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VetMed Year 3-Term 2 > w/c 10-Feb-14 > Flashcards

w/c 10-Feb-14 Flashcards

1
Q

Definition of MAC

A

Minimum Alvelolar concentration of inhalation agent requried to prevent movement in 50% of individuals in response to painful stimuli

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2
Q

MAC of a) Isoflurane

b) Sevoflurane

A

a) Isoflurant: 1.3%
b) Sevoflurane: 2.3%
Potency inversely proprotional to MAC

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3
Q

Which factors reduce MAC?

A

Reduce amount of drug required i.e. MAC.

-Hypothermia, old age or VERY YOUNG, intercurrent disease, pregnancy, use of opiods, hypoxia

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4
Q

Isoflurane and Sevoflurane cause more ____ than halothane

A

Isoflurane and Sevoflurane cause more vasodilation and respiratory depression than halothane. BUT Halothane more myocardial depression (CO) and sensitises to catechoamines = arrthymias
CHECK RESP DEPRESSION

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5
Q

What do Neutromuscular blocking drugs do?

A

Inhibit acetylcholine preventing propagation of action potential therefore muscle contraction. ALL SKELETAL MUSCLES.

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6
Q

What are important considerations when using NMB drugs

A

ensure adequacy of anaesthetic as animals won’t be able to move in response to painful stimuli
ANIMAL WON’T BE ABLE TO BREATHE! VENTILATOR
Reverse using acetylcholinesterase e.g. neostigmine/

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7
Q

What drug should be administered alone with NEOSTIGMINE?

A

Neostigmine is a acetylcholinesterase. Should administer anticholinergic e.g. atropine to prevent bradycardia following reversal of the NMB drug

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8
Q

Pulse oximetry measures the

A

Patients arterial oxygen saturation i.e. SaO2 NOT NOT PaO2

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9
Q

What does capnography measure? What is the normal range?

A

Capnography measures end tidal CO2 which approximates to arterial CO2.
Normally 35-45mmHg

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10
Q

How to detemine sufficient depth of anaesthesia?

A

Eyes rotate ventrally, minimal, sluggish palpebral reflex, loose jaw tone, no swallowing reflex.
Must visualise the laryngeal opening to make sure epiglottis is not pulled dorsally!!

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11
Q

How do you measure the length of endotracheal tube required? Why is this important?

A

Measure to point of shoulder; too long and it may enter the bronchi leading to unilateral perfusion

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12
Q

Important consideration when using ‘Intubeaze’?

A

Don’t spray more than once, easy to overdose; CAVE - Local anaesthetic overdose

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13
Q

5 Injectable GA agents

A

Propofol, Alfaxalone, Ketamine, Thiopental, Etomidate

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14
Q

Which 2 of the injectable GA agents can be used in food producing animals?

A

Ketamine and Thiopental.

ALSO ISOFLURANE ON INHALATIONAL LIST

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15
Q

When using ketamine as an injectable agent for maintenance, what only class of drug has to be given?

A

Muscle relaxant.

Ketamine is the only injectable agent that provides some analgesia

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16
Q

Soluble injectable agents will have a _____ partial pressure in lungs, therefore a ____ partial pressure in brain

A

More soluble= lower pp in lungs and brain. Will be SLOWER induction and recovery agents

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17
Q

But the following in order depending on their relative solubilities and therefore speed of induction
Sevoflurane, Isoflurane, Halothane, N20

A

LIST FROM SOLUBLE –> NOT SOLUBLE
LIST FROM SLOW –> QUICKER
Halothane –> Isoflurane–> Sevoflurant –> N2O

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18
Q

Why can Nitrous oxide not be used as an induction agent?

A

MAC in animals is 200% therefore cannot be used on its own.
Had mild analgesic properties.
Very insoluble therefore very fast onset.
‘Second gas effect’
DIFFUSION EFFECT AT END OF ANAESTHETIC - TURN OFF 5 MINUTES BEFORE AS DISPLACES OTHER GASES .
Check if staff are PREGNANT

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19
Q

Which ions are ‘thoretically’ released from the metabolism of sevoflurane?

A

Theoretically free fluride ions are released which are toxic to kidney. No problems reported clinically.
Compound A formation during reaction with hot/dry CO2 absorber - newer absorbers prevent this

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20
Q

Which induction agent tends to keep the eye more central (rather than turning ventrally as most)

A

Ketamine tends to keep the eye more central (esp in horses)

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21
Q

Which group of premeds can cause poor mucous membrane colour?

A

A2 agonists e.g. Romifidine, Detmoidine, Xylazine

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22
Q

Electrocardiogram is useful to measure….

A

Electrical activity of heart, diagnosis of arrthymias NOT NOT NOT CARDIAC OUTPUT

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23
Q

Normal systolic and mean MAP of dog and cat

A

Dog: Systolic: 140. Mean: 100
Cat: Systolic: 180. Mean 135

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24
Q

Which animals is dopler flow detection best in (for measurement of ABP)

A

Better in small animals than horses.
Add on 15mmHg in cats.
Useful in HYPOTENSIVE patients

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25
Q

In the adult racing horse, which respiratory pathogens are most common?

A

LRT diseases are more common and peak at 2YO.

Equine influenza, EHV 1&4, Step equi equi, Strep zooepidemicis, Strep pneumonia, Pasteurella, Actinobacillus

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26
Q

RAO definition

A

Recurrent Airway Obstruction.

Reversible lower airway obstruction, NATURALLY occuring. INCREASED EXPIRATORY EFFORT

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27
Q

Aetiology of Kennel Cough (Infectious Canine Tracheobronchitis, CIRD)

A

Frequently involves several agents:

Canine parainfluenza, Canine Adenovirus type 2, Bordetella bronchoseptica

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28
Q

How is Bordetella bronchiseptica pathogenic?

A

Attaches to cilliated cells (is cillostatic) although is also found in normal dogs.
If found with Canine Parainfluenza virus = more severe disease

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29
Q

Significance of Canine adenovirus type 2 (CAV-2)

A

TYPE 2 causes RESPIRATORY disease.
Rarely isolated due to good vaccination protocol
TYPE 1 causes HEPATITIS

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30
Q

Canine Herpesvirus

A

Systemic and often fatal disease in neonatal puppies. Under 3 days of age.
Renal, hepatic, lung necrosis.
Thermosensitive virus.
Vaccination avaliable for dam

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31
Q

What vaccinations are avaliable for Canine cornoavirus

A

There is a vaccination for the canine (enteric) cornoavirus but this doesn’t cross protect.
The vaccination for respiratory coronovirus is under development.

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32
Q

Which mycoplasma can be found in dogs with kennel cough (CIRD)?

A

Mycoplasma cynos ‘fried egg appearance on agar’

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33
Q

Clinical signs of Kennel Cough (CIRD)

A

Usually 3-7 days after exposure.
Cough (dry or productive), retching, particually during exervise.
Nasal, Occulr discharge, Sneezing.
Recovery without treatment in 1-3 weeks

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34
Q

When would you start to consider treatment in a dog with kennel cough?

A

WHEN systemic signs are present e.g. Depression, Pyrexia, Inappetance.,
Consider antibiotic, NSAIDs to increase appetitite etc.
Progression to bronchopneumonia caused by seconday bacterial infection

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35
Q

Which two infectious pathogens are most likely isolated from a dog with systemic kennel cough?

A

Canine Distemper virus, Strep equi subsp. zooepidemicus

36
Q

Which parasite do we need to rule out when an animal presents with dyspnoea?

A

DO FAECAL EGG COUNT FOR Angiostrongylus

37
Q

Role of IgA in kennel cough

A

More IgA stimulated from intanasal vaccines on mucosal surfaces.
IgA NEUTRALISES antigen on cell surface

38
Q

How long before kenneling should the kennel cough vaccination be given? Which vaccines are avaliable?

A

B.bonchiseptica: At least 5 days before kennelling.
Immunity is short lived
Canine parainfluenza: Live attenuated
Canine Adenovirus (cav 1 AND 2) cross protection

39
Q

What type of virus is Canine Distemper?

A

Morbillivirus REPLICATES in lymphoid tissue therefore immunosuppresiv . Shed in all body fluids therefore spread by aerosol/ close contact

40
Q

Pathogenesis of Canine Distemper

A

Virus enters respiratory tract, spreads to tonsils and local LN, infects monocytes/macrophages, viremia and systemic dissemination.
Dogs with insufficient immune response with have respiratory, gastrointestinal, CNS signs.
Causes IMMUNOSUPPRESSION therefore secondary bacterial infections

41
Q

Aside from the vominting.GIT and occasional CNS signs what else is common in dogs with Canine Distemper?

A

Hyperkeratosis of foot pads and nose i.e. ‘hard pad and hard nose disease’
Also have distemper teeth- hypoplasia of the enamel

42
Q

What would you expect on haematology for a dog infected with CDV?

A

Haematology: Lymphopenia
Serology: IgM indicitve of recent infection
FERRETS highly susceptible to CDV

43
Q

A dog had pyrexia, haemorrgaic, nasal discharge and sudden death. PM showed severe necro-haemorragic and fibrino suppurative bronchopneumonia. What is the likely pathogen?

A

Streptococcus equi subs. zooepidermicus.
Relative common in horses (associated with abortion/URT)
Not likely to be dog - horse transmission
Likely to be dog-dog via fomites.
High mortality due to sudden onset
Zoonosis

44
Q

Upper limit for horse temperature

A

Above 38.5 degrees = hyperthermic

45
Q

You tend to investigate heart mumurs in horses when they are above grade

A

IV or more.

Grade II systolic right murmur is probably tricuspid regurg

46
Q

How to differentiate DV for VD view?

A

DV - ANIMAL ON STERNUM. Policemans hat appearance

VD- GAP between diaphram and cardiac silhouette

47
Q

If you have identified dilated oesophagous in a radiograph, what else should you check for?

A

Aspiration pneumonia; check VENTRALLY! Alveolar pattern

48
Q

How do you differentiate veins are arteries on radiograph?

A

Veins are VENTRAL (on lateral view) and MEDIAL/CENTRAL (on VD view)

49
Q

Two Ddx for cochal destruction

A 
URT disease. Conchal destruction indicates aggressiveness.
Either Aspergillosis (checkboard apperance) or Neoplasm (more uniform/ less lucent)
50
Q

What causes increased expiratory effort?

A

Intrathoracic obstruction e.g. Tracheal collapse or lung worm.

51
Q

Mediastinal widening is suspected when the cranial mediastinum is…

A

twice the width of the vertebral bodies

52
Q

How can the crus of the diaphram be used to determine if a xray is taken from right or left lateral view>

A

RIGHT: Crus parallel to each other. vena cava enters first crus
LEFT: Crus angle with each other, vena cava enters second crus

53
Q

Alveolar pattern is characterised by ______

Ddx for diffuse alveolar pattern are…

A

Alevolar pattern is characterised by lack of age in the alveoli of the lung.
Diffuse: Severe bronchopneumonia, severe oedema, near-drowning, smoke inhalaton

54
Q

After taking a bronchoalveolar lavage of a horse following poor performance you get Simonsiella. What do you conclude from this?

A

Oropharangeal contamination (Simonsiella only found in oropharynx), therefore repeat sample

55
Q

When an animal presents with dyspnoea, a useful indicator for differentiating heart disease from pulmonary disease is…

A

MEASURING THE HR.

Often normal in respiratory disease

56
Q

In which breed of dog is pulmonary fibrosis common?

A

West Highland White terriers.

Especially the older ones

57
Q

An inhaled forign body is likely to be present where?

A

Right caudal lung lobe.

Bification of trachea is slightly unsymmetrical

58
Q

What pulmonary pattern would you expect in a dog with lungworm? (angiostrongylus)

A

Alveolar pattern

59
Q

A dog is in acute severe dyspnoea, radiographs are surprisingly normal. This prompts the clinician to think…

A

Pulmonary thromboembolism!

Or upper respiratory disease

60
Q

4 causes of dyspnoea in small animals.

A
  1. obstruction of airways
  2. loss of thoracic capacity
  3. pulmonary parenchymal disease
  4. others: metabolic etc
61
Q

What are the physiological/metabolic causes of dyspnoea?

A

Respiration may be stimulated by changes in pH (i.e. acidosis increases RR), blood supply, PAIN, pulmonary thromboembolism

62
Q

Which organisms contribute to the ‘Cat Flu’ complex?

A

Feline Herpes Virus (FHV-1) = Feline rhinotrachitis
Feline Calicivirus
Chlamydophila felis
Bordetella bronchiseptica

63
Q

Feline Viral Rhinotrachitis

A

Same as Feline Herpes Virus (FHV-1) - Corneal ulcers, reproductive problems .
If kittens affected, encepahlitis and hepatitis

64
Q

Which of the cat flu virus’ cause more occular signs?

A

Chlamydophila felis.
Environmental elementary bodies
Conjuctivitis, nasal discharge.
Can also get corneal ulcers with Feline herpes virus

65
Q

How do you diagnose infection with different organisms in the cat flu complex?

A

Virus: PCR for nucleic acid or virus isolation.

Serology NOT useful if have been vaccinated!

66
Q

How to diagnose a) Chlamydophila b) Bordetella?

A

a) Chlamydophila use PCR
b) Bordetella: Bacteriology
Virus isolation for FCV, FHV

67
Q

When Chamydophila felis or Bordetella are isolated, the antibiotic of choice is normally…

A

Oxytet or Doxacycline.

NOT IN YOUNG ANIMALS = Stain enamel

68
Q

Which two cat flu organisms can be chronically shed by infected animals? I.e. stress

A

Feline herpes and feline calicivirus

69
Q

A terrier with a dry and hacking unproductive cough is most likely to have

A

Chronic bronchitis/ bronchioectasis .
Cough is often exacerbated by excitement or exercise / change in environmental temperature..
Cough easily induced by tracheal palpation

70
Q

What is the prognosis of a terrier with chronic bronchitis/ bronchoectasis?

A

Very unlikely that a cure of the clinical signs will be achieved. Management changes equally as important as bronchodilators.

  1. maintain clean atmosphere
  2. dogs are normally overweight- dietary changes
  3. limited but regular exercise
71
Q

How do bronchodilators work? What are some examples?

A

Either b2 agonists (theophylline, terbutaline) or muscarinic antagonists (atropine)

72
Q

Treatment for chronic bronchitis/ bronchoectasis

A
  1. Bronchodilators
  2. Antibacterial agents (only if bacterial contam)
  3. Expectorants/ mucolytics
  4. Cough suppressants (if not productive)- NOT IF ALVEOLAR PATTERN
  5. Anti-inflammatory medication (corticosteroids)
73
Q

Canine Lungworm is…

A

Angiostrongylus vasorum. Affects pulmonary vasculature and may cause pul hypertension. (also Filaroides but less common).
Associated with systemic coagulopathy and bleeding from any site.

74
Q

Increased ________ noise would b e expected in a dog with lungowrm

A

Inspiratory noise (and increased inspiratory is extrathoracic non-fixed and restrictive disorders e.g. [pleural effusion)

75
Q

A yorkshire terrier with a ‘quacking’ cough is most likely to be

A

Tracheal collapse

Increased expiratory effort (intrathoracic airway obstruction)

76
Q

The most common cause of persistant coughing in the cat is

A

Feline asthma -F eline allergic airway disease (FAAD).

Bronchoconstriction in response to antigenic stimulus. Increased EXPIRATORY effort (Intrathoracic obstruction)

77
Q

What would you expect on blood test for cat with FAAD?

A

I.e. feline asthma. Would expect a circulating easinophillia . May be a bronchial pattern on radiograph.

78
Q

Treatment of FAAD?

A

In emergency situation oxygen therapy and IV corticosteroids (.e.g methyprednisalone succinate), bronchodilating agent e.g. atropine (ONLY EMERGENCY DUE TO SIDE EFFECTS)

79
Q

Atropine is

A

Muscarinic receptor antagonist

80
Q

Which species for pulmonary fibrosis most commonly affect?

A

Idiopathic condition most commonly affecting whwtS.
Poor prognosis.
Progressive cough and dyspnoea. Marked crackles on ausculation

81
Q

Why should atropine be reserved for emergency use in horses?

A

Muscarinic antagnoist.
Reserved for severe dyspnoea.
Causes gut stasis = colic (along with other side effects)

82
Q

Clenbutarol is

A

non selective b2 agonist
Side effects include tachycardia and sweating and it also works on b1 receptors.
Reduce dose if side effects

83
Q

Which valve pathology do horses normally not get?

A

Horses get regurgitant valves

Rare for them to get stenotic valves (therefore normally flow murmurs)

84
Q

How do tests for influenza and equine herpes vary>

A

Herpes can be isolated from blood (as it causes a viremia)
Influenza = nasoswab ELISA
Can do paired serology for both

85
Q

Markers for inflammation in the horse:

A

High fibronogen, globulin

86
Q

DDx for high biliburbin in horse

A
  • Liver danage
  • RBC destruction
  • Anorexia
87
Q

Why is fluroquinolone not an appropriate antibiotic for preventing of secondary bacterial infections in horses with influenza

A
  • Opportunitic pathogens normally Strep and Staph, fluroquinolones is not active against these.
  • Should not be used as first line antimicrobial

VetMed Year 3-Term 2 (11 decks)

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