505144
Pregunta 1
Pregunta
Which of the following is NOT a level of refinement for a problem?
Respuesta
-
Clinical signs
-
Pathophysiology
-
Lab data
-
Tentative diagnosis
Pregunta 2
Pregunta
A problem may be refined with accumulation of facts, temporarily inactivated, resolved, but never removed.
Respuesta
- True
- False
Pregunta 3
Pregunta
Which of the following is NOT an advantage of a problem oriented medical record?
Respuesta
-
Approaches each problem separately
-
Excellent for group practice communication
-
Eliminates oversight
-
Excellent for teaching logical and thorough diagnostic approach
Pregunta 4
Pregunta
What does bifurcation allow us to do?
Respuesta
-
Evaluate broad categories of rule outs
-
Potentially use less invasive diagnostic tools
-
Potentially use less expensive diagnotics
-
All of the above
Pregunta 5
Pregunta
Check all that are included in the minimum data base.
Respuesta
-
Signalment
-
System
-
Degree of evaluation
-
Final diagnosis
-
Physical exam findings
Pregunta 6
Pregunta
The master problem list may contain vaccine information, HW test, Felv status, or drugs dispensed.
Respuesta
- True
- False
Pregunta 7
Pregunta
The last page of the master list acts as an index.
Respuesta
- True
- False
Pregunta 8
Pregunta
A problem is anything that will interfere with the animal's well being and will require further evaluation and treatment.
Respuesta
- True
- False
Pregunta 9
Pregunta
SOAP is the method utilized for progress notes.
Respuesta
- True
- False
Pregunta 10
Pregunta
Which describes the subjective section of a SOAP.
Respuesta
-
Historical, overall assessment (ex. BAR), observations that are not easily quantified (stronger, better appetite, etc)
-
Daily PE findings, quantitated data (lab results, rad findings, ECG, neuro exam)
-
Interpretation and explanation of problem at this time period, current differential diagnosis, evaluation of treatment, how this case differs from typical case, shows student's understanding of case
-
What tests will be performed in the next 24 hrs, list therapeutic objectives and goals, what treatments will be administered in the next 24 hrs (include dose, frequency, route of administration), client education
Pregunta 11
Pregunta
Which of the following describes the assessment section of a SOAP?
Respuesta
-
Historical, overall assessment (BAR), observations not easily quantitated (stronger, better appetite, etc)
-
Daily PE findings, quantitated data (lab results, rad findings, ECG, neuro exam)
-
Interpretation and explanation of problem at this time period, current differential diagnosis, evaluation of treatment, how this case differs from typical case, shows student's understanding of case
-
What tests will be performed in the next 24 hrs, list therapeutic objectives and goals, what treatment will be administered in the next 24 hrs (include dose, frequency, route of administration), client education
Pregunta 12
Pregunta
Which of the following are to be included in recording client education.
Respuesta
-
Time of communication
-
Person talked with
-
Summarize conversation
-
All of the above
-
None of the above
Pregunta 13
Pregunta
Which of the following is FALSE?
Respuesta
-
Shock occurs when oxygen delivery does not equal oxygen consumption
-
Hypovolemic shock can be due to GDV, caval syndrome, cardiac tamponade
-
Distributive shock can occur due to vasodilation effectively removing blood from circulation, sepsis, or anaphlaxis
-
Cardiac shock can result from decreased cardiac output
Pregunta 14
Pregunta
Blood pressure can change when there are changes to systemic vascular resistance and/or cardiac output.
Respuesta
- True
- False
Pregunta 15
Pregunta
Which of the following is NOT a compensatory response to hypotension?
Respuesta
-
Sympathetic activtion
-
RAAS
-
ADH
-
Vasodilation
Pregunta 16
Pregunta
Many of the clinical signs of hypovolemic shock are due to compensatory mechanisms.
Respuesta
- True
- False
Pregunta 17
Pregunta
Which set of clinical signs is associated with compensated shock?
Respuesta
-
Normal mentation, increased heart rate, normal to decrease temperature, normal to tacky pale mucous membranes, normal to around 2 second CRT, normal (+/- bounding pulses) blood pressure, normal to increased (1-4) lactate
-
Mentation may be depressed, obtunded, stupor; heart rate increased in dogs, decreased in cats; decreased temperature; pale, cyanotic mucous membranes; CRT> 2 seconds; low blood pressure; lactate> 3
-
Normal mentation, decreased heart rate, normal to increased temperature, normal to tacky pale mucous membranes, normal CRT, normal (+/- bounding pulses) blood pressure, normal to increased (1-4) lactate
-
Mentation may be depressed, obtunded, stupor; heart rate decreased in dogs, increased in cats; increased temperature; pale, cyanotic mucous membranes; CRT> 2 seconds; elevated blood pressure; lactate> 3
Pregunta 18
Pregunta
Which set of clinical signs is associated with early decompensation?
Respuesta
-
Mentation may be depressed, obtunded, stupor; heart rate increased in dogs, decreased in cats; decreased temperature; pale, cyanotic mucous membranes; CRT> 2 seconds; low blood pressure; lactate> 3
-
Normal mentation, increased heart rate, normal to decreased temperature, normal to tacky, pale mucous membranes, normal to around 2 seconds CRT, normal (+/- bounding pulses), normal to increased (1-4) lactate
-
Mentation may be depressed, obtunded, stupor; heart rate decreased in dogs, increased in cats; increased temperature; pale, cyanotic mucous membranes; CRT> 2 seconds; low blood pressure; lactate> 3
-
Normal mentation, decreased heart rate, normal to decreased temperature, normal to tacky, pale mucous membranes, normal to around 2 seconds CRT, normal (+/- bounding pulses), decreased lactate
Pregunta 19
Pregunta
What is the shock dose for dogs when using crystalloid IV fluids?
Respuesta
-
90 ml/kg
-
80 ml/kg
-
70 ml/kg
-
60 ml/kg
Pregunta 20
Pregunta
You should give most of the shock dose as quickly as you can.
Respuesta
- True
- False
Pregunta 21
Pregunta
Which of the following is NOT true about hypertonic saline?
Respuesta
-
It is 7% saline (NaCl)
-
When given IV it results in rapid movement of interstitial and intracellular fluid into intravascular space
-
It has a short lived effect
-
It is given in small volume over 20-30 minutes
Pregunta 22
Pregunta
Which of the following is/are reasons to use colloids during shock? Check all that you think apply.
Respuesta
-
Hyperproteinemia
-
Hypoproteinemia
-
Lack of response to initial crystalloid administration
-
To improve hydration after initial crystalloid administration
-
None of these
Pregunta 23
Pregunta
Vasopressors and positive inotropes are used due to poor response to volume replacement and for hypovolemic shock.
Respuesta
- True
- False
Pregunta 24
Pregunta
Giving oxygen in shock provides oxygen to tissues but it may not change oxygen transport.
Respuesta
- True
- False
Pregunta 25
Pregunta
Hypothermia improves vascular response to fluids which is why it is important to use passive warming. Coming out of hypothermia too rapidly will impair the vascular response.
Respuesta
- True
- False
Pregunta 26
Pregunta
What % of body weight is blood volume?
Respuesta
-
6
-
7
-
8
Pregunta 27
Pregunta
Which of the following is NOT an indication for fluid therapy?
Respuesta
-
Rehydration
-
Expansion of intravascular volume
-
Decrease plasma oncotic pressure
-
Correct electrolyte imbalances
Pregunta 28
Pregunta
Which of the following clinical signs is associated with 6-8% dehydration?
Respuesta
-
Undetectable
-
Delayed skin tent
-
Dry mucous membranes
-
Sunken eyes
-
Weak pulses
Pregunta 29
Pregunta
Which of the following is NOT an advantage of oral fluid therapy?
Respuesta
-
Most physiologic route
-
No risk of overhydration
-
Reduce electrolyte loss is dehydration
-
Rapid absorption
Pregunta 30
Pregunta
Subcutaneaous fluids are ok for mild dehydration but there is moderate risk of overhydration.
Respuesta
- True
- False
Pregunta 31
Pregunta
Hypertonic solutions should only be administered in a central catheter when given IV.
Respuesta
- True
- False
Pregunta 32
Pregunta
You should not give maintenance solutions unless a patient is hydrated.
Respuesta
- True
- False
Pregunta 33
Pregunta
Hpertonic saline causes a rapid increase in intracellular volume.
Respuesta
- True
- False
Pregunta 34
Pregunta
Which of the following are other treatments for shock, once the animal has been stabilized? Check all that apply.
Respuesta
-
GI protectants to treat/prevent GI ulcers
-
GI protectants that are H2-blockers
-
Antibiotics for septic shock
-
Antibiotics for patients with GI hemorrhage
-
Antibiotics for compensatory shock
-
Analgesia, but not opiods
-
Sodium bicarbonate to treat severe acidosis if present after volume replacement
Pregunta 35
Pregunta
Sepsis is a subset of systemic inflammatory response syndrome.
Respuesta
- True
- False
Pregunta 36
Pregunta
Which of the following distinguishes severe sepsis from septic shock?
Respuesta
-
Severe sepsis has hypotension that responds to fluid therapy and supportive care. It also requires vasopressors.
-
Severe sepsis has hypotension that responds to fluid therapy and supportive care. It does not require vasopressors.
-
Septic shock has hypotension, responds to fluid therapy,and requires vasopressors.
-
Septic shock has hypotension, is unresponsive to fluid therapy, and requires vasopressors.
Pregunta 37
Pregunta
Which of the following pairs is correctly matched?
Respuesta
-
Hypovolemic shock- SIRS infection and hypotension
-
Septic shock- vasodilation + vasoconstriction + thrombosis
-
Cardiogenic shock- decreased myocardial function
-
Distributive shock- excessive capillary permeability and fluid loss
Pregunta 38
Pregunta
Check all that are early clinical signs of sepsis.
Respuesta
-
Depression
-
Fever
-
Tachycardia
-
Tachypnea
-
Pale mucous membranes
-
Rapid CRT
-
Weak pulses
Pregunta 39
Pregunta
Urine should be cultured in suspected cases of sepsis. Bacteriuria can occur in sepsis without clinical signs of UTI.
Respuesta
- True
- False
Pregunta 40
Pregunta
Which of the following would NOT be expected from laboratory tests in a case of sepsis? (sepsis is the only problem)
Respuesta
-
Post renal azotemia
-
Hypoglycemia
-
Hyperbilirubinemia
-
Elevated liver enzymes
Pregunta 41
Pregunta
Which of the following is NOT or would not be part of a treatment plan for sepsis?
Respuesta
-
Narrow spectrum antibiotics
-
Nutritional support
-
Treat for shock if present
-
Treat complications such as DIC, organ failure, hypoglycemia
-
These are all used for treatment of sepsis
Pregunta 42
Pregunta
Which of the following defines hyperthermia?
Respuesta
-
Elevation in core body temperature due to a changed thermoregulatory set point in the hypothlamus
-
Elevation in body temperature above normal range that occurs without a change in the hypothalamic set point
Pregunta 43
Pregunta
Heat gain occurs by 2 broad mechanisms. Which of the following does NOT result in decreased loss?
Respuesta
-
Catecholamines
-
Vasoconstriction
-
Piloerection
-
Seek warm environment
Pregunta 44
Pregunta
Which of the following is NOT a method of heat loss?
Respuesta
-
Vsodilation
-
Panting
-
Postural change
-
Seek cold environment
-
All of the above are methods of heat loss
Pregunta 45
Pregunta
Which of the following are possible causes for fever? Check all that apply.
Respuesta
-
Infection
-
Immune-mediated
-
Neoplastia
-
Inflammation
-
Drugs
-
Toxins
Pregunta 46
Pregunta
Which of the following is NOT a diagnostic tool for stage 2 diagnosis of FUO? (fever of unknown origin)
Respuesta
-
Protein electrophoresis
-
Bone marrow aspirate
-
Dental rads
-
FNA of masses, lymph nodes
Pregunta 47
Pregunta
When doing a therapeutic antibiotic trial for FUO, how long, minimum, should the full dose be given?
Respuesta
-
5 days
-
1 weeks
-
10 days
-
2 weeks
Pregunta 48
Pregunta
Which of the following is FALSE regarding a therapeutic corticosteroid trial for FUO?
Respuesta
-
If truly immune-mediated, pyrexia and clinical signs are usually resolved in 48-72 hrs
-
Many conditions will respond to steroids initially
-
Complicates diagnosis of neoplasia
-
You must rule out infection as the cause first
Pregunta 49
Pregunta
NSAIDs act centrally on the hypothalamus and reduce prostaglandin production via inhibition of cycloxygenase which results in peripheral vasoconstriction.
Respuesta
- True
- False
Pregunta 50
Pregunta
Which of the following does NOT result from excessive core body temperature associated with heat stroke/hyperthermia?
Respuesta
-
Intracellular alterations
-
Protein denaturation
-
Enzyme activation
-
Cell membrane instability
Pregunta 51
Pregunta
Heat stroke can damage the thermoregulatory center. This leads to a predisposition to subsequent hyperthermic episodes.
Respuesta
- True
- False
Pregunta 52
Pregunta
Which of the following is NOT a renal effect from heat stroke?
Respuesta
-
Indirect thermal injury to renal tubular epithelium
-
Hypoxia due to hypovolemia
-
Microthrombi associated with DIC
-
Myoglobin from rhabdomyolysis is nephrotoxic and may exacerbate renal tubular dz
Pregunta 53
Pregunta
Heat stroke can lead to acute respiratory distress syndrome (ARDS).
Respuesta
- True
- False
Pregunta 54
Pregunta
Which of the following treatments is contraindicated for hyperthermia?
Respuesta
-
Spray with cold water
-
Cool with fan after spraying with water
-
Clip thick haircoats from the abdomen and trachea
-
Cool water enema
Pregunta 55
Pregunta
Which of the following is NOT indicated for treatment of hyperthermia?
Respuesta
-
H2 blockers
-
Broad spectrum abx (unicin or ampicillin/baytril combo)
-
NSAIDs
-
Sucralfate
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