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VetMed Year 3-Term 2 > w/c 17-Feb-14 > Flashcards

w/c 17-Feb-14 Flashcards

1
Q

Why do we need to take regular blood tests when administering large blood transfusions?

A

Transfusions contain the anticoagulant, citrate. This citrate can bind to calcium and cause a rapid decrease in [Ca]

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2
Q

Hypoxaemia is defined as

A

Arterial pO2 < 60mmHg SpO2 < 90%

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3
Q

How does pyrexia lead to Hypoxemia?

A

Pyrexia increases O2 demand. Any increase in basal metabolic rate will lead to increased o2 demand.

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4
Q

Normal range for Co2 levels?

A

35-45mmHg

Hypercapnia can occur due to hyperventilation, rebreathing exhaled gas, increase BMR

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5
Q

Hypercapnia can lead to:

A

Hypercapnia causes tachycardia, hypertension, cardiac arrthymias. INCREASED INTRACRANIAL PRESSURE, respiratory acidosis

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6
Q

How do the pressures vary between spontaneous breathing and IPPV? What are the implications of this?

A

Spontaneous breathing intrapleural pressure remains negative.
When ventilating the intrapleural pressure remain above zero throughout cycle/
Decreased venous return = decreased cardiac output

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7
Q

What is important to remember when doing IPPV

A

Don’t just ‘squeeze’ whole bag, work out tidal volume (10-15ml/kg), want end tidal co2 to be 35-45.
want POSITIVE END EXPIRATORY PRESSURE!!!

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8
Q

What are potential causes of bradycardia?

A
  • High vagal tone
  • Electrolyte acid/base disturbances ((esp K+ high)
  • Hypothermia (less anaesthetic required)
  • a2 agonists (cause vasoconstriction then baroreceptor reflex)
  • Raised intracranial pressure
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9
Q

Which arrthymia is common following a2 administration?

A

alpha 2 agonist e.g. medotomidine/ xylazine is arrthymogenic and can cause AV block

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10
Q

How does the type of fluid used to treat hypovolemia vary depending on amount of blood lost?

A

10-15% loss: Crystalloid
15-25% % Colloid
>25%: Blood (beware citrate anticoagulant binding to calcium) OR if PCV <20%

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11
Q

Blood volume in dogs is calculated by

A 
80-90ml/kg= dog
60-70ml/kg = cat
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12
Q

Examples of inotopes

A

Dopamine: Acts of DA receptors at low concentration but higher concentration acts of a1 or b1 receptors. Tachycardia in horses, NOT USED
Dobutamine: Acts mainly on b1 receptors. Acts on a1 and b2 receptors but tend to cancel each other out.
Less arrthymogenic than dopamine

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13
Q

Why is hypothermia a problem in anaesthesia?

A

Hypothermia:
Reduces requirement for anaesthetics
-Alters pharmokinetics of drugs –> prolonged recovery
- shivering increases oxygen demand in recovery
- increases blood loss (increased clotting times)
- increased surgical wound infections (humans)

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14
Q

The cushing reflex is

It can be treated by:

A 
'Impending death' 
Increased blood pressure
Bradycaria
Respiratory changes if not ventilated.
Treatment: hyperventilate to vasoconstrict vessels, use mannitol/ furosamide
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15
Q

Anaesthetic considerations for rabbits

A
  • Post operative ileus (esp with morphine)
  • Anorexia / stress
  • More difficult to intubate
  • Subclinical resp disease ‘snuffles’ common - Pasteurellosis
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16
Q

Hyponorm is a mixture of

A

Fentanyl and Fluanisone (is a butyrophenone)

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17
Q

Which reflexes are indicitive of a medium-deep plane of anaesthetic in rabbits?

A

Tail pinch: Lost at light plane
Toe pinch: Medium-deep
Ear pinch: Medium-deep
Palpebral: Reflex useless

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18
Q

What is important to consider during a rabbits Recovery from anaesthesia?

A

-Hypothermia common
- Provide appropriate analgesia
- Encourage eating and return to owner ASAP.
Want to avoid post operative ileus

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19
Q

Potential ways to avoid post operative ileus in rabbits

A

Prokinetics - Ranitidine/ Metaclopromide (antiemetic but prokinetic) -Dopamine antagonist

  • Get owner to bring in own food/ drink bowl
  • Avoid stress- hospitlise away from other species if possible
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20
Q

Which analgesics are licenced for use in rabbits?

A

NON ARE LICENCED
Morphine can cause ileus
Buprenorphine most often used (opiods)
NSAIDs (meloxicam well tolerated)

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21
Q

Pre-anaesthetic preperation for rabbits?

A

No need to starve for long periods.
200grams= 1-3 hours
Remove water one hour before induction
Examine/ flush mouth before induction

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22
Q

IV access in rats, mouse and G.pig?

A

Rats, mouse, gerbil: Lateral tail vein
G.pig: Medial metatarsal vein
Atropine can be used to prevent excessive salivation

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23
Q

How long should ferrets be starved before induction?

A

Treat ferrets as cats.
i.e. starve for 6 hours before op. BUT CARE as Insulinomas are relatively common
Ferrets have a thick skin
Hypotension

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24
Q

Pleural diseases as a cause of dyspnoea are common in which species?

A

Pleural diseases are common cause of dyspnoea in small animals.
Converesely they are UNCOMMON in the HORSE

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25
Q

The characteristic breathing rate/pattern of an animal with pleural effusion is

A

Rapid shallow short respiration reflecting reduced tidal volume.
I.e. using last bit of tidal volume to breath, orthopnoea

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26
Q

Define Orthopnoea

A

Shortness of breath when lying flat.

Common presenting sign of animals with pleural effusions

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27
Q

Ausculation of a patient with a pleural effusion =

A

Volume of pleural FLUID likely to be dullness of auculation of VENTRAL thorax.
Likely to have muffled heart sounds and no lung sounds in VENTRAL portion of thorax.

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28
Q

If pleural effusion is suspected and the animal has concurrent ascities, it is more likely to be…

A

Protein loosing enteropathy = disseminated disease leading to systemic hypoproteinaemia

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29
Q

If an animal with suspected pleural effusion is systemically ill, what steps do you need to take before undetaking thoracocentesis?

A

If animal is pyrexia, more likely to be pyothorax therefore when aspirating fluid beware zoonotic bacteria e.g. Nocardiosis = human disease.
Exudate contains sulphur granules

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30
Q

How does haematology help diagnose cause of pleural effusion?

A

Hypoproteinaemia may suggest protein loosing enterotomy
Neutrophillia with left shift = pyothorax
Hyperglobuinaermia = Feline infectious peritonitris
Evidence of bone marrow involvement in some lymphoid neoplasms

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31
Q

Why would radiographing a patient with a pleural effusion be helpful?

A

Before and After, check how much fluid has been drained

Also after can check for tumours/ mediastinal masses

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32
Q

A radiograph showing dark space around the lung lobes on radiograph is indicitive of

A

Pneumothorax (air)

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33
Q

How are pleural effusion diseases treated?

A

Remove fluid (thoracocentesis) and treat underlying CAUSE e.g. Right sided heart failure, neoplasm, feline infectious peritonitis (POOR PROG), Diaphramatic hernia

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34
Q

How is pyothorax treated in small animals

A

Hard to drain due to the viscous nature.
Insert indwelling drains and flush with saline.
Systemic antibiotics.

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35
Q

What is a cylothorax

A

Difficult to manage., Failure of lymph to drain normally via the thoracic duct. Various aetiologys:
- Lymphosarcoma, heart failure, IDIOPATHIC.

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36
Q

How is chylothorax treated?

A

Treat underlying disease e.g. RSHF, Neoplasm
Medical management involves low fat diet,
Surgical management: Ligation of all branches of thoracic duct, provide alternative route.
If neither work Pleurodesis (v. uncomfortable)

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37
Q

If the animal has a diagnosed pneumothorax but it is not affecting the animals breathing. What is the recommended treatment?

A

If small in volume and no significant pulmonary abnormalities it will be reabsorbed over a period of days, No further action (MONITOR!)
If large volume, enter needle (3 way tap) DORSALLY,

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38
Q

How can a transudate and exudate be distinguished?

A

Transudate: Almost water like. Few nucleated cells. Protein 5g/l)
EXUDATE: Proetin content >30g/l
Cell count >50x109

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39
Q

Ddx for modified transudate

A

Cell count 1.5 x 109l Protein 25-40g/l

Heart failure, neoplasm, diaphramatic rupture

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40
Q

Ddx for exudate

A

Penetrating injury, Migrating forein body, pleuropneumonia, feline infectious peritonitis

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41
Q

Ddx Chylothorax

A

Often ideopathic, damage to thoracic duct.
Neoplasm
Heart failure

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42
Q

Equine Pleuropneumonia is most likely…

A

Mixed bacterial infection that are normal flora of the pharynx due to suppression of pulmonary defense.

  • Transport over long distances
  • Strenous exercise
  • Surgery, anaesthesia
  • Foaling
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43
Q

Equine Pleuropneumonia normally has what type of distribution

A

Cranioventral distribution due to main stream bronchi

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44
Q

Which bacteria are involved withe quine pleuropneumonia

A

Normal flora of the pharynx

-Ecoli, Klebsiella, Pasteurella, Bordatella, Bacteroides.

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45
Q

How do the acute/chronic signs of equine pleuropneumonia vary

A

Acute: Pyrexia, lethargy, shallow breathing, stiled gait, pleurodynia
Later: Nostril flare, tachycardia, increased jugular pulse height (fluid), toxic mucous membranes
Chronic: Intermittent fever, weight loss, ventral oedema

46
Q

Diagnosis of equine pleuropneumonia

A

History (travelling?Stress?), thoracocentesis, TRANSTRACHEAL ASPIRATE (as its normal pharangeal mucosa, can’t contaiminate)

47
Q

4 aims of treatment for equine pleuropneumonia

A

Remove excess pleural fluid - INDWELLING
Antibiotic therapy
Antiinflammatory/ analgesic
Supportive care (oxygen, bronchodilators, fluids, nutrition)

48
Q

Ideal antimicrobials for treatment of equine pleuropneumonia

A

Penicillin, Gentamycin, Metronidazole THEN BASE ON CULTURE/SENTITIVITY

49
Q

Problems with stocking different age groups together (dairy herd)

A

Older animals may be shedding pathogen that they are immune to.
Could be first exposure for younger animals= clinical disease.
NOT GOOD PRACTICE

50
Q

How can a simple inhouse test tell you whether the calf has consumed enough collostrum>

A

-Take blood sample from HEALTHY CALF
- Let it clot, remove serum
-Test serum using refractometer
Want it to be 5.5 or above

51
Q

When testing serum for adequate collostrum intake, why should ill calfs not be used?

A

If calf is already ill, artificially high specific gravity due to dehydration.
If adequate colostrum in healthy calf should be >5.5

52
Q

Enzoonotic Pneumonia primary pathogens

A

The primary pathogen damages the respiratory tract e.g. Virus or Mycoplasma
Allows for secondary pathogen to invade and cause damage

53
Q

Which 3 virus cause serious respiratory disease in cows

A

Bovine Respiratory Syncitial virus, Infectious Bovine Rhinotrachitis, Bovine Coronavirus
(Parainfluenza = mild)

54
Q

Which secondary bacteria can invade following initial damage (in cows)

A

Mannhemia haemolytica (A1&A6)
Pasteurella multocida
Arcanobacterium pyogenes
Histopillus somni

55
Q

You arrive on a farm where 4 calfs have respiratory disease, what steps do you take

A

SUSPECT PNEUMONIA
- Individual examination of 2/3 calfs
- Take temperatures of ALL IN GROUP
= Treat all with pyrexia (>39.7)

56
Q

Which two groups of drug are used to treat pneumonia

A

Antibiotics

NSAIDs (decrease temperature, increase appetitie)

57
Q

Nuflor (Flurifenicol) should NOT be used in

A

Breeding males.

Effective against bovine respiratory disease e.g. Mannhemia haemolytica

58
Q

When trying to identify pathogens causing respiratory disease in calfs, which are the best ones to sample?

A

Those in VERY EARLY stage of disease e.g. those that are just Pyrexic (above 39)
PME any dead calfs
Paired serology

59
Q

IBR signs

A

Pyrexia, Conjuctivitis, Coughing, Trachetisis (asculatae trachea) –> can be severe. Trachitis is obvious on PM
Caused by BHV-1

60
Q

BHV-1

A

Most identifiable on nasopharangeal swab.
= Infectious bovine rhinotrachitis (IBR)
Also has a RARE genital form- vulvovaginitis

61
Q

BHV-1 (IBR) can be latent, where does it reside?

A

Trigeminal Ganglion (CN V)
Can recrudesce and shed again during periods of stress–>pregnancy, parturition, transport.
Cannot RELIABLY DETECT, Sero-negative may still be latent . Take BULK MILK ANTIBODY TITRE

62
Q

IBR - type of vaccination and how quickly they work

A

Live, Dead, Marker (DIVA)
Live vaccines induce rapid immunmity, 40-96 hours
Often only single dose.
Young animals may need 2 doses due to MDA

63
Q

Pathogen causing Calf Diptheria. Most characteristic sign is…

A

Fusobacterium necrophorum.
Calf Diptheria = necrotic laryngitis.
Lesions in mouth, tongue and larynx, Produces foal smelling necrotic lesions.
OFTEN HAVE HALATOSIS

64
Q

Cause of Calf Diptheria

A

Mucosal injury from teeth, poor hygiene of feeding equipment, poor hygiene of feeding equipment, coarse feeds.
Fusobacterium necrophorum

65
Q

When is aspiration pneumonia a problem in cows?

A

Very severe pneumonia caused by inhalation of milk.

Associated with stomach tubing INCORRECTLY

66
Q

Cause of shipping fever / Presenting signs

A

Pneumonic Pasteurellosis. Mannhaemia haemolytica, Pasteurella multicida
Normally seen 10-30 days after transport = GOOD HISTORY,
Presenting signs: Sudden onset, depressed appetitite, increased respiratory rate, grunting, found dead.

67
Q

Cause of Fog Fever

A

AKA: Acute bovine Pulmonary Oedema and Emphysema.
Non infectious disease.
Asssociated with cattle grazing lush pasture.
Within 2 weeks of moving to Autumn pastures due to TRYPTOPHAN

68
Q

When you suspect Fog Fever what is the first line of treatment

A

REMOVE FROM PASTURE! Tryptophan metabolised to 3-Methyl Indole = pneumotoxic.
CARE MOVING OFF PASTURE. STRESS= DEATH.
Systemic NSAIDs, Diuretics, Corticosteriods (NOT IF PREGNANT!= ABORTION)

69
Q

Bovine Farmers lung is caused by

A

Hypersensitivity following inhalation of allergens from moulds (poorly made hay)
Housed cattle with poor ventilation,
DON’T FORGET LUNGWORM AS DDx

70
Q

How would the ausculatation sounds vary between Pneumothorax and Hydrothorax?

A

Pneumothorax: Same/ enhanced lung soudns
Hydrothorax: Reduced/absent lung sounds
Fluid: more ventral
Air: more dorsal

71
Q

Most intranasal tumours are

A

MALIGNANT. Solid carcinoma, adenocarcinoma or chondro,fibro, osteoSARCOMA.
One exception: Benign polypoid rhinitis (very rare but only indistinguishable on histopath)

72
Q

Primary and Secondary Pathology of Brachycephalic airway obstruction syndrome

A

Primary pathology: Stenotic nares, Long soft palate

Secondary pathology: Evertion of the lateral larngeal ventricles, Larngeal collapse

73
Q

What is a common complication of stressed and severely dysnopic brachiocephalic dogs?

A

Laryngeal and Pharyngeal oedema develops (which worsens the situation)

74
Q

Tracheal Hypoplasia is very common in which breed of dogs? What is the treatment?

A

Bulldogs are very suseptible to tracheal hypoplasia (a narrowing of the trachea). There is no treatment for this condition.

75
Q

Procedure when playing trachetomy tube

A

Try to be aseptic (not in emergency)

  • Ventral midline skin incision in neck, 2-4 cm caudal to larynx
  • Seperate stenohyoid/sternothyroid muscles to reveal trachea
  • LONG STAY SUTURES (Can stablise trachea/pull to surface)
  • TRANSVERSE incision between the fourth and fifth tracheal rings
76
Q

When and HOW do you remove the tracheotomy tube?

A

When the dog demonstrates adequate upper airway movement (air flow around tube)
Remove tube and leave to heal by SECOND INTENTION

77
Q

Clinical features of Laryngeal paralysis

A

Can be congenital, Acquired, Idiopathic

  • History of exercise intolerance
  • Dysphonia
  • Increased respiratory noise (esp inspiration)
  • Cyanosis and collapse
  • Often hyperthermic
78
Q

Treatment of Laryngeal paralysis

A

If acquired and known (e.g. trauma, neoplasia- mediatinal/thyroid, hypothyroidism) TREAT UNDERLYING
LEFT ARYTENOID LATERALISATION (suture of arytenoid to the thyroid)

79
Q

Cause and Signalment of Tracheal Collapse

A

Cause: Poor tracheal cartilage development (low glycosaminoglycans)
Signalment: Small toy breeds e.g. poodles
Goose honk cough.
Can often palpate a dorsoventral flattening of the trachea (can occlude airway with pressure)

80
Q

First and Second line of treatment for Tracheal Collapse

A

First line of treatment is MEDICAL: Older dogs more likely to have other more important diseases. Loose weight, steroids may help control oedema.
Second line of treatment: SURGICAL (only if tracheal collapse is primary disease)

81
Q

How does the surgical treatment for tracheal collapse vary depending on the age of the animal

A

Prosthetic rings if younger animal

Intraluminal stends for older dogs with co-morbid disease

82
Q

Subcutaneous empysema which can be generalised over the whole body is very indicitive of which type of lower airway pathology

A 
Subcutaneous emphysema (air under the skin) is very indicitive of tracheal laceration/trauma e.g. dog bite wounds (always aim for neck!) 
Other clinical features: Pneumomediastinum --> Pneumothorax (respiratory distress)
83
Q

Most common type of primary lung tumour in the dog?

A

Most are malignant.

Adenocarcinoma is the most common.

84
Q

Normally the right middle and right cranial lung lobes are most frequently involved in lung lobe torsion. Which species is the exception where THE LEFT lobe is involved

A

In pugs it is normally LEFT LOBE TORSION.
Normally narrow deep chested dogs
Clinical features of all torsions: Depressed, inappetent, dyspnoea/cough/ muffled lung sounds.
The torsions are normally associated with pleural effusion causing collapse and then twisting follows

85
Q

Treatment of lung lobe torsion

A

Normally right medial/cranial lobes.
DO NOT UNTWIST (releases toxins) just use staples.
Affected lobe looks like liver instead of lung.

86
Q

Why is it important to differentiate acquired from spontaneous pneumothorax?

A

Acquired: Thoracocentesis

Spontaneous (no history of trauma): REFER as more likely to need surgery

87
Q

What are the diaphram attachments?

A

Dorsally to L3 and L4.
Ventrally to Sternum
Laterally to ribs/ sternum

88
Q

Treatment of Acquired Diaphramatic Disease

A

Acute post trauma patient: 24-48 hours stablisation prior to repair of the diaphramatic hernia.
If radiography reveals dilated stomach within thoracic cavity = immediate trans-thoracic gastrocentesis. If decompression cannot be maintained = emergency surgery indicated

89
Q

In which breed of dog is Oesophagial hiatial hernia (EHH) thought to be hereditary>

A

Shar-Pei dog.

Laxity of the oesophageal hiatus allows the abdominal oesophagous and cardia of stomach to slide into thoracic cavity.

90
Q

Clinical signs of EHH>

A

Oesophageal Hiatial Hernia.
Clinical signs = gastrointestinal reflux, regurgitation and/or vomiting.
Chronic oesophagitis, Aspiration pneumonia

91
Q

What are the main lungworms is a) horse b) dog c) cat

A

a) Horse: Dictocaulus arnfieldi
b) Dog: Angiostrongylus vasorum/ Filaroides
c) Aelurostrongylus abstrusus

92
Q

Equine lungworm Diagnosis

A

DICTYOCAULUS ARNFIELDI

  • Grazing History (DONKEY sharing grazing)
  • Faecal examination (McMaster method –> embronated eggs)
  • Tracheobronchial washing
  • Response to anthelmintic treatment
93
Q

How do the tests differ for D.arnfieldi depending on time following expulsion?

A

Faecal examination.
If faeces passed and examined immediately = embryonated eggs (McMaster method)
If faeces passed then left for a bit = test for L1 i.e. Baerman technique

94
Q

TYPE of lungworm that infects dog

A

Angiostrongylus vasorum is a TYPICAL Metastrongyloid namatode (indirect life cycle, slugs/snails 2cm).
Predilection site: Pulmonary arteries, RHS heart.
Cardio-respiratory signs/Coagulopathies/ Neurological signs

95
Q

Mechanism by which Angiostrongyulus vasorum leads to coagulopathy in dog

A

Subcutaneous haematoma, internal haemorrages, prolonged bleeding from wounds.
MECHANISM: Thrombocytopenia, Decrease clotting factors.
Scleral haemorrage/ retinal haemorrhage

96
Q

Diagnosis of Angiostrongylus vasorum

A

Bearman technique for examination of L1 in faeces OR sputum
PPP: 6-10 weeks.
Blood: Idexx ELISA
Easinopohillia/ coagulopathy tests

97
Q

Treatment of lungworm in the dog

A

Two licenced:
Moxidectin (advocate) - single dose prevents infection for a month
Milbemycin (milbemax) - weekly for 4 weeks)
OFF LABEL
Fenbendazole (panacur) daily for 1-3 weeks (works by starvation as is a benzimidazole)

98
Q

Filaroidies lifecycle and transmission

A

Much less common than A.vasorum
Atypical Metastrongyloid
Direct life cycle. Transmission bitch to puppy during grooming.
Can be asymtomatic –> dry cough.

99
Q

Diagnosis Filaroides

A

DIFFICULT as very few and sluggish.
Bearman technique used to recover L1
Endoscopy VIEW TRACHEAL NODULES –> confirm diagnosis.
TREATMENT: Fenbendazole for 7 days

100
Q

Would you you expect on post mortom in a cat infected with Angiostrongylus abstrusus?

A

Typical metastrongyloid.

Greenish nodules in lungs (green when unstained)

101
Q

Dictyocaulus arnfieldi is the most common respiratory parasite of horses. Which others are relatively common?

A

Parascaris equorum (migrating larvae)

102
Q

How does the diagnosis of bovine lungworm differ from the diagnosis of equine lungworm?

A 
Dictocaulus viviparvous (cow) = Trichostrongyle. Bearmans test for L1 larvae 
D. arnfieldi if tested immediately after passing faeces= McMaster for embroynated eggs.
103
Q

Cause of parasitic bronchitis in cows?

A

The trichostrongyle Dictyocaulus viviparus.
Lower milk yield in cows.
PPP: 3.5 weeks
Found in trachea and larger bronchi

104
Q

How can you differentiate Dictyocaulus viviparus from Ostertagia in cows?

A

Both trichostrongyles.
GIT parasite: Longer, Intertinal CELLS
Lungworm parasite: Short, blunt tail, Intestinal GRANULES

105
Q

Pathogenesis of D. viviparus

A 
Penetration phase: Larvae migrate to lungs (even after vacc) 
Prepatent phase (1-3 wks): EASINOPHILLIC EXUDATE in bronchioles. Start clinical signs due to alveolar collapse distal to blockage. Tachypnoea/Coughing
106
Q

Pathogenesis of Parasitic Pneumonia in cows?

A

D. viviparvous (granules causes areas of consolidation due to reaspiration of eggs + larvae
= cellular infiltration by polymorphs, macrophages

107
Q

Why should vaccinationed and unvaccinated cattle not be kept on the same pasture?

A

Vaccinated cattle still excrete SOME L1 in faeces.
Can cause DISEASE in unvaccinated.
BUT ALSO Unvaccinated create MASSIVE CHALLENGE = disease in VACCINATED cattle as well.
VACCINATION PREVENTS DISEASE NOT INFECTION

108
Q

On PM examinated which lung lobes are most commonly infected with D.viviparvous?

A

Diaphramatic lobes have plum coloured areas of consolidation. If placed in formulin will sink due to lack of air space

109
Q

Two lungworm of sheep and their life cycles.

A

Dictyocaulus filaria: Lungworm of sheep with direct life cycle
Muellerius: Indirect, mollusic host, adult worms in alveoli. Creates nodular lesions = NOT SIGNIFICANT

110
Q

How are D. filaria and Muellerius differentiated?

A

D. filaria: Granules (as all lungworm) BLUNT TAIL
Muellerius: Granules. Blunt tail WITH SPINE
‘Lead shot’ nodules.

VetMed Year 3-Term 2 (11 decks)

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