diagnostic approach to respiratory disease

Question 1

symptoms of respiratory disease

Answer 1

dyspnea

tachypnea

orthopnea

abnormal mucous membrane color

cough

abnormal lung sounds

Question 2

patterns of breathing

Answer 2

obstructive pattern: inspiratory (upper airway, increased inspiratory effort, tachypnea) and expiratory (lower airway, expiratory effort, +/- tachypnea)

restrictive pattern

mixed

Question 3

signs of respiratory disease secondary causes

Answer 3

cardiac disease

hematologic disease

metabolic disease

neurologic disease

Question 4

definition of cough

Answer 4

sudden expiratory effort performed to expel debris or secretions from the tracheobronchial tree

indication of tracheobronchial mucosal irritation

Question 5

stimulation of cough

Answer 5

cough receptors sense touch and pressure located in trachea, mainstem bronchi

irritant receptors sense smoke, dust, chemicals located in larynx, trachea and major bronchi

Question 6

localization of cough

Answer 6

cardiogenic: left atrial enlargement leading to main steam bronchi compression, CHF, HW disease

noncardiogenic (respiratory) cough

Question 7

historical character of the cough

Answer 7

duration-acute vs chronic

timing- night vs day

stimulant of cough (ie excitement, pulling on collar-trachea, drinking/eating-laryngeal, pharyngeal, aggravated by exercise-pneumonia, bronchitis, bronchiectasis)

nature of cough (moist vs dry, productive vs nonproductive)

description: moist, dry, goose honk, wheezing, rattling, terminal retch

Question 8

Clues to dx: sound-moist cough

Answer 8

moist cough: edema, pneumonia, parasitic, allergic

Question 9

Clues to dx: sound

dry cough

Answer 9

early cardiac, bronchitis, tracheitis, diffuse pulmonary

Question 10

Clue to dx: sound

goose honk

Answer 10

trachea, bronchial collapse

Question 11

clues to dx: sound

wheezing

Answer 11

asthma, bronchitis

Question 12

Clues to dx: sound

terminal retch

Answer 12

cardiac, tracheal, bronchial

Question 13

you see a dog with 3 day history of a dry, hacking cough that worsens with excitement. This cough is typical for:

Answer 13

Tracheal disease

Question 14

PE findings

Answer 14

mucous membrane color

respiratory rate

respiratory effort

ability to elicit a cough (palpate trachea)

thoracic auscultation: normal, bronchovesicular sounds, crackles, wheezes

Question 15

diagnostic work up

Answer 15

thoracic rads-most helpful

possible flouroscopy

CBC, Chem, UA, blood gas as needed

transtracheal/endotracheal wash

bronchoscopy/BAL

cardiac evaluation (EKG, NT-proBNP, echo)

CT scan