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Small animal (fourth year) > Respiratory > Flashcards

Respiratory Flashcards

(90 cards)

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1
Q

what is the function of a cough?

A

permit removal of material from airways (assist mucociliary clearance, expel inhaled particulate, protect against irritants)

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2
Q

what are the two types of cough receptors?

A

mechanoreceptor
chemoreceptor

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3
Q

where are cough mechanoreceptors found?

A

larger airways

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4
Q

where are cough chemoreceptors found?

A

medium airways

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5
Q

where are cough receptors most numerous in the airways?

A

larynx then trachea then bronchi

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6
Q

what parts of the airway have no cough receptors in?

A

bronchioles and alveoli

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7
Q

what are the three general differentials for coughing?

A

compression of mainstream lobar bronchi
stimulation of cough receptors
excessive mucus/fluid/inflammation

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8
Q

what can cause compression of mainstem lobar bronchi?

A

left atrial enlargement
lymph node enlargement
neoplasia

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9
Q

how will heart rate change in dogs coughing due to cardiac disease?

A

normal or increased

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10
Q

how will heart rate change in dogs coughing due to respiratory disease?

A

normal or decreased

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11
Q

what will the heart rhythm be of a dog coughing due to cardiac disease?

A

regular sinus rhythm or sinus tachycardia/arrhythmia

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12
Q

what will the heart rhythm be of a dog coughing due to cardiac disease?

A

sinus arrhythmia

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13
Q

when will a dog cough if the cough is due to cardiac disease?

A

at night or when sleeping/resting

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14
Q

when will a dog cough if the cough is due to respiratory disease?

A

when excited or on exertion

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15
Q

what sort of information would you like to find out in a history about a coughing patient?

A

environment
worming history
travel history
recent events/illness
other clinical signs

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16
Q

regarding the cough itself, what would you like to find out?

A

onset
character - productive??
description - when’s it worst??
length of cough
changes to bark

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17
Q

how will inflamed bronchioles look on radiographs?

A

doughnuts - side on
tramlines - longitudinal

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18
Q

what are the characteristics of the airways in chronic bronchitis?

A

excessive mucus production due to increased goblet cells and submucosal hyperplasia
damage and loss of cilia often with secondary infections

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19
Q

what dogs is chronic bronchitis most commonly seen in?

A

small/toy breed dogs

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20
Q

what is the prognosis of dogs with chronic bronchitis?

A

often guarded because mucosal changes or normally non-reversible
(aim to manage condition)

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21
Q

what is the diagnostic tool of choice for chronic bronchitis cases?

A

bronchoscopy and broncheoalveolar lavage (cytology, bacteriology…)

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22
Q

what should be visible on a successful BAL?

A

froth/foam on top (surfactant)

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23
Q

what is bronchial collapse?

A

regional to diffuse airway collapse of segmental/subsegmental bronchi with associated clinical signs due to airflow limitations

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24
Q

what is bronchial collapse also known as?

A

bronchomalacia

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25
what type of cough is seen with bronchial collapse?
wheezy cough
26
what respiratory parasites can be found in cats/dogs?
Oslerus osleri Crenosoma vulpis Aelurostrongylus abstrusus (cats)
27
what is the typical finding on bronchoscopy of an animal with Oslerus osleri?
nodules at the bifurcation
28
what is the typical finding on bronchoscopy of an animal with Crenosoma vulpis?
worms readily seen on airway (large worms)
29
what volume is used for BAL?
0.5-1ml/kg
30
how much fluid should be aspirated on BAL?
half of what you put in
31
how many washes should be carried out in BAL?
2-3 sites/washes
32
what are normal cell to see on BALF cytology?
ciliated columnar epithelial cells goblets cells macrophages, neutrophils, lymphocytes, eosinophils
33
how will you know if you BAL sample is contaminated with oral fluids (using cytology)?
presence of certain bacteria (Simonsiella)
34
what will be found on cytology of BALF in chronic bronchitis cases?
increased mucus increased neutrophils and amacrophages possible bacteria and particulate matter possible squamous metaplasia of columnar epithelial cells
35
why should BALF be submitted for bacteriological culture in cases where chronic bronchitis is suspected?
to rule out bacteria or mycoplasma being the cause
36
what should be done in the general management of chronic bronchitis cases?
weight control harness rather than collar/lead avoid irritant/smoky environment
37
how can excess mucous be managed in chronic bronchitis cases?
avoid dry environment nebuliser (put in bathroom when owner shower/bathing)
38
what drugs are used as treatment for chronic bronchitis?
bronchodilators anti-inflammatory (steroids)
39
what effects do the bronchodilators have on managing chronic bronchitis?
reduce lower airway spasm reduce intra-thoracic pressure reduce large airway collapse improve diaphragmatic function improve mucociliary clearance inhibit mast cell degranulation (reduce bronchoconstriction mediators) prevent microvascular leakage
40
what are the bronchodilators used for chronic bronchitis?
theophyline (dogs) terbutaline (not licensed)
41
what are the desired effects of glucocorticoids in chronic bronchitis cases?
broncho-dilatory anti-inflammatory inhibit prostaglandin synthesis potential beta-2 adrenergic activity induce lymphopenia inhibit fibroblast formation modulate immune system
42
what is a mucolytic that can be used if chronic bronchitis cases?
bromhexine
43
what is bronchiectasis?
the entire bronchus is very dilated
44
should an antibiotic for respiratory infections be bactericidal or bacteriostatic?
bactericidal
45
how long should respiratory tract infections be treated with antibiotics?
2 weeks minimum
46
what are some common antibiotics used for respiratory infections?
potentiated amoxycillin cephalexin TMP sulphonamides fluroquinolones doxycycline (myocplasma)
47
what is eosinophilic lung disease?
spectrum of disease from chronic bronchitis to pulmonary granulomatous disease (usually with bronchial and interstitial involvement
48
what dogs is eosinophilic lung disease most commonly seen in?
young large breeds
49
what is the presumed cause of eosinophilic lung disease?
hypersensitivity to inhaled allergens
50
how will eosinophilic lung disease generally present on bronchoscopy?
copious amounts of green mucus and inflammation
51
how is eosinophilic lung disease treated?
immunosuppressive doses of prednisolone (2 mg/kg/day)
52
what is the most common cause of coughing cats?
inflammatory airway disease
53
does feline asthma usually cause an inspiratory or expiratory dyspnoea?
expiratory
54
what is used to treat feline asthma for dyspneic cats?
humidified oxygen minimise stress IV dexamethasone (steroid) bronchodilator (terbutaline)
55
what drugs can be used in inhalers for feline asthma?
salbutamol fluticasone (long term inflammation control)
56
what are the clinical signs of bronchial foreign body?
sudden onset cough halitosis (if its been there a while) history of field/woodland walking
57
what mismatch in ratio do pulmonary parenchymal diseases result in?
ventilation:perfusion mismatch
58
what partial pressure of oxygen will make a patient clearly cyanotic?
<60mmHg
59
is audible breathing noise associated with upper or lower airway disease?
upper
60
what is the main cause of inspiratory dyspnoea?
upper airway obstruction (laryngeal paralysis, mass/compression...)
61
what is the main cause of expiratory dyspnoea?
dynamic airway collapse of bronchial narrowing
62
what can cause both inspiratory and expiratory dyspnoea?
oedema or idiopathic fibrosis
63
what is the main sign of obstructive dyspnoea?
increased breathing effort
64
what is the main sign of restrictive dyspnoea?
fast shallow respirations
65
what can cause inspiratory obstructive dyspnoea?
upper airway obstruction
66
what causes expiratory obstructive dyspnoea?
bronchospasm (feline asthma...)
67
is restrictive dyspnoea usually inspiratory or expiratory?
usually both (pleural effusions...)
68
what percentage oxygen should be given to patients with dyspnoea?
<50% (avoid 100% as can cause toxicity)
69
what does a poor response to supplementing a cyanotic dyspnoeic animal with oxygen suggest?
animal may have congenital heart disease with a right to left shunt
70
what is inspiratory stirtur usually caused by?
upper airway obstruction
71
what breathing pattern is usually seen with pleural effusions?
restrictive (increased effort)
72
how does a radiograph of a pneumothorax look?
lungs partially collapsed heart elevated from sternum
73
what are the physiological mechanisms that cause pleural effusion?
increased hydrostatic pressure decreased plasma oncotic pressure increased vascular/pleural permeability increased fluid production
74
why are standing lateral radiographs discouraged?
dangerous - unless lead lined walls
75
why would a standing lateral radiograph be useful in pleural effusion cases? (discouraged)
will get a clear line of fluid and gas
76
what is used instead of a standing lateral radiograph to visualise pleural effusions?
ultrasound
77
how is thoracocentesis done?
clips and clean area use 21G 1 inch butterfly catheter with and three way tap and syringe and insert into 7th/8th intercostal space at the costochondral junction
78
how does a pure transudate appear?
clear colourless fluid
79
how does a modified transudate appear?
slightly red/straw coloured
80
how much protein and cells do transudates have?
very low protein and cells (pretty much done)
81
how much protein and cells do modified transudates have?
high proteins but low cells
82
how much protein and cells do exudates have?
high proteins and cells
83
what are some examples of exudates?
haemothorax pyothorax chylothorax
84
what is the most common cause of pleural effusion in cats?
congestive heart failure
85
what should be done if you diagnose after thoracocentesis that the pleural effusion is due to a pericardial effusion
rapidly carry out pericardiocentesis
86
what should be done if purulent exudate is drained by thoracocentesis?
submit for aerobic/anaerobic culture and sensitivity insert drain to lavage daily
87
what are some possible broad spectrum antibiotics that can be used while awaiting culture/sensitivity of prothorax fluid?
potentiated amoxycillin metronidazole fluroquinolone combination
88
what are some possible causes of chylothorax?
trauma/lesions disrupting thoracic duct or cranial vena cava pericardial disease congestive heart failure (especially cats) lung lobe torsion idiopathic
89
how can chylothorax be treated following thoracocentesis?
treat underlying disease feed low fat diet rutin (reduce chyle production) most cases require surgery
90
what needs to be done in all pleural effusion cases after thoracocentesis?
radiograph to check for neoplasia (will get a clear view now there is no fluid)

Small animal (fourth year) (26 decks)

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