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Plunkett Emergency > Respiratory Emergencies > Flashcards

Respiratory Emergencies Flashcards

(51 cards)

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1
Q

What is a common history for respiratory problems?

A

Sudden signs of distress
Chewing on something prior to problem
Found being strangulated with leash, collar, etc

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2
Q

What physical exam signs are noted with respiratory problems?

A 
Inspiratory stridor
Inspiratory dyspnea
Ptyalism
Cyanosis
Tachypnea
Pawing at face/ mouth
Anxiety/ distress
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3
Q

What are differentials for respiratory emergencies?

A 
Laryngeal foreign body
Neoplasia
Brachycephalic airway syndrome
NP polyps 
Laryngeal polyps 
Chronic laryngitis 
Cervical mass (abscess, lymph nodes, rattlesnake envenomation)
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4
Q

What are good sedatives to give for respiratory emergencies?

A

Acepromazine

Butorphanol

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5
Q

Are diuretics useful for respiratory emergencies?

A

No

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6
Q

What should you do prior to a tracheostomy?

A

Insert a large-bore catheter attached to oxygen distal to the tracheostomy site

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7
Q

What is the prognosis for tracheal/ tracheobronchial obstructions?

A

Good to grave

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8
Q

What is the common signalment for laryngeal paralysis?

A

Large breed, older dogs (Labs, Goldens, Saint Bernards, Siberian Huskies, Irish Setters) >7 YO
Males > Females
Can sometimes happen in cats

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9
Q

What is the cause of laryngeal paralysis

A

The recurrent laryngeal nerve innervates the cricorarytenoideus dorsalis, causing ab/adduction of arytenoid cartilage

Denervation leads to muscle atrophy and narrowing/ obstruction of the glottis

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10
Q

What are differentials for laryngeal paralysis?

A 
Idiopathic (most common)
Congenital (seen 4-18 mo Bulldogs, Bouvier, Huskies, Malamutes, Bull Terriers)
Trauma
 Iatrogenic
Abscess
Extrathoracic neoplasia
Parasitic
Hypothyroidism
Neuro dz
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11
Q

What diagnostics are useful for laryngeal paralysis?

A

Laryngeal exam with light sedation (can use Doxapram 1 mg/kg IV to help stimulate)

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12
Q

What are management options for laryngeal paralysis?

A 
Medical:
Stress control
Weight control
Temperature control
Useful for mild cases
Will progress to more sever disease overtime

Surgical:
Tie-back
Best long-term prognosis
Has 10-20% complication rate

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13
Q

What condition can occur secondary to laryngeal paralysis?

A

Hyperthermia

Life-threatening anxiety

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14
Q

What is the common signalment for tracheal collapse?

A

Small breed dogs such as Yorkies

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15
Q

What are causes of collapsing trachea?

A 
Unknown but suspected to be:
Congenital malformation
Hypocellular tracheal cartilage
Chronic lower airway disease
Extratracheal masses
Trauma
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16
Q

What history is common with tracheal collapse?

A

Goose-honk cough
Cyanosis
Collapse
Intermittent cough that worsens with excitment

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17
Q

What imaging tools are useful for diagnosing collapsing trachea?

A

Cervical and thoracic radiographs
Fluoroscopy
Bronchoscopy

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18
Q

What are treatment options and prognosis for tracheal collapse?

A 
Medical:
Weight and stress management
Anti-inflammatory pred dose
Antitussive (torb or hydrocodone)
Glucosamine/ chondroiton
Can use bronchodilators (theophylline, aminophylline, terbutaline)
Has good outcome but can still progress

Surgical:
Use if medical does not work
Has several complications

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19
Q

What is aspiration pneumonitis?

A

Acute lung injury secondary to inhalation of irritants

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20
Q

What is aspiration pneumonia?

A

Colonization of bacteria in the lung from injury or inhalation of foreign materials
Usually occurs secondary to another condition
Uncommon in cats

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21
Q

What are causes of aspiration pneumonia?

Study These Flashcards
A 
Altered mentation
Esophageal disorders
GI issues
Persistent vomiting
Iatrogenic
22
Q

What labwork findings are noted with aspiration pnuemonia?

Study These Flashcards
A

Leukocytosis +/- left shift

23
Q

What is the prognosis for aspiration pneumonia?

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A

Causes serious morbity or mortality
Good to grave
One lobe affected typically good

24
Q

What is a pulmonary thromboembolism (PTE)?

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A

Occlusion one or more pulmonary vessel by blood clot, septic emboli, fat, neoplasia, or parasite

25
How is PTE diagnosed
CT angiography - Gold standard Rads: normal or show hyperlucent regions, alveolar infiltrates, loss of pulmonary artery definition CBC/ Chem: non-diagnostics U/A can be useful Clotting times: not diagnostic, D-dimers can be useful
26
What is the prognosis for PTE?
Guarded to poor
27
What is noncardiogenic pulmonary edema?
Occurs as a consequence of primary lung disease such as drowning, electrocution, smoke inhalation, aspiration, oxygen toxicity, blunt traum Caused by increased pulmonary vascular permeability
28
What radiograph findings are noted with noncardiogenic pulmonary edema?
Interstitial or mixed interstitial to alveolar pattern | Bilateral in caudodorsal lung region
29
What is the prognosis for noncardiogenic pulmonary edema?
Always guarded
30
What are acute lung injury (ALI) and acute respiratory distress syndrome (ARDS)?
Life threatening consequences of serious illnesses Occurs when inflammatory cells and inflammatory mediators injure the pulmonary microvascular endotherlium --> leads to protein-rich edema leaking into chest cavity
31
What causes ALI and ARDS?
Primary lung injury such as drowning, electrocution, smoke inhalation, gastric content aspiration, oxygen toxicity, trauma
32
What radiograph findings are noted with ALI and ARDS?
Bilateral caudodorsal infiltrates
33
What are differentials for ALI and ARDS?
Pulmonary edema Noncardiogenic pulmonary edema Fungal pneumonia Diffuse primary or metastatic neoplasia
34
What is the prognosis for ALI and ARDS?
Fair to grave
35
What is feline chronic bronchial disease/ feline asthma?
Hyperresponsiveness of the lower airways to inhaled allergens and results in increased bronchial secretions and bronchospasms
36
What history is noted with feline asthma?
Coughing/ wheezing/ tachypnea Open mouth breathing and anxiety Exposure to allergens (smoke, perfume, dust, cat litter, pollen)
37
What findings on noted on thoracic radiographs?
``` Increased interstitial densities and peribronchial markings Overinflation Diaphragm straightening Lung hyperlucency Aerophagia ```
38
What are differentials for feline asthma?
Cardiac disease Acute/ chronic bronchitis Infectious pneumonia Pulmonary neoplasia
39
What is the prognosis for feline asthma?
Guarded to fair depending on how long it has been going on for
40
What are maintenance drugs for feline asthma?
``` Terbutaline sulfate Albuterol sulfate Prednisolone Theophylline extended release Fluticasone ```
41
What is pleural effusion?
Abnormal accumulation of fluid in the space between the visceral and parietal pleura
42
What physical exam findings are noted with pleural effusion?
Short, shallow, rapid breathing Muffled heart and lung sounds Ascites Jugular distension
43
What radiographs signs are noted with pleural effusion?
Loss of cardiac silhouette Pleural fissure lines Scalloping around lung lobes
44
What should you do if a patient is not stable prior to radiographs?
Thoracocentesis +/- ultrasound-guided
45
What are differentials for transudate/ modified transudate for pleural effusion?
``` Liver/ kidney disease PLE Heart failure Fluid overload Neoplasia PTE Diaphragmatic hernia ```
46
What are differentials for non-septic exudate for pleural effusion?
``` Neoplasia Lung-lobe torsion Diaphragmatic hernia Renal disease Pancreatitis FIP FeLV ```
47
What are differentials for purulent exudate for pleural effusion?
Septic pleuritis | Foreign body
48
What are differentials for chylous exudate for pleural effusion?
``` Ruptured thoracic duct Obstructed thoracic duct Lymphoma Heart failure Heartworm Idiopathic ```
49
What are differentials for hemorrhagic exudate for pleural effusion?
Neoplasia Trauma Coagulopathy
50
What is the prognosis for pleural edema?
Fair to guarded depending on underlying cause
51
What is the difference between canine and feline pyothorax?
Canine should have an exploratory thoracotomy | Feline should be managed medically

Plunkett Emergency (8 decks)

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