Exam 2 Flashcards
(105 cards)
1
Q
3 types of lung patterns
A
Alveolar
Interstitial
Brochiolar
2
Q
Lung patterns : Pulmonary edema vs pneumonia for alveolar pattern
A
Pulmonary edema is caudodprsal
Puemonia is cranioventral
3
Q
Pleural effusion looks like
A
Opaque between the wall and lung
Fissure lines=fluid bw lung lobes
The lung is retracted from the chest wall = atelectasis
Border is effaced between pleural fluid and heart
4
Q
Fat vs pleural fluid which has the same opacity as the heart and which is less
A
Fat is less opaque
Fluid = same as heart
5
Q
Can a lung nodule or cranial mediastinal mass cause a pleural effusion
A
YES can be caused by:
Right sided cardio megaly
- Pericardial effusion
Rib lesion [ie. Chondrosarcoma]
Diaphragmatic hernia that’s chronic
Lung nodule
Cranial mediastinal mass
6
Q
Which framework is better to see the heart VD or DV?
A
VD
Very duh
7
Q
What is the most common mass in mediastinum in cats
A
Lymphoma-> can cause pleural effusion
- moves the trachea dorsally unlike what JUST fluid would do
8
Q
If you see R sided CHF Dog vs cat:
Pericardial effusion or pleural effusion first
A
In dog the pericardial comes first in R sided CHF
In cat….
9
Q
Which virus stays in the upper respiratory tract of cats vs goes into the oral mucosa
A
Herpesvirus- URT [cause some keratitis]
Calicivirus - oral mucosa
10
Q
Equine viral arteritis is reportable or no?
A
Reportable as fuck -
- gonna depopulate
11
Q
What parts of respiratory tract have normal flora
A
Above the larynx there is mix of gram +/-
Sterile caudal to the larynx including the trachea [ there may be transient ]
12
Q
Big particles [do or do not] reach the lower airways
A
Big thing get stuck in the mucosa and they dont go to the LRT
Repairable particles[like bacteria and ALL viruses- smaller things]
- can follow airflow and get deep into lungs
13
Q
Stangles can lead to
A
Puparia hemorrhagica= type 2 hypersensitivity
Bastard strangles
TX via draining abscess
14
Q
Loss of nasal turbinates of pigs happens in this bacterial disease
A
Young pigs = 3-5 weeks
Bordetella bronchoceptica first which damage of nasal mucosa
THEN Pasteurella multocida type D have a dermonecrotic toxin
Atrophied rhinitis
15
Q
Bacteria: Dog cough/retching on tracheal palpation - with some mucus
A
Canine infectious respiratory disease- kennel cough
16
Q
____are two of the most important contagious diseases in their respective hosts (horse and dog)!
A
Strangles and Canine Infectious Respiratory Disease
17
Q
What causes tuberculosis in humans?
A
Mycobacterium
- not NF and persistent in environment
PPL have pulmonary infections and cervical lymphadenopathy
18
Q
Characteristics of a precision vaporizer
A
U Concentration calibrated or variable bypass
u Flow-over with wick
u Temperature compensated u VOC
u High resistance
u Agent specific
19
Q
Isoflurane and sevoflurane -blood/gas partition coefficient
And minimum alveolar concentration
A
blood/gas partition coefficient
Iso 1.46 (all species)
Sevo 0.58
And minimum alveolar concentration (potency)
ISO 1.4
Sero 2.4
Isoflorance is most potent
20
Q
Vessel rich group
Uptake
A
Brain liver kidney
Uptake- when drug taken by not target organ
21
Q
_Is synonymous with solubility
A
Blood/gas coefficient
22
Q
The minimum alveolar concentration of an anesthetic
A
at 1 atm that produced immobility in 50% of subjects exposed to a supramaximal noxious stimulus
- good know because we can measure alveolar concentration aka the potency with end tidal concentration
23
Q
If inhalant MAC>1 =__ICP
A
Increase ICP - to increase cerebral perfusion pressure and increase the metabolic rate
- the pressure increases and the flow increases in the brain but not in the rest of the brain
Avoid inhalant anesthesia in brain neoplasia patient
24
Q
Is MAC BAR, analgesia?
A
NO patient can feel pain cannot response with severe CNS depression with isoflourane
25
Skeletal muscle effects on the inhalant anesthesia
+ malignant hyperthermia tx
Dose- dependent muscle relaxation = really bad for horses though
**Malignant hyperthermia **
- increase in end-tidal CO2 [>70mmHG] - EARLY DIAGNOSIS
- THEN muscle rigidity and rapid increase in temperature
Treat : **dantrolene IV =muscle relaxant**
26
Causes of the mediastinal shift
When the lung is moved from its normal position
After lateral recumbency- recumbent atelectasis
If occluded - then the lung on the distla/downstream end will collapse [rock]
Increase in the size of the contra lateral lung
27
Rad: Mediastinum is thicker
Dorsally than ventrally
28
Air in the mediastinum can occur because of
Trachea or esophagus lasceratuiob
Soft tissue injury
29
T/f: Pulmonary disease will increase lung opacy
True ~ lung pattern
30
What pattern on radiograph of lung is infectious pattern
Cravioventral lung pattern
31
Why is a dilated bronchi an important finding?
**Bronchiectasis **
Dilated bronchi indicates a irreversible airway disease
This is important in clinical practice, because these animals will be prone to repeated airway infection
The mucociliary escalator will have a hard time clearing these particles
32
Which radiographic view is best to visualize the following
Plural effusion
Pneumothorax
Heart
2crus of diaphragm
Plural effusion - vd/dv
Pneumothorax- lateral/dv
Heart -VD
2crus of diaphragm- VD
33
Pericardial -diaphragmatic hernia with small intestine in the pericardial sac
During.embryogenesis there is displacement of the abdominal viscera in the pericardial space -NOT pleural space
34
Virus pathology: epitheliotropic virus versus endotheliotropic virus, clinical signs
Epitheliotropic-affects the epithelial cells in the mucosa so there’s gonna be coughing and ulceration
Endotheliotropic- affects vessels, so there’s gonna be hemorrhaging and edema
35
2 ways that bacteria gets to the CV system
Direct inoculation into blood
Spread from initial site of infection: ie if the animal had a nidus of infection elsewhere where the bacteria proliferated
36
What is infectious valvular endocarditis
Proliferating vegetative lesion in the valves
• probably had transient bacteremia then there was a problem/injury with the heart that allows this infections valvular endocarditis
• valvular infection in heart and can lead to thrombi and continuous seeding
A lot of different bacteria can cause
37
Hemolytic anemia in spleen of cow on blood smear
Long term tx with what
Happens in older animals
Can only see the bacteria on smear if acute infection —> do Pcr
Oxytetracycline
38
Can you get Rocky Mountain spotted fever from your German shepherd?
No it dont pass over
39
Which is maintained in wildlife vs in the dogs, where do they replicate?Diagnosis ; Erlichia canis, RMSF
RMSF - wildlife; endothelium
- serology and PCR
Erilichia canis -reservoir is other dogs ; monocytes
- morula in blood smear
- serology and PCR [acute]
40
Erlichia canis has 2 stages
Acute -most recover well
Persistent infection- Look totally normal and they can still have chronic disease
Chronic - flare up up to months or years [cant detect with PCR] if not then 4DX
41
Feline hemotropic mycoplasmosis
Epi cellular- via tick or placental in utero
Target cell = erythrocyte
42
Bartonellosis aka cat scratch fever
43
T/F Antitussives are for coughs
False - it is a symptomatic treatment
Try to treat primary disease
44
Common virus isolated from the kennel cough [aka infectious tracheobronchitis]
Canine parainfluenza 2
- infection of the larynx that results in edema of the vocal folds —>honking cough
- upper respiratory ;aerosol transmission
Adenovirus 2 : also cause vasculitis
45
The most economically significant reproductive and respiratory virus of pigs
With the **highest mutation rate**
**Porcine reproductive and respiratory syndrome virus [PRRSV]**
Causes pneumonia :
downregulates immune response in macrophages and it weakens the response
Porartevirus
46
Ovine Progressive pneumonia is a sign of which virus
In the ovine lentivirus there is **progressive pneumonia** and there is **encephalitis**
Horizontal transmission via aerosol/ingesting is common
Vertical is possible too
**enlarged lung**
47
Which is better breathing system for small animals?
**Non rebreathing** better for mall animals because less resistance to overcome
More radius
<7kg animals
48
Which is lower the flow rate of a rebreathing, or non-rebreathing system?
A rebreathing system
-@induction or recovery its 40-60 ML/kg/min
-@ maintenance its 10-40 Ml/kg/min
Non-rebreathing will be 100-150 ml/kg/min
49
Is the hole to the dead space or is it just the Y piece?
Y piece is dead space
Mechanical dead space: The space from the Y piece to the endotracheal tube!! The length of the hose is NOT mechanical dead space : so if the endotracheal tube is longer then that is mechanical dead space
~ cause hypoventilation if increased dead space
Not affected by the length of the tubes
50
Scavenging system to avoid environ contamination canbe...
2 types
• active system : a vacuum that is the purple hose and scavenger gases outside the wall
• Passive system: charcoal canister the charcoal is a absorber for inhalants or into open area —> **not for large animals**
51
Unilateral nasal d/c and no fever, lungs auscultation normal
URT or LRT?
URT
52
Define partial pressure
The pressure exerted by a single gas in a mixture
53
Low blood/gas → less soluble in blood
What does this mean for uptake and recovery?
Low blood gas is proportional to love solubility, which means that Lesley is being dissolved in blood, and can be taken up into fat
**This means less uptake and better recovery
And a faster induction **
54
Horse retropharyngeal and submandibular lymph nodes are swollen and limb edema with this infection with tracheal sounds matching the thorax sounds
Influenza primarily
Usually tracheal louder than thorax
55
High neutrophils, low lymphocytes and high monocytes are an example of what leukogram
Stress leukogram
neutrophilia, lymphopenia, monocytosis, eosinopenia
56
What is exercise induced pulmonary hemorrhage
It happens in race horses where the capillary pressure is wayyy greater than the alveoli pressure so the capillary bed ruptures and horses bleed through their nos e
57
T/F Strep equi spp equi is:
Not normal flora
Contagious amongst horses
Causes lymph node abscesses [not lung abscesses like R.equi]
T/F Strep equi spp equi is:
Not normal flora
- it is in carriers
Contagious amongst horses
- yes
Causes lymph node abscesses [not lung abscesses like R.equi]
-yes
-lymph nodes enlarged
Treatment:
Drain abscess
*no antibiotics unless fever*
58
Which diagnostic is indicated for a lower respiratory tract infection in horses?
Transtracheal wash @cranioventral lung
NOT bronchoalveolar lavage- too low
59
Defenses of the cardiovascular system from infection
Innate: macrophages in spleen and liver + neutrophils + lymphoid [b and t cells]
60
Transient bacteremia is cleared in
30 minutes **this ability to fight off transient bacteremia is based on predisposing risk factors**
Can happen bc of acute or chronic conditions
61
Risk factors to bacteremia
And most common causative agent
Immunodeficiency: **neonates** with FPT [common] or adults with chemotherapy/ surgery/ organ failure
Iatrogenic : dental or endoscopic procedures or catheter
Nidus of infection - the origin of the infection is in the body already and then there is more bacteria
**Primary infections - mainly viral!!!**
**most common causative agent: gram negative rods**
62
Reticulopericarditis
- 2NDARY TO GLASSERS DZ
-TRAUMA
Bacteria is tracked in via systemic infection
OR
The trauma of a nail damages the mucosa
63
Gram + rod the form spores
Clostridia and bacillus
64
The BRDC happens most common in these phases
Beef cattle : BRDC @ Early feedlot phase and Early stocker phase
Dairy cattle is **post weaned** [taken away from mom immediately and then given milk replacer]
65
WHAT CAN YOU NEVER USE TO TREAT MYCOPLASMA?
Beta lactams bc they have no cell wall
- no penicillin
- no excede
- no ceftiofur
66
What is the #1 reason a horse gets sick?
Transportation stress
67
4 primary respiratory defense mechanisms
Particle deposition in turbinates
Mucociliary escalator
Alveolar macrophages in LRT
Immune response and inflammation
68
Most common cause of atelectasis
Acquired
Obstruction via mucus or exudate that obstructing the bronchioles
-everything downstream will collapse in cow and pig
- lobar alveolar don't communicate with one another
Fluid or air compression
Fetal- so aspiration
69
Interstitial emphysema
Air filled alveoli rupture & air leaks into interlobular septa
This happens in cows where the bronchioles collapse due to forced expiration
- be the alveoli don't communicate the air is trapped which makes alveoli rupture and leak air into interstitium
** think finger on popoff value and pressure goes up **
In domestics the alveoli communicate so they get big and bust
70
If all three lymph nodes are enlarged
Rickettsia, fungal neoplasia (lymphosarcoma)
Systemic
71
Most common complication under anesthesia
Hypotension → low bp which compromise organ perfusion
72
Inhalant anesthesia can cause these CNS effects
What does the body do to autoregulate?
CNS effects
-CNS depression
-cerebral vasodialation
-increased intracranial pressure.
-No analgesia
Auto regulate through hyperventilation:
Decrease CO2
Decrease, intracranial pressure
73
Contractility changes with
Inhalant anesthesia
How is it monitored?
With Isoflourine and sevoflourine,, there is still a maintenance of contractility until it gets greater than MAC 1
It is measured by the difference between the systolic and diastolic pressure
74
Cardiovascular effects due to inhalant anesthesia
-Decreasing stroke volume
- decrease systemic vascular resistance
-Contractility goes down if Mac > one
- constant heart rate
- Vasodialation
- increase in sympathetic tone
** this is masked when MAC Bar**
There is a overall decrease in cardiac output after 5 to 6 hours
75
Mechanical Ventilation due to venous return, and why
Mechanical ventilation decreases venous return, because it increases intrathoracic pressure, which compresses the vena cava
76
Malignant Hyperthermia
The temperature is over 104°C
there’s muscle rigidity
Increased endtidal CO2
Dantrolene iv + stop anesthesia+ aggressive cool and have O2 on
77
The blood gas coefficient is representative of
The blood gas coefficient is representative of solubility
So with desoflourane having the lowest BG coefficient, it is going to be taken up by non-target organs less
- This makes it so that the drug has a faster induction
78
How to determine how big a rebreathing bag should be
a normal tidal volume is 10 to 20 mL/kilogram
Do you want the bag to be 5 to 6 times that size
79
-Which influenza a zoonotic potential
The swine influenza, which can come from birds can be passed on to humans
This like equine influenza and bovine influenza And bovine rhinotracheitis, a.k.a. herpes virus can all have secondary bacterial pneumonia a.k.a. bronchopneumonia
They are viruses, causing pneumonia. It’s going to be interstitial pneumonia.
80
Host defense mechanisms against respiratory pathogen
Non-Immunological
1.Anatomy
Positioning of the head: animals with more vertical position will
Nasal turbinates : decrease the organisms hitting the inertial impaction on mucosal surfaces
2.Normal Flora
COLONIZATION RESISTANCE : if normal flora binds to the host cell then the pathogens cannot adhere to the host cells
3.Sneezing & Coughing
Coughing helps getting rid of stuff in LRT
Sneezing helps with nasopharynx substances
4.Mucocilliary Clearance
MAJOR NON-IMMUNOLOGICAL DEFENSE - protect LRT
Immunological
5.PAMs
MAJOR DEFENSE in the ALVEOLI - PREDOMINANT INFLAMMATORY CELL IN LOWER AIRAWAY
6.Mucosal Immunity
81
Better bp means what for tissue perfusion?
What does it mean wl systemic vasoconstriction to have high map
Bp high is usually better tissue ' perfusion
But also check:
u Pale mucous membrane
u Capillary refill time > 2 s
u Mean arterial blood pressure < 60 mmHg
W/vasoconstriction there will be ihigh bp but low perfusion
82
Ephedrine
Tachyphylaxis - when several doses given continuously then there is no clinical effect → after 3 doses
83
Horse: Tracheal wash advantages and disadvantages
The advantage
can be collected via endoscopy while also being sterile [can be cultured]
- put sterile saline and pull up from the carina which is before the trachea bifurcates
Gets assessment from both lungs
Disadvantage:
we **cannot collect the anaerobic bacteria**
It also does not go as deep as the bronchoalveolar lavage
84
Rhodococus equi… causes
**Multiple lung abscesses** and the bacteria lives in the gut —> bronchopneumonia in foals
It is **contagious**
Treat with macrolide and rifampin
Keep the feces away from other foals and clean [**bacterial in gut**]
85
Equine asthma starts at what age and what are 3 treatments?
Starts around 7 years and is seasonal
- an inflammatory process
Corticosteroids [like predni**solo**ne and dexmethasone]
- ice boots
- for inflammation
Brochodialators
B2 agonist - like albuterol or **clenbuterol** which helps with increasing lung bronchodialation
Iprotropium -which is also a bronchodialator
86
Which is more common :
Primary epithelial alveolar/bronchiole lung tumor OR metastatic lung tumor
Renal or lung infarct
metastatic lung tumor >>>
Renal infarct>>>
87
Forced expiration causes bronchiolar collapse—> alveolar rupture —> of air in interlobular septa
Vs.
Enzymes —>Alveolar walls are destroyed —> air in lung
**Interstitial emphysema**
- Occurs primarily in cattle - Forced expiration:
- bronchopneumonia
- acute interstitial pneumonia - agonal breathing
- Bronchioles collapse
- Air trapped distally in alveoli - No collateral ventilation
When there is air in lung it is because the alveoli are connected —> **alveolar emphysema**
88
Is there joint damage with mycoplasma as a 3rd infection agent in BRDC?
What can it be treated with?
No there is no joint damage long term because there is just swelling within the joint capsule
Has no cell wall so **no beta lactams**
Draxxin, nuflor, oxytet, adspec
89
Disease of larynx in cattle and not lungs - honking
Fusobacterium necrophorum - diphtheria
90
**Extravascular hemolysis in spleen** and hemolytic anemia are part of which obligate intracellular and epicellular bacteria
Bovine anaplasma marginale - intra in RBC
Feline Mycoplasma haemofelis which is epicellular in RBC
Diagnosis w Pcr and blood smear
91
Clenbuterol is….
A bronchodialator that is a beta 2 agonist
It is prohibited in food animals
92
In the anesthesia there is increased alveolar partial pressure if…
There is higher inspired concentration of anesthetic or there is more tidal volume
93
There is more uptake by non-target organs of the anesthesia if
There is more carrier (blood solubility of the specific inhalant- desflourane has the lowest so its not going to be uptaken)
There is more mixer (cardiac output increases)
94
What’s the position of the eye that you want in the phase 3 medium plane of anesthesia
It should be ventromedial
If it is central then it may be too high or too low
- check this w jaw tone [ relaxed if it is very high ]
95
What are the parameter that we look at under general anesthesia
**Circulation ventilation, oxygenation**, anesthetic depth signs of pain, blood glucose lactate, electrolytes
96
Talk about BP and the relationship to tissue perfusion
MAP is a great measure of tissue perfusion but is not equal to tissue perfusion- **there has to be other measures**
Tissue perfusion is mainly controlled by the **vascular resistance component and the blood flow aka CO**
MAP = CO*SVR
97
What is the number for hypotension
MAP <60mmhg
98
What is normal blood volume?
>30% loss of normal blood volume is BAD- absolute hypovolemia; What is this estimated by?
What happens to BP with hypovolemia
6-8% body weight
PCV <20% then transfusion needed
Aka if blood is lost >30% of normal volume then transfusion!!
BP decreases, hypotension
99
Permissive hypercapnia is
When the paCO2 is up to 56 mmHg during anesthesia
100
What is the measure for hypoxemia? Of the PaO2 blood arterial
SpO2 <90%
PaO2 <60mmHg
PaO2 = 5*FiO2
If FiO2 =100% then PaO2 is 500mmHg
101
What is a normal paCO2?
It is 35-45mmHg paCO2
PaCO2 = 5-10 +(End tidal CO2)
PaCO2 is blood gas and ETCO2 is capnograph
102
Is increased respiration = hyperventilation?
NO because it could be compensatory to the acidosis, etc.
103
Which two problems are very common in general anesthesia?
Hypoventilation (hypercapnia =inc paCO2) and hypotension (decreased BP)
So monitor ventilation with ETCO2 capnography/capnometry
And BP with systolic or MAP via Doppler/Ossilometric measure/arterial BP
104
Causes of hypoventilation [high paCO2 or high EtCO2>60mmHg]
U Deep plan of anesthesia
u Drugs: Opioids, Injectable anesthetics, e.g., propofol, Neuromuscular blocking agents
u Increase in intraabdominal pressure u Atelectasis
u Bronchial intubation
105
Causes of hypoxemia [low paO2]
Hypoventilation
Low FiO2
Ventilation/perfusion mismatch
Right to left shunt
Diffusion is impaired
