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small animal year 4 > Respiratory > Flashcards

Respiratory Flashcards

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1
Q

Is this a cardiac or respiratory cause of coughing?

coughing mostly at night/ sleeping, increased HR, regular sinus rhythm

A

cardiac

note: v rare for cats to cough from cardiac disease

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2
Q

Is this a cardiac or respiratory cause of coughing?

coughing on excitement, decreased HR, sinus arrhythmia,

A

Respiratory

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3
Q

What do simonsiella bacteria indicate on BAL?

A

oral contamination

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4
Q

Broncho-alveolar Lavage

how much fluid
what fluid
how much be able to aspirate?

A

0.5mls/kg ( 2mls- small cat/dog, 10 mls large dog)
saline solution
50% aspirated

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5
Q

does wheezing or crackling correlate to expiratory noise?

A

wheezing> generally expiratory,

crackling> generally inspiratory

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6
Q

What does a positive tracheal pinch test indicate?

A

respiratory irritation, eg kennel cough

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7
Q

what is definition of chronic bronchitis

A

coughing> 2 out of 12 months

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8
Q

are these cells normal in BAL

ciliated columnar epithelial cells, goblet cells, WBCSs inc macrophages

A

yes

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9
Q

what cellular changes occur in chronic bronchitis

A

increased goblet cell nos, hyperplasia of submucosal glands+ increased mucus
ciliated epithelium> squamous metaplasia

secondary bacterial infection common

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10
Q

which sp/br prone to chronic bronchitis

A

small toy dog breeds

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11
Q

how would chronic bronchitis appear on
radiograph
BAL

A

xray: thickened bronchial walls: donuts and tramlines
BAL: +++ mucus, + neutrophils and macrophages, + squamous metaplasia of CCECs (ciliated columnar epithelial cells)

–bacteria, usualy -ve with chronic bronchitis

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12
Q

how would you manage chronic bronchitis

A

weight control, harness rather than collar, nebuliser, shower with owner lol

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13
Q

what 4 components are used in treatment of chronic bronchitis

A

1) bronchodilators
2) anti-inflammatory glucocorticoids- prednisolone
3) antibiotics- if intraceullar bacteria seen on BAL cytology of C and S
4) mucolytics

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14
Q

give 2 bronchodilators used in chronic bronchitis treatment

A

theophylline

terbutuline

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15
Q

which mucolytic could be used to increase mucociliary clearance with chronic bronchitis

A

bromohexine

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16
Q

what is bronchiectasis?
how is it diagnosed
tx?

A

widening of the bronchi- regional area

dx: radiogrpah and bronchoscopy show dilated bronchi full of mucopurulent material
tx: long term ABs, possible lobectomy

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17
Q

what causes eosinophilic bronchopneumopathy (EBP)?

also known as Pulmonary Infiltrate with Eosinophils (PIE)

A

hypersensitivity to inhaled allergens or parasites

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18
Q

which respiratory disease would present with coughing, dyspneic dog, coughing on exercise and generally unwell.

on bronchoscopy it shows copious amounts of yellow green mucus, cytology over 25% eosinophils

A

EBP/ PIE

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19
Q

how would you treat EBP/ PIE

A

prednisolone +/- fenbendazole for parasite

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20
Q

which parasites can cause respiratory disease in dogs

A

Oslerus osleri

Crenosoma vulpis- fox lung worm, 4-16mm

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21
Q

which parasites can cause respiratory disease in cats

A

Aeluostrongylus abstrusus

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22
Q

how would you treat lung worm in dogs or cats

A

fenbendazole 50mg/kg 7 days

23
Q

What are some broad spectrum antibiotics used to treat respiratory disease in dogs and cats

A

Amoxycillin
Sulphonamides
Fluroquinolones

24
Q

What AB would you use for mycoplasma or bordetella bacterial resp infection

A

doxycyline

25
Q

what are the components of the four quadrant treatment used to treat life threatening pneumonia

A

combination antibiotics eg
amoxicillin
fluoroquinolone
metrinidazole

26
Q

What is feline asthma and what causes it?

cough and expiratory or inspiratory dyspnoea?

A

chronic bronchial disease, caused by allergy in airway
reactive bronchoconstriction

cough and expiratory dyspnoea

27
Q

how would you diagnose and treat feline asthma?

A

ausculation of expiratory wheezes
radiograph: diaphragm flattening, increased bronchial markings, barrel chested

tx: reduce stress, humidified o2, IV steroids, bronchodilators (theophylline, terbataline)

life threatening: adrenaline

28
Q

what drugs can be used in feline inhaler for feline asthma

A

salbutamol- β2 adrenergic receptor agonist, relaxes smooth muscle
fluticasone - steroid, reduce inflammation

29
Q

which 2 of the following causes dyspnoea

hypoxaemia
hyperoxaemia
hypocarbia
hypercarbia

A

hypoxaemia + hypercarbaemia

30
Q

what would a shallow resp depth indicate in dyspnoeic patient?

A

mixed inspiratory and expiratory dyspnoea

31
Q

how would you differentiate obstructive vs restrictive dyspnoea

A

obstructive: increased effort- insp (URT obstruction) or exp (bronchial narrowing)
restrictive: mixed dyspnoea, pulmonary or pleural cause

32
Q

what dyspnoea type are these ddx for:
laryngeal paralysis
laryngeal neoplasia
tracheal mass/ stenosis

A

inspiratory dyspnoe- URT conditions only

33
Q

what dyspnoea type are these ddx for:
dynamic airway collapse
feline asthma

A

expiratory dyspnoea - LRT

34
Q

what dyspnoea type are these ddx for:

pulmonary parenchymal disease
pneumonic pulmonary oedema 
idiopathic pulmonary fibrosis 
pleural effusion 
pneumo thorax
pulmonary thromboembolism
A

mixed insp and exp dyspnoea

35
Q

which dyspnoea condition is this

caused by aspiration pneumonia asc with megaoesophagus or laryngeal paralysis after tie back surgery

radiograph: bronchi- air filled, alveoli- fluid filled

A

pneumonia, bronchopneumonia

36
Q

which dyspnoea condition is this
diagnosed:
radiograph: worm seen in pulmonary vessels,
faecal nearmanns: see larvae

A

angiostrongylus vasorum - french heart worm

37
Q

which dyspnoea condition is this
mass close to chest wall on xray- can FNA lung mass

which can metastasise to digits

A

lung neoplasia

bronchogenic carcinoma can metastasise to digits

38
Q

which dyspnoea condition is this

radiogrpah interstitial markings, supportive care

A

idiopathic pulmonary fibrosis

39
Q 
which dyspnoea condition is this 
initial alveolitis 
severe pulmonary fibrosis 
severe dyspnoea 
poor prognosis
A

paraquat (herbicide) intoxication

40
Q

which dyspnoea condition is this
sudden onset dyspnoea, blood gas analysis shows poor o2
treated with anti-coagulants and antiplatelet medication

A

pulmonary thromboembolism

41
Q

what is ARDS

A

Acute Respiratory Distress Syndrome
non cardiogenic pulmonary oedema
cx: resp distress
dx: alveolar infiltrates on radiograph- histopathological criteria for diagnosis

42
Q

are pulmonary osteomas normal on radiograph?

A

yes, these are pleural plaques and are incidental findings

43
Q

List causes of pulmonary oedema

A

CHF

hypoalbuminaemia

44
Q

general clinical signs of pulmonary oedema

A

rapid shallow breaths
decreased percussion
absent breath sounds ventrally + muffled heart sounds
in cats- decreased thoracic compression

45
Q

what clinical signs of pleural effusion are specific to CHF in dogs

A

jugular vein distention (resistance to venous return)
positive hepatojugular reflex

note: in cats, pleural effuision if significant or cranial mediastinal mass can also distend jugular veins

46
Q

name the fluid, possible cause?

protein<25g/l and cells <1.5 x10^ 9/L

A

transudate

hypoalbuminaemia

47
Q

name the fluid, possible cause?

protein>25g/l and cells <5 x10^ 9/L

straw coloured, serosanguinous, slightly viscous

A

modified transudate
R sided CHF
diaphragm rupture
neoplasia

48
Q

name the fluid, possible cause?

protein>25g/l and cells >5 x10^ 9/L

  • bloody:
  • viscous, straw coloured
  • viscous, turbid, purulent
  • milky
A

exudate

  • bloody: trauma, neoplasia, coagulopathy
  • viscous, straw coloured: non-septic inflammation: lobe torsion, chronic chylothorax, neoplasia
  • viscous, turbid, purulent: septic inflammation, ruptured oesophagus, FB, pyothorax, fungal infection
  • milky: chylous, idiopathic, CHF, CrVC obstruction, trauma, lobe torsion
49
Q

where would you place (butterfly needle cats, 16 G needle dogs) for thoracocentesis?

A

7-8th intercostal space, have animal in sternal recumbency

50
Q

how would you treat

  • pyothorax
  • chylothorax
  • pneumothorax
A
  • pyothorax: chest drains + daily thoracic lavage until clear. ABs 2-3 months C+S
  • chylothorax: low fat diet+ medium chain triglycerides to diet, rutin?–> reduce chyle production. surgery
  • pneumothorax: drainage
51
Q

what are important structures to avoid in tracheal surgery

A

recurrent laryngeal nerve

segmental blood supply

52
Q

what does a goose honk, cough, dypnoea, exercise intolerance and cyanosis in a middle age toy breed suggest

A

tracheal collapse- graded 1-4

surgery: stenting

53
Q

when is a lung lobectomy indicated

A

lung lobe torsion
localused pulmonary abscess, neoplasia
seevre lung trauma
broncho-oesophageal fitula

54
Q

when should you do surgery to repair diaphragmatic hernia

A

when patient stable unless stomach herniated

small animal year 4 (6 decks)

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