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Unit 3 cp 19
Small Animal Medical Nursing Objectives 7-10
| Question | Answer |
|---|---|
| chronic kidney disease is characterized by | an irreversible, progressive loss of functioning renal tissue |
| serum elevations of the protein metabolites creatinine and blood urea nitrogen | azotemia |
| what does urine specific gravity test for | it measures the concentration of urine and is a reflection of patient hydration status and of kidney function. Low USG is indicative of impaired kidney function |
| medical management of chronic kidney disease focuses on several key steps they are | slowing progression of the disease, treating concurrent disease, correcting electrolyte imbalances, ameliorating clinical signs and providing nutritional support |
| what is a urolithiasis | a pathologic stone formed from mineral salts found in the urinary tract and is dependent on urine pH, concentration and saturation |
| clinical signs of a urolith depend on | location, number, size and shape, and whether concurrent urinary tract infection is present |
| naming urolith depend on the location of urolith include | nephrolith, ureterolith, urocystolith and urethrolith |
| straining to urinate is called | stranguria |
| abnormally frequent urination | pollakiuria |
| painful urination | dysuria |
| the most common form of bacteria to cause a UTI in small animals is | Escherichia coli |
| UTI is a common secondary infection for pets with | diabetes, CKD or hyperadrenocorticism and patients with indwelling catheters |
| diagnosing a UTI is made based on the presence of | white blood cells, red blood cells and bacteria found during microscopic examination of urine |
| FLUTD stands for | feline lower urinary tract disease |
| FLUTD is a term used to describe the constellation of signs indicating | irritation of the bladder and urethra in the cat with signs of stranguria, dysuria, hematuria, pollakiuria and inappropriate urination |
| FLUTD can be either one of two types they are | obstructive and nonobstructive |
| the underlying cause of patients with nonobstructive FLUTD is | feline idiopathic cystitis or the presence of uroliths |
| a thorough diagnostic approach for FLUTD includes but is not limited to | complete urinalysis, urine c&S, x-ray, US, contrast studies |
| If uroliths, UTI, neoplasia or any other causative disease process is ruled out the diagnoses is then | FIC - feline idiopathis cystitis |
| FIC is a multifactorial disease with a complex pathogenesis that involves disorders of the | hypthalmic pituitary adrenal axis, nervous system and the bladder itself |
| other factors that play a role in FIC are | environmental stressors, behavioral disturbances and dietary factors |
| Endocrine Disease a disease that affects cats in which the thyroid gland is overactive, producing abnormally large amounts of T4 and T3 resulting in an increased basal metabolic rate is called | hyperthyroidism |
| Clinical signs of hyperthyroidism include | weight loss, anorexia, vomiting, depression, tachycardia, heart murmur, enlarged thyroid gland and hypertension. also elevated serum T4, T3 |
| treatment of hyperthyroidism falls into two categories | curative and palliative |
| palliative treatment consists of | antithyroid medication, given once or twice a day which blocks thyroid hormone synthesis, decreasing the levels of circulating thyroid hormones |
| Curative treatment consists of | surgical removal of the thyroid gland either one or both lobes |
| disease that primarily affects dogs, although a rare congenital form can be seen in kittens | hypothyroidism |
| underactive tyroid, resulting in subnormal circulation levels of thyroid hormones causing a decreased metabolic rate | hypothyroidism |
| clinical signs of hypothyroidism include | weight gain, exercise intolerance, altered mentation, lethargy |
| diagnostic conformation of hypothyroidism includes | low serum T4 and T3 levels and elevated TSH |
| disease that results from insufficient production of insulin by pancreatic beta cells, or from insulin resistance | diabetes mellitus |
| high blood glucose | hyperglycemia |
| glucose in the urine | glucosuria |
| clinical signs of diabetes mellitus include | PU/PD, weight loss and increased appetite, cats have plantigrade stance, dogs have cataracts |
| cats with diabetes should eat a diet of | high-protein/low-carbohydrate |
| dogs with diabetes should eat a diet of | high fiber |
| DKA-diabetic ketoacidosis | develops in patients that go a long time with out treatment of diabetes |
| the toxic metabolite found in patients with DKA is | ketones in the urine |
| ketones develope in the urine over time because | the body is unable to use glucose an alternate pathway for carbohydrate metabolism is formed. Ketones are the by product of that pathway |
| disease that primarily affects dogs and is characterized by elevated circulating levels of cortisol produced by the adrenal cortex | Hyperadrenocorticism or Cushings syndrome |
| the cause of HAC can be | a anterior pituitary tumor secretes ACTH or adrenal tumor secretes cortisol or pharmacologic intervention aidmed at decreasing the amount to cortisol produced by the adrenal glands |
| The treatment of choice for adrenal-dependant HAC is | the removal of the adrenal tumor |
| disease caused by adrenal glad atrophy or destruction, resultin in inadequate secretion of glucocorticoids and mineralocorticoids | hypoadrenocorticism or Addisons disease |
| clinical abnormalities include | anemia, azotemia, hypoglycemia, elevated serum K and decreased Na |
| Reproductive diseases inflammation of one or more mammary glands | mastitis |
| decreased flow of milk in the mammary glands, resulting in enlarged painful mammary glands | galactostasis |
| a bacterial infection of the uterus | metritis or pyometra?? |
| disorder occurs usually 2-3 weeks after birth and patients present with trembling, convulsions and low Ca serum levels | Eclampsia or hypocalcemia |
| a condition that occurs in old intact male dogs who present with trouble urinating, blood in urine, and trouble defecatating | prostatic disease |
| those diseases in which the immune system has lost tolerance of self and perpetuates damage to the bodys organs | immune-mediated disease |
| the most common cause of immune-mediate hemolytic anemia in dogs is | immune-mediated, the RBC's, |
| the most commmon type of IMHA in dogs is | primary where the immune system targets the RBC as foreign or an antigen and makes antibodies against RBC tissue |
| IHMA in cats is different it is | secondary to blood parasite infection of the RBC, where the immune system attacks the parasite but kills the RBC in the process |
| a disorder of neuromuscular transmission that causes muscle weskness | acquired IM) Myasthenia Gravis |
| myasthenia gravis is caused by an immune system dysfunction that produces autoantibodies against | acetylcholine receptors in the postsynaptic membrane |
| a chronic progressive deterioration of the articular cartilage of the joint caused by joint laxity and/or abnormal load bearing of the joint | joint disease osteoarthritis |
| prevention of OA is ideal and entails | early detection |
| administration of chondroprotective medications and supplements promotes | synovial joint health |
| diseases caused by pathogenic microorganisms that invade and colonize within the tissues and fluids of an individual animal are called | infectious diseases |
| Infectious diseases involve many different pathogens such as | viruses, bacteria, fungi and rickettsiae |
| A Transmissible disease (Infectious Disease) must be able to avoid host defense systems, reproduce in the host and cause disease | The pathogen |
| can be an animal, insect or fomite (inanimate object) in which he pathogen can survive | The reservoir |
| Where/how the pathogen leaves the reservoir, often related to clinical signs of the disease process | Portal of exit |
| how the pathogen travels to the next host | mode of transmission |
| direct transmission | immediate and requires direct contact of skin or mucous membranes with infected animal or its secretions or excresions |
| Indirect transmission | delayed and requires contact with a contaminated fomite (inanimate object or insect) |
| Transplacental transmission | passed from mother to neonate |
| where/how the pathogen gains entry into the new host | portal of entry |
| exposure to a pathogen does not guarantee infection and disease | Host susceptibility |
| infectious diseases that are transmitted directly between animals or indirectly through fomites contaminated with animal secretions are considered | contagious |
| infectious diseases that require a biological vector are called | vector borne |
| infectious diseases that are transmitted directly from animals to human are called | zoonotic |
| Infectious agents that can infect a human or animal via a common vector are called | shared vector zoonoses |
| infectious diseases that are transmitted from humans to animals are called | reverse zoonoses |
| control of transmissible infectious diseases involves | 1.Kill the pathogen while it is in the host 2. Kill the pathogen while it is living on a fomite 3. kill pathogen while it is living in a vector 4. strengthen host defense systems 5. decrease host exposure |
| the most effective management approach against contracting a zoonotic disease is called | barrier nursing - a method that creates a "barrier" between a contagious patient and the nurse in an effort to reduce transmission of an infectious pathogen to other patients |
| the study of cancer | oncology |
| cancer is | a disease of uncontrolled growth of abnormal cells |
| the process of uncontrolled cell growth and subsequent formation of a tissue mass is called | neoplasia |
| a multifactorial process by which normal cells are transformed into tumors | carcinogenesis |
| three events must take place before malignant transformation can occur | initiation, promotion and progression |
| initiation | the cell is exposed to a factor that rapidly and irreversibly alter its DNA |
| further mutatuions of the initiated cell by an agent or event that stimulate proliferation of the cell to grow into neoplasm is called | promotion |
| factors with carcinogenic potential include | inherited genetic defects, hormones, viruses, diet, immune system dysfunction, trauma, chronic inflammation, radiation, variety of chemicals |
| tumors can be | benign or malignant |
| tumors that do not invade or destroy surrounding normal tissues or spread to a new site are considered | benign tumors |
| tumors capable of invasion and destruction of local tissue and of metastasis are considered | malignant tumors |
| the process by which cancer cells spread ffrom a primary tumor to secondary locations such as lungs,lymph nodes. | metastasis |
| steps in the metastatic process | 1. cancer cells of the primary tumor must detach from the mass and invade other tissue 2. cells are transported to distant tissues where they reach metastatic site 3. a metastatic tumor is established when cells can survive and grow at the new site |
| carcinomas | spread through both the lymphatic system and the blood stream. lymph node and lung metastases is common |
| sarcomas | arise from mesenchymal tissues like cartilage, so not usually seen in the lymph system, spread through the blood stream and are more prevalent in pulmonary tissue |
| "oma" | usually refers to a benign tumor |
| "sarcoma" or "carcinoma" | malignant tumor |
| tumor grading is done by the | veterinarian according to features of the tumor at the primary site (T), whether lymph nodes are involved (N), and whether the tumor has metastasized (M) |
| hormones or other substances synthesized by the tumor that circulate systemically and affect multiple organ systems or tissues | parneoplastic syndrome |
| syndrome characterized by weight loss and muscle wasting caused by the presence of the tumor and by the secondary problems ie nausea, vomiting anorexia is called | cancer cachexia |
| three primary treatment options are available for both dogs and cats with cancer diagnosis | surgery, chemotherapy and radiotherapy |
| surgical approach | resection should be performed in the normal tissues surrounding the mass so that a generous margin of normal tissue is removed along with the tumor |
| limitations of surgery include | potential for damage to surrounding normal structures and its inability to address systemic spread of tumor, if long term disease control is not possibel |
| a cold source is used to freeze superficial cancers that are smaller in diameter | cryosurgery |
| cryosurgery should not be performed in patients with | very large tumors, in which definitive distologic diagnosis has not yet been made |
| radiotherapy is most appropriately prescribed for the treatment of | localized cancers and does not address systemic cancers.It is used alone or in conmbination with surgery or chemotherapy |
| because radiation targets DNA it is most effective against | tumor cells with rapid rates of proliferation |
| potential side effects of radiation are divided into two phases | late phase and acute phase |
| late phase effects of radiotherapy develope | over a course of months to years and usually involve permanent changes such as necrosis or fibrosis of normal tissues |
| acute effects | usually seen during the latter stages of radiotherapy and and require nursing care but are temporary, vomiting, nausea |
| preferred method of treatment for local cancers is | surgery and radiotherapy |
| preferred treatment for systemic cancers | chemotherapy |
| the treatment of cancer with chemical agents | chemotherapy |
| indications for chemotherapy include | 1. primary treatment for known chemotherapy sensitive tumors to "shrink" them for better resection 2. palliative vs. curative treatment for temporary relief of clinical signs caused by cancer and quality of life |
| if a chemotherapy agent a potent vesicant is given perivascularly | do not remove the iv catheter, but irrigate the area with sterile saline both through the catheter and SQ to dilute the drug. Giving dexamethasone in the area is often recommended, cold compressesd |
| some administration of chemotherapy drugs may elicit | an allergic reaction so a premed of antihistamines and glucocorticoids is recommended |
| the most clinically relevant blood line affected after administration of chemotherapy is | bone marrow suppression, myelosuppression |
| other reactions include | GI upset, loss of hair |
Created by:
tnewhouse
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