Test 2 - IAD & RAO Flashcards

1
Q

Recurrent Airway obstruction is also known as ______.

A

Heaves

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2
Q

IAD or RAO?

  • Exercise intolerance
  • Young - Middle aged
  • Poor Performance
  • Occasional Cough
  • Airway Remodeling
A
  • Exercise intolerance: RAO
  • Young - Middle aged: IAD
  • Poor Performance - IAD
  • Occasional Cough: IAD
  • Airway Remodeling: Both
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3
Q

IAD or RAO?

  • > 7 y/o
  • Improves spontaneousy or with minor treatment
  • Seasonal
  • Regular to frequent cough
  • Cannot be cured but can be controlled
  • Airway Hyper-responsiveness
A
  • > 7 y/o : RAO
  • Improves spontaneousy or with minor treatment: IAD
  • Seasonal: RAO
  • Regular to frequent cough: RAO
  • Cannot be cured but can be controlled: RAO
  • Airway Hyper-responsiveness: Both
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4
Q

What are the BAL findings associated with IAD?

A

neurtrophilia >10%

mast cells >5%

eosinophils >5%

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5
Q

TRUE/FALSE

Cough is not always seen in IAD

A

TRUE

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6
Q

What are the diagnostic test for IAD?

A

BAL

Pulmonary function Test

Histamine Bronchoprovocation

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7
Q

What is the treatment of IAD?

A

Treatment:
↓ of air borne dust
bedding
Feed
Anti-inflammatories
Broncho-dilators

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8
Q

What is RAO characterized by?

A

Excessive mucus production
Neutrophil accumulation
Bronchial hyperreactivity
Reversible bronchospasm (bronchoconstriction)

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9
Q

TRUE/FALSE

RAO occurs in a wet and cool climate and is associated with poor ventilation & dusty or moldy hay (round bales), dust, pollen & mold exposure.

A

TRUE

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10
Q

Nostril flaring & markedly accentuated expiratory effort is known as ________.

A

Heave

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11
Q

TRUE/FALSE

Anxious facial expression, reluctance to move, and tachypnea >40breaths/min is associated with IAD.

A

FALSE

It is associated with RAO

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12
Q

In RAO, exposure to moldy hay, endotoxins, fungal spores result in air way _________.

A

In RAO, exposure to moldy hay, endotoxins, fungal spores result in air way neutrophilia.

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13
Q

What are the inflammatory mediators released that causes bronchoconstriction?

A

Histamine & 5-HT

They augment the release of Ach which activates PSNS muscarinic receptors

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14
Q

What are the histological findings associated with RAO?

A

Goblet cell hyperplasia
Epithelial cell damage
Bronchial and bronchiolar epithelial cell hyperplasia
Smooth muscle hypertrophy & hyperplasia
Collagen deposition
overinflation of the alveoli

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15
Q

What are the cytological findings of RAO?

A

Suppurative non-septic inflammation
Neutrophilia >25%, ↓ lymphocyte and alveolar macrophages
Tracheal mucus accumulation
% of eosinophils and mast cells are not affected

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16
Q

Upon endoscopic exam of a horse with RAO, you will see…..

A
  • Demonstrates tracheobronchial secretions that originate from bronchial segments
  • Distal airways are edematous and inflamed and airways easily collapse during expiration
17
Q

The Hay Challenge Test is a diagnostic test for _____.

A

RAO

18
Q

The Pulmonary Function test is a diagnostic test for _____.

A

IAD

19
Q

What is the most important aspect of treatment of RAO?

A

↓ environmental challenges: most important aspect.
Well-ventilated stall, adequate bedding, minimized
dust, pellet feed, hay cubes, soak hay in water.

20
Q

What is the big picture treatment of RAO?

A
  • Bronchodilator
  • Anti-inflammatory
21
Q

What are the 2 anticholinergics that may be used in the treatment of RAO?

Which has a longer duration of action and minimal systemic effects?

A

Atropine and Ipratropium bromide

Ipratriopium Bromide has longer duration of action and minimal effects.

22
Q

What is important to know about dosing clenbuteral (B2 agonists) when treating RAO?

A

If clinical improvement is not observed within 3 days, ↑ dose for another 3
days. Effective dose of clenbuterol may vary. AE: anxiety, shivering, sweating, tachycardia. Occurs @
higher doses but appear to minimize when clenbuterol is ↑ in a stepwise manner. Also has antiinflammatory
effect.

23
Q

______ have similar effects to those produced with atropine except no AEs (in the treatment of RAO)

A

Phosphodiesterase Inhibitors

24
Q

What is the MAO of B2 agonists when treating RAO?

Give some examples.

A

relaxation of muscle by ↑ intracellular levels of cAMP.

Albuterol (preferred), clenbuterol,
fenoterol, pirbuterol, salmeterol

25
Q

TRUE/FALSE

Oral prednisone shows signifianct impromvement with 6 hrs of lung function parameters when treating RAO.

A

FALSE.

THat’s Dexamethasone.

26
Q

For maximal therapeutic effects, _____ should be used in conjunction with _______.

Which goes first?

A

For maximal therapeutic effects, inhaled steroids should be used in conjunction with inhaled bronchodilators.

Bronchodilators should go first

27
Q

What is a potential side effect of using inhaled corticosteroid when treating RAO?

A

Inhaled corticosteroid may dry respiratory epithelium discontinue of cough worsens