Respiratory Flashcards
What are the two key functions of the larynx
To produce sound, and to protect the airway
Describe how tracheal size is quantitatively assessed, to diagnose tracheal hypoplasia.
Lateral radiographs, described as the ratio of the thoracic inlet diameter to the diameter of the trachea.
What is a normal tracheal ratio ? How is this different to brachycephalic breeds, and then English bulldogs?
0.16 normal in dog, 0.14 general boas dog, 0.12 EBD
Why would a dog with BOAS have a concurrent polycythaemia?
Chronic hypoxia, leads to generation of more RBCs
What is doxapram? Why might it be used in the diagnosis of an acquired respiratory condition?
Respiratory stimulant. Can cause av block however. Diagnosis of laryngeal paralysis.
Why would thoracic radiographs be indicated as part of diagnostics for laryngeal paralysis?
Evaluate for screening for causes (masses, megaO), however evaluated concurrent noncardiogenic pulmonary oedema or aspiration pneumonia
What characterises the clinical sign of Ptyalism?
Excessive saliva production
What is a chemodectoma?
Tumour made up of chemoreceptor most commonly seen along one of the carotid arteries or the aorta
What are the clinical signs of lower airway disease?
Wheezing, dyspnoea, cough (potentially productive), crackles on auscultation
Describe what a bronchial radio graphic pattern would look like in a dog. What causes this appearance? How is this different to cats?
Thickened end-on bronchi (donuts), caused by chronic bronchial inflammation. Cats have a tram line appearance to their bronchi.
Capillaria aerophila, paragonimus kellicotti, oslerus osleri and crenosoma vulpis are all kinds of what?
Respiratory parasites, typically infect dogs
Which respiratory parasite only infects cats, of the list provided: Capillaria aerophila, paragonimus kellicotti, oslerus osleri, crenosoma vulpis and Aelurostrongylus abstrusus
Aelurostrongylus abstrusus
Why is it good practice to collect pooled faecal analysis for baermann technique faecal analysis?
Because parasites may intermittently shed their ova or larvae, and will increase the possibility of an accurate result
Tracheobronchial malacia is otherwise known as?
Tracheal collapse
Why is doxycycline typically the first antibiotic of choice for respiratory infections (before culture and sensitivity are back?
Because of its broad spectrum of activity, ability to penetrate the airway and minimal side effects
What type of drug is dextromethorphan?
Anti-tussive
List three side effects of bronchodilators (such as theophylline, terbutaline and albuterol)
GI upset, tachycardia and hyperexcitability
What are the side effects of long term glucocorticoid use to control inflammatory airway disease?
Weight gain (worsens signs), thinning of cartilage and predispose to secondary infections.
What is fluticasone propionate and why might it be used?
Inhaled corticosteroid, used to treat chronic bronchiolar inflammation
Which non-medical treatment options are there for tracheobronchial malacia?
External polypropylene ring supports, to provide lumen support. Endoscopic or fluoroscopic placed tracheal stenting
What is a contraindication of an antitussive such as theophylline, terbutaline and albuterol
Mucus in the lungs, as patients will need to clear the exudate
Describe the pathophysiology that characterises feline asthma (or feline bronchial disease)
Disorder of the lower airways that causes airflow limitation due airway inflammation, accumulated airway mucus and smooth muscle contraction. These factors impede airflow and trigger chronic coughing.
What classes of drug to theophylline, albuterol and terbutaline belong?
Albuterol and terbutaline are beta-2 agonists, whilst theophylline is a methylxanthine derivative
What is ciliary dyskinesia? How does this affect the respiratory system?
Function of cilia is impaired, in the respiratory system this leads to impaired mucociliary clearance
What is Kartagenners syndrome otherwise known as? What characterises this rare inherited syndrome?
Primary ciliary dyskinesia. Characterised by situs inversus (left to right reversal of internal organ position including dextrocardia). Patients have chronic sinusitis, bronchitis, ear infections, are infertile and are predisposed to chronic bronchopneumonia.
In terms of alveolar gas exchange, why might there be adequate CO2 expulsion, with concurrent hypoxaemia, in a patient with pulmonary disease?
Patients with pulmonary disease may have oedematous or thickened alveoli. CO2 more readily diffuses compared to oxygen, therefore a patient can have normal to low CO2 and be hypoxaemic due to impaired gas exchange
What are the protein concentrations in g/dL of transudate, Modified Transudate and Exudate?
<2.5, 2.5-4.5 and >3
Where would you expect to auscultate on the thorax to best hear rhonchi? Describe what this respiratory sound indicates.
Auscultated in Isolated lung fields. Due to thick secretions causing narrowing of the airway, can be cleared with coughing. Low pitch. Rumbling, gurgling sound.
What denotes the difference between wheezing and rhonchi on respiratory auscultation ?
Rhonchi is low pitch, wheezing is high pitch
How can crackles be further classified when auscultated during a thoracic examination?
Fine or coarse.
How can bronchial, vesicular and bronchovesicular be classified as lung sounds?
Normal lung sounds.
Describe the classification of S1-S4 heart sounds
S1, closure of AV values. S2 closure of semilunar valves (aortic and pulmonary). S3 (not in healthy heart) end of rapid ventricular filling. S4 (not in healthy heart) end of atrial emptying and start of the filling of ventricles.
If you wanted to auscultate the pulmonary valve in a dog, where would you place your stethoscope?
Left apex, 2- 4th intercostal space
Describe the pathophysiology that’s leads to acute respiratory distress syndrome.
- Injury to alveolar epithelium or capillary endothelium leads to increased permeability of pulmonary capillaries.
- This leads to proteinatious noncardiogenic pulmonary oedema, inflammation, hypoxaemia, decreased lung compliance.
- rapidly progressive respiratory failure.
Explain why diuretics are poorly effective at treating acute respiratory distress syndrome.
Fluid accumulation is proteinatious in nature and poorly responsive to diuretics.
Why might a clinician be cautious with intravenous fluid therapy in patients recovering from smoke inhalation?
Aggressive fluid therapy can worsen pulmonary oedema. Close monitoring is required.
Eosinophilic bronchopneumopathy is a diagnosis of exclusion. List causes that would need to be ruled out.
Heart worm (dirofilaria immitis), lungworm (angiostrongylus), respiratory fungal infections, migration of other parasites, neoplasia.
What are the three main classifications that are used to describe thoracic radiographic abnormalities?
Interstitial, alveolar, bronchial
Describe the difference between structured and unstructured interstitial lung pattern on thoracic radiography
Unstructured is characterised by generalised increase in pulmonary parenchyma background opacity with reduced visualisation of thoracic vasculature.
Structured interstitial lung pattern appear as discrete or coalescing soft tissue nodules within the pulmonary lung fields.
Describe how an alveolar pulmonary pattern would appear on a thoracic radiograph.
Overall increase in lung tissue opacity. Major vessels will be obscured. Atelectasis is a common cause of alveolar patterns, and the mediastinum will usually shift toward the side of atelectasis.
