Gen Vet Med Midterm 1

Clinical signs

Pathophysiology

Lab data

Tentative diagnosis

Approaches each problem separately

Excellent for group practice communication

Eliminates oversight

Excellent for teaching logical and thorough diagnostic approach

Evaluate broad categories of rule outs

Potentially use less invasive diagnostic tools

Potentially use less expensive diagnotics

All of the above

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

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

Time of communication

Person talked with

Summarize conversation

All of the above

None of the above

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

Sympathetic activtion

RAAS

ADH

Vasodilation

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

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

90 ml/kg

80 ml/kg

70 ml/kg

60 ml/kg

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

6

7

8

Rehydration

Expansion of intravascular volume

Decrease plasma oncotic pressure

Correct electrolyte imbalances

Most physiologic route

No risk of overhydration

Reduce electrolyte loss is dehydration

Rapid absorption

Hypovolemic shock- SIRS infection and hypotension

Septic shock- vasodilation + vasoconstriction + thrombosis

Cardiogenic shock- decreased myocardial function

Distributive shock- excessive capillary permeability and fluid loss

Post renal azotemia

Hypoglycemia

Hyperbilirubinemia

Elevated liver enzymes

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

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

Catecholamines

Vasoconstriction

Piloerection

Seek warm environment

Vsodilation

Panting

Postural change

Seek cold environment

All of the above are methods of heat loss

Protein electrophoresis

Bone marrow aspirate

Dental rads

FNA of masses, lymph nodes

5 days

1 weeks

10 days

2 weeks

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

Intracellular alterations

Protein denaturation

Enzyme activation

Cell membrane instability

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

Spray with cold water

Cool with fan after spraying with water

Clip thick haircoats from the abdomen and trachea

Cool water enema

H2 blockers

Broad spectrum abx (unicin or ampicillin/baytril combo)

NSAIDs

Sucralfate