Companion Animal Advanced Clinical Management WEEK 1
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Questions and Answers

Which of the following is a water-based solution that contains electrolyte and nonelectrolyte solutes, can enter all body compartments, and is used for rehydration?

  • synthetic colloid
  • isotonic crystalloid (correct)
  • hypertonic crystalloid
  • human albumin

Fill in the blanks. The shock dose of fluids for cats is __________ and the shock dose of fluids for dogs is __________.

  • 90mL/kg, 90mL/kg
  • 90mL/kg, 60mL/kg
  • 60mL/kg, 90mL/kg (correct)
  • 60mL/kg, 60mL/kg

Which of the following fluids can be administered subcutaneously?

  • hypertonic crystalloids
  • hypotonic crystalloids
  • isotonic crystalloids (correct)
  • 50% dextrose

Which of the following drug doses should be reduced in a dog with liver dysfunction?

<p>metronidazole (C)</p> Signup and view all the answers

In a hospitalized dog or cat, what is the preferred way to deliver nutrition?

<p>enteral (C)</p> Signup and view all the answers

A 22lb dog has not eaten for 3 days and is currently in the hospital. You need to calculate the dog’s RER to start supplementing his nutrition. Using the following equations, what is your goal daily caloric intake for the dog?

RER = (√ ( √ (BW x BW x BW))) x70

RER = (30 x BW) + 70

BW = body weight in kilograms

√ = square root

<p>370kcal/day (C)</p> Signup and view all the answers

Which of the following is true regarding a patient with peripheral edema and third-spacing?

<p>Drugs with a narrow safety margin should be dosed on lean body weight. (A)</p> Signup and view all the answers

What effect do opioids have on the gastrointestinal tract?

<p>Opioids slow gastrointestinal motility. (C)</p> Signup and view all the answers

Why can patients with hypoalbuminemia experience drug toxicity?

<p>Patients have more pharmacologically active free drug. (D)</p> Signup and view all the answers

What value in a blood chemistry can be used to reduce the dose or adjust the dosing interval in a patient with renal disease?

<p>creatinine (C)</p> Signup and view all the answers

In which of the following disease processes is IV isotonic crystalloid fluid therapy contraindicated?

<p>congestive heart failure (D)</p> Signup and view all the answers

What type of fluid is 7.5% saline?

<p>hypertonic crystalloid (B)</p> Signup and view all the answers

Which option is the autonomic receptor that directly modulates cardiac output through changes in inotropy and chronotropy?

<p>beta 1 adrenergic (C)</p> Signup and view all the answers

Which drug DIRECTLY acts at the aldosterone receptor, resulting in decreased Na+/K+ exchange in the distal tubule and collecting duct of the nephron?

<p>spironolactone (C)</p> Signup and view all the answers

Your physical exam and thoracic radiographs evaluation lead you to conclude that your patient has severe pulmonary edema as a result of left-sided heart failure. Which drug would likely provide the most immediate benefit to the patient?

<p>furosemide (C)</p> Signup and view all the answers

Which RAAS inhibiting drug has greater antihypertensive effectiveness than ACE inhibitors and is FDA-approved for the treatment of systemic hypertension in cats?

<p>telmisartan (D)</p> Signup and view all the answers

Which drug is LEAST likely to cause hypokalemia?

<p>spironolactone (C)</p> Signup and view all the answers

Which muscle type do dihydropyridine calcium channel blockers (for example, amlodipine) have the greatest effect on?

<p>vascular smooth muscle (D)</p> Signup and view all the answers

Which drug is indicated for the treatment of pulmonary arterial hypertension?

<p>sildenafil (C)</p> Signup and view all the answers

Which anti-thrombotic drug is LEAST likely to cause gastric ulcer disease in cats?

<p>clopidogrel (C)</p> Signup and view all the answers

Which heartworm adulticide drug commonly causes injection-site reactions in the epaxial muscles?

<p>melarsomine (B)</p> Signup and view all the answers

Which antitussive drug has the greatest likelihood of causing constipation as an adverse drug effect?

<p>hydrocodone (D)</p> Signup and view all the answers

Which of the following drug classes is the main drug therapy for osteoarthritis?

<p>NSAIDs (A)</p> Signup and view all the answers

Which of the following drugs should not be used in cats?

<p>azathioprine (A)</p> Signup and view all the answers

Which of the following statements about ear cleaning and ear cleansers is correct?

<p>Most ceruminolytics and detergents are contraindicated with a ruptured tympanum (D)</p> Signup and view all the answers

For a canine patient with otitis, when the ear canal is too painful and swollen for otoscopic exam and ear flushing, what is the best treatment approach?

<p>Anti-inflammatory doses of oral prednisone with topical treatment of infection (A)</p> Signup and view all the answers

What chemotherapy agent can be administered to increase circulating platelet count?

<p>vincristine (D)</p> Signup and view all the answers

For long-term management of immune mediated disease, why is it critical to taper the immunosuppressive medications to the lowest effective dose?

<p>to minimize adverse effects of the drugs (B)</p> Signup and view all the answers

Which of the following is considered an acceptable second-line immunosuppressive medication?

<p>mycophenolate (C)</p> Signup and view all the answers

In relation to prednisone, which of the following is true regarding dexamethasone?

<p>dexamethasone is more potent (C)</p> Signup and view all the answers

Which of the following immunosuppressive drugs is used to treat atopic dermatitis in cats and dogs and perianal fistulas in dogs in addition to treating a variety of other immune-mediated diseases?

<p>cyclosporine (C)</p> Signup and view all the answers

Which of the following immunosuppressive drugs causes gastrointestinal toxicity in up to 67% of patients?

<p>mycophenolate (D)</p> Signup and view all the answers

Flashcards

Balanced Crystalloid

A water-based solution containing electrolytes and nonelectrolytes, used for rehydration and capable of entering all body compartments.

Shock Dose of Fluids

A critical volume of fluid administered rapidly to stabilize a patient in shock, typically 20-30 ml/kg for cats and 40-60 ml/kg for dogs.

Enteral Nutrition

The preferred method of delivering nutrition to hospitalized dogs and cats, providing nutrients directly to the gastrointestinal tract.

RER Calculation for Dogs

A formula for estimating a dog's resting energy requirement (RER) based on its body weight.

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Third-Spacing

The accumulation of fluid in the interstitial space, leading to swelling and increased fluid loss, often seen in patients with peripheral edema.

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Opioid-Induced Constipation

A common side effect of opioids, resulting in slowed bowel movements and difficulty passing stool.

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Hypoalbuminemia

A condition characterized by low albumin levels in the blood, leading to increased free drug concentrations and potential toxicity.

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Creatinine Value

A blood chemistry test used to assess kidney function and potentially adjust drug dosages in patients with renal disease.

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Hypernatremic Dehydration

A condition where the body has too much sodium in its fluids, making IV isotonic crystalloid fluid therapy inappropriate.

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Hypertonic Fluid

A type of fluid with a higher concentration of solutes compared to blood, drawing water from cells to the bloodstream.

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β1 Receptor

The autonomic receptor primarily responsible for modulating cardiac output by influencing heart rate and contractility.

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Aldosterone Receptor

A hormone receptor targeted by spironolactone, leading to decreased sodium reabsorption and potassium excretion in the kidneys.

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Furosemide

A diuretic medication that can rapidly reduce fluid buildup in the lungs, providing immediate relief for patients with severe pulmonary edema.

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RAAS Inhibiting Drugs

A type of medication that blocks the renin-angiotensin-aldosterone system (RAAS), lowering blood pressure and improving kidney function.

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Azilsartan

A drug that effectively lowers blood pressure and is specifically approved for systemic hypertension treatment in cats.

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Hypokalemia

A condition characterized by low potassium levels in the blood, which is less likely to occur with potassium-sparing diuretics.

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Dihydropyridine Calcium Channel Blockers

Calcium channel blockers that primarily affect vascular muscle, leading to relaxation and dilation of blood vessels.

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Sildenafil

A medication used to treat pulmonary arterial hypertension, a condition that increases pressure in the arteries of the lungs.

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Clopidogrel

A medication that inhibits platelet aggregation, reducing the risk of blood clots.

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Melarsomine Dihydrochloride

A medication used to kill adult heartworms, typically administered by injection.

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Codeine

A medication used to suppress coughing, often causing constipation as a side effect.

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NSAIDs for Osteoarthritis

A class of medications commonly used to manage the pain and inflammation associated with osteoarthritis, a condition affecting joints.

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Tetracyclines in Cats

A class of antibiotics that should not be used in cats due to potential side effects like tooth discoloration and liver damage.

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Ear Cleansers

Solutions used to clean the ears, requiring careful use in cases of ruptured eardrums to avoid further damage.

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Otoscopy

A procedure for examining the ear canal, requiring alternative approaches such as oral antibiotics and pain management for severe inflammation.

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Plerixafor

A medication used to increase platelet count, crucial for blood clotting and wound healing.

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Immunosuppressive Medications

Medications that suppress the immune system, requiring careful tapering to minimize side effects.

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Azathioprine

A second-line option for treating immune-mediated diseases, offering an alternative when other medications are ineffective.

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Dexamethasone

A corticosteroid medication with greater potency than prednisone, requiring lower dosages for similar effects.

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Cyclosporine

A medication commonly used to treat immune-mediated diseases, including atopic dermatitis, perianal fistulas, and others.

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Mycophenolate Mofetil

A medication used to suppress the immune system, known for causing gastrointestinal side effects in a significant portion of patients.

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Study Notes

Fluid Therapy

  • A water-based solution that contains electrolyte and nonelectrolyte solutes, can enter all body compartments, and is used for rehydration is a balanced crystalloid.
  • The shock dose of fluids for cats is 20-30 ml/kg, and for dogs, it is 40-60 ml/kg.

Nutrition

  • In a hospitalized dog or cat, the preferred way to deliver nutrition is through enteral nutrition.
  • To calculate the dog's RER, use the equation RER = (√(√(BW x BW x BW))) x 70 or RER = (30 x BW) + 70, where BW is body weight in kilograms.

Edema and Third-Spacing

  • In a patient with peripheral edema and third-spacing, the interstitial space expands, leading to increased fluid loss.

Opioids and Gastrointestinal Tract

  • Opioids have a constipating effect on the gastrointestinal tract.

Hypoalbuminemia

  • Patients with hypoalbuminemia experience drug toxicity because many drugs are protein-bound, and decreased albumin levels lead to increased free drug concentrations.

Renal Disease

  • The creatinine value in a blood chemistry can be used to reduce the dose or adjust the dosing interval in a patient with renal disease.

Fluid Therapy Contraindications

  • IV isotonic crystalloid fluid therapy is contraindicated in hypernatremic dehydration.

Fluid Types

  • 7.5% saline is a hypertonic fluid.

Autonomic Receptors

  • The autonomic receptor that directly modulates cardiac output through changes in inotropy and chronotropy is the β1 receptor.

Aldosterone Receptor

  • Spironolactone directly acts at the aldosterone receptor, resulting in decreased Na+/K+ exchange in the distal tubule and collecting duct of the nephron.

Pulmonary Edema

  • Furosemide would likely provide the most immediate benefit to a patient with severe pulmonary edema as a result of left-sided heart failure.

RAAS Inhibiting Drugs

  • Azilsartan has greater antihypertensive effectiveness than ACE inhibitors and is FDA-approved for the treatment of systemic hypertension in cats.

Hypokalemia

  • Potassium-sparing diuretics are LEAST likely to cause hypokalemia.

Calcium Channel Blockers

  • Dihydropyridine calcium channel blockers (e.g., amlodipine) have the greatest effect on vascular muscle.

Pulmonary Arterial Hypertension

  • Sildenafil is indicated for the treatment of pulmonary arterial hypertension.

Anti-Thrombotic Drugs

  • Clopidogrel is LEAST likely to cause gastric ulcer disease in cats.

Heartworm Adulticides

  • Melarsomine dihydrochloride commonly causes injection-site reactions in the epaxial muscles.

Antitussive Drugs

  • Codeine has the greatest likelihood of causing constipation as an adverse drug effect.

Osteoarthritis

  • NSAIDs are the main drug therapy for osteoarthritis.

Contraindicated Drugs

  • Tetracyclines should not be used in cats.

Ear Cleaning

  • Ear cleansers should be used with caution in dogs and cats with ruptured tympanic membranes to avoid exacerbating the condition.

Otoscopy

  • When the ear canal is too painful and swollen for otoscopic exam and ear flushing, the best treatment approach for a canine patient with otitis is to use oral antibiotics and pain management.

Chemotherapy Agents

  • Plerixafor can be administered to increase circulating platelet count.

Immunosuppressive Medications

  • It is critical to taper the immunosuppressive medications to the lowest effective dose for long-term management of immune-mediated disease to minimize side effects.

Second-Line Immunosuppressive Medications

  • Azathioprine is considered an acceptable second-line immunosuppressive medication.

Dexamethasone

  • Dexamethasone is 7-10 times more potent than prednisone.

Cyclosporine

  • Cyclosporine is used to treat atopic dermatitis in cats and dogs and perianal fistulas in dogs, as well as other immune-mediated diseases.

Mycophenolate Mofetil

  • Mycophenolate mofetil causes gastrointestinal toxicity in up to 67% of patients.

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