Science Quiz / Equine Med Midterm 2 part 2

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Can you name the Equine Med Midterm 2 part 2

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What is the limiting organ for a 500 kg horse's exercise capacity?
 
Approximately how many L of blood are in a 500 kg horse?
 
What is the resting heart rate of a horse?
 
True or false: horses can increase their HR to 240-250 bpm at maximal exercie, for a CO of around 240 L/min?
 
Which of the following values does NOT raise significantly in horses during exercise?
a)blood volume b)PCV c)hemoglobin d)respiratory rate e)all of the above raise during exercise. 
Which of the following values does NOT raise during exercise for a horse?
a)blood volume b)blood lactate c)blood pH d)rectal temperature e)all of these values raise 
The left third intercostal space is the best place to listen to the _____ valve. The ____ is the best for the mitral, and the _____ for the aortic.
 
 
 
The basal area is the best place to auscultate S_.
 
Diastole lasts from the end of __ to the start of __.
 
 
When auscultating on the right side of the chest the PMI of THIS defect is in the middle of the heart area, whereas THIS defect has its PMI along the bottom of the area.
 
 
The firing of the SA node is represented on an ECG by this structure?
 
The QRS complex is representative of what on an ECG?
 
What does ICP refer to in the cardiac cycle? (Hint: NOT insane clown posse.)
 
Which of the following is not a likely etiology of a heart murmur?
a)increased turbulence b)decreased blood flow c)increased blood flow d)decreased diameter e)decreased viscosity 
This is the lowest grade of heart murmur which may be associated with pathology?
 
This is the lowest grade of murmur accompanied by a cardiac thrill?
 
On which side of the body would a systolic murmur be of greater concern?
 
True or false, the majority of pathologic murmurs are caused by PDA or VSD?
 
The _______ degeneration of connective tissue is marked by a weakening of connective tissue and an accumulation of glycosaminoglycans.
 
This valve commonly has some regurgitation in older horses, with no clinical signs.
With clinical signs, endocarditis is a DDx. The PMI should be at the heart base on the left. 
This valve is second most commonly affected by diastolic murmurs, after aortic?
 
Mitral regurgitation is often the cause of pathologic heart murmurs. These tend to be holo or pan-systolic plateau types. What would be the cause of late systolic crescendo?
Occasionally auscultated as part of these murmurs. PMI is at left apical area. Also audible at right apex. 
This type of regurg is said to have a soft blowing quality, has the PMI over the right side, and is a holosystolic or panysstolic plateau type.
 
A ______ murmur goes from the start of S1 to the end of S2. ______ murmurs go from the end of S1 to the beginning of S2.
 
 
This most common congenital deformity (still uncommon) is often auscultated as a holo- to pan-systolic right sided murmur.
If higher up in location, you may hear on the left side or both sides instead. Small ones can be compatible with performance, large ones will progress to heart failure. 
What is not true regarding VSDs?
a)the right anterior thorax is usually the PMI of associated murmurs b)ECG is the primary method of diagnosis c)animals with VSD are not good for breeding d)cyanosis, exercise intolerance, poor growth and a thrill may be present e)left to right flow is more likely, but right to left ones may cause pulmonary hyperperfusion or hypertension 
Right sided systolic murmurs are usually either ______ valve or ____ _____ _____
 
 
A holodiastolic descrescendo murmur with the PMI at the left base is most likely ______ valve regurgitation.
 
True or false: continuous murmurs may be normal immediately postnatal?
 
Solitary PDA is rare in horses- this defect more commonly presents as part of the ______ __ ______
 
When does the ductus arteriosus normally stop functioning?
 
What is not true regarding PDAs?
a)left to right shunting is most common b)they can progress to right to left shunts after pulmonary hypertension develops c)they produce a continuous murmur d)the physical findings are similar to VSDs e)the PMI is around the right 3rd or 4th intercostal 
True or false: it is relatively easy to diagnose PDA by echocardiography?
 
A grade I or II systolic ejection murmur over the left heart base in young horses is termed an _____ murmur.
 
Which of the following is not part of the tetralogy of Fallot?
a)overriding aorta b)PDA c)VSD d)pulmonic stenosis e)right ventricular hypertrophy 
What is the prognosis for tetralogy of Fallot?
 
A PR interval of over 0.5 seconds is generally called?
These intervals may gradually increase leading to a missed QRS complex, which then will reset the interval back towards normal. 
When some P waves are not followed by a QRS complex at all, with no warning, this is termed?
 
This term refers to the ability of a cell to spontaneously initiate an action potential?
 
This term refers to the ability of a damaged area of myocardium to allow a propagating impulse to persist, re-exciting the heart.
 
ECGs are necessary for diagnosis and treatment of this group of cardiac conditions?
You may only notice the abnormality after exercise. 
Quinidine sulfate may be used to treat this condition, converting to a normal sinus rhythm?
Works by use-dependent blockade of fast Na+ channels, slowing of their reactivation. Watch for colic, nervous signs, tachycardia. 
If Quinidine sulfate is unsuccessful in treating atrial fib, or if it has been persistent for over 4 months, consider this therapy, involving catheter-mounted electrodes for intrac
 
True or false: with normal quinidine sulfate treatment, a horse with atrial fibrillation may race again within 2 months, although there is a risk of relapse?
 
Which of the following may support atrial fibrilation?
a)myocardial insult b)high vagal tone c)large heart size d)all of the above  
True or false: most cases of atrial fibrillation will show at rest as well as during/after exercise?
 
True or false: with many cases of Premature Atrial Contraction or PVC, no treatment is required.
 
Which of the following clinical signs would you NOT associate with Tetralogy of Fallot?
a)stunting of growth b)cyanosis c)syncope d)mild exercise intolerance e)grade IV+ holosystolic murmur over left 4th-6th intercostal space 
More than 4 consecutive PVCs in a rapid regular rhythm constitute _____ _______.
This may alternate with normal rate or rhythm, and can be monomorphic or polymorphic. 
What is the name for a loud heart sound in association with a ventricular tachycardia?
Hint: Think about Quebec city? What language do they speak? What do they have a bunch of? 
True or false: myocardial disease is a common primary condition causing ventricular tachycardia, as are GI conditions?
 
______ such as lidocaine, quinidine, procainamide, or magnesium sulfate are recommended for ventricular tachycardia with HR over 120 bpm or signs of heart failure.
 
Wide, polymorphic ventricular tachycardia which is very rapid and treated by magnesium sulfate is called?
Watch for pulse deficits, and syncope. This is a life threatening condition! 
Increased AST and CK on serum biochemistry could be indicated by saying increased ____ enzymes?
 
Which is not characteristic of endocarditis?
a)tachypnea and tachycardia b)intermittent fever c)weight loss and anorexia d)murmur and/or arrhythmia e)all of the above are legit 
a)valvular form is often secondary to trauma b)mitral is most common valve affected by valvular endocarditis c)vegetative lesions are composed of platelets and fibrin as well as bacteria d)there is a risk of thromboembolism due to the vegetative and friable nature of the lesions e)broad spectrum AMDs for at least 4 weeks is the treatment, but there is a poor prognosis. 
This is a term for intermittent lameness associated with exercise?
 
This condition may be caused by verminous migration, and affects males more than females.
Lameness and poor performance are the typical results, with slight decreases in temperature on the affected limb, and reduced filling in saphenous vein or decrease in peripheral pulse. You can diagnose on rectal pallpation. 
Signs of this condition include tachycardia, weak rapid pulse, muffled heart sounds, venous hypertension, ventral edema and jugular distension.
The condition is most often idiopathic, and may be effusive or later constrictive (affecting right side more). ON ECG you'll note a decreased amplitude of the QRS and electrical alternans. 
Prognosis is ____ for effusive pericarditis, ____ for constrictive.
 
 
As in other animals, ______ _____ most frequently occurs with the mtiral valve.
Results will be acute failure of the mitral valve, acute left heart failure with pulmonary edema and frequently sudden death. 
This condition is most common in aged stallions, and usually presents as sudden death.
If they don't present PM, you'll see ventricular dysrythmias, aorticoventricular fistulas and acquired VSD. The lesion will never heal and they will always be at risk of sudden death. 
Visible scars and fibrosis at histology will be found PM on myocardial examination with this lesion.
The causes include toxic insult, infectious processes, neoplasia, trauma, degeneration, and infarct. 
This is the most common cause of toxic myocarditis in horses?
Calcium overload is the mechanism. 
Name another cause of toxic myocarditis that is not the most common one in horses?
 
What is not true regarding myocarditis?
a)anti-inflammatories and diuretics comprise part of supportive care b)antiarrhytmics must be used very cautiously c)digoxin should be used as the mainstay of monensin toxicity therapy d)guarded prognosis and long term sequelae are to be expected e)electrolyte abnormalities should be corrected 
True or false: chronic left heart failure may often be missed due to substantial lymphatic reserve in lungs?
 
Which would you not commonly associate with right heart failure in horses?
a)jugular distension b)ventral edema c)ascites d)frothy fluid from both nostrils e)both c and d 
This is a term for secondary right heart disease following primary pulmonary hypertension.
You'd expect right heart hypertrophy, dilation and eventual failure. May follow severe respiratory disease or left heart failure. 
Name a type of manipulative test you might perform during a lameness workup?
 
A ____ deformity returns to one in which the distal part of the horses leg past a joint is angled inward ('bowlegged') whereas a _____ deformity has the distal aspect angled outwar
 
 
When the angle of the heel wall is less than that of the toe wall, this is referred to as _____ ____
 
True or false: the back hoof and the pastern should be on an axis in a healthy horse?
 
A bog spavin is more properly referred to as what?
 
Which of the following is not a weight bearing aspect of the leg that should be palpated?
a)frog b)hoof wall (for warmth) c)digital pulses d)heel pulses e)coronary band 
When performing diagnostic analgesia of the forelimb, you must sedate this nerve on the lateral aspect and this nerve on the medial?
 
 
The head tends to go ____ as the lame limb contacts the ground, and ____ as the sound or less lame limb does.
The same patterns may be observed with pelvic limbs, most prominently in the tuber coxae of the lame limb... 
 
This may frequently be mistaken for a hip hike in the sound or less lame of the two pelvic limbs?
 
Which is not a way to use hoof testers?
a)between the sole and the adjacent hoof wall b)between frog sulci and adjacent hoof wall c)between frog and opposite hoof wall d)across the heels e)across hoof walls 
What is the expected result of mild pressure with a pen on each side of the spine? Over the gluteals? On the ventral abdomen?
 
 
 
Which pairing of joints do not flex/extend together?
a)coffin and fetlock b)coffin and pastern c)pastern and fetlock d)elbow and shoulder e)hock and stifle f)stifle and hip g)hip and hock 
What is an advantage, then a disadvantage of intra-articular or intrasynovial blocks as compared to regional blocks?
 
 
True or false: severe lamenesses to a point where fracture is suspected indicate intra-articular anesthesia?
 
Under the AAEP lameness guidelines, a horse with a lameness that is difficult to catch and not consistent regardless of circumstances is grade?
 
Under AAEP lameness guidelines, a lameness consistently observable at a trot under all circumstances is grade?
 
Under AAEP lameness guidelines, a lameness that is difficult to observe but consistent under certain conditions is grade?
 
Under AAEP lameness guidelines, a lameness producing complete inability to move or minimal weight bearing is grade?
 
Under AAEP lameness guidelines a lameness that becomes obvious at a walking pace is grade?
 
Please list, in order the following anesthetics in ascending duration of action: Bupivacaine, lidocaine, mepivacaine.
 
True or false: aspiration of synovial fluid is the normal way to ensure correct needle position for intrasynovial anesthesia?
 
If chemical restraint is necessary for safety during an intrasynovial block, and you choose xylazine, how long would you wait after each block before re-evaluating lameness?
 
True or false: if there is no improvement in lameness at the second check, 20 minutes after injection, then the test is considered negative?
 
The palmar digital nerve block desensitizes the palmar 1/_ of the foot and the entire sole.
 
True or false: the coronary band regions should still have sensation after a palmar digital nerve block?
 
This common nerve block desensitizes the entire foot?
 
This nerve block desensitizes the entire limb distal to the button of the splint bone, except the dorsal surface of the fetlock skin in some horses.
 
True or false: osteochondrosis technically refers to a bone or cartilage disorder of unspecified etiology but usually is used to refer to developmental disorders of abnormal endoch
 
Lesions of the articular cartilage and associated subchondral bone, specifically an abnormal flap, are termed?
 
Osteochondral fragments may be the product of OCD or?
 
When osteochondrosis manifests at the articular-epiphyseal cartilage, it is either as flaps or fragments (OCD) or infolding of defective cartilage to produce ____ ___ ___?
 
This layer of chondrocytes is retained in osteochondrosis?
Due to abnormal chondrocyte differentiation and formation of defective ECM, failure of vascular invasion and subsequent osteogenesis. 
Research has shown that SBCs are more likely in areas of maximal ______ forces, whereas areas subjected to _____ forces tend to become OCD flaps?
Near central weight bearing regions... 
Gliding regions... 
Which of the following has not been implicated as a potential etiologic factor in osteochondrosis?
a)insufficient carbohydrate energy in diet b)low levels of copper ions or high levels of zinc ions c)genetics d)trauma e)all of the above are legit 
What is the primary diagnostic modality of OCD and subchondral bone cysts resulting from osteochondrosis in younger horses?
After initially noting joint effusion and subtle to moderate lameness, with joints that are not hot and will tolerate flexion. 
Which of the following is not a likely lesion in the fetlock joint due to osteochondrosis?
a)osteochondral fragment at proximal palmar or plantar eminence of P1 b)OCD of distal, dorsal MC-3/MT-3 (saggital ridge) c)SBC of proximal dorsal P-1 d)SBC of distal MC-3/MT-3 e)all of the above are likely 
This type of imaging is usually necessary to confirm SBC?
 
When considering osteochondral fragmentation of the palmar or plantar eminence of P1, please give the type # for each subtype?
Osteochondral fragments on the most abaxial aspect, majority of lesion is extra-articular*(one of the two main types) 
Fragments from the base of the sesamoid bones 
Osteochondral fragments of flattened or concave areas in the proximal process of P1. Intra-articular, distal to the sesamoid bones, abaxial to the sagittal groove.* 
Fragments within the distal sesamoidean ligaments 
Which of the following is untrue regarding OC fragments in palmar or plantar P1 area?
a)present with minimal joint effusion compared to other OCD lesions b)associated with a poor prognosis c)lameness tends only to present at high speeds d)treated by arthroscopic debridement e)all of the above are true 
When considering OCD of the distal, dorsal part of MC-3 or MT-3, please name the type # of each subtype described?
Subchondral flattening, typically treated with rest alone. 
Flattening in addition to a bony fragment, treated with arthroscopic debridement. 
Loose osseous body within the dorsal joint, treated with arthroscopic debridement 
Joint effusion is typically the first tip off for OCD of the dorsal MC/MT-3. Lameness tends to be mild, and prognosis is very good if there is minimal associated ___ ____ ____?
 
In rare cases where there are SBCs in MC/MT-3, you may treat with debridement, intralesional corticosteroid injection or intra-articular meds and rest. What is the prognosis?
 
When I say that the DIRT of the hock is the most common location for OCD in the standarbred horse, what does this refer to?
Tarsal OCD is usually marked by joint effusion, with lameness not appearing until athletic training. Treatment is by arthroscopic debridement, prognosis is generally good if not excellent. 
Of the four most common locations for OCD in the tibiotarsal joint, this is the least common?
a)distal intermediate ridge of the tibia b)medial trochlear ridge of the talus c)medial malleolus of the tibia d)lateral trochlear ridge of the talus 
When discussing osteochondrosis of the stifle, OCD is most common at this location on the femur, and SBC at this location on the femur.
Femoropatellar effusion and minimal to moderate lameness are the signs. Debride with arthroscope. Guarded to good prognosis. 
Effusion is less common, lameness may be mild to severe. Debride with arthroscope, give intra-articular meds and rest or put corticosteroids into the lesion. Generally less favourable prognosis than OCD. 
Which is the most likely location to be affected by osteochondrosis in the shoulder?
a)the humeral head b)the glenoid c)both d)all of the above are equally likely 
True or false: as with most locations, osteochondrosis at the shoulder carries a guarded to excellent prognosis?
 
Physeal dysplasia (the physeal version of osteochondrosis) typically causes a metaphyseal flare with heat, pain, and sometimes lameness between these months of age?
 
Which is not a common location for physeal dysplasia to be noted in a growing horse?
a)distal 3rd metacarpal/metatarsal physis b)distal radial physis c)distal tibial physis d)proximal radial physis e)all of the above are legit 
With NSAID therapy, exercise restriction and a decrease in dietary carbs, the prognosis for physeal dysplasia is good unless there is?
 
Name a basic etiology of angular limb deformity?
 
True or false: you may correct a varus angular limb deformity by trimming the medial wall and applying lateral extensions?
 
Periosteal stripping is typically performed on the ____ side of the limb for surgical intervention on angular limb deformities?
This is a form of growth acceleration. 
What is the surgical intervention that is a form of growth retardation performed on the convex side of the limb for angular limb deformity?
 
Distal interphalengeal flexural deformity may occur at birth or 1-4 months into life. What is the structure that is contracted?
Treated with oxytetracycline, distal check desmotomy or corrective trimming to lower the heels. 
Flexural deformity of the fetlock (metacarpo/metatarsophalangeal flexural deformity) is a relative contraction of what structure(s)?
Treated wtih splinting, oxytetracycline(?), heel elevation (?), proximal or distal check desmotomy. 
This flexor tendon abnormality is always congenital. Treated by restricting exercise or applying heel extensions.
 

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