Exam 1 Flashcards
(216 cards)
1
Q
Does anorexia in adult animals result in significant hypoproteinemia?
A
No
2
Q
Mechanisms of decreased protein production
A
Hepatic failure
Inflammatory disease
Malnutrition (maldigestion,malabsorption)
3
Q
Mechanisms of protein loss
A
Renal (PLN)
Intestinal (PLE)
Third spacing
burns/wounds
4
Q
Common presenting complaints of patients with hypoproteinemia
A
Peripheral limb swelling
Abdominal distention
Coughing/dyspnea
Decreased appetite
Vomiting/diarrhea
None
5
Q
Causes of hypoglobulinemia
A
PLE
Blood loss
Failure of passive transfer
Combines immunodeficiency
6
Q
Which values on a chemistry panel are indicators of liver function?
A
Tbili Albumin Glucose Cholesterol BUN
7
Q
Medical concerns associated with hypoproteinemic animals
A
Fluid overload (decreased oncotic pressure, consider colloids or plasma)
Anesthesia (protein bound anesthetic agents)
Wound dehiscence
8
Q
Why are hypoproteinemic animals prone to thromboembolism?
A
Loss of protein also leads to loss of antithrombin
Consider giving clopidogrel
9
Q
Congenital causes of hypoproteinemia
A
Hepatic shunt
Failure of passive transfer
10
Q
Infectious causes of hypoproteinemia
A
Parasites
Viral
Fungal
11
Q
Inflammatory causes of hypoproteinemia
A
Inflammatory bowel disease
Lymphangectasia
Protein-losing enteropathy
12
Q
Metabolic causes of hypoproteinemia
A
Hepatic disease
Renal disease (PLN)
EPI
13
Q
Definition of heat stroke
A
Severe illness characterized by core temperatures of >104 F in humans and >105.8 F in dogs as well as CNS dysfunction
14
Q
Two classifications of heat stroke
A
Classic/non-exertional
Exertional
15
Q
Patient predisposing factors for heat stroke
A
Exercise Age Brachycephalic Obesity Hypothyroidism Laryngeal paralysis Cv disease CNS disease Prior heatstroke
16
Q
What are the protective mechanisms the body uses against heat illness?
A
Thermoregulation
Acclimatization
Acute phase response
Heat shock response proteins
17
Q
Heat dissipation mechanisms
A
Sensible response (conduction, convection, radiation)
Insensible response (evaporative cooling (panting))
18
Q
70% of total body heat loss in dogs and cats is due to which mechanisms?
A
Radiation and convection
19
Q
What is the insensible response to heat?
A
Evaporative cooling via panting
Activation of hypothalamic panting center causes mucosal vasodilation
Partial air system uses unidirectional air flow in through nose and out of mouth to maximize evaporative cooling and heat loss
Salivation further increases evaporative cooling
20
Q
Physiologic effects of increased body temp
A
Inc. sympathetic tone -> inc. HR and CO -> dec splanchnic circulation -> cutaneous vasodilation -> inc muscle blood supply -> inc cutaneous circulation -> heat loss via radiation, conduction, convection
Evaporative cooling via panting
21
Q
At what point does evaporative cooling fail?
A
Environmental temp > body temp
OR
Humidity > 80%
22
Q
How does dehydration affect heat dissipation?
A
Decreases evaporative heat loss because less water is available for respiratory system
Decreases heat dissipation through radiation and convection due to decreased blood flow to periphery
23
Q
What is acclimatization and how long does this process take in dogs?
A
Adaptive physiologic response to environment and climatic change
Partial acclimatization in 10-20 days
Full acclimatization in 60 days
24
Q
How does the body acclimatize to a higher environmental temperature? (7 things)
A
Increased ability to resist rhabdomyolysis
Body water conservation via aldosterone and ADH
Activation of RAAS
Salt conservation
Increased GFR
Plasma volume expansion
Enhanced CV performance (inc HR and CO)
25
What does the acute phase response work (heat stroke)?
Stimulation of anti-inflammatory acute phase proteins in liver
Inhibits production of reactive oxygen species
Inhibits release of proteolytic enzymes from activated leukocytes
Promotes wound healing and repair by stimulating endothelial cell adhesion, proliferation, and angiogenesis
26
What are heat shock proteins (HSP) and what do they do?
Protective proteins produced with cell stress (heat, ischemia, endotoxemia, oxidative/nitrosative stress)
Increase levels of HSPs allow a transient state of tolerance to otherwise lethal stage of heat stress allowing cells to survive
27
Reduced numbers of heat shock protein have been found with
Aging
Lack of acclimatization
Certain genetic polymorphisms
28
What are the physiologic effects of heat shock proteins?
Prevents protein breakdown and assists in refolding of denatures proteins into normal configuration
Prevents loss of epithelial barriers and prevents endotoxin leakage
Interferes with oxidative stress and blocks apoptotic cell signaling pathway
Prevents arterial hypotension to decrease cerebral ischemia and neural damage
Offer CV protection by regulating baroreceptor reflex response to abate hypotension and bradycardia
29
How does heat shock cause cardiovascular collapse?
Decreased central venous pressure and CO (circulatory shock)
Decreased plasma volume and hypoperfusion
Indirect myocyte injury
30
What effects can heat stroke have on the respiratory system?
Direct pulmonary epithelial damage
Increased pulmonary vasculature resistance
Can result in non-cardiogenic pulmonary edema, DIC, ARDS
31
What effect does heat stroke have on the kidneys?
Direct thermal injury
Indirect injury - hypoxia, microthombi
Rhabdomyolysis (nephrotoxic myoglobin)
32
What effects can heat stroke have on the brain?
Indirect injury due to edema, hemorrhage, infarcts
33
What effects does heat stroke have on GI system?
Hypovolemia and splanchnic pooling can cause microthrombi -> hypoxia and ischemia
Causes loss of GI integrity (ulceration and sloughing)
Results in bacterial translocation, sepsis, and endotoxemia
34
How does heat stroke affect the liver?
Decreased hepatic blood flow and thermally-altered hepatocyte function leads to decreased blood detoxification
Can cause centrilobular necrosis and cholestatic liver disease
35
How does heat stroke affect coagulation?
Direct:
Direct damage to vascular endothelium -> release of cytokines and inflammatory responses, adherence of leukocytes and platelets to damaged endothelium
Release of tissue factor (activating clotting cascade, producing uncontrolled systemic coagulation)
Depletion of coagulation factors and platelets
Reduced synthesis of coagulation factors from hepatocytes
Development of DIC
Indirect:
Hemoconcentration due to dehydration
36
Most consistent clinical signs of heat stroke
Panting
Dry, hyperemic MM
Tachycardia
Hyperdynamic femoral pulses
Ptyalism
Can by hyper, normo, or hypothermic!
37
Bloodwork findings with heatstroke
```
Nucleated RBCs
Thrombocytopenia
Prolonged PT/PTT
Inc ALP/ALT
Axotemia
Inc. muscle enzymes
Hypoglycemia
```
38
Treatment for heatstroke
Rapid cooling - whole body wetting with water combined with muscle massage and fans, IV fluids
Oxygen supplementation
CV support (control hypotension, arrhythmias)
management of secondary complications (shock, hypoglycemia, DIC, ARDS, renal failure)
39
When should you stop active cooling techniques in heat stroke patient?
103.5-104 F
40
Should you use alcohol to cool a patient with heat stroke?
No
Risk of fire if need to defibrillate
41
What are exogenous pyrogens?
Infectious agents
Immune complexes
Inflammation
Drugs (e.g. tetracyclines)
Do not directly cause an increase in body temp, but cause an increase in endogenous pyrogens
42
What are endogenous pyrogens?
IL-1, IL-6, TNF, INF
Bind to vascular endothelial cells within anterior hypothalamus ->
Cause PGE1 and PEG2 production ->
Alters the set temperature (thermostat) within the hypothalamus
43
3 most common causes of FUO
Infection
Immune-mediated disease
Neoplasia
44
What are the risks associated with therapeutic trials for patients with FUO?
Continued disease progression
Drug toxicity/side effects
Exacerbating underlying diseae
45
How to treat a fever?
Artificial cooling techniques
Fluid therapy
Antipyretic agents
46
When should you use anti-pyretic agents?
Fever > 106F
47
Which fungi are dimorphic?
Blastomyces
Histoplasma
Coccidiodes
Sporothrix
48
Which fungi have broad-based budding?
Blasto
| Histo
49
Even though Blastomyces is present in all soil, why don’t all animals contract this disease?
Soil organisms destroy blastomyces in the soil
50
What environmental conditions precede highest incidence periods of blastomyces infection?
Heavy rainfall
| Warm temperatures
51
How is blastomyces transmitted?
Inhalation
| Contamination of puncture wounds/open sores
52
Which dogs are prone to getting blastomyces?
Males > females
| Sporting dogs and hounds
53
Transformation from blastomyces conidia to yeast occurs where?
Lungs
54
What important virulence factors does blastomyces have?
BAD-1 (cell surface glycoprotein tht binds to host cell receptors on macrophages and allows fungus to evade host immune system)
Alpha-1,3-glucan
+/- melanin
55
Common clinical signs associated with blastomyces infection
Respiratory signs (cough, dyspnea, exercise intolerance)
Ocular disease (anterior uveitis, chorioretinitis, endophthalmitis, optic neuritits)
Skin disease (cutaneous/SQ nodules, draining tracts)
56
Definitive diagnosis of blastomyces infection is based on
Cytological, histopathologic, or culture demonstration of organism
57
Diagnostic tests for blastomyces?
Cytology
| ELISA Ag assay - may cross react with histoplasma
58
Thoracic rads are abnormal in what % of blastomyces cases?
85%
59
Treatment for blastomyces infection
Intraconazole
Fluconazole
Amphotericin B
Steroids
Treat for at least 60-90 days and continue 1-2 mo past resolution of clinical signs
60
Prognosis for blastomyces infection
~80% cured, 20% relapse
Prognosis poor if CNS involvement
61
Most common systemic mycoses in the cat
Cryptococcosis
62
Which fungus is narrow-budding?
Cryptococcus
63
Route of transmission of cryptococcus?
Inhalation
Hematogenous spread to extra-pulmonary sites
64
How does cryptococcus evade host immune system?
Polysaccharide capsule inhibits phagocytosis, plasma cell function, and leukocyte migration
65
Most common clinical signs seen with cryptococcosis in cats?
Sneezing and nasal discharge (50-8%)
Cutaneous/SQ masses (40-50%)
Ocular lesions (20-25%)
Non-specific signs (lethargy, anorexia)
CNS signs (20%) (blindness, depression, behavior changes, seizures)
66
Most common clinical signs of cryptococcosis in dogs?
Nasal signs
CNS (dull mentation, blindness, hypermetria, cranial nerve deficits)
Eyes
Skin nodules/draining lesions
Non-specific signs
67
How do you diagnose cryptococcosis?
Latex agglutination for Ag in serum, aqueous humor, or CSF
90-100% sensitive
Useful to monitor response to therapy
68
Treatment for cryptococcosis
Itraconazole
Fluconazole (in cats)
Amphotericin B (for systemic or refractory disease or those with ocular or CNS involvement)
Continue for at least 1-2 months past resolution of clinical signs and negative titers
Mean treatment time ~8.5 mo
69
Primary reservoir for histoplasma
Bat (guano and GI tract)
Decaying avian guano (esp. blackbird/starling roosts, chicken coops)
NOT found in fresh feces or shed feces of birds
70
Pathophysiology of histoplasma infection
Inhaled microconidia transform into yeast at body temperature
Yeast binds to CD-11 -18 integrins on alveolar macrophages and are phagocytized
Replicate within and destroy macrophages
Spread via hematogenous or lymphatics
*Most animals’ immune system is able to clear infection
71
Clinical signsof histoplasma infection in dogs
Anorexia/weight loss
Fever
Cough/dyspnea
Large bowel diarrhea
72
Diagnostic tests used to diagnose histoplasma infection
Cytology (rectal scrape, BAL)
ELISA Ag assay (urine)
73
Treatment for histoplasma infection
```
Itraconazole
Amphotericin B (cases with CNS involvement or disseminated disease)
```
Treat for 60-90 days or at least 1-2 mo past resolution of measurable signs
74
Prognosis of histoplasma infection
Excellent with only pulmonary involvement
Guarded to fair with dissemination
75
Which fungus has a sperule containing multiple endospores?
Coccidiodes
76
Which fungus prefers dry, warm climates and sandy soils at low elevation (Ca, NM, AZ, UT, NV)?
Coccidiodes
77
Infection of coccidiodes follows what type of environmental condition?
Moist conditions followed by a dry period, then soil disruption
78
Clinical signs of coccidiodes infection in dogs?
Cough, weakness, lethargy, anorexia, weightloss, fever
Lameness with painful, swollen bone lesions
Localized lymphadenopathy
Ocular lesions
Skin lesions
Diarrhea
79
Clinical sign of coccidiodes infection in cats?
Skin lesions
Fever
Anorexia
Weight loss
80
Diagnosis of coccidiodes
ANTIBODY serology (IgM detectable 2-5 wks, IgG detectable 8-12 wks)
Cytology, histopathology
Bony lesions - may be more proliferative than lytic
81
Treatment of coccidiodes
Treat for 6 months minimum
Itraconazole
Fluconazole (if CNS involvement)
Amphotericin B
Bony lesions -> amputation
Enophthalmitis -> enucleation
82
What organism causes nasal aspergillosis?
Aspergillus fumigatus
83
What organism causes disseminated aspergillosis?
Aspergillus terreus
84
Why are german shepherds more prone to aspergillosis than other breeds?
IgA deficiency
85
Most consistent clinical findings with disseminated aspergillosis?
Vertebral pain, paraparesis, paraplegia, lameness with swelling, draining tracts, kidney disease
Other non-specific signs
86
Diagnosis of aspergillosis
Serological test -aspergillus glactomannan antigen
Cytology/histopathology
PCR for *definitive diagnosis*
87
Treatment for systemic aspergillosis?
Posaconazole
Itraconazole
Amphotericin B
Static disease rather than cure more common, poor prognosis
88
Transmission of sporothrix
Usually cutaneous and SQQ inoculation of organism through puncture wound
Can follow inhalation
89
Clinical signs of sporothrix infection
Cats > dogs
Male cats > female cats
Cutaneous lesions on nose and nasal planum
Regional lymphadenopathy
90
Spread of which fungal disease is facilitated through contaminated claw/bite wounds and autoinoculation during grooming?
Sporothrix
91
Which fungus is cigar shaped with a double wall?
Sporothrix
92
Which fungus is round with a double wall?
Histoplasma
93
Treatment of sporothrix
Itraconazole
16-8 weeks
Supersaturated KI/NaI (old treatment) for 30 days beyond remission
94
Which fungus is potentially zoonotic?
Sporothrix
95
“Large, infrequently septate hyphae with non-parallel walls” describes which organisms?
Phythium and lagenidium
96
In what ways are oomycets not like fungus?
No chitin or ergosterol in cell wall
Diploid
Non-septate hyphae
97
Pathophysiology of pythiosis
Infective, motile flagellate zoospore attracted to damaged tissue
Encysts in damaged skin or GI mucosa
98
What are the two disease spectrums of lagenidium
Chronic nodular dermopathy
Fatal dermatologic and disseminated disease
99
Main body systems affected by pythium vs lagenidium
Pythuim: cutaneous and GI
Lagenidium: cutaneous and vascular/lymphatic
100
Diagnosis of pythium/lagenidium
PCR
101
Why is it important to diagnose the species when dealing with phythium/langenidium?
Need to know species to determine
Prognosis
Prediction of behavior
Treatment options
102
Treatment for pythium/lagenidium
Aggressive surgical resection
Combination antifungal therapy
Newer generation azoles
Caspofungin, mefenoxam (novel agents)
Hyperbaric therapy
Immunotherapy
Prognosis poor without resection,
103
What are basidiobolus and connidiobolus?
Zygomycetes (actual fungi) that can cause skin, nasopharynx, GI lesions and sometimes lower respiratory dz.
104
How do you treat basidiobolus and connidiobolus?
Aggressive surgical excision and anti-fungal medication
105
How do you diagnose basidiobolus and connidiobolus?
Culture
106
What is phaeohyphomycosis?
Cutaneous, SQ, cerebral or disseminated infections caused by cutaneous inoculation with pigmented ( diatiaceous) fungi containing melanin in their cell walls
107
What is hyalohyphomycosis?
Non-pigmented (hyaline or transparent) fungal infection in tissue that can cause systemic, disseminated disease
108
How do you diagnose phaeohyphomycosis/hyalohyphomycois?
Culture + PCR
109
How do you treat phaeohyphomycosis/hyalohyphomycois?
Phaeohyphomycosis: aggressive surgical resection, itraconazole/posaconazole for 3-6 mo after surgery
Hyalohyphomycois: challenging due to systemic disease, poor prognosis
110
Griseofulvin
Derived from penicillium
Disrupts mitosis
Used for dermatophytosis
Oral administration (give with fatty meal)
Side effects: GI, BM suppression, teratogenic
111
Amphotericin B
Derived from streptomyces
Binds sterols -> inc wall permeability
IV administration
NEPHROTOXIC
Acute toxicity - vomiting, myalgia, fever, anaphylaxis
Poor penetration of bones, brain, eyes
112
How can you reduce nephrotoxicity of amphotericin B?
Lipid binding
Cumulative dosing
Monitoring renal values before each treatment
Ensure hydration before administration
113
What fluid type should Amphotericin B be administered with when given IV? Sq?
IV: 5% dextrose, Give NaCl or LRS AFTER
SQ: Give in 2.5% dextrose + 4.5% NaCl
114
How does lipid bound amphotericin B work?
Taken up by macrophages and taken to site of inflammation
Achieves greatest concentrations in liver, spleen, and lung (spares kidneys)
Still need to monitor renal values!
115
Flucytosine
Fluorinated pyrimidine that inhibits DNA/RNA synthesis
Good oral absorption
Penetrates BBB/CSF, use in severe CNS disease
Nephrotoxic
Dogs -> drug eruption
Cats -> thrombocytopenia
116
Mechanism of action of azoles
Inhibits cytochrome p-450
FUNGISTATIC
NEED TO TREAT BEYOND CLINICAL SIGNS OF DZ
117
hY should you not use antacids concurrently with azoles?
Azoles need acid for absorption
118
Ketoconazole
Oral administration (fatty meal)
Poor penetration of brain and eye
Topical administration for candida and malassezia
Side effects: GI, hepatotoxicity, thrombocytopenia, cortisol suppression
119
How are azoles metabolized?
Liver
120
Itraconazole
Oral administration (capsules -> fatty food, liquid -> fasted)
IV administration
Does not penetrate CNS
Side effects: nausea, vomiting, inappetence, hepatotoxicity, cutaneous drug rxn
121
Which fungal diseases can itraconazole treat?
```
Histo
Blasto
Crypt
Coccidiodes
Asprgillus
Sporothrix
```
(Pretty much all of them)
122
Fluconazole
Good oral bioavailability
DOES penetrate brain, eye
Renal excretion
123
Which antifungal is the drug of choice for crypto?
Fluconazole
124
What fungal diseases can fluconazole treat?
Crypto
Candida
Blasto
Histo
125
Voriconazole
Good oral bioavailabilty
More potent than itraconazole, fluconazole
Expensive
126
Posaconazole
Itra analogue
Expensive
127
Which fungal disease can posaconazole treat?
```
Candida
Crypto
Systemic asper
Blasto
Histo
```
128
Main use of topical azoles (clotrimazole, enilconazole)?
Primary nasal aspergillus
129
Side effects of topical azoles
Irritation
Erythema
Airway obstruction
130
What is clotrimazole used for?
Nasal aspergillosis
Non-responsive candida cystitis
Renal pelvis infusions (renal aspergillosis)
131
Iodides as antifungal therapy
KI, NaI
Used for sporothrix
Not commonly used
132
Mechanism of action of terbinafine
Inhibits ergosterol synthesis
133
Terbinafine
Commpnly used for dermatophytosis
Good oral bioavailability
Renal excretion
Side effects: GI, hepatotoxicity, pancytopenia
134
Which drugs are chitin synthesis inhibitors?
Lufenuron
Nikkomycin
135
Which drug is a glucan inhibitor?
Caspofungin
*slow onset of action, expensive*
136
What is mefenoxam?
Agricultural fungicide
Inhibits RNA polymerase
Effective against plant pathogen oomycets
Has been used to tx pythium
137
What is the MIC?
Minimum inhibitory concentration
Lowest concentration of a drug that inhibits growth of the organism cultured
NOT the concentration that kills the organism
138
When do you consider anti-fungal sensitivity testing?
Systemic aspergillosis
Non-responsive infection
Minimal $$ constraints
139
Why is nasal discharge not noticed until underlying cause is fairly advanced?
Usually the animal will swallow the discharge, so seeing it come out the nose means that the capacity of the mucociliary clearance has been exceeded
140
Differentials for unilateral nasal discharge
Foreign bodies
Neoplasia
Tooth root abscess
Fungal rhinitis
141
Differentials for bilateral nasal discharge
Bacterial/viral infection
Allergic rhinitis
Fungal rhinitis
Advanced neoplasia
142
Differentials for epistaxis
```
Fungal disease
Neoplasia
Hypertension
Ricketsial disease
Thromocytopneia/pathia
Coagulopathy
Trauma
```
143
Are large populations of bacteria seen on nasal cytology concerning?
No, can be normal
144
Diagnostic test that is most likely to yield a specific diagnosis if there is primary nasal disease
Biopsy
145
Test that are recommended before performing nasal boipsy
```
Platelet count
PT/PTT
BMBT
BP
Crossmatch
```
146
How do you prevent penetrating the calvarium via cribiform plate during nasal biopsies?
Measure the distance between the nostril and the medial canthus of the eye with the biopsy instrument and do not advance past that
147
3 primary biopsy techniques used in nasal biopsy
Pinch biopsy
Core biopsy
Traumatic nasal flushing
148
Clinical signs of nasal tumors
Nasal discharge
Sneezing
Decreased airflow through nostril
Deformation of nasal bones, hard palate, or maxillary dental arcade
Non-specific signs such as weightloss and anorexia
149
Treatment of choice for benign nasal tumors? Malignant tumors?
Benign: surgical excision
Malignant: radiation, NSAIDs
150
Survival time for malignant nasal tumors treated with radiation?
6-12 months
151
Clinical signs of nasal polyp
Stertorous breathing
Nasal discharge
Upper airway obstruction
Signs of otitis externa/media/interna (horner’s, head tilt, nystagmus)
152
Primary pathogens in bacterial rhinitis
Bordetella bronchiseptica
| Mycoplasma spp
153
How can cardiac disease cause coughing?
1. Chamber enlargement putting pressure on airway
| 2. Congestion or pulmonary edema
154
T/F: fecal examination should be done on almost all patients presenting for chronic cough
True
155
Most common complication associated with pulmonary aspirates
Pneumothorax
156
Main use of bronchoscopy
Facilitate collection of samples from the lower respiratory tract
157
What should you do is your patient experiences transient hypoxemia after tracheal wash or BAL?
This is normal
Will respond to oxygen therapy, crackles are normally heard for several hours after and are not of concern if other respiratory parameters are WNL
158
Diseases that present with an acute cough
Canine infectious respiratory disease
Pneumonia
PTE
CHF
Non-cardiogenic pulmonary edema
159
How do you definitively diagnose canine infectious respiratory disease?
PCR
160
Best antibiotic choices for canine infections respiratory disease?
Doxy
TMS
Clavamox
161
When should you use antibiotics with aspiration pneumonitis?
No improvement after 2-3 days
Inflammatory leukogram getting worse
Fever develops
Animal has been on H2 blockers or PPIs
162
Causes of chronic cough
```
Collapsing trachea
Canine chronic bronchitis
Bronchiectasis
Primary ciliary dyskinesis
Parasites
Eosinophilic bronchopneumopathy
```
163
What radiographic view can you see intrathoracic tracheal collapse? Extrathoracic?
Intra: expiratory films
Extra: inspiratory films
164
Emergency management of a patient with tracheal collapse and in respiratory distress should include:
Oxygen
Anxiolytic
Anti-inflammatory (short-acting steroids)
Intubation or tracheostomy
165
Medical management of tracheal collapse includes:
```
Weight reduction
Minimize exercise
Replace collar with harness
Reduction of inhaled irritants
Anti-tussives
Lomotil
Glucocorticoids
Bronchodilators
```
166
When should surgery be considered for a patient with tracheal collapse?
Only in cases where medical management has failed and owners are prepared to accept negative outcomes
167
Most common clinical sign of canine chronic bronchitis
A dry cough exacerbated by excitement and exercise
168
Treatment for chronic canine bronchitis includes:
Glucocorticoids
Bronchodilators (B agonists or methylxanthines)
Antibiotics
Cough suppressants
169
What is bronchiectasis?
Permanent dilation of the bronchi and is commonly a complication of chronic respiratory disease such as chronic bronchitis
170
What is primary ciliary dyskinesis?
Congenital defects in the ciliary microtubule structure, resulting in reduced clearance of respiratory secretions, inhaled particles, and infectious agents.
Dogs < 2 yrs, English Pointers and Springer Spaniels
Usually also infertile because cilia on sperm and fallopian tubes are abnormal
Diagnosed with electron microscopy
171
What is eosinophilic bronchopneumopathy?
Used to describe a variety of conditions which share the central feature of eosinophilic infiltration of lung and bronchial mucosa
Cause is usually not identified
172
Treatment for eosinophilic bronchopneumopathy?
Steriods
173
5 mechanisms by which hypoxemia occurs
1. Decreased inspired O2
2. Hypoventilation
3. Diffusion abnormalities
4. Anatomic shunts
5. V/Q mismatch
174
Clinical signs of laryngeal paralysis
Stridor
Bark change
Cyanosis
Syncope
175
Treatment for laryngeal paralysis
Oxygen
Anxiolytic
Anti-inflammatory
Intubation/tracheostomy
Surgery
176
Components of brachycephalic airway syndrome
Elongated soft palate
Stenotic nares
Everted laryngeal saccules and laryngeal collapse
Hypoplastic trachea
177
Diagnosis of laryngeal collapse
Laryngoscopy
178
Surgery can help with which components of brachycephalic airway syndrome?
Elongated soft palate
Stenotic nares
Everted laryngeal saccules
179
Primary diseases that have been associated with PTE
```
Hyperadrenocorticism
Hypothyroidism
PLN
IMHA
HW disease
Sepsis
DIC
Pancreatitis
Neoplasia
```
180
Clinical signs of PTE
Sudden onset of dyspnea in an animal previously not know to have respiratory disease
Acute dyspnea, tachypnea, depression
181
Diagnosis of PTE
Angiograpahy
Scintigraphy
CT/MRI angiography
182
Treatment of PTE
Anticoagulants (heparin, warfarin)
183
What should you know about the use of heparin for treatment of PTE?
Heparin prevents the deposition of fibrin and platelets on the thrombus surface.
For heparin to be effective, adequate concentrations of antithrombin III must be present in the plasma.
High variation between patients.
184
How do you monitor effects of heparin in treatment for PTE?
Activated partial thromboplastin time
185
What is the prognosis for PTE?
Poor
Usually associated with underlying disease
186
Physical exam findings with feline asthma
1. Increased expiratory effort
2. Increased expiratory time
3. Expiratory wheeze
4. Crackles (+/-)
187
Treatment for feline asthma
Long-term corticosteroids
| Bronchodilators
188
Causes of non-cardiogenic pulmonary edema
```
Neurogenic causes
Electrocution
Upper airway obstruction
Vasculitis
ARDS
Allergic reactions
Inhalation of toxins
```
189
How does near drowning result in severe pulmonary damage?
Aspiration pneumonia
Water dilution of pulmonary surfactant leading to alveolar collapse and reduced compliance
190
Clinical signs associated with smoke inhalation
Carboxyhemoglobinemia
Tissue hypoxia
Thermal injury to airways (inflammation, edema)
Direct toxic effects with certain chemicals
Suppression of pulmonary mucociliary and macrophage mechanism
DIC
191
How much fluid does it take for clinical signs of pleural effusion to become apparent?
60 ml/kg
192
Reasons for negative tap (thoracocentesis)
No fluid present
Fluid in walled off pocket or on contralateral side of chest
Very thick fluid
Fluid more ventral or deeper than needle
193
What are transudates?
Fluids with low protein (< 2.5 - 3 g/dL) and low nucleated cell counts (<500 - 1000/ ul)
194
What are modified transudates?
Fluids with protein concentrations up to 3.5 g/dl and cell counts up to 5000/ul
195
What starling forces result in transudates or modified transudates?
Increased hydrostatic pressure
Decreased oncotic pressure
Increased vascular permeability
196
What are exudates?
Fluids with protein > 3 g/dl and cell count >5000/ul
197
Differentials for non-septic exudate pleural effusion
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FIP
Neoplasia
Lung lobe torsion
Chronic diaphragmatic hernia
Resolving septic exudate
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198
Differentials for septic exudate pleural effusion
Idiopathic
Penetrating wounds
Migrating grass foreign body
Extension of bacterial pneumonia
199
Treatment for pyothorax
Antibiotics(IV ampicillin, enrofloxacin initially, then orals)
Chest tubes
+/- lavage
200
Comparing what component of pleural fluid and serum can help identify chyle?
Triglycerides
201
Common causes of chylothorax
Most are idiopathic
Trauma
Cardiac disease
HW
Lung lobe torsion
Diaphragmatic hernia
202
Treatment for chylothorax
Medical treatment - low fat diet, rutin, intermittent chest taps
Surgery
203
Differentials for hemothorax
Trauma
Systemic bleeding disorders
Neoplasia
Lung lobe torsion
204
What is the only neoplasia that readily exfoliates into effusions?
Lymphoma
205
What is a tension pneumothorax?
One-way valve is formed by the tissue at the site of the leak, allowing air to move into pleural space during inspiration but prevents it from moving out during expiration
206
Most common cause of pneumomediastinum?
Rupture of airways
207
How is pneumomediastinum diagnosed radiographically?
When you are able to see
1. Dorsal and ventral tracheal walls
2. Cranial branch of aorta
3. Longissimus dorsi muscle
208
Treatment of pneumomediastinum?
Strict cage rest
Bronchoscopy to locate lesion
Surgery (esophageal laceration)
209
How can mediastinal masses cause respiratory distress?
Displacing lung tissue and decreasing lung volume
Displacing tracheal lumen
Causing pleural effusion
210
CT finding most consistent with nasal aspergillosis?
Loss of turbinate density
211
Diseases that would benefit from cough suppressants
Collapsing trachea
Chronic allergic or sterile bronchitis
Neoplasia
212
What causes crackles?
Fluid in the small airways/alveoli
Opening or collapse of small airways/alveoli
Parenchymal fibrosis
213
What does an end-expiratory grunt indicate?
Air trapping and/or obstruction of lower airways
214
Disease that cause inspiratory distress?
Laryngeal paralysis
Tracheal collapse
Brachycephalic airway syndrome
Pleural space disease
215
Diseases that cause expiratory distress?
Asthma
Pneumonia
CHF
PTE
216
Parasitic rhinitis can be cause by which organisms?
Pneumonyssoides caninum
Cuterebra
