SAM I- Final Flashcards
Cat is prsents with upper respiratory disease with Punctuate/dendritic ulcers. . DDx?
Herpes
Dog presented for lamness and pneumonia, Has ulcers on his nose, tongue, hard palate. DDx?
Calici
Kitty presents with Conjunctivitis and chemosis. Dx?
Chlamydophila felis
T/F Calici & chlamydophila can shed without distress
True
You perscribe topical decongestants and supportive treatment(humidifier) to a herepes positive kitten. Why did the Senior vet laugh/be-disappointed-in-you and say the kitten will be back soon?
You did not prescribe systemic antibiotics
Which nerve provides lifelong latency for herpes?
Trigemnial ganglia
What are the three main complications of recurrent Herpes?
- Chronic rhinitis/sinusitis (turbinate damage predisposes to secondary bacterial infections of the nasal cavity) 2. Chronic conjunctivitis 3 Fibrosis of the lacrimal ducts= epiphora
Kathy has a kitty with herpes. How do you make the kitty better?
Ocular: Topical antivrals Oral lysine Supportive- fluids, antibiotics
“But I gave my kitty a vaccination for Herpes” and you reply with “…
1) does not protect from infection 2) does not reduce severity Intranasal; only useful for outbreaks
Can comes with with ulcers around nose and tounge with pneuonia. “my other Vet vaccinated against Calici”. What’s the probable Dx?
Calici…. still High mutation rate, no cross protection from vaccines or strains.
Which is more common. FCV with Pneumonia or Herpes with Pneumonia?
FCV w/ pneumonia
What should/can you look out for in an animal that has Calici?
GI signs Lameness
A kitten comes in with lamness and ulcers on his paws w/ sore joints. Dx?
FCV- Calici Limping kitten syndrome; one of the two
Clients cat is diagnosed with FCV- VIrulent hemorrhagic systemic syndrome. What’s the prognosis? (mortality rate?)
40-60% mortality rate FCV- Virulent hemorrhagic systemic syndrome.
What’s the difference in treatment between FCV and Herpes?
There is none; supportive, Interferon may be effective, Sequealae
Cat walks in with Conjunctivits and chemosis. Dx?
FUCKING CHLAMYDOPHILA FELIS
Kitty is congested with Upper respiratory signs. How do you treat?
Topical decongestants; Phenylephrine keep warm & hydrated
The new vet struts in to the break room after diagnosing her first case upper respiratory problems. “what was it?” everyone asks. Her answer “Bacterial rhinitis”. What causes the others vets insecurity and possible to call the patient back in?
Bacterial rhinitis is rarely a primary disease; dig for other possibilities
A long nosed dog presents with snot. Your physical exam reveals Nasal ulceration and depigmentation. What should be your next diagnostic step?
Imaging [nasal aspergillosis] Rhinoscopy white plaques Radiographs- not very helpful CT/MRI
Doggy diagnosed with Nasal Aspergillus; what du?
Debride Infuse; Clotrimazole, enilconazole Repeat if sings persist after 2 weeks
Unilateral discharge in a dog. Plaque on rhinoscopy. Dx?
Aspergillosis
Cat has upper respiratory signs and you suspect Cryptococcosis. What is a reliable way to test?
Serum titer test is very reliable for Cryptococcus.
How do you treat an Upper respiratory cat with cryptococcosis?
systemic Conazoles
Dog presents with sneeze and reverse sneezing. Dx?
Pneumonyssus caninum Parasitic; nasal mites
A dog ‘Nosey’ presents with recurrent inflammatory rhinitis and reverse sneezing. A accompanying vet suggests a biopsy (histopathologcal diagnosis); what is she/he thinking?
Lymphoplasmacytic Rhinitis (LPR) (common in dogs with long noses)
A dog is shown to have destruction of the nasal septum. Which DDx is thrown out?
LPR- does not usually cause damage to the nasal septum, frontal sinus, cribiform plate
On rhinoscopy of a dog you notice; Red, edematous mucosa, bleeds easily, turbinate atrophy and destruction. What do you need before you can make a Dx?
Radiography to ensure cruciform plate is enact Biopsy and histopathology Can differentiate between neoplasia and fungal rhinitis
How do you treat LPR?
Nothing proven can; nasal steroids, long term doxycycline (or azithromycin) with NSAIDS –flushes –maropitant (cerenia)
MoA of Cerenia
Blocks substance P
Dog who has presented in the pass with nasal problems is brought in again, This time with dysphagia. On physical exam you notice one nostril does not have airflow. Dx?
Nasal cancer
“Doctor, My fluffy has been diagnosed with nasal carcinoma. How long does it have to live?”
Well my sultry minx. 12-16 months with debridment/radiation 3-6 without treatment
which tumors provide better survival times?
Adenocarcinomas and Sarcomas
Which tumors provide poor-er surival times?
Undifferentiated carcinomas and squamos cell carcinoma
Who lives longer with radiation therapy? Dogs/cats
Cats- because fuck cats
You find a neoplasia in the nose. It is most likely what? (malignant or non)
Most are Malignant
which neoplasias are more common in cats?
Lymphomas and adenocarcinomas
Dog presents with Bronchitis, has presented with bronchopneumonia in the past and shows signs of a developing Respiratory tract infection. Top DDx?
PCD (Primary ciliary dyskinesia)
What is Kartageners syndrome?
Bronchiectasis, complete transposition of viscera (situs invertus) and CHRONIC RHINOSINUSISiTS
You suspect PCD, What is the most reliable way to confirm it?
Culturing ciliated cells from biopsy samples
Hey Doc, What type of disease is PCD?
Inherited autosomal recessive Ciliary dysfunction
Dog presents with a non productive cough and retching/gaging. Top DDx?
Tracheal & Bronchial disease
T/F Kennel cough is only associated with one organism
False: Kennel cough often includes secondary bacterial invaders Think: Viruses and bacteria
An owner is confident that FiFi doesn’t have to be checked in on because it’s been two days since the Kennel cough outbreak at the dog show. Why do you tell her she’s wrong? (in nice words of corse)
Kennel cough incubation time is 3-7 days. Tell her to look for Cough
Do presents happy and alter with a dry-cough on tracheal palpation. Also has serous oculonasal discharge. Top DDx?
Uncomplicated Kennel Cough
What to agents can lead Kennel cough to show sever signs?
Mycoplasma & Bordetella
What two agents can lead to kennel cough showing mild signs?
Parainfluenza and Canine adenovirus 2 (also Mycoplasma and bordetella but they are known for sever signs as well)
T/F Complicated Kennel cough will only show with lower airway symptoms
False: Complicated is both UPPER and LOWER problems
What will you see on the work up for a Kennel Cough Dog; Hemogram-? thoracic rads-? PCR-?
Kennel Cough: Hemogram- Leukocytosis with left shift Thoracic rads- bronchopneumonia Positive PCR
Do presents with Complicated Kennel cough; How do you treat?
Gentamycin x2 weeks. NOT Penicillin Cough suppressants (if unproductive)
A cat presents acutely with mucosal edema, excessive mucus production and neutrophilic inflammation and chronically with a cough. Dx?
Chronic bronchitis
What happens in untreated feline astma?
Permanent changes- fibrosis and emphysema
A dog is presented for bumping into things. IOP is 26. DDx?
Hypertension &; Retinal detachment
What topical anesthetic is used in the eye exam?
proparacaine- topical anesthetic
A dog presents with 10 mm/min schirmer test. Is this abnormal?
Yes, it is under-production Dogs >15 mm/min
A dog walks in with Glaucoma. What do you do?
You DON’T perform anything that needs mydriasis
Where is the tapetum on the indirect examination?
It is reflected dorsally
Cat presents with hyperemia and blepharospasm. This cat had also been to see another vet to have topical antibiotics for an eye ulceration. Dx?
cats have been shown to have hypersensitivity to topical tetracyclines
T/F Exopthalmos has a different sized globe; hence why it moved out of the socket
False; Exopthalmos can have normal sized globe
What is Exenteration?
Exenteration: Removal of globe and orbital contents
What is Orbital cellulitis?
Generalized swelling of the Orbit
The Vet you are working along side suggests Idiopatic inflammation (cellulitis) as the diagnosis of a cat that came in; what does she/he need to prove it?
Evidence that there are no other causes (puncture, foreign body, infectious) It is a rule-out diagnosis
A great dane comes in with exopthalmos and a pain on the opening of his mouth during physical examination. Treatment?
He has Orbital cellulitis(or possible retrobulbar abscess) Topical & systemic antibiotics, Broad spectrum (pending culture), anti inflammatory
Do presented with exopthalmos that can be retropulsed. Primary DDx?
Extraocular polymyositis –confirm with preservation of the temporalis and masticator muscles
How do you treat Extraocular polymyositis?
Tx (extraocular polymyositis) Immunosuppressive corticosteroids (slow taper)
5 year old Bassett hound with recent progressive eye swelling mild discomfort. What is a good ‘intro’ step after the ultrasound suggests a neoplasia?
Try to rule out neoplasm; Ultrasound guided biopsy.
What is proptosis?
in ability for animals to close their eye.
What is the prognosis of the eye in proptosis?
only 27% of proptosed canine eyes retained vision.
What am I?
>2cm
Bulla
What am I?
Macule
What am I?
Pustule
What am I?
Wheal
What am I?
Plaque
What am I and what preceeded me?
Epidermal collarette
pustules or vesicles can preceed me
what am I?
Lichenification
A canine presents for Neurologic KCS. How do you treat?
Pilocarpine PO
(or any parasympathomimetic)
and
Eyeways
How do you treat KCS?
Stimulate tear production; Cyclosporine A/tacrolimus
Control secondary inflammation or infection
Lubrication/artifical tears
T/F sclearl conjuctiva are movable
True
You culture Gram positive cocci from a dogs conjunctival. Should you Freak/Treat?
If there is no problem; No, do not treat.
Gram positive cocci can be common commensal microflora of the conjunctiva.
What is Blepharospasm?
Blepharospasm:
it’s a sign of pain seen in conjunctivits.
What is ankyloblepharon?
Ankyloblepharon; fusion of the eyelids
What is symblepharon?
Symblepharon;
Partial or Complete adhesion of the palpebral conjunctiva of the eyelid to the bulbar conjunctiva of the eyeball.
Which dogs are predisposed to congenital acinar hypoplasia? (KCS)
KCS
Yorkies and Chihuahuas
What is descemet’s membrane?
Descemet’s membrane:
A thin basement layer of elastic collagen
What are examples of Ulcerative keratitis?
Corneal ulcers
Superficial punctate keratitis
Bullous keratopathy
Corneal lacerations & foreign bodies
What am I?
Non-healing Superficial ulcer (chronic)
chronic corneal epithelial defect, indolent ulcer, boxer ulcer
What am I?
Deep Corneal ulcer:
See creater-like lesion of variable depth in cornera.
Includes descemetocele and melting ulcer
What can happen if corneal laceration is deep?
Deep corneal laceration;
Exude aqueous humor
&
Iris prolapse
If you suspect a Descement membrane disruption. How long is recovery?
A new descemet’s membrane takes several weeks.
How long does it take to recover from Corenal surgery?
Corneal remodeling occurs over several months
How does the Lens age?
Old fibers are compressed which increases nuclear density which alters ligh refraction eventually; pushed inward.
What are 3 aquired Lense Disorders?
Acquired:
Nuclear/lenticular sclerosis
cataracts
Luxations
T/F
Acute lens luxations are not painful
False;
Acute lens luxations are painful
T/F
All Dogs have the same platlets
Cavleer’s have macrocytic platlets with lowered number
How do you coun’t platelets with oil immersion?
Count the number of platelets in 10 oil immersion fields
Dog; Multiply by 1.5x10^9
Cats: multiply by 2x10^9
What are the four ways platlets can be depleated?
- Production problem
- Platelet destruction
- Increased demand/consumption (acute hemorrhage, DIC/vasculitis)
- Sequestriation
What can be the source of Marked thrombocytopenia?
INfectious
if not then—
neoplasia
if not then—
bonemarrow
Hercules (dog) presents anemic. Normal RBCs but thrombocytopenia. Would a bone aspirate be helpful?
No, will always have other RBC type involvment if there are bone marrow problems.
how quickly should you see a re-bound in platelets for IMTP and Erlichiosis?
3-5 days
How much depletino of coagulation factors do you need before dysfunction?
90%
What test do we use to gauge predispoistion to thromboembolisic events?
D-dimer test
Warning: not sensitive.
What is important to consider the adiminstration of Vincristine?
Vincristine administration: Are the platlets actually functional
What can you use to treat Von Willebrands disease?
Cryopricipitate- lasts 4 hours
Desmopressin- lasts 2 hours
Dog presents with Caudal dorsum alopecia. DDx?
Flea allergy
What is a likely DDx?
(elbow and ear alopecia)
Sarcoptic mange
Doggy presents with Feet licking, chewing;
DDx?
“Rears and ears” = food alergy
Feet licking, chewing= atopy or food alergy
T/F
Atopy is seasonal
Sorta trick question:
It can be both Seasonal and Non-seasonal
What are the diseases we rate with Grade 10 puritis? (the worst)
Scabies
Flea allergy
Food allergy
What are examples of Deep Pyodermas?
Folliculitis/Furunculosis
Lick granuloma (acral lick dermatitis)
What are some examples of Superficial pyodermas?
Impeetigo (puppy pyoderma)
Superficial bacterial folliculits
What is an example of Surface pyoderma?
Pyotraumatic dermatitis (hot spot)
What kind of pyoderma is this?
Surface pyoderma:
Intertrigo
Hotspot/pyotraumatic dermatitis
What am I?
Superifical pyoderma:
epidermal layer and/or hair follicles
Papules, pustules, epidermal collarettes crusts
What layer is disrupted?
Dermal layer or subcutis plus follicles
Exudation of blood and/or pus, crusting, odor, ulceration, tract, fistula, swelling
T/F
If You suspect surface pyoderma you should culture.
False:
If you suspect surface pyoderma
What denotaes a partial response?
Decrease in tumor volume of >50%
What denotaes a stable disease (oncology)?
Decrease of <50%
but
no increase >10%
What is progressive disease?
>10% growth of the tumor
What cell cycle phase are most rapidly dividing tumors at?
Go
What is “Growth Fraction” and how do we use it?
It’s the ratio of G1/2:G0
The higher the growth fraction the greater the efficacy of chemotherapy.
When do cytotoxic drugs work most effectively on tumors
(in respect to the tumor growth curve)?
Early on
When are single drug protocols used?
If cell type is particularly sensitive (TVT, or CML)
In combination with surgery/radiotherapy to prevent metastases
Name some Phase non-specific agents:
Alkylating agents
Anti-tumor antibiotics
Miscellaneous
What are two things we need to keep drugs from doing in multi-drug regiments?
Drug toxicites should not overlap
Drugs should not INTERFERE with each other
What’s the down side of CHOP?
It is a highly toxic Protocol
What is the general outline for the treatment of Lymphoma (hemopoeitic tumors)?
Induction- intense treatment (risk of toxicity)
Consolidation: unrelated rugs to reduce surivial
Maintenance: prolongs relpase
Rescue: no longer in remission, use unrelated/alkylating drugs
What is the progression (works best on -> works the least) of chemoteraphy reponsive tumors?
Best
Hemopoietic
Mast cell tumors
Solid carcinomas/sarcomas
worst
When do seizures usuallyhappen with hypoglycemia?
BG <45-50 mg/dL
Seizures
How do you treat hypoglycemia?
NOT DEXTROSE
Prednisalone
(Diazoxide if you have the money)
What are the three causes of the most severe puritis?
Scabies
Flea allergy
Food allergy
What layer does Pyotraumatic dermatitis effect?
Surface- pyotraumatic dermatitis
What layer of the skin does Impetigo cause pyoderma?
Superficial - Impetigo
What layer of the skin does Folliculitis/furunculosis cause pyoderma?
Deep- Folliculitis/ furunculosis
What layer do Lick granulomas cause pyoderma?
Deep- Lick granuloma
How do we diagnose pyoderma?
Pustules, papules, Crust
(presence of bacteria rules in pyoderma)
Which topical is good against Pseudomonas?
Silver sulfadiazine
Which topical can you use against MRSA?
Mupirocin
What do you use for pyoderma with oily seborrhea or comedomes?
Benzoyl peroixde
What do you use for pyoderma with dry seborrhea or normal skin/coat?
Chlorhexidine
What level of antibiotics is Fluoroquinolones?
3rd Tier; LAST RESORT
How long does simplicef work?
24hrs
How lone does Convenia work?
1-2 weeks
T/F
You have to place a cest tube with Diaphragmatic herniorrhaphy
False:
You do not need a chest tube for Diaphragmatic herniorraphy.
Can use a butterfly catheter with a 3-way-stop’
What is this?
Peritoneopericardial Diaphragmatic Hernia
PPDH
