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23 spring: med surg > Test 1: 15+16: large animal > Flashcards

Test 1: 15+16: large animal Flashcards

1
Q

2nd degree AV block has what type of rhythm

A

regularly irregular

pause or dropped beat
S4 not followed by S1

conduction through AV node blocked

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2
Q
A

2nd degree AV block

missed beat: conduction through AV node blocked

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3
Q

2nd degree AV block can be a normal finding that —

A

goes away with exercise or drugs that increase sympathetic and decrease parasympatetic tone

from high vagal tone

15% of short EKG will show, 44% on 24 hr EKG

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4
Q

— is a variation in P-P interval due to changes in the SA node

A

sinus arrhythmia

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5
Q

sinus arrhythmia in dogs vs horses

A

dogs: controlled by breathing, HR changes with exhale inhale

large: not as common, but can be in athletic horse with high vagal tone

no clinical relevance

change in P-P interval due to changes in SA node

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6
Q
A

irregularly irregular = AFib

R-R interval
wobbly line

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7
Q

clinical signs of Afib

A
  • High intensity exercise horse presented for poor performance
  • Incidental finding in low intensity/pleasure riding horse
  • Secondary to systemic illness
  • Secondary to severe valvular disease and atrial enlargement
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8
Q

what can cause Afib in horse

A
  • High vagal tone
  • Atrial enlargement and remodeling
  • Transient potassium depletion
  • Sweating, diuretics (furosemide), bicarbonate milkshakes
  • Atrial (supraventricular) premature complexes
  • Atrial myocardial inflammation
  • Excessive thyroid hormone administration or iodine containing supplements
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9
Q

auscultation of Afib in large animals

A

irregularly irregular
variable heart sounds and pulses
no S4
heart rate normal unless in CHF or draft breed

HR in dogs, humans, and cattle will be increased

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10
Q

if Afib is first seen what should you do

A

check meds, electrolytes, cardiac troponin, echo (atrial enlargement)

wait, may spontaneously convert

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11
Q

when to not convert Afib in a horse

A

atrial enlargement
severe myocardial dysfunction
HR >60bpm
hyperthyroid

can be happy and healthy with normal activity

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12
Q

prognosis of cardioversion of Afib after 4 months

A

successful cardioversion 80%
can recurr 60%

if underlying heart disease worse odds

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13
Q

what drug used to medically cardiovert a horse

A

quinidine sulfate
85% success rate

can cause seizures, ataxia, edema, QRS prolongation

associated with high plasma concentration

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14
Q

how to convert Afib in horse

A

quinidine sulfate

or

TVEC

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15
Q

adverse effects of TVEC

A

GA
myopathy, 3rd degree AV block, sudden death

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16
Q

how does quinidine work

A

class 1A AA
Na blocker

increases effective refractory peroid

slows conduction and dirupts reentry circuits

vagolytic (positive chronotrope)

negative inotrope (at high doses only)

chemical conversion of Afib in horse

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17
Q

why do you need an exercising EKG on horse with Afib

A

to look for other arrhythmias or high HR that would be dangerous

horse can collaspe or die

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18
Q

3 causes of murmur

A

regurgitation
shunts
stenosis

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19
Q

7 ways to characterize murmur

A
  1. Grade
  2. Timing
  3. Duration
  4. Quality
  5. Shape
  6. Location = PMI
  7. Variable
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20
Q

systole occurs with what heart sounds

A

S1-S2 (short)
+ pulse

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21
Q

diastolic murmur is caused by

A

aortic regurgitation

can also be pulmonic regurg, mitral and tricuspid stenosis

22
Q

aortic regurgitation will cause — mumur

A

1-6/6 decrescendo diastolic murmur

normal finding in horse over 10 years old, usually asymptomatic

if bounding pulses= severe or moderate

23
Q

what kind of pulse for aortic regurgitation

A

mod or severe will cause bounding peripheral pulse

blood leaks through aortic valve causing decrease in diastolic pressure, difference in pulse pressures is greater= bounding

24
Q

Aortic regurgitation with exercise will cause

A
  • ventricular enlargement and remodeling
  • decreased coronary perfusion
  • shortened diastole caused by high HR
  • increased oxygen demand
  • increased sympathetic tone caused by the exercise

leads to arrhythmias

25
Q

what kind of murmur for TR

A

right systolic murmur

grade = severity

usually good prognosis

26
Q

VSD will cause — murmurs

A

right= systolic mumur (shunt >3 panystolic PMI TV area) (shunt moving left to right, shoots toward stethoscope)

left= relative PS (< R cresc-decresecendo PMI PV)

systolic murmurs with right side louder then left side

27
Q

why do horses with bilateral systolic murmurs need echo

A

congenital heart disease (VSD)

can cause mild to severe issues based on size and pressure of defect

28
Q

right sided systolic murmur=

A

TR

29
Q

A loud L sided systolic murmur is — until proven otherwise

A

MR

30
Q

Mitral regurg will cause — murmur

A

loud left sided systolic murmur

grade 1-6 with no correlation with severity

31
Q

right sided only systolic murmurs are —

A

TR

32
Q

diastolic murmurs=

A

AR

33
Q

what are signs of MR in horse

A

loud Left sided systolic murmur

Exercise intolerance
* Increased heart rate
* Increased respiratory rate and effort
* Cough
* Edema
* Arrhythmias (AF)

34
Q

how to tell physiologic vs mitral regurg

A
35
Q

how to tell MR from MV prolapse

A
36
Q

how to tell systolic murmur on left side

A
37
Q

when to worry about left sided systolic murmur

A

If 3-6/6 and holo or pansystolic
* If band shaped and holo or pansystolic (mitral regurg)

When the horse has other signs of heart disease:
* Increased respiratory rate or effort
* Atrial fibrillation
* Exercise intolerance/poor performance

38
Q

continuous mumur in young animals are

A

PDA

39
Q

continuous murmur in adult is caused by

A

aortocardiac fistula

  • Connection from aortic root-RV, RA or LV
  • Signs may be distress, arrhythmia or colic
  • Associated with ventricular arrhythmias
  • Unsafe to ride/risk sudden death
  • Life expectancy days-months
40
Q

what can cause pericardial disease

A

idiopathic, bacterial, viral, traumatic, neoplastic

hardware disease

41
Q

PE of animal with pericardial disease

A

Physical examination: Tachycardia, tachypnea, fever, pericardial friction rub,
muffled heart sounds, jugular and generalized venous distension, weak pulse, ventral edema, weight loss

42
Q

A loud left sided systolic murmur is – until proven otherwise

A

MR

43
Q

A diastolic murmur is — until proven otherwise

A

AR

44
Q

A right sided systolic murmur, if only right is — until proven otherwise

A

TR

45
Q

A right sided systolic murmur, if accompanied by systolic murmur over the pulmonic valve is a — until proven otherwise

A

VSD

46
Q

An irregularly irregular rhythm is — until proven otherwise

A

Afib

47
Q

how to diagnose pericardial disease

A

echo
pericardiocentesis
Xray

can give antimicrobials, steroids and drain the effusion

48
Q

bovine cardiac lymphosarcoma will cause

A

cancer in abomasum, uterus, kidney, and heart

Mass in right atrium, infiltrating pericardium and/or hemorrhagic pericardial effusion

Neoplastic lymphocytes in pericardial or pleural fluid

caused by bovine leukemia virus

49
Q

symptoms of infectious valvular disease

A

intermittent fever, weight loss, depression, anorexia, lethargy, intermittent lameness, synovial distension, tachycardia

May have no auscultable murmur (50% cattle)

effect different valves:
Horse: M>A>T>P
Cattle: T>P>M=A

50
Q

what valves are infected by endocarditis in large animals

A

Horse: M>A>T>P (left side)
Cattle: T>P>M=A (right side)

need to confirm with blood culture

23 spring: med surg (60 decks)

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