Term
|
Definition
haematoma formation
granulation tissue
CT
fibrocartlilage mineralisation
cancellous bone
haversion remodeling
- allows a # to be healed in a matter of weeks |
|
|
Term
| methods of fixation in orthopedics |
|
Definition
external coaptation - eg casts and babdages
External skeletal fixator (ESF)
intamedullary pins
wire
Pins and tension bands
Plates and screws |
|
|
Term
| What is an ESF in orthopedics? |
|
Definition
goes across fractures - diaphyseal fractures and articular immobilastion
Has a bar, fixation pin and clamps
They can be uni or bilateral and have pins just up one side (uniplanar) or bi planar |
|
|
Term
Intramedullary pins have a resistance against what force?
Never used in which bone? |
|
Definition
bending
Never used in the radius |
|
|
Term
| Interlocking nails - good at resisting which forces? |
|
Definition
|
|
Term
| pins and tension bands for hat #s? |
|
Definition
|
|
Term
|
Definition
Cross pins or rush pins
Cross pins - go across a #
Rush pins - bend and go round to make contact with the end of the bone |
|
|
Term
| 3 ways of applying bone plates |
|
Definition
compression
Neutralisation
Bridging |
|
|
Term
| complications in fracture management and repair? |
|
Definition
Mal union
non union
delayed union
implant failure
osteomyelitis |
|
|
Term
|
Definition
ultrafiltrate of the blood
for nourishment and lubrication of cartilage in joints |
|
|
Term
| How would you diagnose joint disease? |
|
Definition
pain
reduction in movement
lameness
crepitus
effusion |
|
|
Term
| categorisation of arthritis? |
|
Definition
two types - degenerative - OA and traumatic arthritis
- Inflammatory - immune mediated, infection or miscellaneous |
|
|
Term
|
Definition
| osteoarthirtis is a degenerative joint codition in which the cartilage degeneration, peri-articular new bone and low grade synovial inflammation |
|
|
Term
|
Definition
Primary - unknown
Secondary - instability
Inflammation
developmental
iatrogenic |
|
|
Term
|
Definition
inflammatory mediators from the synovial imflammation lead to a thickening in the synovium which leads to the cartilage producing proteases which disolve cartilage - so the balance between building and breaking down of cartilage is unbalance
Which can mean erosion and fissues more easily formed |
|
|
Term
| bacterial infectious arthritis? |
|
Definition
aka septic arthirits
direct or indirect
Direct - penetration
Indirect - heamatogenous spread from another septic focus |
|
|
Term
| Pathogenesis of septic arthritis? |
|
Definition
| massive imflammatory reaction leading to rapid cartilage destruction |
|
|
Term
|
Definition
| hx, clinical signs, arthorcentesis - increased volume and reduced viscosity |
|
|
Term
| Treatment of septic arthritis? |
|
Definition
|
|
Term
| Management overall of arthritis |
|
Definition
|
|
Term
| Medical management of OA? |
|
Definition
weight control - obesity is a big risk factor
nutritional supplements like omega FAs
Execise management
Pain management - NSAIDS or corticosteroids - last resort |
|
|
Term
carpal laxity in pups - history related often?
Treatment? |
|
Definition
Often had poor nutrition or period of rest
Treat with nutrition |
|
|
Term
| what group of developmental issues cause elbow dyplasia? |
|
Definition
fractured coronoid process
Ununited aconeal process
OCD of the medial humeral condyle |
|
|
Term
| pathophysiology of fractured coronoid process? FCP |
|
Definition
| abraisons to the medial humeral condyle |
|
|
Term
|
Definition
|
|
Term
|
Definition
medical or surgical
Medical - is as for OA - nutrition etc
Surgery - fragment removal or ulna ostectomy |
|
|
Term
| OCD of the medial humeral condyle? - What is osteochondrosis? |
|
Definition
Osteochondrosis is failure of endochodral osification so you get an overgrowth in articular cartilage
- usually due to ishceamic damage or genetics or nutrition |
|
|
Term
| pathophysiology of OCD of the elbow? |
|
Definition
| due to little nutrition being able to get to chondrocytes in the thickened cartilage so they become necrotic and so are more susceptible to trauma - flap present = OCD |
|
|
Term
|
Definition
signalment - often large breed young dogs about 6-7 months old
elbow pain on extension and may have joint effusions
Radiography |
|
|
Term
|
Definition
surgical removal of the flap
prognosis is good |
|
|
Term
| Ununited anconeal process/? |
|
Definition
It has a separate site of ossification which usualy closes around 5-6 months old
If fails - un-united |
|
|
Term
| Diagnosis of un united anconeal process? |
|
Definition
large breed dog
crepitus
pain on extension
Radiography |
|
|
Term
| Treatment of ununied anconeal process? |
|
Definition
surgical or medical
Surgeyr - fixation or removal |
|
|
Term
| Incomplete ossifation of the humeral condyle results in? |
|
Definition
lead to humeral condyle #
Pain |
|
|
Term
| developmental elbow luxation/subluxation? |
|
Definition
due to asynchonrous growth
premature physis closure |
|
|
Term
| congential subluxation - what are the 2 types? |
|
Definition
Type 1- humeroulna lux
Type 2 - radial head laxation |
|
|
Term
|
Definition
due to failure of endochondral ossification
alway the caudal humeral head
4-8 months old |
|
|
Term
| Reason for carpal luxation in adult dogs? |
|
Definition
| usually a form of trauma has occured leading to palmer ligament loss of function |
|
|
Term
| What sort of stance does a dog with carpal luxation have? |
|
Definition
|
|
Term
| medial patellar deviation? |
|
Definition
a cause of small toybreed immature dog lameness
Due to a misalignment in the quadriceps mechanism so that the patellar deviates medially at the trochlear sulcus |
|
|
Term
| what are the grades of patellar luxation? |
|
Definition
1- in sulcus and spntaneously returns to the sulcus when manually luxated
2. stays in the sulcus when in and stays out when luxated out
3. out of the sulcus and spontaneously returns when luxted into the sulus
4. out of the sulcus, cant be manually luxated into the sulcus |
|
|
Term
| sort of movemetn assoc with patella luxation? |
|
Definition
|
|
Term
| Treatment for patellar deviation? |
|
Definition
|
|
Term
| what are the 4 methods of surgery used for correcting patellar deviation? |
|
Definition
1 lateral tibial tuberosity transpoition
2. trochear wedge
3. medial desmotomy
4. lateral capsular overlap |
|
|
Term
|
Definition
immature small breed dog cause of lameness
#Due to trauma or immobilisation
Have stifle hyperextension and fibrosis |
|
|
Term
| what is legg-perthes disease? |
|
Definition
ischeamic Necrosis of the femoral head
6-9months old dogs affected
Diagnosis based on xray - see lysis and mottling of the femoral head and neck |
|
|
Term
| Treatment of Legg perths disease? |
|
Definition
THR
medical - poor responce |
|
|
Term
|
Definition
flap formation and degeneration of the talkus articular surface
5-7 month old large breed dogs
Usually the medial ridge of the talus affected |
|
|
Term
| Conditions that can occur to the stifle joint that occur in immature large breed dogs? |
|
Definition
OCD
lateral patellar deviation
Cr Cruciate ligament rupture |
|
|
Term
| Lateral patellar luxation? |
|
Definition
hx od skipping gait
graded 1-4 lameness |
|
|
Term
| Treatment of lateral patellar luxation? |
|
Definition
meidial tibial crest transposition
Tibial wedge |
|
|
Term
|
Definition
Immature large breed dog issue - causing lameness
Due to malformation of the hip joint and soft tissue laxity allowing the femoral had to come out of place |
|
|
Term
| Aetiology of hip dysplasia? |
|
Definition
genetics
environment - weight, nutrition |
|
|
Term
| What 3 tests can be carried out to help diagnose hip dysplasia? |
|
Definition
Ortalani sign
Barden's Sign
Barlow's sign |
|
|
Term
| Treatments for hip dysplasia? |
|
Definition
pelvic osteotomy
fem head and neck osteotomy
total hip replacement
Medical management |
|
|
Term
| 3 types of achilles tendon injury/ |
|
Definition
Complete rupture
Partial rupture
Tendonitis |
|
|
Term
| What are the three parts of the achilles tendon? |
|
Definition
The gastrocnemius
common tendon of the semitendonosis
SDFT |
|
|
Term
| Diagnosis of achilles tendon disease? |
|
Definition
| history, c/s , radiography and ultrasound |
|
|
Term
| what are the finctions of the cranial cruciate ligament? |
|
Definition
Limit cranial movement of the tibia
To limit internal rotation
To limit stifle extension
To limit valgus/varus movement |
|
|
Term
| pathogenesis of cr cruciate rupture> |
|
Definition
|
|
Term
| apart from the cranial draw test what other test can be done to see if the crucitae is ruptured? |
|
Definition
| cranial tibial thrust test |
|
|
Term
| Treatment for ruptured cruciate? |
|
Definition
medical - NSAIDS
surgery - debride the ligament to stabilise the joint - can't be repaired as such |
|
|
Term
| stablisation methods for cruciate rupture? |
|
Definition
extracapsular stabilisation
TPLO
Tibial tuberosity advancement |
|
|
Term
|
Definition
| endosteal new bone formation due to inflammation |
|
|
Term
signalment of panosteitis?
Treatment? |
|
Definition
less than 2 years old with shifting lameness
Treat with analgesia and support |
|
|
Term
| what is craniomandibular ostephathy? |
|
Definition
lamellar bone formation on the occipital, tympanic and mandible bones
often happends in west highland white terriers
Dx on xray |
|
|
Term
| Delvosterone treatment in bitchs? |
|
Definition
aka proligestone - a contraceptive that postones heat
repeat injections |
|
|
Term
| suppression of male infertility |
|
Definition
deslorelin GnRH analogue
causes testosterone suppression |
|
|
Term
|
Definition
|
|
Term
| When can you do abdominal palpation? |
|
Definition
d28-35 0 feel vesicles
d55-63 - feel bits of pup |
|
|
Term
| Ultrasound in dogs for PD from what age? |
|
Definition
|
|
Term
| Other tests for PD in the bitch? |
|
Definition
relaxin assay
behavioural/ohysical changes |
|
|
Term
|
Definition
physiological state when no luteolysis of the CL occurs even though not pregnant
High prolactin P4 |
|
|
Term
| Treatments fir pseudopregnancy? |
|
Definition
dopamine agonists
Galastop |
|
|
Term
| Messaliance options for treatment? |
|
Definition
alizin
Mesalin
OVH
galastop
prostaglandins |
|
|
Term
|
Definition
PG steroid
competes with realy PG receptors
used up to day 42
2 injections 24hrs apart |
|
|
Term
|
Definition
pus fulled uterus
Usually 6-8 weeks after a season
pu/pd, vomiting
depressed
vulval discharge |
|
|
Term
|
Definition
clincial signs and history
Ultrasound
heamatology and biochem
xray |
|
|
Term
| How owuld you manage a pyometra? |
|
Definition
stabilise - fluids antibioticz and take a blood sample
Treat with - surgery
- medically - alizin |
|
|
Term
| why would you opt to treat a pyo medically and not remove it via surgery? |
|
Definition
If it is a young bitch that is gping to be used for breeding
Open pyo??
if no renal compromise and is in good health and condition |
|
|
Term
|
Definition
occurs in pre pubertal bitches
vulva will be inflammed and there may be a small amount of dischargw but it self resolves |
|
|
Term
| Ovarian remnant syndrome? |
|
Definition
occurs when an OVH has not been carried out successfully and a bit of ovarian tissue has been left in situ
bitch will still show oestrous behaviour |
|
|
Term
| DDX for ovarian remnant syndrome? |
|
Definition
neoplasia
anal gland infections
cystitis |
|
|
Term
| How can you tell when whelping is imminent? |
|
Definition
P4 levels <2ng/ml
Body temp will reduce a little
on time - 64-66days post LH surge |
|
|
Term
| First stage of labour in the bitch? |
|
Definition
6-24hrs prior
restless
nesting |
|
|
Term
| 2nd stage labour in the bitch? |
|
Definition
3-6hrs long
uterine and abdominal contractions and pups are expelled
can have almost an hour between expelling each pup |
|
|
Term
| 3rd stage of labour in the whelping bitch? |
|
Definition
| licking and placenta expellation after each pup |
|
|
Term
| What classes as dystocia? |
|
Definition
if gestation is over 72 days
no pup after 2-3 hours
no pup after 30 mins of hard stage 2 labour
more than 4hrs between pups
fetal compromise
Maternal compromise |
|
|
Term
Causes of mastitis in bitches?
Signs? |
|
Definition
red hot firm and painful
often ecoli or staphs
Antibiotics and draining the glands
IVFT |
|
|
Term
| why do bitches have an increased sensitiivty to aneathetics? |
|
Definition
| becuase they have increased circulating levels of P4 which acts like an aneathetic |
|
|
Term
| What pre medication can a pregnant bitch have? |
|
Definition
low dose ACP
and a short acting opioid |
|
|
Term
| which pre med should not be used? |
|
Definition
|
|
Term
| what is contraindicated during aneatheisa in a pregnant bitch? |
|
Definition
| no mask induction is allowed |
|
|
Term
| best induction protocol in a pregnant bitch? |
|
Definition
| rapid sequence injection - rapid blous of propofol |
|
|
Term
| indications for c section in a bitch? |
|
Definition
elective
Dysticia - palpated or radiography
mummified pups
maternal toxaemia |
|
|
Term
| Prep for a c section in a bitch? |
|
Definition
clip, scrub
midline or flank
Double drape - so once pups removed and loads of fluid everywhere can whisk one drape off and be drier or cleaner for closure |
|
|
Term
|
Definition
midline incision
exteriorise and pack off the uterus, incise over the body of the uterus and milk the pups down to it and clamp cords for a couple of miniutes beofre cutting them.
Closure:-
Mucosae and submuscosae - simple continuoys PDS/vircryl |
|
|
Term
| timing of an elective caesarian? |
|
Definition
progesterone assay?
vaginal cytology
temp change
first stage labour
immaging |
|
|
Term
| how are brain lesions divided up? |
|
Definition
| brainstem, cerebellum and forebrain |
|
|
Term
| 3 signs of cerebellar disease? |
|
Definition
intention tremors
ataxia
hypermetria |
|
|
Term
| how are brain stem lesions usually presented? |
|
Definition
| as cranial nerve deficits |
|
|
Term
| clincial signs of cerebellar disease? |
|
Definition
dysmetria
Ataxia
High stepping gait
head tremor |
|
|
Term
| Clinical signs of forebrain disease? |
|
Definition
- seizures
- altrered behaviour eg loss of house training or ownner recognition
- ipsilateral head tilt
- decreased consciousness
- blindess - contralateral |
|
|
Term
| which cranial nerves are assoc with the forebrain? |
|
Definition
CN 1 AND 2
1- olfactory
2- optic |
|
|
Term
|
Definition
menace responce and the PLR
Menace- tests the whole pathway form the eye to the cerellum and visual cortex
PLR - asses pupillary motor nerve and the pathway up to the optic chiasm |
|
|
Term
|
Definition
| make the animal blink - just checks that the animal is not facially paralysed |
|
|
Term
|
Definition
| vestibular lesion usually |
|
|
Term
| Brainstem disease - clinical signs? |
|
Definition
reduced mentation
proprioception issues
CN3-12 deficits
Brain stem disease is fatal |
|
|
Term
CN 3,4 and 6?
Innervate?
Lesions and testing them? |
|
Definition
3 - occular
4- trochlear
5- abducent
innervate the occular muscles and pupil constriction
Test: PLR, strabismus, physiological nystagmus
lesions - pupil dilation |
|
|
Term
|
Definition
Trigeminal nerve - facial mouscles and corneal sensation
loss of sensation
Assess - facial sensation
Jaw tone and maticatory muscles - atrophy? |
|
|
Term
|
Definition
Facial nerve
muscles of facial expression and salivary glands
Lesions - dropping lips, excess salivation
Assess - Paplpebral reflex, sensational mvemtn and schmirmir tear test |
|
|
Term
|
Definition
vestibulocochlear
blanace and hearing
Lesions - headtilt, ataxia, nystagmus, vomiting
Asses - physiological strabismus |
|
|
Term
| Vestibulo-occular reflex? |
|
Definition
physiological strabismus - fast phase movement of eyes - mediated through the brainstem
slow phase is vestibular in origin |
|
|
Term
| vestibular dysfunction can be seen as...? |
|
Definition
spontaneous strabismums
vertical,horizontal or rotational |
|
|
Term
| paradoxical vestibular disease? |
|
Definition
| when there is a elsions with CN 8 and so have a head tilt ipsilateral to the lesion - slow phase towards the lesion |
|
|
Term
| cerebellar lesion - fast phase and slow phase nystagmums is in which direction? |
|
Definition
fast phase towards lesion and slow phase away from the lesionand the head tilit is contraltaeral
Oppostie to a CN8/brainstem lesion |
|
|
Term
|
Definition
9 - glossopharyngeal
10- Vagus
Lesion would lead to an altered bark, problems swallowing and regurgutation
Because these nerves innervate laryngeal and pharyngeal muscles
Gag reflex |
|
|
Term
|
Definition
11- Accessory
12- hypoglossal
tongue and cervial muscle innervation
assess tongue tone |
|
|
Term
| signs of horner's syndrome? |
|
Definition
miosis
enopthalmus
3rd eyelid protrussion
sweating
ptosis
eythema |
|
|
Term
| what are come of the conditions that cause acute paralysis and paresis? |
|
Definition
intervertebral disc disease
neoplasai
discophondylitis
lumbosacral stenosis
atlanto-axial subluxation
canine chiari malformation |
|
|
Term
| Spinal cord pain in young dogs <2years old - causes? |
|
Definition
meningitis
Discospondylitis
atlanto-axial subluxation
chiari malformation |
|
|
Term
| Olde dogs spinal cord pain causes? |
|
Definition
intervertebral disc issues
neoplasia
lumbosacral stenosis |
|
|
Term
| Initial work up for a dog with spinal pain? |
|
Definition
radiography
CSF tap sample
blood work
APPs |
|
|
Term
| What is discospondylitis? |
|
Definition
infection of inter-vertebral disk and the adjacent end plates
1y cause - from heamatogenous spread or from a direct injury such as a bite |
|
|
Term
| common sites for discospondylitis? |
|
Definition
LS junction
TL junction
Caudal cervical |
|
|
Term
| Diagnosis of discospondylitis? |
|
Definition
Xray - will see roughening and destruction of the end plates and both vertebrae are affected
blood and urine culture |
|
|
Term
| treatment of discospondylitis? |
|
Definition
Antibiotics - for 6-8 weeks
aalgesics
strict rest |
|
|
Term
| Steroid responsive meningitis? SRM |
|
Definition
Low head and stiff neck and slow walking
fever
anorexia
young animal 8-18months old
fluctating signs
Diagnosis on CSF - full of neutrophils |
|
|
Term
| how do you collect a CSF tap? |
|
Definition
cisternal cerebrospinal fluid puncture
- back of the head btween the atlas and occipital crest |
|
|
Term
|
Definition
steroids - prednisolone at immunosuppressive dose for 12 days
May self resolve by 24 months old |
|
|
Term
| Atlanto axial subluxation? |
|
Definition
toybreeds
young
cervical pain
Dx - Xray
Tx - conservative or arthordesis |
|
|
Term
| Canine Chirari malformation? |
|
Definition
king charles cavaliers
scratchy and painful
No neuro issues
Caudal occipital malformation - hypoplsia so the cerrebellum is too big for the skull - which leads to reduced circulation of CSF which leads to another syndrome called syringohydromyelia |
|
|
Term
| syringohydromyelia is what? |
|
Definition
is a sequale to chriari malformation due to reduced CSF flow
dialtion of the central canal of the spinal cord and a fluid filled cavitation in the spinal cord
This is what leads to the scratching issues |
|
|
Term
Age of onset of chiari malformation?
Diagnosis and Treatment? |
|
Definition
6months to 10 years old
Diagnosis - MRI
Treatment - medical - nsaids and gabapentin or low dose steroid
- surgical - decompress the foramne magnum |
|
|
Term
Lumbo-sacral stenosis?
Clinical signs? |
|
Definition
large breed dogs in middle age
clinical signs:- pain over that area in hyperextension
intermittant lameness
There are 3 types of stenosis
always occurs l7-s1 |
|
|
Term
Diagnosis of LS stenosis?
Treatment? |
|
Definition
CT/MRI
medical or surgical treatment
medical - nsaids and gabapentin |
|
|
Term
| Conditions presenting as acute paralysis? |
|
Definition
disc disease - degenerative and traumatic
Fibrocartilagenous embolism
Neoplsia
Trauma |
|
|
Term
| Degenerative disc disease? |
|
Definition
Hansen type 1 and 2
protrusion and extrusion |
|
|
Term
|
Definition
Dis extrusion
Nucleus pulposes - chondroid degeneration and hardening so herniates through the annulus fibrosis dring a traumatic event
ACUTE |
|
|
Term
|
Definition
Disc protrusion
CHRONIC
due to annulus fibrosis degeneration and hardens and protrudes out to compress the spinal cord |
|
|
Term
| Hansen type 1 in which type of breeds? |
|
Definition
chondrydyplastic - eg basett
young
TL region and cervical |
|
|
Term
| diagnosis of disk disease? |
|
Definition
|
|
Term
| Treatment of Disc diseasE? |
|
Definition
conservative - rest
Surgical |
|
|
Term
|
Definition
non degenerative
traumatic extrusion causing spinal cord injury but not compression |
|
|
Term
|
Definition
fibrocartilagenous embolism
- Ischemic damage from acute emboli - disc derived cartilage
Large breed dogs |
|
|
Term
|
Definition
|
|
Term
|
Definition
must stabilise first!!
A,B,C, thoracic xrays etc
Assess the presence of deep pain perception
Often occurs in thoraco-lumbaar area and areas of movement
Treatment p conservative |
|
|
Term
| Conditions presenting as progressive paresis? |
|
Definition
Neoplsai
LS stenosis
Hansen type 2
degenerative myelopathy
myleitis |
|
|
Term
|
Definition
extradural - outwith the meninges
Intradural - affects the meninges but not the cord
Intrameduallary - affects the cord |
|
|
Term
degenerative myelopathy?
clinical signs? |
|
Definition
ataxia
older dogs 6-7 years old
large breeds
gradual onset
no spinal pain |
|
|
Term
| diagnosis of degenerative myelopathy? |
|
Definition
PM
genetic testing
History and signs |
|
|
Term
|
Definition
inflammation of the spinal cord
2 types :- immune mediated (granulomatous meningioencephalitis)
or infectious - FIP/ toxoplasma |
|
|
Term
|
Definition
| due to chronic cervical spinal cord compression |
|
|
Term
| What are the two types of wobbler's syndrome you can get? |
|
Definition
Disk associated:- like a hansen type 2 - c5,6,7 - older dogs
or
osseous associated:- younger dogs due to articular facets on the dorsal arch causing compression |
|
|
Term
what is a neuropathy?
Junctionopathy?
myopathy? |
|
Definition
neuropathy - disease that affects the neurone
Myopathy - disease tha affects the muscle
Junctionopathy - disease that affects the motor juntions |
|
|
Term
| How do peripheral neuropathyies present themselves? |
|
Definition
|
|
Term
| Initial diagnositcs of neuropathies etc? |
|
Definition
Heamatology and biochem
Endocrine tests
Muscle enzymes
infectious disease titres
Abdominal ultrasound |
|
|
Term
| what disease present with persistant deficits - broad catergories? |
|
Definition
Degenerative
metabolic
neoplsia
infectious
TINFLAMMATORY
toxic
vascular |
|
|
Term
| Degeneratiove neuropathies? |
|
Definition
motor or sensory neuropathies
(Motor neuropathy is inherited and all legs affected
demyelinating polyneuropathy
DIABETIC NEUROPATHY
- axonal denegeration due to poor controlled diabetes melitus |
|
|
Term
| Malignant tumour of the nerve sheath? |
|
Definition
common and occurs in old
brachial or lumbar plexus affected
no orthodpedic cause
will fell a mass at each intumesance - dx
Diagnose - ultrasound and MRI and electromyography |
|
|
Term
|
Definition
an infectious neuropathy
infection via ingestion or transplacental to the pups ]Diagnosis is on serology
Treat with clindmycin
causes stiff pelvic limbs and quads contracture |
|
|
Term
|
Definition
infection via ingestion of bradyzoites
causes a ultisystemic disease - resp apparatus, msucels etc
clincial signs - short stride and stiff |
|
|
Term
|
Definition
| traumatic neuropathy - interfers with conduction of the nerve signal without physical disruption to the axon |
|
|
Term
| Diseases presenting with exercise intolerance? |
|
Definition
| junctionopathies and myopathies |
|
|
Term
| name some junctionopathies |
|
Definition
myasthenia gravis
exercise induced collapse |
|
|
Term
|
Definition
|
|
Term
| what is myasthenia gravis? |
|
Definition
| congenital or aquired condition that results in the formation of antibodies against acetylcholine receptors so no nerve signals can be conducted |
|
|
Term
| which form of myasthenia gravis is most common? |
|
Definition
most commonly acquired form
which can be focal or generalised -
focal - could be any muscle group
Generalised - collapsing episodes exercise intolerance |
|
|
Term
| Diagnosis of myasthenia gravis? |
|
Definition
ach receptor AbS?
tension test - endrophonium which is a drug that blocks the ach'ase enzyme that normally breaks up Ach - blocking this enzyme allows more Ach to be produced which can overcome the antibodies present |
|
|
Term
| what are some poor prognostic indicators of mysathenia gravis? |
|
Definition
aspiration pneumonia
thymoma
pharyngeal weakness |
|
|
Term
| what is exercise induces collapse |
|
Definition
common in labradors
genetic mutation of a gene that gelps fusion of synaptic vesicles |
|
|
Term
| what are the 3 causes of polymyositis? |
|
Definition
autoimmune
infectious
paraneoplastic |
|
|
Term
diagnosis of polymyositis?
treatment? |
|
Definition
CK, ALT and AST
tapering immunosuppressive drugs |
|
|
Term
| Asymmetrical signs imply what sort of lesion? |
|
Definition
|
|
Term
| what are the major extracranial forebrain disease? (nb not always neurologically based) |
|
Definition
Metabolic diseases - portosystemic shunt, electrolyte issues, low glucose
Endocrine Disease - hypo/hyperthryoid, HAC
Toxins - lead poinsoning etc |
|
|
Term
| Major intracranial forebrain disease? |
|
Definition
neoplsia
immune mediated inflammatory dz
Infectious
traumatic
congenital |
|
|
Term
|
Definition
limited treatment
give preds |
|
|
Term
|
Definition
| grows at the base of the forebrain |
|
|
Term
|
Definition
| grows towards the ventricals |
|
|
Term
| Immune mediated inflammatory CNS disease? |
|
Definition
meningorncephalites - granulomatous, necrotic or necrotic leukoenchephalites
Steroid responsive meningoencephalites |
|
|
Term
|
Definition
common in small toy breeds
young to middle age
progressiveneuro dysfunction |
|
|
Term
| diagnosis of Meningoencephalites? |
|
Definition
|
|
Term
| Treatment of Meningoencephalites? |
|
Definition
immunosuppressive steroids
cytaribine - tapering doses |
|
|
Term
| what are the four ways in which a brain can herniate? |
|
Definition
sub-faulx
rostral transtentoral
caudal transtentorial
through the foramen magnum |
|
|
Term
| How do you recognise an increase in intracranial pressure? |
|
Definition
alterred mentation
cushing reflex - increased blood pressure and a bradycardia
papilloedema
reduced gag reflex |
|
|
Term
|
Definition
Hypoplasia
inherited metabolism disorders
inflammatory
infectious
Neiplsia
Vascular |
|
|
Term
| what are the forms of seizure activity? |
|
Definition
focal - starts in and stays in one cereral hemisphere
involves isolated parts of the body
Generalised - activity throufhout bot hemispheres, usual tonic-clonic action
Focal-generalised - starts as focal and spreads to have generalised activity throughot the brain +
+ |
|
|
Term
| stages of an epileptic fit? |
|
Definition
pre-ictal
- prodrome - start
- aura
- ictus - the actual seizure
Post ictal - transient alterations and impaired consciousness |
|
|
Term
| What happens during a seizure? |
|
Definition
Tonic phase - irregular respiration, contracted libs
Clonic phase - paddling and jerking of limbs and chewing action |
|
|
Term
|
Definition
Extracranial - metabolic, inflammatory
Intracranial - structural or functional |
|
|
Term
| important extra cranial cuases of seizures? |
|
Definition
hepatic shunts
hypoglycaemia
toxic causes |
|
|
Term
| intracranial causes of seizures? |
|
Definition
tumours
granulomatous meningoencephalitis
head trauma
infectious
congenital conditions |
|
|
Term
| what anti convulsant medications can you use for seizues? |
|
Definition
pexion
phenobarbitone
potassium bromide - NOT FOR CATS |
|
|
Term
| what are the aims of seizure treatment? |
|
Definition
reduce freq, severity
reduce risks for owners
delay progression
minimise side effects |
|
|
Term
| Reasons to treat an animal that fits? |
|
Definition
more than one a month
reduced quality of life
History of clusters
Increased freq of fits |
|
|
Term
| reasons not to treat a dog with seizures |
|
Definition
less than one a month
no effect on the quality of life
if they are breif and milk
side effects of drugs may have a greater impact |
|
|
Term
| first lineoptions for medication in dogs? |
|
Definition
phenobarbitone
imepitoin
potassium bromide |
|
|
Term
| first lineoptions for medication in cats? |
|
Definition
phenobarbitone
diazepam
levetricetam |
|
|
Term
| side effects to drugs for seixure control? |
|
Definition
sedation PU/PD
ataxia and paresis
hepatotoxicity - so must regularly check liver enzymes |
|
|
Term
| when should serum levels be checked after starting seizure control medication? |
|
Definition
|
|
Term
| what must you monitor when animals are on phenobarbitone medication? |
|
Definition
| liver enzymes - ALKP and ALT |
|
|
Term
| what is good about imepition? |
|
Definition
no hepatic toxicity
shirt half life no drug interactions |
|
|
Term
|
Definition
|
|
Term
|
Definition
Continuous seizure activity for more than 5 minutes
fatal
Start with a short acting anticonvulsant first and supportive care then go onto maintenance anticonvulsants - diazepam or midozalam
Give rectal diazepam and can be repeated up to 3 times
IV also possible |
|
|
Term
| what are the different segments of the spinal cords? |
|
Definition
c1-c6
c6-t2
t3-l3
l4-s1
s2 -sacral |
|
|
Term
|
Definition
| partial loss of volountary movement |
|
|
Term
|
Definition
| complete loss of volountary movement |
|
|
Term
| How can you assess proprioception? |
|
Definition
knuckling response
hopping reastion
hemiwalking
wheelbarrow
postural thrusting
hip sway
visual and tactile placing |
|
|
Term
| Proprioceptive tests test which pathway? |
|
Definition
| from the limb, spinal cord and brain and motor nerves back |
|
|
Term
| what things are involved in a reflex arc? |
|
Definition
| sensory and motor neurone and a ganglion |
|
|
Term
| what are a couple of the spinal reflexeS? |
|
Definition
|
|
Term
| signs that a LMN is affected? |
|
Definition
reduced muscle tone, mass, loss of reflex
sp if pelvic limbs had no lesions involving LMN - the lesions would be L4-l6 |
|
|
Term
|
Definition
| hyperadrenocortism - iatrogeni or spontaneous |
|
|
Term
|
Definition
pituitary tumour - Pituitray dependant -MOST COMMON
or
adrenal tumour/hypertrophy |
|
|
Term
| Pituitray dependant Cushings? |
|
Definition
| Pituitray mass -n so large amounts of ACTH produced which leads to lots of cortisol release form the adrenal gland |
|
|
Term
| Effects of increased cortisol on the body? |
|
Definition
catabolic hormone - increased metabolism, increased protein lipid, gluocse metabolism, symmetircal allopecia,
PU/PD |
|
|
Term
|
Definition
PU/PD, alopecia,weight loss, pot belly lethargy
Often older small terrier type dogs |
|
|
Term
| Serum biochemistry of a dog with cushings? |
|
Definition
high ALKP
High cholesterol
high bile salts
high glucose
Decreased urea and creatinine |
|
|
Term
| what haematology would be seen in a dog with cushings? |
|
Definition
stress leukogram
Neutrophilia
lymphopenia
eosinophilia |
|
|
Term
| urinalysis in a cushingoid dog? |
|
Definition
low USG
proteinuria
glucosuria |
|
|
Term
|
Definition
ACTH stimulation test
Stimulate the adrenal gland to secrete cortisol
Blood sample before and after admin
after should be 30mins to 2hrs post admin |
|
|
Term
| what is another test apart from the ACTH stimualtion test that can be used? |
|
Definition
low dose dexmth test
so this will normally stop/inhibit acth release
But in HAC - they will rapidly recover or it will fail completely to suppress |
|
|
Term
| what is the disadvantage of the Low dose dexmeth test? |
|
Definition
time consuming
stress induced cortisol interfers with the results so have to do it when nothing else is going on - not even a dental |
|
|
Term
|
Definition
trilostant - steroid enzyme inhibitor
mitotane |
|
|
Term
| monitoring of a cushings patient? |
|
Definition
monitor the clinical signs such as PuPD
do the ACTH stumilation test 10-14 days later
do a pre and post cortisol level test |
|
|
Term
| complications of treatment of a cushings paient? |
|
Definition
|
|
Term
|
Definition
uncommon
would present as thin skinned |
|
|
Term
| hypothyroidism is common in which species? |
|
Definition
|
|
Term
| how is the thyroid hormone controlled? |
|
Definition
TRH from the hypothalamus
TSH from th anterior pituitary
both causing the release of t3 and t4 which have a -ve effect on TSH and TRH |
|
|
Term
| what is sick euthyroid syndrome? |
|
Definition
patient has an illness non related to the thyroid but thyroid levels are low as a result of this other illness
eg starvation
surgery |
|
|
Term
| causes of hypothryoidism? |
|
Definition
primary - lymphocytic immune mediated thyroiditis - MOST COMMON
2y - TSH failure
3t - TRH failure |
|
|
Term
| which signalment is most likely to be assoc with hypothyroidism? |
|
Definition
large young breeds
HAVE THRYOGLOBULIN ANTIBODIES |
|
|
Term
| general diagnosis of hypothyroidism? |
|
Definition
bloods
clincial signs
other specific tests |
|
|
Term
| clincial signs assic with hypothyroidism? |
|
Definition
lethargy, obesity,
cold intolerance, symmetrical allopecia - non pruritic
bradycardia
pale mms
Lower motor neurone disease |
|
|
Term
| confirming the diagnosis of hypothroidism? |
|
Definition
increased cholesteral and triglycerides
total T4 levels
TRH and TSH stimulation tests |
|
|
Term
| what level of t4 would indicate hypothryroidism? |
|
Definition
|
|
Term
| clinical diagnosis of hypothyroidism? |
|
Definition
| clinical signs, low t4 AND high TSH |
|
|
Term
| Hyperthyroidism is common in which animal usually? |
|
Definition
| cats - older and its a gradual onset |
|
|
Term
| causes of hyperthryoidism? |
|
Definition
adenomatous hyperplsia - benign
functional |
|
|
Term
| clincial signs of hyperthryoidism? |
|
Definition
clincial signs:_
metabolic - weight loss
behaviour - neurotic/excitable
Skin - poor condition
GIT - vomiting and diarrhea
high heart rate
thyroid nodule |
|
|
Term
| risk factors for hyperthyroidism? |
|
Definition
canned food
ectoparasiticides
litter trays |
|
|
Term
| causes of weight loss in older cats? |
|
Definition
hyperthyroidism
chronic renal failure
diabetes mellitus
cardiomyopathy |
|
|
Term
| what is considered a diagnostic level of t4 for a cat to be classed as hyperthyroid? |
|
Definition
|
|
Term
| Treatment options for hyperthyroidism? |
|
Definition
4 methods
1. Nutritional
2. medical
3. surgical
4. radiotherapy |
|
|
Term
| Dietry management of hyperthyroid cats? |
|
Definition
| something like the Hills Y/D diet which is low in iodine |
|
|
Term
| medical control of hyperthyroidism? |
|
Definition
methimazole or carbimazole
thyrotoxic |
|
|
Term
| complications that can occur with hyperthyroid cats when undergoing surgical removal of the goitre? |
|
Definition
heamorhage
hypocalceamia - due to the parathyroid gland being lifted aswell - try to leave it in
Vocal changes |
|
|
Term
| Radiotherapy treatment for hyperthyroidism in cats? |
|
Definition
a single jag of radioactive iodine
- destroys cells DNA |
|
|
Term
| what diseases can hyperthyroidism cover up and how? |
|
Definition
it can mask the effects of chronic kidney disease
Becuase with jhyperthyroidism - you get an increased heart rate which means increased blood pressure alleviating any poor kidney perfusion and therefore improving their function if they are diseased |
|
|
Term
| monitoring hyperthryoid patients? |
|
Definition
if being medically managed - can check their t4 levels 1, 3 and 6 months then every 6 months
Surgery - measure 1 and 3 months post opp |
|
|
Term
| what is diabetes mellitus? |
|
Definition
chronic state of hyperglyceamia due to a lack if insulin or its affects
- |
|
|
Term
| what does insulin do normally? |
|
Definition
| convert glucose to glycogen in the liver which allows glucose uptake and ketogenesis is swtiched off |
|
|
Term
| Type 1 vs type 2 diabetes mellitus? humans |
|
Definition
Type 1 - immune mediates form - insulin dependant
Type 2 - non immune mediated - due to amyloid deposition and so is non insulin dependant too |
|
|
Term
| in veterinary - type 1 is? |
|
Definition
canine insulin dependant but not early onset
Cats can get both types but type 2 is more common |
|
|
Term
| pathology of diabetes mellitus in cats? |
|
Definition
| Islet cell destruction (via amyloidosis) etc plus peripheral insulin resistance - leads to reduced production of insuin and there for less control over glucose metabolism |
|
|
Term
| pathology to diabetes in dogs? |
|
Definition
| resistance to insulin in the body causes an increased production which exhausts the islet cells and they die and so dog develops diabetes relative to requirement |
|
|
Term
| D. mellitus clinical signs? |
|
Definition
weight loss
PUPD
glucosuria
hungry
weak
exercise intolerance
UTI
bright alert and responcive though |
|
|
Term
| how can you confirm the problem of diabetes mellitus? |
|
Definition
urinalysis - glucosuria
plus the clinical signs
Serum Biochem - increased glucose, liver enzymes
Cholesterol |
|
|
Term
| stabilisation of d.mellitus patients? |
|
Definition
| diet, exercise and insulin - right balance |
|
|
Term
| types of insulin available? |
|
Definition
length of actions -
Short - soluble
Intermediate - lente
Long acting - protamine |
|
|
Term
|
Definition
|
|
Term
| diet considerations for a diabetic? |
|
Definition
avoid simple sugars
Give complex carbs
eg starches |
|
|
Term
|
Definition
| high blood glucose - rebound hyperglycaemia - due to a too rapid a drop |
|
|
Term
| complications associated with diabetes mellitus? |
|
Definition
cateracts
ketoacidosis
hypoglycaemia
failure to stabilise |
|
|
Term
| why would a diabetic collapse? |
|
Definition
ketoacidosis
hyopglycaemia
septicaemia |
|
|
Term
diabetic ketoacidosis clinical signs?
diagnosis? |
|
Definition
fatal, need ICU
c/s:- tachycardia, vomiting, collapsed, dehydrated, haemorhagic diarrhoea
Dx - presence of ketones |
|
|
Term
|
Definition
glucose and ketones in the urine
Biochem - hypoK+
- hyperglycaemia
- azotemia |
|
|
Term
| treatment of ketoacidotic diabetes |
|
Definition
fluids - with K+ supplementation
Insulin - small doses |
|
|
Term
| signs of hypophosphateameia? |
|
Definition
|
|
Term
|
Definition
common complication of chornic insulin medication
Rapid onset
hungry
ataxic
fitting |
|
|
Term
| what happens if a seuizuring hypoglycaemic patient comes in? |
|
Definition
stop the insulin and feed ASAP - sugar solution
glucagon |
|
|
Term
| other causes of hypoglycaemia? |
|
Definition
insulinoma
addisons
severe liver failure |
|
|
Term
| clinical signs of insulinoma? |
|
Definition
weakness
episodic collapse
depressed
incoordination? |
|
|
Term
|
Definition
aka addisons - Low cortisol - high K+ and low Na2+
can collapse
cause is often unknown |
|
|
Term
| DDx of metabolic collapse? |
|
Definition
diabetic ketoacidosis
hypoglycaemia
hypo/perkalaemia
hepatic encephalopathy
Hypo/percalcaemia
Hypo/pernatraemia |
|
|
Term
| History often assoc with addisons? |
|
Definition
| weakness and falling over |
|
|
Term
| Investigation of addisons? |
|
Definition
if heart sounds ok ,
run bloods - check calcium and glucose |
|
|
Term
|
Definition
<3
intestinal
chronic renal failure
Chronic diuresis |
|
|
Term
|
Definition
immune mediates aldosterone and cortisol deficiency
- Kidney excretes K+
and get retention of Na+ |
|
|
Term
|
Definition
young - middle aged
could have been mitotane/trilostane induced |
|
|
Term
| clincial signs of addisons? |
|
Definition
dehydrated
anorexia
vomiting
bradycardia
Haemorrhagic enteritis
All due to low K+ |
|
|
Term
|
Definition
parvo
AV block
chronic heart failure
Myasthenia gravis |
|
|
Term
| haematology of addisonian patient? |
|
Definition
aneamia
dehydrated
WBC-s will show a massive stress leukogram |
|
|
Term
| Biochem of addisonian patient? |
|
Definition
high K+
low Na
urea and creatinine increased
glucose, bilirubin etc all decreased |
|
|
Term
| what does hyperkalaemia causes? |
|
Definition
|
|
Term
| Diagnostic tests for addisons? |
|
Definition
ACTH stimulation test
Cortisol should rise to above 80 |
|
|
Term
|
Definition
reduced k+
fluids!
glucocorticoid replacement |
|
|
Term
| what do you treat hyperkalaemia with? |
|
Definition
|
|
Term
| ddx for inspiratory dyspnoea? |
|
Definition
nasopharyngeal mass/stenosis/DB
larhyngeal paralysis
tracheal mass/fb/stenosis |
|
|
Term
| dx for expiratory dyspnoea? |
|
Definition
airway collapse
asthma
parenchymal disease |
|
|
Term
| DDx for inspiratory/expiratory dyspnoea or tachypnoea? |
|
Definition
pleural effusion
pneumomedastinum
thromboembolism |
|
|
Term
| what does an increased resp effort on inspiration tell you? |
|
Definition
|
|
Term
| what does increased expiratory effirt suggest? |
|
Definition
|
|
Term
|
Definition
trauma
spontaneous
iatrogenic |
|
|
Term
| treatment of pneumothorax? |
|
Definition
none/rest
simple drain
surgery |
|
|
Term
| diagnosis if pleural effusion? |
|
Definition
xray
ultrasound
cytology
biopsy |
|
|
Term
pyothorax?
cause and clincial signs? |
|
Definition
aka exudatative pluerisy
often due to a cat bite of some form of trauma, FB,
intrapleural infection
Clincial signs - dyspnoea
pyrexic, inappetant
ventral thoracic dullness |
|
|
Term
|
Definition
drainage / lavage
Antibiotics - braod spec - 4-6 weeks
NSADIS |
|
|
Term
|
Definition
| trauma, neoplsia, iatorgenic, CHF |
|
|
Term
| Treatment of chylothorax? |
|
Definition
conservative - diuretics drainage and a low fat diet
Surguical - ligate the thoracic duct |
|
|
Term
| mediastinal disease type? |
|
Definition
megoesophagus
masses
pneumomediastinum
mediastinitis |
|
|
Term
| mediastinal masses - effects? |
|
Definition
venous congestion
dyspnoea
- effusion
dysphagia
horeners syndorme |
|
|
Term
pulmonary fibrosis?
treatment? |
|
Definition
in middle aged small breeds
progressive
cough
crackles
Tx - antiinflammatories |
|
|
Term
|
Definition
immunodeficiency
viral infeciton
megaoesophagus and aspiration |
|
|
Term
|
Definition
|
|
Term
|
Definition
cardiogenic - CHF
toxic
neuro
Tx with diuretics and oxygen |
|
|
Term
| laryngeal paralysis? causes |
|
Definition
neurogenic
muscular
neuromuscular
Treat with surgery |
|
|
Term
Tracheal collapse? signalment
management |
|
Definition
young to middle aged
Cough - goose honk and dyspnoea |
|
|
Term
| Tracheal collapse management? |
|
Definition
acp to calm, oxygen
cool environment short acting steroids
Chronic management- avoid using collar and lead, avoid infections, control obesity |
|
|
Term
|
Definition
brincholdilators
coticosteroids
control the environment |
|
|
Term
| management of congestive heart failure? |
|
Definition
preload reduction
Afterload reduction
postive ionotropic effects
imporoved diastolic finction
management of arrythmias
prevent remodelling |
|
|
Term
|
Definition
|
|
Term
|
Definition
ACE inhibitors - redcue vasocntriction and adh secretion and aldosterone
Pimobendan - postive inotrop |
|
|
Term
| posotive inotropic support? |
|
Definition
|
|
Term
| How to improve diastolic function? |
|
Definition
beta blockers
abnormal diastolic finction offten asssic with myocardial concentric hypertrophy |
|
|
Term
| what arrythmias contribute to CHF? |
|
Definition
| supraventircular, ventricular and brdycardia |
|
|
Term
| remodelling prevention for CHF? |
|
Definition
| all the drugs that are already being used to treat CHF - spironilactone, pimobendan and ACE inhibitors |
|
|
Term
| Grade A, B1, B2, C and D classes of CHF? |
|
Definition
A - at risk
B1 - murmur but no enlargement
B2 mumur and enlargement
C - CHF - dyspnoea and ascites
D - refractory CHF |
|
|
Term
|
Definition
| monritor and maybe start on pimobendan |
|
|
Term
|
Definition
| pimobendan, frusemide, ACE inhibitors |
|
|
Term
|
Definition
a diuretix used to treat reduce preload in CHF
Stimulates the RAAS |
|
|
Term
|
Definition
reduced afterload and remodelling
positive inotrope |
|
|
Term
diet for CHF patients?
overal management considerations? |
|
Definition
little salt content
regular exercise - not exertive
no exercise when hot |
|
|
Term
| when monitoring CHF patients - what do you monitor? |
|
Definition
| urinalysis - for electrolytes and renal finction |
|
|
Term
| what to do if CHf patient goes into acute decompensation? |
|
Definition
IV frusemide
glyceral trinitrate
oxygen |
|
|
Term
| drug for any arrythmias assoc with CHF? |
|
Definition
|
|
Term
| causes of pericardial effusions? |
|
Definition
left atrial ruptire
idiopathic
neoplastic
CHF
hypoprtieneamia |
|
|
Term
| pathophysiology of a pericardial effision? |
|
Definition
an effusion leads to compression of the RHS and then reduced filling so decreased CO and forward failure
Decreased filling also leadsd to rhs CHF |
|
|
Term
| peridcardial effusion signlament? |
|
Definition
large breeds
Present with - exercise intolerance
lethargy
pale mms
abdominal distension
weakness |
|
|
Term
| physical findings of pericardial effision? |
|
Definition
Poor CO - pale, weak, lethargic, exercise intolerant, weak pulse, tachycardia
RHS CHF - ascites, liver congestion, jugular distension |
|
|
Term
| what do you find on ECG with pericardial effisions? |
|
Definition
| small QRS due to reduced transmission |
|
|
Term
| treamtne tof pericardial effusion? |
|
Definition
|
|
Term
| some pericardial effusions are of smaller quantity and dont cause tamponade - small volume effusions are seen with what conditions? |
|
Definition
CHF, hypoproteinaemia
uraemia
FIP
infection |
|
|
Term
| abdominal effusions in the dog - causeS? |
|
Definition
hypoalbuminaemia
liver disease
neoplsia
Cardiac disease - DCM MV disease |
|
|
Term
| signs of an abdominal effusion? |
|
Definition
fluid thrill
tachypnoea
abdominal pain |
|
|
Term
|
Definition
clear
Low cells <1500/ul
low protein<15g/l
Caused by pre sinusoidal obstruction
or hypoalbuminaemia |
|
|
Term
|
Definition
straw yellow
High cells - >5000
high prtein >30 |
|
|
Term
|
Definition
heamorrhagic
sero-haemorrhagic
pseudochylous
chylous |
|
|
Term
| cardiac diseae that result in ascites? |
|
Definition
pericardial disease]biventricular CHF
caval syndrome
pulmonic stenosis |
|
|
Term
| causes of pleural effusions? |
|
Definition
infectious
neoplsatic
haemorragic
heart disease |
|
|
Term
| diagnosis of pleural disease? |
|
Definition
| xray and ultrasound and abdominocentesis |
|
|
Term
| heart worm in cats and dogs? clincial signs, treatment, diagnosis etc |
|
Definition
dirofilaria immitus
clincial signs - cough, eercise intolerance, tachypnoea
syncope
ascites
Dianosis - blood smear
echo
haematolody - eosinohphilia
Tx with avermecticsmelarsomine |
|
|
Term
| aquired heart mrurmurs can be classified into two broad categories which are? |
|
Definition
|
|
Term
| of these two catergories - what can be causing an acquired murmur? |
|
Definition
Endocardial - endocardiosis and endocarditis
Myocardial - DCM, HCM, myocarditis |
|
|
Term
|
Definition
aka endocardiosis
it is myxomatous degeneration of the heart valves which causes blood regurgitation - murmur
Kind charles cavalier spaniels commonly have it
>9years old
Caises CHF |
|
|
Term
| pathophysiology of endocardiosis |
|
Definition
blood leakage causes volume overload of the Lv which dilates and get reduced CO - stimualtes the RAAS
leads to CHF left sided
so exercise intolerance, cough, and rhs failure due to LV failure - pulmonary hypertension |
|
|
Term
| clincial signs of MV disease? |
|
Definition
systolic murmur
ascites, dyspnoea
exercise ontolerance |
|
|
Term
|
Definition
|
|
Term
| why do dogs with endocardiosis often have a cough? |
|
Definition
| due to the main bronchus being compressed by the enlarged heart |
|
|
Term
| ECG finding with a dog in endocardiosis? |
|
Definition
large R wave - die to atrial enlargement
atrial fibrilation?
ectopics |
|
|
Term
| treatment of endocardiosis? |
|
Definition
| use the CHF scheme to grade and treat accodringly |
|
|
Term
|
Definition
bacterial cause that affetcs the aortic valve first and the mitral secondly
clinical sogns - pyrexia
Joint stuffness and a new left sided murmurs never been preent before |
|
|
Term
diagnosis of endocarditis?
Treatment? |
|
Definition
bloods
urine
joint tap
echo
ultrasound
Treat with antibiotics and supportive therapy |
|
|
Term
| prebention of endocaritis? |
|
Definition
| if undergouing dentals etc and have a predisposing factor such as a aortic stenosis then use prohpylactic Antibiots |
|
|
Term
|
Definition
DCM - dogs or
HCM in cats
or myoarditis |
|
|
Term
|
Definition
dilated cardiomyopathy - common in dogs more so than cats
primary or secondary causes
Often idiopathic or hereditary
large to medium breed dogs |
|
|
Term
|
Definition
DCM - leads to systolic failure - leads to reduced CO - so stimulates the RAAS
which leads to fluid retention then causing CHF - left or RHS |
|
|
Term
|
Definition
| same as CHF aims - preload and afterload reduction, reduce remodelling and treat arrythmias |
|
|
Term
| cardiomyopathies in cats? |
|
Definition
hypertrophic
restrictive
dilated |
|
|
Term
|
Definition
inherited condition
Caused by sytemic hypertension or hyperthyroidism |
|
|
Term
| pathophysoligy of HCM in cats? |
|
Definition
| becuase of a thickened wakk - it cont contract a ell - diastolic failure which leads to LA enlargemnt - LHS heart failure |
|
|
Term
| In a cat with HCM - what tests would you run? |
|
Definition
blood tests - check BP
kidney fnction
thyroid function
genetic tests |
|
|
Term
|
Definition
taurine deficiency realated
Treat with AC inhibitors |
|
|
Term
| what is myocarditis, the causes and the treatment? |
|
Definition
inflammation of the myocardium - can cause murmurs
Due to toxoplasmosis, neospora, parvo,
may go on to develop CHF
Treat - tx the 1y disease and also the arryhtmias |
|
|
Term
| causes of murmurs in pups and kittens? |
|
Definition
commonly congential inherited disorders
or systemic disease |
|
|
Term
| most common causes of congential heart disease in dogs and cats? |
|
Definition
Dogs - Aortic stenosis, PDA and pulmonic stenosis
Cats - VSD, mitral valve dysplasia, tricuspid valve dysplasia |
|
|
Term
| based on loactatio and character - what murmurs can be heard left heart base, apex and RHS? |
|
Definition
LHS base:-
PDA - continous
pulmonic stenosis - systolic
Aortic stenosis - systolic
Left apex:-
mitral valave - systolic
RHS - tricuspid valve dysplasia
vsd
TOF |
|
|
Term
| on ECH what trace will LEFT side and right sided heart enlargement create? |
|
Definition
left side enlargement - tall R wave
Right sided - deep S wave |
|
|
Term
|
Definition
narrowing - can be sub valvular
supravalvular |
|
|
Term
| clinical findings of aortic stenosis? |
|
Definition
weak pulses
harsh systolic murmur
radiography - often looks normal
ECH - tall R waves |
|
|
Term
| pathophysiology of aortic stenosis? |
|
Definition
narrowed opening -decreased CO - forward failure - Exercise intolerance
and hyperthorphy of LV - diastoilc failure |
|
|
Term
| treatment of aortic stenosis? |
|
Definition
| severe - beta blockers, calcium channel blockers |
|
|
Term
|
Definition
a vessle that usually joins the pulomnary artery and aorta in the fetus to bypass non functional lungs in utero
Should disaapear after borth but sometimes does and causes oxygenated blood to mix with non oxygenated as blood flows from left to right
pulmoary hypertension
Left side CHF |
|
|
Term
| what would you see on xray of PDA? |
|
Definition
| hypervascularisation of the lungs |
|
|
Term
|
Definition
| surgucak ligation ir insertion of a coil |
|
|
Term
|
Definition
| due to the excessive volume overload of the lungs and pulmonary hypertension statr getting right to left shunt |
|
|
Term
|
Definition
narrowing of the pulmonry valve
due to fused or thickened valves
Valvular, subvalvular
Infundibular |
|
|
Term
| finding on clinical exam of pulmonic stenosis? |
|
Definition
due to forward failure and the rhs CHF
:-
exercise intolerance, weakness, dyspnoea, weak puleses
will see RV hypetrohpy on xray too
Deep S wave |
|
|
Term
|
Definition
ventricular septal defect -so blood shunts left to right (high to low)
Over circulation of the lungs
often asymptomatic
LHS CHF |
|
|
Term
|
Definition
tetralogy of fallot
4 major issues
right ventricular hypertrophy
overriding right persistant aorta
VSD
pulmonic stenosis |
|
|
Term
| radiography - signs of t.o.f? |
|
Definition
RV enlargement
hypovascularity of lungs
pulm A bulg
ECG - deep S wave |
|
|
Term
|
Definition
| phlebotomy for polychythemia |
|
|
Term
| what are the direct clincial signs of aneamia? |
|
Definition
lethargy
exercise intolerance
weakness
tachycardia
pale mms
increased resp rate
sollapse |
|
|
Term
| what are the two types of aneamia? |
|
Definition
regenerative - new blood cells made 0 heamolytic or haemorrhagic
Non regenerative - eg Fe3+ deficiency - no red cells produced |
|
|
Term
|
Definition
PCV
total protein
smear
slide agglutination
reticulocyte count |
|
|
Term
| Normal PCV in a dog and cat? |
|
Definition
37-55% in a dog
25-45% in a cat |
|
|
Term
| slide agglutination test - what is the purpose? |
|
Definition
| mis 2 drops of EDTA blood with a drop of saline and it will disperse any rouloux formation that may be present |
|
|
Term
| what are spherocytes and schistocytes? |
|
Definition
soherocytes - early form RBC- no central pallor
Schistocytes - fragments of RBC |
|
|
Term
|
Definition
immature forms of RBC
slow to react - so will appear 3-4 days post assult |
|
|
Term
| non regenerative aneamia will have lots or few reticulocytes? |
|
Definition
|
|
Term
| what are the types of regenerative anaemia? |
|
Definition
Acute heamorrhagic
chronic heamorrhagic
haemolytic |
|
|
Term
| does the PCV indicate whether there has been blood loss? |
|
Definition
| no - it just tells you the numbers of rbc's present - heamorrhage looses all components of blood |
|
|
Term
| what are the usual features of acute heamorrhagic anaemia? |
|
Definition
normal PCV
low/ish protein
few/no reticulocyte - BECAUSE THERE HASNT BEEN ENOUGH TIME FOR THE RETICULOCYTES TO REACT IN ACUTE SITUAION |
|
|
Term
| Usual features of chornic aneamia? |
|
Definition
high reticulocytes and low/normal protein levels
- except when it it fe3+ deficincy anaemia if chronic blood loss externally no fe3+ recycling and so stores become depleted and would have low reticulocytes |
|
|
Term
| haemolytic anaemia findings? |
|
Definition
| reticulocytes present and normal prtien |
|
|
Term
| emergency management of acute haemorrhage? |
|
Definition
calm,
fluids, blood transfusion if PCV is less than 10% |
|
|
Term
| do fluids increase the PCV? |
|
Definition
|
|
Term
| does dehydration increase the PCV? |
|
Definition
|
|
Term
| how dose it arise that a non regenertive aneamia often acconpanies chronic or inflammatory disease? |
|
Definition
non regenerative becuase no reticulocytes are produced becuase inchornic inflammation - cytokines etc lead to the body shut down of Fe3+stores and any free iron is transfered to transferrin so that bacteria cannot use it to survive and multiply - but this also means that Fe is not available to make new RBC
cytokines also have an impact on EPO |
|
|
Term
| How does Fe3+ defeicncy anaemia arise and what do the RBCs look like? |
|
Definition
due to external haemorrhage
cells will be microcytic and hypochromic
Confirm the diagnosis by meaasuring bone marrow Fe3+ levels |
|
|
Term
| aneamia f chronic renal failure - type and what it looks like and why it happens? |
|
Definition
normochromic, normocytic, non regenerative anaemia
De to kidney failure - no/little EPO produce which usually stimulates the bone marrow to produce more cells
Uraemia of kidney disease also leads to damage of the cells and platelets so reduced survuval along with no/reduced production |
|
|
Term
| Treatment of aneamia of chronic renal disease? |
|
Definition
human recombinanr EPO
iron supplementation |
|
|
Term
|
Definition
| macrocytic non regenerative |
|
|
Term
| sites of bone marrow samping? |
|
Definition
sternal, costochondral
iliac crest
femoral fossa |
|
|
Term
pure red cell aplasia
causes? |
|
Definition
| often thought immune mediated |
|
|
Term
|
Definition
1y - vessel contracts and narrows and platelets form a primary plug
Von willebrands factor is activated to allow for the platelet clumping
2y - when the fibrin stablisises the plug |
|
|
Term
| what inhouse tests can be used to assess clotting times? |
|
Definition
platelet count
buccal mucosal bleeding time
activated clotting time
Labs - Activated prartial thrombo[lstin (APPT) TEST
Prothrobin time |
|
|
Term
| What should a dogs platelet count be? |
|
Definition
|
|
Term
| how can you assess platelet function? |
|
Definition
buccal mucosal bleeding time
clot retraction |
|
|
Term
| causes of thrombocytopeania? |
|
Definition
failure of megakrosis
increased consumption
destruction |
|
|
Term
| what can be test internal clotting pathway? |
|
Definition
| APPT and activated clotting time |
|
|
Term
| what tests can be used to assess the extrinsic pathway? |
|
Definition
| PT time and PIVKA (proteins induced by vit K atagonism) |
|
|
Term
|
Definition
| plasmin breaks down fibrin to fibrin degredation products - D dimer is the smallest of these |
|
|
Term
|
Definition
fibrinogen
d dimer levels
Fibrin degredation products |
|
|
Term
Vit K antagonism?
treatment? |
|
Definition
from eating coumarin derivatives like warfarin
Must inject vit K first and then give oral |
|
|
Term
| what is DIC and how do you diagnose it? |
|
Definition
systemic coagulation and fibrinolysis
Diagnosed on aPPT and PT
Treat with heparin |
|
|
Term
| immune mediated aneamia - causes? |
|
Definition
babesia
mycoplasma
autoimmune IMHA |
|
|
Term
|
Definition
clinical signs
evidence of red blood cell regeneration
spherocytes
positive slide agglutination |
|
|
Term
| seconadary immune mediates anaemia is caused by what in dogs and cats? |
|
Definition
cats - mycoplasma
Dogs - babesia, neoplasia, inflammatory disease |
|
|
Term
| How can you eleminate secondary cuases of IMHA? |
|
Definition
chest xray
blood tests
abdominal ultrasound |
|
|
Term
|
Definition
feline infectious anaemia - caused by mycoplasma
transmitted by cat bites
Diagnosis on blood smear and PCR
Treatment is doxycycline for 6 weeks
and glucocorticoids to manage IMHA |
|
|
Term
| primary IMHA?= common incats or dogs mostly? |
|
Definition
|
|
Term
|
Definition
transfusion - acute
immunotherapy - azothloprine |
|
|
Term
|
Definition
| small hard erytheatous elevation accumulation of bacertia |
|
|
Term
| what confirms pyoderma on smear? |
|
Definition
| degenerate neutorphils and bacteria |
|
|
Term
| what three things underly folliculitis? |
|
Definition
demidicosis
staphylococcus
dermatophytosis |
|
|
Term
| What contrast methiods are there to image the urogenital tract in dogs and bitches? |
|
Definition
+ve retrograde urethrogram in bitches
postive urethrogram in
Both could have a double contrast cytogram
IVU - IV urography - not used widely |
|
|
Term
| what are the 3 phases following ingection after an IVU? |
|
Definition
vascular
neohrogram
pyelogram |
|
|
Term
| why would a kidney have a hyperechoic cortex? |
|
Definition
ethylene glycol poisoning
renal failure
neoplsia |
|
|
Term
| what chahges would you see with an IVU? |
|
Definition
mass
cytstic change
hydronephrosis |
|
|
Term
| what is acoustic enhancement? |
|
Definition
| when you get increased echo amplitude returning distance from an object being imaged |
|
|
Term
| what does a double contrast stud consist of? |
|
Definition
| pneumocyystogram and contrast - so some air blown into the bladder which allows you to see the wall thickness and then some contrast which lines the muscose |
|
|
Term
| pneumocytsogram vs positive contrast studt - advantages? |
|
Definition
pneumo - can assess the thickness of the wall and se the positiion of the bladder and the prostate
advadantage of the contrast is thaut you can assess the muscosal surface |
|
|
Term
| circumferential thickening of the bladder often indicates what? |
|
Definition
|
|
Term
| what is a retrograde urethrogram? |
|
Definition
done befire a double contrast
used in males more so than females |
|
|
Term
| how are calculi often seen in the bladder on ultasound? |
|
Definition
| hyperechoic with acoutitc shadow |
|
|
Term
| when carrying out a +ve retorigrade vaginogram - where is the preloaded catheter inserted to? |
|
Definition
distal vagina
or vestibule and aim is dorsally |
|
|
Term
| what can be a tell tale sign of urethral neoplsia? |
|
Definition
| ragged rough muscosal interface with the contrast |
|
|
Term
|
Definition
| an abnormal increase in the urea and creatinint in the blood |
|
|
Term
|
Definition
synth in the liver from break down of AAs
excreted thru the kidney |
|
|
Term
|
Definition
from the breakdown of muscle
Constant rate of production
excreted unchanged
an increase in serum levels would be due to a decreased GFR |
|
|
Term
|
Definition
pre renal - issue with blood supply - inadequate perfusion
Renal - due to kidney disease
Post renal - blockage or ruptureof the urinary tract |
|
|
Term
|
Definition
glomerular filtration rate
Measure of the rate at which things are cleared throught the glomerulus
Defines the excretory finction |
|
|
Term
| what would reduce the GFR? |
|
Definition
reduced perfusion
reduced kidney function
obstruction |
|
|
Term
| what use are urea and creatinine? |
|
Definition
| they can be used to assess kindey finction like GFR but in a less direct way |
|
|
Term
| what makes creatinine better for asssessing tge renal finction instead of urea? |
|
Definition
| it is produced at a constant rate and is freely filtered and not absorbed |
|
|
Term
| is creatinine sensitive to kidney failure? |
|
Definition
| no not until GFR is really low |
|
|
Term
| clincial signs of azotemia? |
|
Definition
| they are not really any apart fom the syndrome of uraemia caused by a state or azotemia and so clinical signs are often realted to the ureamia |
|
|
Term
| clinical signs of uraemia? |
|
Definition
| inappetance depression vommint, nausea, halitosis, stomatits |
|
|
Term
| a history of dysuria or stanguria is often assoc with what? |
|
Definition
|
|
Term
| what clinical signs are assoc with post renal azotemia? |
|
Definition
free sub cut lfuid around the perineum
unable to pass a catheter
grossly enlarged bladder on palpation |
|
|
Term
|
Definition
very concentrated urine
will make youthink there is pre renal issue |
|
|
Term
| urine sediment - if ou saw crystals orhaematuria what would you think the cause? |
|
Definition
crystals - will be a renal cause
haematuria - renal or post renal |
|
|
Term
| what are the values for the hyper/iso/hyposthenuria? |
|
Definition
hyposthenuria- 1.000-1.007
iso - 1.008 - 1.012
hyper 1.033-1.055 |
|
|
Term
| renal insufficiency, disease, failure |
|
Definition
disease - damage or functional impairment
Insufficiency - functional impairment that is nt enough to cuase azotemia but will cause loss of renal finction
Failure 0 damage enough to cuase azotemia and urine concentrating ability of lost |
|
|
Term
|
Definition
| sudden often reversible reduction in the ability to clear things and metabilic finctions of the kidney |
|
|
Term
| causes of reduced renal perfusion? |
|
Definition
| dehydration, shock hypovolaemia, reduced CO and low BP |
|
|
Term
| clinical signs of acute renal failure? |
|
Definition
| vomiting, diarrhoea, halitosis, inappetant and depressed |
|
|
Term
| if in failure - what abnormalities would you see on biochem? |
|
Definition
initial hyperkalaemia
hyperphosphataemia
hypercalcalaemia?
metabolic acidiosis |
|
|
Term
| what is the normla urine output? |
|
Definition
1-2ml/kg/hr
>2ml/kg.hr is considered to be pokyuric |
|
|
Term
| addisonian patients are often simialr to acute renal failure patients - what clincopatholigcal signs will they have? |
|
Definition
hyperk+
hyperphosphataemia
and minimally concentrated
pre renal azotemia |
|
|
Term
| treatment of acute renal failure? |
|
Definition
hospitalise
hydration status
CVPmonitoring
reove the inciting problems and restore renal pressure
monitor elcetrolytes |
|
|
Term
| prevention of acute renal failure? |
|
Definition
ID the risk factors
eg existing disease , dehydrated, sepsis
recdec CO
trauma
Hypoporteineamia |
|
|
Term
| what is chronic renal failure? |
|
Definition
loss of renal function for a prolonged toime of more than 2 months
progressive and irreversible |
|
|
Term
|
Definition
degenerative
developmental
metabolilc
neoplastic
infectious
idiopathic
immune mediated
iatrogenic |
|
|
Term
| degenerative causes of CRF? |
|
Definition
chronic interstitial nephritis
renal infarcts |
|
|
Term
|
Definition
|
|
Term
|
Definition
cronic kidney disease leads to loss of nephrons and damage
1/3 loss means urine concentrating ability is lost
1/4 loss - means azotemia
further progression leads to uraemia
so you get dehydration, failure of vit D synth, failure of excretion of nitrogenous waste and failure of EPO prdcution |
|
|
Term
|
Definition
| becuase once it starts secondary processes are initiated and the contribute to the renal damage |
|
|
Term
| what secondary processes contribute to renal damage? |
|
Definition
renal fibrosis
systemic hypertension
proteinuria |
|
|
Term
|
Definition
P/PD,
GIT signs - vomitnig and diarrhoea etc
depressed lethargic, inappetant, sudden onset blindess
dehydrated |
|
|
Term
| how do you go about investigating CRF? |
|
Definition
| ID presence of azotemia, ID if acute or chronic stage disease and id the underlying causes |
|
|
Term
|
Definition
hyperphospahemia
hyperkalaemia
meabolic acidosis |
|
|
Term
| why do you get hyperphps[phataemia with CRF? |
|
Definition
| becasue kidneys arethe 1y route of excretion |
|
|
Term
| why does CRF lead to 2y renal hyperparathyroidism? |
|
Definition
| becasue a reduced GFR leads to reduced PO4- excretion, and a redced calcitorl production so that leads to a reduced calcium level which stimualtes PTH sectrion from the PTHgland to oincrase the serum Ca2+ but this also increases serum po4- |
|
|
Term
| what sort of aneamia do you get with CRF? |
|
Definition
due to the reduced EPO production there is a normohromic normocytic non reghenerative aneamia
so animal will be ltheragic |
|
|
Term
| management of vomiting and nausea assoc with CRF? |
|
Definition
anti emetics - metoclopramide
H2 blockers - cimetidine
gastirc protectants - sucralfate |
|
|
Term
|
Definition
o=low fat
high energy
high quality reducded protein
postassium supplmentation
soluble finbre |
|
|
Term
| angiotensin receptor blockers? |
|
Definition
licensed for the use in reducing proteinuria in cars
telamasartin |
|
|
Term
| what is acute on chonic renal failure |
|
Definition
| acute decompensation if CRF |
|
|
Term
| how do you class female incontinance? |
|
Definition
sphincteric
abnormal storage
anatomic |
|
|
Term
| signalment of ectopic ureters? |
|
Definition
12weeks old to 1year
can pass a normal stream but always have a wet bed and carpet etc
wet coat and inflammed oerineum |
|
|
Term
| diagnosis of ectopic ureters? |
|
Definition
|
|
Term
| when would you most likely see sphincter mech incontinance? |
|
Definition
not speyed and less than 1year old
often incontinatn when sleeping or jumping
often have an intrapelvic bladder and a wide urethra |
|
|
Term
| treament for sphincter mech incontinance |
|
Definition
alpha adrenergic agonist
phenylopromanaoline
Estriol
surgery - colosuspension
surgery - colo |
|
|
Term
| causes of urinary incontinance in males? |
|
Definition
ectopic ureters
sphincter mech incontinance
prostate issues
atonic bladder
reflex dysenergia |
|
|
Term
|
Definition
often asynptomatic - becuase they have such a long urethra - enters the prostate and causes dilation
lack of J shape |
|
|
Term
| what is reflex dysenergia? |
|
Definition
when they go out to urinate and nothing happens then come in and flood the floor due to a failure in the relaxation of the sphincter and the detrusor contracts so the bladder stretchs adnd becomes atonic due to damage at the neuromuscular junction
Catherterise and keep bladder drained
Bethanecol |
|
|
Term
| sphincter mech incontinance in males? |
|
Definition
same as females - 12wks old to 1year old
intrapelvic bladder
Treat with phenylprompanololamine and testosterone |
|
|
Term
|
Definition
due to inflammation- prostatitis, abscess
or an obstruction - cyst, abcess, neoplsia, paraprostatic cyst |
|
|
Term
| investigating prostatic issues? |
|
Definition
| prosatic wash or a biopsy |
|
|
Term
|
Definition
very common just a large symmetrical cyst with central urthra
do a retrograde urethrogram and a DCS |
|
|
Term
| what will a prostatic cyts look like on ultrasoudn? |
|
Definition
| large, non symmertirical, cavitations and floaters ub ut |
|
|
Term
|
Definition
| may nto have an enlarged gland - may jsut have dystrophic mineralisation and hyperreflectivity |
|
|
Term
|
Definition
ddx - perineal hernia
thin mineralisation of the while outline solooks like an egg shell
no contrast leakage
may cause fecal staining |
|
|
Term
|
Definition
|
|
Term
|
Definition
pre renal - abnormal laod presented to kidney - kidney failure
Renal - inflam of the tract from below the kidney
post renal |
|
|
Term
| false -ve protein dipstick test? |
|
Definition
|
|
Term
| investigation of proteinuria? |
|
Definition
pre renal cause s- haem and biochem
renal cause s- urinalysis and imaging
post renal - sediment and culture |
|
|
Term
| urine protein to creatinine ratio? |
|
Definition
| used to quantify the disease progression and severity |
|
|
Term
| causes of renal proteinuria? |
|
Definition
| imflammation andglomerular and interstital disease |
|
|
Term
|
Definition
| excluded on the basis of hisotr, clincial exam and lack of sediment |
|
|
Term
|
Definition
| due to the fact that there is kidney damage s the remaining neprons are hyperfiltrating which leads to increased protein loss aka prtien loosing nephropathy |
|
|
Term
| what is glomerulonephritis? |
|
Definition
| when immune complexes are depositied in the glomerulus due to idiopathic cuases or antigenic causes |
|
|
Term
| clicial signs of protein loosing nephrooathy? |
|
Definition
| late stage - effusions and odeama |
|
|
Term
|
Definition
inflammation of the interstitium of the kidney due to bacterial infecion
- causes from an ascending infection of haematogenous spread |
|
|
Term
|
Definition
pupd
vomiting
renal pain,
dehydration
pyrexia |
|
|
Term
| diagnosis of pyelonephritis? |
|
Definition
haemturia
pyuria
hard to ddx from bacterial cystitis |
|
|
Term
| how do you ddx from bacterial cytitis and pyelonephritis? |
|
Definition
| pyelonephritis will have dilute urine whereas cystis wont |
|
|
Term
| ddx for cervical swellings? |
|
Definition
thyroid carcinoma
pharyngeal stick injury
sialoceole
lymphadenopathy
inset bite |
|
|
Term
| which 3 ways can a pharyngeal stick go? |
|
Definition
|
|
Term
| with a pharyngeal stick inhury = what clincial sugns would be seen if the oesophagus was involved? |
|
Definition
dyspnoea
pneumomediastininum
subcut emphysema |
|
|
Term
|
Definition
a defect in a polystomatic sublingual gland
spft painless swelling
not attached to underlying structures
honey coloured fluid |
|
|
Term
| which 3 regions may you find a sialoceole? |
|
Definition
| cervial, ranular and pharyngeal |
|
|
Term
| how do you cofirm if it is a sialoceole? |
|
Definition
take an aspirate and do the drip trst
stringy
or sialography |
|
|
Term
| treatment of a sialoceole? |
|
Definition
treat by diesecting down through the ducts and muscle to the gland and remving atleast 3 lobules of the polystomatic gland
and implant a drain |
|
|
Term
| thyroid carcinoma? clincial signs? |
|
Definition
coughing
regurgitation
a firm mass ventrolalteral to the pharynx
attached to the underlying mucosae |
|
|
Term
|
Definition
aka necrosis of salivary gland
pain and pyrexia
NSADIS antiobiotics and steroids |
|
|
Term
| ddx for imaging the GIT and seeing free gas? |
|
Definition
pneumoperitoneum
recent surgery
GIT perforation
iatrogenic |
|
|
Term
| if the liver gets large - what happends to the stomach and the gastric axis? |
|
Definition
| stomach will move caudally and gastric axis roatation |
|
|
Term
| what happens to the gastric axis with microhepatomegally |
|
Definition
| gastric axis rotates craniallu |
|
|
Term
| what would you see when there is a small ointestinal obstruction?? |
|
Definition
| single or a few dilated loops of intestine and may be thickened may or may not see the FB can use contrast |
|
|
Term
|
Definition
generalised SI dialtion
could be finctional - peritonitis, GDV, dsyautonomia
may be seen with A distal obstruction |
|
|
Term
|
Definition
when there is a chronic partial SI obstruction
will see a cpollection of mineralised material immediately above the obstruction
Animal would have a history of persistant vomiting or something |
|
|
Term
| pros and cons of ultrasound? |
|
Definition
pro's - major dx tool
good for soft tissue
safe and non invaseive and real time
Cons - need to be trained well to do it , poor bone and gas detaild |
|
|
Term
| diffue change to the liver? |
|
Definition
hyperechoic - loose clarify of the portal vessles and could be due to hepatitis or stroids
Hypoechoic - due to congestion, acute inflammation, oedema |
|
|
Term
| git assessment using ultrasound what can you assess and what sort of thinsg may you see? |
|
Definition
function
thickness - neoplsia or enteritis
obstruction - contents or intussusesption |
|
|
Term
| liner FB in the GIT would be seen as what on ultrasound? |
|
Definition
| like an accordian - lots of short sharp turns if loops of intestines - plicated |
|
|
Term
| signs of GI neoplasia on ultrasound? |
|
Definition
loss of layering and irregular lumen
marled;ly thickened |
|
|
Term
| what will th epqncreas look like on u/s when pancreatitis? |
|
Definition
| oedematous, hypoechogenicwith surrounding peritonitis and free fluid |
|
|
Term
| common oesophageal diseases? |
|
Definition
aquired megaoesophagus
vascular ring anomaly
foreign body
myasthenia gravis
reflux oesophagitis |
|
|
Term
| clinical signs of oesophageal disease? |
|
Definition
regurgitation
dysphagia
hypersalivation
ravenous apetite
weight loss |
|
|
Term
| what are the three stages of barium aspiration and whast is the treatment? |
|
Definition
bronchial
alveolar
nodes
if inhalation of barium occurs - just give antibiotics for 14 days |
|
|
Term
|
Definition
can be primary or secondary
primary is idiopathic and secondary is caused by -- myasthenia gravis, hypoadrenocortism, myopathy, toxins |
|
|
Term
|
Definition
no GI stumlants really hlp
acquired thing that comes about <6months old and only helps if feed form a height and have the right food consistnacy |
|
|
Term
|
Definition
congenital
from embryological development - persistant right aoritc arch
double aortic arch
treat with ligation |
|
|
Term
preoperati e considerations for animals with oesophagelal FBs?
Post op care? |
|
Definition
hydration
electrolytes
oesophagitis
acid base balance
Post op:- proton pump inhibitors, gastric protectants/h2 antagnosits
analgesics
Antibiotics |
|
|
Term
| complications of Fbs in the oesophagus? |
|
Definition
stricture
stenosis
failure of retrieval when doing surgery
perforation
fistuale |
|
|
Term
| stricures of the oesophagus? |
|
Definition
| can be congenital or acquired or 2y to inflammation |
|
|
Term
|
Definition
pgastrointestinal reflux
chronic vomiting
caustic agents
physical agents
treat with baloon degeneration |
|
|
Term
|
Definition
occurs a lot in the brachycephalic breeds
congenital and acquired types
clincial signs - relfux oesophagitis, dyspnoea, regurgitation, body condition |
|
|
Term
| management of a hiatal hernia? |
|
Definition
h2 blockers
metaclopramide
gastric protectants
then anatomic restitution |
|
|
Term
| GDV - typical signs seen on xray? |
|
Definition
| fundus is ventral and the pylorus is dorsal and a thickened wedge of tissue |
|
|
Term
| what does the GDV syndrome consist of? |
|
Definition
gastric dilation
gastric dilation and volvulus
chronic dilation |
|
|
Term
|
Definition
restless
aggitated
progressive abdominal distension
unproductive vomiting
hypovolemic shock - collapse, tachypnoea, tachycardia poor peripheral pulse, weakness and palor
PAIN |
|
|
Term
intrinsic risk factors of GDV?
and extrinsic risk fctors that predispose to GDV? |
|
Definition
intrinsic:- breed, age, narrow deep chest thin
Extrinsic :- big meals and gulping food |
|
|
Term
|
Definition
failure of the gastooesophageal spincter mechanism so that cant erructate and so fills with air over time and strecthes the hepatic ligament
this plus impaired motility |
|
|
Term
| which way does a GDV commonly twist? |
|
Definition
|
|
Term
|
Definition
vascular ocmpromise - stomach hypoxia due to twist
leads to avulsion of the short axis gastirc arteries
Spleen too |
|
|
Term
| systemic effects of a GDV? |
|
Definition
- reduced venous return due to the increased pressure on the vena cava and portal vein
- tissue perfusion poor :imcreased alctic acid and inflammatory mediators which could lead to myocardial ischaemia and stimach necrosis |
|
|
Term
|
Definition
tympanic abdomen
right lateral xray - show a gas filled stomach |
|
|
Term
|
Definition
correct the hypovolaemic shcok - fluids
take bloods for PCV and total proteins
oxygen
antibiotics |
|
|
Term
|
Definition
| by passing a gastic tube down or percutaneous gastrocentesis |
|
|
Term
| when would you have a reduced prognosis for a GDV patient? |
|
Definition
if the color or thickness is bad looking
if there are tears or thorombi |
|
|
Term
| what are the methods of repositioning and attaching a GDV? |
|
Definition
| once in the correct orientation - gastropexy - belt and loop, incisional or circumconstal |
|
|
Term
| complications of GDV's post opp? |
|
Definition
arrythmias#pneumonia
abnormal gastirc motility
gastric necrosis |
|
|
Term
|
Definition
difinite entity
flatulance ad oerphagia
weight loss an intermiitant GDV |
|
|
Term
| medical management for chronic vomiting? |
|
Definition
| pro kinetics, anti emetics and antacids |
|
|
Term
| what can oesophagtitis cause? |
|
Definition
hypersalivation
regurgitation
vomiting, anorexia |
|
|
Term
| difference between Si and LI diarrhoea? |
|
Definition
Si-
large volume, look of urgency, malaena, no mucus, weightloss, normal freq
LI:- small amount frequesntly, fresh blood or mucus normal weihght mainatinaeed |
|
|
Term
| categories of causes of chronic diarrhoea? |
|
Definition
| Extra intestinal or intestinal |
|
|
Term
| Extra intestinal causes of chronic diarrhoea? |
|
Definition
pancreatitis
hypoadrenocortism
liver disease
renal disease |
|
|
Term
| intestinal causes of chronic diarrhoea? |
|
Definition
parasites
infectious
food responcive diarrhoea
neoplsai
IBD
ab Responcive diarrhoea |
|
|
Term
| investingations into chronic diarhoea? |
|
Definition
fecal parasitology tests
bloods and urinalysis
antibiotic trial diagnositc imaging biopsy |
|
|
Term
| bacteriology and parasitlogy for chronic diarrhoea? |
|
Definition
giardia
toxocarina
ucinaria
trichuris
FEC r an elisa for giradia or just a 5 day fenbendazole course |
|
|
Term
| what fe the markers for absorbtion? |
|
Definition
Trypsin like indicator
cobalaminne - absorbed from the distal SI
folate absorbed from the prox SI |
|
|
Term
|
Definition
| diagnosi of exclusion after parasites, diet responcive tests unknown aetilogy due toa breakdown of normal immune tolerance |
|
|
Term
|
Definition
immunosuppressive therapy
also probiotics
kaolin and peridale
which aim to restore the fecal consistnacy |
|
|
Term
| +signs of acute pancreatitis? |
|
Definition
vomiting anorexia depression, abdominal pain cranially,
diarrhoea |
|
|
Term
| how does the pancrease protect itself from autodigestion? |
|
Definition
proteolyic enzymes are synth and stored as inactive zymogens and packed into granules . granules also have pancreatic secretory trypsin inhibitor so protect
these granules are then released into the ductal lumen and then exocytosed to the SI |
|
|
Term
| why does acute pancreatitis occur? |
|
Definition
initating even is thought to be a premature activation of the zymogen granules in the pancrease and once activated in the parenchyma of the pancreas can get into the circulation
lysozymes fued with the zymogens and create a vaculose that birsts and releases active trypsin |
|
|
Term
| what are the result of acute pancreatits? |
|
Definition
local inflam and necrosis
systemic disperssal of the enzymes
systemin inflamatory response |
|
|
Term
| causes of acute pancreatitis? |
|
Definition
trauma, drugs, reduced pancreatic perfusion
duodenal billary relfux that causes irritation |
|
|
Term
| clinical pathology assoc with acute pancreatitis? |
|
Definition
leukocytosis
increased liver enzymes
hypokalaemia
hypocalcaemia
increased amylase and lipase - not specific though |
|
|
Term
| tests for pancreatic function? |
|
Definition
Trypsin like immunoreactivity - TLI
Snap test for lipase - good rule out test, does get false +ves
Lab lipase test |
|
|
Term
| signs of acute pancreatitis? - diagnostic imaging? |
|
Definition
radiography - loss of conrast in the cranial abdomen
peritonitis
gastirc displacement
Ultrasound:- hypoechoic, enlarged |
|
|
Term
| Treatment of acute pancreatitis? |
|
Definition
fluids, treat shockand supplement with KCl
Analgesia - not nsaids, - buprenorphone best
antiemetics - maropitant
gastric protectants
Food asap |
|
|
Term
| clincial signs of pancreatitis in cats? |
|
Definition
dont vomit
pale, dehydrated and dyspnoea, hypothermic |
|
|
Term
|
Definition
| more so in cats than in dogs but is an acute on chronic situation |
|
|
Term
| clinical signs of chronic pancreatitis? |
|
Definition
Exocrine pancreatic insufficiency
OR Acute signs
OR intermittent |
|
|
Term
| Treatment of chronic pancreatitis? |
|
Definition
| as if it were acute :- fluids, analgesia, vit b12, appetite stimulants |
|
|
Term
|
Definition
| exocrine pancreatic insufficiency - when the pancreas doesnt make enough enzymes |
|
|
Term
|
Definition
acinar atrophy
chroic pancreatitis
pancrastic neoplsia |
|
|
Term
|
Definition
enzyme supplementation
dietcobalamin |
|
|
Term
| failure of treatment in EPI? |
|
Definition
not enough enzyme
Gastric acid effects
disturbed GI flora
diet change
concurrent SI disease |
|
|
Term
|
Definition
not common
Treatment - chemo, surgery or radiation |
|
|
