VETC 241 final

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VETC 241 final
2014-03-10 18:26:09
vet tech
vet tech
vet tech 241 final including dental, digestive, respiratory, reproductive, urinary, ER
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  1. Formulae for cat and dog dentition, Triadan system (know tooth numbers)
    • puppy: 2(3/3I, 1/1C, 3/3PM)=28
    • dog: 2(3/3I, 1/1C, 4/4PM, 2/3M)=42
    • *kitten: 2(3/3I, 1/1C, 3/2PM)=26
    • *cat: 2(3/3I, 1/1C, 3/2PM, 1/1M)=30
    • triadan: 100s URQ, 200s ULQ, 300s LLQ, 400s LRQ
    • Canines always 04, 4th premolar 08, 1st molar 09.  Cats missing 05, 06(1/2), 10, 11
  2. Names and purposes of instruments (periodontal probe, curette, scaler, explorer, elevator)
    • Periodontal probe: subgingeval, checking presence and depth of pockets (gingeval sulcus depth)
    • curette: subgingeval, removing plaque (scaling and root planing)
    • scaler: remove exterior plaque (crown of tooth)
    • explorer: hook on end of probe, NOT subgingeval, checking for defects in enamel
    • elevator: usually winged, for loosening periodontal attachment of tooth, for extraction (displace tooth from support structures)
  3. Indications for extraction
    • periodontal pocket has reached the apex, stage II perio disease when O won’t do home care, can’t do multiple anesthesia, severe systemic or mucogingeval disease, O preference
    • Stage IV periodontal disease or teeth with less than 20-30% of normal bone height
  4. What can arise from proximity of max 4th PM and M 1 and 2 to retrobulbar space
    damage to optic nerves or exophthalmus from severe periodontitis
  5. Definition of endodontic disease and standard treatments for it
    Disease inside the tooth (pulp tissue).  extraction, vital pulpotomy, root canal
  6. Definition of and treatment for resorptive lesions
    Odontoclastic attack on otherwise normal tooth, extraction or crown amputation based on severity.  Body resorbs tooth root, turns into bone.
  7. Definition of and treatment for gingivostomatitis
    disease cats get, we don’t know why (immune), ulcerated mouth especially towards throat.  Includes mucosa, not just gingeva.  inflammation not around teeth, returns immediately after cleaning.  Remove all the teeth, fixes 80%, then try cephalosporin or glucocorticoids.
  8. Definition of distoclusion and mesioclusion, buccal, lingual, caries, furcation, enamel hypoplasia
    • distoclusion: overbite.  Class II.
    • mesioclusion: underbite, class III
    • buccal: cheek-side surface of tooth
    • lingual: tongue-side surface of tooth
    • caries: cavities.  Show as brown spots on tooth, soft or sticky if a problem. More dogs than cats.
    • furcation: where the roots of the tooth meet, important for multi-root extractions and for gingeval/bone loss
    • enamel hypoplasia: Loss of production of enamel as a juvenile, often due to high fever (distemper).  Tooth is damaged-looking, painful until dentin grows out.
  9. Complications of extraction
    • broken and displaced root tips, can go into nasal cavity or mandibular canal
    • hemorrhage, intra- or post-operatively.  Maxillary, infraorbital and palatine artery all near dental structures, disrupted by disease or surgery. 
    • jaw fracture, usually mandible.  Esp canine and first molar extractions.
    • (oronasal fistula, eye issues)
  10. The oral neoplasias Dr. Buelow discussed
    • Squamous cell carcinoma and fibrosarcoma in cats, melanoma and fibrosarcoma in dogs
    • 6% of malignant tumors in dogs are oral tumors (2.6x more in dogs than cats)
  11. When to use parallel vs. bisecting angle technique in dental radiography (which sections of the dental arcade work with which technique)
    Mandibular molars and premolars for parallel technique, all other teeth with bisecting angle
  12. For either scaling or polishing, no more than 5 sec per tooth, or ?
    damage to the enamel can occur—it’s like a jackhammer.
  13. Differentiate large bowel from small bowel diarrhea
    • lg: increased urgency, hematochezia, straining, normal volume, mucus, no weight loss
    • small: no increased urgency, polyphagia, melena, large volumes with no effort, weight loss, no mucus
  14. Difference between regurg and vomiting and what each implies about the location of the problem
    • regurg: no effort, comes up immediately after eating, food looks the same as going in.  Problem is upper GI, food not making it to stomach, likely esophageal.
    • vomit: abdominal effort, can be more time between eating and return, food can be digested, may not vomit food.  Problem can be more widespread, lower GI, toxicity, etc.
  15. Home care for megaesophagus
    Put food up so gravity helps it go down, frequent small meals, wet food
  16. Slide on causes and treatment of ulcer
    • Parasites, NSAIDS, metabolic (uremia). Sucralfate, omeprazole, famotidine, d/c
    • NSAIDS
  17. GDV: what it stands for, typical patient, treatment
    Gastric dilitation and volvulus, large, deep-chested breeds like greyhound and Great dane. Can try to insert gastric tube and VERY GENTLY attempt to untwist, if not, surgery to revolve and gastropexy to prevent recurrence. Raise food dish, small frequent meals, canned food.
  18. Signs of enteric disease
    • vomiting, diarrhea, anorexia or polyphagia, melena (parasites like toxocara,
    • ancylostoma, diplydium, coccidia, giardia, parvo, bacteria)
  19. Cause and treatment of SIBO
    • small intestinal bacterial overgrowth, EPI, ileus, prolonged enteritis.
    • caution with Abx, acidophilus and possibly cobalamine.
  20. Causes and signs of colitis
    • caused by: (acute) diet change/indiscretion
    • parasites (trichuris, ancylostoma)
    • fungal (histoplasma)
    • obstruction
    • (chronic) lymphocytic/plasmacytic, eosinophilic; megacolon;
    • signs: hemochezia,mucus
  21. Causes and treatment of constipation/obstipation
    • causes: Inflammatory, dietary, dehydration, megacolon, neoplasia, trauma
    • tx: RADIOGRAPHS, then (if not obstructed), enema (emolient like dactyl sodium
    • sulfosuccinate) and hydrate/repeat, laxative (laxatone or pumpkin), pro kinetic (cisapride), careful deobstipation if necessary, colectomy if necessary (resect abnormal section)
  22. Causes of liver disease
    CAV (canine adenovirus 1 and 2), ICH (infectious canine hepatitis), FIP (feline infectious peritonitis), bacterial cholangiohepatitis (usu secondary), platynostonum (liver fluke), copper-storage disease (Westies and Bedlingtons), Feline cholangiohepatitis (triaditis?)
  23. Signs of hepatic lipidosis
    anorexia, weight loss, vomiting, icterus

    primary or secondary, fatty acid metabolism/mobilization issue
  24. What PSS is and what it causes
    Portosystemic shunt. Abnormal connection between portal blood and systemic circulation, liver bypassed, liver atrophies or malfunctions, toxins like ammonia go into circulation

    Neuro signs, encephalitis
  25. Signs and treatment of pancreatitis
    pain in upper right quadrant (not cats), hunched posture, anorexia, vomiting, diarrhea, dehydration, electrolyte issues. Middle aged or older overweight dogs.

    24h fast, fluids, abx, analgesia
  26. Causes of prolonged estrus
    too much estrogen, from wherever. ovarian cyst, iatrogenic
  27. Causes of reproductive failure
    • glucocorticoids, fluoroquinolones, brucella, canine herpesvirus, feline: herpes,
    • panleukopenia, FIP, FeLV
  28. Definition of eclampsia
    hypocalcemia, often tetany and fever. treat with calcium gluconate
  29. Know the two transmammary parasites we talked about
    • ancylostoma (hookworm)
    • toxocara (roundworm)
  30. Types of pyometra, signs of each, treatment
    open or closed. Open has vaginal discharge/draining and fever. Closed does not. 1-2 months post estrus, septicemia, shock. abdominal pain in both. tx: fluids, abx sensitive to e coli. Then OHE.
  31. Signs and location of scrotal hernia
    abdominal contents protude through inguinal ring. sx. Goes back in if pressed on.
  32. Type of pathogen brucella is, and species it’s seen in most
    • bovine and canine
    • b. canis, B. abortus. Causes abortion storms in cow herds. Bacteria.
    • gram - coccobacilli
  33. Cryptorchidism: most common type, how the surgery is prepped, what the
    consequences of ignoring it are
    • unilateral most common, 
    • prep for exploratory surgery, similar to spay. Shave and scrub up to xiphoid. Ignoring will likely cause it to become cancerous, also it will continue to pump out testosterone and possibly make reproduction possible. Sertoli Cell Tumor.
  34. Causes of ARF (general, not specifics, EXCEPT please know the infectious causes)
    ischemia, toxic injury, immune-mediated, infectious (leptospirosis, baterial disease like ascending infection, lyme (acute or chronic)
  35. Signs of ARF vs. CRF
    ARF: emesis, kidneys normal on palpation, K normal to high, metabolic acidosis (severe)

    CRF: PUPD, weight loss, kidneys atrophic on exam, K levels decline over time, anemic, retinal hemorrhage with hypertension
  36. Treatment for hyperkalemia
    Saline, insulin, dextrose/glucose, possibly calcium gluconate to protect heart.
  37. Reason for association of PUPD with dehydration
    Tubules not resorbing water from urine, so even though animal keeps drinking, body is not getting the water it needs. Thirst center continues to be activated by hyperosmolarlity of blood, P keeps drinking.

    decreased renal blood flow
  38. Need for gastroprotectants in renal disease – why, which ones
    acidemia and uremia can cause gastric ulcers. Sucralfate if already ulcerated, famotidine, omeprazole
  39. Why hypertension associated w/ renal disease
    • hyperkalemia caused by urine not being excreted or not exchanging Na for K causes
    • bradycardia, which causes hypotension, which causes sympathetic stimulation causing vasoconstriction and tachycardia, causing
    • hypertension. Dehydration causes lowered blood volume, also causing sympathetic stimulation.
  40. causes of renal tubular disease
    tubular disease: toxins (ethylene glycol), Hereditary (Fanconi syndrome), Inflammatory (glomerular disease lets large molecules through tubules), secondary (abrnomal urate crystals cause uroliths/cystoliths
  41. causes of UTI
    UTI: Ascending infection (e coli), urinary stasis (obstruction, neuro, spay incontinence), incontinence (spay), damage to mucosa (uroliths, neoplasia), immune factors (Cushings, DM, renal failure, chemotherapy, FeLV/FIV), Iatrogenic (steriods, trauma from catheter), urachal diverticulum, uroliths
  42. Disorders of micturition
    detrusor muscle dysfunction (UMN disease/trauma), ectopic ureter (most common in dogs), sphincter muscle insufficiency/spay incontinence, trauma
  43. Pathogenesis and treatment of blocked cat
    • crystals or mucus/sludge gets trapped in bend of male cat’s narrow urethra, block urine from going past. This causes urine to back up, causes kidney damage, azotemia, hyperkalemia, then cardio issues and/or neuro problems if it gets bad enough. MUST unblock, emergency.
    • Gently insert tomcat catheter, try to expel plug, then flush and flush and flush. Catheter in 2+ days, pain and fluids. Penile urethrostomy if frequent
  44. Treatment of FLUTD
    canned food, increase water, extra litter boxes, anti-inflammatories, pheromones
  45. 3 types of renal/urinary cancer, and usual location of transitional cell carcinoma
    transitional cell carcinoma (neck of urinary bladder into trigone), lymphoma (kidney), renal cell carcinoma
  46. Causes of respiratory diseases (general)
    infection, inflammation, FB, sinusitis, dental disease, neoplasia, fungus, virus (FVR, Calici, virulent calici)
  47. Signs of upper vs. lower respiratory disease
    URD: stertor, stridor, sneeze, increased inspiratory effort, slow deep breaths, tracheal palpation cough

    LRD: increased effort including abdominal effort, shallow, rapid breathing
  48. nursing considerations of respiratory disease
    • humidifier/nebulizer, harness not collar, antihistamines/antitussives, monitor RR and
    • dyspnea
  49. Causes, clinical signs and nursing re: pleural effusion
    • causes: fluid overload, infection, lymphatic obstruction, coagulation disorders, cardiovascular disease
    • clinical signs: respiratory distress or effort, decreased lung or heart sounds
    • tx: thoracocentesis (pending rads), c/s, supplement/monitor O2, CAGE REST
  50. Things to watch for in lower respiratory disease
    • electrolyte/acid-base abnormalities
    • hypoxemia (arterial blood gas)
    • ventilation/perfusion mismatch
    • cyanosis/pallor
    • tissue oxygenation less than 95% (atelectasis)
  51. 3 factors in determining inpatient feeding methods
    • route (oral, enteral, parenteral)
    • amount fed (MRE, RER)
    • How food is offered (free choice, food-restricted, time-restricted)
  52. What AAFCO is and what letters stand for
    • Association of American Feed Control Officials
    • evaluate how food has been formulated, approve FOOD, not snacks/treats/supplements. Statement must appear on commercial foods.
  53. Nutrient profile vs. feeding trial (ie, what each one is)
    when new foods want to come on the market, have to prove that they provide complete nutrition. Can do so by chemical testing and proving exactly what nutrients are in the food (nutrient profile) or feeding trial, where at least 8 animals get ONLY that food for 6 months with constant monitoring and blood tests for “signs of deficiency”.
  54. What has to be on a food label (8)
    • product name
    • manufacturer name and phone number
    • statement of intent
    • net weight of bag/can
    • ingredient statement
    • guaranteed analysis
    • nutritional adequacy statement (AAFCO)
    • feeding guidelines
  55. What RER and MER are, how they relate to each other, how to calculate RER
    • Resting energy requirement vs maintenance energy requirement. Resting is how many calories the animal needs per day just to exist. Maintenance adds in energy for movement/activity.
    • RER = 30(kg) + 70 (for 2-45 kg animals) = KCals OR 70(kg)^0.75
    • MER can be 2 or 3 times that, etc.
  56. Why we calculate DMB (not how to do it, just what it’s used for)
    Dry matter basis. To compare different foods, especially to compare wet to dry food.
  57. The definitions of the basic nutrients (6)
    • water - most necessary, needed for hydrolysis, temp, tissue shape and resilience
    • carbohydrates - monosaccharides, disaccharides and polysaccharides that break down into glucose. Quick glucose source. Dogs need more than cats. Turn into starch or fiber
    • proteins - chain of amino acids, needed to make more amino acids, enzymes, tissues, antibodies, hormones, organs
    • lipids - energy production and fat soluble vitamin (ADEK) absorption, essential fatty acids
    • minerals - any inorganic element in food, macro and micro.
    • vitamins - diagnosis of exclusion. Organic necessary material in diet that isn’t anything else.
  58. What IS the deal with taurine?
    Essential amino acids that cats don’t make on their own. If they don’t get enough of it, they get DCM. Used to be common, but since we figured it out much less common.
  59. Definitions of pre-biotics and pro-biotics
    • pre-biotics are non digestible ingredient that influences that growth and activity of bacteria in colon in a way that helps the animal. Esp fructose/carbs
    • probiotics supplies beneficial microorganisms. Acidophilus.
  60. 5 things you would recommend for an obese patient
    • calculate calories
    • palatable food
    • transition gradually
    • no human food/treats
    • increase water intake and exercise
  61. Qualities of an ideal food for dog/cat with digestive disease, renal disease, cystoliths
    • digestive disease: varies by species. D/C - digestible protein, low fat, antioxidants. Equine high protein forage.
    • renal disease: increase water, decrease Phosphorus, low protein, adjust K as needed, 1.1-1.4 (RER) for cat, 1.1-1.6 (RER) for dog.
    • cystoliths: pH neutral diet, high water (watch for dalmation/urate, Ca oxalate = toxicity). Not all will respond
  62. How nutritional secondary hyperparathyroidism relates to the lizard’s diet
    Lizards MUST receive Ca supplementation to avoid bone problems like rubberjaw. They do not get enough calcium in their diet, so they are always hypocalcemic (without supplementation), so the parathyroids pump out hormone to resorb calcium and phosphorus from the bones, causing the bones to become weak and mobile.
  63. What cecotropes are and why they’re important
    cecotropes are the night feces of rabbits, which need to be reingested for added nutrients. They come out of the cecum.
  64. triage
    "to sort".  evaluation and prioritizing of patients based on severity of condition to maximize survivors.
  65. Quick assessment for triage
    • Respiratory, cardiovascular, CNS
    • determines stability.  Perfusion/O2 delivery a priority.
  66. neurologic order of assessment of consciousness
    • hyperexcitable
    • alert/responsive
    • dill/lethargic
    • obtunded (minimally responsive)
    • stupor (responds to pain only)
    • coma (unresponsive)
  67. ER managment: shock
    supplemental O2, fluid resuscitation to optimize preload
  68. ER managment: cardiovascular
    • auscult, ECG/radiograph/Echo
    • minimize stress, O2, diuretics(furosimide), vasodilator (nitro), positive inotrope (dobutamine)
  69. ER managment: respiratory upper airway
    O2, decrease stress, sedation, ET tube, PPV
  70. ER managment: CNS, seizures
    • seizures, head trauma, spinal cord injury
    • catheter, fluids, correct metabolic issues, anticonvulsants, cooling
    • watch perfusion, O2/aspiration, deterioration of neuro status
  71. Brain injury assessment
    • level of consciousness (alert vs stupor etc.)
    • pupilary evaluation (miotic, anisicoria, mydirasis, PLR)
  72. ER managment: CNS, brain injury
    • maintain airway/ventilation
    • maintain cerebral perfusion
    • minimize intracranial pressure (elevate head/neck)
  73. spinal cord function assessment
    • 1. conscious proprioception
    • 2. voluntary movement (paresis or paralysis)
    • 3. pain sensation (not withdrawal reflex)
  74. ER managment: CNS, spinal cord
    • function assessment
    • medical vs surgical managment.  Meds: pain mgmt, sedatives, steroids
    • patient mgmt: recumbent care, urine output monitoring
  75. ER managment: GDV
    • abd rads (rt lateral), assess severity of hypoperfusion
    • O2, fluid resuscitation, gastric decompression (if possible)/gastrocentesis, surgery
    • IVF, analgesia, ECG (arrhythmias), monitoring
  76. ER managment: addisonian crisis
    • VDA, weight loss, weakness, lethargy, bradycardia, shock
    • ACTH stim, BW (no stress, electrolyte), rads (decreased heart), urinalysis (dilute)
    • tx: IVF, glucocorticoids
  77. ER managment: DKA
    • signs: PUPD, dehydration, weakness, lethargy, VDA
    • tx: IVF (dehydration and acid/base), insulin (humulin R), concurrent disease
  78. ER managment: hypocalcemia
    • <2mmol/L
    • signs: muscle tremors, twitching, seizures
    • tx: Ca gluconate, ECG monitoring (prolonged Q-T), parental Ca
  79. ER managment: feline urinary obstruction
    • alert to obtunded, vocalizing, vomiting, distended painful bladder, shock, stranguria
    • O2 for shock, IVF, drugs (insulin, Ca gluconate, dex)
    • diuresis, MONITOR INS VS OUTS
  80. ER managment: dystocia
    • prolonged gestation (>65d), unproductive straining for 30-60m, >2h between deliveries, stuck, foul odor
    • decrease stress, oxytocin and Ca gluconate, surgery (C-section)
  81. ER managment: pyometra
    • 4-5 weeks post-heat, VDA, depression, PUPD, vaginal discharge, fever (dehydration, sepsis, shock, death)
    • OHE, medical mgmt with antibiotics and PGF2 for contractions
    • treat electrolyte/shock
  82. tx for external toxin
    • remove gross contaminate from fur/skin
    • protect eyes with ophthalmic
    • protect airway
    • bathe with mild detergent and lots of water
    • monitor temp
  83. tx for inhalation toxicology
    • protect airway
    • humidified O2
    • nebulize and coupage
    • intubate and ventilate
  84. tx for GI toxins
    • Most common route of poisoning
    • emesis (within <1.5h, not with corrosive, coma)
    • gastric lavage (rapid removal, caustic ok, gives charcoal, needs general anesthesia)
    • adsorbents (activated charcoal, stops entero absorption, repeated doses safe, not for metals, acids, alkalis, alcohols)
    • cathartics (decrease GI transit time to limit resorption)
  85. rodenticide toxicity, 2 kinds
    • 2 kinds, dif tx times
    • 1st gen: warfarin and dicumarol (4-6 days)
    • 2nd gen: brodifacoum and bromadiolone (3-4 weeks)
  86. Rodenticide toxicity
    • 3-5 days post ingestion, bleeding from anywhere, petechia, ecchymosis
    • tx: emesis if possible, vitK PO for 4-6d or 3-4w, blood products
  87. bromethalin
    • rodent bait that doesn't cause bleeding.  causes CNS because of decrease in ATP production.
    • 12-24h post ingestion, CNS signs, seizures, weakness, ataxia
    • tx: emesis, activated charcoal, anticonvulsants/mannitol, IVF
  88. acetominophen toxicity
    • cats get glutathione deficiency, can't replenish, in cytochrome P450 pathway.
    • signs: VD, lethargy, abd. pain, coma, METHEMOGLOBINEMIA (brown mm, facial/paw edema)
    • decontamination, supportive care, N-acetylcistine to replace glutathione, ascorbic acid (breaks down methemoglobin)
  89. NSAID toxicity
    • VD, pain, lethargy, melena, anemia, shock, ARF
    • tx: emesis, gastric lavage, activated charcoal, support/correct ulceration
  90. chocolate toxicity
    • VD, agitation, tremors, PUPD, ataxia, tachycardia, arrhythmias
    • tx: emesis, activated charcoal, IVF, anticonvulsants, beta blockers
  91. raisin/grape toxicity
    • VD, lethargy, dehydration, weakness
    • tx: emesis, diuresis, supportive care
  92. onion/garlic toxicity
    • anemia, pallor, tachycardia, tachypnea, lethargy
    • Heinz body anemia
    • tx: emesis, supportive care.  No antidote
  93. xylitol toxicity
    • triggers insulin release, hypoglycemia, liver enzymes
    • weakness, seizures
    • emesis, activated charcoal, IVF with dextrose, denosyl for hepatocytes
  94. Lily toxicity (TEDS)
    • tiger, easter, day and star of bethlehem lillies
    • Star toxic to both, others cat
    • v/d and death
  95. pyrethrins/pyrethroids toxicity
    • flea/tick. sodium channels
    • salvation, tremors, ataxia, vomiting, anorexia
    • bathe, emesis, activated charcoal, cathartics, diazepam
  96. paintball toxicity
    • HYPERNATREMIA, metabolic acidosis
    • v/d, ataxia, tremors
    • decontaminate, NO ACTIVATED CHARCOAL (sorbitol), correct electrolytes
  97. zinc toxicity
    • pennies after 1982
    • irritates gastric mucosa
    • v/d, anorexia, lethargy, intravascular hemolysis (ANEMIA WITH BASOPHILIC STIPPLING and nRBC), hematuria, hemoglobinuria, jaundice, death
    • supportive tx, chelation, h2 blockers
  98. ethylene glycol toxicity
    • antifreeze, biphasic
    • phase 1: ataxia, nausea, stupor (1-2h)
    • phase 2: metabolic acidosis, CNS depression, calcium oxalate in kidney
    • CNS or GI
    • emesis < 1h, IVF, hemodialysis, activated charcoal, FOMEPAZOLE (4-MP) = antidote