EqMed Q2, Cardio

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HLW
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212929
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EqMed Q2, Cardio
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2013-04-11 17:21:04
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EqMed Q2 Cardio
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EqMed Q2, Cardio
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  1. how do you describe normal equine urine?
    • Pale yellow to deep tan
    • Turbid: hi Ca carbonate
    • Viscous: Goblet cells
    • SG: >1.025
  2. what blood work findings are suggestive of GFR function?
    creatinine and BUN
  3. what part of the urinary system can be examined via endoscopy?
    • Urethra
    • Bladder
    • Proximal ureters
  4. why would normal urine test positive for proteins on dipstick?
    Alkaline urine
  5. what are your two differentials for positive blood reaction on dipstick?
    • myoglobin
    • hemoglobin
  6. How will fluid administration help you determine if azotemia is prerenal vs. renal?
    • Prerenal Azotemia =  
    • Creatinine decrease >50% w/in 24hrs
  7. Expected electrolyte abnormalities with ARF?
    • low Na/Cl
    • hi K/P
  8. What are expected clin path findings with NSAID toxicosis?
    • Azotemia with LOW USG
    • Low PCV/TP
    • (PLE w/ ulcers)
  9. how do aminoglycosides (gentamicin, amikacin) cause problems in kidney?
    Dx?
    How can this be avoided?
    • Binds to proximal tubular epithelial cells
    • Acute tubular necrosis
    • Saturates brush border

    Proteinuria and GGT in urine

    SID helpful
  10. how does rhabdomyolysis damage kidneys?
    Tx?
    Pigment nephropathy (myoglobin) - toxic to tubules

    Diuresis
  11. Common Manifestations of Lepto
    • Renal Damage
    • Abortion
  12. Why should alfalfa be removed from diet of  CRF P?
    • High Ca
    • (already hyperCa from CRF)
  13. Urolithiasis rare but may be associated with...?
    CRF
  14. what is most common cystolith?
    calcium carbonate stones
  15. what is recommended treatment for cystolith? 4
    • Removal via paramedian incision
    • Antimicrobials (TMS)
    • Decr. Ca intake
    • +/- Acidification (rarely successful)
  16. What is a sabulous urolith?
    Why is this a problem?
    C/S?
    Sandy material in bladder forms concretion of CaCO3

    Prevents complete emptying of bladder

    Stranguria/Dribbling
  17. how is sabulous urolith managed?
    Bladder lavages with anti-inflammatories (difficult)
  18. Locations for peripheral pulse? 6
    • Facial A
    • Transverse facial A
    • Median A
    • Digital A
    • Metatarsal A
    • Carotid A
  19. Which heart sounds are audible in the horse?
    What does each represent?
    • S1: Closure of AV valves (systole)
    • S2: Closure of semilunar valves (end systole)
    • S3: Elastic recoil at end of rapid Ventricular filling
    • S4: Atrial contraction
  20. Two mechanisms for arrythmias?
    • Impaired conduction
    • Changes in automaticity
  21. Causes of sinus tachycardia? 6
    Appearance on ECG?
    • Excitement
    • Pain
    • Fever
    • Dehydration
    • Anemia
    • Hemorrhage

    HR >60 w/ N complexes
  22. what is most common arrythmia in horse?
    • Atrial Fibrillation
    • (80% have underlying heart disease)
  23. What are some contributing factors leading to atrial fibrillation? 6
    • Incr. vagal tone
    • Enlarged atria
    • Atrial mass
    • HypoK
    • Myocardial damage
    • Short refractory period
  24. C/S associated with atrial fibrillation? 5
    • *exercise intolerance*
    • Dyspnea and tachypnea
    • Epistaxis
    • CHF
    • None
  25. S4 is absent with...
    Atrial Fib
  26. Expected HR with atrial fib?
    HR: 30-50
  27. ECG findings associated with atrial fibrillation?
    • Regular R-R 
    • F waves
  28. How is A-fib treated if present < 2wks?
    • IV Quinidine Gluconate
    • Electrocardioconversion
  29. Tx for long standing A fib?
    • PO Quinidine Sulfate
    • electrocardioconversion
  30. C/S of quinidine toxicity? 8
    ECG? 3
    • Colic
    • Flatulence/diarrhea
    • Respiratory distress/Edema/Congestion of nasal mucosa
    • Hypotension/Syncope
    • Neuro signs
    • Urticaria
    • Laminitis
    • Sudden death

    • A-fib
    • Prolonged QRS
    • V tach
  31. What % of P will successfully convert electrical cardioconversion?
    90%
  32. Tx of Afib change with CHF?
    • No quinidine
    • Tx underlying cause
  33. What is normal cardio finding with to high vagal tone?
    What drug can also induce this?
    • 2nd degree AV block
    • Xylazine
  34. ECG finding seen with 3rd degree AV block?
    • Dissociated P and R's
    • Normal P-P and R-R
    • Ventricular rate > atrial
  35. Complete heart block Tx?
    • Stall rest
    • Corticosteroids
    • Pacemaker
  36. What ECG finding is indicative of a VPC w/ poor prognosis?
    Multiform with R on T
  37. C/S associated with VPCs? 6
    • HR >120
    • Venous distention
    • Ventral edema
    • Poor performance/collapse
    • Anxiety
    • Colic
  38. When should you treat V Tach? 5
    • Sustained V-tach
    • HR >100
    • R on T
    • Multiform
    • CV collapse
  39. V-tach Tx? 5
    • Continous ECG monitoring
    • Lidocaine IV
    • Quinidine gluconate IV
    • Procainamide IV
    • MgSO4 IV
  40. C/S of monensin toxicosis? 6
    • Depression/anorexia
    • Ataxia/hind limb weakness
    • Profuse sweating
    • Tachycardia
    • Colic/diarrhea
    • Death
  41. What changes are seen on clin path with monensin toxicosis? 4
    • Elevated...
    • CK
    • AST
    • LDH
    • CTnI
    • (damaged cardiac and skeletal m)
  42. ECG changes seen with monensin toxicity?
    • Prolonged P-QT 
    • S-T abnormalities
  43. What is best determinant of prognosis in a P with Monensin Tox?
    • Echo = Fractional shortening
    • 30-40% excellent

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