Internal Medicine and Nursing
What the exam tests
Internal Medicine and Nursing covers chronic disease management, fluid therapy, endocrine monitoring, cardiac and respiratory nursing, and client education.
Core rules
- CKD: monitor hydration, renal values, phosphorus, potassium, blood pressure, and urine protein; support with fluids and renal diet.
- Diabetes mellitus: insulin type, dose, syringe matching (U-40 vs U-100), feeding schedule, and hypoglycemia signs.
- Hyperthyroidism in cats: monitor weight, heart rate, and thyroid values; treatment options include medication, diet, radioiodine, and surgery.
- CHF: monitor respiratory rate and effort, cough, and exercise tolerance; diuretics and oxygen support as prescribed.
- Fluid deficit (mL) = body weight (kg) × % dehydration × 1000.
Worked example
A 5 kg cat is estimated 5% dehydrated. Deficit = 5 × 0.05 × 1000 = 250 mL. Add maintenance and ongoing losses, then deliver the deficit over a planned period while reassessing perfusion and respiratory rate.
Traps
- Shaking insulin vigorously; roll instead, and never mix insulins unless instructed.
- Missing hypoglycemia after insulin; monitor behavior and glucose.
- Giving potassium IV bolus; always dilute and use a pump.
- Assuming a normal creatinine rules out early CKD; use SDMA and urine concentrating ability when available.
- Ignoring owner observations about appetite, thirst, and breathing.