Respiratory

Question 1

What are the two key functions of the larynx

Answer 1

To produce sound, and to protect the airway

Question 2

Describe how tracheal size is quantitatively assessed, to diagnose tracheal hypoplasia.

Answer 2

Lateral radiographs, described as the ratio of the thoracic inlet diameter to the diameter of the trachea.

Question 3

What is a normal tracheal ratio ? How is this different to brachycephalic breeds, and then English bulldogs?

Answer 3

0.16 normal in dog, 0.14 general boas dog, 0.12 EBD

Question 4

Why would a dog with BOAS have a concurrent polycythaemia?

Answer 4

Chronic hypoxia, leads to generation of more RBCs

Question 5

What is doxapram? Why might it be used in the diagnosis of an acquired respiratory condition?

Answer 5

Respiratory stimulant. Can cause av block however. Diagnosis of laryngeal paralysis.

Question 6

Why would thoracic radiographs be indicated as part of diagnostics for laryngeal paralysis?

Answer 6

Evaluate for screening for causes (masses, megaO), however evaluated concurrent noncardiogenic pulmonary oedema or aspiration pneumonia

Question 7

What characterises the clinical sign of Ptyalism?

Answer 7

Excessive saliva production

Question 8

What is a chemodectoma?

Answer 8

Tumour made up of chemoreceptor most commonly seen along one of the carotid arteries or the aorta

Question 9

What are the clinical signs of lower airway disease?

Answer 9

Wheezing, dyspnoea, cough (potentially productive), crackles on auscultation

Question 10

Describe what a bronchial radio graphic pattern would look like in a dog. What causes this appearance? How is this different to cats?

Answer 10

Thickened end-on bronchi (donuts), caused by chronic bronchial inflammation. Cats have a tram line appearance to their bronchi.

Question 11

Capillaria aerophila, paragonimus kellicotti, oslerus osleri and crenosoma vulpis are all kinds of what?

Answer 11

Respiratory parasites, typically infect dogs

Question 12

Which respiratory parasite only infects cats, of the list provided: Capillaria aerophila, paragonimus kellicotti, oslerus osleri, crenosoma vulpis and Aelurostrongylus abstrusus

Answer 12

Aelurostrongylus abstrusus

Question 13

Why is it good practice to collect pooled faecal analysis for baermann technique faecal analysis?

Answer 13

Because parasites may intermittently shed their ova or larvae, and will increase the possibility of an accurate result

Question 14

Tracheobronchial malacia is otherwise known as?

Answer 14

Tracheal collapse

Question 15

Why is doxycycline typically the first antibiotic of choice for respiratory infections (before culture and sensitivity are back?

Answer 15

Because of its broad spectrum of activity, ability to penetrate the airway and minimal side effects

Question 16

What type of drug is dextromethorphan?

Answer 16

Anti-tussive

Question 17

List three side effects of bronchodilators (such as theophylline, terbutaline and albuterol)

Answer 17

GI upset, tachycardia and hyperexcitability

Question 18

What are the side effects of long term glucocorticoid use to control inflammatory airway disease?

Answer 18

Weight gain (worsens signs), thinning of cartilage and predispose to secondary infections.

Question 19

What is fluticasone propionate and why might it be used?

Answer 19

Inhaled corticosteroid, used to treat chronic bronchiolar inflammation

Question 20

Which non-medical treatment options are there for tracheobronchial malacia?

Answer 20

External polypropylene ring supports, to provide lumen support. Endoscopic or fluoroscopic placed tracheal stenting

Question 21

What is a contraindication of an antitussive such as theophylline, terbutaline and albuterol

Answer 21

Mucus in the lungs, as patients will need to clear the exudate

Question 22

Describe the pathophysiology that characterises feline asthma (or feline bronchial disease)

Answer 22

Disorder of the lower airways that causes airflow limitation due airway inflammation, accumulated airway mucus and smooth muscle contraction. These factors impede airflow and trigger chronic coughing.

Question 23

What classes of drug to theophylline, albuterol and terbutaline belong?

Answer 23

Albuterol and terbutaline are beta-2 agonists, whilst theophylline is a methylxanthine derivative

Question 24

What is ciliary dyskinesia? How does this affect the respiratory system?

Answer 24

Function of cilia is impaired, in the respiratory system this leads to impaired mucociliary clearance

Question 25

What is Kartagenners syndrome otherwise known as? What characterises this rare inherited syndrome?

Answer 25

Primary ciliary dyskinesia. Characterised by situs inversus (left to right reversal of internal organ position including dextrocardia). Patients have chronic sinusitis, bronchitis, ear infections, are infertile and are predisposed to chronic bronchopneumonia.

Question 26

In terms of alveolar gas exchange, why might there be adequate CO2 expulsion, with concurrent hypoxaemia, in a patient with pulmonary disease?

Answer 26

Patients with pulmonary disease may have oedematous or thickened alveoli. CO2 more readily diffuses compared to oxygen, therefore a patient can have normal to low CO2 and be hypoxaemic due to impaired gas exchange

Question 27

What are the protein concentrations in g/dL of transudate, Modified Transudate and Exudate?

Answer 27

<2.5, 2.5-4.5 and >3

Question 28

Where would you expect to auscultate on the thorax to best hear rhonchi? Describe what this respiratory sound indicates.

Answer 28

Auscultated in Isolated lung fields. Due to thick secretions causing narrowing of the airway, can be cleared with coughing. Low pitch. Rumbling, gurgling sound.

Question 29

What denotes the difference between wheezing and rhonchi on respiratory auscultation ?

Answer 29

Rhonchi is low pitch, wheezing is high pitch

Question 30

How can crackles be further classified when auscultated during a thoracic examination?

Answer 30

Fine or coarse.

Question 31

How can bronchial, vesicular and bronchovesicular be classified as lung sounds?

Answer 31

Normal lung sounds.

Question 32

Describe the classification of S1-S4 heart sounds

Answer 32

S1, closure of AV values. S2 closure of semilunar valves (aortic and pulmonary). S3 (not in healthy heart) end of rapid ventricular filling. S4 (not in healthy heart) end of atrial emptying and start of the filling of ventricles.

Question 33

If you wanted to auscultate the pulmonary valve in a dog, where would you place your stethoscope?

Answer 33

Left apex, 2- 4th intercostal space

Question 34

Describe the pathophysiology that’s leads to acute respiratory distress syndrome.

Answer 34

1. Injury to alveolar epithelium or capillary endothelium leads to increased permeability of pulmonary capillaries.
2. This leads to proteinatious noncardiogenic pulmonary oedema, inflammation, hypoxaemia, decreased lung compliance.
3. rapidly progressive respiratory failure.

Question 35

Explain why diuretics are poorly effective at treating acute respiratory distress syndrome.

Answer 35

Fluid accumulation is proteinatious in nature and poorly responsive to diuretics.

Question 36

Why might a clinician be cautious with intravenous fluid therapy in patients recovering from smoke inhalation?

Answer 36

Aggressive fluid therapy can worsen pulmonary oedema. Close monitoring is required.

Question 37

Eosinophilic bronchopneumopathy is a diagnosis of exclusion. List causes that would need to be ruled out.

Answer 37

Heart worm (dirofilaria immitis), lungworm (angiostrongylus), respiratory fungal infections, migration of other parasites, neoplasia.

Question 38

What are the three main classifications that are used to describe thoracic radiographic abnormalities?

Answer 38

Interstitial, alveolar, bronchial

Question 39

Describe the difference between structured and unstructured interstitial lung pattern on thoracic radiography

Answer 39

Unstructured is characterised by generalised increase in pulmonary parenchyma background opacity with reduced visualisation of thoracic vasculature.

Structured interstitial lung pattern appear as discrete or coalescing soft tissue nodules within the pulmonary lung fields.

Question 40

Describe how an alveolar pulmonary pattern would appear on a thoracic radiograph.

Answer 40

Overall increase in lung tissue opacity. Major vessels will be obscured. Atelectasis is a common cause of alveolar patterns, and the mediastinum will usually shift toward the side of atelectasis.