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SA DX & TX I > Exam 2 - Diseases of the Pharynx & Larynx > Flashcards

Exam 2 - Diseases of the Pharynx & Larynx Flashcards

1
Q

what are the most common clinical signs of pharyngeal disease?

A

stertor, reverse sneezing, gagging, retching, & dysphagia

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2
Q

diseases of the larynx typically result in what clinical signs?

A

stridor & respiratory distress

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3
Q

T/F: a change in voice is diagnostic for laryngeal disease

A

true

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4
Q

what is the general pathogenesis of laryngeal disease?

A

exacerbating event results in a sudden worsening of signs

increased inspiratory effort causes increased negative pressure in the upper airways, & soft tissue is sucked inward

this leads to tissue edema & inflammation

can lead to cyanosis, collapse, & even death

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5
Q

what does stertor indicate?

A

indicates turbulent flow in the upper airways

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6
Q

what does stridor indicate?

A

indicates laryngeal disease

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7
Q

what does reverse sneezing indicate?

A

nasopharyngeal irritation

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8
Q

T/F: respiratory distress is typically in the inspiratory phase

A

true

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9
Q

to evaluate the pharynx & larynx, what meds can be given?

A

anesthesia with a short-acting sedative!!! no pre-med!!!

want to achieve a depth where the larynx can be evaluated but deep spontaneous respirations are present

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10
Q

what would be expected of arytenoid movement during normal respiration?

A

arytenoids should abduct widely & symmetrically during inspiration & return to a resting position during expiration

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11
Q

what is the positioning used for radiographs when evaluating the larynx & pharynx?

A

head is held with the neck extended without rotation, lateral views, and ventrodorsal views

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12
Q

why is culture from the pharynx or larynx not helpful?

A

diverse bacterial population is normal

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13
Q

what is obstructive laryngitis?

A

non-neoplastic infiltration of the larynx with inflammatory cells causing irregular thickening, hyperemia, & swelling - signs of obstruction results

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14
Q

what is the common name for canine infectious respiratory disease complex?

A

kennel cough

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15
Q

what organisms are associated with causing kennel cough?

A

canine adenovirus-2
parainfluenza virus
bordetella bronchiseptica
mycoplasma

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16
Q

what is the shedding period of canine adenovirus-2?

A

<14 days

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17
Q

what is the pathogenesis of canine adenovirus-2?

A

infects URT including tonsillar crypts & can infect type 2 alveolar cells causing interstitial pneumonia

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18
Q

what is the shedding period for canine parainfluenza virus?

A

shed for up to 10 days

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19
Q

where does parainfluenza virus infect in the respiratory system?

A

infection is restricted to the upper respiratory tract

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20
Q

what is the pathogenesis of parainfluenza virus?

A

denudes the epithelium of cilia

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21
Q

what kind of organism is bordetella bronchiseptica?

A

gram negative rod

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22
Q

what is the pathogenesis of bordetella bronchiseptica?

A

colonizes the upper respiratory tract epithelium (trachea, bronchi, bronchioles, & pulmonary interstitium)

paralyzes the cilia decreasing mucociliary clearance & secretes toxins that impair phagocytic function

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23
Q

T/F: mycoplasma can be apart of normal flora in the upper respiratory tract of dogs & cats

A

true

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24
Q

what is the shedding period for mycoplasma?

A

chronic shedding for months

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25
Q

what is the pathogenesis of mycoplasma?

A

colonizes lower respiratory tract epithelium predominantly

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26
Q

in kennel cough, how do you identify the causative agent?

A

you don’t - clinically indistinguishable

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27
Q

how is kennel cough spread?

A

aerosolized droplets, dog-dog transmission

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28
Q

T/F: an animal needs to be immunocompromised to get kennel cough

A

false - highly contagious disease where 50% of the dogs in the environment are affected

29
Q

what is the incubation period of kennel cough?

A

3-10 days

30
Q

T/F: an animal with kennel cough can have preclinical shedding

A

true

31
Q

what is the shedding period for kennel cough?

A

2 weeks-3 months post infection

32
Q

what is the most common presentation of kennel cough?

A

BAR, honking cough, may gag/retch when coughing, if present, serous nasal discharge, & a change in bark from laryngitis/tonsilitis

33
Q

how long is an animal affected by kennel cough?

A

resolves after 7-14 days with no long term consequences

34
Q

when can there be complications associated with kennel cough in dogs?

A

unvaccinated dogs, very young dogs, poor overall health

35
Q

if kennel cough becomes complicated, what clinical signs may be seen? what disease do you need to rule out?

A

progressive cough, lethargy, fever, mucopurulent nasal discharge

rule out distemper!!!

36
Q

how is kennel cough diagnosed?

A

presumptive diagnosis based on clinical signs & recent exposure, radiographs if pneumonia is suspected, PCR panels are available but often not necessary in most cases

37
Q

when may PCR be pursued in an animal with kennel cough?

A

trying to document an outbreak

38
Q

what should be included in the supportive care for kennel cough?

A

outpatient when possible - isolate them!

feed warm, soft food, appetite stimulants, clean nasal discharge, nebulize, & avoid antitussives in complicated cases

39
Q

what are the proposed benefits using antibiotics for a kennel cough patients?

A

may decreased symptomatic days & risk of secondary pneumonia - 10 day course of doxycycline, amoxicillin-clavulanate, trimethoprim-sulfa

40
Q

why should you avoid cough suppressants in pneumonia patients?

A

may impede airway clearance

41
Q

how is pneumonia treated?

A

if patient is stable - perform an airway wash for culture & susceptibility

empirical antibiotics while results are pending - doxycycline & amoxicillin-clavulanate, & may require hospitalization

42
Q

T/F: glucocorticoids shorten the duration of clinical signs & bronchodilators improve clinical signs in patients with kennel cough

A

false

43
Q

how is kennel cough prevented?

A

vaccines!! IN vaccine with bordetella and/or CPiV given atleast 1 week prior to boarding & within 6 months of boarding

44
Q

why is the vaccine for canine influenza virus used?

A

killed vaccine used to reduce clinical signs & reduce viral shedding

45
Q

what is the series of canine influenza vaccines?

A

2-dose initial series & annual booster

46
Q

if there is an outbreak of kennel cough in your clinic, what should be your next steps?

A

admit only dogs that are up-to-date on vaccines

isolate affected dogs immediately

clean everything & ensure adequate ventilation

ideally, close the population for 2 weeks

treat animals symptomatically

47
Q

what is the minimum database for the coughing patient?

A

thoracic rads, heartworm test, & CBC

48
Q

what may coughing be mistaken for in dogs and cats?

A

dogs - owner may mistake cough as normal

cats - hairballs

49
Q

what is coughing?

A

sudden expulsion of air, glottis is closed, & used to expel material from the airway

50
Q

what are some examples of differentials for a non-productive cough?

A

post-nasal drip, respiratory irritant, neoplasia, foreign body, pleural effusion

51
Q

what are some examples of differentials for a productive cough?

A

cardiogenic edema, non-cardiogenic edema, pneumonia

52
Q

what is hemoptysis?

A

coughing up blood

53
Q

what are some examples of differentials for hemoptysis?

A

heartworm disease, neoplasia, PTE, fungal disease, trauma, or systemic bleeding disorder

54
Q

tracheal collapse generally affects what animals?

A

small breed dogs

55
Q

when should antitussives be used?

A

for non-productive coughs to palliate & break the cough cycle

56
Q

what is the mechanism of action of opiods used as antitussives?

A

opiods act at peripheral receptors & centrally at the cough center

57
Q

what are 2 options of opioids that can be used for antitussives?

A

oral hydrocodone & oral butorphanol

58
Q

why would expectorants & mucolytics be used in the coughing patient?

A

loosen mucus congestion

59
Q

why should you not use acetylcysteine in cats?

A

causes bronchospasm

60
Q

why not used guaifenesin in cats?

A

some forms contain acetaminophen

61
Q

what are b1 & b2 receptors responsible for?

A

b1 - heart rate & strength of contraction

b2 - bronchodilator

62
Q

what are the side effects associated with bronchodilators?

A

tachycardia, agitation, & gi upset

63
Q

what are some examples of b-receptor agonists used?

A

albuterol - oral or inhaled

terbutaline - oral or injectable, selective B2

64
Q

what is the mechanism of action for theophylline extended-release? how does it help your patient

A

unknown - but may improve the strength of diaphragmatic contraction & respiratory muscle strength & improve mucociliary clearance

65
Q

what drug should be avoided when using theophylline extended release?

A

enrofloxacin

66
Q

T/F: theophylline can be used in both dogs & cats

A

false - only dogs

67
Q

what are some examples of corticosteroids & sedatives that can be used in coughing patients?

A

corticosteroids - injectable dexamethasone, oral pred, inhaled fluticasone, & temaril-p

sedatives - trazodone, butorphanol, gabapentin

68
Q

how is a diagnosis of obstructive laryngitis made?

A

upper airway exam & laryngeal biopsy

69
Q

what is the prognosis for an uncomplicated case of kennel cough?

A

recovery within 2 weeks

SA DX & TX I (59 decks)

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