Clin Med IV

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Clin Med IV
2012-05-06 09:00:38
Clin Med IV

Clin Med IV
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  1. What node generates the heart rate and why?
    SA node generates the heart rate because its faster
  2. What is the first priority of the heart?
    maintain normal systemic arterial pressure
  3. What is the second priority of the heart?
    maintain normal tissue blood flow
  4. What is the third priority of the heart?
    maintain normal systemic and pulmonary capillary pressures
  5. What is the ability of the heart to change its force of contraction and therefore stroke volume, in response to changes in venous return?
    frank-starling mechanism
  6. What is involved in heart disease and failure?
    volume overload, pressure overload pump failure, electrical abnormalities
  7. What are clinical signs that owners see in regards to heart disease and failure?
    synscope, exercise intolerance, cough, dyspnea, abdominal distention, cyanosis.
  8. What is the number one reason owners bring their pet in for heart failure?
    exercise intolerance
  9. What are clinical signs that VETS see in regards to heart disease and failure?
    pulse abnormalities, murmurs, arrhythmias, jugular pulses
  10. What are signs of congestive heart failure (CHF)?
    backwards failyre, respiratory signs, ascites
  11. What are signs of low cardiac output - usually late onset?
    forward failure, exercise intolerance, syncope, pre-renal, azotemia, cyanosis
  12. What comes first, signs of backward heart failure or signs of forward heart failure?
    backward heart failure
  13. What is a sign of canine left sided backwards heart failure?
    pulmonary edema
  14. What is a sign of left or right sided failure?
    pleural effusion in cats
  15. What is a sign of right sided backwards heart failure?
    hepatic congestion/ ascites
  16. What is structural of pathophysiologic remodeling, involves conduction abnormalities, automaticity errors. Has genetic factors, environmental stresses, ischemia?
  17. What is the appearance of an animal with arrhythmias?
    anxious, open mouth breathing, orthopnea, elbows abducted, tachypnea, pulmonary edema, hyperpnea
  18. What is caused by exertion or excitement, has rear limb weakness, sudden collapse, lateral recumbency, stiffening of the forelimbs and opisthotonos, micturation, vocalization, hypoxia?
  19. What is a sign of CHF, involves mainstem bronchi compression, and pneumonitis and vascular disease, secondary to heart worm disease?
  20. In a complete physical exam for heart failure, why pay close attention to the mucous membranes?
    anemia or hypotension and poor perfusion, differential cyanosis
  21. What diseases are involved in right sided failure of the heart?
    tricuspid disease, pulmonary hypertension, caval syndrome
  22. What diseases are involved in increased venous pressure of the jugular pulses?
    right sided failure, pericardial disease, volume overload, cranial mediastinal mass
  23. What can be auscultated on the left side of the heart?
  24. What can be auscultated on the right side of the heart?
    ventricular septal defect
  25. What is a very soft murmur that is intermittent?
    grade I
  26. What grade is a soft murmur, can hear consistently in a quiet room?
    grade II
  27. What is a moderately intense murmur?
    grade III
  28. What is a loud murmur?
    grade IV
  29. What is a loud murmur with a precordial thrill?
    grade V
  30. What is a very loud murmur, can hear with stethoscope off the body wall?
    grade VI
  31. What is non-invasive, images of the heart chambers, vessels, and valves, and is a doppler - evaluate flow and pressure?
  32. What are causes of systemic arterial hypertension?
    CKD, HAC, hyperthyroidism, pheochromocytoma, diabetes mellitus, liver disease, hyperaldosteronism, intracranial lesions
  33. What are types of oscillometric BP evaluation?
  34. What are types of doppler BP evaluation?
    jorgensen, parks, vet-dop
  35. What is the most common type of hypertension?
    secondary hypertension, concurrent with clinical disease or drug administration
  36. What are causes of increased pulmonary blood flow or pulmonary hypertension?
    congenital L to R shunt, increased CO, increased blood viscosity, increased pulmonary vascular resistance, luminal narrowing
  37. In pulmonary hypertension, what must the TR be?
    greater than 2.7 m/sec
  38. Where does the aVR lead go?
    right arm + to left arm and left leg -
  39. Where does the aVL lead go?
    left arm + to right arm and left leg -
  40. Where does the aVF lead go?
    left leg + to right and left
  41. What are the 5 questions involved in evaluating ECG?
    rate, rhythm, P/QRS and QRS/P, QRS morphology, measurements
  42. What are functions of the kidneys?
    filtration, secretion, absorption, excretion
  43. What are functions of the ureters and urethra?
  44. What are functions of the tubules?
    reabsorption, secretion, concentration
  45. What is any pathology affecting the kidneys?/
    renal disease
  46. What is impaired function without azotemia, suggests tubular dysfunction, polyuric, and represents 66% lost?
    renal insufficiency
  47. What is decreased GFR, azotemic, 75% lost, will progress to uremia?
    renal failure
  48. What are urine diagnostics?
    urinalysis, urine culture, clearance evaluations, osmolaity evaluation, microalbuminuria, urine protein:creatinine ratio
  49. What is a quantification of protein loss, accurate reflection of 24 hour testing, must have urinalysis first (hematuria, pyuria), is a diagnostic and monitoring tool?
    urine protein:creatinine ratio
  50. What is the equation of endogenous creatinine clearance?
    (urine Cr) x (urine volume) / (serum Cr) x (time) x (kg) = ml/min/kg
  51. What test should you never do on an azotemic or dehydrated dog?
    water deprivation test
  52. What can be shown with an excretory urography?
    filling defects, renal pelvic dilation, hydronephrosis, hydroureter, ureteral obstruction, ectopic ureters, extravasation of contrast material