EBCM Exam Two Flashcards
Asthmatic horses are typically young/middle/older (choose) aged horses.
(Middle and older)
Pair the clinical signs with the progression of asthma in horses:
Moderate exercise intolerance
A - Severe disease
B - Early disease
C - Moderate disease
(B)
Pair the clinical signs with the progression of asthma in horses:
Cough and mucoid nasal discharge
A - Severe disease
B - Early disease
C - Moderate disease
(C)
Pair the clinical signs with the progression of asthma in horses:
Nostril flare and abdominal push
A - Severe disease
B - Early disease
C - Moderate disease
(A)
Which form of equine asthma is associated with exposure to barn dust, hay dust or hay mold and is more commonly observed in winter?
(Typical equine asthma)
Which form of equine asthma is associated with pasture, humidity, and hot temperatures and is observed in the south-eastern states such as Virginia?
(Summer Pasture Airway Obstructive Disease (SPAOD))
What results from exposure to an inhaled irritant that causes bronchoconstriction and mucous hypersecretion?
(Airway neutrophilic inflammation)
What in the history may distinguish between asthma and an infectious agent in horses?
(Exposure history (exposure to infectious agent → infectious; new environment/seasonal onset → asthma), clinical sign (fever → infectious; no fever → asthma), if other animals are affected or not, and onset (acute → infectious; gradual/chronic/recurring → asthma))
What are the advantages of a transtracheal wash or brush?
(More representative and sterile)
What is the advantage of a bronchiolar lavage?
(It is a more immediate assessment of inflammation in the lower airways)
What type of drug are atropine, ipratropium bromide, and buscopan and which of them is the drug of choice for asthma and why?
(They are M3 receptor antagonists; ipratropium bromide is the drug of choice because it does not affect the GI tract like atropine and buscopan do (inhibits GI motility)) They are M3 receptor antagonists; ipratropium bromide is the drug of choice because it does not affect the GI tract like atropine and buscopan do (inhibits GI motility))
How do alpha 2 agonists help with asthma?
(They block the release of AcH at the neuromuscular junction in the airway → reduces contraction; also increases mucous and water transport and generally promotes smooth muscle relaxation)
How do beta 2 agonists help with asthma?
(When beta 2 receptors are activated they cause bronchodilation and increase mucous secretions and mucociliary clearance)
What are the disadvantages to using systemic steroids for treatment of asthma?
(Systemic distribution affects overall immune response → more susceptible to infection, heavy parasite load, and skin disease; and increased risk for laminitis)
If you perform a BAL because you want to see if you can stop administering corticosteroids to a horse with asthma, what would indicate that you cannot stop your treatments?
(Any presence of neutrophilic inflammation → clinical compromise will return once treatment is stopped)
What are some ways to distinguish between inflammatory airway disease and asthma in horses?
(Age (IAD → young; asthma → middle to old age); history (IAD → no hx of recurring resp dz; asthma → recurring hx))
What is the method of choice for identifying cytological changes that can indicate exercise induced pulmonary hemorrhage?
(BAL → you’ll be looking for hemosiderophages)
What are the acute signs of equine respiratory viruses? 4 answers.
(High fever, general malaise, cough that often persists for several weeks, and clear to mucoid nasal discharge; some viruses can also acutely cause local lnn swelling/tenderness and limb/ventral edema)
Pair the following time period in a viral infection with the suggestive clinical pathology that would be found during that time:
Acute
A - Mild to moderate neutrophilia
B - Leukopenia with mild to moderate lymphopenia
C - Monocytosis
A - Leukopenia with mild to moderate lymphopenia
Pair the following time period in a viral infection with the suggestive clinical pathology that would be found during that time:
After several days
A - Mild to moderate neutrophilia
B - Leukopenia with mild to moderate lymphopenia
C - Monocytosis
A - Mild to moderate neutrophilia
Pair the following time period in a viral infection with the suggestive clinical pathology that would be found during that time:
During early convalescence
A - Mild to moderate neutrophilia
B - Leukopenia with mild to moderate lymphopenia
C - Monocytosis
C - Monocytosis
(T/F) Fibrinogen is always increased with viral respiratory infections in horses.
(F, fibrinogen is usually normal if there is not secondary bacterial infection)
(T/F) Modified live vaccines have a chance of stimulated cell mediated responses.
(T, killed vaccines have no chance of stimulated CMI)
The equine respiratory panels that Davis, Cornell, and Idexx have available are which of the following tests:
A - ELISA
B - Virus neutralization
C - PCR
D - IHC
(C)
Are RNA or DNA viruses more fragile and less likely to survive in mucosal discharge?
(RNA (influenza and viral arteritis are RNA)
What are the common equine respiratory viruses? 4 answers.
(Equine influenza, equine herpesvirus 1, equine herpesvirus 4, and equine viral arteritis)
Antigenic drift/shift (choose) is the change of antigenicity within a viral subtype?
(Drift)
What is antigenic drift?
(The change of antigenicity within a viral subtype → mild change in surface antigens but they maintain the same category)
What is antigenic shift?
(Development of a new viral subtype → H3N8 versus H7N7)
Which type of equine influenza is associated with more severe disease?
(H3N8)
What is the incubation period for equine herpes virus?
(2-10 days)
(T/F) Most horses are infected with equine herpes virus by the age of 2 years old.
(T)
Which of the following transmission routes are viable options for herpes virus?
A - Fomites
B - Vertical
C - Direct contact
D - Recrudescence of infection
E - All of the above
F - None of the above
iykyk
(E)
Herpes virus can become latent in infected horses, where does it chillax waiting for a stressful period or corticosteroid usage to peek back out? 2 answers.
(Respiratory lympho-reticular system or the trigeminal ganglion)
There are multiple clinical syndromes that are associated with equine herpes virus, one of which is a typical upper respiratory tract infection, what are the other four clinical syndromes?
(Pulmonary vasculotropic infection (can be lethal, causes pulmonary edema), late-term abortion (primarily EHV-1), neonatal foal death (d/t interstitial pneumonia), and myeloencephalopathy)
Neurologic signs associated with herpes virus are due to mutation of which strain of herpes virus?
(EHV-1)
Abortions caused by equine herpes virus are early/mid/late (choose) term.
(Late term)
Broodmares should be vaccinated against herpes virus at what months of gestation to prevent abortion?
(5, 7, 9, 11)
If you are presented with an equine abortion case that occurred at 6 months of gestation, the mare currently has respiratory signs, and the fetus is autolyzed, what virus is your top differential?
(Equine viral arteritis → abortion occurs from 3-10 months of gestation, mare usually has resp signs at time of abortion and fetus is autolyzed, which herpes → always 5 months or greater into gestation, mares typically had resp signs a few weeks/months ago, and fetus will not be autolyzed)
Persistent infection of equine viral arteritis in stallions is dependent on the presence of which hormone?
(Testosterone)
Why might infection of the retropharyngeal lymph node with Strep equi equi not be associated with any swelling?
(Bc they can rupture into the medial floor of the guttural pouch and drain there)
What is the treatment for donkey lungworms (Dictyocaulus arnfieldi) that causes eosinophilia, which can be seen on a TTW?
(Ivermectin)
What are the three causes for pleural effusion in horses?
(Secondary to pulmonary lymphatic blockage by pneumonic exudate (i.e. secondary to pneumonia), secondary to thoracic neoplasia, and penetrating wound/trauma)
What type of history is often associated with infectious pleuritis?
(Stress, transport, recent viral infection, strenuous exercise, and general anesthesia)
Why may horses with pleuropneumonia be confused with horses with colic, laminitis, and/or myositis?
(Because they take up a base wide stance d/t pleurodynia)
What virus is equine multinodular pulmonary fibrosis associated with?
(EHV-5)
What is the most common neoplasia of the equine airway?
(Granular cell tumor)
(T/F) Inspiratory noise is always pathologic as it indicates narrowing of the upper airway lumen.
(T)
Stridor/stertor (choose) is associated with a low pitched sound.
(Stertor is associated with low pitched sounds, stridor is associated with high pitched sounds)
(T/F) Exercising expiratory sounds are normal at a trot, canter, and gallop.
(F, not at a trot, yes at a canter/gallop)
What is the primary diagnostic for upper airway cases?
(Endoscopy)
Of the following diagnostic techniques, sort them into whether they would be more useful for sinus/nasal passage disease versus larynx/pharynx diseases:
Head radiographs
Dynamic/treadmill endoscopy
Watch during exercise
Head CT/MRI
Dental examination
Ultrasound
Head radiographs (Sinus/nasal passage)
Dynamic/treadmill endoscopy (Larynx/pharynx)
Watch during exercise (Larynx/pharynx)
Head CT/MRI (Sinus/nasal passage)
Dental examination (Sinus/nasal passage)
Ultrasound (Larynx/pharynx)
What procedure can be performed to provide an airway in a horse with a life-threatening URT obstruction?
(Tracheotomy)
Give causes for the following discharge presentations:
Serous discharge
Serous discharge (Viral respiratory infection, allergic rhinitis)
Give causes for the following discharge presentations:
Mucoid to purulent discharge
Mucoid to purulent discharge (Primary or secondary bacterial respiratory infection, sinusitis, tooth root abscess)
Give causes for the following discharge presentations:
Fresh hemorrhagic discharge
Fresh hemorrhagic discharge (Guttural pouch mycosis, trauma, lower airway causes such as exercise induced pulmonary hemorrhage)
Give causes for the following discharge presentations:
Old hemorrhagic discharge
Old hemorrhagic discharge (Ethmoid hematoma, lower airway causes such as necrotizing pneumonia)
Give causes for the following discharge presentations:
Discharge with feed
Discharge with feed (Choke, dysphagia d/t pharyngeal obstruction)
Give causes for the following discharge presentations:
Discharge with a fetid odor
Discharge with a fetid odor (Dental or chronic causes)
Is the sinus drainage angle rostral or caudal to the nasal septum termination?
(Rostral, so drainage from the sinus drainage angle will be unilateral)
Will discharge from the nostrils be unilateral or bilateral in guttural pouch disease with lots of discharge?
(Bilateral; I put the caveat of lots of discharge because it could be unilateral if there is minimal discharge that only drains down one side but something like GP mycosis induced hemorrhage will be bilateral bc the nasopharyngeal ostia are caudal to the termination of the nasal septum)
(T/F) Epidermal inclusion cysts, aka atheroma of false nostril, rarely obstruct the airway and are primarily a cosmetic problem.
(T)
Rare enlargement or failure of which muscle allows for alar fold collapse during exercise?
(Transversus nasi muscle)
Alar fold collapse is most common in which horse breeds?
(Standardbreds and saddlebreds)
Alar fold collapses are associated with noise during inspiration/expiration (choose).
(Both, inspiration mainly/- expiration)
(T/F) Alar fold collapses can cause reduced performance.
(T)
What is the purpose of performing a resting and/or dynamic endoscopy in cases of alar fold collapse?
(Rule out other causes of noise and exercise intolerance as alar fold collapses can occur in conjunction with other problems)
(T/F) There is evidence that nasal strips reduce peak inspiratory pressure and resistance when a horse is maximally exercising by pulling the dorsal conchal folds laterally and expanding the dorsal meatus.
(T)
Why is it optimal to close lacerations and wounds of the nares with a primary closure as opposed to second intention healing?
(Scarring can cause secondary stenosis, primary closures minimize scarring)
Paralysis of which cranial nerve leads to a lack of tone in the nostril(s) and may cause flutter or even collapse of the nostril?
(Facial nerve/CN VII)
(T/F) Nasal mucosal hemorrhage is rare and all other possible causes of epistaxis should be ruled out first.
(T)
When may the collection of blood vessels aka nasal varicosities that bleed in cases of nasal mucosal hemorrhage bleed?
(May bleed during turbulent airflow or randomly)
What radiographic projection should be taken in a case of wry nose to determine the degree of deviation?
(A dorsoventral radiograph of the nose)
What treatment is pursued in mild cases of wry nose?
(If no dyspnea or problems nursing in a foal, no treatment needed → reduce owner expectation for athleticism and will need to correct asymmetric growth of incisors as needed)
What treatment is pursued in severe cases of wry nose?
(Permanent or temporary trach and/or correction via premaxillary/maxillary osteotomy with internal or external fixation)
What results from a failure of bucconasal membrane rupture in early gestation?
(Choanal atresia, can be bilateral or unilateral, bilateral cases are fatal without trach)
How do the treatments for choanal atresia and choanal stenosis differ?
(Atresia → can relieved the atresia surgically with a laser or long instruments; stenosis → palliative care (can’t really widen the nasal passages))
What should you rule out prior to removing a nasal polyp via amputation with an OB wire?
(Rule out an extension of a sinus cyst or involvement of the polyp with the dorsal or ventral nasal conchae → done via radiograph or endoscopy)
What is the treatment for fungal rhinitis in horses?
(Surgical debulking AND systemic antifungals (fluconazole or voriconazole)
What does the success of treatment of fungal rhinitis in horses depend on?
(Extent of the lesions, causative pathogen, and site of infection)
Infections with which fungal organism is common after sinus surgery in horses?
(Aspergillus)
(T/F) Nasal septal defects can be congenital or acquired.
(T, congenital makes sense, acquired can be from a conchal mass effect; surgery to resect nasal septum is difficult and associated with blood loss)