Exam 2 Lee-Fowler

Question 1

Term used to describe high levels of CO2 in the blood

Answer 1

hypercapnia

Question 2

This pattern of breathing is characterized by prolonged inspiration, a pause, followed by insufficient expiration.

Where would you localize the problem?

Answer 2

apneustic breathing

pons or upper medulla

Question 3

This pattern of breathing is characterized by increasingly rapid breathing followed by a pause

Answer 3

Cheyne-stokes respiration

Question 4

Kussmaul breathing is typically associated with which disease condition?

Answer 4

Metabolic acidosis (deep, semi-rapid breathing to rid body of CO2)

Question 5

Give 4 potential reasons for decreased BV sounds

Answer 5

low flow (shallow breath)
retraction
attenuation (air)
reflection (mass)

Question 6

Give 3 reasons for increased BV sounds

Answer 6

lungs are “wet”

1) edema
2) pneumonia
3) contusions (blood)

Question 7

When are the following sounds normally loudest:

1) crackles
2) Wheezes

Answer 7

1) inspiration (worse after cough)

2) expiration

Question 8

Rapid, shallow breaths indicate what type of disease?

Answer 8

Restrictive (lungs can’t expand)

Question 9

Slow, deep breaths indicate what type of disease

Answer 9

obstruction to breathing (i.e. lar par)

Question 10

Localize:

1) inspiratory dyspnea
2) expiratory dyspnea
3) mixed

Answer 10

1) upper airway (noisy) or pleural space (quiet)
2) lower airway
3) pulmonary parenchyma

Question 11

What two components make up physiologic dead space?

Which increases when there is disease?

Answer 11

Alveolar dead space and anatomic dead space

Alveolar increases when there is disease

Question 12

Name 2 ways the lungs can deal with vascular pressure increases

Answer 12

1) recruitment (open previously closed vessels)

2) distension (hold more blood)

Question 13

For inhalation:

1) 2 primary inspiratory muscles
2) 2 accessory muscles

Answer 13

1) Diaphragm** & external intercostals

2) scalene & sternomastoids

Question 14

Which muscles are primarily involved in normal, quiet expiration?

Answer 14

NONE–passive process (recoil of the lungs)

Question 15

Name the 3 respiratory regulatory centers in the brainstem (pons, medulla)

Answer 15

Medullary respiratory center

Apneustic Center

Pneumotaxic center

Question 16

Describe the medullary respiratory center

Answer 16

made up of 2 areas:
1) inspiratory area–has intrinsic periodic firing to set the rhythm of ventilation

2) expiratory area (not active during normal breathing)

Question 17

Which area of the brain is responsible for rate and volume control of inspiration

Answer 17

Pneumotaxic center

Question 18

Where are peripheral chemoreceptors located? What 3 things do they monitor?

Answer 18

carotid bodies
aortic body

Monitor: PO2, PCO2, and pH

Question 19

Which lung receptors are located in the alveolar walls? What do they respond to?

Answer 19

J receptors

Respond to pulmonary capillary engorgement and increased interstitial fluid volume

Question 20

3 factors that determine rate of diffusion of a gas through a tissue

Answer 20

surface area
tissue thickness
partial pressure difference

Question 21

primary factor that determines rate of diffusion of gas through a liquid

Answer 21

solubility

Question 22

Hallmark signs of hypoventilation?

Answer 22

increased arterial PCO2

Question 23

Of the causes of hypoxemia, which is NOT responsive to oxygen therapy?

Answer 23

Shunting

Question 24

Contrast:

1) High V/Q
2) Low V/Q

Answer 24

1) high V/Q means there is more ventilation than perfusion to an area. The few RBCs that pass will be highly saturated
2) low V/Q means there is more perfusion than ventilation; lots of RBCs will pass through but won’t be fully saturated due to lack of oxygen

Question 25

A young kitten that presents with stertor and mucopurulent nasal discharge is found to have some type of growth in its pharyngeal area. Top DDx?

Answer 25

Nasopharyngeal polyp

Question 26

The top differential for an older dog or cat that presents with CHRONIC nasal discharge that bloody (+/- facial deformations) would be?

Answer 26

Neoplasia

Question 27

What is the most common nasal neoplasm of dogs

Answer 27

adenocarcioma

Question 28

Why should you recommend a CT before beginning treatment for fungal rhinitis in dogs?

Answer 28

to make sure the cribiform plate hasn’t been eroded; if it has, you can old use oral meds to treat

Question 29

Though many of the pathogens of the feline upper respiratory disease complex present with similar signs, each one can give a clue:

1) FCV
2) FHV
3) B. bronchiseptica
4) C. felis

Answer 29

1) oral ulcers
2) dendritic corneal ulcers; salivation
3) coughing
4) severe conjuctivitis

Question 30

When evaluating for laryngeal paralysis, which medication type is important to avoid?

Answer 30

Pre-meds (also, keep anesthesia light)

Question 31

If needed, which medication can be used to stimulate deeper breaths for evaluation of laryngeal function

Answer 31

Dopram

Question 32

Primary concern for an older large breed dog that presents with inspiratory dyspnea and neurological abnormalities

Answer 32

laryngeal paralysis

Question 33

A small breed, middle age dog that presents with bouts of a harsh, honking cough following excitement that can also be elicited with tracheal palpation is likely to have?

Answer 33

Tracheal collapse

Question 34

BEST option (most sensitive) for detecting tracheal collapse?

Answer 34

Fluoroscopy (but it’s not always available… rads are also okay)

Question 35

Which diagnostic modality is used for grading tracheal collapse?

Answer 35

Bronchoscopy

Question 36

Due to the wide variety of infectious agents that can cause infectious tracheobronchitis, which is a good first medication to start with?

Answer 36

Doxycycline

Question 37

Two key features of feline asthma

Answer 37

eosinophilic airway inflammation

smooth muscle contraction and airway narrowing

Question 38

Though useful in treating feline asthma, this class of drugs should not be used a sole therapy

Answer 38

bronchodilators (it only treats signs, not the cause)

Question 39

Common parasites of the airway in:

1) dogs only
2) cats only
3) dog or cat

Answer 39

1) Filaroides, O. osleri
2) A. abstrusus
3) Capillaria, Cuterebra

Question 40

A young animal with recurring infections (i.e. pneumonias, bronchitis, rhinits, etc.) may potentially have?

Answer 40

Ciliary Dyskinesia

Question 41

A unique test to evaluate for ciliary dyskinesia

Answer 41

Technetium scan–inject bolus into the lungs and watch to see if it can be cleared

Question 42

Most common radiographic change seen with bacterial pneumonia?

Answer 42

alveolar pattern with ventral distribution

Question 43

Though many of the fungal pneumonias present similarly, this one can impact the GI system and lead to significant weight loss

Answer 43

Histoplasmosis

Question 44

Aspiration pneumonia usually impacts which areas of the lung?

Answer 44

right cranial lobe
right middle lobe
cranial portion of the left cranial lung lobe

Question 45

Loud crackles are typically auscultated with which two diseases?

Answer 45

Pulmonary Fibrosis

Pulmonary edema

Question 46

Two negative sequale of pulmonary thromboembolism

Answer 46

V/Q mismatch

Pulmonary hypertension

Question 47

The only definitive way to diagnose pulmonary fibrosis

Answer 47

Biopsy