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Medical aspect of upper airway disease Flashcards

1
Q

Physical examination of the upper airway

A

check the respiratory rate: 8-12

effort to breath? is there any?

examine the horse at different angles, at rest and during exercise

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2
Q

Definition of rhinitis?

A

infection of the nasal passage, independent of the sinuses

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3
Q

What can cause rhinitis (generally)

A

a variety of virus, bacteria, fungal and parasitic agents

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4
Q

Viral agents causing rhinits

A

Equine influenza

Equine herpesvirus 1-4

Equine rhinovirus and adenoviruses

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5
Q

Bacterias causing rhinitis

A

uncommon

can be secondary to trauma (locus minoris)

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6
Q

Fungi causing rhinitis

A

aspergillus spp

condidobolus

cryptococcus

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7
Q

Parasites that can cause rhinitis

A

Habronema (muscae)

Draschia (mega)

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8
Q

What diagnostic measures can be used to diagnose rhinitis?

A

physical exam

endoscopy: sampling for culture, PCR

radiography

treatment: systemic or local

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9
Q

Different sinusitis

A

primary and secondary

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10
Q

Causative agents of primary sinusitis?

A

bacterial and fungal

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11
Q

Causative agents of secondary sinusitis?

A

Dental disease (molar teeth)

Sinus cysts

Neoplasia

PEH - progressive ethmoid hematoma

Trauma

sinonasal polyps

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12
Q

How is the nasal discharge when there is a rhinits?

A

usually unilateral discharge

it an be mucopurulent/serosanguineus with a fetid (bad) odor

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13
Q

General clinical signs of rhinits?

A

facial swelling

respiratory noise

head shaking

unilateral nasal discharge

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14
Q

Is there a secific sign shown when the rhinits is involving the frontal/maxillary sinuses?

A

lacrimal and exopthalmus

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15
Q

Diagnosis of rhinits, steps (alternatives)

A
  1. history
  2. percussion
  3. oral examinaion
  • endoscopy/sinus scopy
  • radiography
  • CT
  • MRI
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16
Q

What are the most common bacteria causing rhinits?

A

streptococcus, staphylococcus, polymicrobial infections

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17
Q

What treatments are used agains rhinits?

A

antibiotics - if bacterial

debridement

flushing

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18
Q

Methods of debridement in rhinits?

A

trephination (make a hole into bone)

sinus flap - drilling to get room for ndoscope/flushing

drainage

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19
Q

Diseass of the guttural pouch

A

Mycosis

empyema

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20
Q

Where is the fungal plaque of the guttural pouch?

A

it is typically located in the dorsal aspect of the medial compartment

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21
Q

What are the dangers of fungal plaque in the medial compartment of the guttural pouch

A

within the medial compartment of the guttural pouch lies a nervovasular bundle: 3 cranial nerves and arteries

if the arteris are affected they can rupture and give a nasty bleed

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22
Q

What are the most frequent fungi infecting the guttural pouch

A

aspergillus spp

mucor

fusarium

trichosporon

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23
Q

Clinical signs of guttural pouch mycosis

A

epistaxis - nosebleed

dysphagia

recurrent laryngeal neuropathy

nasal discharge

coughing

horners syndrome

fungal encephalitis

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24
Q

Different treatments for mycosis of guttural pouch

A

Medical

Lavage

Local antimycotic treatment

supportive treatment

systemic antimycotic treatment

supportive therapy

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25
How is lavage performed on guttural mycosis?
with sterile infusion solutions
26
What are the local antimycotic treatment of guttural mycosis?
nystatin enilconazole ketokonazol thiabendazole natamycin
27
Supportive treatment to guttural mycosis
NSAID Vitamin B1, C, E, selenium nutritonal support because of their dysphagia potassium iodine ethylene diamine immunomodulants: levamisole (cheap anthelminitc), zylexis DMSO
28
Which drugs can be used systemically to treat mycosis of guttural pouch?
Ampetricin-B Itrakonazol Flukonazol Voriconazole - very good
29
What can cause guttural pouch empyema?
bacterial infection of the pouch ruptured retropharyngeal abscesses stenosis of GP opening - impaired drainage inspissanted purulent material forming chondrosis
30
which bacteria often cuases empyema of guttural pouch?
streptococcus equi - strangels of horses
31
what can cause stenosis of the GP?
neoplastic grwth fluid accumulation
32
Clinical signs of GP empyema
intermittent chronic discharge submandibular lymphadenopathy parotis enlargement increased respiratory noise neuropathy/dysphagy are uncommon
33
how can empyema of GP be diagnosed?
endoscopy radiography: fluid lines ultrasound: abscesses
34
How is a bacterial GP empyema handled/treated?
it is highly contagious so there need to be strict biosecurity protocols removal of exudate, fluishing iwth saline sedating the horse to achieve a low head position local AB - penicillin mixed with gelatin catheter or endoscope
35
How are chondroid removed from GP in case of empyseam
endoscopy (surgery)
36
Define pharyngeal lymphoid hyperplasia
common in younger horses, but in older: chronic inflammtion of the pharyngeal lymphoid tissue
37
What are some causative agents of pharyngeal lymphoid hyperplasia?
Viral: EHV 1-2-4, influenza Bacteria: streptococcus
38
How is Pharyngeal lympoid hyperplasia diagnosed
endoscopy and graded from 1-4
39
Clinical signs of Pharyngeal lympoid hyperplasia
nasal discharge enlarged lymhnodes coughing poor performance
40
Treatment of Pharyngeal lympoid hyperplasia
mild:reduce training antiinfammtory treatment: dexamethasone, throath spray iwth nitrofurazone, dexamethasone, DMSO systemic immunomodulators: interferon alpha
41
Causative agent of strangles of horses
streptococcus equi spp equi
42
Whate age groups does strangles usually affect?
younger horses 1-5y
43
morbidity and mortality of starngles?
morbidity: 100% mortality: 10%
44
For how long is the virus of strangels shedded?
4-6w
45
how long is the incubation period for strangels?
2-12d
46
clinical signs of strangles?
fever, lethargy serous to mucopurulent nasal discharge hyperaemic nasal/ocular mucous mmbranes mucopurulent ocular dicharge firm then fluctuant lymph nodes sowllen/painful throatlatch - stands with a stretched neck refuse to eat
47
Diagnosis of strangles?
clinical sign bacterial cultur and PCR
48
Treatemtn for strangels?
supportive care soft palatable feed NSAID: fluxin, bute antibiotics after consideratoin
49
How is AB considered for strangels case with no abscess formation?
early clinical signs, but no abscess formation - penicillin for 5 days - should be isolated
50
how should horses with strangles that get abscess oframtion be treated with AB?
is they are stable: it is contraindicated,
51
horses that are systemically ill or have complications from strangles - how should they be treated?
supportive care, IV penicillin, broad spectrum antibiotics
52
What are some complications that can occur from strangels?
abscess formation in the mesentery/organs purpura hemorrhagica GP empyema/chondroid septicaemia/septic arthritis pneumonia DNS disease infarctive purpura hemorrhagica immune mediated myositis
53
What is purpura hemorrhagica?
leakage from the vessels, forming red spots on membranes and skin. edema of limbs
54
General clinical signs of inflammatory airway diseases (IAD) - general? secretions? auscultation? respiratory rate? abdomnial breathing?
often subclinical poor performance chronic cough increased airway secretion: mucous, muco-purulent nasal discharge thoracic auscultation often noral slighlt ucreased resp rate abdomnial breathing increased
55
What can be the cause if there is tracheal secretion at rest?
lower airway inflammation
56
What causes horses with IAD to have poor performance(findings?
airway mucus impaired gas exchange: hypoxaemia BALF neutrofilia
57
How would you check if the horse has IAD?
history and clinical signs endoscopy BALF cytology throacic ultrasonography Thoracic radiography lung function test respiratory endoscopy after work
58
what is tracheal mucus scoring?
quantifying mucus accumulation grading: * 2-5: poor performance in race horses * 3-5: poor performance in sport horses
59
What is expected to find when performin BALF cytology in IAD case?
elevated nucleated cell count mild neutrophilia, lymphocytosis and monocytosis eosinophilia mastocytosis abnormal BALF - poor performance
60
What is tracheal wash? and how is it as a diagnostic tool for IAD?
Collection of tracheal respiratory secretions for cytology and bacteriology using a fiberoptic endoscope or videoendoscope and collection catheter, to aid in the investigation of pulmonary disease. not suitable to diagnose IAD
61
How will a thoracic ultrasound look like in a ultrasound?
normal or comet tail artefacts (marked acoustic mismatch between small fluid-filled lung spaces and surrounding air.)
62
How ill IAD look on the radiography
bronchial pattern poor sensitivity
63
What are the differential diagnosis of of IAD?
RAO Upper airway disease pleuropneumonia viral infection EIPH Neoplasia Lungworm infestation
64
What is a simple treatment to fight IAD?
environmental management change to shavings instead of hay proper ventilation of the stable
65
What medical treatment can be applied to treat IAD
Antibiotics glucocorticoids sodium-chromoglycate interferon-alpha bronchodilators omega-3 FA
66
When is glucocortiocids given in IAD case?
if infectious cause could be ruled out
67
how long is usually the treatment of IAD?
2-4w
68
what are the names of inhalational GGC?
fluticasone beclomethasone
69
Systemic GGC given to trat IAD
prednisolone dexamethsone
70
name a mast cell stabilizer given to treat IAD
sodium chromoglycate
71
how is interferon alpha used in IAD case, what is its properties
one week rest treatment for 5 days anti inflammatory properties
72
Clenbuterol, salbutamol and salmeterol are?
B2 adrenergic agonists
73

Equine Medicine (6 decks)

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