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lam copy > Test 2 - Cough > Flashcards

Test 2 - Cough Flashcards

1
Q

The _______ is compromised of continuous waves of ciliary motion that start at the level of the bronchioles.

A

Mucociliary Escalator

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2
Q

The ______ removes secretions from the tracheobronchial tree proximal to the level of the segmented bronchi.

A

Cough Reflex

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3
Q

TRUE/FALSE:

Sneezing is an important and normal respiratory defense mechanism.
It is a sudden, forceful noisy expulsion of air through the glottis to clear particles & other material from the tracheobronchial tree and glottis.

A

FALSE

We’re on the cough lecture…

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4
Q

The mucociliary escalator works at the level of the _______ while the cough reflex works at the level of the _________.

A

The mucociliary escalator works at the level of the bronchioles while the cough reflex works at the level of the tracheobronchial tree (proximal to the level of the segmented bronchi)

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5
Q

_________________ is a constant component of cough.

A

Bronchoconstriction is a constant component of cough.

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6
Q

List the nerves involved in the cough as an involuntary reflex.

A

Vagus n.

Glosopharyngeal

Trigeminal

Phrenic

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7
Q

TRUE/FALSE.

Things such as sloughing of the airway epithelium, intra/extramural pressure (ie tumor/fibrosis), and increased epithelial permeability (pulmonary edema) can stimulate cough.

A

TRUE

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8
Q

_______ & ______ are part of the mucucilliary clearance mechanism.

A

Pseudostratified ciliated columnar epithelium & Clara cells are part of the mucucilliary clearance mechanism.

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9
Q

___________ are located in terminal and respiratory bronchioles. Source of surfactant-like substance which aids in maintaining patency of airway. Metabolize airborne toxins.

A

Clara Cells are located in terminal and respiratory bronchioles. Source of surfactant-like substance which aids in maintaining patency of airway. Metabolize airborne toxins.

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10
Q

How long does airway epitheliuam take to heal?

A

about 7 weeks

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11
Q

Nasal discharge with a foul smell is indicative of a(n) _______ infection.

A

Anaerobic

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12
Q

Fill in the cause of these lungs sounds:

  • ________: ↑ lung sounds, crackles and wheezes
  • ________: ventral dull sound
  • ________: cardiac sound larger than normal b/c improves sound conduction
A
  • Pneumonia: ↑ lung sounds, crackles and wheezes
  • Pleuropneumonia: ventral dull sound
  • Pleural effusion: cardiac sound larger than normal b/c improves sound conduction
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13
Q

____________ is a symptom of peracute presentation of respiratory disease and has signs similar to colic.

A

Pleurodynia is a symptom of peracute presentation of respiratory disease and has signs similar to colic.

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14
Q

TRUE/FALSE:

Infectious causes of coughing present with no fever.

A

FALSE

Infectious - Fever always with horses.

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15
Q

________ is a major cause of respiratory disease in horses.
What are some other features about this disease?

A

Equine Influenza is a major cause of respiratory disease in horses.

  • Aerosolized respiratory secretions, >35 ft
  • Young - 3 y/o
  • Crowding, transport & stress
  • Destroy ciliated epithelium
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16
Q

A young horse about 2 y/o presents with conjunctivitis, lymphadenopathy, edema,
vasculitis, and polysynovitis. What is yur most likely diagnosis?

A

EHV-1 or 4

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17
Q

Identify the right EHV virus to the signs listed.

_______: respiratory & reproduction signs
______: respiratory & neurologic signs
_____: EMPF

A

EHV4: respiratory & reproduction signs
EHV1: respiratory & neurologic signs
EHV5: EMPF

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18
Q

______ causes respiratory disease, abortions, and foal pneumonia through close contact transmission. It has a long lasting immunity (both natural and vaccines).

What is the typical age of the horse affected by this disease?

A

Equine Viral Arteritis causes respiratory disease, abortions, and foal pneumonia through close contact transmission. It has a long lasting immunity (both natural and vaccines).

NOT AGE RELATED

19
Q

________ is associated with immunocompromised Arabian foals (SCID)

A

Equine Adenovirus associated with immunocompromised Arabian foals (SCID)

20
Q

_______ infectious are usually clinically inapparent but may present with pharyngitis, mild bronchitis, nasal discharge.

A

Equine Rhinovirus infectious are usually clinically inapparent but may present with pharyngitis, mild bronchitis, nasal discharge.

21
Q

________ is a commensal aerobic bacteria associated respiratory infections.

A

Streptococcus zooepidemicus is a commensal aerobic bacteria associated respiratory infections.

22
Q

List the parastes associated with lung disease.

A
  • Lung worms: Dictocaulus arnfieldi
  • Roundworms: parascaris equorum.
23
Q

_____ is the most common pathogen associated secondary fungal pneumonia.

A

Aspergillus is the most common pathogen associated secondary fungal pneumonia.

24
Q

____________ is a major contributor for bacterial pneumonia and pleuropneumonia

A

Physiologic stress is a major contributor for bacterial pneumonia and pleuropneumonia

25
Q

How do transportaiton and exercise contribute to the development of cough?

A
  • Transportation: Head elevated & secure (compromise mucocilliary clearance mechanism), dehydration (↓ secretions)
  • Exercise: high intensity exercise results in ↓ peripheral blood neutrophil function, oxidative burst of pulmonary alveolar macrophages, EIPH
26
Q

What kind of synthetic surfaces are associated with aspiration?

A

Synthetic surface → fibers, sand, rubber, coated with wax

27
Q

Stomach tube, choke, LH, dysphagia (neonatal encephalopathy, botulism, guttural pouch disease, strangles) are all causes of _______.

A

Aspiration.

28
Q

What are the affects of carboxyhemoglobin?

A

Carboxyhemoglobin: ↓ ability for O2 to be released at the tissue site leading to hypoxia

29
Q

What are the results of smoke inhalation? How can it be diagnosed?

A

Carboxyhemoglobin (diagnosis >10%)

Severe bronchoconstriction

Pseudomembranous cast

30
Q

What are the factors related to the development of cough during anesthesia?

A
  • Transtracheal Intubation: excessive cuff pressure → tracheal necrosis
  • Dorsal recumbency
  • Anesthetics cause depression of the respiratory defense mechanism
31
Q

What are the primary lung tumrs in the horse?

A

granular cell tumor, pulmonary chondrosarcoma

32
Q

A horse presents thin, with a dull attitude, tachypneic with increased respiratory effort. The presenting complaints are

Occasional Dry Cough, Exercise intolerance and Acute Respiratory Distress.

Initial Lab work shows:

↑ WBC count, ↑ fibrinogen, anemia, lymphopenia.

Radiographs show

a diffuse bronchointerstitial pattern with multiple coalescing circular nodules throughout the lung field.

What is the most likely diagnosis?

A

Equine Multinodular Pulmonary Fibrosis, most comomnly associated with EHV-5 Virus

33
Q

What are the proposed treatments for Equine Multinodular Pulmonary Fibrosis?

A

corticosteroids

NSAIDs

antibiotics, antivirals (acyclovir,valacyclovir),

bronchodilators, O2 supplementation,

antifibrotic agents -colchicine

immune modulators (IFN-y)

34
Q

What are the differentials for foal pneumonia in each of the following age groups?

1 Months

1-6 months

A

• <1 month: in utero or perinatally lung infection, meconium aspiration, aspiration
pneumonia, iatrogenic, surfactant inactivation, EVA, EHV-1, EHV-4.
• Adenovirus-combined immunodeficiency in Arabian foals
• 1-6 mos: S. zooepidemicus, R. equi, Respiratory viruses are often the 1° agents.

35
Q

What are the clinical findings asociated with foal pneumonia (Chem/CBC/Blood Gas)

A
  • CBC: Abnormal, nonspecific, reflects chronicity & severity of inflammatory process
  • Acute: hyperfibrinogenemia & neutropenia
  • Chronic: neutrophilia, anemia of chronic disease
  • Hyperbilirubinemia: anorexia
  • Azotemia: pre-renal or renal

Arterial blood gas: hypoxemia, hypercapnia, respiratory acidosis.

36
Q

What does U/S assess vs. Radiographs in foal pneumonia?

A

• U/S → pleura irregularities, limited deeper pulmonary parenchymal
• Rads: more efficient evaluating deeper parenchyma, evaluate the amount of lung consolidation, evaluates long
term progression

37
Q

What are complications of a TTW?

A

• Complications: cellulitis & chondritis

38
Q

TRUE/FALSE

When treating foal pneumonia, chronic pneumonias rarely require fluid therapy.

A

TRUE.

Fluid therapy should be used in the event of acute/hypovolemic patients.

39
Q

You perform a TTW in a foal with pneumonia and submit samples for cytology. Match the infectious agent with the appropriate treatment:

Agents:

  • S. Zooepidemicus
  • Rhodococcus Equi
  • Bacteroides fragilis (anaerobe)

Treatments (note: some may not be used, some may be combined)

  • Clarithromycin
  • TMS
  • Aminoglycosides
  • Rifampin
  • Penicillin
  • Metronidazole
  • Ceftiofur
    *
A
  • Penicillin: most common pathogen S. zooepidemicus
  • Ceftiofur: convenient in foals
  • Combination of TMS or aminoglycoside
  • Clarithromycin and Rifampin: Rhodococcus qui
  • Metronidazole: anaerobes (Bacteroides fragilis)
40
Q

What is the benefit of using aerosolized anti-microbials? Which are commonly used?

A
  • Reach 12 times higher concentration than iV administration with lower toxicity
  • Gentamicin & ceftiofur
41
Q

You treat your foal with an anti-microbial for its foal pneumonia. What else can you use?

A
  • Anti-inflammatory:
  • NSAIDs: phenylbutazone, flunixin meglumine
  • Corticosteroids: if unresponsive to antimicrobial and anti-inflammatory therapy
  • Bronchodilators: albuterol, clenbuterol
  • Palatable feed: green grass → monitor body weight
  • Stall rest
  • Immune modulators: IFN-y
  • Antivirals: acyclovir, valacyclovir
42
Q

TRUE/FALSE

When treating foal pneumonia, steroids should only be used if they are unresponsive to antimicrobial and anti-inflammatory therapy.

A

TRUE

43
Q

TRUE/FALSE

Abscessation, necrotic tissue and pleuropneumonia are all potential compllications of foal pneumonia.

A

TRUE

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