Respiratory

Question 1

What factors increase the risk of infectious respiratory diseases in animals?

Answer 1

Juveniles, immunocompromised, or unvaccinated animals.

Question 2

Which breed is predisposed to chronic pulmonary fibrosis?

Answer 2

West Highland White Terriers.

Question 3

What are common environmental factors that may affect respiratory health?

Answer 3

Exposure to other animals in shelters, boarding facilities, or multi-pet households.

Question 4

What posture is associated with reverse sneezing?

Answer 4

Neck extended, head tilted backward, mouth closed.

Question 5

What does open-mouth breathing in dogs indicate?

Answer 5

Common response to upper airway obstruction.

Question 6

What is the physiological role of a cough?

Answer 6

To clear the lower airways of noxious substances or retained secretions.

Question 7

What characterizes a cough originating from the alveolar/small airways?

Answer 7

Typically preceded by deep inspiration and may be productive or nonproductive.

Question 8

What is a common cause of cough related to pleural space disease?

Answer 8

Lung compression due to pleural effusion.

Question 9

What does paradoxical breathing indicate?

Answer 9

Severe respiratory muscle fatigue.

Question 10

What is stridor?

Answer 10

Continuous, high-pitched sound from turbulent airflow at the nasopharyngeal meatus.

Question 11

What is the clinical insight regarding stertor?

Answer 11

Often more pronounced at night due to nasopharyngeal narrowing.

Question 12

What are normal bronchovesicular sounds characterized by?

Answer 12

Peak inspiratory flow near end of inspiration and peak expiratory flow early in the expiratory phase

Generated by laminar flow through central airways, filtered by alveoli, pleura, and chest wall.

Question 13

What indicates increased breath sounds?

Answer 13

Increased respiratory effort and pulmonary edema

Decreased sounds can result from shallow breathing, obesity, pleural effusion, interstitial fibrosis, or pneumothorax.

Question 14

What are wheezes?

Answer 14

Continuous, musical sounds caused by airway narrowing, especially in intrathoracic small airways

Typically heard during expiration.

Question 15

What do fine crackles represent?

Answer 15

Pressure equilibration across obstructed airways

Loudest at end-inspiration.

Question 16

What are coarse crackles associated with?

Answer 16

Airflow through secretions

Heard throughout inspiration and sometimes expiration.

Question 17

What is a common technique to enhance detection of respiratory signs during physical exams?

Answer 17

Induce a sigh by closing the mouth and partially occluding nostrils for 4–5 breaths

Other techniques include gently palpating the trachea to induce a cough or asking owners to record signs at home.

Question 18

What notable abnormality may indicate chronic hypoxia?

Answer 18

Erythrocytosis

Other abnormalities include neutrophilic leukocytosis in bacterial infections and transient lymphopenia in acute bronchopneumonia.

Question 19

What are the limitations of traditional fecal testing for respiratory parasites?

Answer 19

Lack of sensitivity due to intermittent shedding

This can result in false negatives.

Question 20

What does an unstructured interstitial pattern indicate?

Answer 20

Diffuse hazy increase in pulmonary opacity

Causes may include viral pneumonia, early pulmonary edema, or neoplastic infiltrates.

Question 21

What are the radiographic signs of an alveolar pattern?

Answer 21

Air bronchograms, lobar margin visualization, mediastinal shift

Common causes include cardiogenic edema and bronchopneumonia.

Question 22

What is indicated by a bronchial pattern on radiographs?

Answer 22

Thickened bronchial walls or peribronchial space infiltration

Signs include ‘donuts’ and ‘tram lines’.

Question 23

What are the signs of pleural space disease on radiographs?

Answer 23

Pleural fissure lines, retraction of lung lobes, rounded lung borders

Must exceed ~100 mL in medium dogs to be visibly apparent.

Question 24

What are the key benefits of CT for evaluating nasal and upper airway diseases?

Answer 24

Superior bone and cartilage detail, high sensitivity for early lesions

Useful for surgical planning and guided biopsies.

Question 25

What are the advantages of Computed Tomography (CT) in respiratory disease evaluation?

Answer 25

High-resolution, thin-slice images enhance localization and characterization of lesions in: * Lower airways * Alveoli * Chest wall * Pleural space ## Footnote CT is particularly useful for diagnosing chronic bronchitis and bronchiectasis.

Question 26

What does thin-slice CT allow for in terms of imaging?

Answer 26

Reconstruction into: * Virtual bronchoscopy * 3D anatomic maps for bronchoscopy, surgery, or biopsy planning ## Footnote This enhances the diagnostic capabilities of CT.

Question 27

What is the detection threshold of CT for pulmonary nodules?

Answer 27

As small as 1 mm ## Footnote This is significantly smaller compared to the ~7–9 mm threshold on radiography.

Question 28

What are the strengths of Magnetic Resonance Imaging (MRI) in respiratory evaluations?

Answer 28

Excellent soft tissue resolution, superior for: * Early neoplasia * Fungal granulomas * Fluid vs. soft tissue discrimination ## Footnote MRI is similar to CT in nasal disease and neoplasia.

Question 29

What are the limitations of MRI for pulmonary imaging?

Answer 29

Poor sensitivity for bony/cartilaginous changes and unsuitable for gas-filled lung ## Footnote Motion artifact from respiration and limited image quality in dynamic structures are also concerns.

Question 30

What does fluoroscopy provide in respiratory tract imaging?

Answer 30

Real-time imaging of the respiratory tract ## Footnote This includes visualization during clinical events like coughing and swallowing.

Question 31

What are the applications of fluoroscopy in diagnosing aerodigestive disorders?

Answer 31

Swallow studies using contrast food or liquid to detect: * Nasopharyngeal or esophagopharyngeal reflux * Aspiration ## Footnote Fluoroscopy is useful in postprandial sneezing and recurrent bronchopneumonia.

Question 32

What is the role of ultrasonography (US) in evaluating the upper airway?

Answer 32

Limited utility due to air-tissue and bone interfaces, but useful for: * Extraluminal masses * Distinguishing solid vs. fluid-filled lesions * Evaluation of laryngeal function ## Footnote US can assess tracheal collapse morphologically.

Question 33

What are the limitations of nuclear scintigraphy?

Answer 33

Poor spatial resolution and requires specialized facilities ## Footnote It is generally limited to academic or research institutions.

Question 34

What is the gold standard for evaluating pulmonary gas exchange?

Answer 34

Arterial Blood Gas (ABG) analysis ## Footnote It assesses oxygenation and ventilation.

Question 35

What are the normal values for PaO₂ in room air?

Answer 35

80–100 mmHg ## Footnote Hypoxemia is indicated by PaO₂ < 80 mmHg.

Question 36

What does elevated A–a gradient indicate?

Answer 36

V/Q mismatch, diffusion impairment, or shunt ## Footnote Normal A–a gradient indicates hypoventilation or low inspired oxygen.

Question 37

What are the major causes of hypoventilation?

Answer 37

* CNS depression * Upper airway obstruction * Pleural space disease * Thoracic wall restriction * Anesthesia ## Footnote These factors can lead to increased PaCO₂.

Question 38

What are the three critical roles of the nasal airways in dogs and cats?

Answer 38

* Thermoregulation * Olfaction * Respiration

Question 39

What anatomical structures create extensive surface areas in the nasal cavity for warming and detecting odors?

Answer 39

Intricate turbinates (nasal conchae)

Question 40

How is the nasopharyngeal airway functionally divided?

Answer 40

* Nasal entrance (nares and vestibule) * Respiratory chamber * Olfactory chamber * Nasal exit (nasopharyngeal meatus and choanae)

Question 41

What is the primary function of the ventral nasal conchae?

Answer 41

Thermoregulatory and respiratory functions

Question 42

What is the significance of airway mucus in respiratory defense?

Answer 42

* Traps foreign particles * Contains bactericidal proteins (e.g., lysozyme, lactoferrin) * Supports mucociliary clearance

Question 43

How do dogs thermoregulate during panting?

Answer 43

By inhaling through the nose and exhaling through the mouth

Question 44

What is a major risk for dogs with obstructed nasal airflow?

Answer 44

Heat stress and hyperthermia

Question 45

What are common clinical signs of nasal disease in dogs and cats?

Answer 45

* Nasal discharge * Stertor * Sneezing * Epistaxis * Exercise intolerance

Question 46

What commonly indicates significant underlying disease in dogs with nasal discharge?

Answer 46

Mucopurulent or purulent nasal discharge

Question 47

What should be avoided in cases of chronic nasal discharge in dogs?

Answer 47

Initiating antibiotics without a clear diagnosis

Question 48

What percentage of nasal discharge cases in dogs is attributed to nasal neoplasia?

Answer 48

~30%

Question 49

What are common causes of nasal obstruction?

Answer 49

* Congenital malformations * Trauma * Chronic inflammation * Iatrogenic stenosis * Intranasal masses * Foreign bodies * Oronasal defects

Question 50

What is the role of the lateral nasal gland in thermoregulation?

Answer 50

Secretes fluid into the nasal vestibule for cooling during panting

Question 51

What does the nasal cavity account for in terms of inspiratory and expiratory resistance?

Answer 51

* ~80% of inspiratory resistance * ~74% of expiratory resistance

Question 52

What does a thorough external exam of the nasal area assess?

Answer 52

* Symmetry of facial bones * Nares size and movement * Pigmentation and condition of nasal planum * Nasal airflow patency

Question 53

List some types of intranasal masses.

Answer 53

* Neoplasia (malignant or benign) * Cysts * Inflammatory polyps or granulomas * Foreign bodies ## Footnote These masses can incite inflammation and discharge, leading to secondary obstruction.

Question 54

In which breeds is a deviated nasal septum commonly described?

Answer 54

Small breeds and brachycephalic dogs ## Footnote Deviated nasal septum has also been reported in cats.

Question 55

What is stenosis of the nasal exit?

Answer 55

Stenosis of the nasopharyngeal meatus and nasopharynx, functionally and anatomically linked ## Footnote These conditions are often addressed together.

Question 56

What are common clinical signs of nasal foreign bodies?

Answer 56

* Acute sneezing * Pawing at the face * Persistent unilateral nasal discharge ## Footnote These signs are indicative of retained foreign bodies.

Question 57

What congenital condition can lead to oronasal communication?

Answer 57

Cleft palate ## Footnote This condition often involves the soft palate and may predispose to otitis media.

Question 58

What is idiopathic rhinitis?

Answer 58

A type of rhinitis with an unknown cause, prevalent in ~30% of chronic nasal discharge cases in dogs ## Footnote It often requires a diagnosis of exclusion.

Question 59

What are the clinical signs of idiopathic rhinitis?

Answer 59

* Chronic nasal discharge (uni- or bilateral) * Sneezing * Reverse sneezing * Cough ## Footnote No facial deformity or systemic illness is typically present.

Question 60

What is the treatment approach for idiopathic rhinitis?

Answer 60

Individualized therapy may include: * Immunomodulatory antibiotics * Corticosteroids * NSAIDs * Supportive care ## Footnote Relapses are common, and treatment often provides only partial relief.

Question 61

What clinical signs indicate allergic rhinitis?

Answer 61

* Sneezing * Oculonasal discharge * Nose rubbing * Head shaking ## Footnote Allergic rhinitis is likely underdiagnosed in dogs and cats.

Question 62

What are the common types of sinonasal neoplasia in dogs?

Answer 62

* Carcinomas (most commonly adenocarcinoma) * Sarcomas (chondrosarcoma, fibrosarcoma, osteosarcoma) ## Footnote Approximately 80-90% of nasal masses are malignant.

Question 63

What are the clinical features of sinonasal tumors?

Answer 63

* Nasal discharge * Sneezing * Facial asymmetry or swelling * Stertor * Epistaxis ## Footnote Early signs often mimic benign rhinitis.

Question 64

What is the prognosis for untreated nasal carcinoma in dogs?

Answer 64

Median survival time is ~3.1 months ## Footnote This emphasizes the importance of early diagnosis and treatment.

Question 65

What is the primary treatment for sinonasal tumors?

Answer 65

Radiation therapy ## Footnote It is the mainstay for palliation and improved survival.

Question 66

What is the role of surgery in sinonasal tumor treatment?

Answer 66

Endonasal endoscopic tumor ablation is used for visible tumor tissue removal ## Footnote This approach preserves critical structures and improves quality of life.

Question 67

What are non-malignant nasal masses?

Answer 67

* Angioleiomyomas * Angiofibromas * Hamartomas * Intranasal cysts * Inflammatory granulomas ## Footnote These benign lesions can obstruct airflow and mimic neoplasia.

Question 68

What is the function of the Eustachian tube?

Answer 68

Equalizes pressure between the middle ear and atmosphere ## Footnote It also protects the middle ear and allows mucociliary clearance.

Question 69

What are common clinical signs of nasopharyngeal disease?

Answer 69

* Stertorous breathing * Reverse sneezing * Nasal discharge * Retching ## Footnote These signs can affect respiratory, gastrointestinal, and neurologic systems.

Question 70

What is a common consequence of functional failure of nasopharyngeal closure?

Answer 70

Food and fluids enter the nasopharynx and nasal cavities ## Footnote This can lead to foreign body reactions and secondary nasal inflammation.

Question 71

Where can obstruction of the nasopharyngeal meatus occur?

Answer 71

At the rostral meatus, tubular midsection, and caudal choanae. ## Footnote Each site has different implications for diagnosis and treatment.

Question 72

What are common etiologies for nasopharyngeal obstruction?

Answer 72

* Congenital malformation * Skull trauma * Foreign bodies * Ulcerative mucosal disease * Scarring from infection or regurgitation

Question 73

What is choanal atresia?

Answer 73

A rare condition caused by failure of embryologic resorption of the oronasal membrane. ## Footnote It can be bony, membranous, or mixed.

Question 74

What are the etiologies of nasopharyngeal stenosis and collapse?

Answer 74

* Congenital anomalies * Post-inflammatory fibrosis * Intramural lesions * Extraluminal lesions * Dynamic collapse

Question 75

What are the treatment modalities for nasopharyngeal stenosis?

Answer 75

* Balloon dilation * Surgical mucosal advancement * Temporary silicone stenting ## Footnote Each technique has associated risks.

Question 76

What is a promising approach for treating nasopharyngeal stenosis in cats?

Answer 76

Removable silicone stents ## Footnote These stents can open the stenotic segment without leaving permanent foreign material.

Question 77

What is the most common tumor in cats affecting the nasopharynx?

Answer 77

Lymphoma ## Footnote Other common tumors include adenocarcinoma.

Question 78

What are the clinical signs of nasopharyngeal neoplasia?

Answer 78

* Progressive stertor * Nasal discharge * Open-mouth breathing * Neurologic signs if extension occurs

Question 79

What are nasopharyngeal inflammatory polyps?

Answer 79

Non-neoplastic masses arising from chronic inflammation of the middle ear or auditory tube. ## Footnote Their etiology is unknown but may involve several factors.

Question 80

What are the common clinical signs of nasopharyngeal inflammatory polyps?

Answer 80

* Progressive stertor * Nasal discharge * Open-mouth breathing * Horner’s syndrome if tympanic bulla is involved

Question 81

What are common disorders affecting the frontal sinus?

Answer 81

* Aspergillosis * Tumors * Idiopathic rhinitis * Cysts

Question 82

What is sinonasal aspergillosis?

Answer 82

The most frequent fungal disease of the nasal/sinus cavities, typically affecting frontal sinuses. ## Footnote Characterized by fungal plaques, ulceration, and bony lysis.

Question 83

What are the common anatomical malformations in brachycephalic dogs?

Answer 83

* Stenotic nares * Undersized nasal cavity * Elongated soft palate * Laryngomalacia * Hypoplastic trachea

Question 84

What is the impact of airway resistance in brachycephalic animals?

Answer 84

Airway resistance is inversely proportional to the fourth power of the radius, leading to significantly increased resistance with minor diameter reductions.

Question 85

What are the features of Pugs' trachea?

Answer 85

Weak, flattened cartilage rings and a redundant dorsal tracheal membrane that may prolapse into the lumen

Question 86

How does skull shortening affect brachycephalic dogs?

Answer 86

Reduces the craniofacial box size, leading to crowding of soft tissues

Question 87

What is the impact of an overlong soft palate in brachycephalic dogs?

Answer 87

Increases negative nasopharyngeal pressure during inspiration, increasing collapsibility

Question 88

What causes an overthick soft palate in brachycephalic dogs?

Answer 88

Increased stromal and salivary tissue, not muscle hypertrophy

Question 89

What is the hamular bottleneck?

Answer 89

Narrowed space between the pterygoid hamuli that can be worsened by obesity

Question 90

What gastrointestinal signs are associated with brachycephalic airway syndrome?

Answer 90

Dysphagia, regurgitation, vomiting, laryngopharyngeal reflux

Question 91

What percentage of Pugs/French Bulldogs could walk only 10-30 minutes in summer?

Answer 91

75%

Question 92

What are key aspects to assess during a clinical examination of brachycephalic dogs?

Answer 92

* Nare diameter and nasal vestibule * Respiratory rate * Mucous membrane color * Stridor/stertor characteristics * Laryngeal, tracheal, and thoracic auscultation

Question 93

What are some components of modern multilevel surgery?

Answer 93

* Alar vestibuloplasty * Laser-Assisted Turbinectomy Endoscopically (LATE) * Staphylectomy with palatine volume reduction * Bilateral tonsillectomy * Microlaryngoscopic laser ablation of averted ventricles

Question 94

What was the reduction in life-threatening events following surgery?

Answer 94

90%

Question 95

What is the main purpose of non-surgical management of brachycephalic airway syndrome?

Answer 95

Supportive, temporizing, or preparatory for surgery

Question 96

What medications are commonly used in the medical management of brachycephalic dogs?

Answer 96

* Corticosteroids * Antibiotics

Question 97

What is a goal of emergency management during acute respiratory distress?

Answer 97

* Sedation * Prevention of hyperthermia * Stabilization of breathing * Avoidance of non-cardiogenic pulmonary edema

Question 98

What is one effective non-invasive way to improve airflow dynamics in brachycephalic dogs?

Answer 98

Weight control

Question 99

What is the primary function of the larynx?

Answer 99

Control of airflow, protection of lower airways during swallowing, control of phonation

Question 100

Name four common laryngeal diseases.

Answer 100

* Laryngeal paralysis * Laryngeal collapse * Laryngeal stenosis * Laryngeal masses

Question 101

What clinical signs may prompt veterinary evaluation for laryngeal diseases?

Answer 101

* Respiratory stridor * Voice changes * Coughing * Gagging

Question 102

Laryngeal paralysis primarily affects which age group and breed type?

Answer 102

Older (>9 years) large and giant breed dogs

Question 103

Which breeds are documented to have congenital laryngeal paralysis?

Answer 103

* Bouvier des Flandres * Siberian Huskies * White-coated German Shepherds * Miniature Bull Terriers

Question 104

What is the genetic risk factor identified in Miniature Bull Terriers for laryngeal paralysis?

Answer 104

RAP-GEF6 gene variant

Question 105

What are common causes of acquired laryngeal paralysis?

Answer 105

* Polyneuropathy * Polymyopathy * Trauma * Neoplasia * Endocrinopathies * Infectious diseases * Toxicities

Question 106

What are the clinical signs of laryngeal paralysis?

Answer 106

* Stridor * Exercise intolerance * Voice changes * Coughing * Gagging * Dysphagia * Cyanosis * Collapse

Question 107

What anesthetic agent is identified as most appropriate for preserving laryngeal motion?

Answer 107

Thiopental IV to effect

Question 108

True or False: Doxapram hydrochloride is superior to mechanical stimulation for triggering arytenoid movement.

Answer 108

True

Question 109

What are common complications associated with temporary tracheostomy?

Answer 109

* Airway obstruction * Tube dislodgement * Aspiration pneumonia * Stoma swelling

Question 110

What are the potential complications of permanent tracheostomy?

Answer 110

* Major complications in 50% of cases * Revision surgery in 20% * Acute death in 26% of cases

Question 111

What is the most common post-operative complication for dogs undergoing unilateral arytenoid lateralization?

Answer 111

Aspiration pneumonia

Question 112

What factors are associated with increased risk for complications post-surgery (tie-back)?

Answer 112

* Progression of neurologic signs * Perioperative aspiration pneumonia * Post-operative esophageal dysfunction * Concurrent neoplastic disease

Question 113

In cats, what percentage of laryngeal disease cases does laryngeal paralysis account for?

Answer 113

40%

Question 114

What is the typical age range for cats affected by laryngeal paralysis?

Answer 114

Middle-aged to older cats (mean age: 9–14 years)

Question 115

What is the mean age range of cats affected by laryngeal paralysis?

Answer 115

9–14 years

Question 116

What are the documented causes of laryngeal paralysis?

Answer 116

* Trauma * Neoplastic infiltration * Iatrogenic damage, particularly post-thyroidectomy

Question 117

What diagnostic tool has been described for cats with suspected laryngeal paralysis?

Answer 117

Echolaryngography

Question 118

What is the conservative therapy for managing laryngeal paralysis?

Answer 118

* Weight loss * Minimizing excitement or exertion

Question 119

What is the median survival of conservatively managed cats with laryngeal paralysis?

Answer 119

811 days

Question 120

What is laryngeal collapse?

Answer 120

A progressive condition secondary to chronic upper airway obstruction.

Question 121

What breeds are most commonly affected by laryngeal collapse?

Answer 121

Brachycephalic breeds

Question 122

What are the stages of laryngeal collapse?

Answer 122

* Stage I: Eversion of laryngeal saccules * Stage II: Collapse of cuneiform processes * Stage III: Complete laryngeal collapse

Question 123

What is the preferred method for diagnosing laryngeal collapse?

Answer 123

Direct visualization during laryngoscopy

Question 124

What are the premedications used for laryngeal functional examination?

Answer 124

* Glycopyrrolate * Butorphanol * Buprenorphine * Hydromorphone

Question 125

What is the recommended treatment for early-stage laryngeal collapse?

Answer 125

Sacculectomy

Question 126

What is the preferred surgical approach for laryngeal stenosis?

Answer 126

Ventral laryngotomy

Question 127

What are common clinical signs of laryngeal stenosis?

Answer 127

* Exercise intolerance * Inspiratory stridor * Respiratory distress

Question 128

What types of tumors are reported in canine laryngeal neoplasia?

Answer 128

* Rhabdomyosarcoma * Oncocytoma * Squamous cell carcinoma * Adenocarcinoma

Question 129

What is the most common laryngeal tumor in cats?

Answer 129

Squamous cell carcinoma

Question 130

What is the prognosis for laryngeal neoplasia in dogs and cats?

Answer 130

Generally guarded, as diagnosis often occurs in advanced stages.

Question 131

What are histopathologic patterns associated with inflammatory laryngeal disease?

Answer 131

* Granulomatous * Lymphocytic * Plasmacytic * Eosinophilic

Question 132

What is the treatment for inflammatory laryngeal disease?

Answer 132

* Mass debulking * Corticosteroid therapy * Permanent tracheostomy

Question 133

What are laryngeal cysts?

Answer 133

Rare, benign, cystic lesions that can obstruct airflow.

Question 134

What is the typical treatment for laryngeal cysts?

Answer 134

Surgical excision

Question 135

What are the common non-infectious tracheal disorders in dogs and cats?

Answer 135

* Dorsal tracheal membrane flaccidity * Tracheal collapse * Tracheal injury or laceration * Post-traumatic stenosis * Tracheal foreign bodies or tumors * Tracheal avulsion * Tracheitis ## Footnote Tracheitis refers to inflammation of the tracheal epithelium and may be infectious or non-infectious.

Question 136

What factors can lead to non-infectious tracheitis?

Answer 136

* Excessive barking * Oropharyngeal, esophageal, or gastric disease * Aerodigestive disorders in cats ## Footnote In cats, tracheitis is often associated with feline upper respiratory infections but may not always produce a prominent cough.

Question 137

What are some causes of extratracheal compression and deviation?

Answer 137

* Severe cardiomegaly * Mediastinal enlargement * Megaesophagus * Space-occupying masses ## Footnote These conditions can displace or alter the shape of the tracheal lumen.

Question 138

What are the primary structural defects involved in tracheal collapse?

Answer 138

* Chondromalacia * Trachealis muscle laxity * Tracheal malformation * Dorsal membrane prolapse ## Footnote Chondromalacia refers to degeneration of tracheal cartilage.

Question 139

What are some secondary triggers that may promote tracheal collapse?

Answer 139

* Obesity * Cardiomegaly * Inhaled irritants/allergens * Periodontal disease * Recent endotracheal intubation * Respiratory infections ## Footnote Chronic inflammation and coughing can perpetuate the disease through a vicious cycle.

Question 140

What are common clinical signs of tracheal collapse in dogs?

Answer 140

* Chronic harsh 'goose honk' cough * Exercise intolerance * Panting * Dyspnea * Cyanosis in advanced cases ## Footnote Cough can be triggered by excitement, tracheal pressure, drinking water, and more.

Question 141

What are some key strategies in the long-term management of collapsing trachea?

Answer 141

* Reduce cough and inflammation * Address underlying comorbidities * Avoid triggers * Promote weight loss * Replace neck collars with harnesses * Limit exposure to respiratory irritants ## Footnote Pharmacologic agents may include antitussives, steroids, and bronchodilators.

Question 142

What complications can arise from tracheal stenting?

Answer 142

* Tracheal granulomas * Migration * Infection * Tracheobronchial or bronchoesophageal fistulas ## Footnote Stenting is not curative but can improve quality of life.

Question 143

What types of neoplasia are rare in dogs and cats but can occur in the trachea?

Answer 143

* Osteochondroma * Lymphoma * SCC * MCT * Fibrosarcoma * Adenocarcinoma * Osteosarcoma * Extramedullary plasmacytoma * Leiomyoma ## Footnote SCC stands for squamous cell carcinoma and MCT stands for mast cell tumor.

Question 144

What are the clinical signs associated with tracheal granulomas?

Answer 144

* Inspiratory stridor * Expiratory intolerance * Cough * Gagging * Exercise intolerance * Change in bark * Fever * Intermittent cyanosis * Collapse ## Footnote Cats may exhibit open-mouth breathing.

Question 145

What is the definition of chronic bronchitis?

Answer 145

A syndrome characterized by chronic cough and airway inflammation without a defined cause.

Question 146

What are the diagnostic criteria for chronic bronchitis?

Answer 146

* Cough lasting ≥ 2 months * Evidence of mucus hypersecretion * Exclusion of other causes ## Footnote Other causes include CHF, bronchopneumonia, and pulmonary neoplasia.

Question 147

What is the primary etiology of chronic bronchitis in dogs?

Answer 147

Unknown; considered idiopathic and often a diagnosis of exclusion.

Question 148

What are some potential risk factors for chronic bronchitis in dogs?

Answer 148

* Overweight and obese dogs * Periodontal disease * Environmental pollutants * Infectious triggers * Gastroesophageal reflux (GERD) ## Footnote GERD is known to be among the most common causes of chronic cough in humans.

Question 149

What is usually the sole presenting complaint of chronic bronchitis?

Answer 149

The cough ## Footnote Chronic bronchitis typically presents with a persistent cough as the main symptom.

Question 150

What is chronic bronchitis classified as?

Answer 150

A diagnosis of exclusion ## Footnote Other causes of chronic cough must be ruled out before confirming chronic bronchitis.

Question 151

What does eosinophilia in a CBC suggest?

Answer 151

Eosinophilic bronchopneumopathy (EPB) or parasitic infection ## Footnote Eosinophilia can indicate underlying allergic or parasitic conditions.

Question 152

What does an elevated NT-proBNP level suggest?

Answer 152

Left atrial enlargement, CHF, or pulmonary hypertension ## Footnote Elevated NT-proBNP should prompt further investigation via echocardiography.

Question 153

What imaging findings may indicate chronic bronchitis on thoracic radiographs?

Answer 153

* Bronchial wall thickening * Peribronchial interstitial opacity ## Footnote These findings help rule out other conditions like masses or CHF.

Question 154

What is the purpose of bronchoscopy in diagnosing chronic bronchitis?

Answer 154

To observe airway changes and collect samples ## Footnote Findings may include loss of normal mucosal appearance and mucus accumulation.

Question 155

What are some findings that can be observed during bronchoscopy?

Answer 155

* Loss of normal glistening mucosa * Roughened, granular surface * Thick mucus accumulation * Bronchial collapse * Bronchiectasis ## Footnote Similar findings can also be seen in older, healthy dogs.

Question 156

What is the management goal for chronic bronchitis?

Answer 156

* Reduce inflammation * Control cough * Prevent exacerbation * Improve quality of life ## Footnote Chronic bronchitis is considered incurable, and management focuses on enhancing the dog's well-being.

Question 157

What environmental factors should be eliminated in managing chronic bronchitis?

Answer 157

* Indoor pollutants (e.g., smoking, perfume, sprays) * Excessive barking ## Footnote Reducing exposure to irritants can help manage symptoms.

Question 158

What are the most effective narcotic antitussives for managing cough in dogs?

Answer 158

* Butorphanol * Hydrocodone * Tramadol ## Footnote These medications have specific dosing guidelines and potential side effects.

Question 159

What is Eosinophilic Bronchopneumopathy (EBP)?

Answer 159

A spectrum of eosinophilic pulmonary diseases ## Footnote EBP includes eosinophilic bronchitis, bronchopneumonia, and pulmonary granulomatosis.

Question 160

What are the suspected triggers of EBP?

Answer 160

* Fungi * Molds * Parasites * Drugs * Bacteria ## Footnote Bordetella bronchiseptica is also suspected in severe cases.

Question 161

What breeds are predisposed to EBP?

Answer 161

* Huskies * Malamutes * Young dogs ## Footnote Other breeds may also be affected, but these are more commonly noted.

Question 162

What are the clinical signs of EBP?

Answer 162

* Coughing * Gagging * Retching * Nasal discharge * Respiratory distress ## Footnote Signs may resemble gastrointestinal issues in acute cases.

Question 163

What imaging findings are associated with EBP?

Answer 163

* Moderate to severe bronchointerstitial pattern * Bronchial wall thickening * Bronchiectasis * Mucus plugging * Pulmonary nodules ## Footnote CT may show variable findings based on disease severity.

Question 164

What is the prognosis for dogs with EBP?

Answer 164

Most respond well initially to corticosteroids, but relapse is common ## Footnote Some dogs may remain in remission after treatment withdrawal.

Question 165

What is Primary Ciliary Dyskinesia (PCD)?

Answer 165

An inherited disorder causing defects in ciliary ultrastructure ## Footnote This leads to ineffective mucociliary clearance and recurrent respiratory infections.

Question 166

What are the clinical signs of PCD?

Answer 166

* Chronic mucopurulent nasal discharge * Recurrent bronchitis/bronchopneumonia * Recurrent otitis media * Infertility ## Footnote Signs often appear in young, purebred dogs.

Question 167

How is PCD diagnosed?

Answer 167

Based on clinical features, imaging, and functional analysis ## Footnote Scintigraphy and ciliary beat analysis are key diagnostic tools.

Question 168

What is the management approach for PCD?

Answer 168

Supportive care only; no cure ## Footnote Management includes judicious antibiotic use, hydration, and regular exercise.

Question 169

What is bronchiectasis?

Answer 169

Permanent, irreversible dilation and distortion of bronchi ## Footnote It results from chronic airway inflammation and leads to a cycle of further damage.

Question 170

What are the etiologies of bronchiectasis?

Answer 170

* Congenital defects (e.g., PCD) * Chronic infections * Inflammatory airway disease ## Footnote Bronchiectasis is often secondary to other chronic pulmonary conditions.

Question 171

What are the common parasitic mimics of Eosinophilic Bronchopneumopathy (EBP)?

Answer 171

* Eucoleus aerophilus * Filaroides spp. * Serratostoma vulpis * Paragonimus kellicotti ## Footnote These parasites can induce airway eosinophilia and mimic EBP.

Question 172

True or False: Inhaled corticosteroids are often sufficient for induction of remission in EBP.

Answer 172

False ## Footnote Inhaled steroids alone may not be enough; systemic corticosteroids are typically required.

Question 173

What is the etiology of Ciliary Dyskinesia (PCD)?

Answer 173

Inherited disorder caused by defects in ciliary ultrastructure leading to ineffective mucociliary clearance ## Footnote This condition results in recurrent respiratory infections, mucus accumulation, and chronic inflammation.

Question 174

What are the hallmark features of Ciliary Dyskinesia?

Answer 174

* Bilateral mucopurulent nasal discharge * Recurrent, antibiotic-responsive pneumonia from a young age

Question 175

What genetic inheritance pattern is associated with Ciliary Dyskinesia?

Answer 175

Autosomal recessive inheritance

Question 176

Which breeds are documented to have mutations associated with Ciliary Dyskinesia?

Answer 176

* Old English Sheepdogs * Alaskan Malamutes

Question 177

What is Kartagener's Syndrome?

Answer 177

Triad of bronchiectasis, chronic sinusitis, and situs inversus ## Footnote Reported in both humans and dogs.

Question 178

What clinical signs are commonly seen in dogs with Ciliary Dyskinesia?

Answer 178

* Chronic rhinosinusitis * Bronchitis * Bronchopneumonia * Bronchiectasis * Otitis media * Infertility * Hydrocephalus * Renal fibrosis or tubular dilation

Question 179

What diagnostic methods are required for a definitive diagnosis of Ciliary Dyskinesia?

Answer 179

* Functional ciliary analysis (in vivo and in vitro) * Ultrastructural evaluation (e.g., via TEM) * Scintigraphy to assess mucociliary clearance

Question 180

What is the prognosis for dogs with Ciliary Dyskinesia?

Answer 180

Progressive disease with diminishing treatment efficacy over time; median survival can span several years with proper management.

Question 181

What is bronchial mineralization and its significance in dogs and cats?

Answer 181

Rare finding that may occur secondary to chronic bronchial inflammation or infection; frequently an incidental finding with no clinical relevance.

Question 182

Define bronchiectasis.

Answer 182

Permanent dilation and distortion of subsegmental bronchi resulting from chronic inflammation damaging elastic and muscular components.

Question 183

What are common clinical signs of bronchiectasis in dogs?

Answer 183

* Chronic cough * Gagging * Tachypnea * Dyspnea * Intermittent fever or recurrent infections

Question 184

What imaging modalities are used to diagnose bronchiectasis?

Answer 184

* Radiographs * CT (Gold standard) * Bronchoscopy

Question 185

What are the management goals for bronchiectasis?

Answer 185

* Control clinical signs * Prevent or treat bacterial infections * Address underlying disease

Question 186

What characterizes bronchomalacia?

Answer 186

Dynamic or static collapse of the bronchial walls due to cartilage weakness or loss of structural integrity.

Question 187

What breeds are commonly affected by bronchomalacia?

Answer 187

* Yorkshire Terriers * Miniature and Toy Poodles * Overweight or brachycephalic dogs

Question 188

What constitutes Feline Lower Airway Disease (FLAD)?

Answer 188

Encompasses inflammatory (most common) and non-inflammatory bronchial conditions.

Question 189

What are common clinical signs of Feline Inflammatory Bronchial Disease (FIBD)?

Answer 189

* Cough (with or without dyspnea) * Wheezing * Exercise intolerance * Acute exacerbations

Question 190

What diagnostic imaging is recommended for FLAD?

Answer 190

* Thoracic Radiographs * Thoracic CT

Question 191

What are the common differential diagnoses for FLAD?

Answer 191

* Lungworms (Aelurostrongylus abstrusus, Troglostrongylus spp.) * Feline heartworm disease (Dirofilaria immitis)

Question 192

Name two species of parasitic worms associated with feline respiratory disease.

Answer 192

* Strongylus abstrusus * Troglostrongylus spp. ## Footnote These species can cause eosinophilic inflammation in cats.

Question 193

What is the role of serum allergen-specific IgE testing in feline asthma?

Answer 193

Inconsistently useful ## Footnote Positive IgE reactivity does not significantly differ in asthmatic cats versus controls.

Question 194

What are the recommended tests for ruling out parasitic causes of eosinophilic inflammation?

Answer 194

* Baermann test for A. abstrusus * Fecal flotation for Toxocara cati ## Footnote Other species to consider include Troglostrongylus spp., Eucoleus aerophilus, and Dirofilaria immitis.

Question 195

What are common bronchoscopic findings in feline asthma?

Answer 195

* Mucoid or viscous secretions * Airway mucosal hyperemia * Infrequent bronchiectasis visualization ## Footnote Findings are often non-specific.

Question 196

What is the typical cytologic evidence of inflammation in BALF for cats with asthma?

Answer 196

* Eosinophils (suggestive of asthma) * Neutrophils (suggestive of chronic bronchitis) ## Footnote Up to 15% eosinophils can be present in healthy cats.

Question 197

What BALF threshold indicates asthma-associated eosinophilia?

Answer 197

>20–50% eosinophils ## Footnote This threshold is used to interpret eosinophilic patterns in BALF.

Question 198

What microbiologic tests should be submitted for BALF?

Answer 198

* Aerobic bacterial culture * Anaerobic bacterial culture * Mycoplasma PCR or culture ## Footnote Mycoplasma spp. may be commensals.

Question 199

Which inflammatory biomarkers in BALF are investigated to differentiate asthma from chronic bronchitis?

Answer 199

* Cytokines: IL-4, IFN-γ, TNF-α * Endothelin-1 (ET-1) * Exhaled hydrogen peroxide ## Footnote Endothelin-1 is elevated in experimental asthma.

Question 200

What are alternative methods for pulmonary function testing in cats?

Answer 200

* Tidal Breathing Flow Volume Loops (TBFVL) * Barometric Whole Body Plethysmography (BWBP) * Forced Expiratory Volume (FEV) ## Footnote Spirometry is not practical due to poor compliance in cats.

Question 201

What are some differential diagnoses for feline inflammatory bronchial disease?

Answer 201

* Airway foreign bodies * Airway collapse or malacia * Infectious pneumonia * Parasitic pneumonia * Neoplasia * Feline pulmonary fibrosis ## Footnote Empirical antiparasitic treatment may be justified in endemic areas.

Question 202

What is the initial management protocol for acute respiratory distress in cats?

Answer 202

* Minimize stress * Oxygen-enriched environment * Parenteral bronchodilators (e.g., terbutaline) * Parenteral corticosteroids (e.g., dexamethasone) ## Footnote Thoracocentesis may be life-saving if spontaneous pneumothorax is suspected.

Question 203

What is the first-line therapy for chronic feline asthma management?

Answer 203

* Oral corticosteroids (e.g., prednisolone) * Adjunct bronchodilator (e.g., propentofylline) ## Footnote Gradual tapering to the lowest effective dose is recommended.

Question 204

What are common inhaled medications for feline asthma?

Answer 204

* Fluticasone propionate * Budesonide * Racemic albuterol ## Footnote Albuterol is for rescue use only and may worsen airway inflammation with chronic use.

Question 205

What adjunct therapies may be beneficial for managing feline asthma?

Answer 205

* Weight management * Saline nebulization * Mucolytics * Stem cell therapy (experimental) ## Footnote Weight management is crucial for pulmonary function improvement.

Question 206

What is the maximum diameter of small airways?

Answer 206

<2 mm

Question 207

Where are small airways anatomically situated?

Answer 207

Between the larger, conducting bronchi and the distal pulmonary acini

Question 208

Name two environmental exposures that may cause small airway disease in dogs.

Answer 208

* Air pollution * Inhaled inorganic dust

Question 209

List three potential inhaled toxicants associated with bronchiolar diseases.

Answer 209

* Cigarette smoke * E-cigarette vapor * Mold and radon

Question 210

What are the two forms that bronchiolar diseases may present in?

Answer 210

* Obstructive * Restrictive

Question 211

What type of clinical signs are associated with small airway diseases?

Answer 211

There are no pathognomonic clinical signs

Question 212

Name four respiratory symptoms that may be observed in affected animals.

Answer 212

* Chronic cough * Wheezing * Tachypnea * Exercise intolerance

Question 213

What physical examination finding may suggest intraluminal narrowing?

Answer 213

Wheezes

Question 214

What is the gold standard for definitive diagnosis of bronchiolar disorders?

Answer 214

Lung biopsy

Question 215

What imaging technique is preferred for assessing bronchiolar disease in anesthetized patients?

Answer 215

Thoracic CT

Question 216

What are two direct CT signs of bronchiolar disease?

Answer 216

* Tree-in-bud pattern * Bronchiolectasis

Question 217

What should be done for respiratory health maintenance in dogs with bronchiolar disease?

Answer 217

* Remove inhaled irritants * Improve indoor air quality

Question 218

What is the prognosis for bronchiolar disease associated with large airway disease?

Answer 218

Favorable prognosis

Question 219

What is a guarded prognosis associated with in bronchiolar diseases?

Answer 219

* Significant parenchymal fibrosis * Pulmonary hypertension

Question 220

What is a common sequela to prior injury or inflammation in bronchiolar diseases?

Answer 220

Fibrosis

Question 221

What is the primary function of the pulmonary parenchyma?

Answer 221

Facilitates gas exchange ## Footnote The pulmonary parenchyma consists of alveolar air spaces, capillary networks, and interstitial tissue.

Question 222

What components make up the pulmonary parenchyma?

Answer 222

* Alveolar air spaces * Dense capillary network * Fine interstitial tissue * Larger pulmonary arterioles and veins ## Footnote These components are essential for gas exchange in the lungs.

Question 223

List common respiratory signs of pulmonary parenchymal disease.

Answer 223

* Cough * Tachypnea * Exercise intolerance * Excessive panting * Increased respiratory effort or distress ## Footnote Mixed inspiratory and expiratory effort is often observed.

Question 224

What are less common signs of pulmonary parenchymal disease?

Answer 224

* Hemoptysis * Collapse or syncope * Cyanosis ## Footnote Cats may show minimal signs or sudden death as the first indication of disease.

Question 225

What systemic findings can be associated with pulmonary parenchymal disease?

Answer 225

* Weight loss * Fever * Lymphadenomegaly * Distal limb swelling ## Footnote Hypertrophic osteopathy is an example of distal limb swelling.

Question 226

What changes might be noted upon auscultation in pulmonary parenchymal disease?

Answer 226

* Increased or decreased bronchovesicular sounds * Adventitial sounds (e.g., crackles, wheezes) ## Footnote These findings can indicate different types of lung disease.

Question 227

What is neutrophilia associated with in CBC findings?

Answer 227

Pneumonia, inflammatory lung disease, ARDS ## Footnote Neutrophilia is a common response to infection or inflammation in the lungs.

Question 228

What is the significance of thoracic CT in pulmonary diagnostics?

Answer 228

Higher sensitivity for small/miliary nodules and pulmonary masses ## Footnote CT provides 3D imaging and requires anesthesia and controlled ventilation.

Question 229

What is the recommended treatment for Toxocara spp. pulmonary migration?

Answer 229

Pyrantel pamoate 5 mg/kg PO, repeated in 2 weeks ## Footnote Short courses of glucocorticoids may help with severe cough after ruling out infectious pneumonia.

Question 230

What are common clinical signs of Paragonimus kellicotti infection?

Answer 230

* Often subclinical * May cause cough * Respiratory distress ## Footnote Complications can include pneumothorax and hemoptysis due to cyst rupture.

Question 231

What clinical signs are associated with Dirofilaria immitis infection in dogs?

Answer 231

* Cough * Exercise intolerance * Weight loss * Syncope * Right-sided heart failure ## Footnote Cats can experience severe pulmonary disease even with one worm.

Question 232

What is a major cause of pulmonary disease in dogs and cats in temperate climates?

Answer 232

Dirofilaria immitis (Heartworm Disease) ## Footnote This parasite can cause chronic inflammatory and thromboembolic damage.

Question 233

What is the significance of eosinophilia in pulmonary diagnostics?

Answer 233

Suggests potential parasitic infection or hypersensitivity ## Footnote Eosinophilia is often associated with allergic responses and parasitic diseases.

Question 234

What are the differential diagnoses associated with an alveolar pattern on radiographs?

Answer 234

* Pneumonia (bacterial, parasitic, viral) * Pulmonary edema * Hemorrhage * Neoplasia * Pulmonary thromboembolism ## Footnote Each of these conditions can present similarly on imaging.

Question 235

What are common imaging findings in cases of Angiostrongylus vasorum infection?

Answer 235

* Bronchial patterns * Interstitial patterns * Alveolar patterns ## Footnote CT can reveal ground-glass opacities and subpleural nodules.

Question 236

What is aspiration pneumonia?

Answer 236

May be infectious or sterile; secondary bacterial infection is common after inhalation of food, liquids, or gastric contents. ## Footnote Aspiration pneumonia can occur when foreign materials enter the lungs, leading to inflammation and infection.

Question 237

What are common clinical signs of suspected parasitic lung disease?

Answer 237

Cough, dyspnea, bleeding, neurologic signs. ## Footnote These signs may indicate a range of parasitic infections affecting the lungs.

Question 238

What laboratory clues may suggest parasitic lung disease?

Answer 238

Eosinophilia, thrombocytopenia, prolonged clotting times, anemia. ## Footnote Eosinophilia, in particular, is often associated with parasitic infections.

Question 239

What imaging findings are associated with parasitic lung disease?

Answer 239

Interstitial/bronchial patterns, subpleural nodules (especially on CT or ultrasound). ## Footnote Imaging can help identify structural changes in the lungs caused by parasites.

Question 240

What are the routes of infection for bacterial pneumonia?

Answer 240

Inhalation or aspiration, hematogenous spread, direct extension from pleura or adjacent thoracic structures. ## Footnote Understanding the routes of infection is crucial for prevention and treatment.

Question 241

Name common bacterial pathogens associated with pneumonia.

Answer 241

* Streptococcus spp. * Enteric organisms: E. coli, Klebsiella spp. * Pasteurella spp. * Coagulase-positive Staphylococcus spp. * Mycoplasma spp. * Bordetella bronchiseptica ## Footnote These pathogens can cause varying degrees of pneumonia severity.

Question 242

What are risk factors for developing bacterial pneumonia?

Answer 242

* Age extremes (young or geriatric) * Debilitation or recumbency * Immunosuppression * Anatomical/functional issues * Other: ARDS, neoplasia, mediastinal or pleural infections ## Footnote Various underlying health conditions can predispose animals to pneumonia.

Question 243

What are typical clinical signs of bacterial pneumonia?

Answer 243

* Soft, productive cough * Nasal discharge * Exercise intolerance * Respiratory distress * Anorexia and lethargy ## Footnote These signs may vary in severity depending on the infection's progression.

Question 244

What is the general principle for treating bacterial pneumonia?

Answer 244

Start empiric antimicrobial therapy after sampling. ## Footnote Prompt treatment is crucial to improve outcomes in pneumonia cases.

Question 245

What factors can worsen the prognosis of bacterial pneumonia?

Answer 245

* Delayed treatment * Comorbidities * Aspiration or foreign body involvement * Multidrug-resistant organisms ## Footnote Early intervention and addressing underlying issues are key to improving prognosis.

Question 246

What are the benefits of nebulization in pneumonia treatment?

Answer 246

Sterile saline enhances mucus fluidity. ## Footnote Though benefits are extrapolated from human medicine, use in veterinary patients is still under investigation.

Question 247

What are the indications for bronchodilators in pneumonia treatment?

Answer 247

Unresponsive hypoxemia, concurrent bronchoconstriction, especially in cats. ## Footnote Bronchodilators can help alleviate respiratory distress in certain cases.

Question 248

What are some unique pathogens associated with bacterial pneumonia?

Answer 248

* Bordetella bronchiseptica * Streptococcus equi subsp. zooepidemicus * Mycoplasma spp. ## Footnote These pathogens have distinct characteristics and treatment considerations.

Question 249

What is the primary respiratory pathogen causing severe pneumonia in young dogs?

Answer 249

Bordetella bronchiseptica ## Footnote This pathogen is highly contagious and can lead to severe outcomes, especially in puppies.

Question 250

What is the typical treatment for Mycoplasma pneumonia?

Answer 250

* Macrolides * Tetracyclines * Fluoroquinolones * Chloramphenicol ## Footnote These antibiotics are effective against Mycoplasma due to their unique cell wall structure.

Question 251

What is the epidemiology of pneumonic plague?

Answer 251

Endemic in parts of the Midwest and Western U.S.; transmission occurs through ingestion of infected rodents or flea bites. ## Footnote Awareness of endemic areas is crucial for prevention and early diagnosis.

Question 252

What are the clinical signs of canine influenza?

Answer 252

* Acute cough * Fever * Lethargy * Nasal discharge ## Footnote Canine influenza is highly contagious but typically has low mortality.

Question 253

What are common viral causes of pneumonia in dogs?

Answer 253

* Canine distemper virus * Canine parainfluenza virus * Canine adenovirus-2 * Canine herpesvirus ## Footnote These viruses can lead to severe respiratory disease and require supportive care.

Question 254

What is the maximum time frame for administering treatment to shorten disease duration?

Answer 254

Must be given <48 hours from symptom onset

Question 255

What are common viral causes of pneumonia in dogs?

Answer 255

* Canine distemper virus * Canine parainfluenza virus * Canine adenovirus-2 * Canine herpesvirus * Canine respiratory coronavirus

Question 256

Which virus causes severe pneumonia and neurological signs in dogs?

Answer 256

Canine distemper virus

Question 257

What is the primary impact of canine parainfluenza virus?

Answer 257

Mild-to-moderate upper/lower respiratory disease

Question 258

Which virus is known to cause severe disease in neonatal dogs?

Answer 258

Canine herpesvirus

Question 259

What are the key pathogens associated with mycotic pneumonia?

Answer 259

* Blastomyces dermatitidis * Histoplasma capsulatum * Coccidioides immitis

Question 260

What is the main treatment for mycotic pneumonia?

Answer 260

Antifungals (itraconazole, fluconazole, amphotericin B)

Question 261

What is the organism responsible for Pneumocystis pneumonia?

Answer 261

Pneumocystis carinii (P. jirovecii)

Question 262

Which breeds are predisposed to Pneumocystis pneumonia?

Answer 262

* Miniature Dachshunds * Cavalier King Charles Spaniels * Shih Tzus

Question 263

What are the main causes of aspiration pneumonia?

Answer 263

* Inhalation of gastric contents * Inhalation of food particles * Inhalation of irritants

Question 264

What are common clinical signs of aspiration pneumonia in dogs?

Answer 264

* Panting * Tachypnea * Cough * Adventitial/diminished lung sounds

Question 265

What is a key characteristic of non-cardiogenic pulmonary edema?

Answer 265

Edema fluid is protein-rich

Question 266

What is Acute Respiratory Distress Syndrome (ARDS)?

Answer 266

Severe non-cardiogenic pulmonary edema secondary to acute pulmonary inflammation

Question 267

What are the severity classifications for ARDS based on PaO₂/FiO₂ ratio?

Answer 267

* Mild: 200–300 mmHg * Moderate: 100–200 mmHg * Severe: < 100 mmHg

Question 268

What are common clinical signs of non-cardiogenic pulmonary edema?

Answer 268

* Tachypnea * Moist cough ± frothy sputum * Respiratory distress * Cyanosis * Hemoptysis

Question 269

What is the primary goal in treating non-cardiogenic pulmonary edema?

Answer 269

Treat underlying cause and correct hypoxemia

Question 270

What is the prognosis for ARDS?

Answer 270

Guarded to grave, especially with severe ARDS

Question 271

What are primary lung tumors compared to metastatic lung tumors?

Answer 271

Primary lung tumors are less common than metastatic disease

Question 272

What are common clinical signs of primary lung tumors?

Answer 272

* Cough * Hemoptysis * Respiratory distress

Question 273

What is the core principle of treatment for pulmonary diseases?

Answer 273

Support oxygenation, treat underlying cause, allow self-repair of pulmonary tissue

Question 274

What is the prognosis for severe ARDS?

Answer 274

Guarded to grave

Question 275

What factors influence the outcome of pulmonary diseases?

Answer 275

* Severity of hypoxemia * Response to ventilation * Reversibility of underlying condition

Question 276

What are some clinical signs of primary lung tumors?

Answer 276

* Cough * Hemoptysis * Respiratory distress * Often asymptomatic, detected incidentally

Question 277

What are paraneoplastic syndromes associated with primary lung tumors?

Answer 277

* Hypertrophic osteopathy

Question 278

What is a major reason the lung is a common site for metastatic tumors?

Answer 278

Large capillary surface area and high blood flow from the right heart

Question 279

What is the ‘seed and soil’ theory in relation to lung neoplasms?

Answer 279

Lung microenvironment favors certain neoplasms

Question 280

Name common primary cancers that metastasize to the lung.

Answer 280

* Hemangiosarcoma * Osteosarcoma * Oral and nasal melanomas * Histiocytic sarcoma * Thyroid carcinoma * Mammary carcinoma

Question 281

What is the typical presentation of metastatic pulmonary cancer in animals?

Answer 281

Many are asymptomatic, despite significant tumor burden

Question 282

What exceptions exist for a better prognosis in metastatic pulmonary cancer?

Answer 282

* Thyroid carcinoma * Anal sac adenocarcinoma (metastases may grow slowly)

Question 283

What are the treatment options for metastatic pulmonary cancer?

Answer 283

* Surgery (metastectomy) if limited * Tyrosine kinase inhibitors * Radioiodine therapy * Inhaled chemotherapy * Gene therapy (experimental)

Question 284

What is the radiographic appearance of pulmonary lymphoma?

Answer 284

* Interstitial, alveolar, or mixed patterns * ± Hilar/mediastinal lymphadenopathy

Question 285

What is lymphomatoid granulomatosis (LG)?

Answer 285

Rare lymphoproliferative disease with infiltration and destruction of pulmonary vasculature by atypical lymphoid cells

Question 286

In which animals is lymphomatoid granulomatosis more common?

Answer 286

More common in dogs than cats

Question 287

What is the typical clinical presentation of histiocytic sarcoma?

Answer 287

* Nonspecific signs: lethargy, anorexia, cough, dyspnea

Question 288

What breeds are more commonly affected by histiocytic sarcoma?

Answer 288

* Bernese Mountain Dogs * Flat-coated Retrievers * Golden Retrievers * Miniature Schnauzers * Pembroke Welsh Corgis * Rottweilers

Question 289

What is the typical clinical sign of primary pulmonary neoplasia in older animals?

Answer 289

* Weight loss * Lethargy * Anorexia * Non-productive cough (in ~50% of dogs)

Question 290

What is the most common type of primary lung tumor?

Answer 290

Adenocarcinoma

Question 291

What diagnostic imaging features are typical for primary pulmonary neoplasia?

Answer 291

* Solitary, well-marginated parenchymal masses * Bronchiocentric, well-circumscribed masses with internal air bronchograms

Question 292

What are some differential diagnoses for pulmonary nodules?

Answer 292

* Primary lung neoplasia * Metastatic neoplasia * Pulmonary abscess or cyst * Fungal granuloma * Parasitic granuloma * Tuberculosis * Pneumonia * Hematoma

Question 293

What factors are favorable prognostic indicators for pulmonary tumors?

Answer 293

* Single, well-differentiated tumor * Complete surgical excision * No metastasis or lymph node involvement * Absence of clinical signs

Question 294

What is the general prognosis for idiopathic pulmonary fibrosis (IPF)?

Answer 294

Generally poor

Question 295

What breeds of dogs are strongly associated with idiopathic pulmonary fibrosis?

Answer 295

* West Highland White Terriers * Staffordshire Bull Terriers * Bull Terriers * Cairn Terriers * Scottish Terriers * Pekingese

Question 296

What are some common clinical signs of idiopathic pulmonary fibrosis in dogs?

Answer 296

* Exercise intolerance * Cough * Tachypnea * Dyspnea

Question 297

What are the common CT features of IPF in dogs?

Answer 297

* Ground-glass opacity * Mosaic attenuation * Reticular pattern

Question 298

What are some causes of eosinophilic pneumonia?

Answer 298

* Parasitic infections * Fungal infections * Drugs, allergens, toxins

Question 299

What is the typical demographic for idiopathic eosinophilic pneumonia in dogs?

Answer 299

Young to middle-aged dogs with slight female predominance

Question 300

What is the prognosis for eosinophilic granulomatosis?

Answer 300

Poor prognosis

Question 301

What are the determined causes of eosinophilic pneumonia?

Answer 301

* Parasitic infections (e.g., Dirofilaria immitis, lungworms) * Fungal infections * Drugs, allergens, toxins

Question 302

In which species is idiopathic eosinophilic pneumonia more common?

Answer 302

Dogs ## Footnote More common than in cats, often affecting young to middle-aged dogs.

Question 303

Which breeds are predisposed to idiopathic eosinophilic pneumonia?

Answer 303

* Siberian Husky * Alaskan Malamute * Labrador Retriever * Rottweiler

Question 304

What are common clinical signs of eosinophilic pneumonia?

Answer 304

* Cough (± gagging, retching) * Respiratory effort, nasal discharge * Exercise intolerance * Peripheral eosinophilia: ~50% of dogs

Question 305

What are the typical findings on radiographs for eosinophilic pneumonia?

Answer 305

* Bronchial or bronchointerstitial patterns * Most severe in caudodorsal lung fields * Bronchiectasis is common * ± alveolar infiltrates

Question 306

What is Eosinophilic Pulmonary Granulomatosis (EPG)?

Answer 306

Uncommon but severe condition characterized by nodular masses of eosinophils/fibrous matrix

Question 307

What are the two types of lipid pneumonia?

Answer 307

* Exogenous: due to aspiration of oily substances * Endogenous: due to intrinsic surfactant/cholesterol release from pneumocyte injury

Question 308

What is a common diagnostic method for lipid pneumonia?

Answer 308

Use Oil Red O staining on BAL or lung FNA samples

Question 309

What are common clinical signs of lung lobe torsion?

Answer 309

* Anorexia * Lethargy * Vomiting * Respiratory signs (tachypnea, dyspnea, cough, exercise intolerance)

Question 310

What diagnostic imaging is most sensitive for lung lobe torsion?

Answer 310

Thoracic CT

Question 311

What are common clinical signs of pulmonary contusion?

Answer 311

* Tachypnea * Dyspnea * Crackles * Diminished breath sounds

Question 312

What is the definition of atelectasis?

Answer 312

Atelectasis is not a disease, but a descriptor of non-aerated lung.

Question 313

What are the types of atelectasis?

Answer 313

* Congenital * Compression * Resorptive * Filling defects

Question 314

What are cavitary lung lesions?

Answer 314

May be cystic (wall < 3 mm) or cavitated/mass-like (wall ≥ 3 mm)

Question 315

What are the clinical signs of pulmonary abscesses?

Answer 315

* Systemic illness * Cough * Dyspnea * Fever

Question 316

What are the definitions of blebs and bullae?

Answer 316

* Blebs: Subpleural air pockets * Bullae: Intraparenchymal air-filled spaces due to alveolar wall destruction

Question 317

What are common causes of pulmonary blebs and bullae?

Answer 317

* Idiopathic * Infections (parasitic, fungal, neoplastic) * Congenital bronchopulmonary dysplasia

Question 318

What is a common clinical presentation of Blebs and Bullae?

Answer 318

Often discovered after rupture, resulting in spontaneous pneumothorax ## Footnote Bullae may be incidental on imaging or life-threatening when ruptured.

Question 319

What is the sensitivity of thoracic radiographs for diagnosing Blebs and Bullae?

Answer 319

<50% ## Footnote CT scans have a higher sensitivity, up to 75%.

Question 320

What is the definitive therapy for Blebs and Bullae?

Answer 320

Partial lung lobectomy ## Footnote This surgical intervention is used to remove the affected lung tissue.

Question 321

What is a potential etiology for Congenital Lobar Emphysema?

Answer 321

* Idiopathic * Secondary to bronchial obstruction, defect, or compression ## Footnote These factors contribute to the development of the condition.

Question 322

What happens during the pathophysiology of Congenital Lobar Emphysema?

Answer 322

Overexpansion of one lobe causes: * Compression of normal lobes * Blebs, bullae formation * Progressive air trapping ## Footnote This can lead to significant respiratory issues.

Question 323

What are the radiographic features of Congenital Lobar Emphysema?

Answer 323

* Hyperinflated lobe * Thin vasculature * Mediastinal shift * Caudal diaphragm displacement * Atelectasis of other lobes ## Footnote These features are critical for diagnosis.

Question 324

What is the typical treatment for Congenital Lobar Emphysema?

Answer 324

Surgical removal (lobectomy) ## Footnote Typically, only one lobe is affected and prognosis is favorable.

Question 325

Name an example of an infectious cause of cavitary lung lesions.

Answer 325

* Lung abscess * Necrotic fungal granulomas (e.g., Aspergillus) * Pneumocystis carinii * Paragonimus * Post-aspiration ## Footnote These conditions can lead to significant lung pathology.

Question 326

What are examples of neoplastic causes of cavitary lung lesions?

Answer 326

* Primary (e.g., bronchogenic carcinoma) * Metastatic cavitary neoplasia ## Footnote Neoplastic lesions can complicate lung health and require careful evaluation.

Question 327

What are some congenital causes of cavitary lung lesions?

Answer 327

* Cysts * Bronchopulmonary dysplasia * Congenital lobar emphysema ## Footnote These conditions can be present from birth and may require intervention.

Question 328

What vascular event can cause cavitary lung lesions?

Answer 328

Pulmonary infarction ## Footnote This event can cause localized tissue death in the lungs.

Question 329

Fill in the blank: Pneumatoceles are examples of _______.

Answer 329

ruptured alveoli ## Footnote These can occur due to various lung injuries.

Question 330

What is the recent evidence-based cutoff for diagnosing PH in humans?

Answer 330

mPAP >20 mmHg.

Question 331

What are the primary mechanisms that can lead to pulmonary hypertension?

Answer 331

* Increased Pulmonary Blood Flow / Cardiac Output * Increased Pulmonary Vascular Resistance (PVR) * Increased Pulmonary Venous Pressure * Combinations of the Above

Question 332

What defines pre-capillary pulmonary hypertension?

Answer 332

Increased PVR with normal pulmonary venous pressure.

Question 333

What characterizes post-capillary pulmonary hypertension?

Answer 333

Increased pulmonary venous pressure, typically from left heart disease causing left atrial hypertension.

Question 334

What is the gold standard for diagnosing pulmonary hypertension?

Answer 334

Right heart catheterization.

Question 335

What measurements can be obtained through right heart catheterization?

Answer 335

* Systolic, diastolic, and mean PAP * Pulmonary artery wedge pressure (PAWP) * Cardiac output

Question 336

What is the formula for calculating pulmonary vascular resistance (PVR)?

Answer 336

PVR = (Mean PAP - PAWP) / Cardiac Output.

Question 337

What are the core components of disease progression in pulmonary hypertension?

Answer 337

* Increased PVR * Pulmonary vasoconstriction * Pulmonary vascular remodeling

Question 338

What are contributing factors to pulmonary hypertension?

Answer 338

* Endothelial cell dysfunction: ↓ nitric oxide & prostacyclin, ↑ endothelin-1 * Impaired vasodilation * Chronic hypoxemia * Thrombosis and hypercoagulability

Question 339

What are common clinical signs of right-sided heart failure due to pulmonary hypertension?

Answer 339

* Exercise intolerance * Exertional syncope * Respiratory distress * Ascites * Jugular distension

Question 340

What echocardiographic tool is most practical for assessing pulmonary hypertension in veterinary medicine?

Answer 340

Doppler echocardiography.

Question 341

What is tricuspid regurgitation velocity (TRV) used for in estimating pulmonary arterial pressure?

Answer 341

To estimate systolic PAP via the simplified Bernoulli equation.

Question 342

What is the classification of pulmonary hypertension based on estimated systolic pulmonary arterial pressure (sPAP)?

Answer 342

* Mild PH: sPAP ≈ 30–50 mmHg * Moderate PH: sPAP ≈ 50–75 mmHg * Severe PH: sPAP > 75 mmHg

Question 343

What are the six clinical groups of pulmonary hypertension according to ACVIM classification?

Answer 343

* Group 1: Pulmonary Arterial Hypertension (PAH) * Group 2: Left Heart Disease (Post-capillary PH) * Group 3: Respiratory Disease / Hypoxia * Group 4: Thromboembolic Disease * Group 5: Parasitic Disease * Group 6: Multifactorial / Unknown Mechanism

Question 344

What echocardiographic finding strongly supports post-capillary pulmonary hypertension?

Answer 344

Unequivocal left atrial enlargement.

Question 345

What clinical signs may indicate the need for pulmonary hypertension assessment?

Answer 345

* Syncope unrelated to arrhythmia * Unexplained abdominal effusion * Refractory signs in MMVD or respiratory disease * Loud right apical systolic murmur

Question 346

What are the general principles for managing pulmonary hypertension?

Answer 346

Treat the underlying disease, if possible.

Question 347

What are the three molecular pathways targeted by pulmonary hypertension-specific therapies?

Answer 347

* Prostacyclin * Endothelin * Nitric oxide

Question 348

What is the mechanism of action of PDE5 inhibitors in the treatment of pulmonary hypertension?

Answer 348

Prevents degradation of cyclic GMP, promoting vasodilation.

Question 349

What are the specific considerations for using PDE5 inhibitors in veterinary medicine?

Answer 349

Use cautiously or avoid in post-capillary PH and if cardiogenic pulmonary edema is present.

Question 350

What gene polymorphism may limit sildenafil efficacy in some dogs?

Answer 350

PDE5A gene polymorphism ## Footnote This polymorphism can affect how well sildenafil works in treating pulmonary hypertension.

Question 351

In what conditions should PDE5 inhibitors be used cautiously or avoided?

Answer 351

* Post-capillary PH (Group 2) * Cardiogenic pulmonary edema * CPC-PH or left-to-right shunts ## Footnote These conditions can lead to worsening pulmonary edema when PDE5 inhibitors are used.

Question 352

Which type of pulmonary hypertension (PH) are PDE5 inhibitors not beneficial for?

Answer 352

IPC-PH ## Footnote IPC-PH refers to idiopathic pulmonary hypertension.

Question 353

What are some additional or anecdotal therapies for pulmonary hypertension in dogs?

Answer 353

* Calcium channel blockers * PDE3 inhibitors (e.g., pimobendan, milrinone) * Tyrosine kinase inhibitors (e.g., toceranib, imatinib) * L-arginine * Antithrombotics ## Footnote These therapies are largely experimental and reserved for refractory cases.

Question 354

What factors influence the prognosis of dogs with pulmonary hypertension?

Answer 354

* Underlying cause of PH * Severity of pulmonary vascular changes * Presence of concurrent right-sided heart failure * Response to therapy ## Footnote The prognosis can vary significantly based on these factors.

Question 355

What are some examples of potentially reversible pulmonary hypertension?

Answer 355

* Early-stage heartworm disease * Pneumonia ## Footnote The prognosis improves if the underlying disease is successfully managed.

Question 356

What are key prognostic indicators for worse outcomes in dogs with acquired PH?

Answer 356

* Right atrial enlargement * Right ventricular systolic dysfunction * Presence of right-sided congestive heart failure (R-CHF) ## Footnote These indicators reflect maladaptive right ventricular responses to pressure overload.

Question 357

What is the primary goal of monitoring response to pulmonary hypertension therapy?

Answer 357

Clinical improvement ## Footnote This goal focuses on overall patient well-being rather than just echocardiographic normalization.

Question 358

What factors are linked to prognosis in dogs with pulmonary hypertension?

Answer 358

* Etiology * RV function * RA size * Presence of R-CHF ## Footnote These factors are critical in assessing long-term outcomes.

Question 359

What are the best clinical markers for assessing pulmonary hypertension in dogs?

Answer 359

* Exercise tolerance * Breathing * Syncope * Quality of life ## Footnote These markers provide insight into the patient's condition and response to treatment.

Question 360

What induces reflex pulmonary vasoconstriction in PTE?

Answer 360

Neurogenic reflexes, humoral mediators, and alveolar hypoxia.

Question 361

What is the consequence of increased pulmonary vascular resistance (PVR) in PTE?

Answer 361

Pulmonary arterial hypertension (PAH) and elevated right ventricular (RV) afterload.

Question 362

What happens to the interventricular septum as the embolic burden increases?

Answer 362

It shifts toward the left ventricle, impairing left ventricular (LV) filling and diastolic compliance.

Question 363

What is the phenomenon termed when the interventricular septum shifts due to PTE?

Answer 363

Ventricular interdependence.

Question 364

What are common predisposing factors for PTE in dogs and cats?

Answer 364

* Trauma * Dirofilariasis * Indwelling intravenous catheters * Surgery * Neoplasia * Immune-mediated hemolytic anemia (IMHA) * Protein-losing nephropathy (PLN) * Protein-losing enteropathy (PLE) * Hyperadrenocorticism * Sepsis

Question 365

What is the clinical presentation of acute PTE?

Answer 365

* Tachypnea * Dyspnea * Tachycardia * Anxiety * Coughing * Cyanosis * Hemoptysis * Syncope or sudden death

Question 366

What may be heard upon auscultation in dyspneic animals with PTE?

Answer 366

Increased bronchovesicular sounds or muffled cardiopulmonary sounds.

Question 367

What initial diagnostics are often included for PTE?

Answer 367

* Arterial blood gas analysis * Thoracic radiographs * Point-of-care ultrasound (POCUS) * Echocardiography * Minimum database (CBC, serum biochemistry, urinalysis)

Question 368

What do arterial blood gas analysis findings typically reveal in PTE?

Answer 368

Hypoxemia, hypocapnia, and an increased alveolar-arterial (A-a) oxygen gradient.

Question 369

What is the current diagnostic gold standard for PTE?

Answer 369

CT pulmonary angiography (CTPA).

Question 370

What are the primary goals of managing PTE?

Answer 370

* Thrombolysis * Prophylaxis * Stabilization of pulmonary and cardiovascular function

Question 371

What are common antithrombotic drugs used in cats and dogs?

Answer 371

* Clopidogrel * Unfractionated Heparin (UFH) * Dalteparin * Enoxaparin * Rivaroxaban

Question 372

What monitoring is required for unfractionated heparin (UFH) therapy?

Answer 372

aPTT or anti-factor Xa monitoring.

Question 373

What is a key clinical note regarding clopidogrel?

Answer 373

It is superior to aspirin for feline arterial thromboembolism prevention.

Question 374

What factors affect the prognosis of PTE in small animals?

Answer 374

* The underlying disease * Embolic burden and location * Hemodynamic stability

Question 375

How do the hemithoraxes of small animals differ from those of humans and large animals?

Answer 375

In small animals, the hemithoraxes are incompletely separated, allowing equal distribution of pleural effusion.

Question 376

What is the average intrapleural pressure in a healthy animal?

Answer 376

–5 cm H₂O (–3.7 mm Hg)

Question 377

What are the two human clinical syndromes associated with pleural disease?

Answer 377

* Lung entrapment * Trapped lung

Question 378

What are common clinical signs of pleural space disease?

Answer 378

* Tachypnea * Reluctance to lie in lateral recumbency * Rapid, shallow breathing * Marked abdominal effort

Question 379

What is the preferred view for radiographs in cats and barrel-chested dogs?

Answer 379

Dorsoventral (DV) view

Question 380

What are potential complications of thoracocentesis?

Answer 380

* Iatrogenic pneumothorax * Hemorrhage * Subcutaneous leakage of pleural fluid

Question 381

What is the significance of pleural pressure monitoring?

Answer 381

It confirms catheter placement and monitors conditions during thoracocentesis.

Question 382

What are the classifications of pleural effusions based on protein concentration?

Answer 382

* Low-protein transudates * High-protein transudates * Exudates

Question 383

What are the common causes of low-protein transudates?

Answer 383

* Hypoalbuminemia * Overzealous fluid administration

Question 384

What is the most common effusion type in dogs and cats?

Answer 384

High-protein transudates

Question 385

What are the clinical features of pyothorax?

Answer 385

* Lethargy * Fever * Leukocytosis or leukopenia

Question 386

What is the definition of hemothorax?

Answer 386

A pleural effusion is considered a hemothorax when the packed cell volume (PCV) is >20%.

Question 387

What treatments may be indicated for hemothorax?

Answer 387

* Blood transfusion * Vitamin K1 therapy * Surgical intervention

Question 388

What are the common treatments for hemothorax?

Answer 388

* Blood transfusion (PRBCs, plasma, or whole blood) * Vitamin K1 therapy for rodenticide-induced cases * Surgical intervention for neoplastic or traumatic hemorrhage * Rest and supportive care for small-volume, non-progressive hemothoraces * Autotransfusion may be considered except in cases of neoplasia ## Footnote Treatment depends on the underlying cause.

Question 389

What is the mean age at presentation for chylothorax in cats and dogs?

Answer 389

Cats: 6.3 years, Dogs: 4 years

Question 390

What are common physical exam findings in chylothorax?

Answer 390

* Muffled heart sounds (41% of cats, 62% of dogs) * Bronchovesicular sounds may vary ## Footnote No specific clinicopathologic abnormality for chylothorax.

Question 391

What are the triglyceride concentration ranges for chylothorax in cats and dogs?

Answer 391

* Cats: 1,464–4,670 mg/dL (effusion) vs. 84 mg/dL (serum) * Dogs: 877 mg/dL (effusion) vs. 73 mg/dL (serum)

Question 392

What is the most common etiology for chylothorax?

Answer 392

Idiopathic chylothorax accounts for ~50% of cases

Question 393

What is the preferred treatment for chylothorax?

Answer 393

* Surgical therapy (thoracic duct ligation) * Often combined with subphrenic pericardectomy ## Footnote Success rates are ~50–70%.

Question 394

What are the common locations affected by mesothelioma?

Answer 394

* Pleura (79%) * Pericardium (64%) * Peritoneum (7%)

Question 395

What is a key risk factor associated with mesothelioma in dogs?

Answer 395

Asbestos exposure

Question 396

What is the typical clinical presentation of mesothelioma?

Answer 396

Chronic pleural effusion that may develop over weeks to months

Question 397

What are the treatment options for mesothelioma?

Answer 397

* Intracavitary chemotherapy via pleural ports * Systemic chemotherapy ## Footnote 5-fluorouracil and carboplatin are commonly used.

Question 398

What is the prognosis for dogs with mesothelioma?

Answer 398

* Median survival: 195 days * 1-year survival: 22%

Question 399

What are some associated conditions with idiopathic and miscellaneous effusions?

Answer 399

* Pancreatitis * Immune-mediated disease * Chronic diaphragmatic hernia * Pulmonary thromboembolism * Recent thoracic or abdominal surgery

Question 400

What are the most common causes of chronic pleural effusions?

Answer 400

* Idiopathic effusions * Chylothorax * Congestive heart failure (CHF) * Mesothelioma

Question 401

What are the types of pneumothorax?

Answer 401

* Traumatic * Spontaneous (primary or secondary) * Iatrogenic * Open * Closed

Question 402

What is a tension pneumothorax?

Answer 402

A life-threatening form that impairs venous return and cardiac output

Question 403

What is the treatment for blunt trauma pneumothorax?

Answer 403

Supportive care and oxygen supplementation; rarely requires surgery

Question 404

What is the typical resolution time for blunt trauma?

Answer 404

1–4 days with supportive care and oxygen supplementation

Question 405

What is always associated with flail chest?

Answer 405

Severe pulmonary contusions

Question 406

What is the current treatment for flail chest?

Answer 406

Analgesia and supportive care

Question 407

What can mimic flail chest?

Answer 407

Intercostal muscle tears

Question 408

List overrepresented breeds for spontaneous pneumothorax.

Answer 408

* Northern breeds (e.g., Siberian Huskies) * Golden Retrievers

Question 409

What is the prognosis for dogs post-operatively after surgical treatment for spontaneous pneumothorax?

Answer 409

Excellent prognosis

Question 410

What is the rarity of spontaneous pneumothorax in cats attributed to?

Answer 410

Lower incidence and greater likelihood of medical responsiveness

Question 411

What underlying conditions can cause secondary spontaneous pneumothorax?

Answer 411

* Pulmonary neoplasia * Pulmonary thromboembolism * Pneumonia * Asthma or heartworm disease

Question 412

What is a common complication of thoracocentesis?

Answer 412

Iatrogenic pneumothorax

Question 413

What radiographic clues indicate chronic effusion?

Answer 413

* Rounded lung margins * Suspected or confirmed trapped lung

Question 414

What is an autologous blood patch?

Answer 414

Instilling fresh autologous blood into the pleural space to seal air leaks

Question 415

List key advantages of an autologous blood patch.

Answer 415

* Inexpensive * Minimally invasive * Readily accessible * Rapid resolution of pneumothorax * Low complication rates

Question 416

What are reported complications of an autologous blood patch?

Answer 416

* Pyothorax * Tension pneumothorax from blood clot occluding a thoracostomy tube

Question 417

What is the purpose of thoracostomy tubes?

Answer 417

Indicated for large-volume effusions, infectious effusions, and large-volume pneumothorax

Question 418

What is the indication for large-bore chest tubes?

Answer 418

Ideal for large pneumothoraces and need for continuous suction

Question 419

What is the rationale for supplemental oxygen in pneumothorax management?

Answer 419

Lowers alveolar nitrogen creating a partial pressure gradient favoring nitrogen absorption

Question 420

What is the general prognosis for dogs with spontaneous pneumothorax unless associated with neoplasia?

Answer 420

Generally good

Question 421

What is the relationship between swallowing and respiration in aerodigestive disorders?

Answer 421

Aerodigestive disorders highlight the complex interrelationship between swallowing and respiration

Question 422

What is a frequent cause of acute and chronic pulmonary disease in humans?

Answer 422

Gastroesophageal reflux disease (GERD)

Question 423

What percentage of patients with chronic cough, asthma, or COPD exhibit concurrent GERD?

Answer 423

Up to 50%

Question 424

What challenges do aerodigestive disorders present in diagnosis?

Answer 424

Many patients lack overt signs of alimentary disease

Question 425

How does uncontrolled reflux affect respiratory disease in patients?

Answer 425

It is associated with worsened respiratory disease, more frequent exacerbations, greater morbidity, and higher treatment costs

Question 426

What effect does treating GERD and extraesophageal reflux have on COPD patients?

Answer 426

It reduces exacerbation frequency and slows lung function decline

Question 427

What is the most recognized aerodigestive disorder in dogs?

Answer 427

Aspiration pneumonia

Question 428

What percentage of dogs presenting solely for cough had evidence of swallowing dysfunction?

Answer 428

80%

Question 429

What are the two central pattern generators involved in swallowing and respiration?

Answer 429

* Swallow central pattern generator (SwCPG) * Respiratory central pattern generator (RCPG)

Question 430

During which phase does swallowing usually occur in healthy individuals?

Answer 430

After expiration

Question 431

What is swallow apnea?

Answer 431

A brief pause in breathing during swallowing

Question 432

What characterizes swallow apnea?

Answer 432

* Laryngeal adduction * Reduced diaphragmatic contraction * Transient airflow cessation

Question 433

What are basal airway protection mechanisms?

Answer 433

They protect the airway from aspiration under resting conditions

Question 434

What is the function of the Lower Esophageal Sphincter (LES)?

Answer 434

It serves as a high-pressure smooth muscle barrier

Question 435

What is the normal basal LES pressure range in non-anesthetized dogs?

Answer 435

14–45 mmHg

Question 436

What does the Upper Esophageal Sphincter (UES) prevent?

Answer 436

Retrograde flow from the esophagus into the pharynx

Question 437

What triggers volume-clearing reflexes?

Answer 437

Mechanical or chemical stimuli

Question 438

What is the role of the upper esophageal sphincter (UES)?

Answer 438

Maintains a high-pressure barrier between the pharynx and esophagus

Question 439

What activates the pharyngeal–UES contractile reflex?

Answer 439

Mechanical pharyngeal stimulation

Question 440

What is the primary mechanism of cough?

Answer 440

Involves inhalation, pressurized phase, and expulsion phase

Question 441

What is the difference between aspiration pneumonitis and aspiration pneumonia?

Answer 441

* Aspiration pneumonitis: sterile, chemical inflammation * Aspiration pneumonia: infectious

Question 442

What is pepsin active at?

Answer 442

pH < 6.8

Question 443

What are common risk factors for aspiration-associated respiratory syndromes (AARS) in dogs?

Answer 443

* Decreased consciousness * Body posture during anesthetic recovery * Prolonged anesthesia duration

Question 444

What is the significance of detecting pepsin in tracheal secretions?

Answer 444

It confirms the presence of reflux and aspiration

Question 445

What structures are contained within the mediastinum?

Answer 445

* Heart and great vessels * Trachea and esophagus * Thymus * Thoracic duct * Thoracic lymph nodes * Vagus nerve and other autonomic nerves

Question 446

What is a clinical implication of the mediastinum not being a sealed space?

Answer 446

Diseases can spread between the neck, thorax, and retroperitoneum.

Question 447

What are common clinical signs of mediastinal disease?

Answer 447

* Reduced thoracic compliance * Dull or absent breath sounds * Dyspnea or regurgitation * Palpable mass effect in cranial thorax

Question 448

What does a 'sail sign' indicate in young animals?

Answer 448

Presence of the thymus in the left cranial ventral thorax.

Question 449

What does mediastinal shift toward the affected side indicate?

Answer 449

Lung collapse or lobar torsion.

Question 450

What is the most common cause of cranial mediastinal masses in dogs and cats?

Answer 450

Lymphoma or thymoma.

Question 451

What is pneumomediastinum?

Answer 451

The abnormal presence of air within the mediastinum, often without direct pulmonary parenchymal injury.

Question 452

What are common causes of pneumomediastinum?

Answer 452

* Tracheal disruption * Esophageal/pharyngeal rupture * Subcutaneous emphysema * Alveolar rupture * Macklin effect * Retroperitoneal air migration * Spontaneous pneumomediastinum

Question 453

What are the clinical signs of pneumomediastinum?

Answer 453

* Often no respiratory distress * If esophageal rupture: regurgitation, dysphagia, cervical pain

Question 454

What is mediastinitis?

Answer 454

Inflammation of mediastinal tissues, usually secondary to infection, trauma, or perforation.

Question 455

What are common causes of mediastinitis?

Answer 455

* Esophageal or tracheal perforation * Cervical deep tissue infection * Extension from pericardium, pulmonary parenchyma, or pleural space * Migrating foreign bodies * Fungal infections * Bacterial infections * Parasitic infections

Question 456

What are the imaging findings in mediastinitis?

Answer 456

* Focal or diffuse mediastinal widening on radiographs * Pleural thickening, air/fluid in mediastinum on CT

Question 457

What are the clinical signs of mediastinal hemorrhage?

Answer 457

* Related to acute blood loss * Dyspnea if hemothorax develops

Question 458

What are the common causes of mediastinal masses?

Answer 458

* Lymphoma * Thymoma * Ectopic thyroid carcinoma * Neuroendocrine carcinoma * Chemodectoma * Anaplastic carcinoma

Question 459

What is the most common mediastinal tumor in cats?

Answer 459

Lymphoma.

Question 460

What are the clinical signs associated with mediastinal neoplasia?

Answer 460

* Respiratory: cough, dyspnea * GI: regurgitation, dysphagia * Vascular: edema of head, neck, forelimbs * Nervous: Horner syndrome, laryngeal paralysis * Systemic signs: weight loss, anorexia

Question 461

What is thymoma?

Answer 461

An uncommon tumor of thymic epithelial origin, associated with paraneoplastic syndromes.

Question 462

What is flail chest?

Answer 462

Fracture of ≥2 consecutive ribs both dorsally and ventrally, causing paradoxical movement.

Question 463

What are common non-traumatic causes of rib fractures?

Answer 463

Chronic respiratory disease in cats (ribs 9–13).

Question 464

What is the paradoxical movement observed in flail chest?

Answer 464

In with inspiration, out with expiration

Question 465

What neoplasias can cause extrapleural mass?

Answer 465

Osteosarcoma, chondrosarcoma

Question 466

What imaging modality is best for assessing rib neoplasia?

Answer 466

CT for mass origin and bony detail

Question 467

What is pectus excavatum?

Answer 467

Dorsal deviation of caudal sternum compressing heart/lungs

Question 468

Which breeds are predisposed to pectus excavatum?

Answer 468

Maltese, English Bulldog

Question 469

What are clinical signs of pectus excavatum?

Answer 469

Exercise intolerance, respiratory distress, functional murmurs

Question 470

What is the treatment for pectus excavatum based on?

Answer 470

Severity—conservative or surgical

Question 471

What is the most common mediastinal neoplasm in young FeLV+ cats?

Answer 471

Mediastinal lymphoma

Question 472

What are thymomas often associated with?

Answer 472

Myasthenia gravis

Question 473

List the most commonly herniated organs in cats.

Answer 473

* Liver * Small intestines * Stomach * Omentum * Spleen * Pancreas

Question 474

What are acute clinical signs of a diaphragmatic hernia?

Answer 474

* Dyspnea * Tachypnea * Coughing * Exercise intolerance * Lethargy

Question 475

What are chronic clinical signs of a diaphragmatic hernia?

Answer 475

* Anorexia * Vomiting * Weight loss * Non-specific signs

Question 476

What is a caval foramen hernia?

Answer 476

Herniation of liver lobes through foramen of the caudal vena cava

Question 477

What may a caval foramen hernia mimic on radiographs?

Answer 477

A caudal pulmonary mass

Question 478

What are possible sequelae of caval foramen hernia?

Answer 478

Budd-Chiari-like syndrome

Question 479

What is a peritoneopericardial diaphragmatic hernia (PPDH)?

Answer 479

Congenital defect where abdominal organs herniate into the pericardial sac

Question 480

What does a hiatal hernia involve?

Answer 480

Prolapse of abdominal esophagus ± stomach through the esophageal hiatus

Question 481

What radiographic signs indicate a diaphragmatic hernia?

Answer 481

* Loss of diaphragmatic continuity * Displacement of gas-filled GI organs into thorax * Absence of abdominal structures from normal position