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Winter Term 2024 > SAM final > Flashcards

SAM final Flashcards

1
Q

What are the two most common clinical signs indicating nasal cavity disease?

A

nasal discharge
sneezing

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2
Q

What are the differentials for nasal deformity in cats?

A

Carcinoma
lymphoma
Cryptococcus

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3
Q

What are the differentials for nasal deformity in dogs?

A

Carcinomas
Transmissible veneareal tumors
Cryptococcus

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4
Q

Why is CT considered the best imaging modality for evaluating the nasal cavity?

A

allows us to eval:
Cribiform plate integrity
soft tissue
turbinate destruction
etc

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5
Q

What can we use rhinoscopy to evaluate?

A

nasal cavity: helpful id fungal plaques
retropharynx: allows us to biopsy

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6
Q

What are the nasal cavity tumors we see in dogs?

A

carcinomas/ adenocarcinoma
Transmissible venereal tumors

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7
Q

What are the nasal tumors we see in cats

A

lymphoma
carcinoma/ adenocarcinoma
squamous cell carcinoma

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8
Q

What are the two main catagories of rhinitis in sinusoidal diseases? Which is more common?

A

non-destructive rhinitis is more common than
destructive rhinitis

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9
Q

What are our ddx for non-destructive rhinitis?

A

Lymphocytic plasmacytic rhinitis
Acute feline URT disease
Parasitic rhinitis
Foreign bodies
Oronasal fistula

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10
Q

What are our ddx for destructive rhinitis?

A

feline chronic rhinosinusitis
fungal rhinosinusitis
neoplasia

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11
Q

Signalment for lymphoplasmacytic rhinitis

A

young to middle aged
big or long nosed dogs
doxies, whippets, GSD for ex

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12
Q

What are the CS that lymphoplasmacytic rhinitis patients present with?

A

95% will have nasal discharge
mucoid or mucopurulent
hemorrhagic in few dogs
NO systemic signs
Airflow out of nostrils is preserved

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13
Q

What diagnostics should we consider and what will they reveal?

A

CT: 50% have sinus involvement and may present mild.turbinate destruction
Rhinoscopy: hyperemic friable mucosa + mucous accumulation
Biopsy: lymphoplasmacytic infiltrates, mucosal edema

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14
Q

What are some tx options since there is no known best tx for lymphoplasmacytic rhinitis?

A

immunomodulation: doxycycline, Azithromycin
anti-inflammatories: Piroxicam
glucocorticoids: inhaled or oral
Antihistimines: clemastine or hydroxyzine

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15
Q

What are the organisms that make up the feline respiratory disease complex?

A

feline herp (FHV-1)
Feline Calicivirus (FCV)
chlamydia felis
mycoplasma
bordetella
coronavirus

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16
Q

How is acute Feline respiratory disease complex (FRDC) transmitted?

A

inhaled or contact

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17
Q

T or F vital infections are always primary in FRDC

A

False, occassionally bacterial infections can be primary
for ex:
Chlamydia felis, mycoplasma felis, mycoplasma gatae, bordetella bronchiseptica

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18
Q

T or F the viral infections in FRDC are usually self limiting

A

true

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19
Q

What are the classical form of Calicivirus CS ?

A

rhinitis
ORAL ULCERS
sneezing
nasal discharge

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20
Q

T or F calicivirus survives in the environement for days to weeks and patients have continuous lifelong shedding

A

true

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21
Q

What are the atypical form of Calicivirus cs?

A

pneumonia
lameness
Systemic calicivirus:
systemic vasculitis
DIC
multiple organ failure
very high mortality

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22
Q

T or false; 60-75% of young cats are carriers of herpesvirus

A

False: 80-90% of young cats are carriers

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23
Q

What are the cs of FHV-1?

A

classic acute: rhinitis and conjunctivitis
corneal ulcers
Acute atypical: pneumonia, dermatophies
Chronic: ceratitis, chronic rhinitis

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24
Q

What are the CS of chlamydia in cats?

A

ocular disease- nasal disease is secondary
mild respiratory signs
chemosis, blepharospasmus

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25
Q

Is rhinitis without conjunctivitis still considered chlamydia?

A

NO! must have rhinitis and conjunctivitis

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26
Q

How can we diagnose Acute FRDC?

A

clinical presentation
PCR: only helpful in herd outbreaks
bacterial culture: helpful for bordetella and mycoplasma

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27
Q

What antibiotics can be used for tx of secondary infections of Acute FRDC?

A

doxycycline (works against most common bacteria)
Axithromycin and pradofloxacin

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28
Q

What are our options for changing local immunity in FRDC?

A

doixy or azithromycin
intranasal vaccine for FHV-1 and FCV (these have cross protection for bordetella)
maybe alpha interferon 2b (just keep in mind that no control group was used)

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29
Q

What are the benefits of using the topical antiviral medication Cidofovir in FRDC?

A

use 0.5% cidofovir x 12 hrs to decrease viral shedding and help with clinical improvement

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30
Q

What is the benefit of using the systemic antiviral Famciclovir in FRDC?

A

Famciclovir is safer than Cidofovir and is more effective
31.25 mg every 12 horus for 14 days

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31
Q

WHat is Feline URTD conjunctivitis usually caused by?

A

mycoplasma felis
chlamydophilia felis

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32
Q

If you suspect chlamydophia felis as the underlying cause of Feline URTD conjunctivitis and begin tx with doxycycline or tetracycline and see no improvement of conjunctivitis but see rhinitis or corneal ulcers, what is the underlying etiology?

A

FHV-1

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33
Q

What etiology do you suspect if you see cs of conjunctivitis and oral ulcers in a cat?

A

Calicivirus

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34
Q

If we prescribe an antiviral to a FHV-1 patient, what must we warn owners about?

A

that most topical antivirals will lead to local irritations

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35
Q

A cat presetns with a chronic respiratory infection. It has purulent or mucopurulent discharge. What are your diagnostic steps?

A

observation for 10 days
no culture because it is impossible to interpret

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36
Q

If during the 10 day observation period of a cat with a chronic respiratory infection they develop any of the following: anorexia, fever or lethargy, what are our treatment options?

A

Doxycycline for 7- 10 days
Second choice: Amoxicillin of mycoplasma and C. felis are not likely

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37
Q

How many days does a patietn have to exibit clinical signs for them to be considered to have a chronic respiratory bacterial infection? What is your dx plan?

A

over 10 days
look for underlying disease: FB, allergy, fungal infection, cuterebra, cancer
If no underlying disease is found: anbx based on C+ S

38
Q

Describe the options for a “therapeutic vaccine” in regards to respiratory viral infections?

A

Herpes and Calici virus:
MLV intranasal vax may help in some cases
patients that respond revax in 2-3 years

39
Q

What is the name of the arthropod dipteran parasite that infects cats as they hunt? How do we treat for them?

A

Cuterebra - large maggots seen in the skin
tx: mechanical removal, ivermectin 0.1 mg/kg PO q24 horus x 3 days
give prednisolone if p has neuro signs

40
Q

What is the name of the nasal mite than is transmitted dog to dog?

A

Pneumonoyssoides caninum

41
Q

How do we treat pneumonoyssoides caninum in dogs?

A

Ivermectin
Milbemycin
once per week x 3 weeks

42
Q

What is the name of the trichuroid nematode that lives in the nasal epithelium?

A

Enculeus boehmi (prev known as capillaria boehmi)

43
Q

How do we diagnose and treat Eucoleus boehmi

A

DX: eggs are seen in feces or nasal wash
tx: fenbendazole, ivermectin

44
Q

What pentastomide is acquired from sheep viscera?

A

Linguatula serrata

45
Q

How do we dx and tx linguatula serrata?

A

DX: eggs in nasal secretions or rhinoscopy
Tx: mechanical removal

46
Q

What type of disease is a oronasal fistula related to?

A

dental related nasal disease
usually affects the canine teeth

47
Q

What is the signalment of a patient with an oronasal fistula

A

older animals with unilateral mucopurulent discharge

48
Q

How do we dx and tx an oronasal fistula?

A

DX: periodonal probe, rads,
CT
TX: teeth removal with all roots , bone curettage may be required
anbx for secondary infection: clindamycin (gram +)

49
Q

What are CS of a nasal foreign body?

A

paroxysmal sneezing or reverse sneezing
nasal discharge
epistaxis
unilateral nasal discharge that is mucopurulent or purulent
pawing or rubbing face

50
Q

If you suspect a nasal FB, what should you evaluate in a rhinoscopy

A

nasal cavity and retropharynx

51
Q

What is the most common cause of destructive rhinitis in cats? What are the common cs?

A

feline chronic rhinosinusitis
bilateral nasal discharge, increased mucus, sneezing
majority of cats are asymptomatic

52
Q

What is our DX work up if we suspect a cat with Feline chronic rhinosinusitis?

A

dx of exclusion
r/o cryptococcus with antigen test
rhinoscopy and biopsy of the nasal cavity and retropharynx
will see turbinate destruction on CT

53
Q

What will histopath of patients with feline chronic rhinosinusitis look like?

A

lymphopasmacytic inflammation- chronicity (this is common for chronic inflammation anywhere in the body therefore not specific)
eopsinophilic infiltrates- associated with herpesvirus

54
Q

What are our tx options for feline chronic rhinosinusitis

A

anbx for 2ndary infections:
doxycycline (start with this)
azithromycin
Amoxicillin: mycoplasma
Clindamycin: bone involvement
anti inflammatories:
-piroxicam
antivirals: famiciclovir: if eosinophilic inflammation/ herpesvirus

54
Q

What are the common species that cause nasal aspirgillosis?

A

fumigatus- most common
niger
nidulans
flavus

55
Q

What are the forms of nasal aspirgillosis?

A

nasal form: primary infection in young healthy dogs
secondary from penetrating injury or FB
systemic form: rare, mostly GSD

55
Q

What is the signalment for nasal aspirgillosis?

A

young to middle aged dolichocephalic dogs (long nose)

56
Q

What are the cs of nasal aspirgillosis?

A

chronic nasal discharge- purulent or hemorrhagic, sneezing, neuro signs

57
Q

What are our dx options ofr nasal aspirgillosis

A

AGID - 30% false negatives
Cytology:
Nasal discharge - sensitivity < 20%: secondary infections impact the accurancy
Endoscopy - sensitivity > 90%
Fungal culture - sensitivity 77%
Changes in CT
Increased opacity in frontal sinus
Right turbinates are almost not there and left turbinates are pissed
Fungal plaques in rhinoscopy

58
Q

What is considered the best therapy for nasal aspirgillosis?

A

local installation of clotrimazole 1% or enilconazole 1-5%
Topical infusion:
Resolution of signs in 1 treatment - 65%
87% with 2 or more treatments
Use an infusion catheter to administer the cream directly into the frontal sinus
Don’t need any infusion pumps if you are using a cream
Recheck in 1 month - retreat if plaques or nasal discharge
Before you tx- important to remove as much plaque as possible
Clotrimazole cream
Longer contact time
Potentially better results than the liquid
Can be performed by owner at home if you do the the trephination

59
Q

What nasal aspirgillosis patients are not canadities for a trephination?

A

those with cribiform plate compromise

60
Q

What treatment options do we have in nasal aspirgillosis patients with cribiform plate compromise?

A

2-6 months of systemic therapy with:
ketoconazole; 40% efficiency
Fluconazole: 60% efficiency
Voriconazole or posaconazole

61
Q

What is cryptococcus neoformans associated with

A

pigeon shit

62
Q

What is cryptococcus gatti associated with

A

bard and leaf litter from eucalyptus trees
in dogs in OR it is more likely to be crypto than aspirgillosis

63
Q

Before referring a cat with nasal disease + facial deformity what diagnostics should a gp do?

A

FNA of local lnn and confirm crypto with serology before referral

64
Q

What is the most important nasal disease in young cats?

A

nasopharyngeal polyps

65
Q

What is the signalment of a nasopharyngeal polyp?

A

1.5 year old cats
maine coones are more prone

66
Q

What are the CS of a cat with nasopharyngeal polyps?

A

progressive and chronic cs
nasal discharge, STERTEROUS BREATHING, sneezing, reverse sneezing

67
Q

A young cat that snores has _______ until proven otherwise

A

a nasalpharyngeal polyp

68
Q

What are the treatment options for nasopharyngeal polyps?

A

sx (best approach) or mechanical removal

69
Q

How is a feline mesenchymal nasal hamartoma different than a nasal polyp?

A

polyps start on the auditory tube or the tympanic cavity
feline mesenchymal nasal hamartomas arise from native tissue of the nasal cavity

70
Q

What are the cs of a cat with a feline mesenchymal nasal hamartoma

A

progressive stertorous breathing
serous nasal discharge and epistaxis
if severe cases: sinonasal deformation
mass protruding from the nasal cavity

71
Q

What are tx options of a feline mesenchymal nasal hamartoma?

A

spontaneous regression can occur
some may respond to glucocorticoids
mechanical removal is tx of choice via endoscopy or sx

72
Q

What are the causes of an aquired nasoparyngeal stenosis

A

secondary to chronic rhinitis! (most common in cats
aspiration rhinitis ( most common in dogs after aspiration during anesthesia!
sx, trauma, tumors and polyps

73
Q

T or F, dogs are more likely to have patent morphology of their nasopharyngeal stenosis

A

False
Cats 90% are patent
Dogs: 47% are patent

74
Q

What are cs of nasopharyngeal stenosis

A

sterterous breathing
dyspnea
oral breathing
nasal discharge
gagging and repeated swallowing attemps

75
Q

What are our dx options for nasopharyngeal stenosis?

A

Rhinoscopy or CT

76
Q

How do we manage thin nasopharyngeal stenosis lesions? (under 5mm)

A

Balloon dilation
30% success in dogs and 50% success in cats after 1 dilation

77
Q

How do we manage thicker lesions or unsuccesful balloon dilation in nasopharyngeal stenosis cases?

A

Balloon-expandable metallic stent
Balloon stent is left in
Self-expanding metallic stent
Covered metallic stent
Removable metallic stent most common now

78
Q

Describe the procedure of balloon dilation in nasopharyngeal stenosis

A

Wire through the nose into the obstructed area, then pass a progressively larger catheter until you get substantial expansion of the dilation of the balloon
Now you can use a removable stent where you can place the widening removal stent and fix it into place so it is no longer removable
To do this: Send a needle from soft palate and then place something similar to a plastic price tag holder thing through that opening and tie them together

79
Q

What are causes of stridor

A

laryngeal paralysis- most important in dogs and cats
laryngeal inflammation
laryngeal tumors
Acromegaly: rare in dogs

80
Q

What are common complaints of owners with dogs that have inflammatory laryngitis

A

inspiratory difficulty
dysphoria (change in voice)
difficulty swallowing
retching

81
Q

What is crucial to diagnosing inflammatory laryngitis in cats

A

biopsy
it is a result of primary inflammation

82
Q

What are treatment options for inflammatory laryngitis

A

voice rest
cough suppresents
tx underlying respiratory or GI problem
anti inflammatories
sx for mass removal

83
Q

What is often the first sign of a generalized polyneuropathy in a pet and why?

A

laryngeal paralysis because the recurrent laryngeal nerve is the longest nerve in the body

84
Q

What is laryngeal paralysis

A

the inability to abduct the arytenoids during inspiration

85
Q

How does laryngeal paralysis result in a stridor?

A

glottis doesn’t open like it should which increases resistance

86
Q

What is the most common cause of laryngeal paralysis

A

neuropathy or polyneuropathy
GOLPP

87
Q

What is GOLPP?

A

geriatric onset laryngeal paralysis and polyneuropathy
systemic signs of muscular weakness
most important cs is sridor

88
Q
A

Winter Term 2024 (1 decks)

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