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Canine Infectious Diseases: Self-Assessment Color Review, Q&A 12 (view source)
Revision as of 16:33, 8 November 2018
, 16:33, 8 November 2018Created page with "{{CRC Press}} {{Student tip |X = an interesting history, allowing many differentials to be covered. }} <br><br><br> centre <br>..."
{{CRC Press}}
{{Student tip
|X = an interesting history, allowing many differentials to be covered.
}}
<br><br><br>
[[File: Canine Infectious Diseases Q12.PNG|centre]]
<br>
'''A 6-year-old neutered male, 20.6 kg mixed breed dog (see image) was referred for a cardiac work-up, because the referring veterinarian had heard a new continuous heart murmur. The dog was known to have had a systolic murmur for several years. Along with dental prophylaxis, a grade I mast cell tumour had been surgically removed from the right thoracic limb 1 year previously. There was no history of exercise intolerance or other clinical signs. The dog lived in Ingolstadt, Germany, and was current on vaccinations and treated regularly with parasiticides. He had never travelled outside Germany. Physical examination revealed that the dog was active, alert, and responsive. The rectal temperature was 38.9°C (102.0°F), mucosal membranes were moist and pink, capillary refill time was <2 seconds, all lymph nodes were of normal size, and abdominal palpation was unremarkable. Lung sounds were physiologic, and the respiratory rate was 36 breaths/min. A left basal continuous heart murmur with an intensity of V/VI was audible. The regular heart rate was 128 bpm. Pulse quality was normal, without pulse deficit or evidence of jugular vein distension/pulsation. The remainder of the physical examination was unremarkable.'''
<br>
<FlashCard questions="2">
|q1= What is your interpretation of the physical examination, and what are the differential diagnoses for the described heart murmurs?
|a1= The main problem identified on physical examination was the new continuous heart murmur with point of maximal intensity over the left heart base. The previously documented left basal systolic murmur could result from pulmonic stenosis (PS) (infundibular, sub, supra, or valvular), aortic or subaortic stenosis (AS/SAS), tetralogy of Fallot, obstructive outflow disorders, or an atrial septal defect (ASD) leading to a relative pulmonic stenosis. Given the loud murmur intensity and the fact that it had been present for several years, an ASD was considered unlikely. The continuous left basal heart murmur could be due to a congenital persistent ductus arteriosus (PDA) or a coexisting systolic and diastolic murmur (e.g. AS/PS along with severe aortic or pulmonic insufficiency, respectively). As the continuous murmur was newly reported, an acquired cause was more likely than PDA.
|l1= Replace text with name and subsection of relevant WikiVet page if in existence eg. Feather - Anatomy & Physiology#Structure & Function
|q2= What further diagnostic procedure should be recommended?
|a2= Echocardiography should be performed to identify the cause of the heart murmur.
|l2= Replace text with name and subsection of relevant WikiVet page if in existence eg. Feather - Anatomy & Physiology#Structure & Function
</FlashCard>
To purchase the full text with your 20% off discount code, go to the [https://www.crcpress.com/9781482225150 CRC Press] Veterinary website.
[[Category:CRC Press flashcards]]
{{#tag:imagemap|Image:Next Question CRC Press.png{{!}}center{{!}}200px
rect 0 0 860 850 [[Canine Infectious Diseases: Self-Assessment Color Review, Q&A 13|Next question]]
desc none}}
{{Student tip
|X = an interesting history, allowing many differentials to be covered.
}}
<br><br><br>
[[File: Canine Infectious Diseases Q12.PNG|centre]]
<br>
'''A 6-year-old neutered male, 20.6 kg mixed breed dog (see image) was referred for a cardiac work-up, because the referring veterinarian had heard a new continuous heart murmur. The dog was known to have had a systolic murmur for several years. Along with dental prophylaxis, a grade I mast cell tumour had been surgically removed from the right thoracic limb 1 year previously. There was no history of exercise intolerance or other clinical signs. The dog lived in Ingolstadt, Germany, and was current on vaccinations and treated regularly with parasiticides. He had never travelled outside Germany. Physical examination revealed that the dog was active, alert, and responsive. The rectal temperature was 38.9°C (102.0°F), mucosal membranes were moist and pink, capillary refill time was <2 seconds, all lymph nodes were of normal size, and abdominal palpation was unremarkable. Lung sounds were physiologic, and the respiratory rate was 36 breaths/min. A left basal continuous heart murmur with an intensity of V/VI was audible. The regular heart rate was 128 bpm. Pulse quality was normal, without pulse deficit or evidence of jugular vein distension/pulsation. The remainder of the physical examination was unremarkable.'''
<br>
<FlashCard questions="2">
|q1= What is your interpretation of the physical examination, and what are the differential diagnoses for the described heart murmurs?
|a1= The main problem identified on physical examination was the new continuous heart murmur with point of maximal intensity over the left heart base. The previously documented left basal systolic murmur could result from pulmonic stenosis (PS) (infundibular, sub, supra, or valvular), aortic or subaortic stenosis (AS/SAS), tetralogy of Fallot, obstructive outflow disorders, or an atrial septal defect (ASD) leading to a relative pulmonic stenosis. Given the loud murmur intensity and the fact that it had been present for several years, an ASD was considered unlikely. The continuous left basal heart murmur could be due to a congenital persistent ductus arteriosus (PDA) or a coexisting systolic and diastolic murmur (e.g. AS/PS along with severe aortic or pulmonic insufficiency, respectively). As the continuous murmur was newly reported, an acquired cause was more likely than PDA.
|l1= Replace text with name and subsection of relevant WikiVet page if in existence eg. Feather - Anatomy & Physiology#Structure & Function
|q2= What further diagnostic procedure should be recommended?
|a2= Echocardiography should be performed to identify the cause of the heart murmur.
|l2= Replace text with name and subsection of relevant WikiVet page if in existence eg. Feather - Anatomy & Physiology#Structure & Function
</FlashCard>
To purchase the full text with your 20% off discount code, go to the [https://www.crcpress.com/9781482225150 CRC Press] Veterinary website.
[[Category:CRC Press flashcards]]
{{#tag:imagemap|Image:Next Question CRC Press.png{{!}}center{{!}}200px
rect 0 0 860 850 [[Canine Infectious Diseases: Self-Assessment Color Review, Q&A 13|Next question]]
desc none}}