Emergency
Terms
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- Treatment for aortic thromboembolism
-
1) analgesia: torbutrol 0.2mg/kg SQ q8h or acepromazine SQ 0.1mg/kg
2) Fluids
3) +/- sodium bacarbonate 1mEq/kg IV over 2-5 minutes
4) Heparin: 200-300IU/kg IV the SQ q8h for 2 days - Give a good sedation protocol for the emergency cardiac patient
-
Dogs: acepromazine 0.03mg/kg IM, Butorphanol 0.2-0.4mg/kg IM
Cats: acepromazine 0.1mg/kg IM, butorphanol 0.2mg/kg IM - List 4 common causes of metabolic alkalosis.
-
1) Acute,profuse vomiting
2) Pyloric outflow obstruction
3) Excessive use of diuretics
4) Bicarbonate therapy - What 2 things characterize a peritonitis as septic?
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1) Presence of bacteria
2) Degenerate neutrophils - Peritoneal fluid with bewteen 1000-7000 cells/μl and between 2.5-7.5 g/dl protein is called a ...
- modified transudate
- The term for PaCO2 > 45mmHg is ...
- Hypercapnia or respiratory acidosis
- How can one diagnose uroabdomen with abdominocentesis and serum?
-
Creatinine in the abdominal fluid will be greater than serum.
Note that the BUN should be the same in both because BUN reaches equilibrium across the peritoneum - The dose of Benedryl for allergic reactions:
- 1-2 mg/kg IM
- Normal arterial pH:
- 7.35-7.45
- Characterize an exudate.
-
>7000 cells/μl
>3.0 g/dl protein - What are the typical characteristics of an FIP effusion?
-
1) non-septic
2) straw-colored
3) hypocellular
4) foamy (protein rich)
5) macrophages and non-degenerate neutrophils - The term for PaCO2 < 35mmHg:
- Hypocapnia or respiratory alkalosis
- Name the most common causes of NON-septic peritoneal exudate.
-
1) bile peritonitis
2) hemoabdomen
3) chylous effusion
4) uroperitoneum
5) neoplasia -
Peritoneal fluid with:
>7000 cells/μl
&
>3.0 g/dl protein is called a ... - exudate
- Characterize a transudate
-
<1500 cells/μl
<2.5 g/dl protein - Characterize a modified transudate.
-
1000-7000 cells/μl
2.5-7.5 g/dl protein - Name some important causes of spetic peritonitis.
-
1) rupture of GI tract from GDV, obstruction, or surgical breakdown
2) rupture of hepatic, pancreatic, or prostatic abscess
3) contamination from pyometra
4) puncture or bite wound - How many platelets per high-powered field would indicate a thrombocytopenia in danger of bleeding?
- 0-3/hpf in the monolayer
- The emergency CPR dose of epinephrine is ...
-
0.2mg/kg IV
0.4mg/kg IT - Name the components of the cardiac conduction system in order.
-
1) SA node
2) internodal tracts
3) AV node
4) bundle of His
5) right and left bundle branches
6) purkinje fibers -
What does a PvCO2 of 53mmHG indicate?
note: this is VENOUS - Hypercapnia or respiratory acidosis
- Can venous blood be used to assess acid-base balance?
-
Yes.
However, PvCO2 is 3-6 mmHG higher than PaCO2 so ..
Normal PvCO2=38-51mmHG - At what PaO2 do we begin treatment for hypoxemia?
- PaO2<60mmHG
- What is considered hypertensive in dogs and cats?
-
systolic >180mmHg
diastolic >120mmHg - The term for PaO2<80mmHg?
- Hypoxemia
- What is the normal PaO2 on room air at sea level?
- 80 to 110 mmHg
- What is the normal range for base excess?
- -4 to +4 mEq/L
- What is the normal range for HCO3?
- 18-24 mmol/L
- What 2 values can be used to assess the metabolic component of acid-base balance?
-
HCO3-(bicarbonate)
or base excess - What value is used to assess the respiratory component on acid-base balance?
- PaCO2
- What causes hypercapnia or respiratory acidosis?
- alveolar hypoventilation
- The ECG complex abnormality associated with left atrial enlargment:
-
widened P wave
dog: >0.04sec
cat: >0.04sec - Hypocapnia in the dog starts at:
- PaCO2 <35mmHg
-
Peritoneal fluid with:
<1500 cells/μl
and
<2.5 g/dl protein is called a... - transudate
- The term for arterial pH<7.35 is ...
- acidemia, part of the overall process called acidosis
- Name the 6 steps to ECG analysis.
-
1) calculate heart rate
2) interpret rhythm
3) measure durations and amplitudes
4) identify effects of electrolytes
5) establish mean electrical axis
6) identify effects of atrial and ventricular enlargement - The term for arterial pH > 7.45 is ...
- Alkalemia, part of the overall process called alkalosis
- What is represented by the PR interval?
-
impulse travel time from the SA node through the AV node to the ventricles.
(The ventricles fill during this time) - What lactate value is correlated with the need for gastric resection in GDV?
- 6
- Why can't you use hypertonic saline is a dehydrated animal to rapidly incrase vascular tone?
- The extracellular (extravascular) volume is already contracted.
- How does the kidney maintain electroneutrality during excessive loss of chloride?
- By reabsorbing bicarbonate
- Which electrolyte is most commonly affected by changes in acid-base balance?
-
K+
Severe metabolic acidosis increases K+
Severe metabolic alkalosis decrease K+ - What is the maximum dose of bicarb not to be exceeded?
- 0.25 mEq/kg
- Normal PaCO2?
- 35-45mmHg
- List 5 common causes of respiratory acidosis.
-
1) anesthesia
2) respiratory depressant drugs
3) obesity
4) chronic obstructive pulmonary disease
5) brain injuries - list 6 common causes of metabolic acidosis.
-
1) renal failure
2) diarrha
3) chronic vomiting
4) severe shock
5) diabetes mellitus
6) hypoadrenocorticism - What liver enzyme metabolizes ethylene glycol?
- alcohol dehydrogenase
-
What does a PvCO2 of 47mmHg indicate?
note: this is VENOUS -
Nothing.
While outside the range of PaCO2, it is less than 3 mmHG higher that 45 mmHg so still within the normal range of PvCO2 - 2 drugs for ethylene glycol toxicity:
-
1) grain alcohol
2) 4MP (fomepizole) - 3 categories of crystaloids and an example of each
-
1) hypotonic: D5W, 0.45% NaCl
2) Isotonic: LRS, Norm-R, 0.9% NaCl
3) Hypertonic: hypertonic saline ~7% NaCl - Approximate doseof hypertonic saline to raoidly increase blood volume:
- 3-5 ml/kg
- What about ethylene glycol is damaging to the kidney?
- Ocalate and maybe other metabolites from hepatic metabolism of EG.
- What is the biggest problem we worry about with hyperkalemia?
- cardiac arrhythmias (bradycardia)
- List 4 common causes of respiratory alkalosis
-
1) Fever
2) Left to right shunts
3) Shock
4) Hypoxemia - The dose of calcium gluconate for hyperkalemia?
-
50-150 mg/kg slow IV
(3cc/cat) - What is represented by the width of the P wave?
- The time of impulse travel from the SA node to the AV node.
- Give the steps to pass a stomach tube in a GDV dog.
-
1)+/- sedation (hydro-val)
2) roll of tape in mouth
3) Measure tube length to last rib
4) pass tube with care
5) feel for tube in esophagus
6) lavage - The ECG complex abnormality associated with right atrial enlargment?
-
TALL P waves
dog: >0.4mV
cat: >0.2mV - Under what conditions do you treat ventricular tachycardia?
-
1) Very rapid (>200/min)
2) Causing hypotension (<90mmHg systolic)
3) Animal is symptomatic
4) Suspect degeneration to V. fib - Secondary treatment for mitral regurgitation after stabilization with lasix and nitroglycerine?
-
Oral hydralazine 0.5mg/kg PO q12h
increase to 3.0mg/kg over several days - Initial treatment of cardiogenic pulmonary edema regardless of cause?
-
1) Furosemide 2-6mg/kg IV hourly until responsive
2)O2
3) Nitroglycerine 1/2cm to 4cm percutaneously q8h