Respiratory Flashcards
(89 cards)
1
Q
Five differentials for hypoxemia
A
- Low inspired O2
- Right to L shunt
- Diffuse interstitial disease
- V/Q mismatch
- Hypoventilation
2
Q
Broad differentials for hypoxemia with a normal A-a gradient
A
- Low inspired O2
- Hypoventilation
3
Q
Over-represented breeds for tracheal collapse
A
Yorkshire Terrier, Pomeranian, Pug, Poodle, Maltese, and Chihuahua
4
Q
Fluoroquinolones should be used with caution in a dog on what respiratory drug?
A
Theophylline
5
Q
A young Old English Sheepdog presents for fever, cough and chronic nasal discharge. Radiographs show situs inversus (left to right transposition of viscera) and bronchiectasis with a patchy alveolar pattern. This condition is consistent with what congenital abnormality?
A
Primary ciliary dyskinesia (this triad - rhinosinusitis, situs inversus, and bronchiectasis is Kartagener’s syndrome)
6
Q
Why is nebulization generally discouraged in cats?
A
Nebulized drugs can potentially can trigger a bronchospastic reaction and/or occasion extra stress
7
Q
Simplified equation for A-a gradient?
A
PAO2 - PaO2; PAO2 calculated by 150-(PaCO2/0.8)
8
Q
What is intermediate host of Paragonimus kellicotti? What is treatment?
A
Crayfish. Fenbendazole and/or TID praziquantel
9
Q
Treatment for aelurostrongylus abstrusus?
A
Fenbendazole (25-50 mg/kg PO q 24 h for 10-14 days),
ivermectin (300-400 mcg/kg SC), or selamectin (6 mg/kg applied topically)
10
Q
Treatment for Crenosoma vulpis?
A
fenbendazole (50 mg/kg PO q 24 h for 3 days), ivermectin, or milbemycin oxime
(0.5 mg/kg PO, once)
11
Q
Combination of respiratory signs and bleeding can be a cause of what parasite?
A
French heartworm - angiostrongylus vasorum
12
Q
Furosemide may be helpful in cases of neurogenic pulmonary edema. T/F?
A
True - neurogenic can have a component of increased hydrostatic pressure contributing to edema (while most noncardiogenic edema does not)
13
Q
What % of primary lung tumors can affect multiple lobes?
A
1/3
14
Q
This respiratory parasite is found on fecal flotation, not Baerman.
A
Capillaria aerophila aka Eucoleus aerophilus
15
Q
Canine breeds predisposed to interstitial pulmonary fibrosis?
A
Westties, Staffies
16
Q
What resp exam finding is more common in interstitial fibrosis?
A
Inspiratory crackles (not necessarily specific for fibrosis though)
17
Q
Dog breeds predisposed to lung lobe torsion
A
Afghan Hounds and Pugs
18
Q
Echocardiographic findings consistent with pulmonary hypertension
A
RV concentric hypertrophy or RV eccentric hypertrophy, RA enlargement, septal flattening, and
potentially RV systolic dysfunction
19
Q
Over what pressure counts as pulmonary hypertension?
A
> 25-31 mmHg (consensus says that humans use >25). Consensus also recommends clinical PH is probably >46 mmHg
20
Q
Pneumomediastinum on its own does not require treatment and does not cause dypsnea. T/F?
A
True
21
Q
Mediastinal LSA in cats is generally FeLV + or -?
A
+
22
Q
When is a PDE5 inhibitor indicated for a dog with pulmonary hypertension and left sided heart disease?
A
-Right heart failure (needs CHF meds as well)
-Exertional syncope with no other cause
-Compensated CHF that develops ascites (recommended to increase CHF meds at same time)
[Consensus on PH]
23
Q
Most useful signs to guide treatment of pulmonary hypertension?
A
Clinical signs, blood gas, pulse-ox, CXR (echo can be used but improvement is not always identified even on PDE5 inhibitor) [Consensus on PH]
24
Q
TL3 receptors are activated by what? How about TL9 receptors?
A
Viruses; bacteria. JVIM 2019 (TLR agonist complexes targeting these were given to herpes cats to see if improves signs. it did but they still had signs)
25
Twice daily famciclovir to shelter cats improved which of the following: Disease scores, body weight, conjunctival feline herpesvirus 1 (FHV-1) shedding, and adoption rates
Conjunctival FHV-1 shedding (JFMS 2019)
26
Most common two agent responsible for feline upper resp infections in Australia?
Mycoplasma felis and feline calicivirus (JFMS 2019)
27
Most common nasal cancer in cats from UK nasal bx study?
Lymphoma (followed by carcinomas) - JFMS 2020
28
Brachycephalic cats were more likely to develop nasal disease, based on a UK nasal biopsy study. T/F?
False - an association was not found JFMS 2020
29
What is risk for development of aspiration pneumonia 3-4 years following unilateral arytenoids lateralization for dogs with lar-par? What were most significant risk factors associated with pneumonia?
~31%. Post-op megaesophagus and post-op opioid admin. JAVMA 2016
30
What % of dogs examined for cough had laryngeal dysfunction?
~19% (26 of 138) - JAVMA 2016
31
Congenital laryngeal paralysis associated with Alaskan Huskies is associated with mononeuropathy or polyneuropathy?
Mononeuropathy (JAVMA 2016). They also talk about characteristic facial features aka Blue eyes (92%), white facial markings (76%), and oral mucosal tags (52%) but they're also alaskan huskies so....?
32
In a study evaluating treatment of benign nasopharyngeal stenosis and imperforate nasopharynx, ballooning alone was successful in what % of dogs and what % of cats?
NO dogs were successful with ballooning alone; 41% of cats - JAVMA 2018 [overall outcome 78% success; with high rate of complications with stent placement- 68%)
33
Brachycephalic dogs with upper airway obstruction had higher CRP and altered metabolic profile compared to normal dogs. T/F?
False - JVIM 2019
34
Having surgery to correct brachycephalic airway disease decreased subsequent anesthetic complications by how much?
79% - JAVMA 2020
35
Doxepin had no improvement in dogs with lar-par compared to placebo. T/F?
True - actually the placebo dogs seemed to be doing better JVIM 2021
36
Based on owner questionnaires, Norwich Terriers with upper airway syndrome that had surgery performed generally had poorer QOL than those that did not. T/F?
True - JVIM 2021[although may have had confounding variables as surgery was likely pursued for dogs that were worse affected]
37
Stent fracture occurred in what % of dogs with endoluminal stent placement? Dogs with tracheal malformations composed what % of intra-thoracic inlet fractures?
25% (most common major complication), 100% - JVIM 2018
38
What was MST for tracheal stent placement in dogs with severe tracheal disease compared to medical management?
MST was 12 days for medically managed dogs and 1,338 days for dogs that underwent stent placement - JAVMA 2021
39
Maropitant improved cough and inflammatory cells on BAL in dogs with chronic bronchitis. T/F?
False - cough only; JVIM 2016
40
Most common concurrent disease in dogs with bronchiectasis?
Pneumonia (~52%), with inflammatory dz second (36%) - JVIM 2016
41
Maropitant improves signs of feline bronchitis. T/F?
False (JFMS 2016)
42
Trichuris eggs on fecal can be mistaken for what other type of feline respiratory lungworm? How can this be treated?
Capillaria; topical moxidectin JFMS 2016 review
43
Clinical presentation, diagnosis, and treatment for Aelurostrongylus?
Can be like asthmatic cat; Baermann; fenbendazole (CAPC), topical moxidectin/emodepside/selamectin/eprinomectin - this lungworm can be found worldwide (so in the US; C aerophila and T brevior are European lungworms) - JFMS 2016
44
Main complaint of feline tracheobronchial foreign body and method of dx?
coughing, 92% found on CXR, and most (83%) removed via endoscopy JFMS 2017
45
Accuracy for CT in predicting canine bronchitis? Was it more sensitive or specific?
57% accuracy; more specific (90%) than sensitive (46%)- JAVMA 2018
46
Is mainstem bronchi collapse in dog with tracheal collapse associated with worse outcome for stent placement?
No- JAVMA 2019
47
What type of dog more frequently required revision surgery if received permanent tracheostomy? What was the rate of major complication (not necessarily associated with this type of dog)
Brachycephalic, 60% JAVMA 2019.
48
What species of mycoplasma most commonly associated with lower respiratory disease in dogs?
mycoplasma cynos (JVIM 2019 review)
49
Of eosinophilic bronchitis, eosinophilic granuloma, or eosinophilic bronchopneumopathy -which was least likely to develop bronchiectasis or have a high peripheral eosinophilia?
Eosinophilic bronchitis (JVIM 2019)
50
What is generally needed in order to make bronchiolar disease diagnosis in cats?
CT scan, lung histopath (bronchioles too small to be seen on rads) - JVIM 2019
51
Airway injury was significantly associated with what type of inflammation seen on BAL?
lymphocytic JVIM 2019
52
Most common feline lungworm infection?
Aelurostrongylus JFMS 2019. THis study also showed that mixed infections generally had worse clinical signs than monoinfections
53
A cat with known asthma and heartworm infection that presents in INSPIRATORY distress is more likely to be suffering from which disease?
Anaphylaxis from worm death (if expiratory- more asthmatic) - JFMS 2019 review
54
What were main findings in age between cats with eosinophilic, neutrophilic, and mixed airway inflammation?
Lots of overlap, but cats with eosinophilic tended to be younger (median 4 years compared to 7 or 8) - JVIM 2020
55
Which method of nebulization- undiluted or diluted gentamicin - seemed more effective for inducing clinical cure in dogs with Bordetella?
Undiluted JVIM 2020
56
Most common aeroallergen that cats with eosinophilic airway disease were reactive to?
Mites - dust mites (n=4) most common followed by two types of storage mites (n=3 each) - JVIM 2020
57
Which immunoglobulin has been associated with feline asthma?
IgE - degree of reactivity did not correlate with clinical severity (JFMS 2020)
58
Main differentiating factor between feline asthma and feline chronic bronchitis in a study comparing the two evaluating signalment, clinical, laboratory and radiographic parameters?
Asthma more likely to have eosinophilia than chronic bronchitis (40% to 27%) however this is not enough to reliably distinguish the two. So nothing really distinguishes besides airway wash. lol. JFMS 2020
59
Shelter dogs that tested positive for what infectious agent involved in CIRD had lower serum vitamin D concentrations than those that were negative?
CHV-1 JVIM 2021
60
What variables were linked with a final diagnosis of inflammatory lower airway disease in cats that presented to ER in resp distress?
History of cough, abdominal component to respiration, and NOT having pleural effusion (JFMS 2021)
61
A CT-based study in coughing dogs supported the idea that dogs with cough and murmur had more narrowed bronchi than dogs with no cough (and no murmur). T/F?
True - JVIM 2021. Study was basically saying that heart can contribute to cough since heart size was inversely correlated to airway diameter.
62
Normalization of what acute phase protein may be used as a guide to stop antibiotic treatment in dogs with pneumonia?
CRP - JVIM 2017
63
Elevated total bile acid concentration in Westies is indicative of canine idiopathic pulmonary fibrosis. T/F?
False - HEALTHY Westies can also have this. JVIM 2018
This study found that concentrations of TBA significantly high in pulmonary fibrosis, healthy WHWTs, laryngeal dysfunction, and chronic bronchitis compared to healthy beagles, indicating microaspiration
64
H3N2 and H3N8 infection in dogs have similar clinical signs. T/F?
True - JAVMA 2018
65
Which brachycephalic dog breed generally presents later for signs of pneumonia than the others (Pug vs Eng Bulldog vs Bulldog) ?
Pug (83 months) vs French Bulldogs (8 months) and Bulldogs (6 months) JAVMA 2018. Relative risk for overall aspiration is 3.77x normal population.
66
What were CT findings characteristic of canine pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis? These two diseases are linked with what type of disease/condition that results in syncope/exercise intolerance/resp distress?
pulmonary arterial enlargement and perivascular diffuse nodular ground-glass opacities; pulmonary arterial hypertension (JVIM 2019)
67
Recurrent bacterial pneumonia can be found without evidence of immune deficit or primary ciliary defect in which breed? What was a frequent finding in affected dogs?
Irish Wolfhound, focal bronchiectasis (JVIM 2019)
68
What ultrasonographic finding on lung ultrasound were 92% sensitive and 94% specific for cardiogenic pulmonary edema?
10 or more B-lines in 2 or more sites (JAVMA 2019)
69
Serum levels with which matix metalloproteinase were higher in Westies with interstitial pulmonary fibrosis?
MMP-7 (MMP-2 and MMP-9 were higher in BALF) - JVIM 2021 [MMP-2 is probably the most diagnostically useful based on their graphs since others had a lot of overlap but idk if they'd ask that]
70
If you culture Mycoplasma from a wash from a cat with pneumonia, how likely is it be from aspiration?
0% - no aspiration pneumonia cats cultured mycoplasma. Also aspiration cats tended to be sicker with more acute signs (and less likely to present with cough) - JVIM 2021
71
What is the primary cause for lobar emphysema? Which lobe is most commonly affected?
Congenital (82%); right middle lung lobe (71%) - JVIM 2021
72
Based on a study comparing aspiration pneumonia and bordetella infection, a dog with normal to mildly increased CRP concentration would fall into which of the aforementioned groups?
Bordetella (aspiration dogs had very high CRPs) - JVIM 2021
73
Fluoroscopic evaluation of changes in respiration correlate with which of the following? age, sex, thoracic conformation, body weight, body condition score (BCS), or breed.
body weight (JVIM 2017)
74
Mycoplasma felis is associated with upper respiratory or lower respiratory disease in cats?
Upper respiratory (JAVMA 2017)
75
Which had improved deposition of inhaled fluticasone in healthy dogs? Nebulization or metered dose inhaler?
nebulization (JVIM 2017)
76
Lung lobe torsion in juveniles occurred most commonly in what signalment (gender, breed) of dog?
Male pugs. Left cranial lung lobe most affected (JAVMA 2017)
77
High levels of household particulate matter was more significantly associated in dog or cats with respiratory disease?
Cats (JVIM 2018)
78
What is the most likely cause of pleural effusion in cats? What is the overall survival rate for cats with pleural effusion?
CHF (~40%) (second was neoplasia at ~25%); 23% of cats died or euthanized; JAVMA 2018; JFMS 2019 - CHF at 35%, neoplasia at 30% - others pyo, FIP, chylo
79
Pleural non-chylous lymphocyte-rich transudates in cats were most associated with what disease process?
CHF (70%) - 27% were thoracic/mediastinal neoplasia (JFMS 2018)
80
Incidence of desaturation (SpO2 < 90%) associated with feline bronchoscopy?
30% - more frequently with tracheal catheter rather than ETT or mask (JFMS 2019)
81
If stored at 4C, BALF can be stored for up to how long without altering culture results?
24h (JVIM 2020)
82
Absence of bacteria on cytology generally means that the growth of bacteria will be less than which of the following:
No growth; Few colonies; 1+; 2+?
Generally less than 1+ (JVIM 2021)
Cytology positive/culture negative discordancy was uncommon (8/97, 8%). Cytology negative/culture positive discordancy was frequent (102/184, 55.4%), but occurred less often (28/184, 14.2%) when only 1+ growth or greater was considered positive.
83
Chest physiotherapy was not associated with improved P/F ratio (arterial partial pressure of oxygen on fraction of inspired oxygen ratio) in dogs with acute airway fluid accumulation. T/F?
False - it was. JVIM 2021
84
ISCAID recommendations for pneumonia with sepsis in dogs?
FQ + penicillin or clinda
85
Azithromycin for a chronic upper respiratory feline infection is not as effective as doxy for which other common respiratory organism?
Chlamydia felis (ISCAID)
86
Mucopurulent discharge in feline upper respiratory infection is an indication to treat with antibiotics according to ISCAID. T/F?
False - only treat if ill (fever, lethargy, anorexia), persistence (>10 days) or worsening (after 5-7 days)
87
In a dog or cat with pyothorax, anaerobic coverage should be continued regardless of culture results according to ISCAID. T/F?
True
88
Recommended treatment for Pseudomonas aeruginosa organism isolated from feline nasal culture (and is believed to be secondary infection) in cat with chronic rhinitis?
Flush, FQ +/- beta-lactam [and culture] (ISCAID)
89
Recommendations for treatment of acute pneumonia with no sepsis according to ISCAID?
No treatment or beta-lactam/1st generation cephalosporin. (Note: if mega-e or esophageal motility disorder noted - parenteral drug indicated)
