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Pulmonary > Equine respiratory > Flashcards

Equine respiratory Flashcards

1
Q

What does increased exudate when head is lowered indicate

A

Guttural pouch infection

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2
Q

What does unilateral nasal discharge during exercise with no other respiratory disease signs suggest?

A

Sinusitis

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3
Q

Normal RR (adult/young) horse

A

8-24 / 25-40

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4
Q

Normal RR (adult/young) cow

A

12-36 / 30-60

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5
Q

Normal RR (adult/young) sheep/goat

A

12-40 / 30-70

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6
Q

What lymph nodes should be evaluated in horses for respiratory exam

A

Submandibular and retropharyngeal

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7
Q

What should palpation of larynx and trachea evaluate (3)

A

Symmetry/collapse; sensitivity; induction of cough for airway irritation

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8
Q

Where should be checked for edema

A

Ventral abdomen, muzzle, legs

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9
Q

Where should percussion be evaluated in resp exam

A

Paranasal sinuses

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10
Q

How long should it take for a patient to recover from raised CO2 in rebreathing bag

A

les than 10 breaths

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11
Q

What breaths should be evaluated after rebreathing bag

A

The first deep breaths - would reveal abnormal lung sounds

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12
Q

What are the normal resp sounds

A

Bronchovesicular - coarser over mainstem bronchi and decrease in intensity peripherally- uniform bilaterally

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13
Q

What do normal tracheal sounds sound like

A

Coarse I and E, equal pitch and duration, short silent interval

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14
Q

What causes breath sounds

A

Turbulent flow in central airways greater than 2mm

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15
Q

Why dont peripheral airways make sounds

A

Velocity too low to generate sound

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16
Q

Inflated lung vs consolidated

A

Inflated attenuates, consol good conducting medium

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17
Q

Non-musical, short, sharp, explosive sounds

A

Crackles

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18
Q

What causes crackles

A

Equaliztion of pressure when a collapsed region is reinflated or movement of secretions in trachea/bronchi

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19
Q

When do crackles occur

A

I and E, randomly

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20
Q

Musical, high pitched sounds of variable duration

A

Wheezes

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21
Q

What causes wheezes

A

vibration of airway walls before complete closing (expiratory) or opening (inspiratory)

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22
Q

Wheezing- mostly I or E?

A

Either, but one predominantly

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23
Q

What conditions cause wheezing?

A

airway compression, stenosis, masses, bronchoconstriction

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24
Q

When are wheezes more common in horses

A

Expiratory

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25
Q

What is primary cause of wheezes in horses

A

recurrent airway obstruction/heaves (expiratory)

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26
Q

What would indicate severe consolidation, lung abscess or pleural fluid

A

Abscence of audible sounds

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27
Q

What would absence of sounds indicate

A

severe consolidation, lung abscess or pleural fluid

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28
Q

No sounds ventral, heart sounds loud =

A

Pleural effusion

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29
Q

What structures are evaluated by endoscopy

A

Nasal passages, ethmoid turbinates, nasal openings of paranasal sinuses, nasopharynx, guttural pouch opening, larynx, trachea

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30
Q

What size scope can enter eustachian tube?

A

1.2 cm or less

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31
Q

Ultrasound- what cannot be penetrated

A

Normal lung parenchyma

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32
Q

Ultrasound- what can be studied

A

Pleura and lung surface

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33
Q

Evaluate pleural surface and space- which method

A

Ultrasound > xray bc can see small amounts radiographs cant detect

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34
Q

Diagnose viral infection, strep eq. eq.,

A

Nasal/nasoph swab or nasal wash

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35
Q

Why are Nasal/nasoph swab or nasal wash not very effective

A

Normal flora will culture

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36
Q

Dx bacterial or fungal infection suspected

A

TBA- tracheobronchial aspiration prior to Abx

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37
Q

TBA methods (2)

A

TTW or guarded catheter through scope

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38
Q

Describe normal pulmonary alveolar cytology from TBA

A

macrophages, columnar ciliated epithelial cells, less than 40% neutrophils

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39
Q

Describe pneumonia cytology from TBA

A

Primarily neutrophil (degenerate with karyolysis, pyk, hyperseg), intra/extracell bacteria

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40
Q

Describe heaves cytology from TBA

A

non-degen neutrophils and mucus

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41
Q

Non-infectious disease dx method

A

BAL bronchoalveolar lavage

42
Q

Why is BAL > TBA in diffuse non-infectious lower airway dz

A

BAL fluid more consistent among normal

43
Q

TBA or BAL in bacteriologic culture sample

A

TBA > BAL

44
Q

Dx diffuse non-infectious lower airway dz

A

BAL

45
Q

Dx pleural effusion

A

Thoracocentesis

46
Q

When should you use lung biopsy

A

Diffuse dz processes where TTW/BAL give inconclusive results

47
Q

Main complication of lung biopsy

A

Hemorrhage (uncommon- pneumothorax)

48
Q

What vessels for blood gas

A

Carotid, facial, or great mesentary arteries

49
Q

How quickly should a blood gas sample be used

A

10 min, then on ice, 1.5 hours

50
Q

What does PaO2 reflect in blood gas

A

Pulmonary gas exchange and oxygen available to tissues

51
Q

What does PaCO2 reflect in blood gas

A

Pulmonary ventilation

52
Q

Normal PaO2

A

> 85 mmHg

53
Q

Normal PaCO2

A

40-45 mmHg

54
Q

Low O2 with normal CO2 =

A

Decreased inspired O2, R-L shunting, difusion impairment, ventilation/perfusion mismatching

55
Q

Most common cause of Low O2 with normal CO2 =

A

ventilation/perfusion mismatching

56
Q

Blood gas results from ventilation/perfusion mismatching

A

Low PaO2, normal PaCO2

57
Q

Low PaO2 with increased PaCO2

A

hypoventilation/respiratory failure

58
Q

hypoventilation/respiratory failure blood gas results

A

Low PaO2 with increased PaCO2

59
Q

Strangles- species

A

Strep equi equi

60
Q

Purulent lympadenitis of URT - dz

A

Strangles

61
Q

LN involved in strangles

A

Retropharyngeal or submandibular

62
Q

Strangles- epidemiology

A

direct nose/mouth or aerosol; contaminated water/food/walls

63
Q

Strangles- signalment

A

Most severe and common in horses

64
Q

Strangles- morbidity or mortality

A

up to 100% morbidity

65
Q

Strangles- organism persistence explained by

A

Hyaluronic capsule, anti-phagocytic M protein, leukocidal toxin release

66
Q

Strangles- shedding time

A

stop after 4-6 weeks post CS (10% become carriers)

67
Q

Strangles- incubation

A

Moderate- 3-14 days

68
Q

Dx- Acute fever 102-104, depression, bilateral serous nasal d/c changing to mucopurulent, enlarged LN 2-4 days post-fever

A

Strangles

69
Q

Strangles- CS

A

Acute onset fever 102-104, depression, bilateral serous nasal d/c changing to mucopurulent, enlarged LN 2-4 days post-fever

70
Q

Strangles- hematology

A

neutrophilic leukocytosis, increased fibrinogen, increased SAA

71
Q

Strangles- how long before LN rupture

A

7-14 days

72
Q

Dx- strangles

A

PCR > guttural pouch flush culture > nasal wash/swab culture

73
Q

Strangles- tx

A

Early (w/o LN abscess) - penicillin; With LN abscess- help relieve drainage- (hot packs, lancing, etc), no Abx

74
Q

When are Abx indicated in strangles

A

Early before LN involvement or if upper airway obstruction. bastard strangles (penicillin)

75
Q

Strangles- complications

A

Empyema/chondroids from LN rupture into GP; pneumonia, bastard strangles in lung, mesentary, liver, spleen, kidney, brain; Rare- myocarditis, glomerulonephritis, purpura hemorrhagica

76
Q

What is purpura hemorrhagica and what causes it

A

Immune mediated vasculitis causing edema in face, muzzle, limbs and ventral abdomen. Warm and painful to touch. Petechial hemorrhage possible. Occurs 2-4 weeks post-strangles

77
Q

Dx purpura hemorrhagica

A

2-4 weeks post strangles, skin biopsy showing leukocytoclastic vasculitis

78
Q

Tx purpura hemorrhagica

A

penicillin removes Ag’ic stimulus, corticosteroids or NSAIDS

79
Q

Strangles vax and effectiveness

A

SeM protein (IM) or modified live (IN); 50% reduction; modified live may cause strangles symptoms

80
Q

Accumulation of exudate within guttural pouch

A

Empyema

81
Q

Empyema

A

Accumulation of exudate within guttural pouch

82
Q

Most common organism for guttural pouch empyema

A

Strep. equi. zoo post-URT infection

83
Q

Guttural pouch empyema- CS

A

mucopurulent d/c, more profuse when head lowers; rare: dysphagia, formation of chondroid mass

84
Q

Guttural pouch empyema- dx

A

Endoscopy

85
Q

Guttural pouch empyema- tx

A

Lavage GP with saline, antimicrobials,

86
Q

Guttural pouch mycosis- describe

A

fungal infection involving internal carotid artery at roof of medial compartment

87
Q

Guttural pouch mycosis -most common spp

A

Emericella (aspergillus) nidulans

88
Q

Guttural pouch mycosis - CS

A

Epistaxis from erosion of mycotic plaque in internal carotid (occasionally maxillary, ext. carotid); horners, paralysis, laryngeal hemiplasia

89
Q

Guttural pouch mycosis - cause of dysphagia

A

Vagus or glossopharyngeal

90
Q

Guttural pouch mycosis - dx

A

endoscopy to examine mycotic plaque

91
Q

Guttural pouch mycosis - tx

A

Surgical obstruction of affected artery proximal and distal to the lesion via transarterial coil or plug embolization; then resolves on own.

92
Q

Guttural pouch tympany - describe

A

Distention of one or both GP with air causing parotid swelling behind vertical ramus

93
Q

Guttural pouch tympany - origin

A

Congenital or acquired one way valve defect of pharyngeal opening to pouch

94
Q

Guttural pouch tympany - signalment

A

less than 1 year

95
Q

Guttural pouch tympany - CS

A

external swelling, dysphagia, respiratory distress

96
Q

Guttural pouch tympany - tx

A

Surgical ablation of median septum; if bilateral - resection of internal opening cover; or fistula into GP through pharyngeal recess

97
Q

Distention of one or both GP with air causing parotid swelling behind vertical ramus

A

Guttural pouch tympany

98
Q

Sinusitis- CS

A

Unilateral mucopurulent nasal d/c +/- facial deformity

99
Q

Unilateral mucopurulent nasal d/c +/- facial deformity

A

Sinusitis

100
Q

Sinusitis- cause

A

primary or secondary to tooth root abscess, diastema

101
Q

Sinusitis- spp

A

Strep. equi. zoo

102
Q

Sinusitis- dx

A

Radiographs show fluid line in sinus

Pulmonary (4 decks)

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