Exs- Thiopental Sodium, Methohexital, Thiamylal, Pentobarbital, Secanol, and Phenobarbital
+ dry mucous membranes and depressed globes within orbits
+more persistent skin tent, and increased PCV/TP
+ dry, pale MM and CRT >2 seconds
Cats= 110-220 bpm
Water 2-4 hours
Water 8-12 hours
__ in a cat you should report it immediately.
cat lower than 20%
Chondroblasts- immature cartilage cells
Cats- up to 20 ml/kg/hr max of 1 hr
Cats- up to 40-60 ml/kg/hr max of 1 hr
1/4 of max dose given in 15 minute increments then patient is evaluated
Blood volume is 8-9% in dogs and 6-7% in cats.
Involves prostatic or membranous urethra;superior to the urogenital diaphragm.
sx: blood in meatus, inability to void, high-riding prostate. Perineal/scrotal hematoma. Pelvic fracture can cause.
Dx- retrograde urethrogram.
Tx- suprapubic catheter until it heals
Involves the bulbar or penile urethra, inferior to the urogenital diaphragm.
sx: Perineal tenderness or hematoma & bleeding from urethra but normal prostate. Usually 2/2 blunt trauma to perineum or instrumentation.
dx: cystogram shows leak.
Tx: operation and repair of defect followed by Foley drainage.,
gold standard – contrast arteriography
tx: aspiring and cilostazol (PDEi)
Signs: Pneumomediastinum (palpable crepitus –> homanns sign), fever, + pleural effusion, does not cause circulatory collapse
Dx: water-soluble contrast esophagography
Tx: Primary closure of esophagus and drainage of mediastinum within 6hrs to prevent mediastinitis,
broad spec Abx, +/- parenteral nutrition
, Tx: usually heals on it’s own (stop NSAIDs, alcohol, reduce vomiting/coughing)
-endoscopic treatment > epi injection, cautery, compression (endoclip/band)
-surgery is rare
CT – thickening of bowel wall
colonoscopy – cyanotic mucosa with hemorrhagic ulcerations
-damage to lower parts of colon after exposure to X-rays or other ioinizing radiation as part of radiation therapy
sx: diarrhea, rectal bleeding, urgency, tenesmus. Later strictures and fistulas may form
dx: lower endoscopy, colonoscopy or flexible sigmoidoscopy
tx: chronic: sucralfate enemas, endoscopic cauterization of bleeding vessels (APC: argon plasma coagulation or topical formaldehyde)
– numerous atherosclerotic RG
distal: colicky abd pain, vomiting, abd distension, constipation/obstination, dilated loops of bowel on abd x-raysimple: luminal occlusion
strangulation: loss of blood supply to bowel wall
– axillary n damage may be present
-determine degree of displacement and neuro compromise- xray (axillary view r/o dislocation) 2 views, CT scan- surgical planning
-tx: ice, pain meds, sling, ortho referral for ORIF
– suspect if PMH suggests exogenous steroid use (SLE)
CXR – may show rib fx, which is a common cause
-EKG will show PVCs, Twaves changes, ST elevation
-CPK & Troponin enzyme levels elevated
-overall mortality is 10%
dec lung compliance,ph=7.44, PO2 = 64, PCO2 = 34
no medical or surgical tx unless growth becomes sympto or interferes with speech or eating
mc in young pts, womens and asians.
dx: non-contrast spiral CT of abdomen and pelvis
– sharp, localized pain over bony surface that is worse with palpation
– a/w pain bw 3rd and 4th toes on plantar surface
– mulder sign: clicking sensation when simultaneously palpating this space and squeezing metatarsal joints
– tx injections, strength into flexion with nerve gliding and surgery last case scenario
supra condular fx of humerous: brachial a
humeral fx: ulnar n (claw hand)
2. sedation: decrease metabolic demand and control HTN
3. IV manitol: extraction of free water out of the brain tissue –> osmotic diuresis
4. hyperventilation: CO2 washout, leading to cerebral VC
– fall on an outstretched hand.
sx: tender in the anatomic snuffbox or with resisted supination, and has limited range of motion of the wrist and thumb.dx: X-ray is often negative. May require special scaphoid views or repeat x-ray 10 to 14 days after treatment.
tx: thumb spica and referral. Improper treatment may lead to avascular necrosis.
mc a/w anticonvulsants and bactrim
all unstable, penetrating wounds – immediate surgery (regardless zone)
zone 1 – angiography with possible embolization
zone 2 – immediate surgery
zone 3 – angiography, soluble-contrast esophagram, esophagoscopy, bronchogram. even if asympto
if stabbled in upper and middle zones, and azympto, can observe for 12 hours
severe blunt chest trauma (MVA). Dyspnea, chest pain, hypoxemia worse with IVF, patchy alveolar infiltrates.
-may not develop until 1-2 post-trauma
– give colloids, not crystalline. check ABGs, CXR. intubate with PEEP if needed
PE: no breath sounds over entire left chest
xray: multiple air fluid levels on chest
2. Tension PNX
3. rupture of trachea or major bronchus
dx: CXR shows presence of air in tissues
txL fiberoptic bronchoscopy to confirm dx and level of injury. surgery- t/c if putting out very lg amt of air through chest tube and collapsed lung not expanding
– obese, fecund women in 40s has recurrent episodes of abd pain, high AP, dilated ducts on sonogram, non-dilated GB full of stones
dx u/s, confirm with ERCP
tx: sphicterotomy and remove common duct stone. follow with cholecystectomy
– acute cholecystitis that arises 2/2 infection with gas forming bacteria;
-sx: RUQ pain, n/v, low-grade fever, crepitus in abodominal wall near gallbladder;-dx: abdominal U/S w air fluid levels in GB, curvilinear gas shadowing in GB; mild unconjugated hyperbilirubinemia; mild inc LFT;
-comps: gangrene, perforation;
tx: fluid/electrolyte rescucitation, early CCK, parenteral abx effective against G+ anaerobic clostridium (Unasyn, Zosyn, AG/FQ + clinda/metro)
encephalitis-if 3 RF, 85% mortality
if 4 RF, 100% mortality
2. JVD – optimize meds
3. recent MI – defere 6 months
4. severe angina – perfect cath
serum albumin <3
anergy to sking allergy
external rotation and shortened leg
femoral neck fx: femoral head replacement, high risk of avascular necrosis
intertrochanteric fx: open reduction and pinning
femoral shagt fxL intramedullary rod fixation
a diaphyseal fx and displaced dislocation of nearby joint
tx: open reduction and internal fixation of diaphysial fx
closed reduction of dislocated joint
internally rotated and shorted
-psterior neuro problems: visual sx, equilibrium problems
– claudification in the arm during exercisesdx: angiography
tx: bypass surgery