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

w/c 3-Feb-14 Flashcards

1
Q

Which stage of anaesthesia induction is by passed by using IV injectable agents?

A

IV injectable agents: Propofol, Alfaxalone, propofol.
Normally animals show signs of excitement before sedation. IV agents skip this excitement c.f. with inhalation agents which don’t

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2
Q

What respiratory depression effects are seen following general anaesthetic agent induction?

A
  1. Decrease respiratory rate
  2. Decrease tidal volume
  3. Reduced minute volume
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3
Q

Propofol is classified as a ______ and must be given by the ___ route

A

PHENOL and must be given IV.

White emulsion containing lipid

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4
Q

Is metabolism of PROPOFOL faster in DOGS or CATS? Why?

A

Metabolism of propofol is faster in DOGS.
It is SLOWER in CATS as they lack the enzymes to conjugate it.
Recovery is also slower in the cat. Repeated use may cause oxidative injury/ Heinz body production

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5
Q

Why was Propofol clear replaced with Propofol plus?

A

Both designed to reduce anaesthetic waste. Both have shelf-lives of 28 days.
Propofol clear caused pain on injection.
Propofol plus doesn’t cause pain on injection. Contains Benzyl Alcohol preservative (may cause hyperkinesia in cats/ neurological tremors in dogs)

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6
Q

Alfaxalone is another GA induction agent. It is classified as a_____
The advantage it has over propofol is…

A

Steroid. Poorly soluble in water. Can be given IV/IM . Rapid onset of action, short duration.
Less cardiopulmonary depression than propofol

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7
Q

In what way is the induction agent Ketamine different from the induction agents Propofol (and to an extent Alfaxalone)

A

Ketamine rarely given alone as it causes excitement.
Ketamine causes stimulation of sympathetic nervous system (mild hypoertension and tachycardia)
Propofol is a cardiopulmonary depressive (so is alfaxalone to an extent)
With KETAMINE CNS reflexes preserved (jaw tone, swallowing)
Ketamine is also provides SOME ANALGESIA unlike others

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8
Q

Why is Thiopental contraindicated in greyhounds/ whippets?

A

Thiopental is no longer licensed. It accumulates in body fat. Greyhounds too thin therefore longer recovery.
Irritant if administered extravascularly (pH 13)
Sometimes used in horses.
Respiratory/CV effects depressed

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9
Q

Etomidate

A 
Pain on injection.
Minimal CV/Respiratory depression.
Good for sick/compromised patients. 
Depressed adrenal gland function
Injectable Induction agent
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10
Q

Best induction agent for a dog with GDV or Sepsis?

A

Fentanyl (opiod) and Midazolam (benzodiazepine) combination

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11
Q

How does the solubility of the induction drug affect the speed of induction?

A

Agents that are very soluble in blood will have a lower partial pressure in lungs –> lower partial pressure in brain.
Therefore speed of induction is SLOWER for more soluble agents

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12
Q

How does the partition coefficient of Isolflurane compare to that of Sevoflurane?

A

Higher partition co-efficient = most soluble = longer induction & recovery.
Isoflurane has a higher coefficient therefore takes longer induction/recovery than Sevoflurane

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13
Q

4 classes of sedatives

A
  1. Phenothiazines (ACP)
  2. Butryophenones (azoperone)
  3. Benzodiazepines (e.g. diazepam/ midazolam)
  4. a2 agonists (e.g. xyalizine)
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14
Q

The sedative of chose when trying to alter pig behaviour is in what class of sedative?

A

Butryophenone - Azoperone
administer in cervical region and LEAVE for 30 minutes.
Works by dopamine antagonism

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15
Q

ACP is an example of what class of sedative?

A

Phenothiazin. Works by dopamine antagonism.

CONTRAINDICATION IN ORGANOPHOSPHATE POISONING as it potentifies its effect

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16
Q

Which drug should be reduced/ not used in brachiocephalic breeds?

A

Lower dose of ACP to 0.005mg/kg (OR NOT AT ALL) and reply on opiods due to the respiratory depression of ACP

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17
Q 
Which class of sedative have anti-arrythmic effects? 
What negative effect can this alpha one receptor ANTAGONISM have?
A 
Phenothiazines (e.g. ACP) have ANTI-ARRYTHMIC properties (it is a a1 ANTAGONIST). Negative effect: Can cause hypothermia
c.f. with 4th class of sedatives the alpha agnosts which are arrythmogenic!
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18
Q

Constituents of Immobilon

A
  • ACP
  • Etorphine very potent opiod.
    FATAL TO HUMANS HAVE ANTIDOTE READY
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19
Q

How does the mechanism of Benzodiazepines vary from the mechanism of Phenothiazines and Butryophenone?

A

Phenothiazine and Butryophenone = dopamine antagonism

Benzodiazapines: Potentiation of GABA

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20
Q

Primary action of Diazapam/Midazolam.

Advantage and Disadvantage

A

Is a benzodiazapine. Muscle relaxation/ anticonvulsant .
Minimal respiratory/CVS depression
Some patients can become aggressive

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21
Q

Properties of Diazepam?

A

Insoluble in water and is an irritant. Presented in a solution in propylene glycol. IV/ Oral
Absorption into plastic - DO NOT DRAW UP TOO EARLY
Highly lipid soluble
If want to inject IM, less pain use Diazemuls

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22
Q

What is a non- sedative use of Diazepam?

A

Appetite stimulant in cats. Use is now controversial due to Hepatic failure in cats on oral diazepam.
CAUTION IN CATS WITH HEPATIC ENCEPHALOPATHY/ AGGRESSIVE

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23
Q

Properties of Midazolam

A

Water soluble (c.f. diazepam). Can be administered orally IM/IV

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24
Q

Function of Flumazenil and Sarmazenil?

A

Benzodiazepine antagonists. Use to antagonise use of diazepam and midazolam

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25
Q

Why do the side effects associated with alpha 2 agonists occur?

A

Alpha 2 receptors located centrally and peripherally.
Activation of pre-synpatic a2 receceptors = reduces noradrenaline
Activation of post-synpatic = a1 type response (vasoconstriction)
Hypertension –> hypotension

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26
Q

Which would be the best choice of sedative for a mare/foal seperation?

A

Romifidine ‘sedivet’
Less ataxia than other drugs
Is an alpha-2 agonist

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27
Q

Why are alpha 2 agonists contraindicated in cats with a blocked bladder?

A

Sedatives in the alpha 2 agonist category increase inhibit ADH, therefore increase urine outflow = problems if blocked bladder

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28
Q

Is it sympathetic or parasympathetic NS responsible for bronchodilation?

A

Sympathetic –> Epinephrine –> B2 receptors –> bronchodilation

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29
Q

The constant component of coughing is ___

A

Bronchoconstriction (parasympathetic) but seperate reflex; slower onset longer lasting, may increase efficiency of coughing

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30
Q

Which efferent nerves provide motor side to coughing?

A

Vagus (also affarent), Phrenic, Intercostal, Lumber, Trigeminal, Facial, Hypoglossal, Accessory

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31
Q

How can character of cough indicate type of problem?

A

UPPER: harsh, loud, non-productive
LOWER: soft muted, productive
PAINFUL: more muted
Swallowing after coughing = productive

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32
Q

Normal RR for a) horse b) rabbit

A

Horse: 8-15
Rabbit: 30-60
Cow, Sheep, Pig: 10-30

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33
Q

Which change in pH results in tachypnoea?

A

DECREASE. i.e. increase respiratory rate in response to acidosis
Also tachypnoea in response to high CO2

34
Q

In which species is mouth breathing not possible?

A

MOUTH BREATHING (sign of dyspnoea, including adducted elbows, neck extension) is IMPOSSIBLE IN HORSES

35
Q

Inspiratory disease is caused by

A

Extrathoracic NON-FIXED obstruction,. Negative pressure of inspiration suck into airway e.g. soft palate disorders.
Restrictive diseases as they limit lung expansion e.g. pleural effusion

36
Q

Expiratory disease is caused by

A

Intrathoracic airway obstruction e.g. bronchoconstriction, tracheal collapse

37
Q

A dog presents with inspiratory and expiratory dyspnoea, this is characteristic of

A

Extrathoracic fixed obstruction e.g. intraluminal mass of foreign body.
Extrathoracic non-fixed obstruction= only inspiratory distress

38
Q

When would dyspnoea be most apparent if the patient was suffering from pleural effusion?

A

Pleural effusion is a restrictive disease (limit lung expansion) it would be inspiratory distress

39
Q

Difficulty breathing while recumbant is known as

A

Orthopnoea e.g. pleural fluid accumulation, neonates, diaphramatic

40
Q

Why is it important to distringuih unilateral from bilateral nasal discahrge?

A

Unilateral: Origininate in structures ROSTRAL to nasal septum
Bilateral: Lower in respiratory tract (but if very low volumes could be unilat)

41
Q

Cyanosis is only visible when PaO2 is below

A

50mmHg (normal is >100mmHg).

If patient is polycythaemic patients can show cyanosis at higher PaO2 concentrations

42
Q

Wheezing indicates

A

Bronchoconstriction.

Crackles indicate small airway alveoli disease

43
Q

Advantage of transtranchal aspiration over endoscopically-guided tracheal aspirate?

A

Transtracheal aspirate has no pharyngeal contamination if procedure is performed successfully.

44
Q

If lung sounds are only reduced dorsally, this is indicitive of

A

air is dorsal

fluid is ventral.

45
Q

Which parts of tract make up the lower respiratory tract?

A

Treachea, Bronchi, Bronchioles and Alveoli

46
Q

Which parts make up the upper respiratory tract?

A

Nasal cavity, paranasal sinueses, nasopharynx, larynx, guttural pouch (horses)

47
Q

The mucocillary esculator runs from the

A

terminal bronchioles to the larynx therefore infections tend to start at junction of terminal bronchi with alveoli

48
Q

Difference between primary and secondary atelectasis?

A

Primary: Failure of lung tissue to expand at birth
Secondary: Collapse of lung tissue that was previously ventilated

49
Q

Normal colour of healthy lung tissue?

A

Salmon pink. Very useful to see neonate has taken first breath= gradual process. Important at post mortom

50
Q

Which pathologys can cause secondary atelectasis?

A 
Pulmonary or mediastinal masses
Hydrothorax
Pneumothorax
Prolonged recumbancy (large animals)
Prolonged abdominal distention (large animals)
51
Q

Secondary atelectasis due to obstruction is more common in cattle, why?

A

Lack of collateral ventrilation,

Due to bronchiolar obstruction by exudate, acts as plug

52
Q

Emphysema is defined as

A

Excessive air in the lungs.

At post mortem lungs may not deflate on opening cavity, may be inprints of ribs on lungs

53
Q

Three types of emphysema?

A
  1. Alveolar: Permanent enlargement of airspaces distal to terminal bronchioles due to destruction of alveolar walls by neutrophil elastasis (RAO horses)
  2. Interstitial: Lymphatics dilated with air secondary to forced expiration
  3. Compensatory: Emphysema is adjacent to area of consolidation
54
Q

Pneunomnia in cattle is likely to lead to what type of emphysema?

A

Emphysema: Excessive air in lungs
Pneunomonia: Struggling to breath, force air into lymphatics leading to Interstitial emphysema.

55
Q

Difference between hyperaemia and congestion?

A

Hyperaemia: increased arterial flow / inflow
Congestion: decreased outflow/ obstruction (heart failure)

56
Q

Aspiration pneumonia nomrally affects the ___lobes

A

Cranioventral lobes.

Same as bronchopneumonia (through airways!) bacterial gravitate

57
Q

Why does pulmonary oedema lead to formation of a ‘foamy’ substance?

A

Flooding of alveoli by fluid mixes with sufactant which leads to foam, this compromises ventrilation.
Normal conditions prevent accumulation of fluid by balancing pressures (lymphatic drainage)

58
Q

What is the triad of thrombosis?

A

Abnormal blood flow, hypercoagubility and endothelial injury.

59
Q

Three main types of pneumonia

A

Bronchopneumonia (fibrinous or suppurative)
Interstitial: Diffuse throughout the lung
Embolic
Granulomatous

60
Q

How can you determine if animal has bronchopneumonia by looking at gross lung?

A

LOCATION.
Cranioventral distribution - SOMETHING THROUGH THE AIRWAYS! Graviated downwards.
Normally bacterial infection

61
Q

What is bronchiectasis?

A

Principally in cattle.
Permanent dilation of some bronchi due to irreversible damage to the bronchial wall.
Sequel to chronic bronchitis or persistant bronchopneumonia.
FEEDBACK TO FARM IF LOTS COMING THROUGH ABBATOIR - underlying respiratory problem

62
Q

Interstitial pneumonia is secondary to ____ spread

A

Haematogenous spread rather than inhaled (bronchopneumonia).
Distribution is more diffuse than bronchopneumonia
e.g. distemper in dogs/

63
Q

Significance of Paraquat

A

Herbicide, very pneumotoxic.
Doses target interstital cells.
Not sold anymore

64
Q

Following movement of his cattle to lush pasture in autumn a lot of his cows are ill/ die. PM shows lung damage. What is the likely pathogenesis?

A

Acute bovine pulmonary oedema and emphysema ‘Fog fever;
Excess tryptophan metabolised to toxic compound.
Lungs enlarged with wet and widened interlobular spetum. Alveoli flooded with protein rich fluid.
= Interstitial pneumonia secondary to toxins

65
Q

Characteristic appearance of embolic pneumonia?

A

Multifocal (DDx granulomatous pneumonia)

Embolic pneumonia is secondary to endocarditis, secondary to hepatic abscessation/phlebitis

66
Q

Most nasal/paranasal sinus tumours are

A

most tumours are Malignant (but Ddx polyps)

67
Q

Most primary lung tumours are carcinomas that originate in the ___ region

A

Hilar region before spreading to local lymph nodes.

68
Q

Bordetella bronchiseptica

A

Strict aerobe, gram negative rod.
Normal inhabitant of UPT in animals.
Associated with trachreobronchitis (kennel cough)

69
Q

There are lots of bacterial which are NORMALLY present in the URT, which bacteria are NORMALLY present in the LRT?

A

LOWER REPIRATORY TRACT IS NORMALLY STERILE

70
Q

On postmortom there is a transudate fluid in the thorax and parts of the lung are dark. Why is this?

A

Transudate (Hydrothorax) is indicitive of CHF (e.g. DCM of dog).
The darkened areas of lung are likely to be secondary atelectasis (should be salmon pink)

71
Q

Following cows being turned out in Autumn, one suddenly dies after respiratory distress. The PM shows green diaphramatic lobes and interstitial emphysema. Likely cause is

A

Excess tryptophan from lush autumn pasture.
Increased cellularity on histo and hyaline membrane lining most alveoli seen.
The metabolite of typtophan is toxic to type 1 pneumoncytes

72
Q

How is supprative bronchopneumonia diagnosed on histo?

A

Airways are plugged with exudate. Causes irritation and increased inflammatory cells, eventually leads to fibrosis

73
Q

Why is pulmonary oedema commonly seen post mortem in the absence of any noticiable primary disease?

A

Barbiturates cause pulmonary oedema/

74
Q

Difference between Turbinate atrophy and atrophic rhinitis?

A

Both pig respiratory disorders.
Turbinate atrophy: Damages osteoblasts preventing bone growth. Bordetella bronchiseptica
Atrophic rhinitis: Stimulates osteoclasts = reabsoption= Pasteurella multicida

75
Q

Glassers disease is caused by

A

A disease of pigs caused by Haemophilus parasuis cases polyserositis (inflamm of multiple MM e.g. pleuritis, pericarditis, peritonitis), fibrinous exudate.
Suppurate bronchopneomonia.
Mortality high in young animals

76
Q

Enzootic pneumonia in the pig is caused by which pathogen

A 
Mycoplasma hyopneumoniae. 
Very common in young growing pigs. Aerosol transmission. Reduced growth rates
Cranioventral consolidation.
Diag: ELISA
Vaccination
77
Q

Which virus causes ‘red nose’ of the cow

A

IBR -infectious bovine rhinotrachitis.
Herpes virus. Intranuclear viral inclusion bodies.
(also respiratory syncitial virus, bovine parainfluenza virus)

78
Q

Bacteria and Clinical Signs associated with Pasteureollosis in sheep

A

Caused by Mannhemia haemolytica. (common commonsal in nasopharaynx of ruminants)
Causes epizootic pneumonia in cattle.

79
Q

Snuffles in rabbits is caused by

A

Pasturella multocida. Chronic nasal discharge, colonisation of RT, middle ear, genitalia, lungs.
Severe suppurative pnemonia

80
Q

Which bacteria causes peracute death in young calves

A

Histophillus. Normal commensal in genital tract.

Causes acute thromboembolitic meningoencephalitis, pneumonia and myocarditis in calves

VetMed Year 3-Term 2 (11 decks)

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