Small Animal Emergency and Critical Care exam 2

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Emergency Area
should be centrally located, facilitate assessment and treatment, equipment and drug inventory checked frequently
Minimum Requirements for Emergency
oxygen, suction, electrical supply, lighting, and a crash cart
Crash Cart Requirements
establish airway, venous access, emergency drugs, and dose chart
Fluid Therapy
maintain hydration, replace fluid loses, maintain IV access and med administration, treatment of shock or hypoproteinemia, increase urine output, correct acid-base electrolyte abnormalities, and nutritional support
Crystalloid Fluids
isotonic; contain water with sodium or glucose (25% remain in vascular space after one hour)
Colloid Fluids
expand vascular volume; contain high-molecular weigh particles, intravascular remain in space longer (hetastarch)
Overhydration
coughing, tachypnea, respiratory distress, nasal discharge, and chemosis
ABC Protocol
A: airway
B: breathing
C: cardiac
Methods of Oxygen Supplementation
mask, blowby, nasal cannula, and O2 cage
Hemothorax
blood in the abdomen
Pneumothorax
fluid in the abdomen
Quick Evaluation
1. thoracic auscultation
2. mm color and CRT
3. femoral and artery pulse
Corticosteroids
reduce inflammation
Spinal Trauma
complete nero exam, spinal shock for 24 hours, palpation of spine, tendon reflexes
Technician Role
evaluate, communicate, treatment, prevention
Pain
vocalization, depression, anorexia, hypotension, abnormal postures
DIC
disseminated intravascular coagulation-vicious cycle of clotting and bleeding
DIC Causes
trauma, pancreatitis, heatstroke, cancer, liver disease, anemia.
DIC Treatment
fluids, oxygen, blood products, and anticoagulants
Hypovolemic Shock
most common, caused by bleeding dehydration, or fluid loss
Distributive Shock
misdistribution of blood flow, trauma, heatstroke, anaphylaxis
Cardiogenic Shock
heart failure, or cardiac arrhythmia
Septic Shock
extensive tissue damage from trauma,
Treatment of Shock
dogs: 90ml/kg/hr
cats: 45-60ml/kg/hr
A 3 year-old lab mix is in exam room 1 with the following clinical signs: ptyalism, retching, and abdominal distention. These signs started after this dog ate his food and then went jogging with his owner. Your veterinarian suspects GDV. Which abdominal radiograph view is diagnostic for this emergency?
Right lateral
Which electrolyte imbalance is most likely to be found in a cat with total urethral obstruction?
Hyperkalemia
Which drug is administered sublingually in a neonate to stimulate respiration?
Doxapram
The stuporous cat in exam room 1 has ketone breath odor. What disease process does this cat most likely have?
Diabetes mellitus
It is lunch time and all the veterinarians are out of the hospital. A women comes running into the hospital with her 8-week old toy poodle that has collapsed 20 minutes ago and is now just lying on its side. The puppy has been healthy and active until now. You suspect the puppy is hypoglycemic. Initially, what is the best procedure for this puppy?
Rub 50% dextrose on the puppy's buccal mucosa.
Sassy is a 2 year-old intact female cocker spaniel that has a 12 hour history of vomiting, lethargy and slight mucoid vulvar discharge. Her last estrus cycle was four weeks ago. Based on these clinical signs, what is most likely her diagnosis?
Pyometra
A patient has not eaten well for several days, and your veterinarian elects to provide supplemental nutrition. Which of the following fluid products would provide more than a calories?
D5W
Nutritional support of the veterinary patient is indicated when
The patient has not eaten well for 3 days
Nutritional supplementation should be administered to
Any adult patient that has lost 10% of its body weight, Any patient with increased nutrient demands, such as surgery or infection and Any patient that has poor food intake for more than 3-5 days
The calculated RER for a 33 lb patient would be
520 kcal/ day
The administration of parenteral nutrition requires the placement of a catheter in which of the following locations?
In a central vein
When a method of tube feeding is required for long term maintenance of an anorectic patient, the most successful tube placement location is via
Gastrotomy tube
A small dog is unwilling to eat following surgery. Having someone sit with the dog and pet the dog to encourage it to eat would be an example of what type of enteral feeding?
Coax feeding
If Hill's Prescription Diet A/D contains 180 kcal/ can, how many cans will be required to supply the IER of a 6 lb cat?
1 can
You have a 22 lb cancer patient with a gastrotomy tube in place for feeding. If you make a blenderized diet of one 12.5 oz can (318 ml) of Hill's Prescription Diet N/D that contains 569 kcal/ per can mixed with one 12.5 oz can (318 ml) of water, how many mls of diet must be supplied to the patient daily to provide the patient's IER?
510 ml
If the calculated IER of a patient is 865 kcal/ day, and the patient is supplied with 875 ml of LRS daily, what percent of the IER will be supplied by the LRS?
1%
One disadvantage of orogastric tube feeding is
Orogastric feeding requires multiple tubing procedures daily which may be stressful
The RER, or resting energy requirement, is the number of calories required for body maintenance purposes
In a caged healthy animal
If the IER is 1.5 times the RER, the calculated IER for a 97 lb dog would be _________ kcals/ per day. (Round your answer to the nearest 10 kcal's--for example, 120 kcal's, not 123 kcal's).
2090
The number of 5.5 oz cans of Feline C/D that should be fed to a 7 lb cat to provide the IER if I/D contains 150 kcal/ can is ______ cans if the IER is 1.25 times the RER. (Round your answer to the nearest 1 decimal point--example, 1.2, not 1.23)
1.4 cans
Calculate IER
KG TIMES 30KCAL PLUS 70KCAL
How much to feed
1/3 of their IER on day 1
2/3 of their IER on day 2
All of their IER on day 3
IER
illness/injury/infection energy requirement
RER
most situation 1.25 times rer
burns require 1.5 times rer
cats 1.0 to 1.25 times rer
You have just witnessed a dog that has been hit by a car and is now lying on the side of the road. You pull over to the side of the road, and activate the emergency lights on your car, and then approach the animal. Which is the best way to initially approach the dog?
Rostrally
Permanent brain damage can occur if oxygen is not delivered within _______ minutes.
4
Cardiac compressions for a cat 2 kg
should be preformed with the thumb located on one side of the chest and the fingers of the same hand located on the other side of the chest.
A recumbent animal needs to be turned at least every ___________ to prevent decubitial ulcer formation.
2 to 3 hrs
Defibrillation is the passing of an electrical current through the heart to
prevent the cardiac cells from depolarizing, thus maintaining rhythm.
Binky, a 1 year old spayed DSH was sent home yesterday with a meta-mason splint on her right forelimb. Her owner called to say that Binky's toes are now enlarged and cold to the touch. What should you tell the owner to do?
Tell Binky's owner that Binky's circulation may be compromised and that Binky should return to the veterinary hospital immediately.
Stella is in examination room 1 with a 2 cm laceration on her left lateral proximal hindlimb. Her owner reported that she came home yesterday afternoon with this laceration and now the owner wants the wound to be sutured closed. You tell the owner that
suturing wounds greater than 8 hours after the incident is usually not advisable.
A client calls to say she has come home to find her cat lying on its side with a lamp cord in its mouth. Your initial advice to the client is to
disconnect the plug of the lamp cord from the wall socket.
When giving intratracheal emergency drugs, they must be
given at twice the IV dose.
Fracture Healing Steps
1. Hematoma formation at sire of fracture.
2. Soft Callus formation occurs due to osteoblast activity.
3. Primary bone union occurs when fracture is completely immobilized an blood vessels across the gap in the bone cortex
Ehmer Sling
used to prevent weight bearing of rear limb
Spica Splint
used to immobilize elbow, stifle, shoulder or hip
Robert Jones Bandage
external splint applied to a limb for the temporary support of a fracture before surgical intervention can occur. It is used to treat many canine and feline limb injuries
Physical Therapy
dry heat applied to an area can reduce pain and muscle spasm
laser therapy
applied to an area can reduce pain, muscle spasm and help to increase speed of healing.
Recumbent Care
Bladder emptied 3-4 times daily.
Provide proper nutrition.
Discharge patients as soon as possible.
Dyspnea
difficult or labored breathing
Apnea
temporary absence of spontaneous breathing
Which of the following are considered common cardiac emergency clinical signs?
Syncope, Dyspnea Abbey has just been rushed to your veterinary hospital with acute hindlimb paresis and is continuously howling (probably due to pain). Both of her hind limbs are cold to the touch. She is a 7 year-old indoor only spayed Persian that is up to date on all her vaccinations. Most likely, what is her diagnosis? Aortic thromboembolism
A normal CVP range is
0 to 5 cm water
The most common artery used to palpate a dog or cat's pulse is:
Femoral
Rapid administration of large amounts of intravenous potassium can result in
cardiac arrest.
The duration of a wave on an EKG is measured in
milliseconds.
Which arrhythmia is considered to be the most life-threatening?
Ventricular fibrillation
What is an injured blood vessel's first response to slow or stop hemorrhage?
Vasoconstriction
The blood test Partial Thromboplastin Time measures:
Intrinsic pathway and Extrinsic pathway
A cat has significant arterial bleeding from a distal extremity. It is best to
apply a blood pressure cuff inflated to 30 mm Hg above systolic pressure proximal to the bleeding.
Which of the following methods of controlling hemorrhage from a traumatic wound is least likely to cause further damage to the animal?
Direct pressure
Bear, a free-roaming 2 year-old intact male pointer mix, is in exam room 2 with lethargy and slight dyspnea. When performing venipuncture, you notice that his blood seems to have a prolonged clotting time. Which of the following substances may cause this prolonged bleeding when ingested?
Anticoagulant rodent poison
A client called to say his outdoor cat was just shot in the abdomen with a BB but the cat is acting normal. What should you recommend?
See the veterinarian immediately.
NSAIDS such as Rimadyl® or aspirin can cause
Acquired thrombopathia
von Willebrand's disease
...
Plasma coagulation factors are produced in the body
in the liver.
What is the most common hereditary bleeding defect in the dog?
von Willebrand's disease
A 0.5 kg kitten has severe flea-bite anemia and the veterinarian-in-charge has ordered a whole blood transfusion to be given. You are unable to insert an IV catheter. Which of the following sites would be the best choice to give the transfusion?
Intraperitoneal injection
Whole blood transfusion
administered immediately after collection to treat massive bleeding
Packed Red Blood Cells
administered to patient clinical signs respiratory compromised, tachycardia, poor pulse quality and lethargy.
Cryoprecipitate Administered to patients with von Willebrand's disease, hemophilla a, or fibrinogen deficiency.
...
Frozen plasma
used to treat stable clotting factor deficiencies and certain cases of acute hypoproteinemia such has parvo
Which product would be the best to transfuse in a dog with thrombocytopenia?
Platelet-rich Plasma
Choose the incorrect statement.
Feline blood donors should be checked yearly for brucellosis.
Which of the following species usually does not have any transfusion reactions with the initial transfusion?
Dog and Horse
Which of the following is not a sign of blood transfusion reaction?
Seizure
Which of the following species has been known to have neonatal isoerythrolysis?
Cats , Horses and Humans
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