Week 1 - Triage and initial stabilization

Question 1

Bounding or “water hammer” pulses

Answer 1

Forceful, rapidly increasing
-Fever
-Sepsis
-PDA
-Anemia

Question 2

Reasons for tachycardia

Answer 2

-Early shock
-Anemia
-Arrhythmia
-Hypoxemia
-Hypercapnia
-Excitement

Question 3

Pale MM’s

Answer 3

(Muddy, grey, or white)
-Poor perfusion
-Vasoconstriction from shock
-Anemia

Question 4

Red MM’s

Answer 4

-Vasodilation
-Sepsis
-Hyperthermia
-Anaphylaxis
-Carbon Monoxide toxicity (alarm)

Red = fire alarm

CRT <1

Question 5

START method

Answer 5

RED - critical, needs life saving treatment immediately
YELLOW - can wait a few hours for treatment
GREEN - green = go, with or without treatment
BLACK - will die regardless of treatment

Question 6

Brown MM’s

Answer 6

-Methemoglobinemia
-Acetaminophen toxicity in cats

Tylenol = Carprofen (brown pills)

Question 7

Yellow MM’s

Answer 7

-Icterus
-Bile duct obstruction, liver disease
-Sepsis in cats (cats can have yellow eyes)
-Hemolysis
-Hyperbilirubinemia

Question 8

Blue MM’s

Answer 8

-Hypoxia
5g/dL of hemoglobin to show blue

Blue = Blaine 2005

Question 9

Fluid overload signs

Answer 9

-Serous nasal d/c
-Increased RR/RE
-Chemosis (3rd eyelid coming up)
-Increased skin turgor
-Increased weight
-Peripheral edema

Question 10

ABCD’s

Answer 10

-Airway
-Breathing
-Circulation
-Disabilities

Question 12

Hypoxemia

Answer 12

SPO2 <95% and PaO2 <80mmHg

Question 13

Pulsus alternans

Answer 13

-Alternates between small and large volume pulses
-Can be seen on ECG, R wave amplitude = pericardial effusion
-L sided heart failure
-DCM

Question 14

Pulsus paradoxus

Answer 14

-Pulse volume decreases on inspiration
-Pulse volume normal on expiration
-Can be seen on ECG

Cardiac tamponade

Question 15

Decreased lung sounds

Answer 15

-Pleural effusion
-Pnemonthorax
-Pulmonary consolidation (pneumonia, pulmonary edema)

Question 16

Crackles in lungs

Answer 16

-Pneumonia
-Pulmonary edema
-Pulmonary hemorrhage

Crackles = snap, crackle, pop (P)

3 P’s

Question 17

Expiratory wheezing

Answer 17

-Bronchitis
-Small airway collapse

Question 18

Stridor breathing

Answer 18

High pitched, upper airway partial obstruction

Stridor = high, upper

Laryngeal paralysis

Question 19

Stertor breathing

Answer 19

Low pitched, lower airway partial obstruction

Stertor = stern voice = low

Question 20

Primary assessment

Answer 20

-Visual
-TPR
-Owner history

Question 21

Relative bradycardia

Answer 21

Unexpected Low HR despite the under condition

Relative = not related to symptoms

A dog with hypovolemic shock with HR of 100bpm (should be tachycardic)

Question 22

Kussmaul breathing

Answer 22

Slow, deep breathing

-Severe Metabolic disease
-DKA
-Kidney disease

K’s

Question 23

Pulse deficits

Answer 23

Difference between pulses felt and heart rate heard

= cardiac arrhythmias, VPC’s

Decreased blood flow

Question 24

Muffled heart sounds

Answer 24

-Pericardial effusion
-Pleural effusion

Question 25

Secondary assessment

Answer 25

-PE (ABCD’s) -Cardiovascular -Respiratory -CNS, LOC

Question 26

Paradoxical breathing

Answer 26

When chest and abdomen move in opposite directions during inhalation and expiration Tx = thoracocentesis X - in both paradoxical and tx

Question 28

Level of consciousness (LOC)

Answer 28

-Obtunded: less responsive to visual or tactile stimuli, depressed -Stupor: only responsive to painful or vigorous stimuli (toe pinch) -Coma: non-responsive

Question 29

YELLOW (START method)

Answer 29

Will survive with treatment within a few hours -Mild respiratory distress -Uncontrolled, mild hemorrhage -History of unconsciousness -Fractures -V/D -Ophthalmology injuries

Question 30

GREEN (START method)

Answer 30

Will survive with or without treatment Green = Go

Question 31

RED (START method)

Answer 31

Critical condition and needing life saving treatment immediately -Severe decompensatory shock -Exsanguinating hemorrhage -Severe respiratory distress -Active seizures -GDV -Acute poisoning

Question 32

Reasons for bradycardia

Answer 32

-Shock in cats -Athleticism -Cushing’s disease -Medication (opioid, alpha-2 agonist) -Electrolyte imbalance (hyperkalemia)

Question 33

Neonates

Answer 33

-Hypothermia: lack of insulating fat -Hypoglycemia: demand for glucose, poor liver and muscle glycogen reserves -Dehydration

Question 34

Inspiration:Expiration Ratio

Answer 34

I:E is 1:2