Lecture 13 - coughing cases (specht)

Question 1

what diseases would you consider cough suppression?

Answer 1

non productive ones 
collapsing trachea
chronic allergic bronchitis 
neoplasia 
HW dz

Question 2

which would not cause cyanosis? 
anemia 
CHF
forgetting to turn O2 on during anesthesia 
pneumonia 
PTE

Answer 2

Anemia; RBC can still carry O2 there’s just not enough RBCs

the others all involve RBC not getting enough O2

Question 3

heart dz that can cause coughing

Answer 3

CHF from; DCM, HW, pulm hypertension, endocarditis, endocardiosis

Question 4

T/F: patients with CHF causing cough will probably have a murmur and fast HR

Answer 4

true

Question 5

T/F: patients with atrial enlargement causing cough will probably have a murmur

Answer 5

true

Question 6

T/F: a fast HR + loud heart murmur + crackles confirms CHF in coughing patient

Answer 6

False

Question 7

respiratory causes of cough

Answer 7

non-cardio edema 
pneumonia 
hemorrhage 
PTE 
neoplasia

Question 8

6 yo FS DSH NP cough, tachypnea/dyspnea, increased expiratory

Answer 8

asthma

Question 9

0.6 yo MN Golden acute NP cough

Answer 9

CIRD

Question 10

6 yo MN Poodle acute P cough, tachypnea/dyspnea

Answer 10

bacterial pneumonia

dyspnea is not usually a CS of chronic bronchitis and this cough is acute and productive

Question 11

10yo M basset chronic, dry, NP cough, increased expiratory

Answer 11

chronic bronchitis

Question 12

6 yo F pomeranian chronic, progressive, NP loud cough, increased inspiratory

Answer 12

collapsing trachea

Question 13

if a dog had mild tracheal collapse that suddenly worsened think

Answer 13

concurrent dz, something is making p breath harder (weight gain? )

Question 14

medical management for collapsing trachea

Answer 14

weight loss
cough suppressants
harness

Question 15

cough suppressants used in collasping trachea cases

Answer 15

hydrocodone
lomotil
cons: sedation and constipation

Question 16

ideal order of dx for a coughing patient

Answer 16

MDB
HW, FeLV/FIV
CXR 
fecal 
CT

Question 17

risks of tracheal stent sx

Answer 17

improper measurement of stent
granuloma formation
migration of stent
stent failure

Question 18

most dogs with tracheal collapse have been show to have concurrent tracheal __

Answer 18

malformations

may require additional sx like ballooning with the stent

Question 19

sign of chronic airway dz that can be seen on radigraphs and puts patient at higher risk of infection/persistent infections

Answer 19

bronchiectasis (really big bronchi)

PI may require lung lobectomy

Question 20

if there is still __ after tracheal stent placement the patietn will still cough

Answer 20

bronchial collapse (may need bronchodilator)

Question 21

always one of the top dx tests for a coughing patient

Answer 21

CXR , doesn’t give a dx but helps localize ddx

Question 22

interstitial to bronchial pattern in coughing cat

Answer 22

asthma
HW
neoplasia (lymphoma)

Question 23

multifocal, interstitial well defined nodules dog CXR

Answer 23

Neoplasia

fungal granuloma

Question 24

what causes crackles

Answer 24

fluid in, collapse or opening of the small airways/alveoli

parenchymal fibrosis

Question 25

what does an end-expiratory grunt indicate

Answer 25

air-trapping and/or obstruction of lower airways

must put effort and use diaphragm to get the air out of lungs

Question 26

airway washes can be helpful to differentiate

Answer 26

bronchitis/asthma
neoplasia
pneumonia

Question 27

patient is coughing but not tachycardic, what can be r/o

Answer 27

heart dz

Question 28

on CXR the cardiac silhouette and diaphragm have a lot of space between them; this indicates

Answer 28

hyperinflated lungs

Question 29

pleural space dz causes increased __ time

Answer 29

inspiration

Question 30

SE of BAL is transient __

Answer 30

hypoxia

Question 31

__ may be seen on BAL cytology and indicate chronic bronchitis

Answer 31

curshmann’s spirals (mucus)

Question 32

__ is a contaminant from the mouth that is large and purple and may be seen on BAL cytology

Answer 32

simonciella ; do not treat this!

Question 33

general tx for canine chronic bronchitis

Answer 33

steroids
cough suppression
weight loss
environmental control

+/- bronchodilators

Question 34

what would make you include antibiotics as part of therpy for aspiration pneumoninits

Answer 34

develop fever after 1-2d
on PPI at time of aspiration
worsening inflammatory leukogram after 2-3d