Abnormal Breathing

Question 1

Abnormal breathing: Normal lung sounds

Next step:

Answer 1

Temperature

Question 2

Abnormal breathing: Normal lung sounds
Normal temperature
Next step:

Answer 2

Arterial Blood Gas: CO2

Question 3

Abnormal breathing: Normal lung sounds
Normal temperature
ABG hypocapnia

Answer 3

Pain / central

Question 4

Abnormal breathing: Normal lung sounds
Normal temperature
ABG hypercapnia

Answer 4

Diaphragmatic dyfunction

• Botulism
• Trauma
• Paralysis

Question 5

Abnormal breathing: Normal lung sounds
Normal temperature
PFT / HBP / BAL or Bronchodilator
If test is positive:

Answer 5

• IAD

- RAO

Question 6

Abnormal breathing: Normal lung sounds
Normal temperature
PFT / HBP / BAL or Bronchodilator
If test is negative:

Answer 6

Do a cardiac evaluation

Question 7

Abnormal breathing: Normal lung sounds
Increased temperature
Next step:

Answer 7

CBC

Question 8

Abnormal breathing: Normal lung sounds
Increased temperature
Normal CBC

Answer 8

Hyperthermia

Toxin

Question 9

Abnormal breathing: Normal lung sounds
Increased temperature
Abnormal CBC

Answer 9

Pulmonary abscess
Interstitial pneumonia
Other systemic disease

Question 10

Abnormal breathing: Normal lung sounds
Increased temperature
Abnormal CBC
How to confirm diagnosis

Answer 10

US

Radiographs

Question 11

Abnormal breathing: Abnormal lung sounds

Possible breathing patterns:

Answer 11

Mixed inspiratory and expiratory

Inspiratory/ stridor

Question 12

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
What to listen for:

Answer 12

Crackles and Wheezes

Decreased lung sounds

Question 13

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
With Crackles and Wheezes
What to check next

Answer 13

Temperature

Question 14

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
With Crackles and Wheezes
No fever
What to do next:

Answer 14

PFT
HBP
BAL
Bronchodilator

Question 15

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
With Crackles and Wheezes
No fever
With Positive PFT / HBP / BAL / Bronchodilator

Answer 15

IAD

RAO

Question 16

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
With Crackles and Wheezes
No fever
With Negative PFT / HBP / BAL / Bronchodilator

Answer 16

Do cardiac evaluation

Question 17

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
With Crackles and Wheezes
With fever
What’s the next step:

Answer 17

Radiograph

Tracheal wash

Question 18

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
With Crackles and Wheezes
With fever
What can I diagnose from radiographs / tracheal wash

Answer 18

Bronchopneumonia
Interstitial pneumonia
EMPF (Equine multinodular pulmonary fiborisis)
Neoplasia

Question 19

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
With decreased lung sounds
What’s my next step:

Answer 19

Auscultate for

- Heart sound quality

Question 20

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
With decreased lung sounds
With loud heart sounds but dull percussion

Answer 20

Pleural effusion

Question 21

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
With decreased lung sounds
With diminished heart sounds and hyperresonant percussion

Answer 21

Pneumothorax

Question 22

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
With decreased lung sounds
With loud heart sounds but dull percussion
How to confirm pleural effusion

Answer 22

Radiographs

Thoracic U/S

Question 23

Abnormal breathing: Abnormal lung sounds
Mixed inspiratory and expiratory
With decreased lung sounds
With diminished heart sounds and hyperresonant percussion
How to confirm Pneumothorax

Answer 23

Radiographs

Thoracic U/S

Question 24

Abnormal breathing: Abnormal lung sounds
Insiparotory / stridor pattern
What’s my next step:

Answer 24

Confirm upper airway obstruction with endoscopy