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LAM I > Test 2 > Flashcards

Test 2 Flashcards

1
Q

Trace air through the horse’s respiratory tract starting at the nares

A

Nares > nasal passage > ethmoid > nasopharynx > guttural pouch > larynx > trachea

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2
Q

2 distinct circulations in respiratory tract

A

Pulmonary and bronchial

Pulmonary – low pressure, high volume, oxygenation of blood. Resting PAP = 25-30mmHg, exercise PAP = 125mmHg
Bronchial – high pressure, low volume, distribution of pulmonary tissues. Resting = 100mmHg, exercise = 220mmHg

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3
Q

Why do we rebreathe horses?

A

increase rate + depth of respiration, used to elicit or accentuate abnormal lung sounds

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4
Q

Which mainstem bronchi is larger?

A

Right

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5
Q

How can you tell which ethmoid turbinate you are looking at?

A

The first most superficial comes from the lateral side

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6
Q

Which is the most relevant test in diagnosis of upper airway diseases and involvement?

A

Endoscopy

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7
Q

T/F: Radiographs are good to evaluate pulmonary disease while US is good to evaluate thoracic disease.

A

TRUE

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8
Q

Transtracheal wash

A

sterile
focal, infectious diseases
can culture sample

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9
Q

Bronchoalveolar lavage

A

non-sterile
diffuse, non-infectious diseases
cannot culture sample

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10
Q

Upper airway disease

A

unilateral or bilateral nasal discharge
inspiratory component
lung sounds are normal

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11
Q

lower airway disease

A

bilateral nasal discharge
expiratory component
lung sounds = abnormal

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12
Q

Most common cause of epistaxis

A

trauma (nasogastric intubation

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13
Q

Guttural Pouch Mycosis

A

young horses
minor bouts of hemorrhage then unpredictable major bleeding episode, bilateral epistaxis
usually internal carotid artery, also external carotid artery +/- maxillary artery
CS: epistaxis and dysphagia
Treatment: if not bleeding - topical + systemic antifungals (temporary indwelling catheters), if bleeding, surgical (occlude both ends of vessel bc Circle of Willis)
complication - blindness

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14
Q

Progressive Ethmoid Hematoma

A

old, male, thoroughbred
CS: unilateral epistaxis, mild, spontaneous, intermittent
Dx: endoscopy, rads, CT
Tx: laser ablation (transendoscopically preferred), cauterize while you cut, medical can use formalin (necrosis, desiccate lesion)

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15
Q

Exercise induced pulmonary hemorrhage

A

INTENSITY, not duration of exercise
Capillary stress theory - high intrathoracic pressure, inflammation, bronchial angiogenesis, pulmonary fibrosis
CS: poor performance, epistaxis in only 1-10%
Dx: endoscopy for direct observation of blood in tracheobronchial tree –> 30-90mins post race, can see up to 7 days, graded 0-4. Hemosiderophages in secretions
Tx: LASIX (furosemide)

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16
Q

what condition of epistaxis do you see hemosiderophages?

A

EIPH

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17
Q

top Ddx for old horse with bilateral epistaxis

A

ethmoid hematoma

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18
Q

Top Ddx for young horse with unilateral epistaxis

A

guttural pouch mycosis

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19
Q

Airway epithelium takes ______ to heal

A

7 weeks

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20
Q

Clara cells

A

terminal + resp bronchioles, source of surfactant like substance which aids in maintaining patency of airway

21
Q

_______ is a constant component of cough

A

bronchoconstriction

22
Q

maximal expiratory flow maneuver

A

forceful inspiration -> compression: close glottis -> expression: rib cage, abdomen, diaphragm -> relaxation

23
Q

Specific lung sounds for pneumonia, pleuropneumonia, pleural effusion

A

pneumonia - increased lung sounds, crackles, wheezes
Pleuropneumonia - ventral dull sound
pleural effusion - cardiac sounds larger area than normal bc better sound conduction

24
Q

Equine influenza

A 
young-3yr olds
crowding, transport, stress
major cause resp distress
aerosolized >35 feet
destroy ciliated epithelium
25
Equine herpesvirus
young-3yr olds destroy ciliated epithelium EHV-1 - resp + repro EHV 4 - resp + neuro CS: conjunctivitis, lymphadenopathy, edema, vasculitis, polysynovitis EHV5 - equine multi nodular pulmonary fibrosis
26
Bacterial causes of cough
Aerobic - streptococcus zooepidemicus | Anaerobic - bacterioides fragillis (treat with metronidazole)
27
Most common secondary organism of fungal pneumonia
aspergillus spp.
28
Equine multinodular pulmonary fibrosis
Diffuse bronchointerstitial lung pattern with multiple coalescing circular nodules throughout lung field US - multiple circular hypo echoic masses Tx: corticosteroids, NSAIDs, antivirals, antifibrotic agents EHV5
29
Foal pneumonia Ddx for <1 month vs 1-6 months
<1 month - meconium aspiration, aspiration pneumonia, iatrogenic, surfactant inactivation, equine viral arteritis, EHV 1-6m - S. zooepidemicus or R. equi, resp viruses
30
Foal pneumonia
Dx: rads allow evaluate deep parenchyma, lung consolidation | Tx; antimicrobials against most common bacteria based on C/S
31
two diseases encompassed by the term "equine asthma"
inflammatory airway disease (IAD) and recurrent airway obstruction (RAO)
32
Inflammatory airway disease (IAD)
young, non-seasonal CS: occasional cough, poor performance, normal RR, tracheobronchial fluid accumulation, normal lung Inflammation of lower airway as response to possible allergens BAL - neutrophilia >10%, mast cells >5%, eosinophils >5% Tx: improves spontaneously or with minor treatments
33
Recurrent airway obstruction (RAO)
old animals, seasonal CS: regular cough, increased RR, accentuated expiratory effort (heave line), abnormal lung sounds w/ rebreathing bag environmental source goblet cell hyperplasia, over inflation alveoli suppurative, non-septic inflammation, neutrophilia >25%, no change in mast cell or eosinophil numbers endoscopy: distal airways edematous + inflamed Tx: environmental management is most important, bronchodilators, corticosteroids (dexamethasone, prednisOLONE)
34
T/F: Prednisone is drug of choice to treat RAO
NO, use PREDNISOLONE. prednisone --> treatment failure
35
Guttural pouch empyema
Strep zooepidemicus, strep equi var equi CS: intermittent nasal discharge, lymphadenitis, parotid swelling, dysphagia, chondroids Dx: rads, endoscopy + culture Tx: penicillins, flush pouches w/ retention catheter (LRS then Abs, acetylcysteine to dissolve concretions), Sx - drain then heal by second intention
36
Strangles
highly contagious, young horses, gets into guttural pouch via retropharyngeal LN strep equi var equi CS: high fever w/ depression, purulent yellow green discharge, respiratory distress Pathophysiology - organism infects macrophages in upper resp tract, replicates in pharynx (fever w/o any other CS), engulfed by macrophages, to regional LN -> rupture + drainage highest environmental contamination - water sources day 7-14 (LN rupture) = most contagious Dx: C/S, PCR
37
How do you treat bastard strangles?
let disease run its course, if complicated give penicillin
38
Purpura hemorrhagica
leukocytoplastic vasculitis - neutrophilic infiltration of venues CS: hot and painful edema in all 4 limbs Tx: steroids (is immune mediated), penicillin (for infection) hydrotherapy on limbs to avoid skin slough
39
Pleuropneumonia
pleural effusion assoc w/ pneumonia secondary to abscessation CS: fever, resp dz, weight loss if chronic, pectoral edema (depending on drainage) Dx: pulmonary sounds absent ventrally, louder dorsally, straight line across thorax, crackles and wheezes CBC: early - early fibrinogen, CBC of ill endotoxic horse; later - elevated fibrinogen, neutrophilic leukocytosis
40
Rhodococcus equi
gram +, intracellular facultative aerobic subacute to chronic bronchopneumonia foals 1-6m MC in dry season, inhalation Rads: abscessation, miliare, broncho-pneumonia, interstitial Tx: erythromycin estolate, rifampin
41
Foal pneumonia associated with rad patterns:abscessation, miliare, broncho-pneumonia, interstitial
Rhodococcus equi
42
Special pneumonia that we treat with erythromycin estolate and rifampin
rhodococcus equi
43
What shows remarkable sensitivity as indicator of myonecrosis?
creatine kinase (CK)
44
CK vs AST
- elevations in CK and AST reflect recent or active myonecrosis - CK remains persistently elevated - myonecrosis likely ongoing - elevated AST with normal or decreasing CK - myonecrosis not continuing
45
Positive hemastix test
urinalysis | in absence of hemolysis or RBC in urine - highly suggestive of myoglobinuria
46
Exercise challenge
measure CK pre and post work out (4-6h) slow trot increase >5x indicative of exertional rhabdomyolysis
47
Biopsy of muscle
pathological alterations that cant be seen in formalin fixed tissue but can be seen with histochemical stains local anesthetic SQ, 1 inch square sample minimum
48
Sweeney
atrophy of supra scapular muscles due to denervation bc damage of supra scapular nerve

LAM I (8 decks)

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