Week 4 - March 3 Day 1 Flashcards

Question

Answer 1

Spica splints are large padded bandages placed over the affected limb and torso, often in order to immobilize proximal fractures.

Answer 2

Schroeder-Thomas splints represent another type of splint that has been used in the past for fracture immobilization.

Answer 3

Dark red vaginal discharge occurs normally for up to 6 weeks after whelping. Subinvolution can cause fresh bleeding for 12-15 weeks post-partum. Metritis is usually accompanied by systemic signs and may have abnormal vaginal discharge but not usually hemorrhage. Retained placentas typically do not occur in bitches. Pyometras occur during the luteal phase when progesterone levels are high, up to 9 weeks after estrus, and would not occur post-whelping.

Answer 4

Hypovolemic shock is characterized by a critical reduction in intravascular volume (severe dehydration, hemorrhage, third-space loss). The decrease in intravascular volume (preload) results in a decrease in stroke volume and subsequently cardiac output, which will eventually result in a decrease in tissue perfusion and oxygenation. Cardiogenic shock is the result of a decrease in myocardial contractility with subsequent decrease in oxygen delivery. It is always associated with primary heart disease. Obstructive shock occurs when there is an abnormal blood distribution that impairs blood return such as in gastric dilation-volvulus where obstruction of the vena cava can occur or in pericardial tamponade. Distributive or vasogenic shock is typically secondary to sepsis and anaphylactic reaction causing vasodilatation.

Answer 5

1. High number of malassezia yeast visualized on cytology. This organism can be responsible for perpetuating otitis externa. It is not unusual to see yeast in the ear canal of a dog; however, yeast numbers of greater than 5 per high powered field can be considered abnormal. 2. Other clinical signs of otitis externa may include ear pain, pruritis, aural discharge, bad odor, and neurologic signs. 3. Effective treatments for uncomplicated otitis externa typically contain an antifungal, antibiotic, and an anti-inflammatory. Since this dog primarily has a yeast infection it is imperative that the ear medication prescribed has an anti-fungal. - Triple antibiotic ointment (neomycin, bacitracin, and polymyxin B) *Note: no antifungal here* - Tresaderm (thiabendazole, neomycin, and dexamethasone) - Mometamax (mometasone, gentamicin, clotrimazole) - Otomax (gentamicin, betamethasone valerate, and clotrimazole). Additionally, the ears should be cleaned before applying the ear medication. Many ear cleaners contain antifungals too (Triz Ultra + Ketoconazole), which may enhance treatment response.

Answer 6

The medial meniscus is commonly damaged in a dog with a ruptured cranial cruciate ligament because the meniscus is closely associated with the medial collateral ligament, which prevents the meniscus from moving around within the joint when the femoral condyle compresses and slides against it. When there is joint instability following the CCL rupture, the medial collateral ligament is no longer able to prevent movement of the medial meniscus and damage occurs The lateral meniscus is not associated with the collateral ligament and can freely move around when compressed by the femur.

Answer 7

Coccidioidomycosis. The travel history and clinical signs are consistent with this answer. Additionally, finding spherules on cytology is pathognomonic for Coccidioidomycosis. Prolonged antifungal treatment will be necessary. Fluconazole is the treatment of choice.

Answer 8

Carbonic anhydrase inhibitors (such as dorzolamide) act by decreasing aqueous production, which is partially dependent on the conversion of carbon dioxide to bicarbonate. It can be used topically or systemically. Latanoprost (Xalatan) is a prostaglandin analog frequently used topically in the treatment of glaucoma. IV mannitol works to decrease lOP through its properties as an osmotic attractant; it is not used topically. Atropine is contraindicated in some glaucoma cases. Tacrolimus is used as a topical immunosuppressant, and used most commonly for dry-eye.

Answer 9

1. Pyrexia, lethargy, dehydration, inappetence, vomiting, and icterus. 2.The key to this diagnosis is the liver biopsy - will see infiltration of lymphocytes and plasma cells but not neutrophils into portal areas. This is in contrast to chronic cholangiohepatitis which typically has neutrophils in portal areas. 3. Chronic cholangiohepatitis carries a fair prognosis with about half of cats doing poorly (dead or euthanized within 3 months) and half of cats responding favorably to treatment with long term survival. For cats with lymphocytic portal hepatitis, although treatment can be challenging, the disease is very slowly progressive and the reported mean survival is approximately 3 years. 4. Prednisone?

Answer 10

Atropine & any beta blocker. Atropine thickens bronchial secretions and encourages mucous plugging of the airway. Stimulation of beta-2 receptors in smooth muscle leads to bronchodilation. If blocked --> bronchoconstriction

Answer 11

The correct answer is that the cat has primary metabolic acidosis with compensatory respiratory alkalosis. The low pH tells you the cat is acidemic so the primary disorder must be an acidosis because compensatory mechanisms will never overshoot the primary abnormality. In this case, the negative base excess or low HCO3 tells us there is a metabolic acidosis (renal disease can cause this). The low PaCO2 tells us there is a respiratory alkalosis or hyperventilation. The primary abnormality must be the metabolic acidosis. The respiratory alkalosis can then be interpreted as compensatory.

Answer 12

The correct answer is Horner's syndrome. This is likely as a result of direct disruption of the sympathetic trunk traveling along the neck. Any time there is a neck mass present, it is important to evaluate the patient for the possibility of Horner's syndrome. Additionally, disruption of the recurrent laryngeal nerve should be considered as this will result in laryngeal paralysis. Hypercalcemia of malignancy is always a possibility with any mass; however, it is not reported commonly with thyroid adenocarcinomas in cats. Hypertrophic cardiomyopathy can be a feature of hyperthyroidism, which is usually secondary to a thyroid adenoma. Based on this patient's blood work, there is no evidence of hyperthyroidism. Renal failure is not a reported complication.

Answer 13

Bone tumors are relatively rare in cats, but the most common bone tumor in cats is osteosarcoma. In cats, osteosarcomas are slow to metastasize so amputation in many cases can be curative. Osteosarcomas are most commonly found in the hind limbs in cats. Cats with appendicular osteosarcoma have a much better prognosis than dogs with osteosarcoma due to a lower rate of metastasis. Some papers cite a survival time of over 2 years, but a more recent study sited approximately 12 months. In comparison, dogs with appendicular osteosarcoma have a median survival time of approximately 3-4 months with amputation alone. Metastasis to the lungs in dogs is usually the reason for death.

Answer 14

Treatment for coccidia is usually with sulfonamides such as sulfadimethoxine or trimethoprim sulfa. Droncit- Primarily for cestodes (tapeworms) Revolution- For fleas, heartworms, hookworms, roundworms, and ear mites Strongid- Primarily for roundworms and hookworms Clavamox- A broad spectrum antibacterial Metronidazole- Primarily for anaerobes, also used for giardia

Answer 15

GGT is NORMAL ALP is ELEVATED

Answer 16

Fecal oral transmission The primary source of infection of the FIP virus is due to fecal-oral transmission. Eventually, feline corona virus mutates to a virulent feline infectious peritonitis virus which is able to multiply in macrophages. Ideally, a strong cell-mediated immune response eliminates the virus, but in some cats, the infection can become latent and is reactivated with stress. If a cell-mediated immune response is not mounted, pyogranulomatous vasculitis will occur due to the deposition of antigen-antibody complexes in the venous endothelium. Complement-mediated inflammation results in pleural and peritoneal effusion (wet form) and partial cell mediated immune response results in slow viral replication with granuloma formation (dry form).

Answer 17

Asthma causes expiratory dyspnea, or a marked abdominal push seen on expiration with normal inspiration. This occurs as a result of collapse of the lower airways during expiration. This occurs in asthmatics because negative intrathoracic pressure (exerted during expiration) can more easily cause collapse of the thickened and weak bronchial walls. This traps air inside the alveoli. During the next inspiratory cycle, there is decreased fresh air exchange and increasing hypoxemia. Obstructive breathing is characterized by long slow inspirations and can be accompanied by stridor or stertor. This occurs as a result of upper airway disease such as laryngeal paralysis, brachycephalic airway syndrome etc. Restrictive breathing occurs as a result of pleural space disease and causes short, shallow and rapid breathing. Labored breathing is a catch-all phrase to describe short rapid and deep breathing. This generally occurs with pulmonary parenchymal diseases such as pulmonary edema or pneumonia.

Answer 18

The correct answer is shedding of virus via saliva. The main mode of transmission is via saliva. It requires prolonged, close contact. Cats may shed the virus for months to years. Transmission may also occur through reuse of instruments and blood. Virus is shed in saliva, tears, urine, and feces.

Answer 19

The correct answer is tendonitis. The intermittent lameness and bulge at the metacarpals are classic for bowed tendon or tendonitis.

Answer 20

The correct answer is an elevated alkaline phosphatase. The horse, unlike the dog, does not have a steroid-induced isoenzyme of alkaline phosphatase. Hyperglycemia is common due to the counter-insulin effects of cortisol. Low urine specific gravity is a common feature of Cushing's seen in dogs and horses and is the reason affected animals are polyuric and polydipsic. The stress leukogram (neutrophilia, lymphopenia) is due to the effects of cortisol as well.

Answer 21

The correct answer is 9OL. Total body water is 60% of body weight. Extracellular fluid is approximately 1/3 of total body water, therefore 450kg x .6 = 270L total body water 270L x .33 = 89.1L ECF. ECF is composed of plasma, interstitial fluid and transcellular lymph such as CS and synovial fluid.

Answer 22

Myoglobinuria is characterized by brownish urine that does not clear on centrifugation along with normal-colored plasma. Myoglobin does not bind to serum proteins and is quickly excreted before reaching levels that would discolor the plasma. Conversely, hemoglobinuria is associated with a reddish discoloration of the plasma because hemoglobin is maintained in the plasma longer and is lost in the urine more slowly.

Answer 23

With EPM, the important signs to remember are asymmetry, ataxia, and atrophy. Lateralization of the signs (asymmetry) and quadriceps and/or gluteal muscle atrophy are most consistent with EPM. Herpes myeloencephalitis is caused by EHV1 and often has an acute onset following an episode of fever, cough and nasal discharge or following abortions on a farm. This condition often affects more than one horse on a farm. The ataxia and weakness is usually symmetric. Cervical vertebral stenotic myelopathy (CVM) and equine degenerative myeloencephalopathy are seen in younger horses (< 3-4 yrs of age) and typically cause symmetric signs with the hindlimbs usually a grade worse than the forelimbs. The signs of CVM may be worsened by flexing or hyperextending the neck. Polyneuritis equi is more common in mature horses and usually starts with hyperesthesia progressing to anesthesia. There is progressive paralysis of the tail, rectum, bladder and urethra leading to urine dribbling. You may also see tail rubbing and urinary and fecal incontinence as a result. Verminous myeloencephalitis is less common and the onset is usually sudden with rapid deterioration and death. Equine protozoal myeloencephalitis (or myelitis) can affect any age horse and is caused by Sarcocystis neurona. It should be suspected in this case due to the asymmetry of clinical signs, as it is a multifocal disease of the central nervous system. Wobbler syndrome and degenerative myeloencephalopathy are diseases seen primarily in younger horses (< 3-4 years of age). Degenerative myelopathy causes a symmetrical ataxia. Cauda equina neuritis typically causes tail rubbine and urinary and fecal incontinence.

Answer 24

The correct answer is hyperosmolality and decreased circulating volume. In the horse, as in other species, ADH increases renal water reabsorption and urine osmolality by increasing permeability of the collecting tubules. Osmoreceptors in the hypothalamus detect subtle changes in plasma osmolality. If osmolality rises, you will hope to see ADH secretion so that the urine excreted would be more concentrated. The same is true if circulating volume decreases; thus, a lesser volume of water would be lost. When ADH secretion does not occur or if the kidneys are unable to respond to ADH, this is likely diabetes insipidus, and animals will be very polyuric, polydipsic and have extremely dilute urine. `

Answer 25

Both small intestinal obstruction and duodenitis-proximal jejunitis (DP)) present with similar clinical signs. The problem is that a small intestinal obstruction will be a surgical disease, and duodenitis-proximal jejunitis responds better to medical treatment. The cause of duodenitis-proximal jejunitis remains unknown. Clinical signs include acute colic with increased respiratory rate, heart rate, and pain. Additionally, there will be lots of gastric reflux. After decompression of the stomach via nasogastric intubation and removal of excess gastric/intestinal fluid, horses with DPJ may appear much more comfortable.

Answer 26

The correct answer is twice. This finding is diagnostic for a uroperitoneum. In a foal, this is usually due to urinary bladder rupture at the time of parturition due to large pressures exerted on the urinary bladder during parturition.

Answer 27

The correct answer is venereally. Carrier stallions can infect mares. It can also be spread by aerosol. Equine viral arteritis (EVA) is in the genus Arterivirus, family Arteriviridae and causes vasculitis leading to edema, conjunctivitis, rhinitis, and abortion.

Answer 28

The correct answer is combined immunodeficiency. Any Arabian foal with persistent infection should be suspected of having this heritable immunodeficiency of B and T lymphocytes. Typically, foals with CID do not demonstrate evidence of repeated infection until maternal antibodies begin to wane. There is no treatment for this disease.

Answer 29

The correct answer is damage to cranial nerves VII (facial nerve) and VIII (vestibular nerve) on the left side caused by fracture of the basisphenoid bone. This is a common injury when a fractious young foal rears up and falls backward on the poll. The basisphenoid bone becomes injured resulting in injury to cranial nerves VII and VIII. Damage to the facial nerve results in the muzzle deviation (opposite direction of the side of injury, in this case deviated to the right), ptosis of the left eye and drooping of the left ear. Damage to the vestibular nerve results in the head tilt.

Answer 30

The correct answer is Equine Herpes Virus Myeloencephalitis. Clinical signs that are common with EHV myeloencephalitis include bladder paralysis with urine dribbling, fecal retention, and hindlimb ataxia. The xanthochromic CSF with the high protein and normal cell count (albuminocytologic dissociation) is also very suggestive of EHV myeloencephalitis. Virus isolation can be attempted on buffy coat samples, nasal swabs, and/or CSF in an attempt to identify the virus.

Answer 31

The correct answer is fetal or neonatal hemoabdomen. All other choices listed were potential disease manifestations of MRLS. The exact pathogenesis of MRLS is still unknown, but the presence of eastern tent caterpillars was strongly associated with the disease. Later, experimental studies in which pregnant mares were exposed to or fed, via NG tube, eastern tent caterpillars resulted in early and late fetal loss.

Answer 32

Stringhalt is a myoclonic disease affecting one or both pelvic limbs. It causes spasmodic hyperflexion of the leg. The etiology is unknown but sweet pea poisoning is thought to be associated with the condition. Diagnosis is based on clinical signs, but electromyography can be used to confirm the diagnosis. Treatment involves tenectomy of the lateral digital extensor; however, not all cases respond to the treatment.

Answer 33

Aminocaproic acid is the best choice of those listed. This medication is believed to facilitate clot stabilization by blocking the activation of plasminogen to plasmin. As you may recall, plasmin is the active enzyme that dissolves clots; therefore, aminocaproic acid inhibits fibrinolysis. The other medications listed would have an anti-coagulant effect and would be contraindicated in this mare.

Answer 34

Cloudy and bloody This cow is likely to have acute pyelonephritis. It is most commonly ascending and associated with E. coli, other coliforms, or Corynebacterium renale. You could also use ultrasound to confirm the diagnosis, but finding neutrophils, RBCs and bacteria with these signs is indicative of acute pyelonephritis.

Answer 35

The correct answer is epizootic bovine abortion (EBA), also called foothill abortion. EBA is an important disease for beef producers in the foothill and mountainous regions of California, Northern Nevada and Southern Oregon. The lesions described in the question are consistent with this diagnosis. The etiologic agent of EBA is a bacteria, Pajaroellobacter abortibovis and the vector is a tick, Ornithodoros coriaceus. Tritrichomona foetus is involved with early embryonic death. Brucellosis abortions are rare since it has been almost completely eradicated from the U.S. Lesions include autolysis, placentitis, and bronchopneumonia. Infectious Bovine Rhinotracheitis (IBR) causes rapid fetal death; therefore, there is very little time for fetal response. Lesions you are likely to see include autolysis and focal necrosis of the organs.

Answer 36

One dose of 40 mg/kg florfenicol is reported to be an effective therapy and would be favored by a feedlot because the single treatment would avoid costly repeated handling. The use of chloramphenicol is prohibited in cattle in the USA.

Answer 37

The correct answer is PGF2-alpha and dexamethasone. This is because at this point (5 to 8 months), both the CL and the fetus are involved in maintaining the pregnancy.

Answer 38

transfuse 20 to 40 ml/Kg body weight of plasma

Answer 39

The correct answer is Amsinckia intermedia. This plant (aka fiddleneck, fireweed, and tarweed) contains pyrrolizidine alkaloids. PAs are hepatotoxic and cause three classical liver lesions. Do you recall them? Megalocytosis, biliary duct hyperplasia, and fibrosis. As a result of liver damage, the liver will be unable to clear normal chlorophyll breakdown products such as phylloerythin, which causes photosensitization secondary to liver damage. The other answer choices are primary photosensitizing agents.