Chapter 2 Review Questions
1.) “Sara” is an all Black 7 year old spayed female domestic short haired (DSH) cat who presents to the emergency service for vomiting, lethargy, and anorexia of four days duration. On physical exam she is severely depressed with a heart rate is 140bpm, respiratory rate is 42bpm, temperature is 98.7F, and her mucous membranes are pink and dry. Her capillary refill time (CRT) is 4 seconds, her eyes are sunken, and she had a significant skin tent. She is estimated to be 12% dehydrated upon exam. What class of cardiovascular shock is “Sara” experiencing?
a. Obstructive
b. Distributive
c. Cardiogrenic
d. Hypovolemic
2.) This type of cardiovascular shock is associated with an increased cardiac preload, an increased cardiac afterload, and a decreased in cardiac contractility.
a. Cardiogrenic
b. Distributive
c. Obstructive
d. Hypovolemic
3.) Which of the following conditions is least likely to be associated with distributive shock?
a. Anaphylaxsis
b. Systemic inflammatory response syndrome (SIRS)
c. Hypoadrenocorticism
d. Sepsis
4.) “Goof Ball” is a 2 year old castrated male chocolate Labrador retriever (30kg) who presents to the emergency service 10 minutes after being hit by a car. On presentation he is ambulatory with bright pink mucous membranes, a heart rate of 160bpm, bounding pulses, temperature of 103F, and is panting with minimal respiratory effort. Which stage of cardiovascular shock is this patient best classified as having?
a. Compensatory phase
b. Early Decompensatory phase
c. Late Decompensatory phase
d. This patient is not currently in shock
5.) “Timothy” is a 5 year old castrated male greyhound (28kg) who presents to the emergency service 1.5 hours after being hit by a bus. On presentation he is laterally recumbent and dull, his mucous membranes are white, his heart rate is 200bpm, respiratory rate is 48bpm with moderate effort, temperature 101.5F, and femoral pulses are not present. Which stage of cardiovascular shock is this patient best classified as having?
a. Early Decompensatory phase
b. Compensatory phase
c. Late Decompensatory phase
d. This patient is not currently in shock
6.) Which of the following hemostatic tests in veterinary medicine is currently the only means of evaluating hypercoagulability?
a.) Prothrombin (PT)
b.) Thromboelastography (TEG)
c.) Activated partial thromboplastin time (aPTT)
d.) Activated Clotting Time (ACT)
7.) “Hermione” is a 16 year old spayed female Siamese cat who is hospitalized in the critical care unit for chronic renal failure. The patient also has a history of hypertrophic cardiomyopthay (HCM). You note that her respiratory rate has increased from 24bpm to 52bpm over the past 6 hours and that she has some clear discharge coming from her nose. The rest of her vital signs appear within normal limits. Which of the following is the most appropriate action?
a. Upon approval of the clinician, administer 100ml of LRS to treat for apparent hypovolemia.
b. Shave the cat’s chest wall and set up for emergency bilateral thoracocentesis.
c. Discontinue fluid therapy immediately and notify the attending clinician of possible volume overload/fluid intolerance.
d. Re-evaluate the patient in 6 hours.
8.) “Petunia” is a 10kg spayed female pug who presents to the emergency service for acute collapse on a warm Sunday morning. Physical exam findings are unremarkable aside from the patient appearing to be in the early decompensatory stage of cardiovascular shock. The attending clinician requests an initial fluid bolus of 0.9% NaCl over 15 minutes. Followed by patient re-evaluation, what initial fluid bolus is most appropriate?
a. 5ml/kg
b. 20ml/kg
c. 55ml/kg
d. 90ml/kg
9.) Which of the following agents is not a “pressor” (meaning an agent used to adjust vascular tone)?
a. Dobutamine
b. Dopamine
c. Vasopressin
d. Phenylephrie
10.) Which of the following fluid types is least appropriate to rapidly restore intravascular volume?
a. 0.9% NaCl (isotonic saline)
b. 0.45% NaCl (hypotonic saline)
c. 7% NaCl (hypertonic saline)
d. 6% Hetastarch in 0.9% NaCl