Q

What should be monitored for when casts are used?

A
  • 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
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61
Q

How should a cast be removed?

A
  • 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
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62
Q

What are the aims of managing chronic wounds?

A
  • Prevent further contamination
  • Decontaminate as much as possible
  • Debridement of necrotic tissue
  • Infection control
  • Healthy wound bed allows healing
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63
Q

What causes congestive heart failure?

A
  • Pooling blood in venous system
  • Due to damming back effect
  • Due to cardiac disease
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64
Q

What does left sided congestive heart failure cause?

A
  • Congestion of vessels in lungs
  • Fluid leaking causes pulmonary oedema
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65
Q

What does right sided congestive heart failure cause?

A
  • Congestion of venous circulation
  • Particularly vessels returning from abdomen and chest cavity
  • Results in ascites and pleural effusion
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66
Q

What clinical sign can cats show with either side congestive heart failure?

A

Pleural effusion

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67
Q

What are the clinical signs of congestive heart failure?

A
  • Dyspnoea
  • Tachypnoea
  • Exercise intolerance
  • Cough
  • Syncope (collapse)
  • Weight loss
  • Pale/bluish MMs
  • Ascites
  • Dull breath sounds with effusion
  • Increased breath sounds with pulmonary oedema
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68
Q

Why can coughing occur in congestive heart failure?

A

Oedema or cardiomegaly pressing on main stem of bronchi

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69
Q

What is a foramen oval?

A
  • 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
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70
Q

What is Ductus Arteriosa?

A
  • Connects pulmonary artery and aorta
  • Blood bypasses lungs from right to left
  • Closes shortly after birth as lungs expand
  • Seen in neonates
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71
Q

What is Ductus Venosus?

A
  • Venous shunt within liver
  • Connects umbilical vein to caudal vena cava
  • Blood bypasses foetal liver
  • Mothers liver already metabolised nutrients
  • Seen in neonates
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72
Q

What differences are seen in neonatal circulation?

A
  • Foramen Ovale
  • Ductus Arteriosa
  • Ductus Venosus
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73
Q

What is PDA?

A
  • Patent Ductus Arteriosus
  • Failure of Ductus to close after birth
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74
Q

What are the signs of Patent Ductus Arteriosus?

A
  • Often detected as machinery type murmur as first vaccination
  • Often no clinical signs at that stage
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75
Q

What are the long term effects of Patent Ductus Arteriosus?

A
  • 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
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76
Q

What is the treatment for Patent Ductus Arteriosus?

A
  • Surgical closure
  • Treatment for congestive heart failure if diagnosed late
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77
Q

What are artial and ventricular septal defects?

A
  • Failure of foramen ovale to close
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78
Q

What are the clinical signs of atrial and ventriculare septal defects?

A
  • Similar to PDA
  • Systolic murmur is heard
  • Bigger hole = quieter murmur
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79
Q

What is the treatment for atrial and ventricular septal defects?

A
  • Symptomatic treatment for congestive heart failure
  • Open heart surgery
  • Surgery requires heart bypass, is very expensive and not commonly done
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80
Q

What is aortic stenosis?

A
  • Narrowing of the outflow (valve) of the left ventricle?
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81
Q

What are the signs of aortic stenosis?

A
  • Typically a left sided murmur
  • Output failure leads to fainting/collapse
  • Congestive heart failure
  • Sudden death due to cardiac dysrhythmias
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82
Q

What is the treatment for aortic stenosis?

A
  • Symptomatic treatment with anti dysrhythmic drugs and beta blockers
  • Mild cases may not require treatment
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83
Q

What is pulmonic stenosis?

A

Narrowing of pulmonary valve or artery leaving the heart

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84
Q

What are the signs of pulmonic stenosis?

A
  • Typically right sided murmur
  • Congestive heart failure
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85
Q

What is the treatment for pulmonic stenosis?

A
  • Severe cases require dilation of artery
  • Symptomatic treatment in non-surgical cases
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86
Q

What is mitral/tricuspid dysplasia?

A

Underdevelopment of the mitral or tricuspid valve

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87
Q

What is tetralogy of fallot?

A
  • 4 heart defects
  • Pulmonic stenosis
  • Ventricular septal defect
  • Abnormally positioned aorta
  • Often have more than one congenital defect
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88
Q

What is myocarditis?

A

Inflammation of heart muscle

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89
Q

What causes myocarditis?

A
  • Parvovirus in puppies
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90
Q

What are signs of myocarditis?

A
  • Acute heart failure
  • Death
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91
Q

What is dilated cardiomyopathy (DCM)?

A
  • Thinning of myocardium
  • Leads to loss of contractility
  • Enlargement of heart chambers
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92
Q

What causes dilated cardiomyopathy?

A
  • Common in Dobermans
  • Often idiopathic
  • Seen in taurine deficiency
  • Was common in cats
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93
Q

What are the signs of dilated cardiomyopathy?

A
  • L+R congestive heart failure
  • Ascites and pulmonary oedema in dogs
  • Pleural effusions + pulmonary oedema in cats
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94
Q

What is the treatment for dilated cardiomyopathy?

A
  • Symptomatic treatment for congestive heart failure
  • Taurine supplementation
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94
Q

What is hypertrophic cardiomyopathy (HCM)?

A
  • Thickening of cardiac muscle
  • Reduction in heart chamber size
  • Most common cardiac disease in cats
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95
Q

What does stenosis mean?

A

Narrowing

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96
Q

What are the signs of hypertrophic cardiomyopathy?

A
  • Congestive heart failure
  • Sudden death
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97
Q

What is the treatment for hypertrophic cardiomyopathy?

A
  • Drugs to slow heart and improve chamber filling
  • Congestive heart failure treatment
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98
Q

What is myxomatous valvular disease (MVD)?

A
  • 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
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99
Q

What are the signs of myxomatous valvular disease?

A
  • Progressing murmur
  • Congestive heart failure
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100
Q

What is the treatment for myxomatous valvular disease?

A

Symptomatic treatment

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101
Q

What is pericarditis?

A
  • Inflammation of pericardium
  • Causes pericardial effusion
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102
Q

What is pericardial effusion?

A
  • Fluid accumulation inside pericardial sac
  • Prevents heart filling during diastole
  • More often in dogs (Golden retrievers)
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103
Q

What are the causes of pericardial effusion?

A
  • Idiopathic
  • Secondary to tumours or infection
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104
Q

What are the signs of pericardial disease?

A
  • Lethargy
  • Dyspnoea
  • Muffled heart sounds
  • Weak pulses
  • Pale MMs
  • Jugular distension
  • Ascites
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105
Q

What is the treatment for pericardial disease?

A
  • Drainage of fluid around the heart (pericardiocentesis)
  • Removal of part of the pericardium (pericardectomy)
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106
Q

What is auscultation?

A

LISTEN FOR
- Heart rate and rhythm
- Murmurs
- Dullness
- Respiratory sounds

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107
Q

What is ECG?

A
  • Measures electrical conductivity of the heart
  • Gives info on rate and rhythm
  • Gives crude indications of cardiac chamber size
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108
Q

What is the wave in an ECG?

A

P
- Depolarisation of the atria
- Starting from SA node
QRS WAVE
- Depolarisation of ventricles
- From AV node
T
- Repolarisation of ventricles

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109
Q

What positions are the ECG leads attached to the patient?

A
  • RED = Right
  • YELLOW = Left
  • GREEN = Below sun
  • BLACK = Right hind
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110
Q

How should the patient be positioned for an ECG?

A
  • 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
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111
Q

How can radiography be used to look at the heart?

A
  • 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
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112
Q

What is the most common haemopoietic disease seen in practise?

A

Anaemia

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113
Q

What is erythropoiesis?

A

Formation of erythrocytes (RBCs)

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114
Q

What is lymphoid tissue?

A
  • Found in lymph nodes and spleen
  • Matures agranular leukocytes
  • Lymphocytes + monocytes
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115
Q

What is myeloid tissue?

A
  • Found in red bone marrow
  • Forms erythrocytes and granular leukocytes
  • Neutrophils, esinophils, basophils
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116
Q

What is serum?

A
  • Plasma minus clotting factors
  • Does not have fibrinogen or prothrombin
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117
Q

What is anaemia?

A
  • Reduced number of erythrocytes (RBCs)
  • Reduced haemaglobin concentration
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118
Q

What does anaemia lead to?

A
  • Reduced circulating oxygen
  • Causes hypoxia in tissues
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119
Q

How is anaemia classified?

A

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

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120
Q

What causes regenerative anaemia?

A

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)

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121
Q

What causes non-regenerative anaemia?

A
  • Bone marrow hypoplasia
  • Iron deficiency
  • Renal disease
  • Leukaemia
  • Lymphosarcoma
  • Lead poisoning
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122
Q

What are the clinical signs of anaemia?

A
  • Pale/jaundice MMs
  • Evident blood loss
  • Bounding, weak pulses
  • Tachycardia
  • Lethargy
  • Hypotension (if losing whole blood)
  • Inappetence
  • Dyspnoea/Tachypnoea
  • Exercise intolerance
  • Collapse/syncope
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123
Q

How is anaemia dianosed?

A
  • 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
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124
Q

What does epistaxis mean?

A

Nose bleed

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125
Q

How is anaemia treated?

A

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

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126
Q

What are the nursing considerations for aneamia?

A
  • Monitor vital signs
  • Pain scoring
  • Monitor hydration status
  • Encourage eating
  • Monitor fluid intake and output
  • Monitor excretions
  • Assess exercise tolerance
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127
Q

What type of fluids are least likely to be required in anaemia treatment?

A

Whole blood

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128
Q

What are the congenital coagulopathies?

A
  • Von Willebrand’s Disease
  • Haemophillia A
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129
Q

What is Von Willebrand’s Disease?

A
  • 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
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130
Q

What are the signs of Von Willebrand’s Disease?

A

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

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131
Q

How is Von Willebrand’s Disease diagnosed?

A
  • Biochem and haematology
  • Clotting profile
  • Activated clotting time
  • Von Willebrand factor
  • Platelet function test
    CARE WHEN BLOOD SAMPLING
  • Lots of pressure post venepuncture
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132
Q

How is Von Willebrand’s Disease treated?

A
  • 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
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133
Q

How can Von Willebrand’s Disease be detected in breeding programs?

A
  • Von Willebrand’s factor levels can be measured
  • Important in breeding
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134
Q

What are the nursing considerations for Von Willebrand’s Disease?

A

Same as anaemia

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135
Q

What is Haemophillia A?

A
  • Lack of clotting factor VIII
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136
Q

What are the signs of haemophillia A?

A
  • Haemorrhage into joints
  • Haematoma formation
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137
Q

What is the treatment of haemophillia A?

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
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138
Q

What are the nurse considerations of Haemophillia A?

A
  • Same as anaemia
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139
Q

What are the acquired coagulopathies?

A
  • Immune-mediated thrombocytopaenia
  • Anticoagulant rodenticide poisoning
  • Sever liver disease
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140
Q

What is immune-mediated thrombocytopaenia?

A
  • Immune system damages and destroys platelets
  • Leads to spontaneous bleeding
  • Can be idiopathic, from infection or inflammatory disease
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141
Q

What are the signs of immune-mediated thrombocytopaenia?

A
  • Bruising
  • Epistaxis
  • Haematemesis
  • Haematuria
  • Pale MMs
  • Tachycardia
  • Tachypnoea
  • Anorexia
  • Lethargy
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142
Q

How is Immune-mediated thrombocytopaenia diagnosed?

A
  • Biochem and haematology
  • Platelet count
  • Clotting profile
  • Thorax + abdomen radiographs
  • Ultrasound
  • CT
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143
Q

What is the treatment for immune-mediated thrombocytopaenia?

A
  • Immunosupressive therapy (steroids)
  • Blood transfusion
  • Treat underlying cause
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144
Q

What is anticoagulant rodenticide poisoning?

A
  • Rodenticides impair vitamin K production
  • Vit K required for some clotting factor functions
145
Q

What are the signs of anticoagulant rodenticide poisoning?

A
  • Severe haemorrhage
  • Especially into body cavities
146
Q

How is anticoagulant rodenticide poisoning diagnosed?

A
  • Biochem and haematology
  • Clotting profile
  • Toxicology
147
Q

What is the treatment for anticoagulant rodenticide poisoning?

A
  • Induction of emesis
  • Activated charcoal
  • Supplementary vitamin K
  • Frozen plasma
  • Supportive therapy (packed RBC transfusion)
148
Q

What is sever liver disease?

A
  • Clotting factors reduced
  • Lack of production in liver
149
Q

What is the treatment of sever liver disease?

A
  • Supportive + supplementary vitamin K
  • Frozen plasma
150
Q

How long does clotting process take in healthy patients?

A

3-5 minutes

151
Q

What is hypercoagulation?

A

Abnormal clotting

152
Q

What is IMHA

A
  • Immune-mediated haemolytic anaemia
  • Immune system attacks RBCs
153
Q

What is evans syndrome?

A

IMHA with immune-mediated thrombocytopoenia

154
Q

Why are plasma and transfusions used with vitamin K in treatment for anticoagulant rodenticide poisoning?

A
  • Vitamin K takes time to work
  • Plasma gives clotting factors immediately
155
Q

What are the signs of sever liver disease?

A

Same as anaemia

156
Q

When would coupage be contraindicated?

A

In patients with lung injury

157
Q

What is dysuria?

A

Difficulty urinating

158
Q

What is Polyuria?

A

Increased urination

159
Q

What is Oliguria?

A

Reduced urination

160
Q

What is Anuria?

A

Not urinating

161
Q

What is Pollakiuria?

A

Frequent urination in small amounts

162
Q

What is cystitis?

A

Inflammation of the bladder

163
Q

What is Tenesmus?

A
  • Straining
  • Urine or faecal
164
Q

What is Stranguria?

A

Small dribbles

165
Q

What is Haematuria?

A

Blood in urine

166
Q

What is Incontinence?

A
  • Lack of control of urination
  • Not aware
167
Q

Feline lower urinary tract disease

168
Q

Where does each endocrine gland sit?

A

Pituitary gland - base of brain
Thyroid gland - Lateral to trachea
Parathyroid gland - next to TG
Pancreas - along proximal duodenum
Ovaries - next to kidneys

169
Q

What is hyperadrenocorticism?

A
  • Cushsings syndrome
  • Production of excessive amounts of cortisol from the adrenal gland
170
Q

What is iatrogenic?

A

From excessive steroid administration

171
Q

What is cushings disease?

A
  • Hyperadrenocorticism
  • Production of excessive amounts of cortisol from adrenal glands
172
Q

What can hyperadrenocorticism be caused by?

A

PITUITARY TUMOUR
- Usually benign (PDH)
ADRENAL TUMOUR
- Can be benign or melignant
- (ADH)

173
Q

What are the clinical signs of hyperadrenocorticism?

A
  • 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
Q

What is hepatomegaly?

A

Enlarged liver

175
Q

What is calcinosis cutis?

A

Thickened, hard skin from calcium deposits

176
Q

Why can hyperadrenocorticism cause a pendulous abdomen?

A
  • Weakened abdominal muscles
  • Redistribution of abdominal fat
177
Q

What skin changes can be seen with hyperadrenocorticism?

A
  • Alopecia
  • Comedomes
  • Thinning skin
  • Lack of elasticity
178
Q

What diagnostic tests should be completed first when testing for hyperadrenocorticism?

A
  • Must have compatible signs and results before specific endocrine tests
  • Haematology (neutrophilia + lymphoaenia
  • Biochemistry
179
Q

Stress leucogram??

180
Q

What are the 3 parts of the vomiting reflex?

A

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
Q

What is the difference between vomiting and regurgitation?

A
  • Regurgitation is ejection of undigested food from larynx or oesophagus before reaching the stomach
  • Vomiting is from the stomach
182
Q

What is regurgitation from the pharynx?

A
  • Immediate
  • Undigested, neutral pH
  • Multiple swallowing attempts
  • Poor ability to drink
  • Dysphagia present
  • Can see dyspnoea and coughs
  • Food consistency can aggravate this
183
Q

What is regurgitation from the oesophagus?

A
  • 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
Q

What is vomiting from the stomach and proximal small intestine?

A
  • 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
Q

What can cause acute vomiting?

A
  • CNS disorders
  • Gastric/intestinal disease
  • Infections
  • Gastric foreign bodies
  • Intestinal foreign bodies
  • GDV (
  • Gastric mobility disorders
  • Inflammation
  • Haemorrhagic gastroenteritis
  • Metabolic disease
  • Acute pancreatitis …
186
Q

What CNS disorders can cause vomiting?

A
  • Vestibular disease
  • Epilepsy
187
Q

What gastric and intestinal diseases can cause acute vomiting?

188
Q

What is collitis?

A
  • Inflammation of colon
  • Often results in LI D+
  • Can confuse tenesmus + increased frequency with constipation
189
Q

What is osmotic diarrhoea?

A
  • Most common
  • Unabsorbed solutes increases faecal water
190
Q

What is secretory diarrhoea?

A
  • Increased secretion of fluids and ions
  • Or decreased absorption
  • Cause by bacteria, toxins, viruses and some laxatives
191
Q

What is permeability diarrhoea?

A
  • 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
Q

What is constipation?

A
  • Failure to pass faeces
  • Resulting in impaction
193
Q

What are the clinical signs of constipation?

A
  • Failure to pass faeces
  • Tenesmus
  • Hard faeces +/- blood
  • V+
  • Dyschezia
194
Q

What is Dychezia?

A

Pain while passing faeces

195
Q

How can constipation be diagnosed?

A
  • Physical/rectal exam
  • Radiography
  • Ultrasonography
  • Proctoscopy
196
Q

What is proctoscopy?

197
Q

What is the treatment for constipation?

A
  • Enemas
  • IVFT if dehydrated
  • Dietary changes
  • Lactulose
  • Bulking agents
  • Obstruction removal surgery
  • Increased exercise
198
Q

What are the causes of collitis?

A
  • Chronic inflammation
  • Infections secondary to SI fat maldigestion
  • Neoplasia/polyps
  • Motility disorders
  • Local irritation; prostatitis, peritonitis
199
Q

What are the diagnostic tests for collitis?

A
  • Clinical and rectal exam
  • Faecal analysis
  • Biochem + haematology
  • Radiography/ultrasonography
  • Biopsy
  • Protoscopy
200
Q

What is the treatment for colitis?

A
  • Hypoallergenic (hydrolysed) diet
  • Increased soluble + insoluble fibre
  • Dietary omega-3 fatty acids
  • Dietary changes often enough to control colitis
201
Q

What is cirrhosis?

A

Scarring
- Occurs in liver when 70-80% cell damage

202
Q

What is prostatic disease?

A
  • 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
Q

What are the signs of prostatic disease?

A
  • Faecal + urinary tenesmus/constipation
  • Flat faeces
  • Haematuria from infection/neoplasia
  • Dysuria/incontinence
  • Abdominal pain
204
Q

How is prostatic disease diagnosed?

A
  • Rectal examination
  • Ultrasonography/radiography
  • Prostatic wash + cytology
  • Urinalysis
  • FNA/biopsy
205
Q

How is prostatic disease treated?

A
  • 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
Q

What are the nursing requirements for prostatic disease?

A
  • Prevent urine scalding
  • Monitor urine + faecal output
  • Pain scoring
  • Post op surgical care
207
Q

What are testicular tumours?

A
  • Most common; sertoli cell, interstitial cell (leydig cell)
  • Most important; sertoli cell
  • Usually related to retained testicle
208
Q

What are the signs of testicular tumours?

A
  • Feminisation; increased oestrogen
  • Alopecia
  • Gynecomastia; mammary development
  • Pendulous prepuce
  • Bone marrow suppression
209
Q

How are testicular tumours diagnosed?

A
  • Clinical signs and exam
  • Are they castrated?
  • Blood test; oestrogen concentration
210
Q

How are testicular tumours treated?

A
  • Surgical removal
  • Chest radiographs needed to check for metastases
211
Q

What is pyometra?

A
  • 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
Q

What are the signs of pyometra?

A
  • 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
Q

How is pyometra diagnosed?

A
  • Clinical signs
  • Abdomen palpation
  • Radiograph/ultrasonography
  • Vaginal swab
214
Q

How is pyometra treated?

A
  • Ovariohysterectomy
  • May need medical stabilisation
  • IVFT and antibiotics
  • Aglepristone treats medically to empty uterus if open
  • Medical treatment can lead to complications
215
Q

What is false pregnancy?

A
  • Pseudopregnancy/pseudcyesis
  • More common in bitches
  • Unknown causes
  • Usually worse after each season
216
Q

What are the signs of false pregnancy?

A
  • Signs seen 6-8 weeks post oestrus
  • Mainly behavioural changes
  • Nesting and mothering toys
  • Mammary development and mastitis
217
Q

How is false pregnancy diagnosed?

A
  • Easily recognised from signs
  • Must rule out pregnancy
218
Q

How is false pregnancy treated?

A
  • 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
Q

What are mammary tumours?

A
  • More common in bitches
  • 50% are benign in bitches
  • 80% are malignant in cats
  • Mammary carcinoma is malignant
220
Q

What are the signs of mammary tumours?

A
  • Enlarged, lumpy mammary tissue
  • Can become large and ulcerated if left
221
Q

How are mammary tumours diagnosed?

A

FNA/biopsy

221
Q

How are mammary tumours treated?

A
  • 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
Q

What is an antiprolactin?

A
  • Cabergoline
  • Manages pseudopregnancy
  • Stops lactation
223
Q

What is aglepristone?

A
  • Termination of pregnancy
  • Used up to 45 days post mating
  • Medical treatment of pyometra
224
Q

What is proligesterone?

A
  • Synthetic progesterone
  • Used for oestrus control
  • Treats false pregnancy
225
Q

What is delmadinone?

A
  • Progesterone injection
  • Used as chemical castration
  • Reduced libido, not infertility
226
Q

What is deslorelin?

A
  • Chemical castrate implant
  • Induced temporary infertility in healthy entire male dogs
  • Takes 6 weeks for full effects
  • Lasts 6 months
227
Q

What is elbow dysplasia?

A
  • Abnormal development of elbow joint
  • Usually inherited
  • Affects young giant and large breed dogs
228
Q

What are the clinical signs of elbow dysplasia?

A
  • Lameness
  • Lifting head when affected leg put down
  • Limping
  • Arthritis in older age
229
Q

How is elbow dysplasia diagnosed?

A
  • Radiography
  • CT scan
  • MRI
  • Elbow arthroscopy
230
Q

How is elbow dysplasia treated?

A
  • Weight management
  • Physio/hydrotherapy
  • Anti-inflammatory medication
  • Stem cell treatment
  • Total elbow replacement
231
Q

How can cases of elbow dysplasia be reduced?

A
  • BVA/KC elbow scoring scheme
  • Assess predisposed breeds before breeding
  • Aim to eliminate/reduce occurrence
232
Q

What is patella luxation?

A
  • Dislocation of patella
    CONGENITAL
  • Anatomical deformities at birth
  • Can be inherited
    AQUIRED
  • Result of trauma
233
Q

What are the clinical signs of patellar luxation?

A
  • Inability to extend stifle joint
  • Lameness
  • Non-weight baring
  • Deformity
  • Small fractures
  • Pain
  • Abnormal gait (skipping)
234
Q

How is patellar luxation diagnosed?

A
  • Radiography
  • CT scan
  • MRI
235
Q

How is patellar luxation treated?

A
  • 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
Q

What is the cruciate ligament?

A
  • Normal stifle joint has 2 cruciate ligaments
  • Form a cross to stabilise joint
  • Menisci serve as shock absorber
237
Q

How is cruciate rupture caused?

A

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
Q

What are the clinical signs of cruciate rupture?

A
  • Acute onset lameness after trauma
  • Pain
  • Limping
239
Q

How is cruciate rupture diagnosed?

A
  • Manipulating joints to assess cranial draw
  • Radiography
  • MRI
  • Exploratory surgery/arthroscopy
240
Q

How is cruciate rupture treated without surgery?

A
  • Anti-inflammatory medication
  • Weight management
  • Physio/hydrotherapy
  • Dogs <15kg normally stabalise
  • Dogs >15kg may require surgery
241
Q

How is cruciate rupture treated with surgery?

A

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
Q

What are the clinical signs of conjunctivitis?

A
  • Uni/bilateral inflammation of conjunctiva
  • Blephrospasm
  • Increased lacrimation
  • Oedema/swelling
  • Ocular discharge
243
Q

What is the treatment for conjunctivitis?

A
  • Visually diagnosed
  • Antibiotic, antiinflammatory or antiviral eyedrops
  • Remove foreign bodies
  • Surgical correction of eyelids
244
Q

What are the clinical signs of entropion?

A
  • Inward turning of eyelids
  • Blephrospasm
  • Squinting
  • Increased lacrimation
  • Ocular discharge
245
Q

What are the clinical signs of ectropion?

A
  • Outward turning eyelids
  • Blephrospasm
  • Squinting
  • Increased lacrimation
  • Ocular discharge
246
Q

What are the clinical signs of distichiasis?

A
  • Extra rows of eyelashes
  • Blephrospasm
  • Squinting
  • Increased lacrimation
  • Ocular discharge
247
Q

What is the treatment for entropion, ectropion and distichiasis?

A

-Visually diagnosed
- Anti-inflammatory or antibiotic eyedrops
- Surgical correction

248
Q

What are the clinical signs of a corneal ulcer?

A
  • Ocular pain
  • Ocular discharge
  • Blephrospasm
  • Increased lacrimation
249
Q

How are corneal ulcers diagnosed?

A
  • Visual diagnosis
  • Fluorescein dye to expose epithelial erosion
250
Q

What are the treatments for corneal ulcers?

A
  • Remove cause
  • Antibiotics
  • Analgesia
  • Contact lens placement
    Surgery; debridement, grid kerarectomy
251
Q

What are the clinical signs of cataracts?

A
  • Lens clouding
  • Poor vision
  • Blindness
  • Common with diabetes mellitus
252
Q

What is the treatment for cataracts?

A
  • Visually diagnosed
  • Surgical treatment
253
Q

What are the clinical signs of glaucoma?

A
  • Increased intra-ocular pressure
  • Painful red eyes
  • Corneal oedema
  • Globe swelling
  • Dilated pupil
  • Retinal damage
254
Q

How is glaucoma diagnosed?

A
  • Ophthalmoscopy
  • Measure intra-ocular pressure
255
Q

How is glaucoma treated?

A
  • Emergency; IV mannitol to draw out fluid
  • Carbonic anhydrase inhibitors reduces aqueous + vitreous humour production
  • Miotics increase aqueous outflow
  • Analgesia
  • Enucleation
256
Q

What nursing considerations are there for eye condtions?

A
  • Pain scoring
  • Analgesia
  • Bathe eyes
  • Apply barrier cream under eyes
  • Avoid cross-contamination
  • Minimise environmental dust
  • Prevent patient interference
257
Q

What are the nursing considerations for patients with impaired vision?

A
  • Avoid hazards
  • Always keep on lead
  • Avoid moving furniture
  • Reassure patient of presence
258
Q

What are the clinical signs for otitis externa?

A
  • Head shaking
  • Scratching
  • Pain
  • Smell
  • Aural haematoma
  • Head tilt
  • Heat
  • Redness
259
Q

How is otitis externa diagosed?

A
  • Otoscopic examination
  • Swabs; cytology culture + sensitivity, microscopy of discharge
260
Q

What is the treatment for otitis externa?

A
  • Topical antibiotics
  • Anti-inflammatories
  • Antifungals
  • Cleaning
  • Surgery; lateral wall resection, total ear canal ablation
261
Q

What are the clinical signs of otitis media?

A
  • Head shaking
  • Horners syndrome; miosis, upper eyelid droop
  • Extension of otitis externa
262
Q

How is otitis media diagnosed?

A
  • Radiography of tympanic bullae
  • Aspiration of bullae contents
263
Q

How is otitis media treated?

A
  • Systemic antibiotics
  • Severe cases may require bullae ostotomy
264
Q

What are the clinical signs of otitis interna?

A
  • Head tilt
  • Nystagmus
265
Q

What is meosis?

A

Constricted pupil

266
Q

How is otitis interna diagnosed?

A
  • Radiography of tympanic bullae
  • Aspiration of tympanic bullae
  • MRI/CT scan
267
Q

What is the treatment for otitis interna?

A
  • Antibiotics
  • Steroids
  • Surgery
268
Q

What are the clinical signs for vestibular syndrome?

A
  • Nystagmus
  • Strabismus
  • Ataxia
  • Mental depression
  • Neurological signs
  • Horners syndrome
  • Nausea
  • Signs of external ear disease
269
Q

What is Horners syndrome?

A
  • Upper eyelid droop
270
Q

How is vestibular syndrome diagnosed?

A
  • Neurological assessment
  • MRI/CT scan
  • Cerebral spinal fluid analysis
271
Q

How is vestibular syndrome treated?

A
  • Treat underlying cause
  • Comfortable environment
  • IVFT
  • Assisted feeding
272
Q

What nursing consideration is important when treating patients with ear conditions?

A
  • May not hear clearly or be deaf
  • Always approach so they can see
273
Q

How is contact dermatitis caused?

A
  • Commonly by soaps
  • Any detergent or chemicals
274
Q

What are the clinical signs of contact dermititis?

A
  • 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
Q

How is contact dermatitis treated?

A
  • Avoid contact with identified allergens
276
Q

How is contact dermatitis diagnosed?

A
  • Patch testing to check for reactions
  • Contact elimination to see if resolves then reintroduce and observe for reaction
277
Q

How is food hypersensitivity caused?

278
Q

What is pruritis?

279
Q

What is alopecia?

A
  • Hair loss
  • Can be symmetrical, patchy, partial, complete, diffuse or focal
  • Can be associated with hormonal disease
280
Q

What is atopy?

A
  • Allergic skin disease
281
Q

What is erythema?

282
Q

What is pyoderma?

A

Bacterial skin infection

283
Q

What is seborrhoea?

A
  • Excessive sebum production
284
Q

How do tumours grow in different stages?

A
  • Early, rapid growth
  • Slow down and reach plateau
  • Growth normally slowed when clinically detectable
285
Q

What is tumour doubling time?

A

Time takes for tumour to double in size

286
Q

What is tumour growth fraction?

A
  • Cell Cycle time
  • Time for dividing cells to complete process of cell division
287
Q

What is the difference of rate of growth between benign and malignant tumours?

A

BENIGN
- Relatively slow
- Growth can stop in some cases
MALIGNANT
- Often rapid
- Rarely stops growth

288
Q

What is the difference in manner of growth between benign and malignant tumours?

A

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
Q

What is the difference in effects on surrounding tissue between benign and malignant tumours?

A

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
Q

What is the difference in metastasis between benign and malignant tumours?

A

BENIGN
- Does not occur
MALIGNANT
- Spread through lymph and blood
- Can spread throughout body cavities

291
Q

What is the difference in effect on host between benign and malignant tumours?

A

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
Q

What is the difference between malignant tumours metastasising via lymph and blood?

A

LYMPH
- To local and regional lymph nodes
BLOOD
- Secondary tumours can develop in any body organ

293
Q

Where are secondary tumours most commonly found in small animals?

A
  • Most common in lungs
  • Liver, spleen, kidneys, skin, bone
  • None should be ignored
294
Q

What is the most life threatening characteristic of malignant tumours?

A

Ability to spread and grow in distant organs

295
Q

What is a mast cell tumour?

A
  • Malignant
  • Found on skin
  • Histamine release causes acute inflammation in skin
296
Q

What is a squamous cell carcinoma?

A
  • Malignant
  • Found in squamous epithelium
  • Found in oral cavity
297
Q

What is a histiocytoma?

A
  • Benign
  • Found in skin
  • Formed from histiocytes
  • Immune cells in skin
298
Q

What is a lipoma?

A
  • Benign
  • Made of adipose tissue
  • Common in older, overweight animals
299
Q

What is a liposarcoma?

A
  • Malignant
  • Made of adipose tissue
  • Rare
300
Q

What is an osteosarcoma?

A
  • Malignant
  • Found in bone
  • Tumour of osteoblasts
  • Usually in limb bones
301
Q

What is a haemangiosarcoma?

A
  • Malignant
  • Found in vessels
  • Tumours can develop anywhere
302
Q

What is a lymphoma?

A
  • Benign
  • Found in lymphocytes
  • Can be called benign lymphoid hyperplasia
303
Q

What is a transitional cell carcinoma?

A
  • Malignant
  • Found in the bladder
304
Q

What is a thyroid adenoma?

A
  • Benign
  • Found on thyroid gland
  • May present as hyperthyroidism
305
Q

What is a thyroid adenocarcinoma?

A
  • Malignant
  • Found in mammary glands
  • Common in older entire females
306
Q

How can true diagnosis of tumours be made?

A
  • Microscopic examination of cells collected from tumour
    HISTOLOGY
  • Biopsy
  • Most accurate
    CYTOLOGY
  • Fine needle aspirate
  • Not definitive diagnosis
  • Useful for neoplasia investigation
307
Q

What is needed before starting therapy for tumours?

A

Vital to diagnose before starting treatment

308
Q

How can tumours be treated?

A
  • Surgery
  • Radiation
  • Antinroplastic/cytotoxic chemotherapy
  • Must be tailored to suit individual cases
309
Q

What is the most effective treatment for majority of solid neoplasms in animals?

A
  • Surgery
  • Best chance for curing
310
Q

What is the primary objective of surgery on tumours?

A
  • 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
Q

What are the different types of surgical excision of tumours?

A

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
Q

Which tumour treatment is often restricted to larger referral institutes for animals?

A
  • Radiation therapy
  • Due to lack of equipment facilities
313
Q

What is radiation therapy for tumours?

A
  • 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
Q

What types of radiation are used in radiation therapy?

A
  • X rays
  • Gamma rays
  • Electrons
  • Can be applied via external beam or implanted into tumour
315
Q

What is chemotherapy?

A
  • 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
Q

What do all chemotherapy agents act upon?

A
  • Process of cell growth and division
  • Most effective against growing and dividing cells
317
Q

What important factors need to be considered when administering chemotherapy?

A
  • 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
Q

What are the stages and grades of tumours?

A
  • 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
Q

What levels do chemotherapy normally consist of?

A

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
Q

What are the complications of chemotherapy?

A
  • 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
Q

What chemotherapy toxicity is associated with cyclophosphamide?

A
  • 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
Q

What chemotherapy toxicity is associated with doxorubicin?

A
  • Cardiotoxicity
  • Chronic changed with cumulative doses
  • Can lead to irreversible cardiomyopathy
323
Q

What chemotherapy toxicity is associated with cisplatin?

A
  • Nephrotoxicity
  • Can cause acute tubular necrosis
  • Can effect renal blood flow
  • IVFT must be given with this
324
Q

Why are safety precautions are needed for safely handing cytotoxic drugs?

A
  • Carcinogenic and mutagenic
  • Some are teratogenic
  • Some extremely irritant
  • Produce harmful local effects after direct contact with skin or eyes
325
Q

How are cytotoxic drugs available?

A
  • Tablets / Capsules
  • Powders
  • Solutions for injection
326
Q

What factors must be considered for tablets/capsules of cytotoxic drugs?

A
  • 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
Q

When is the main risk of exposure to injectable cytotoxic drugs?

A

During preparation and administration

328
Q

What are the minimum PPE requirements for injectable cytotoxic drugs?

A
  • 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
Q

How should injectable cytocoxic drugs be reconstituted?

A
  • 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
Q

How should injecable cytotoxic drugs be administered?

A
  • Luer lock preferred over push connections
  • Patients must be restrained effectively by trained staff with full PPE
331
Q

What should be done in the case of a spillage of injectable solution of chemotherapy?

A
  • Mopped up using absorbent towel
  • If powder, towel should be damp
  • Contaminated surfaces should be washed with lots of water
332
Q

How should waste be disposed of following administration of cytotoxic waste?

A
  • 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
Q

What does carcinogenic mean?

A

Cancer causing

334
Q

What does mutogenic mean?

A

Includes mutations

335
Q

What does teratogenic mean?

A

Malformation of embryo / phoetus

336
Q

What is the menace response check?

A
  • 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
Q

What is the central nervous system?

A
  • Brain and spinal cord
338
Q

What is the peripheral nervous system?

A
  • All nerves off from the CNS
  • Cranial nerves
  • Spinal nerves
  • Autonomic nervous system; nerve fibres from brain and spinal cord
339
Q

What is a seizure?

A
  • Altered electrical activity in brain
  • Symptom of disease
  • Not a diagnosis
340
Q

How are the signs of seizures divided into phases?

A

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
Q

What is epilepsy?

A
  • Multiple seizures
  • Metabolic disorder in brain cells
  • More common in dogs than cats
  • Can be inherited
  • Young animals normally effected (1-5 years)
342
Q

What are the clinical signs of epilepsy?

A
  • True seizure
  • Loss of consciousness
  • Bowel and bladder evacuation
  • Collapse
  • Clonic (twitches)/Tonic (rigid)
  • Vocalisation
  • Jaw chomping
343
Q

How is epilepsy diagnosed?

A
  • Ruling out other causes
  • MRI/CT scan
344
Q

How is epilepsy treated?

345
Q

What is passive physiotherapy?

A
  • Coupage
  • Petrissage
  • Friction
  • Efflurage
  • Passive joint movement
346
Q

What is coupage?

A

Striking the chest with cupped hands

347
Q

What is Petrissage?

A
  • Chinese burn/twisting skin
  • Aids lymph return
348
Q

What is Friction physiotherapy?

A
  • Circular massage movements
349
Q

What is efflurage?

A
  • Massage distal to proximal
  • Aids lymph return
350
Q

What is passive joint movement?

A
  • Moving joint through normal ranges
351
Q

What is active physiotherapy?

A
  • Animal has to perform the movements
  • Therapeutic exercises
  • Apparatus
  • Hydrotherapy
352
Q

What are therapeutic exercises?

A
  • Harness controlled lead walks
  • Walking up and down slopes
  • Walking over different surfaces
  • Weave poles
353
Q

What apparatus can be used in active physiotherapy?

354
Q

What is hydrotherapy?

355
Q

What is the primary aim of a neurological examination?

A

Determine the location of any pathological process

356
Q

What should be the first part of a neurological examination?

A
  • Hands off examination
  • Watch how the patient moves on their own
357
Q

What spinal reflexes can be tested in a neurological examination?

A
  • Patellar reflex
  • Cranial tibial reflex
  • Extensor carpi radialis
  • Perinneal reflex

Vet Nurse Small Animal Diploma CQ (14 decks)

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