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Small Animal Medicine > Nasal Disease > Flashcards

Nasal Disease Flashcards

1
Q

How does hypoxia differ from hypoxemia?

A 
Hypoxia = decreased O2 delivered to tissue
Hypoxexmia = decreased O2 content in blood (PaO2 below ref range)
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2
Q

How does tachypnea differ from hyperpnea vs. hyperventilation?

A 
Tachypnea = increased rate/frequency 
Hyperpnea = increased depth/airflow
Hyperventilation = increased minute volume of alveolar airflow
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3
Q

Define apneustic breathing

A

Deep, long inspiration followed by breath-holding, then rapid exhalation

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4
Q

Define ataxic or agonal breathing

A

Continuous irregular shifts of hyper- and hypo-ventilation and apnea

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5
Q

Define paradoxic breathing

A

Different parts of the resp support apparatus moving in opposition

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6
Q

Define Kussmaul (air hunger)

A

Regular deep (and rapid?) breathing

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7
Q

Define Cheyne-Stokes

A

Regularly irregular, with alternating periods of progressive or waxing/waning hyperpnea and apnea

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8
Q

Define Biot’s respiration

A

Irregularly irregular, with alternating periods of identical-depth hyperpnea and apnea

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9
Q

Describe bronchial (tracheal) respiratory sounds

A

Intermediate/high pitch, “tubular/hollow”, sound produced by turbulent airflow in trachea; hear over trachea, thoracic inlet, maybe peri-hilar; timing/duration of sound: both I and E w/ I about same length of E and pause in between; Intensity: I>E

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10
Q

Describe vesicular respiratory sounds

A

Low pitch, “soft rustling’ sound from turbulent airflow in large bronchi, heard over most of thorax; Timing/Duration: both I and E w/ I»E; Intensity: I»E

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11
Q

Describe bronchovesicular respiratory sounds

A

Intermediate pitch combination sound, hear over peri-hilar region, Timing/Duration: I about same as E with pause in between, Intensity: I>E

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12
Q

Define stertor

A

Snoring sound produced by partial obstruction of nose/nasopharynx

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13
Q

Define stridor

A

High pitched, harsh, vibratory noise caused by partial obstruction of the upper airway (oropharynx/larynx/trachea)

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14
Q

Define crackles

A

Discontinuous bubbling/popping sounds as air passes thru fluid or forces collapsed airway/alveolar walls open

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15
Q

Define wheezes

A

Continuous whistling sounds caused by air turbulence in narrowed airways

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16
Q

Define end-expiratory grunts

A

May indicate air-trapping associated with bronchoconstriction

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17
Q

Define pleural rubs

A

May indicate irregular pleural surface scraping against another surface

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18
Q

Define fluid lines

A

Typically muffled sounds centrally

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19
Q

Causes of unilateral nasal discharge

A

FB, neoplasia, tooth root abscess, fungal rhinitis

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20
Q

Causes of bilateral nasal discharge

A

Viral/bacterial infections, allergic rhinitis, advanced neoplasia/fungal rhinitis

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21
Q

Causes of serous nasal discharge

A

Allergens, irritants, ocular inflammation, viral rhinitis, neoplasia, nasal mites

22
Q

Causes of mucoid nasal discharge

A

Mycotic rhinitis, neoplasia

23
Q

Causes of mucopurulent or purulent nasal discharge

A

Viral/bacterial upper or lower respiratory tract infection, neoplasia, fungal infection, nasopharyngeal polyp, oronasal fistula, nasopharyngeal stenosis/stricture, pneumonia, primary ciliary dyskinesia, cleft palate, xerostomia, algal infection (prototheca)

24
Q

Causes of hemorrhagic nasal discharge

A

Fungal disease, neoplasia, hypertension (pheo, Cushing’s), Rickettsial dz, thrombocytopenia/pathia, coagulopathy, trauma

25
Q

In what situations would a cytology of nasal secretions be helpful?

A

Nasal cryptococcus (NOT for bacteria - presence is always normal)

26
Q

When might serology be useful in diagnosing and monitoring treatment response of a nasal disease?

A

Nasal cryptococcosis

27
Q

Which test is useful for Aspergillus testing?

A

Urine galactomannan -NOT specific, should improve with treatment

28
Q

T or F: Nasal radiographs are highly useful in diagnosing most nasal diseases

A

False; difficult to achieve and time consuming for little result

29
Q

What are some indications for rhinoscopy?

A

Suspected FBs, neoplasia, fungal rhinitis, nasopharyngeal disease (polyps) or for sample collection

30
Q

What diagnostic test is most likely to yield a specific diagnosis if there is a primary disease (particularly if cost is an issue)?

A

Nasal biopsy (blind if cost is an issue)

31
Q

How many biopsy samples minimum should be taken when sampling?

A

At least 6

32
Q

What are the 3 methods of nasal biopsies and which one is least likely to cause massive hemorrhage?

A

Pinch, core, and traumatic nasal flushing; core (b/c you’re crushing, not sectioning)

33
Q

What must you do prior to performing any type of nasal biopsy?

A

Measure the distance from the nostril to the medial canthus of the eye to prevent accidental penetration of the cribriform plate into the calvarium

34
Q

What are the two most commonly cultured fungi from nasal swabs?

A

Aspergillus fumigatus (different from systemic species) and Penicillium spp.

35
Q

Feline rhinotracheitis virus can cause what?

A

Corneal ulceration, abortion and neonatal death

36
Q

Feline calicivirus can cause what?

A

Oral ulceration, pneumonia and polyarthritis

37
Q

Chlamydial disease typically causes what?

A

Mild disease and conjunctivitis only

38
Q

Antibiotics are indicated in treatment of feline URIs only if….

A

Chlamydia or Mycoplasma is suspected OR in very severe cases where secondary bacterial infections are suspected (Doxy, azithromycin, amoxicillin or ampicillin)

39
Q

What are the most common types of nasal tumors in dogs? Are these typically benign or malignant?

A

Adenocarcinoma, SCC, and undifferentiated carcinoma; malignant

40
Q

What are the most common types of nasal tumors in cats? Are these typically benign or malignant?

A

Lymphoma and adenocarcinoma; malignant

41
Q

What is the treatment of choice for most malignant nasal tumors?

A

radiation

42
Q

Palliative care for nasal tumors might include what?

A

NSAID’s (COX-2 selective) to decrease inflammation and pain

43
Q

What are the clinical signs of a cat with a nasopharyngeal polyp?

A

Stertorous breathing, nasal D/C (serous to mucopurulent, often unilateral), upper airway obstruction, signs of otitis externa/media/interna (Horner’s, head tilt, nystagmus)

44
Q

What are the clinical signs of Cryptococcosis?

A

Sneezing and nasal d/c (serous to mucopurulent and may be blood-tinged, uni or bilateral), +/- granulomatous lesions causing facial deformity or ulceration of nasal planum

45
Q

What are the two methods of diagnosing Cryptococcus neoformans?

A

Cytology of nasal d/c or latex agglutination for antigen in serum, aqueous humor or CSF (highly sensitive and specific)

46
Q

What is the treatment for Cryptococcosis?

A

Long term antifungals (Keto/Itra/Fluconazole, 5-flucytosine) or Amphotericin B in life threatening cases

47
Q

What are the clinical signs of Aspergillosis?

A

Nasal d/c (serous, mucopurulent, sangiuno-purulent), epistaxis, nasal pain, ulceration of external nares

48
Q

How might you differentiate nasal aspergillosis from nasal neoplasia on imaging?

A

Both cause turbinate destruction, but neoplasia does not cause as much radiolucency within the nostril as aspergillosis

49
Q

How do you treat nasal aspergillosis?

A

Topical (intra-nasal) clotrimazole or enilconazole

50
Q

T or F: Bacterial rhinitis is an extremely common primary nasal disease

A

False, highly uncommon although can be a SECONDARY complication in almost all other nasal dz (Bordetella and Mycoplasma are primary pathogens)

Small Animal Medicine (4 decks)

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