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Flashcards in CAL: airway inflammation Deck (17):
1

What do these images show?

Cytological Findings Mostly macrophages, occasional neutrophil Giant cell No intracellular bacteria Curshmann’s spiral Diagnosis Non septic lower airway inflammation (RAO)

2

Treatment - RAO

- Oral clenbutarol - Beclamethasone via MDI - (Oral prednisolone = could be used but inhaled steroids more appropriate)

3

Define MDI

metered-dose inhaler

4

Pros and cons of oral clenbutarol

PROS: - Bronchodilator - Increases mucociliary clearance - Stabilises mast cells - Improves airway secretions   CONS: - Variable absorption from GIT - Clinical efficacy variable at lower doses - Receptor down-regulation with prolonged use - Dose dependent side effects : tachycardia, sweating

5

Pros of oral prednisolone

Potent anti-inflammatory; decrease smooth muscle contraction and epithelial damage by inhibiting effects of inflammatory cells and the mediators they produce reduce mucus production.

6

Cons of oral prednisolonePros of oral prednisolone

Some improvement seen clinically after a few days, but takes a week for maximal clinical response. Side effects: immunosuppression, laminitis Variable absorption from GIT

7

Pros - beclamethasone via MDI

Use lower dose compared to systemic therapy, therefore lower risk of side effects, but still get high local concentration.

8

Cons - beclamethasone via MDI

May not provide therapeutic benefit for 24 to 72 hours Horse may not be co-operative to method of administration

9

What does sodium chromoglycate do?

Stabilises mast cells and reduces need for corticosteroid therapy

10

Cons - sodium chromoglycate

Only preventative, no role in therapy Need nebuliser to administer which is expensive, time consuming and horse may not cooperate Tend to cause horse to cough

11

What does this show?

Cytology: Increased amount of mucus Increased numbers of degenerate neutrophils Intracellular bacteria (gram positive chains of cocci) Interpretation: Septic airway inflammation

12

How should a septic airway inflammation (Step. zooepidemicus) be treated?

ABs that it is sensitive to (e.g. IM penicillin)

13

T/F: Ceftiofur is only licensed for IM administration in the horse

True

14

What does this show?

Cytology: Squamous epithelial cells with extracellular Simonsiella (only found in oropharynx) Interpretation: Oropharyngeal contamination --> repeat the sample!

15

What does this show?

Cytology: Predominantly macrophages, giant cells Interpretation: Resolving inflammation

16

What does this show?

- Cell types in tracheal wash: macrophages, eosinophils - Organism present in second picture Dictyocaulus arnfieldi larvae  - Interpretation: Lungworm infection – parasitic pneumonia

17

What drugs are very effective against lungworm in the horse?

Oral ivermectin Oral moxidectin Oral fenbendazole