Lecture 14 - Respiratory distress intro (specht)

Question 1

respiratory distress is a sign of ineffective __

Answer 1

02 delivery to tissues

cause may or may not be respiratory problem

Question 2

__ can significantly worsen respiratory distress, must be very careful

Answer 2

stress

Question 3

if pleural dz is suspected upon PE p may require __ before anything else

Answer 3

thoracocentesis

Question 4

if __ is suspected, mild sedation and O2 therapy can be effective in improving condition

Answer 4

laryngeal paralysis

Question 5

severe upper airway dz or obstruction may require emergency

Answer 5

bypass

Question 6

when observing patient in respiratory distress look at

Answer 6

rate, effort, characterize (IvE) 
postural changes 
abdominal movement (effort, paradoxical, flail)

Question 7

inspiratory distress/prolonged inspiratory phase often indicates

Answer 7

extra-thoracic airway obstruction
extrathoracic trancheal collapse
lar par
pleural space dz

Question 8

expiratory distress/prolonged expiratory phase indicates

Answer 8

intra-thoracic airway obstruction
intrathroacic tracheal collapse 
chronic bronchitis
asthma 
pneumonia

Question 9

true respiratory distress automatically localizes problem to the

Answer 9

larynx or lower

Question 10

laryngeal, or other upper airway dz generally presents as

Answer 10

loud stridor
head/neck extension
inspiratory component

Question 11

cardiac dz significant enough to cause distress is usually associated with

Answer 11

tachycardia
murmur
pulse abnormalities

Question 12

expiratory effort with auscultable wheezes is highly suggestive of a

Answer 12

bronchoconstrictive dz

Question 13

absence of lungs sounds, esp if only ventral, in face of tachypnea/dyspnea is suggestive of

Answer 13

pleural space dz

Question 14

differentials for upper airways obstruction

Answer 14

laryngeal paralysis
tracheal collapse
masses
FB

Question 15

ddx for lower airway dz

Answer 15

asthma (bronchitis) 
pulmonary fibrosis 
bronci collapse 
airway obstruction 
infectious bronchitis

Question 16

ddx for lung dz

Answer 16

pneumonia 
CHF
PTE
Neoplasia 
electrocution 
strangulation

Question 17

ddx for pleural space dz

Answer 17

air or fluid

Question 18

don’t forget about other ddx not respiratory tract related

Answer 18

anemia
smoke
drowning

Question 19

5 mechanisms of hypoxemia

Answer 19

decreased inspired O2 (FIO2) 
hypoventilation
diffusion abnormalities 
anatomic shunts 
v/q mismatch

Question 20

brachycephalic dogs think

Answer 20

congenital abnorms

Question 21

small breed dogs predisposed to

Answer 21

collapsing trachea

Question 22

old labrador think

Answer 22

laryngeal paralysis

Question 23

cockers think

Answer 23

IMHA (predisposes to PTE)

Question 24

inspiratory wheezes associated with

Answer 24

extrathoracic airway obstruction (masses, stenosis, collapse of upper airway)

Question 25

expiratory wheezes associated with

Answer 25

intrathroacic airway obstruction (COPD, intrathroacic collapse, stenosis, mass)

Question 26

in a standing patient the dorsal area of lungs auscults dull

Answer 26

pneumothorax

Question 27

most important dx when inspiraotry distress is observed

Answer 27

oropharyngeal exam (lar par, masses esp in cats)

Question 28

when sedating for a oropharyngeal exam in a patient with distress always be prepared to

Answer 28

intubate

Question 29

the measurement of __ in arterial specimens provides useful info about pulmonary function

Answer 29

PaO2
PaCO2

helps differentiate pulmonary dz from hypoventilation

Question 30

normal PaO2 for animal healthy breathing room air

Answer 30

85-100mmHg

Question 31

normal PaCO2 for animal healthy breathing room air

Answer 31

40+/-4 mmHg

Question 32

normal HCO3 for animal healthy breathing room air

Answer 32

24+/-4 mmol/L

Question 33

normal pH for animal healthy breathing room air

Answer 33

7.4 +/- 4

Question 34

if the PaO2 is very low and patient is normal physically

Answer 34

may have mixed or venous sample

Question 35

PaO2 less than __ is considered dangerous and should be tx asap

Answer 35

60mmHg

less than 50mmHg and patient will need assisted ventilation bc of pulmonary failure

Question 36

__ occurs as result of increased concentration of non-O2 hgb in blood

Answer 36

cyanosis

function of hgb concentration and oxygenation

Question 37

Normal FIO2: PaO2 on 100% oxygen is

Answer 37

400-500

Question 38

pulse oximetry measures

Answer 38

oxygen saturation (SpO2)

Question 39

a low pulse ox indicates that

Answer 39

insufficient amt of O2 bound to hgb in blood

Question 40

T/F: a normal SpO2 value rules out hypoxia

Answer 40

false

can’t r/o (ie anemia)