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SAMS 1 > Lecture 22: Airway disease part 2: lower airway > Flashcards

Lecture 22: Airway disease part 2: lower airway Flashcards

(72 cards)

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1
Q

what is distinctive characteristic/sing of lower airway coughs

A

coughs with terminal retch

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2
Q

what dogs is canine chronic bronchitis most common in

A

older small breed dogs

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3
Q

what are the 4 criteria for canine chronic bronchitis

A
  1. Cough > or = 2 months
  2. Evidence of excessive mucus secretion
  3. Exclusion of chronic cardiopulmonary disease
  4. BALF cell distribution >7% non-degenerate neutrophils
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4
Q

what are some clinical signs of chronic bronchitis

A

Persistent cough with paroxysms of coughing following by terminal retch

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5
Q

what is pathophysiology of canine chronic bronchitis

A

inflammatory changes within bronchial mucosa with increased mucus production

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6
Q

T or f: must do diagnostics can’t assume all dogs with chronic cough have chronic bronchitis

A

true

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7
Q

what is most useful test for dx canine chronic bronchitis if diagnostic testing is limited

A

thoracic rads

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8
Q

t or f: can rule out canine chronic bronchitis with normal rads

A

false- sensitive 50%, so 50% dogs with chronic bronchitis missed with rads

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9
Q

dog presents with chronic coughing, based on rads what is likely dx

A

canine chronic bronchitis

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10
Q

what is the best way to investigate for chronic bronchitis

A

bronchoscopy

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11
Q

identify what wrong in images

A

left: normal
Right: chronic bronchitis

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12
Q

what BALF findings are consistent with chronic bronchitis

A

predominately non-degenerate neutrophils >7%, excessive mucus, small # other cells, cell count >200-400/ul

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13
Q

what is tx for chronic bronchitis

A
  1. Eliminate environmental pollutants
  2. Air purifiers
  3. Obesity tx
  4. Glucocorticoids: prednisone (except DM), inhaled fluticasone
  5. Cough suppressants
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14
Q

how/what steroids should you start dog on for chronic bronchitis

A

start on oral prednisone, once clinical signs controlled recheck at 4 weeks and transition to fluticasone with a 2-4 week overlap between pred and fluticasone

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15
Q

if tx for chronic bronchitis should have marked improvement within __ days of starting oral prednisone, if not __

A

14 days, if not rethink dx

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16
Q

t or f: dogs with chronic bronchitis never enter remission

A

true

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17
Q

what are some sequela of chronic bronchitis

A

bronchiectasis, bronchomalacia, fibrosis, pulmonary hypertension

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18
Q

t or f: chronic bacterial tracheobronchitis is uncommon cause of chronic cough

A

true

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19
Q

what are some signs of chronic bacterial tracheobronchitis

A

cough > or = 2 months, paroxysmal, dry to productive, normal appetite and energy

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20
Q

how do radiographs appear with chronic bacterial tracheobronchitis

A

normal or bronchial pattern
Should not have heavy interstitial or alveolar pattern

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21
Q

how do you dx chronic bacterial tracheobronchitis and what finding would support dx

A

airway wash +/- bronchoscopy

Evidence of septic neutrophilic inflammation

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22
Q

what is tx for chronic bacterial tracheobronchtiis

A

abx for 14-21 days

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23
Q

what is age range for feline chronic bronchitis and asthma

A

2-8 years

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24
Q

what cat breed is at higher risk for asthma

A

Siamese

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25
what are some clinical signs of feline chronic bronchitis and asthma
1. Subclinical- pick up lung sounds on auscultation 2. Cough 3. Decreased activity 3. Increase breathing rate/effort or respiratory distress
26
only cats with __have intermittent expiratory distress from bronchoconstriction
asthma
27
Cats with chronic bronchitis compared to cats with asthma: cats with chronic bronchitis do not have __ therefore __ does nothing to tx CB. Whereas asthma has __ which is why they respond well to __
CB: not reversible bronchoconstriction, bronchodilators not helpful Asthma: reversible bronchoconstriction, bronchodilators helpful
28
cats with chronic bronchitis do not have ___
reversible spontaneous bronchoconstriction
29
how do you dx feline chronic bronchitis and asthma
1. Clinical signs 2. TXR or CT 3. BALF/cytology 4. Exclusion of other disorders when eosinophilic inflammation present
30
suspected dx of chronic bronchitis and asthma can be made base don respond to empirical therapy in asthmatic patients with __ and __ with both
bronchodilators, glucocorticoids
31
t or f: thoracic rads from cats with chronic bronchitis and asthma can look normal, up to 25%
true
32
what do you see on rads of cats with chronic bronchitis or asthma
1. Variable bronchial and bronchiointerstitial patterns 2. Hyperinflation: increased radiolucency and flat diaphragm on lateral 3. Lung lobe atelectasis (not pneumonia)
33
cat presents with chronic cough, based on rads what are 2 likely dx
1. Chronic bronchitis 2. Asthma
34
cat presents with chronic cough, based on rads what wrong
chronic bronchitis
35
Before performing BALF in cats for suspected chronic bronchitis or asthma administer __
terbutaline
36
BALF of chronic bronchitis has >__%___
7% non-degenerative neutrophils
37
BALF of asthma has >__% ___
7% eosinophils
38
for feline asthma consider __ testing or __ testing
serum allergen IgE, or intradermal skin testing
39
eosinophilic BALF does not = __
asthma
40
if BALF contains eosinophils must rule out __
HW, fungal, neoplasia, lungworms
41
if you dx chronic bronchitis or feline asthma and patient has DM what is tx plan
1. Fluticasone 2. Fenbendazole if eosinophils on BALF NO PRED
42
if you dx chronic bronchitis or feline asthma and patient does not have DM what is tx plan
1. Prednisolone 2. Fenbendazole 4 weeks recheck 3. Add in fluticasone and overlap with 2 weeks pred
43
Make sure owners have emergency __ for cats with asthma
albuterol inhaler
44
why differentiate chronic bronchitis vs asthma
Chronic bronchitis: won’t have expiratory resp distress episodes and bronchodilators won’t help Asthma- can have life threatening expiratory distress episodes, bronchodilators help, allergen testing
45
if client won’t let you work up cat with suspected CB or asthma what do you do
1. Thoracic rads 2. Tx for asthma (pred, fluticasone) and deworm with fenbendazole
46
can dx idiopathic lung disease aka eosinophilic bronchopneumopathy if you ruled out __
lungworms, HW, neoplasia, fungal
47
define eosinophilic bronchopneumopathy
infiltration of eosinophils in bronchial mucosa and parenchyma
48
eosinophilic bronchopneumopathy is hypersensitivity to __, inflammation without __
aeroallergen, inflammation without bronchoconstriction
49
what dog breeds is eosinophilic bronchopneumopathy msot common in
Siberian husky and Alaskan malamute
50
how do you dx eosinophilic bronchopneumopathy
1. Clinical signs 2. Rads or cT 3. Eosinophilic infiltration of BALF or tissue or cytology 4. Peripheral eosinophilia on CBC 5. BALF >7% eosinophils
51
what is tx for eosinophilic bronchopneumopathy
Initial tx 1. Pred 2. Fenbendazole 3. Abx if indicated 4. Cough suppressants 4 week recheck: 1. Continue pred and transition to fluticasone
52
if you have eosinophilic inflammation in airways what tests do you need to run
1. HW snap test 2. Fecal float 3. Baermann fecal
53
who enters remission: dogs with chronic bronchitis or eosinophilic bronchopneumopathy
Eosinophilic bronchopneumopathy
54
canine bronchomalacia aka__
bronchial collapse
55
what phase of respiration does bronchial collapse occur with bronchomalacia
expiration
56
What breeds is canine bronchomalacia common in
brachycephalics- especially pugs
57
how do you dx bronchomalacia
1. Bronchoscopy 2. Thoracic CT
58
what is tx for bronchomalacia
1. Weight loss if obese 2. Pediatric nebulization with saline 3. +/- pred 4. Cough suppressants
59
dogs with bronchomalacia have decrease mucus clearance and therefore high risk for __
infection
60
__is common for dogs with bronchomalacia to develop
pulmonary hypertension
61
What lung lobe is FB inhalation most common in
accessory lung lobe
62
what is tx for FB inhalation
1. Try to remove endoscopically 2. Lung lobe to my
63
t or f: cough relapses soon after d/c abx with FB inhalation
true
64
what lower airway parasite is common in cats
aelurstrongylus abstrusus
65
what lower airway parasite is common in dogs and cats
capillaria aerophilia
66
what are some signs of lung lobe torsion
dyspnea, tachypnea, panting, increased effort, cough, anorexia, hyperexia, lethargy Or no signs
67
what breeds is lung lobe torsion most common in
afghan hounds and pugs
68
what is cause of lung lobe torsion
idiopathic
69
what lobes are most commonly affected by lung lobe torsion
right middle and left cranial
70
what lung lobe in pugs is most likely affected by lung lobe torsion
left Cranial
71
what is best way to dx lung lobe torsion
CT
72
what is prognosis for lung lobe torsion
95% survive with sx

SAMS 1 (28 decks)

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