Respiratory

Question 1

Hallmark of upper airway diseases

Answer 1

Nasal discharge

Question 2

Hallmark of lower airway disease

Answer 2

Cough

Question 3

Stertor

Answer 3

Gurgling or snoring

Question 4

Stridor

Answer 4

High pitched noise or whine usually on inspiration

Question 5

Dyspnea

Answer 5

Difficult or labored breathing. ‘air hunger’

Question 6

Orthopnea

Answer 6

Can only breath in upright position with elbows out

Question 7

Brochial

Answer 7

Loudest over hilus and during expiration. ‘wind blowing’

Question 8

Vesicular

Answer 8

Heard best on inspiration at periphery of chest.’rustling of leaves’

Question 9

Best diagnostic tool for collapsing trachea

Answer 9

Bronchoscopy

Question 10

4 general mechanisms of pulmonary edema

Answer 10

Vascular overload/ increased hydrostatic pressure

Decreased plasma oncotic pressure

Increased alveolar-capillary membrane permeability

Lymphatic obstruction

Question 11

Signalment: 3 YO Siamese
CC: intermittent coughing last few weeks
PE: Harsh lung sounds; otherwise normal. Which of the following is NOT indicated?

Fecal exam
Thoracic Rads
Analysis of pleural fluid
TTW

Answer 11

Analysis of pleural fluid

Question 12

9 week old puppy presents because it has blood coming from left nostril. On exam, you find distortion to bridge of nose. Which differential should be at the top of your list?

Answer 12

Nasal trauma

Question 13

Signalment: 4 year old cat
CC: intermittent coughing. Now has open mouth breathing; audible wheezing.
PE: stressed cat; cyanotic; confirmed open mouth breathing
Which diagnostic test would be the worst idea at this time?

Answer 13

Get thoracic rads

Question 14

For the last case, (4 year old cat with intermittent coughing. Now open mouth
breathing & audible wheezing; cyanotic), you ausculted abnormal lung sounds but
thoracic radiographs were normal. Which diagnoses would
still be most likely?

Answer 14

Idiopathic feline

bronchitis (asthma)

Question 15

For the last case, if it was feline asthma, which of the following
would most likely be administered in an emergency situation?

Answer 15

Oxygen, terbutaline and dexamethasone

Question 16

The local humane society has an outbreak of upper respiratory signs in
dogs. One dog was coughing up blood and died overnight. Which
disease would you be most concerned about?

Answer 16

Influenza Type A H3N8

Question 17

How does cardiogenic pulmonary edema differ from noncardiogenic
pulmonary edema?

Answer 17

Etiology

Question 18

16 month old maltese terrier
At 4 months old: snotty nose
At 10 months: coughing; suspected kennel cough; successfully treated
At 12 months: bacterial rhinitis
Now: crackles on auscultation; T = 40 C. Air bronchograms
What disease best explains all these signs?

Answer 18

Ciliary dyskinesia

Question 19

A 5 year old shepherd x has been diagnosed with lymphocytic
plasmacytic rhinitis. Which of the following does NOT FIT?

A. Eye discharge
B. Unilateral nasal
discharge
C. Bilateral nasal
discharge
D. Facial distortion
E. Sneezing, reverse
sneezing
Eye discharge
Unilateral

Answer 19

Facial distortion

Question 20

A 12 year old lab:
CC: unilateral nasal discharge x 3 months. Started out mucoid, now is bloody.
Which of the following diagnostics is the best to start with?

Answer 20

Test for nasal

passage obstruction

Question 21

A 2 year old lab
CC: coughing.
PE: enlarged popliteal & axillary lymph nodes; anterior unveitis
Which of the following diagnostics is NOT indicated at this time for this
case?

A. Lymph node aspirate
B. Lung aspiration
C. TTW or BAL cytology
D. Thoracic radiographs

Answer 21

B. Lung aspiration

Question 22

Which of the following is least likely to cause an eosinophilia in a
cat with coughing?

1. Toxoplasmosis
2. Feline asthma
3. Aleurostrongylus
4. Chronic bronchitis
5. Lungworms

Answer 22

Chronic bronchitis

Question 23

A 12 year old poodle presents because of a dry hacking cough. You
pinch on trachea and a ‘goose honk’ cough occurs. What can you
conclude?

Answer 23

This is likely tracheal

collapse

Question 24

What best describes the meaning of increased

or harsh bronchovesicular sounds?

Answer 24

There may be underlying

lung disease

Question 25

Which of the following is most likely to produce audible gurgling or snoring sounds? ``` A. Nasal passage obstruction B. Laryngeal paralysis C. Fluid accumulation in lungs (pulmonary edema) D. Bronchial constriction ```

Answer 25

A. Nasal passage | obstruction

Question 26

A 10 year old pointer has had left sided nasal discharge x 3 months. Discharge is now slightly bloody. When you put a wisp of cotton in front of left nasal passage, there is no movement of the cotton compared to right where cotton moves. This is most compatible with ``` A. Aspergillus B. Nasal foreign body C. Neoplasia D. Ciliary dyskinesia E. Lymphocytic plasmacytic rhinitis ```

Answer 26

Neoplasia

Question 27

Bacterial pneumonia can not result in | a nasal discharge.

Answer 27

False

Question 28

Where are bronchial sounds the | loudest?

Answer 28

Over the hilar area

Question 29

Where are vesicular sounds heard the | best?

Answer 29

In the peripheral | lung field

Question 30

Which of the following is best treatment for nasal aspergillus? ``` A. Oral fluconazole or itraconazole and local clotrimazole infusion B. Local infusion of itraconazole C. Nasal flushing with ketaconazole D. Debridement followed by local clotrimazole infusion ```

Answer 30

D. Debridement followed by local clotrimazole infusion

Question 31

Which of the following is a concurrent significant feature of tracheal collapse cases? ``` A. Recurrent urinary tract infections B. Cardiomyopathy C. Splenomegaly D. Abnormal liver function E. Cushing’s disease ```

Answer 31

D. Abnormal liver | function

Question 32

Which of the following has the best prognosis? ``` A. 7 year old dog with medium sized left lung lobe consolidated mass B. 10 year old dog with multifocal masses of different sizes within most lung lobes C. 5 year old dog with hilar lymph node enlargement and a single small mass in right middle lung lobe D. 4 year old dog with peripheral lymphadenopathy and 2 different sized masses in left lung lobe ```

Answer 32

A. 7 year old dog with medium sized | left lung lobe consolidated mass

Question 33

Which of the following group of diseases has been associated with heartworm disease? ``` A. Pulmonary thromboembolism & eosinophilic bronchopneumopathy B. Idiopathic interstitial fibrosis & acute lung injury C. Non-cardiogenic pulmonary edema & mycotic pneumonia D. Chronic bronchitis & ARDS ```

Answer 33

A. Pulmonary thromboembolism & eosinophilic bronchopneumopathy

Question 34

Which of the following would be used to retrieve material from the lower airways? ``` A. Thoracocentesis B. Transtracheal wash/aspirate C. Chest tube D. Transthoracic lung aspirate ```

Answer 34

Transtracheal | wash/aspirate

Question 35

A 2 year old lab is coughing. It has enlarged popliteal & axillary lymph nodes. There is a toe nail infection. Thoracic rads show a diffuse nodular pattern. Which of the following diagnostics is NOT indicated for this case? ``` A. Lymph node aspirate B. Rhinoscopy C. Urine antigen test for fungal disease D. Lung aspiration E. TTW or BAL cytology ```

Answer 35

Rhinoscopy

Question 36

A 3 year old shepherd is coughing. It has enlarged popliteal & axillary lymph nodes. There is a toe nail infection. Thoracic rads show a diffuse nodular pattern. How would you get a diagnosis?

Answer 36

``` A. Lymph node aspirate B. Lung aspirate C. Urine antigen titer to fungal disease in your area D. Cytology of toenail infection E. TTW or BAL ```