SA- problem based approach Flashcards
(113 cards)
1
Q
What are the two segments of the URT
A
Rostral to nasopharynx; pharynx, larynx, cervical trachea
2
Q
What defines the LRT
A
Pulmonary airways and parenchyma
3
Q
Eupnea
A
normal breathing
4
Q
hyperpnea
A
increased depth or force of airflow
5
Q
hyperventilation
A
(exchanging more air in a time period) faster and/or deeper
6
Q
What is the typical cause of bradypnea
A
Brain issues
7
Q
Hypopnea
A
Shallow, decreased
8
Q
Apnea
A
Cessation greater than 10 seconds
9
Q
Hypoventilation
A
Slower and/or more shallow
10
Q
Orthopnea
A
dyspnea while laying down
11
Q
Apneustic
A
Deep long inspiration then breath holding and rapid exhalation
12
Q
Ataxic/agonal
A
Irregular shifts of hyper and hypoventilation and apnea- DYING!
13
Q
Cousmal
A
Air hunger- swallowing air
14
Q
What is it called when abdomen and thorax are moving in opposition to each other
A
Paradoxic breathing
15
Q
What are the usual causes of paradoxic breathing
A
diaphragmatic hernia or paralysis
16
Q
Decribe flail chest
A
Segment of chest wall moves independently from others- usually rib fractrue
17
Q
Two normally auscultable sounds
A
Bronchial- normal turbulent air flow in trachea; vesicular- lower area normal sounds that are longer and more intense on inspiration
18
Q
Audible abnormal sounds
A
Stertor, stridor, wheeze
19
Q
Stertor (describe)
A
Snoring produced by partial obstruction of upper airway
20
Q
Stridor (describe)
A
High pitched, harsh, vibratory, from partial obstruction at upper trachea
21
Q
Stridor (locations)
A
Larynx, caudal oropharynx, cervical trachea
22
Q
Stertor (locations)
A
Only mouth/nasal/nasopharynx
23
Q
Wheeze
A
In cats on inspiration
24
Q
Laryngeal paralysis will cause what audible sound
A
Stridor (also could be caused by tumor)
25
What causes crackles
Fluid! Air passing through fluid or forcing open a collapsed airway/alveolar wall
26
What causes wheezes
Continuous whistling from air turbulence in lower airways from obstruction or narrowed airway
27
When do crackles occue (I vs E)
Both
28
When do wheezes occur (I vs E)
Typically expiratory
29
Where do wheezes originate
Typically below carina but def. below the larynx
30
What is an end expiratory grunt
Push to get air out by contracting diaphragm
31
What is the difference between pleural rubs and crackles
Happen at the same time of inspiration every time, less diffuse than crackles, lungs catching due to decreased fluid or fibrin
32
What is the snare drum sound
Pleural rubs
33
What is the classic presentation of fluid in the chest
Sounds dorsally but not ventrally
34
What do sounds ventrally but not dorsally indicate
Air accumulation in lungs
35
Which region is this associated with - epistaxis
Nose/nasopharynx
36
Which region is this associated with - sneezing
Nose/nasopharynx
37
Which region is this associated with - stertor
Nose/nasopharynx
38
Which region is this associated with - facial asymmetry
Nose/nasopharynx
39
Which region is this associated with - stridor
URT obstruction
40
Which region is this associated with - coughing
URT obstruction below larynx or LRT
41
Which region is this associated with - I >E
URT obstruction
42
Which region is this associated with - exercise intolerance
URT or LRT
43
Which region is this associated with - hyperthermia
URT
44
Which region is this associated with - Tachypnea, dyspnea, distress
URT or LRT
45
Which region is this associated with - wheezing
LRT bronchi, bronchioles
46
Which species gets polyps in the nasal/nasoph
Cats
47
What species is more predisposed to aspergillosis
Dogs
48
Cause of cat cough
Rare, but if: asthma, HWDz, bronchitis
49
Lower airway- cat vs dog
feline asthma, canine chronic bronchitis
50
Pleural space disease cats vs dogs
CHF- cats- pleural space edema dogs- alveolar edema
51
Tracheal collapse symptoms in large dog is likely
Chronic bronchitis
52
Signalment for blastomycoses or pyothorax
Hunting dogs
53
Spontaneous pneumothorax- Signalment
Huskies
54
Pneumocystis/protozoal pneumonia- signalment
Doxies
55
Younger or older? Polyps
Younger
56
Younger or older? viral infection
Younger
57
Younger or older? Fungal infection
Older
58
Younger or older? Allergic rhinitis
older
59
Younger or older? Immune mediated
Older
60
Rule outs for cough
regurg/vomiting, reverse sneeze, HWDz
61
Chronic or acute? fungal
Chronic
62
Chronic or acute? viral/bacterial
Acute
63
Chronic or acute? CHF
Acute
64
Ocular retropulsion tests for
Nasal/nasoph
65
Observing abdominal movements and postural changes - for:
Airway or pulmonary disease
66
Increased time/effort of inspiration- tx
Bypass upper airway, tap chest
67
Increased time/effort of expiration- tx
bronchodilators, steroids
68
Characterize cough
Productive, dry, moist, harsh, soft; spasmodic, paroxysmal; induced/spontaneous
69
Characterize wheezes
Sonorous- low pitch; sibilant- high pitch
70
Causes of respiratory distress
Lack of oxygen delivery from obstruction, cardiac, hematologic
71
True airway distress localizes issue to :
Larynx or lower
72
Head/neck extension posture, inspiratory component localized:
Laryngeal/ upper airway
73
Tachycardia, murmur, pulse abnormalities significant enough to cause distress- primary ddx
Cardiac disease
74
Iatrogenic pathology of decreased O2
Environmental O2
75
Squeeze cat cranial thorax- cant compress =
Mass
76
Where are cough receptors found
URT and large airways primarily
77
Why can cough occur when URT not primary affected
movement of secretions, compression,
78
Two causes of cardiac cough
Chamber enlargement compressing airway (should have murmur);
79
True respiratory distress only occurs if lesion is
At or below larynx
80
Muffled lung sounds indicate
pleural space disease
81
Expiratory effort- localized
Intrathoracic lesions
82
Inspiratory effort- localized
Extrathoracic lesions
83
First test performed for chronic respiratory distress
HWT! Ab in dogs, Ab/Ag in cats
84
How are FELV and FIV linked to respiratory issues
Cause cancers or immumosuppressive opportunistic infections - no primary respiratory component
85
What parasite tests should be done?
Baermann with float, +/- direct smear
86
Most common infectious disease test
PCR
87
What will blood gas test tell
Severity of disease - pulmonary dz vs hypoventilation (disease must be severe to be appreciated)
88
What does pulse ox measure
% Hg molecules saturated with O2- not total content
89
What is a limitation of pulse ox
Anemia or toxicity (usually CO2) poisoning will look like 100% - but actual carrying ability decreased
90
FiO2: PaO2 ideal
>400 nomral
3-4 mild-moderate
below 3 - severe
91
Pulse ox reading 90 - corresponding PaO2
65 - tissue damage (FiO2 of 300)
92
Normal room air PaO2
97-99
93
Danger level for PaO2 and corresponding pulse ox
60 or below; pulse ox - 88
94
Fatal level of PaO2 and corresponding pulse ox
50 or below (pulse ox 80)- need intervention! O2 to assisted ventilation
95
Intervention point of PaO2 and pulse ox
50 / 80
96
Primary reason for angiography
PTE or lung perfusion
97
Primary reason for fluoroscopy
dynamic collapse
98
Primary reason for CT
Bone
99
Primary reason for MR
Soft tissue
100
When would an oropharyngeal exam be indicated
CS localized to URT - teeth, palate, masses, etc. REQUIRE ANESTHESIA
101
3 types of nasal cytology
FNA/impression smear, FNA of local lymph nodes, nasal flush sample - not a great test (bacteria normal
102
When is nasal cytology most useful
Fungal rhinitis or neoplasia
103
What are the only things that can be diagnosed via rhinoscopy
Foreign body or nasal mites
104
Best nasal test for specific diagnosis
Nasal biopsy
105
What is bronchoscopy
Direct visualization of airways that facilitates sample collection from LRT
106
What is obtained in tracheal wash
Cells and fluid from large airways that bypasses normal oral flora
107
What diseases should use a tracheal wash for dx
Large airway and severe diffuse alveolar
108
What is the only tracheal wash that doesnt require anesthesia
TTW
109
What are the two main techniques for bronchoalveolar lavage
Bronchoscopy guided and endotracheal lavage
110
What cells should predominate in normal respiratory secretions
mononuclear cells
111
What do neutrophils in a TW indicate
inflammation or infection
112
What do eosinophils in a TW indicate
allergic or parasitic infection
113
Normal or abnormal: organisms within phagocytes
Abnormal especially if one species predominates
