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Flashcards in Nasal Cavity Deck (140):
1

What are 5 potential characteristics of nasal discharge?

- Unilateral
- Bilateral
- Mucoid
- Purulent
- Bloody

2

What should be considered as a potential etiology if depigmentation of the nasal area is noted?

Aspergillosis

3

What is the most important diagnostic test to perform when a dog/cat presents with nasal discharge?

Imaging

4

If we want to know more about what other organ systems or systemic conditions might be causing the nasal discharge, what can be done?

Blood work

5

What are 7 differential diagnoses for nasal discharge?

- Foreign body
- Rhinitis
- Dental disease
- Neoplasia
- Trauma
- Ciliary dyskinesia
- Systemic disorders

6

What are 3 things to take into consideration when diagnosing a nasal foreign body?

- Signalment
- History
- Clinical signs

7

What are 5 nasal cavity clinical signs?

- Nasal discharge
- Sneezing
- Pawing at face
- Respiratory difficulty on inspiration
- Stertor (noisy respiration)

8

Sudden onset, acute sneezing, gagging, reverse sneezing, pawing at the nose and nasal discharge can all be seen with what?

Nasal foreign body

9

Wha is the diagnotic method of choice for nasal foreign bodies?

Radiographs

10

When performing a rhinoscopy, where should the cuffed tracheal tube be pre-measured to?

Medial canthus

11

Inflammation of the nasal cavity is known as what?

Rhinitis

12

What are four possible causes of rhinitis?

- Infectious
- Parasitic
- Allergic
- Lymphocytic plasmacytic

13

90% of feline upper respiratory disease cases are caused by what 2 viruses?

- Feline herpesvirus
- Feline calicivirus

14

10% of feline upper respiratory disease cases are caused by what 4 organisms?

- Chlamydophila felis
- Mycoplasma
- Coronavirus
- Bordetella

15

Ulcerative keratitis with punctate or dendritic ulcers are a hallmark of which feline virus?

Feline herpesvirus

16

Ulcers on the nose, tongue, or hard palate seen with pneumonia and lameness is characteristic of what feline virus?

Feline calicivirus

17

Severe conjunctivitis with chemosis is seen with what feline agent?

Chlamydophilia felis

18

Which virus in a carrier state can shed the virus with stress?

Feline herpesvirus

19

Which 2 feline agents can be shed in a carrier state with or without stress?

- Feline Calicivirus
- Chlamydophila felis

20

What does feline herpes virus cause?

Feline viral rhinotracheitis

21

What are 2 ways feline herpes virus can be spread?

- Direct contact
- Fomites

22

What are 3 types of secretions herpes virus can be shed in?

- Ocular
- Nasal
- Pharyngeal

23

The serous discharge seen with feline viral rhinotracheitis can progress to mucopurulent due to what?

Secondary bacterial infection

24

T/F: Feline herpesvirus establishes a temporary latency in the trigeminal ganglia.

False - It establishes a LIFELONG latency in the trigeminal ganglia.

25

What are 3 aspects used to diagnose feline herpes virus?

- Clinical signs
- Viral isolation
- PCR

26

Treatment of feline herpes virus is mainly what?

Supportive

27

What are 5 examples of supportive treatments that can be used with feline herpes virus?

- Humidify air
- Topical decongestants
- Systemic antibiotics
- Topical antibacterial
- Antiviral eye ointments

28

What are 3 possible sequelae that can be seen with feline herpes virus?

- Chronic rhinitis/sinusitis (feline chronic rhinosinusitis)
- Chronic conjunctivitis
- Fibrosis of lacrimal ducts leading to epiphora

29

An overflow of tears due to excessive secretion of the lacrimal glands or obstruction of the lacrimal ducts is known as what?

Epiphora

30

Feline chronic rhinosinusitis is common in what type of cats?

Short nosed breeds

31

Turbinate damage caused by feline chronic rhinosinusitis predisposes the cats to what?
What are these cats called?

- Secondary bacterial infections of the nasal cavity
- "Snufflers"

32

80% of cats recovered from feline herpes virus are what which do what?

- Carriers
- Shed when stressed

33

What can be given for the treatment of feline herpesvirus that may reduce viral replication and recrudescence?

Oral lysine

34

What are 2 oral antivirals that can be given to treat feline herpes virus?

- Famciclovir
- Acyclovir

35

What is the trade name for Famciclovir?

Famvir

36

What is the trade name for Acyclovir?

Zovirax

37

Since mucus gets thicker and is harder to remove in a dehydrated patient, what should be included with supportive care?

Fluid therapy

38

T/F: The feline herpesvirus vaccine does not prevent infection.

True

39

T/F: The feline herpesvirus vaccine does not reduce severity.

False - It DOES reduce severity.

40

What are 2 ways the feline herpesvirus vaccine can be administered?

- Parenteral
- Intranasal

41

Which vaccine administration route for the feline herpesvirus vaccine can be blocked by maternal antibodies and does not prevent the carrier state?

Parenteral

42

Which administration route for the feline herpesvirus vaccine can be useful in outbreaks, is not blocked by maternal antibodies, can have post vaccine sneezing, may prevent the carrier state and is shed?

Intranasal

43

Which can survive longer in the environment, feline herpesvirus or calicivirus?

Feline Calicivirus

44

Which feline virus is resistant to routine disinfectants?

Feline calicivirus

45

Does feline calicivirus have a low or high mutation rate?

High mutation rate

46

Do new mutation strains of feline calicivirus have cross protection from vaccines or other strains?

No

47

What are 2 ways feline calicivirus can be transmitted?

- Direct transmission
- Fomites

48

What is the incubation period for feline calicivirus?

2-4 days

49

Feline calicivirus (FCV) has similar clinical signs to feline viral rhinotracheitis (FVR) except for the formation of ulcers in what 2 locations with FCV?

- Oral
- Nares

50

What are 3 ways in which FCV is different from feline herpes virus?

- Pneumonia more common with FCV
- FCV can cause GI signs
- FCV can cause lameness

51

50% of cats with calicivirus shed the virus up to how many days post-infection?

75 days

52

Do cats require stress to shed calicivirus?

No

53

Lameness, ulcers on paws and sore joints are clinical signs seen with what syndrome caused by what virus?

- Limping kitten syndrome
- Feline calicivirus

54

What are the 2 distinct syndromes that can be seen with feline calicivirus?

- Limping kitten syndrome
- Virulent hemorrhagic systemic syndrome

55

A mutation of the feline calicivirus can cause what syndrome?

Virulent hemorrhagic systemic syndrome

56

Edema, hepatitis, diarrhea, pustular dermatitis and hemorrhagic cystitis can be found with which syndrome associated with feline calicivirus?

Virulent hemorrhagic systemic syndrome

57

What is the mortality rate for the FCV virulent hemorrhagic systemic syndrome?

40-60%

58

What is the main type of treatment used with feline calicivirus?

Largely supportive

59

What are 4 possible sequelae seen with feline calicivirus?

- Chronic rhinitis
- Sinusitis
- Conjunctivitis
- Carrier state

60

An abnormal condition resulting from a previous disease is known as a what?

Sequelae

61

What is the hallmark clinical sign seen with Chlamydohila felis?

Conjunctivitis with chemosis

62

The swelling of the conjunctiva is known as what?

Chemosis

63

What is an intracellular bacteria that presents with similar signs to feline herpesvirus and feline calicivirus?

Chlamydophila felis

64

What are 2 possible ways to diagnose Chlamydophila felis?

- Conjunctival smear to look for intracytoplasmic inclusion bodies
- PCR a conjunctiva sample

65

What are 2 examples of topical treatments for a Chlamydophila felis infection?

- Tetracycline
- Erythromycin

66

What are 2 antibiotics that can be used with there are systemic signs associated with a Chlamydophila felis infection?

- Doxycycline
- Azithromycin

67

Is the vaccine for Chlamydophila felis a core vaccine?
Why?

- No
- Cats tend to have more vaccine reactions compared to other antigens.

68

If a cat presents with upper respiratory signs, where should it be treated ideally?

Outpatient if possible; isolation if in hospital.

69

Is it ok to remove the crusts form the nose and eyes of a cat presenting with upper respiratory signs?

Yes

70

What is the preferred topical decongestant for cats with upper respiratory signs?
What is an alternative?

- Phenylephrine
- Pseudoephedrine

71

Is bacterial rhinitis commonly a cause of upper respiratory disease?

No

72

Mucopurulent or purulent nasal discharge with transient antibiotic response can be seen with what possible upper respiratory condition?

Bacterial rhinitis

73

Is bacterial rhinitis more commonly a primary or secondary disease process?

Consider it always secondary

74

What are 5 possible primary causes that can lead to a a secondary bacterial rhinitis infection?

- Foreign body
- Abscessed tooth
- Chronic viral infection
- Fungal infection
- Neoplasia

75

Nasal ulceration and depigmentation with possible facial distortion can be seen with what upper respiratory condition?

Nasal Aspergillosis

76

How is nasal airflow usually affected with nasal aspergillosis in the dog?
Turbinates?

- Nasal airflow usually ok
- Turbinate destruction

77

T/F: Most cases of nasal aspergillosis are systemically ok.

True

78

What diagnostic tests should be done before rhinoscopy or nasal flush?
Which are more helpful? Why?

- Imaging
- CT/MRI: more helpful since radiographs can't distinguish between neoplasia and fungal rhinitis.

79

Cultures and smears for nasal aspergillosis should be done from what type of sample?
What should not be used?

- Plaque
- Not discharge

80

What is done first, if necessary, to treat nasal aspergillosis?

Debridement

81

What are 2 things that can be infused into the nasal cavity for the treatment of nasal aspergillus?
For how long?

- 1% clotrimazole or 2% enilconazole
- Over 1 hour

82

What are 2 possible risks associated with the treatment of nasal aspergillus?

- Aspiration pneumonia
- Neural signs

83

What is a contraindication for the treatment of nasal aspergillus?

Damaged cribriform plate

84

Treatment of nasal aspergillus should be repeated if signs persist for longer than what?

2 weeks

85

What is the most common cause of fungal rhinitis in dogs?

Aspergillosis

86

What is the most common cause of fungal rhinitis in cats?

Cryptococcosis

87

What are 2 common signalments of aspergillosis in dogs?

- Dolichocephalic
- Young adults

88

What is the percent chance of seeing hyphae on the cytology of nasal discharge with aspergillosis?

20%

89

Chorioretinitis can be seen with what type of fungal rhinitis in cats?

Cryptococcosis

90

Where can cryptococcosis samples be taken from in cats?

Nasal discharge

91

What can be given to treat cryptococcosis?

Conazoles systemically

92

What is Pneumonyssus caninum?

Canine nasal mite

93

Is Pneumonyssus caninum found in cats?

No

94

what are 2 clinical signs associated with Pneumonyssus caninum?

- Sneezing
- Reverse sneezing

95

What are 3 possible drugs that can be used to treat Pneumonyssus caninum?

- Ivermectin
- Milbemycin
- Selamectin

96

Do you see Pneumonyssus caninum in dogs on hearworm prevention?

No

97

Chronic inflammatory rhinitis characterized by lymphocytic-plasmacytic infiltration of nasal mucosa in the absence of an obvious underlying etiology is known as what?

Lymphoplasmacytic Rhinitis (LPR)

98

What are 3 proposed mechanisms of LPR?

- Infectious
- Allergic
- Immune-mediated

99

What is the usual signalment of dogs presenting with LPR?

Medium to large breed with long noses.

100

What is the most common clinical sign seen with LPR?

Uni or bi-lateral nasal discharge

101

What are 2 other differentials to consider when LPR is on the list?

- Aspergillosis
- Neoplasia

102

If destruction of nasal septum, frontal sinus or cribriform plate are detected on CT/MRI, is this likely caused by LPR?

No

103

How does the mucosa of an LPR case appear with rhinoscopy?

Red, edematous, bleeds easily

104

What is needed for the diagnosis of LPR?

Biopsy and histopathology

105

What is the recommended treatment for LPR?

No effective protocols at this time.

106

What should be avoided with LPR?

Any type of smoke.

107

Continuous dosing of what drug robs the body of substance P which can lead to what?

- Cerenia (maropitant)
- Tremors

108

Progressive unilateral nasal discharge that may become bilateral can be a clinical sign of what?

Nasal Cancer

109

Loss of airflow due to mass effect is often caused by what?

Nasal Cancer

110

Sneezing, facial deformity, epiphora, exophthalmia, dyspnea, open mouth breathing and dysphagia are clinical signs that can be associated with what?

Nasal Cancer

111

What can seen if the cribriform plate is invaded by nasal cancer?

Neurological signs

112

The clinical signs seen with nasal cancer can't be distinguished from the signs seen with what other upper respiratory disease cause?

Fungal rhinitis

113

Can a carcinoma in the nasal cavity be distinguished from an aspergillus infection based on radiographs?

No

114

What is a nice option for diagnosing nasal cancer that is not always available?

Rhinoscopy

115

What are 5 possible diagnostic tools that can be used to diagnose nasal cancer?

- Nasal discharge cytology
- FNA of ipsilateral nearby lymph nodes
- Imaging
- Rhinoscopy
- Tissue biopsy

116

Chemotherapy is not effective for the treatment of nasal cancer except for which type of cancer?

Lymphosarcoma

117

Will surgery cure the nasal cancer?

Unlikely, it is usually palliative.

118

Does surgery prolong survival times with nasal cancer?

Not unless used with radiation.

119

What is the treatment of choice for many nasal tumors?

Radiation

120

What is the estimated survival time for nasal cancer treated with radiation and surgical debulking?

12-16 months

121

What is the average survival time for nasal cancer with no treatment?

3-6 months

122

What are 3 possible causes of death resulting from nasal cancer?

- Airway obstruction
- Euthanasia due to labored respirations
- Persistent epistaxis or nasal discharge

123

Nasal cancer patients with adenocarcinomas and sarcomas have a better survival time after what?

Radiation

124

What are 2 types of nasal cavity tumors that have a shorter survival time?

- Undifferentiated carcinomas
- Squamous cell carcinomas

125

Which species lives longer with radiation therapy, cats or dogs?

Cats

126

What signalment of dog is more prone to nasal neoplasia?

Long nosed breeds greater than 8 years old

127

T/F: Most nasal tumors are benign.

False - Most are malignant.

128

Are nasal tumors locally invasive?

Yes, they can also metastasize to regional lymph nodes.

129

What are the 2 most common types of nasal neoplasia seen in dogs?

- Adenocarcinoma
- Squamous cell carcinoma

130

What are the 2 most common types of nasal tumors in cats?

- Lymphoma
- Adenocarcinoma

131

What is needed for a diagnosis of nasal neoplasia?

Tissue biopsy

132

An inherited autosomal recessive defect with structural and functional changes of the cilia of the respiratory tract resulting in poor clearance of mucus from airways leading to chronic mucus plugging and inflammation is known as what?

Primary ciliary dyskinesia (PCD)

133

What are 3 areas affected by PCD?

- Nasal cavities
- Trachea
- Lower airways

134

What is the classic presentation of PCD?

Young, purebred dog with recurrent respiratory tract infections/signs.

135

Bronchiectasis with complete transposition of viscera (situs inversus) and chronic rhinosinusitis is known as what syndrome?
This syndrome is associated with what inherited disorder?

- Kartagener's syndrome
- PCD (primary ciliary dyskinesia)

136

Diagnosis of primary ciliary dyskinesia requires what?

Culturing ciliated cells from biopsy samples and using transmission electron microscopy to see ciliary structure abnormalities.

137

Is there any treatment for PCD?

No

138

T/F: Nasal neoplasia can result in exophthalmia, facial distortion and sneezing.

True

139

T/F: The main clinical sign associated with nasal mites is sneezing.

True

140

T/F: Nasal aspergillus does not respond to systemic antifungal therapy.

True