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Flashcards in Coughing Deck (39)
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1

T or F: Although the cough receptors are located primarily in the upper resp tract and large airways, they can be triggered even when the primary disease is distant from these sites

True; due to the movement of respiratory secretions or external secretion

2

What are some differentials for acute coughing?

Viral/bacterial infection, airway FB, CHF, aspiration pneumonia

3

What are some differentials for chronic coughing?

Chronic bronchitis - allergic bronchitis, collapsing airways, L atrial enlargement, fungal pneumonia

4

What are some medications ghat can cause coughing?

ACE inhibitors and KBr

5

What is a primary goal of your physical exam for a coughing patient?

To differentiate between cardiac and respiratory causes

6

What are the two ways cardiac disease can cause coughing?

Chamber enlargement putting pressure (expect murmur) on an airway or congestion or pulmonary edema building up in the airways

7

What are the most prominent parasites affecting the respiratory system of dogs and cats?

Filaroides osleri (D), Eucoleus aerophilus (D + C), Paragonimus kellicotti (D + C), Dirofilaria immitis (D + C)

8

What ancillary blood tests should be performed on dogs and cats presenting with chronic coughing?

Heartworm antigen +/- antibody (cats), FeLV and FIV

9

What specific radiographic views are needed to help in diagnosing heartworm disease? How about collapsing airways?

DV (accentuates pulm vessels); inspiratory and expiratory right laterals

10

Transthoracic aspirates are useful in patients with what?

Solitary lung masses, diffuse pulmonary disease, and pneumonia

11

How do you determine where you will be taking your transthoracic aspirate?

For solitary masses - use location based off 2 orthogonal rads; for diffuse disease, caudal lung lobes (b/t 7-9th ribs) 2/3 distance from costochondral junction to spine

12

T or F: TTW and ET washes both require general anesthesia

False, only ET washes do

13

What is one of the most important benefits of bronchoscopy?

It can be used to facilitate the collection of samples from the lower resp tract

14

What are the indications for bronchoalveolar lavage?

Evaluation of diseases affecting the small airways and alveoli (+/- interstitium)

15

What is a common adverse effect following any technique used for tracheal washes or BALs?

Transient hypoxemia - readily responsive to O2 therapy

16

Endotracheal washes and BALs are useful in what animals?

Cats and small dogs

17

What type of cells should predominate in a cytology of wash or BAL fluid?

Large mononuclear cells (I.e. macrophages)

18

When should anaerobes be considered for wash/BAL fluid cultures?

In cases of aspiration pneumonia or pulmonary abscesses

19

What the heck is whole body plethysmography?

A chamber where awake patients are placed that detects volumes of air displaced as they breathe

20

What are the clinical signs of CIRD (aka Kennel Cough)?

Severe sudden onset of cough (productive or non productive), gagging, retching, nasal d/c, recent history of exposure to high dog volume, often NO signs of systemic illness

21

Which drugs should be restrictively used in CIRD treatment?

Cough suppressants (only in non-productive coughs) and antibiotics (only if secondary bacteria pneumonia/infection - doxy, TMS or Clavamox)

22

What is the clinical presentation of bacterial pneumonia?

more common in dogs, route of infection either inhalation or hematogenous, typically nonspecific signs including coughing, dyspnea, or nasal d/c +/- fever, cyanosis, or crackles

23

How do you diagnose bacterial pneumonia?

Interstitial to alveolar pattern on rads, Hematology - inflamm leukogram, TTW, bronchoscopy, BAL, pulm aspirate

24

What is the treatment protocol for bacterial pneumonia and what’s the prognosis?

Antibiotics (based on C+S, ampicillin, cefazolin, TMS, aminoglycoside), hydration, nebulation and coupage, ANTITUSSIVES CONTRAINDICATED; treat for at least 1 week past resolution of CS; Px is generally good

25

What disease is viral pneumonia typically associated with?

Canine distemper virus

26

How do you diagnose fungal pneumonia?

Diffuse miliary interstitial pattern and hilar lymphadenopathy on rads, TTW, bronchoscopy, BAL, pulm aspirate - pyogranulomatous/eosinophilic inflamm, organisms within macrophages

27

How do you treat fungal pneumonia?

Itra/Fluc/Ketoconazole (Ampoteracin B in life threatening cases), O2 therapy, corticosteroids?; treat for at least 3 MONTHS beyond resolution of CS; Px is fair to guarded

28

How do you diagnose aspiration pneumonia?

Alveolar pattern in right middle lung lobe (or dependent lung lobe) +/- megaesophagus on rads, TTA - sterile inflammation initially w/ eventual 2ndary bacterial infection

29

How do you treat aspiration pneumonia and what’s the prognosis?

Symptomatic care (O2, nebulization and coupage) +/- abx if no improvement after 2-3d, inflamm leukogram gets worse, fever or if on H2 blockers/PPI; can be fatal

30

Where anatomically does collapsing trachea most commonly occur?

At the thoracic inlet

31

What does the term canine chronic bronchitis refer to?

Long-term airway inflammation with some irreversible damage

32

How do you diagnose canine chronic bronchitis?

Prominent bronchial/peri-bronchial infiltrates and some interstitial infiltrates, bronchiectasis and right sided cardiomegaly (advanced cases) all on rads; TTW - nonspecific inflammation w/ goblet cell hyperplasia and squamous metaplasia; bronchoscopy - excess mucus secretion, mucus membrane unusually friable

33

What is important to stress to owners of patients with chronic canine bronchitis?

That because the damage to most of the airways is irreversible, treatment is aimed at relieving clinical signs, NOT a cure

34

What diseases that cause coughing are the only ones where corticosteroids are the mainstay of therapy?

Canine chronic bronchitis and eosinophilic bronchopneumopathy

35

What are the multiple drugs used in treating canine chronic bronchitis?

corticosteroids, bronchodilators (b agonists or methylxanthines), cough suppressants (only in non-productive coughs), +/- antibiotics (based on C+S), anticholinergics and inhaled steroids/b-agonists

36

What is bronchiectasis?

The permanent dilation of bronchi - typically complication of chronic resp disease such as chronic bronchitis

37

Describe the clinical presentation of eosinophilic bronchopneumopathy

Dogs typically young adults (4-6yrs) with interval b/t disease onset and diagnosis varying between 3 wks to 6 yrs; harsh, sonorous cough, persistent, followed by gagging/retching +/- crackles, wheezes and increased lung sounds

38

How do you diagnose EBP?

Mild to marked eosinophilia on CBC, chest rads may show mod to severe bronchinterstitial pattern and thickening of bronchial walls, yellow/green airway secretions, thickening of mucosa, airway hyperemia, exaggerated concentric airway closure upon expiration, incr eos/neut % on BAL

39

What disease should be considered in any young patient with recurrent respiratory secretions?

Primary ciliary dyskinesia