Test 4 Flashcards
What is a chest tube?
a tube is placed to remove an unwanted substance from the thoracic cavity
Why is the skin tunnel important?
no direct path inside the chest to outside, less chance air in chest, barrier to bacteria entrance
Why are air leaks bad?
having air leak into the tube cause a pneumothorax and collapse
Three-way stop cock are a way to do what?
attach suction, then turn off and clear syringe
How do you care for chest tubes?
place a vaseline soaked gauze over incision, cover in sterile gauze squares, then wrap chest in conforming gauze and vet wrap
How often should you check a chest tube?
every 2 hours
What is a tracheostomy?
surgical introduction of a tracheostomy tube into the trachea to allow direct airflow
In what cases would a tracheostomy be performed?
blocked upper-airways, facilitate removal of fluids from lungs, allow anesthesia when doing surgery on nose or mouth
What is a tracheotomy?
incision of the trachea through the skin and muscles of the neck for exploration, for removal of a foreign body
What may be planned as for post-op care?
tracheostomy
When might a tracheostomy be performed?
in an emergency situation with obstruction of the upper airway
What is more important in a tracheostomy than clipping and sterile prep?
reestablishing upper airway
What is the site for a tracheostomy?
midway between the larynx and thoracic inlet, on the midline
What should be avoided in a tracheostomy?
jugular, carotid, vagus nerve
What is helpful in a tracheostomy?
line block with local anesthetics
Separate muscles over trachea and enter where in a tracheostomy?
between trachea rings
What are the different types of tracheostomy tubes?
stainless steel, flexible plastic or latex, single and double lumen tubes, cuffed tubes
Goals of maintenance for a tracheostomy?
asepsis of site and lungs, patency, patient comfort
What are the maintenance steps for a tracheostomy?
incision care, humidity, suctioning-continued patency, care of tube
You should clean the incision of a tracheostomy with what?
q-tip or 2x2 gauze soaked in .05% chlorhexadine solution
What should be placed down tracheostomy tube hourly?
.5-3 mls of sterile normal saline
What should be done for a tracheostomy tube every 4 hours?
nebulize with saline =/- meds for 10-15
Why should you suction a tracheostomy tube?
fluid and debris will accumulate in lumen of tube
What may debris or fluid in tube cause?
a life-threating blockage of the tube
What is the procedure for suctioning a tube?
attach sterile catheter to syringe and suction out inside of tube every 2 hours
How often should tubes be replaced?
every 24 hours
What should you be careful of in tube maintenance?
removing and replacing rubes and no debris goes into tube
Why should the tube site be cleaned frequently?
to remove respiratory secretions
What should be done to care for a tracheostomy site?
apply petroleum jelly on the skin around the site to prevent scalding if needed
Upon removal of tracheostomy tube, site heals by what?
second intention
What is removed in a permanent tracheostomy?
3 to 4 rings is removed
What is sutured to the skin in a permanent tracheostomy?
tracheal mucosa
How do you care for a permanent tracheostomy?
clean frequently and apply petroleum jelly around the site
What is a pharyngostomy tube?
red rubber catheter
Where is a pharyngostomy tube placed?
from the pharynx to the esophagus
What is the proestrus of canines?
9-10 days
What is the estrus of canines?
9-10 days
What is the diestrus in canines?
57-58 days
What is the anestrus in canines?
2-5 months
Inestrus in canines >4 months is associated with what?
infertility
What happens during proestrus?
vulva swollen, serosanguinous discharge
What happens with the male in proestrus?
attractive to male but will not mate
What do cornified cells look like?
angular-shaped cytoplasm, nucleus pyknotic or missing
What do noncornified cells look like?
rounded cytoplasm, large stippled nucleus
What causes cells to cornify?
estrogen levels increasing
What happens to the female during estrus?
female receptive to male, stands, “flags” tail
What happens during estrus?
vulvar swelling may decrease slightly, discharge changes to straw color
What happens to the vaginal cytology in estrus?
100% cornified
What happens to vaginal cytology during diestrus?
abrupt decline in % cornified cells
Day 1 of diestrus is used for what?
to predict whelping
When should you breed in dogs?
3x/week as long as vaginal cytology shows fully cornified cells
What is important with AI frozen or fresh cooled semen?
timing to coincide with ovulation
Immature oocysts mature in how many days?
2-3
How long are oocysts viable?
2-3 days
When should you breed when using fresh chilled semen?
days 3 and 5 OR days 4 and 6 after LH peak
Viability of fresh chilled semen is what?
reduced
When should you breed when using frozen semen?
day 5 or 6 after LH peak or intitial rise in progesterone or 3 days after progesterone level of 5
AI is performed how?
surgically into uterus or by transcervical endoscopy
One ejaculate=what?
one breeding
How often should you breed?
every other day beginning day 9 until female will not accept male or vaginal smear indicates diestrus
What should be done in assisted breeding?
assist the male to mount, control the female so she will not bite the male, bring female to the male’s territory
What should be done with theale in assisted breeding?
vaginal smear to determine correct timing and cleanse the vulva with alcohol
What should be done to the male during assisted breeding?
stimulate the male by manipulating the shealth/penis and collecting ejaculate into a warm, clean, dry container
What is the first fraction of ejaculate?
urethral secretions, discard if urine included
What is the second fraction of ejaculate?
sperm rich, has milky appearance
What is the third fraction of ejaculate?
prostatic fluid to rinse the sperm from its container
What can kill sperm?
water, urine, blood, and alcohol
What should you allow the male to do in assisted breeding?
“tie” and wait until ejaculate is complete
What should be done with the semen after the male has ejaculated?
evaluate a drop of it on a warm, dry slide
What is evaluated in the semen?
motility and morphology
What can be used to count ejaculate numbers?
hemocytometer
Ejaculate numbers should exceed what in a normal male?
300 million
What number of ejaculate per insemination is needed for average conception?
200 million
Where is collected semen placed?
in vagina near cervix
What should you avoid getting caught on when injecting collected semen?
clitoris
What can be used to pass dorsally into vagina to cervix when injecting semen?
catheter/pipette
What should be done to the female when injecting semen?
elevate her hind quarters by holding hock region
How long should the females haunches be elevated post-AI?
5 minutes
What should be done after injection of semen?
walk for 5 minutes
What is the best type of semen?
undiluted, fresh semen used immediately
When is refrigerated extended semen best?
if used within 25-48 hours
What are some extenders for semen?
lactose, glycerin, egg yolk extender
What do serum progesterone levels rise to on the day of LH surge?
from <1ng/ml to 1.5 to 2ng/ml
What continues to rise during diestrus and pregnancy?
progesterone
When does ovulation occur?
2 days after LH surge
How should a progesterone test be ran?
at room temp
What is done with the blood for a progesterone test?
blood allowed to clot in refrigerator, serum separated within 20 minutes of collection
What happens if the blood is serum separated after more than 20 minutes?
rbcs bind to progesterone, results in artificially low progesterone
What can interfere with a progesterone test?
hemolysis and lipemia
Can frozen serum be used in a progesterone test?
yes, warm to room temp first
What should still be monitored post-breeding?
vaginal cytology
When does diestrus occur?
8 days after LH peak or 6 days after ovulation
What is the best way to estimate day of ovulation and period of peak fertility?
progesterone test
Why can a progesterone test estimate day of initial rise in progesterone even if a day of testing is missed?
because progesterone continues to rise during diestrus or pregnancy
What test does not give a precise prediction of ovulation?
vaginal cytology
What must be tested daily to know when ovulation occurs?
LH serum
How long does LH peak last?
one day
What are some reasons we do vaginal cultures?
vaginitis, post parturient discharge, discharges during pregnancy, postabortion discharge, prebreeding in normal or infertile bitches
How can you diagnose pregnancy?
palpation, ultrasound, radiography, assay relaxin
When is the best time to do an ultrasound?
after approximately day 20 post diestrus
When is the best time to diagnose pregnancy with radiology?
after day 45 post diestrus
What is the gestation length?
57 to 58 days from diestrus
What is the first stage of partition?
nesting
How long does nesting take?
6-12 hours up to 36 hours
What happenings during nesting?
dilation of cervix, rectal temp drops 1-2 degrees to 99 degrees
What is stage 2 of parturition?
abdominal contractions-delivery of fetus
What is the maximum time between delivery of pups?
2 hours
No pup in 30 minutes means what?
dystocia
What is the maximum delivery time?
12 hours
Blackish green discharge during stage 2 of parturition is what?
normal
What is stage 3 of parturition?
expel placentas
When should placentas be expelled?
within 12 hours
What kind of discharge is normal postpartum?
nonodorous for 8-10 weeks
Postpartum discharge of 12 weeks or more indicates what?
sub involution of placental sites
How do you treat sub involution of placental sites?
treat medically, surgically, conservative
Crying/whining pups indicate what?
bitch has problems (pups are hungry or sick)
What indicates metritis?
foul smelling vaginal discharge
What indicates retained placenta?
green discharge
What indicated mastitis?
fever, lethargy, swollen mammary glands, discolored glands
When should you hand feed or supplement pups?
often with metritis or mastitis
What indicates eclampsia?
tremors, excitation
How do you treat eclampsia?
calcium
All bitches have an elevated what whether they’re pregnant or not?
serum progresterone
As progesterone declines at end of diestrus, many non-pregnant bitches will have what?
mammary development, lactation, maternal behavior
What kind of hormonal treatment can be used in pseudopregnancy?
cabergoline and mibolerone
What can NOT be used as a hormonal treatment for pseudopregnancy?
megestrolscetate
Pyometra usually occurs in who?
older females
When do pyometras occur?
diestrus
What is pyometra associated with?
pseudopregnancy, recent breeding, recent heat cycle
What are signs of pyometra?
lethargic, depressed, febrile, PU/PD, Leukocytosis on CBC
How do you treat pyometra?
surgery Ovarian Hysterectomy
How does mismating happen?
when bred accidentally or escaped during estrus
What are some options for mismating?
OVH, allow to carry litter and whelp, wait until pregnancy can be diagnosed and then treat
What does Brucellosis cause?
abortion and infertility
How is brucellosis spread?
venereal and oronasal routes, spread in infected male urine and semen, aborted material
What is the treatment of brucellosis?
no treatment 100%
What antibodies can cause a false positive brucellosis test?
pseudomonas aeruginose, bordetella bronchiseptica, staphylococcus spp
What breed of dog has an exceptionally high false positive brucellosis rate?
english sheepdogs
A negative brucellosis result is highly accurate unless what?
infection is recent or the animal is chronically infected and recently treated with antibiotic
What is required for LH surge in felines?
vaginal stimulation
How long is gestation in felines post-mating?
63-66 days
A queen may ovulate but what?
not become pregnant or become pregnant
Most feline estrous cycles occur during the what?
spring
Indoor cats may cycle when?
all year long
How long is proestrus in cats?
1-3 days long
How long is estrus in cats?
8-10 days
How long is anestrus in cats?
2-6 weeks
Cats receiving rbcs must be what?
cross matched
Dogs receiving first time rbcs should be what?
cross matched
Compatibility is not linked to what?
blood type
Blood of the same type can be what?
incompatible
Blood typing uses what?
rbc surface antigens
Positive blood typing test means what?
they have the blood antigen
Negative blood typing test means what?
they do not have the blood antigen
If antibodies are present when two blood types are mixed what can occur?
reactions
What kind of reactions can occur if antibodies are present when two blood types are mixed?
mild to severe and potentially fatal
Most cats have what to foreign blood types?
natural preexisting antibodies
Many dogs do not what to foreign blood types?
preexisting antibodies
Most dogs tolerate a first transfusion but will make what within 7 days?
antibodies to incompatible blood
What are the three blood types in cats?
A, B, AB
Most cats are what blood type?
A
Which blood type is uncommon in cats?
B
Which blood type is rare in cats?
AB
Blood types in cats vary by what?
geographic regions and breeds
What percentage of cats are type A in the U.S.?
90%
What blood type is more common in certain purebreeds?
B
Which purebreds is type B more common?
Persian, Abyssinian, Himalayans, British Shorthair
Blood type A may have what?
low level natural preexisting antibodies against type B antigens
Giving type B blood to a type A cat may result in what?
mild transfusion reaction on 1st transfusion
In cats, which blood type ALWAYS have naturally occurring high antibody titers against type A blood antigens?
B
Giving type A blood to type B cat results in what?
rapid, severe, potentially fatal allergic reaction
Blood type AB cats express what?
antigens from both blood groups on surface of their rbcs
Blood type AB cats do not develop what?
antibodies against either blood group
Type AB cats can receive transfusions from who?
any feline donor
With cats what is a must before first transfusion?
crossmatch
What type of system is used in blood typing dogs?
DEA (Dog Erythrocyte Antigen)
How many DEA types are there?
10
Most clinically significant transfusion reactions associated with what?
DEA 1.1 and 1.2
Which DEA is most antigenic blood type?
DEA 1.1
Blood donors for dogs are ideally what?
DEA 1.1 negative
DEA 4+ means what?
universal
Natural antibodies to DEA 7 do what?
occur
DEA 7 causes what kind of reaction?
fever only
Do you need to do a cross match before first transfusion in dogs?
you should but you can get away with not doing one
Do you need to do a cross match before second transfusion in dogs?
yes, a MUST
What is the cause of death in kittens borne to type B mothers?
neonatal isoerythrolysis
Type B mothers have strong what?
anti-A antibody titers
Antibodies are absorbed by colostrum by nursing kittens and then do what?
attack blood cells of type A or type AB kittens
What are the symptoms of Fading Kitten Syndrome?
severe hemolytic anemia, jaundice within first 2 days of life, necrotic tail tip that falls off at 10 to 14 days of life
What should be done with type A kittens with type B mother?
foster them the first 24 hours of life with a type A queen or hand-raise and give supportive care as fluids, colostrum free of antibodies
When should type A kittens be returned to their mother?
day 2 of life
How is foal neonatal isoerythrolysis contracted?
ingestion of colostrum containing antibodies to one of the neonate’s blood group antigens
Maternal antibodies develop to specific blood group antigens during what?
previous pregnancies and unmatched transfusions
Horses usually have what antigens?
A, C, and Q
A, C, Q antigens are most common in what?
thouroughbreds and mules
Horses with neonatal isoerythrolysis are normal at birth but develop what within 2-3 days?
severe hemolytic anemia and become icteric
How can you diagnose neonatal isoerythrolysis?
screen maternal serum, plasma or colostrum against paternal or neonatal RC
How can you treat neonatal isoerythrolysis?
stop any colostrum while giving supportive care with transfusions
If necessary, neonates with neonatal isoerythrolysis can be transfused with what?
triple-washed maternal rbc
What should be avoided with neonatal isoerythrolysis?
withholding maternal colostrum
How can you test for neonatal isoerythrolysis?
mix newborn rbcs with maternal serum to look for agglutination before the newborn is allowed to nurse
Transfusion reactions may occur even when animals are what?
administered blood of a compatible type
Cross match is used for what?
to further document compatibility between blood donor and recipient
What do you check for when doing a cross match?
hemolysis, macro agglutination, micro agglutination
How do you check for hemolysis in a cross match test?
spin sample and look for evidence in the plasma protein
How do check for macro agglutination in a cross match test?
resuspend centrifuged sample and look for agglutination “clumps”
How do you check for micro agglutination in a cross match test?
look under microscope for microscopic clumps
Agglutination false-positive and false-negative reactions occur in who?
horses
Why do agglutination false positives and false negatives occur in horses?
due to spontaneous rouleaux formation
What is a cross match test by kit like?
gel diffusion test with several steps done to prepare the cells and plasma/serum prior to placing in the gel column tubes
What is the positive control in the cross match test kit?
tube with red bordered label
What is the negative control in the cross match test kit?
tube with green bordered label
A positive cross match test means what?
a reaction occurred= do not transfuse using this donor
A negative cross match test means what?
no reaction occurred=okay to transfuse using this donor
What happens in a positive cross match test?
majority of rbcs at or near top of gel column
Do in house gel kits test for hemolysis?
no, only for agglutination or clumping
What is immune mediated hemorrhagic anemia?
agglutination of patient rbcs occurs spontaneously
What makes interpretation of crossmatch nearly impossible?
immune mediated hemorrhagic anemia
In a major cross match, donor cells are mixed with what?
recipient plasma
In a minor cross match, recipient cells are mixed with what?
donor plasma
How much is a unit of blood in a cat?
50 ml
What is a unit of blood in a dog?
450ml
Transfusion is almost always what?
a symptomatic therapy
What is whole blood?
all components, minimal processing, easy for practice
How long is fresh whole blood good?
6 hours
What does fresh whole blood contain?
rbcs, plasma, clotting factors 5 and 8 and von willibrands
How long is stored whole blood good for?
older than 6 hours
What does stored whole blood contain?
decreased platelets, 5 and 8 and von willibrands are gone
What is plasma used for?
known or anticipated coagulation abnormalities as rodenticide ingestion
When is FFP frozen?
within 6 hours of collection
What does FFP contain?
all clotting factors plus albumin and globulin proteins
How long is FFP good for?
up to 1 year in regular freezer temps
When is FP frozen?
after 6 hours of collection
What does FP lose?
some of the unstable clotting factors
What does FP contain?
majority of clotting factors including fit K dependent factors and albumin and globin
What are the benefits of blood component therapy?
extend useful life of blood donations, use in more patients, reduce risk of transfusion reaction
Why does blood component therapy reduce risk of reactions?
because separated blood components contain less reactive substances and fewer antigens
What are some signs indicating need of transfusion?
weakness, malaise, tachycardia, tachypnea, syncope
Acute anemia patients may need what?
blood at a higher hematocrit compared to chronic anemia patient
1ml/lb of whole blood in dogs does what?
raises the patent hematocrit by 1%
How much blood should you give a cat?
1 unit of whole and reassess after each transfusion
How much plasma should you give to dogs and cats?
15-20ml/kg
Is there a limit to amount or number of transfusions?
no maximum limit to blood or blood products given
Repetitive blood or plasma transfusion raises what?
risk of side effects
What rate of transfusion should you use?
start slow, 0.5-1ml/kg/hr
When should you finish a transfusion?
in 4-6 hours
Why should you finish a transfusion in 4-6 hours?
to prevent chances of contaminant bacterial growth
What should be taken every 15 minutes at start of transfusion for first hour?
TPR
If there is no reaction to transfusion the maximum rate is what?
5ml/kg/hr
If you increase the rate of transfusion how often should you check TPR?
every hour
What is the standard drip chamber for transfusion?
15ggt/ml
If patients fever is 104-105 degrees F what should you do?
stop transfusion, treat with antihistamines, corticosteroids, begin transfusion at slower rate
At the end of transfusion what should you do?
reassess patients hematocrit and TP after fluid and rbc volumes have been fully distributed
When should hematocrit and TP be assessed?
usually 30 minutes to an hour after the end of transfusion
What should be done in clinics without blood bank availability?
maintain population of healthy, large dogs and cats owned by vets, staff and informed clients
What is a normal temp for a dog?
100-102.5
What is a normal pulse for a dog?
70-160bpm
What is a normal respiration for a dog?
10-30bpm
What is normal temp for a cat?
100-102.5
What is a normal pulse for a cat?
160-240bpm
What is a normal respiration for a cat?
20-30 bpm
Benefits of Omega 3 Fatty acids in patients include what?
Anti-inflammatory and Anti-arrhythmic effects
Dietary fat can have positive affects on which functions?
Immune, inflammation, and hemodynamics
Essential fatty acids can or cannot be synthesized by dogs and cats?
cannot
Omega 3 fatty acids are responsible for what?
brain function, skin health, and cell membrane fluidity
Omega 3 and Omega 6 fatty acids do not compete for enzymes required for metabolism, true or false?
false
Dietary fats are what?
the most concentrated form of energy in pet foods
Heart failure patients have a deficiency of plasma DHA and EPA, true or false?
true
Recommended dose for EPA?
40mg/kg
Recommended dose for DHA?
25mg/kg
Peak plasma concentration of Omega’s can be achieved after how many weeks of supplementation?
4-6 weeks
Nutritional goals that should be considered when managing cardiac patients include what?
ideal body condition, appropriate balance of nutrients, pharmacologic doses of specific nutrients
Risks for recumbent or neurologic patients include what?
chronic pain, decubital ulcers, self-inflicted trauma
Why is Passive Range of Motion important for the recumbent patient?
to maintain joint lubrication, cartilage nutrition and positional awareness through mechanoreceptor stimulation and improves extensibility of the soft tissues such as muscle and the joint capsule so helps to prevent contracture
How often should a pain score be recorded for these in hospital patients?
every time the patient is handled
Decubital ulcers take weeks to develop, true or false?
false
Bladder overflow means what?
inability to urinate voluntarily where the bladder remains large, palpable and needs to be manually expressed or have a urinary catheter in place
Depression and lethargy can be alleviated by providing the patient with what?
environmental enrichment
Range of Motion exercises can be performed on any patient at any time, true or false?
true
What is the purpose of assisted standing exercises?
to encourage neuromuscular function, develop strength and stamina of supporting postural muscles and enhance proprioception
Types of transitions for rehab patients includes what?
lateral to sternal recumbency, sternal recumbency to sit, sit to stand
All slings made for assisted walking are expensive and clients must be made aware of this cost, true or false?
false
Having what kind of parameters makes it easier to detect changes in patient vitals?
baseline
Patient temperature may elevate in response to a transfusion reaction, true or false?
true
Capillary refill time is an indication of what?
vascular perfusion
Pulse deficits can be detected using what?
stethoscope
One risk of transfusion a patient too fast is what?
tachycardia
As long as patient parameters are within normal limits, changes in patient cognition or levels of alertness should not be reported to the technician or veterinarian, true or false?
false
As long as all precautions are taken prior to administration, transfusion reactions will not occur, true or false?
false
Training on equipment required to be used during transfusion should occur when?
before transfusing patients
It is considered safe to administer other medications at the same time as blood and blood products, true or false?
true
Transfusion reactions can be detected early with close monitoring, true or false?
true
Von Willebrand Disease is caused by what?
the lack of a functional plasma protein, vWF
Von Willebrand Factor does what?
facilitates the formation of a platelet plug by creating a bridge between platelets and injured blood vessels
Which of the following breeds of dogs are most likely to be affected by Type 1 vWD?
Doberman Pinscher, German Shepherd, Golden Retriever
Genetic testing for vWD in dogs is what?
accomplished through the submission of a cheek swab or blood sample to an outside laboratory
What test results would most likely indicate Type 1 vWD?
prolonged BMBT, normal platelet numbers, vWD:Ag of 10%
The blood component that contains the highest amount of vWF per millimeter is what?
plasma
DDAVP may be most useful in what?
Type 1 vWD
Veterinary Technicians can assist patients with vWD by what?
using standard techniques of sample collection, such as cystocentesis and jugular venipuncture
