II - Kahoot Questions

Question 1

True or False:

Prolonged transportation is associated with the development of pneumonia.

Answer 1

True

Question 2

Tachypnea is defined as:

Answer 2

Fast, shallow breathing

Question 3

Stridor is associated with:

Answer 3

Upper airway pathology

Question 4

True or False:

Coughing is pathognomonic for lower respiratory disease.

Answer 4

False

Question 5

True or False:

BAL fluid sample is typically submitted for culture and cytology.

Answer 5

False - no culture!

Question 6

True or False:

A nasopharyngeal wash is the sample of choice for strangles (Streptooccus equi).

Answer 6

True
Gold standard is culture or PCR from pus, guttural pouch or nasopharyngeal washes.

Question 7

Which cranial nerves are contained in the guttural pouches?

Answer 7

IX, X, XI, XII

Question 8

The treatment for purpura hemorrhagica is:

Answer 8

Corticosteroids (dexamethasone 0.1 - 0.2 mg/kg Q24h)
Antibiotics can be administered if active infection is suspected.
Supportive care as needed (bandaging, IV fluids, hydrotherapy)

Question 9

True or False:

Horses shed Streptococcus equi two days after the development of fever.

Answer 9

True - use in outbreak situation to monitor horses
Can shed from weeks to years for persistent carriers.
Subclinical carriers can also shed.

Question 10

True or False:

Silent carriers for Strangles have high SeM titers.

Answer 10

False - not useful for identification of in apparent carriers or ongoing infection.

Useful to diagnose metastatic disease and purpura hemorrhagica (usually >1:12,800) or to evaluate need for vaccination booster (do not vaccinate if >1:3200).

Question 11

Administration of the strangles vaccine to horses with high titers is associated with:

Answer 11

Purpura hemorrhagica

Question 12

True or False:

Most racehorses develop EIPH.

Answer 12

True

Question 13

BALF cytology of a horse with severe asthma will show:

Answer 13

Marked neutrophilic inflammation >25%
Percentage of macrophages and lymphocytes are usually reduced.
Mucus plugs (Curshmann’s spirals) are also common.

Question 14

EIPH is diagnosed using:

Answer 14

Within 60-90 minutes of exercise - airway endoscopy

Otherwise - BAL with cytology - hemosiderin within macrophages from previous hemorrhage persist up to three weeks after a bleeding episode.

Question 15

What is seen in BALF cytology of a horse with mild asthma?

Answer 15

10-15% Neutrophils
>1-5% Eosinophils
>2-5% Mast cells

Question 16

Chronic dyspnea at rest without signs of infection is indicative of:

Answer 16

Severe equine asthma / recurrent airway obstruction (RAO)

Question 17

Which one of the following is NOT used to treat mild asthma?

Corticosteroids
Environmental management
Mast cell inhibitors
Bronchodilators

Answer 17

Bronchodilators

Question 18

True or False:

BALF procedure collects fluid from the caudodorsal lung.

Answer 18

True

*BAL is NOT A STERILE COLLECTION PROCEDURE - NO CULTURE!

Question 19

A 16-year-old Fjord mare presents to your clinic for a five month history of exercise intolerance and body weight loss; both are getting worse over time. Physical examination reveals a rectal temperature of 99F, a heart rate of 40 beats per minute, the rhythm is normal and there are no murmurs present. Respiratory rate is 48 breaths per minute, and you note marked respiratory effort at rest. The owner states that the mare has been breathing like that for a few months now. Cytology of the broncheoalveolar lavage fluid in this horse will reveal:

45% non-degenerative NT, 35% macrophages, and 20% LT
5% non-degenerative NT, 55% macrophages, 40% LT
20% degenerative NT, 50% macrophages, and 10% LT
5% non-degenerative NT, 55% macrophages, 39% LT, and 1% mast cells

Answer 19

45% non-degenerative NT, 35% macrophages, and 20% LT

degenerative NT are seen with bacterial infections

Question 20

A yearling filly presents to your clinic for evaluation of fever of three days duration. Your physical exam reveals a respiratory rate of 40 breaths per minute, a regular heart rate of 40 beats per minute and a rectal temperature of 103F. Moderate nostril flaring is present. Thoracic auscultation reveals cranioventral crackles that are more prominent in the right side of the chest. Thoracic ultrasonography reveals consolidated lung cranioventrally. To obtain a DEFINITIVE diagnosis of the cause of this filly’s problems, select the BEST diagnostic test from the list below.

• nasal swab: cytology and culture
• percutaneous transtracheal wash: cytology and culture of the fluid
• Bronchoalveolar lavage using a BAL tube: cytology and culture of the fluid
• guttural pouch lavage: cytology and culture of the fluid
• lung biopsy: cytology and culture of the fluid

Answer 20

Percutaneous transtracheal wash - cytology and culture of the fluid

Question 21

What would you do NEXT for this gelding?

• start oral antibiotics
• give a dose of anti-inflammatory Ed to decrease swelling and improve breathing
• perform a tracheostomy to improve breathing
• drain the lymph nodes and flush

Answer 21

Perform a tracheostomy to improve breathing

Question 22

You visit a farm to evaluate an outbreak-like situation at a stable that has an arena and organizes shows during the weekends. The stable does not have a vaccination policy and does not quarantine horses prior to entry. You find five resident horses (3-5 YO) with 104-105F rectal temperatures, all are lethargic and have serous nasal/ocular discharge. What is the most appropriate immediate course of action?

• Call the state vet so they can perform all the testing needed.
• Quarantine the place. Perform nasopharyngeal washes and submit for EHV-1 and EHV-4.
• Quarantine the place. Collect nasopharyngeal swabs and blood. Submit for EHV-1, EIV, EHV-4.
• Quarantine the place. Collect vaginal/uterine swabs and semen. Submit for EVA.

Answer 22

Quarantine the place. Collect nasopharyngeal swabs and blood. Submit for EHV-1, EIV, EHV-4.

Question 23

You evaluate a five-year-old Thoroughbred gelding that presents for dyspnea and absent lung sounds on auscultation. You suspect pleural effusion. The BEST diagnostic test to confirm the effusion is:

• thoracic radiographs
• thoracic ultrasonography
• arterial blood gas: hypoxemia confirms pleural effusion
• blood work: low albumin confirms pleural effusion

Answer 23

Thoracic ultrasonography

Question 24

You evaluate a four-month-old Quarter Horse colt that is lethargic and has a temperature of 103.2F. The colt was dewormed at three months; mare’s vaccination and deworming are up-to-date. PE reveals dyspnea, tachypnea, and tracheal tales. Thoracic ultrasound reveals multiple 2-3 cm abscesses in the caudo-dorsal lung field, bilaterally. Which of the following is the MOST appropriate plan of action for thsi colt?

• Perform a bronchoalveolar lavage and submit the fluid for cytology and culture. Antimicrobial treatment will be selected based on results as soon as they become available.
• Perform a transtracheal wash and submit the fluid for cytology and culture. While results come back, start the foal on azithromycin and rifampin.
• Start the foal on gentamicin and penicillin IV.
• Take radiographs of the chest.

Answer 24

Perform a transtracheal wash and submit the fluid for cytology and culture. While results come back, start the foal on azithromycin and rifampin.