DISCUSS IN DETAIL ALL OF THE PATHOPHYSIOLOGICAL PROCESSES THAT LEAD TO HYPOXAEMIA IN A PATIENT WITH TICK PARALYSIS.

DISCUSS IN DETAIL ALL OF THE PATHOPHYSIOLOGICAL PROCESSES THAT LEAD TO HYPOXAEMIA IN A PATIENT WITH TICK PARALYSIS.

Discuss in detail all of the pathophysiological processes that lead to hypoxaemia
in a patient with tick paralysis.

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1. Tick paralysis caused by Ixodes holocyclus is a condition that commonly leads to
respiratory compromise.
Answer all parts of this question:
a) Discuss in detail all of the pathophysiological processes that lead to hypoxaemia
in a patient with tick paralysis. Include in your answer how to determine which
of these processes are contributing to hypoxaemia in a patient with tick paralysis.
Write in full any equations that you would use. (25 marks)
b) ARDS (acute respiratory distress syndrome) may occur secondary to tick
paralysis. Discuss and describe the diagnosis and pathophysiology of ARDS in a
tick paralysis patient. (25 marks)
c) Compare and contrast the use of the following two (2) tidal volume settings in a
tick paralysis patient that has developed severe pneumonia: (10 marks)
i. 6 mL/kg
ii. 15 mL/kg
Section B starts over page
Veterinary Emergency Medicine and Critical Care Paper 1 Page 3 of 6
© 2015 The Australian and New Zealand College of Veterinary Scientists ABN 00 50 000894 208
Section B: Answer ALL five (5) short-answer questions
1. Answer all parts of this question:
a) Define central venous pressure (CVP). List the parameters that are estimated
using CVP. (3 marks)
b) Define venous return. Write an equation that shows the relationship between
venous return, CVP and right atrial pressure. (2 marks)
c) List the cardiovascular factors that have an effect on CVP (central venous
pressure) and describe their relationship to CVP. (10 marks)
d) Draw the pressure-volume loop for the left ventricle. Label the points where the
mitral and aortic valves open and close. Indicate what represents the stroke
volume on your curve. (6 marks)
e) In a fluid-filled hemodynamic monitoring system for direct arterial blood
pressure monitoring, abnormal waveforms may occur due to overdamping and
under-damping. Define damping and list three (3) causes of over-damping in a
fluid-filled hemodynamic monitoring system. (3 marks)
2. Answer both parts of this question:
a) Describe how mast cell degranulation leads to the clinical signs of anaphylaxis.
Include in you answer any key differences between dogs and cats. (14 marks)
b) Corticosteroids and antihistamines are commonly administered to treat
anaphylaxis. If a dog presents with signs of severe anaphylaxis after a bee sting
describe the decision making process on whether or not to administer
corticosteroids and/or antihistamines to the dog. Include in your answer
recommendations for dosing. (10 marks)
Continued over page
Veterinary Emergency Medicine and Critical Care Paper 1 Page 4 of 6
© 2015 The Australian and New Zealand College of Veterinary Scientists ABN 00 50 000894 208
3. Answer all parts of this question:
a) Describe the immunological mechanisms of red cell destruction that occur in
primary immune mediated haemolytic anaemia (IMHA). Include in your answer
the role of complement proteins and mechanisms whereby intravascular and
extravascular haemolysis occur. (14 marks)
b) For each of the following drugs, outline the mode of action when used for
treatment of IMHA: (4 marks)
i. azathioprine
ii. human immunoglobulin.
c) State, with brief justification, why you would or would not use each of the drugs
in 3 b) to treat a patient with IMHA. (6 marks)
4. Answer both parts of this question:
a) Discuss in detail the three (3) mechanisms by which fluid and solutes are
transported across the peritoneal membrane. In your answer explain how these
mechanisms are used in the process of peritoneal dialysis. (14 marks)
b) Explain the pathophysiology of dialysis disequilibrium. How can this condition
be prevented in a patient receiving haemodialysis? (10 marks)
5. Answer all parts of this question:
a) Discuss in detail the aetiology and pathophysiology of coagulopathy of trauma.
(20 marks)
b) Describe the mechanism of action of tranexamic acid. (2 marks)
c) Briefly state the findings of the CRASH 2 trial as published in the Lancet 2010.
(2 marks)

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