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Small Animal Med. I > Nasal Disorders - Corrigan > Flashcards

Nasal Disorders - Corrigan Flashcards

1
Q

What are 3 characteristics common to all nasal diseases?

(Clin Med TQ)

A
  • Mucosal edema
  • Inflammation
  • + 2° bacterial infections
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2
Q

Which URT sound is ties you to Nasal disease?

A

Stertor

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3
Q

What is an important part of your PE if you suscept Nasal dz.?

A

A Full Oral Exam!!!!!!

(as well as a good PE)

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4
Q

What should be on your DDX List when you see

Serous discharge coming from the nose?

A
  • Viral infection
  • Early
    • 2° Bact. infection
    • Fungal infection → Aspergillus, Cryptococcus
    • Parasitic infection
    • FB
    • Neoplasia
    • Nasopharyngeal polyp
    • Oral dz.
    • Allergic rhinitis
    • Feline chronic rhinosinusitis
    • K9 chronic rhinitis
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5
Q

Which 3 VIRUSES should be on your DDX List when your patient has

MUCOPURULENT nasal discharge + blood?

A
  • Feline Herpesvirus
  • Calicivirus
  • K9 Influenza
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6
Q

Which 4 FUNGI should be on your DDX List when your patient has

MUCOPURULENT discharge + blood?

A
  • Aspergillus (dogs)
  • Cryptococcus (cats)
  • Penicillium
  • Rhinosporidium
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7
Q

Which 2 PARASITES should be on your DDX List when your patient has

MUCOPURULENT discharge + blood?

A
  • Pneumonyssoides
  • Capillaria
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8
Q

Which 3 NEOPLASIAS should be on your DDX List when your patient has

MUCOPURULENT discharge + blood?

A
  • Carcinoma
  • Sarcoma
  • Lymphoma
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9
Q

A cat presents to you with Mucopurulent nasal discharge.

On PE, it pulls away in pain when you try to look in its ears or examine its mouth.

What will be high on your DDX List?

A

Nasopharyngeal polyps

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10
Q

What do Allergic rhinitis, Feline Chronic Rhinosinusitis & K9 Chronic Rhinitis have in common?

A

MUCOPURULENT discharge!

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11
Q

What are 3 weird reasons patients may present for EPISTAXIS?

A
  • Fungal infections
  • Systemic dz.
  • Hypertension
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12
Q

What 4 things do you need to do a good initial work up of “Nose” cases?

A
  1. Detailed HX
  2. Good PE
  3. Thoracic Rads
  4. Funduscopic exam (if avaiable)
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13
Q

What is an essential test to do on any dog with nasal dz?

A

Aspergillosis titer

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14
Q

What are 3 essential tests for cats w/ nasal dz?

A
  • Nasal swab cytology
  • Cryptococcal Ag. titer
  • Viral testing → FeLV, FIV, FHV, Calicivirus
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15
Q

What is a Deep Nasal Culture better for: Bact or Fugi?

Who would you get the sample?

A
  • Fungi
  • Rhinoscopy
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16
Q

What structure should you not pass when performing a Rhinoscopy?

A

Don’t go past the Medial Canthus!!

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17
Q

What are 2 main causes of Feline Upper Resp. Infection?

A
  • FHV → Feline Rhinotracheitis
  • Feline Calicivirus (virulent strain)
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18
Q

C/S of Feline Upper Respiratory Infection?

A
  • Fever
  • Sneezing
  • Nasal/Ocular discharge
  • Conjunctivitis
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19
Q

What samples would you need to collect if you wanted to perform an IFA & VI/PCR for FHV & FCV?

Who might ask you to do these test?

A
  • Conjunctival, pharyngeal or tonsillar scrapings/biopsy
  • The crazy cat lady (who has a cattery)
20
Q

How do you typically TX Feline Upper Respiratory Infections?

A
  • Supportive care
    • Nebulization
    • Clavamox® (amoxicillin/clavulanic acid) → for 2° bact
  • Ophthalmologic care
    • oral L-lysine
21
Q

A cat has Feline Upper Respiratory Infection.

You suspect it’s due to Bordetella, Chlamydophila or Mycoplasma.

What would you prescribe?

Possible SE?

Can you do something to help w/ SE?

A
  • Doxy
  • SE = Esophageal Strictures (w/ pills)
  • Help = Bolus H2O or use Liquid Doxy
22
Q

A cat has an Upper Respiratory Infection and a dendritic ulcer.

List 3 drugs you can prescribe to help this patient.

A
  • Trifluridin
  • Idoxuridine
  • Arabinoside
23
Q

A cat presents to you for changes in temperment, unilateral nasal discharge & a firm, SQ swelling under the bridge of its nose. On PE you find cutaneous lesions and dilated, unresponsive pupils. While taking the HX, the owner won’t stop complaining about their crazy neighbor that keeps throwing stale bread into their yard to feed the birds & how much they hate pigeons.

What dz do you suspect?

How are you going to test for this?

A

Cryptococcosis neoformans (a saphrophytic yeast)

Latex agglutination (Ag test) or Cytology

24
Q

What is the GS TX for Crytococcosis neoformans?

While discussing TX, the owner asks “What’s a less expensive option, Doc?”

What now?

A
  • Lipid complex Amphotericin B is the GS
  • an “-azole” is a less $ option
  1. Itraconazole
  2. Fluconazole → can go to the CNS
  3. Ketaconazole → avoid if can, causes liver SE in cats
25
Q

Where does **Aspergillosis fumigatus ** like to go in dogs?

Which types of dogs are at risk?

A
  • Nasal passages & frontal sinuses
  • Young-middle aged mesati-/dolichocephalic breeds
26
Q

A GSD comes in for “snotty nose” and intermittent epistaxis that has been going on for the past 6 months. The regular vet prescribed ABXs on 3 seperate occasions, but it’s not getting better. You perform a nasal swab and roll it out on a slide. This is what you see under the microscope.

What’s your DX?

A

Nasal aspergillosis

27
Q

What is the DI modality of choice for Nasal Aspergillosis?

A

CT

28
Q

This sample came from a nasal swab.

What is it?

Who gets it?

A

Cryptococcus neoformans

Cats → most common fungal infection they get

29
Q

When is it NOT okay to TX Aspergillosis w/ Topical Clotrimazole (what we typically reach for) ?

Other TX options?

A
  • NOT w/ intracranial disease (disseminated aspergillosis)
  • Itraconazole/Fluconzaole + Terbinafine P.O.
30
Q

Which 4 species of Aspergillosis like to disseminate throughout the dog’s body?

A
  • A. terreus
  • A. deflectus
  • A. flavipes
  • A. fumigatus
31
Q

What is the GS for TXing Immunocompromised dogs w/ Aspergillosis?

Prognosis in these animals?

A
  • IgA
  • Poor prognosis
32
Q

This SX procedure depicts Clotrimazole being infused through the nares.

What is the success rate of this therapy?

A

80-85% success w/ 1 TX

33
Q

C/S of Pneumonyssoides caninum?

A
  • Violent sneezing
  • Head shaking, pawing
  • Reverse sneezing
  • Chronic nasal discharge
  • Epistaxis
34
Q

You see this little guy while performing Rhinoscopy on a dog that presents for nasal disease.

How are you going to TX?

A
  • Milbemycin oxime (Inteceptor® or Sentinel®)
  • Ivermectin
35
Q

A cat presents with mucopurulent nasal discharge, stertor and neuro signs.

On PE, you discover a ruptured tympanic membrane in the left ear.

What is your 1° Rule Out?

A

Nasopharyngeal polyps.

36
Q

How can you TX Nasopharyngeal polyps?

A

SX excision

  • Traction (can regrow if you don’t get it all)
  • Bulla osteotomy + rhinotomy
37
Q

How will the nasal discharge progress w/ nasal tumors?

A

Unilateral → Bilateral

(can be serous/mucopurulent/hemorrhagic)

38
Q

List the 4 Benign Nasal Tumors.

TX?

A
  • Adenomas
  • Fibromas
  • Papillomas
  • TVT - dogs

SX removal or Chemo

39
Q

List the most malignant nasal tumors.

A
  • Adenocarcinoma
  • SCC
  • Undifferentiated (bad, bad, bad!!!)
  • Lymphoma
40
Q

What is the prognosis for Nasal Tumors?

A
  • Radiation responsive
    • MST 13 months
    • 45% alive at 2 years
41
Q

How do dogs manifest allergies?

A

In their skin

42
Q

Allergic Rhinitis is often ____ diagnosed.

A

Over diagnosed

43
Q

How do you DX Allergic Rhinitis?

TX?

A
  • HX relationship btwn C/S & exposure & improvement after irritant is removed
  • Chlorpheniramine or Cetirizine(Zyrtec®)
44
Q

Idiopathic Rhinitis is more common in which species?

A

Cats!

45
Q

Idiopathic Rhinitis is a DX of ___________.

A

Exclusion

(Must rule out all other causes 1st)

46
Q

How can you TX Idiopathic Rhinitis?

A
  • Facilitate drainage → Nebulization & Intermittent nasal flushes
  • Decrease environmental irritants
  • Control 2° bacterial infections (Mycoplasma)
  • + Anti-histamines
  • + Corticosteroids
47
Q

What drug will some dogs respond to if they have Chronic/Lymphoplasmacytic Rhinitis?

A
  • TX & DX like in cats
  • Some dogs respond to Piroxicam

Small Animal Med. I (18 decks)

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