Lecture 15 - Respiratory diseases (specht)

Question 1

arytenoid cartilage fails to abduct during inspiration creating upper airway obstruction

Answer 1

laryngeal paralysis

Question 2

what causes laryngeal paralysis

Answer 2

idiopathic most common
trauma
tumor
myopathies

Question 3

primary signalment and CS of laryngeal paralysis

Answer 3

old fat lab

resp distress
stridor 
bark change 
cyanosis 
synocope

Question 4

dx laryngeal paralyssi

Answer 4

sedated laryngoscopic exam

Question 5

explain the movement of the arytenoid cartilage with laryngeal paralysis

Answer 5

arytenoids CLOSE during inspiration (should be open)

only open slightly during expiration

Question 6

a lot of dogs with laryngeal paralysis have concurrent issues with

Answer 6

esophageal motility

Question 7

acute/emergency tx for laryngeal paralysis

Answer 7

O2
sedative
steroids
intubation/tracheostomy

Question 8

prognosis for laryngeal paralysis tx with surgical correction

Answer 8

fair to good depending on underlying cause

Question 9

patients that have laryngeal tie back surgery are predisposed to

Answer 9

aspiration pneumonia

Question 10

components of brachycephalic airway syndrome

Answer 10

stenotic nares
elongated soft palate 
everted laryngeal saccules
hypoplastic trachea
\+/- laryngeal collapse or paralysis

Question 11

upper airway obstruction conditions can be exacerbated by

Answer 11

excitement
exercise
high temperature
secondary edema/inflammation further worsens

Question 12

which conditions of brachycephalic syndrome cannot be sx corrected

Answer 12

hypoplastic trachea

laryngeal collapse

Question 13

peri-operative complication when sx correcting components of brachycephalic syndrome

Answer 13

morbidity/mortality from inflammation

Question 14

disease characterized by wheezing, coughing, and dyspnea due to spontaneous bronchoconstriction

Answer 14

feline bronchitis (asthma)

Question 15

factors that contribute to feline asthma

Answer 15

bronchospasm 
SM hypertrophy 
increased mucous, decreased clearance 
inflammation 
fibrosis 
emphysema

Question 16

cat w/ sudden onset of dyspnea, cough or wheezing or crackles, increased expiratory effort/time

Answer 16

feline asthma/bronchitis

Question 17

asthma is normally slowly progressive, but can be exacerbated by

Answer 17

environmental changes (smoking, cat litter, cleaner, pollen, etc)

Question 18

CXR of feline asthma

Answer 18

Bronchial pattern
hyperinflation of lungs
+/- aerophagia

Question 19

airway wash of feline asthma p

Answer 19

eosinophilic, neutrophilic or mixed inflammation

Question 20

basic tests that should be done before dx cat with asthma

Answer 20

HW ab and ag test

fecal analysis

Question 21

emergency tx for feline asthma

Answer 21

O2
short-acting steroids (for inflammation)
short acting bronchodilators

Question 22

mainstay therapy for feline asthma

Answer 22

long-term corticosteroids (prednisolone PO)

Question 23

sympathomimetic beta agonist bronchodilators that can be used for feline asthma

Answer 23

terbutaline
albuterol

these can be used if patient is not maintaining on steroids or as emergency
only use bronchodilator with an antiinflamm/steroid on board do not only use bronchodilators (may increase mortality)!

Question 24

prognosis of feline asthma

Answer 24

poor for cure
good for control of CS
common cause of sudden death in cats

Question 25

obstruction of pulmonary arterial blood flow resulting in altered respiratory and hemodynamic function

Answer 25

PTE

Question 26

dz that have been associated with PTE

Answer 26

Cushing's 
hypothyroidism
PLN
IMHA 
cardiac dz 
HW dz 
spesis 
DIC 
pancreatitis 
neoplasia

Question 27

__ prevents the deposition of fibrin and platelets on the thrombus surface and is a controversial tx for PTE

Answer 27

Heparin

controversial bc must have enough antithrombin 3 in plasma and this may vary between patients

Question 28

abrupt cessation of heparin therapy should be avoided bc

Answer 28

may induce prothrombic state

Question 29

primary concern when using anticoagulant therapy to resolve PTE is

Answer 29

bleeding

Question 30

prognosis for PTE

Answer 30

Poor

may be due to underlying dz
PTE may reoccur

Question 31

most feline asthma patients require __ for the rest of their life

Answer 31

some steroids

Question 32

pathophys of PTE

Answer 32

Clot blocks blood flow of pulmonary artery = VQ mismatch = neurogenic reflex = decreased CO and increased pulmonary vascular resistance, bronchoconstriction, more clots/prothrombic state

bad situation :(

Question 33

SUDDEN onset of respiratory distress, tachypnea, dyspnea, depression, tachycardia, shock or sudden death

Answer 33

PTE

Question 34

definitive dx for PTE

Answer 34

CT/MRI with angiogram

Question 35

tx for PTE

Answer 35

No tx, just support

O2
+/- diuretic
reverse prothrombic state to dissolve thrombi (heparin, warfarin, clopidogrel)
fibrinolytics (streptokinase, TPA) - little data

Question 36

anticoagulants used to prevent growth and formation of thrombi but do not directly dissolve already present clots

Answer 36

heparin, warfarin, clopidogrel

primary SE/concern: bleeding

Question 37

common causes of non-cardiogenic pulmonary edema

Answer 37

neurogenic causes
electrocution
upper airway obstruction
vasculitis 
ARDS 
allergic rxn
toxins 

tx w/ O2 and +/- furosemide, support

Question 38

__ results in severe pulmonary damage due to aspiration pneumonia and water dilution of pulm surfactant leading to alveolar collapse and reduced compliance

Answer 38

near drowning

Question 39

CS associated with smoke inhalation are due to

Answer 39

carboxyhemoglobinemia 
tissue hypoxia 
thermal injury = inflamm and edema 
direct toxic effect/chm burn
suppression of mucociliary escalator and macs = increased risk of infection 
DIC

Question 40

other common causes of respiratory dz not to forget about/not discussed

Answer 40

CHF
neoplasia 
hypertension
fibrosis 
hemorrhage 
... more