Respiratory Flashcards

Question

What bacteria causes strangles?

Answer 1

Streptococcus equi equi

Answer 2

Sudden pyrexia (24 - 48h pre-shedding) Mucopurulent nasal discharge RF and SM LN abscessation Pharyngitis - Nasal discharge - Dysphagia - Cough - Laryngeal associated pain - Extended head Right – moderate lymphoid pharyngeal hyperplasia – inflammation Can see dorsal displacement of soft palate in severe inflammation with dyspnoea LN abscessation - Abscessation 3-14 days after infection Retropharyngeal – can rupture into guttural pouch Submandibular Parotid Cranial cervical Can be drained externally Guttural pouch empyema – pus in body cavity

Answer 3

Pneumonia to bronchal pleural fistula Distant abscesses in different body systems - lymphatic or haematogenous spread Severe dyspnoea - severe retropharyngeal abscessation, guttural pouch empyema Immune mediated ascites - uncommon Type 3 hypersensitivity reaction

Answer 4

History - onset, exposure, travel, new horses? Clinical signs - variable, non specific, but vital Endoscopy, US, radiography Pathogen identification Culture - 30-40% sensitivity - false negative tests - PCR of nasopharyngeal lavage is optimal - nasopharyngeal swab then nasal swab

Answer 5

Culture PCR of endoscopic guttural pouch lavage 3x 7 days apart

Answer 6

NSAIDs - pyrexia and pain, inflammation Soft, calorific diet Abscess management - hot packing, drainage, lavage Isolation Nursing care Do not lance until mature abscess GP lavage for empyema Antibiotics for severe persistent infection - benzylpenicillin For with severe dyspnoea, dysphagia or persistent fever

Answer 7

Infection of lower respiratory tract Broncho - bronchi and parenchyma If in pleural space - pleuropneumonia Exudative stage - sterile transudate in pleural space Fibrinopurulent stage - bacterial invasion and fibrin deposition Organisation stage - fibroblasts in exudate - pleural peel

Answer 8

After viral infections Strenuous exercise Transportation and prolonged elevation of head - mucocilliary clearance GA Overcrowding Inclement weather Dysphagia - aspiration

Answer 9

Dysphagia - pharyngeal and postpharyngeal Oesophageal obstruction GA Cleft palate

Answer 10

Streptococcus equi zooepidemicus – normal commensal Staphylococcus aureus and S. pneumonia Actinobacillus (gram negative non enteric) Escherichia coli, Pasteurella, Enterobacter, Klebsiella, Bordetella Bacteroides fragilis Fusobacterium and Peptostreptococcus anaerobius

Answer 11

Tachycardia/tachypnoea Respiratory distress Fever Anorexia, depression +/- nasal discharge Exercise intolerance Auscultation – crackles, dull areas – use rebreathing bag to auscultate Crackles and wheezes Dull areas Dull area follows flat line – pleuropneumonia Pleural ribs – pleuropneumonia Radiation of cardiac sounds

Answer 12

Pain intercostal spaces – palpate Reluctance to walk, colic Grunting during respiration Abduction of elbows Ventral oedema

Answer 13

Physical exam and rebreathing bag Haematology and biochemistry Endoscopy TTW and BAL - hugely useful - Aerobic and anaerobic (do not refrigerate) US - white line pleura and surface of lung - Comet tails - pathology Radiography Thoracocentesis Thoracoscopy CBC - Neutrophilia leukocytosis - Leukopenia - Anaemia - chronic cases Increased fibrinogen and SAA Decreased Fe2+

Answer 14

Penicillin and Gentamycin IV Penicillin and Gentamycin and Metronidazole in aspiration pneumonia Adjust based on C+S Inhaled drugs Gentamycin Ceftiofur Cefquinome

Answer 15

Infection of respiratory epithelial cells URT, nasopharyngeal shed, destroyed cilia Clinical signs - Fever - Cough - Nasal discharge - serous, may become purulent - secondary bacterial infection Diagnosis - Nasal swab - ELISA, PCR - Serum - antibodies, ELISA, haemagglutination inhibition - Treatment - Nursing care and anti-inflammatories - Antibiotics for secondary infection - Vaccine available

Answer 16

Transmission - inhalation of aerosol, contact with infected fomites, reactivation from latency Infection of respiratory epithelial cells - nasopharyngeal shed Abortion - rare Spiral cord - neuro disease - rare Clinical signs Common - Fever, mild cough, slight nasal discharge, poor performance Occasional - abortion, sick neonatal foal, neurological disease - equine herpes myoencephalopathy - EHM Diagnosis - Nasal swab (and placenta/fetus) - PCR - Blood sample - anticoagulated blood acute - Antibodies - complement fixation test - serum Treatment - Rest in athletic animals - EHM - nursing care and antiinflammatories - Vaccine available

Answer 17

Respiratory, venereal, congenital, fomite spread URT and LRT, to regional lymph nodes, and replicates into bloodstream Clinical signs - Often asymptomatic, fever, nasal discharge, loss of appetite, respiratory distress, skin rash, muscle soreness, conjunctivitis, depression Relatively rare in UK Diagnosis PCR ELISA for prebreeding or sales Treatment Supportive when acute, no treatment for persistent infection in stallions Vaccine available

Answer 18

Parasitic roundworm Ingestion of L3 larvae from faeces, pasture - donkeys Mucupurulent exudate, hyperplastic epithelium, lymphocytic infiltrate in lamina propria - alveolitis, brochiolitis, bronchitis Moderate to severe coughing - exercise Diagnosis Larvae in faeces - rarely Tracheal wash for eggs, larvae and WBC Failure of antiobiotic therapy, season, history Treatment Moxidectin and Ivermectin - stable to treat

Answer 19

Systemic sepsis - FPT Congenital abnormalities Meconium aspiration Milk aspiration Birth trauma

Answer 20

Bilateral choanal atresia Stenosis of nares Severe laryngeal oedema or collapse DDSP (dorsal displacement soft palate) Subepiglottic cyst Severe pulmonary abnormalities Congenital cardiac abnormalities

Answer 21

Respiratory failure syndrome - non cardiogenic pulmonary oedema, decreased pulmonary compliance, ventilation/perfusion mismatch Exaggerated inflammatory response - severe tissue damage Surfactant deficiency - progressive atelectasis (partial/total lung collapse) Treatment - Intranasal oxygen - Ventilation - mechanical due to lung collapse - Anti-inflammatories - corticosteroids - Broad spectrum antibiotics - gentamycin Poor prognosis

Answer 22

Aspirate material from nasal passages and pharynx Nasotracheal intubation and careful suction Intranasal oxygen supplementation +/- mechanical ventilation Anti-inflammatory therapy Pentoxyfylline - improves circulation Secondary bacterial pneumonia treatment - broad spectrum - pencillin, gentamicin, TMPS

Answer 23

Secondary to - Generalised weakness, poor suckle reflex Dysphagia - prematurity or neonatal maladjustment Congenital abnormalities Diagnosed with history of milk regurgitation Abnormal lower respiratory sounds systemic inflammation pulmonary dysfunction Endoscopic examination of URT Thoracic radiography Treatment - correct cause of aspiration - naso-oesophageal feeding tube - Broad spectrum antimicrobial therapy - TMPS, penicillin, gentamicin

Answer 24

Diagnosis Physical exam - Crepitus - Auscultation - grinding or clicking Ultrasonography Treatment - Conservative Box rest - avoid pressure on handling Surgical repair may be necessary if multiple fractures and risk thoracic viscera Haemothorax - address primary cause of haemorrhage and patient stabilisation and support

Answer 25

Uncommon EHV1, EHV4, Equine influenza, Equine arteritis, equine adenovirus Older foals Dry cough, fever, +/- mucopurulent nasal discharge (secondary bacterial infection) Usually self limiting EAV - ventral and limb oedema due to vasculitis

Answer 26

Severe and typically fatal in neonatal foals Presents similarly to neonatal sepsis Cardiovascular and respiratory insufficiency Congested MMs Leukopenia, neutropenia, lymphopenia PCR testing of nasal secretions or whole blood Treatment Antivirals - Acyclovir, valacyclovir - some efficacy in less affected foals Supportive care

Answer 27

Following ingestion of lavated eggs of parascaris - ineffective larvae emerge in intestinal lumen - through liver and lungs - cough up and ingested Substantial inflammation with migration through lungs Clinical signs of LRT disease Usually self limiting Anthelmintic treatment - Widespread resistance - treat with pyrantel or fenbendazole

Answer 28

Haematogenous spread secondary to bacteraemia or in utero infection. Can be aspiration - milk or meconium Typically gram negative - e.coli Most common cause of death in 1-6 month foals Strep equi zooepidemicus, Rhodococcus equi Stress of weaning, change in environment

Answer 29

Pneumonia Gram positive coccibacillus Ubiquitous Inhalation Clinical disease - Insidious - LRT infection - Fever - Lethargy - Coughing - Tachypnoea - Dyspnoea - nostril flaring and prominent abdominal expiratory effort Intrapulmonary abscesses Interstitial or alveolar pattern Tracheobronchial lymphadenopathy Pleural effusion Diagnosis TTW - cytology and PCR Oxygen insufflation NSAIDs Cool shade Macrolide and rifampin - azithromycin and clarithromycin Prevent Hyperimmune plama No vaccine yet

Answer 30

Young (any age possible) Clinical signs - Decrease performance - No resting dyspnoea - Occasional cough - >3 weeks Spontaneous improvement, response to treatment, no reccurence History of stabled Diagnostics - Endoscopy - tracheal mucous +1 +3 - Cytology - increased neutrophils - Pulmonary function - 0

Answer 31

>7 year old Big decrease in perfomance Frequent cough Resting dyspnoea Variable duration Long term treatment/management/recurrence History - stabled or pasture, familial history, seasonality Diagnostics Treacheal mucus - +1+5 Marked increase neutrophils Marked effect on pulmonary function

Answer 32

ARD - airborne respirable dust Steamed hay Much more dust from nets Breathing zone- 30cm from horses nose Type I and III hypersensitivity Bronchospasm secondary to inflammation - bronchodilators Activation of macrophages Airway neutrophilia Mucus accumulation Tissue remodelling Look for tolerance on rebreathing bag - cough, recovery Wheezes, crackles, tracheal rattles Endoscopy - rule out upper airway disease, tracheal mucous - 1h post exercise BAL - diagnostic of EA

Answer 33

Foreign body Fungal granulomas Neoplasms

Answer 34

Iatrogenic Ethmoid haematoma Trauma - variable

Answer 35

Rostral to caudal border of nasal septum so usually unilateral Spontaneous Highly vascular structures - ethmoid turbinates - so could be profuse

Answer 36

Trauma Neoplasia Ethmoid haematoma Coagulation disorders

Answer 37

Mycosis - fungal plaques penetrate into carotid artery and erode wall Foreign body Neoplasia Purpura haemolytica DIC - disseminated intravascular coagulation - very serious overactive clotting proteins Rectus capitis muscle rupture - fall back and hit back of head - stretch muscle - can fracture base of skull

Answer 38

Foreign body Neoplasia Purpura DIC Clotting defects Trauma Iatrogenic

Answer 39

Pulmonary haemorrhage - EPIH - exercise induced pulmonary haemorrhage Trauma Neoplasia Foreign body Iatrogenic - Lung biopsy - NG tube

Answer 40

Duration, how many times, colour of blood (mucopurulent, frank), uni/bilateral, associated with exercise, URT disease, recent trauma, toxic plants Physical exam - MM, haematomas, prolonged bleeding - Neuro exam - Evidence of trauma - Nasal and flat bones - Exophthalmos or epiphora - Symmetry of airflow, stridor Evaluation of head and resp system Complete blood count Clotting profile and platelets - citrate tbe Biochemical profile - liver enzyme and function tests Radiography, US TTW, BAL Assess blood loss - No change in PCV with whole blood for 4 hours - Splenic contraction with hypoxia - increase in PCV - Fluid from extracellular fluid - decline in TP, decline in PCV 4-6 hours Determine transfusion need on CS, pathology, history - Tachypnoea, tachycardia - Thready or non-palpable pulse quality - Cool extremities - Pale MM - mentation changes - anxiety, depressed, compulsive thirst - Increased blood lactate - serial measurement increase - Acute PCV drop >10% or <13%

Answer 41

Epidermal inclusion cysts Redundant alar folds Lacerations Congenital conditions Wry nose - maxilla deformation - euthanasia

Answer 42

4th 5th and 6th cheek teeth lie in maxillary sinus Infection may cause sinusitis Nasolacrimal canal and infraorbital canal also lie within maxillary sinus

Answer 43

3rd cheek tooth Infection may cause sinusitis

Answer 44

Tie forward - prosthesis replacing thyrohyoid muscle - success rate 80%

Answer 45

Collapse of pharyngeal wall when negative pressure highest - maximum inspiration collapse in Treatment limited

Answer 46

Nasal reflux of milk/food material and aspiration pneumonia Endoscopy diagnosis Poor prognosis - recurrent infections and poor athletic function - euthanasia

Answer 47

Causes inspiratory stridor with laryngeal muscle paresis - due to recurrent laryngeal nerve paresis Underlying cause - is it nerve pathology or physical problem - typically idiopathic - left sided hemiplegia Tie back procedure - physically replicate the dorsal circoaryternodeus - coughing is common side effect as irritation of trachea or aspiration pneumonia as completely open permanently

Answer 48

Inflammation of arytenoid cartilage Racehorses - inhaled on kicking up Diagnosis - endoscopy resting - size, mucosa, drainage and granulation tissue, palpation Treatment Medical - antimicrobials broad spectrum, antiinflammatories - systemic and local Sugery Local excision Arytenoidectomy Permanent tracheostomy (esp if bilateral)

Answer 49

Can be concurrent with chondritis and affect prognosis Excision Complications - loss of normal anatomy/function ideally local excision only - laser

Answer 50

MDAF - laser to remove excess tissue - high inspiratory negative pressures

Answer 51

Congenital or acquired Treat by removal - Excision through laryngotomy or snare wire good prognosis

Answer 52

Clear distinction from DDSP needed Typically expiratory noise Resect transendoscopic laser

Respiratory Flashcards

(76 cards)