Respiratory Flashcards

Question

What is the distribution of bronchopneumonia?

Answer 1

Cranial and ventral regions of the lungs

Answer 2

1. Bronchiolar infection with initial bronchiolitis 2. Exudate of fluid, proteins and inflammatory cells into the mucosal surfaces and lumen 3. Spread of infection to alveoli, resulting in an accumulation of exudate in the alveolar spaces 4. Involvement of both bronchioles and alveoli = bronchopneumonia 5. Can spread infection to adjacent alveoli 6. The interlobular septa may help contain the infection within lobules by acting as a barrier, more pronounced in animals with thicker interlobular septa 7. Spread to other lobules may occur via the airways/bronchial tree

Answer 3

Cattle and pigs have prominent and relatively thick interlobular septa. Sheep, horses, cats and dogs have thinner and less obvious ones

Answer 4

Lot of aggregations of small blue dots which represent densely packed inflammatory cells within exudate arising from the inflammatory response. Nearly all alveolar spaces contain inflammatory exudate, which inhibits ventilation of the affected parts of the lung.

Answer 5

- Affected regions are red, brown or greyish with time/chronic inflammation - Flabby to firm due to exudate filling the airspaces and collapse of alveoli due to airway obstruction - Patchwork appearance with affected and unaffected lobules, most prominent in pigs and cattle

Answer 6

Most common type, has mucopurulent exudate exuding from airways on the cut lung surface

Answer 7

Inflammation may be severe and cause a large amount of plasma protein release in inflammatory exudate in the airways, including fibrinogen, forming fibrin. In animals with prominent interlobular septa, fibrinous bronchopneumonia may expand the interlobular septa with oedema and fibrinous exudate, resulting in a marbled appearance.

Answer 8

Result in progression to chronic bronchopneumonia.

Answer 9

Airway obstruction Bronchiectasis Abscess formation

Answer 10

- Dark red-purple with multiple, coalescing, raised, pale pink irregular foci - Pale pink foci are firm and nodular, they are dry, caseous necrosis

Answer 11

Inhalation and infection with mycoplasma hypopneumoniae

Answer 12

- Loss of cilia and epithelial cells - Altered mucus composition which affects mucociliary escalator - Reduced neutrophil phagocytic function and immunosuppression - Lymphoid hyperplasia – can create cuffs around airways - Predisposes to secondary bacterial infection > suppurative bronchopneumonia

Answer 13

There is an initial injury to the lung parenchyma, injury directed at any component of the alveolar wall. Inhalation or haematogenous

Answer 14

- Viruses, migrating parasites, protozoa - Septicaemia - Toxins - Allergens

Answer 15

Most commonly diffuse/generalised

Answer 16

1. Entry to the lungs via the airways or the bloodstream 2. Diffuse injury to the alveolar walls 3. Acute inflammatory in alveolar walls - hyperaemia and exudation of fluid, followed by a cellular response with emigration of inflammatory cells. 4. Initial swelling within the alveolar wall. As the fluid increases it spills over into alveolar spaces 5. Oedematous fluid/exudate accumulating in the alveolar walls flows into the alveolar spaces, which fill with exudate.

Answer 17

Capillaries are stuffed with red blood cells due to vasodilation and hyperaemia caused by inflammatory response. Pink areas often highlighting the alveolar walls represents hyaline membrane formation, which occurs when plasma proteins leak from the inflamed blood vessels and mix with the surfactant lipids in the alveolar space.

Answer 18

- Alveolar wall now looks very thick - Vasodilation and hyperaemia of the capillaries and there are some inflammatory cells - Type II pneumonocytes proliferate to replace the flattened type I pneumonocytes that have been injured - To complete healing process when conditions improve, type II pneumocytes will proliferate into type I - Alveolar macrophages phagocytose and remove exudate and cellular debris

Answer 19

Fibrosus Chronic inflammatory cells Persistence of type II pneumonocytes

Answer 20

Difficult to detect grossly because it causes diffuse changes

Answer 21

- Red/grey - Lungs fail to collapse when thorax opened - Might have rib impressions on surface - Heavier than expected - Firmer, rubbery or elastic texture - In acute interstitial pneumonia, pulmonary oedema may be present - Cattle may have interstitial emphysema

Answer 22

- Occurs when air escapes from the alveoli and accumulates within the interlobular septa - Cattle have thick septa so in cattle, interstitial emphysema can occur where there is partial obstruction of the bronchioles by oedema, fluid or exudate and strenuous respiratory effort

Answer 23

Acute bovine pulmonary oedema and emphysem

Answer 24

1. When moved from sparse to lush pasture in which the grass contains high levels of L-tryptophan 2. Converted to 3-methyl indole in rumen upon ingestion 3. Absorbed into the blood and reaches the lungs via the circulation 4. An epithelial cell called club cells convert into a toxic metabolite (bronchiole cells) 5. Causes necrosis of the bronchial cells and type I pneumocyte injury. Causes acute interstitial pneumonia

Answer 25

Hyaline membrane formation and alveolar oedema

Answer 26

Bacteria – haematogenous of septic emboli containing emboli to the lungs

Answer 27

Random foci. The lungs have randomly distributed, multifocal to sometimes coalescing discrete, round to irregular, raised, yellow to greenish foci of varying size.

Answer 28

Liver abscesses (cattle) Bacterial endocarditis (right side of heart) Umbilical infections Chronic skin or hoof infections Mastitis Endometritis Intravenous catheterisation

Answer 29

Agents that persist in tissues and are resistant to phagocytosis and the acute inflammatory response. Inhaled or haematogenous

Answer 30

1. Chronic inflammatory response 2. The cellular infiltrate contains many macrophages 3. The macrophages may form aggregates or granulomas 4. Typically present as nodular lesions/masses

Answer 31

- Bacterial – mycobacteria, actinomyces, rhodococcus - Parasitic – lungworms - Fungal – cryptococcus - Viral – feline infectious peritonitis

Answer 32

Variable, focal/multifocal, (nodular)

Answer 33

- Multiple nodular to focally extensive, relatively large lesions that would be firm - May become mineralised in some cases - Parenchyma is being replaced by a yellowish material/granulomatous inflammation and caseous necrosis - Variable degrees of granulomatous inflammation and caseous necrosis

Answer 34

Can be nodular and focal or multifocal and mass like in their appearance, can be more generalised to diffuse with extensive coalescing pale brown lesions

Answer 35

Epithelial – such as stratified squamous, transitional, respiratory Mesenchymal – osteocytes, chondrocytes, endothelium, fibroblasts Round cell – lymphoid Others – such as neuroendocrine, melanocytes

Answer 36

Dog - carcinomas Cats - carcinomas and lymphomas

Answer 37

- Slow growing - Space occupying - Locally invasive and destructive - Late to metastasise

Answer 38

Can be destructive, can cause swelling or distortion of the face and be a cause of nasal discharges (secondary infection) or epistaxis.

Answer 39

- Proliferative but non-neoplastic - Presents as an enlarging haemorrhagic nasal mass that can cause obstruction of the nasal passages - May cause local distortion and destruction of the soft tissues and bone, ulceration of the mucosa encapsulating the mass may result in mild haemorrhage and epistaxis

Answer 40

Airway obstruction

Answer 41

- Epithelial – stratified squamous, respiratory - Mesenchymal – chondrocytes, skeletal muscle, smooth muscle, fibroblasts - Lymphoid

Answer 42

Generally, secondary metastatic spread of tumour to the lung is more common than primary lung neoplasia.

Answer 43

- Carcinoma and adenocarcinoma are most common. Large airway epithelial origin often near hilus - Parenchymal epithelial origin often peripheral. - Epithelial – respiratory in airways and glands, alveolar - Mesenchymal – chondrocytes (and osteocytes), fibrocytes, mesothelium - Lymphohistiocytic

Answer 44

- Lymphatic invasion – spread within the lung and spread to hilar lymph nodes - Intra-airway seeding – spread within the lung - Vascular invasion – spread to distant sites - Transcoelomic spread – spread within the pleural cavity space

Answer 45

Ovine pulmonary adenocarcinoma/sheep pulmonary adenomatosis/Jaagsiekte - retroviral-induced neoplasia – Jaagsiekte sheep retrovirus

Answer 46

Neoplastic epithelial cuboidal to columnar cells end up papilliform structures. As masses grow, they tend to compress the surrounding alveoli and may cause a significant increase in collagen that can result in fibrosis.

Answer 47

Long incubation period Clinical disease mostly 2-4 years old

Answer 48

Solid grey or grey-purple tumour masses, can appear nodular. Cranial and ventral areas of the lungs

Answer 49

- Secondary infections and abscesses can occur - Production of excessive fluid in the lungs

Answer 50

Local trauma Irritation or inflammation

Answer 51

An inflammatory condition that principally affects the arytenoid cartilages and the associated mucosa

Answer 52

Due to suppurative inflammation, focal areas of ulceration and necrosis on the mucosal surface adjacent to the vocal folds. Can obstruct the larynx or can cause laryngeal oedema that leads to acute respiratory obstruction.

Answer 53

Oedema disease in pigs by some strains of E.coli Anaphylaxis/allergic reactions

Answer 54

Alveoli contain pale pink staining fluid. The oedematous fluid will have originated with the alveolar walls but has now spilled over into the alveolar spaces, filling them with fluid.

Answer 55

- Increased hydrostatic pressure - Increased endothelial or alveolar epithelial permeability - Decreased colloid osmotic pressure - Block lymphatic drainage

Answer 56

Oedema/transudate in the pleural space. Causes include CHF, hypoproteinaemia (other cavities too), intra-thoracic tumours

Answer 57

- Inflammatory diseases – nasal aspergillosis, guttural pouch mycosis - Inflammation of the lower RT - Neoplastic disease - Progressive ethmoid haematoma in horses - Exercise induced pulmonary haemorrhage in horses - Trauma - Coagulopathies

Answer 58

1. Liver abscess impinges on the vena cava 2. Septic thrombus formation 3. Thromboembolism to the lung 4. Arterial septic embolic abscess 5. Erodes into a bronchial wall 6. Ruptures into airway allowing arterial blood flow into the airway 7. Fatal epistaxis (exsanguination)

Answer 59

Trauma Erosion of blood vessels by tumours Clotting disorders

Answer 60

- Lung lobe torsion - Massive pulmonary artery thrombus or thromboembolism

Answer 61

- Conditions causing activation of vascular endothelium - Conditions promoting procoagulant tendencies/coagulopathies - Conditions causing vascular stasis

Answer 62

- Rupture of the thoracic duct due to a mass - Obstruction of the thoracic duct - Disease causing occlusion of the cranial vena cava

Answer 63

Fluid filled cyst with a thin wall of bone lined by respiratory epithelium. Causes airway obstruction, facial distortion and compression of surrounding soft tissues and bone.

Answer 64

Facial swelling Epiphora

Answer 65

Skull has shrunk over time while soft tissues have not so excess soft tissues can obstruct airways at various sites. This can result in altered pressures within the respiratory passages.

Answer 66

- Stenotic nares - Elongated soft palate - Relatively large tongue - Turbinates may protrude into the nasopharynx - Hypoplastic trachea in some cases

Answer 67

- Inflammation and oedema – palate and larynx - Everted tonsils - Everted laryngeal saccules - Laryngeal collapse from laryngeal cartilage rigidity

Answer 68

Miniature, toy and brachycephalic dogs. Dorsoventral flattening of the trachea causing tracheal collapse.

Answer 69

- Lumen pressure reduces below surrounding pressure causing collapse during inspiration - Lumen pressure is higher than the surrounding pressure during expiration

Answer 70

- Lumen pressure greater than pleural pressure during inspiration - Expiratory forces on the intrathoracic trachea promote collapse during expiration

Answer 71

Cough (“goose honk”) Increased respiratory rate and effort Exercise intolerance Respiratory distress Cyanosis Collapse

Answer 72

Degeneration of the recurrent laryngeal nerve.

Answer 73

Horses – usually unilateral, left sided Dogs – large breed dogs predisposed, often bilateral

Answer 74

The muscles on the left side of the larynx are smaller and paler red-brown compared to those on the right side. This is because the muscles on the left are undergoing atrophy due to loss of innervation caused by degeneration of the left recurrent laryngeal nerve.

Answer 75

1. Atrophy and paralysis of the dorsal, lateral and transverse cricoarytenoid muscles 2. The dorsal cricoarytenoid muscles abducts the arytenoid cartilage during inspiration 3. Failure of arytenoid cartilages to abduct during inspiration can result in airway obstruction

Answer 76

- Primary (idiopathic) neuronal degeneration - Secondary to nerve trauma, compression, irritation or injury - Component of a generalised polyneuropathy - Neurotoxins - Liver failure - Hypothyroidism in dogs - Congenital nerve abnormality

Answer 77

Equine asthma Feline lower airway disease/feline asthma Canine chronic bronchitis

Answer 78

Function of sympathetic stimulation – adrenaline acts on alpha and beta adrenoreceptors to cause bronchodilation

Answer 79

B-adrenergic receptor agonists, such as adrenaline, and anticholinergic drugs such as atropine.

Answer 80

- Short acting non-specific – adrenaline - Longer-acting β2 specific – terbutaline, Salbutamol, Clenbuterol - Sodium chromoglycate - Anticholinergic drugs – atropine, ipratropium - Methylxanthines – theophylline

Answer 81

- Act by working through the cAMP pathway - Bronchial smooth muscle relaxes so bronchodilation

Answer 82

- Stabilises mast cells by inhibiting mast cell degranulation - May increase mucociliary clearance

Answer 83

- Short acting, non-specific - Stimulates α and β adrenergic receptors, so widespread effects - vasopressive and cardiac effects

Answer 84

Life-threatening bronchoconstriction – CPR, anaphylactic shock

Answer 85

- Developed to avoid adverse cardiac effects of non-specific drugs - Longer acting so suitable for long-term use

Answer 86

- Lasts 6-8 hours - Off license for cats with asthma – give prior to bronchoscopy or bronchoalveolar lavage (BAL), injectable in emergencies

Answer 87

Used in inhalers

Answer 88

Partial agonist so may be less effective Aids mucociliary clearance

Answer 89

Sweating Tremors Restlessness Tachycardia

Answer 90

- Cardiovascular – tachycardia, especially with β1 agonists or high dose β2 - Illegally as a growth promoter in cattle - Tolerance with chronic use (weeks) – down-regulation of receptors. Use for short-term treatment of bronchoconstriction

Answer 91

Stabilises mast cells – inhibit release of histamine and leukotrienes to reduce bronchoconstriction

Answer 92

Equine asthma off license - used in cases with increased mast cells on tracheal wash or bronchoalveolar lavage, usually increased neutrophils so not particularly useful for the majority of cases

Answer 93

- Relaxation of bronchial smooth muscle - May also have anti-inflammatory effect - Increase mucociliary clearance

Answer 94

Dogs for chronic bronchitis Cats for feline lower airway disease Not horses due to side effects

Answer 95

- Mild – nausea, vomiting, diuresis - Cardiac – tachycardia, increased contractility, arrhythmias - CNS – can cause agitation and seizures (more common with caffeine use/toxin)

Answer 96

- Relies on hepatic metabolism and cytochrome P450 enzymes - Fluoroquinolones, erythromycin, cimetidine inhibits its metabolism – dose reduction - Phenobarbitone, rifampicin active its metabolism – dose increase

Answer 97

Muscarinic antagonism

Answer 98

- Equine asthma - Mainly for colic but also useful as an emergency bronchodilator (IV)

Answer 99

In horses IV in emergencies Side effects – ileus, CNS toxicity, tachycardia

Answer 100

Given to horses by aerosol Less side effects

Answer 101

Depression of the cough centre in the medulla oblongata, bronchodilation B2 receptor agonist

Answer 102

- Cough is a protective mechanism - Contraindicated if productive, such as pneumonia - Chronic cough can increase airway inflammation/irritation - Dynamic airway disease, such as tracheal collapse

Answer 103

Codeine Hydrocodone Diphenoxylate Butorphanol

Answer 104

μ-receptor agonist

Answer 105

Sedation and constipation

Answer 106

μ-receptor agonist

Answer 107

- More potent - Has anti-cholinergic component to discourage overuse

Answer 108

Opioid agonist

Answer 109

- Direct suppression of the cough centre - Minimal side effects

Answer 110

κ-receptor agonist

Answer 111

Poor bioavailability orally (1st pass effect) so much higher dose required than when injected

Answer 112

Dextromethorphan β-agonists also have some effect due to bronchodilation

Answer 113

Often contain other drugs which may be toxic, such as paracetamol

Answer 114

Bromhexine (bisolvon)

Answer 115

- Increases secretion of fluid and breakdown of mucus to make it more watery - Increase mucociliary clearance in calves with respiratory disease

Answer 116

Thought to accelerate particle clearance

Answer 117

Guaifenesin (glyceryl guaiacolate) and guaiacol

Answer 118

- Used in veterinary anaesthesia as muscle relaxants - May also stimulate bronchial secretions - Cough medicine in humans

Answer 119

Small droplets of a drug delivered to the airways, possible less systemic absorption, can still see side effects

Answer 120

- Management strategies - Glucocorticoids - Bronchodilators

Answer 121

- Management changes - Bronchodilators - Glucocorticoids - Antibiotics if secondary infections - Antitussives occasionally - codeine - Mucolytics generally contraindicated

Answer 122

Chronic bronchial inflammation with over-secretion of mucus in middle aged to older dogs

Answer 123

Tracheal/bronchial collapse Mitral valve disease Pulmonary hypertension

Answer 124

Kennel cough Irritants/allergens Parasites

Answer 125

- Smaller airways become obstructed by mucus causing obstructive dyspnoea, emphysema - Alteration of mucociliary escalator causing possible concurrent bacterial infections - Inflammation of the lower airways – narrowing, bronchomalacia due to weakened cartilage, bronchiectasis due to end-stage bronchial change

Answer 126

- Chronic cough for over 2 months – often productive - Gagging/retching - Dyspnoea/tachypnoea - Pyrexia is concurrent pneumonia - Thoracic auscultation – wheezes, crackles (concurrent pneumonia, emphysema)

Answer 127

Bronchial pattern Possible mild interstitial pattern Mild broncho-interstitial pattern

Answer 128

Mucus, neutrophils and possibly bacteria. If eosinophils seen, consider angiostrongylus vasorum or eosinophilic bronchopneumopathy

Answer 129

- Weight control - Harness - Avoiding airway irritants – tobacco smoke, dust

Answer 130

- Glucocorticoids – lowest possible dose - Bronchodilators – theophylline, methyxanthine - Antibiotics if suspicious of bacterial infection, antitussives, mucolytics

Answer 131

- Ideally using culture and sensitivity BAL result - Need good airway penetration - First line doxycycline – broad spectrum, 7-10 days

Answer 132

In middle aged small breed dogs with mitral valve disease and chronic bronchitis, stage B2 heart disease can cause a cough due to cardiomegaly without CHF, CHF usually causes tachypnoea/dyspnoea.

Answer 133

- Cardiac or respiratory? - Ideally chest radiographs with/without BAL, with/without faecal parasitology - Treatment trials – fenbendazole, bronchodilators, with/without antibiotics

Answer 134

Young/middle aged cats – Siamese over-represented

Answer 135

Bacterial, virus, parasites, irritants/allergens

Answer 136

1. Type I hypersensitivity (IgE mediated) – histamine and serotonin production by mast cells 2. Smooth muscle contraction – acute bronchoconstriction 3. Oedema and eosinophilic inflammation of the lower airway 4. Mucus hypertension

Answer 137

Large – atelectasis of the right middle lung lobe Small – emphysema, bronchiectasis and possible pneumothorax

Answer 138

No signs/few signs to asthmatic crisis Cough Dyspnoea/tachypnoea Open-mouth breathing Cyanosis Wheezes +/- crackles if mucus/emphysema Dull lung sounds if pneumothorax

Answer 139

- Generalised bronchial/bronchointerstitial pattern with/without alveolar pattern - Over-inflated lungs – see flattened diaphragm - Possible atelectasis of the right middle lung lobe - Possible pneumothorax

Answer 140

SC terbutaline the night and the morning before the procedure

Answer 141

Inflammation, mucus and airway narrowing

Answer 142

Stress-free Oxygen Bronchodilators – terbutaline Corticosteroids – dexamethasone

Answer 143

- Dust free litter - Cigarette smoke – no smoking inside the house - Reduce use of aerosol - Regular parasite control - Monitor for secondary infections

Answer 144

- Glucocorticoids – lowest effective dose - Bronchodilators – oral theophylline long term, inhaled salbutamol for acute bronchoconstriction - Doxycycline if mycoplasma infection, fenbendazole if parasitic infection

Answer 145

1. Infection by eating intermediate host (mollusc) or paratenic host (frog) 2. L3 larvae are liberated in intestines, travel to the pulmonary vasculature 3. Adult worms live in the pulmonary arteries and right side of the heart 4. Larvae migrate into the alveoli and are coughed and swallowed

Answer 146

Chronic cough Acute dyspnoea Severe pulmonary hypertension (cor pulmonae – abnormal RV function and structure) Syncope Bleeding diathesis CNS haemorrhage

Answer 147

Anaemia Eosinophilia Thrombocytopenia Abnormal coagulation times Hypercalcaemia

Answer 148

- Fenbendazole 10-20 days - Moxidectin 2 doses 30 days apart

Answer 149

Dyspnoea, ascites and sudden death

Answer 150

Chronic bronchitis Bronchiectasis Immunosuppression Foreign body Aspiration

Answer 151

Cough (soft and productive) Mixed dyspnoea Tachypnoea Exercise intolerant Crackles and/or wheezes on auscultation Pyrexia Lethargy Inappetence

Answer 152

Usually alveolar pattern with ventral distribution, but variable lung patterns: - Dorso-caudal distribution = haematogenous spread - Aspiration – right middle lung lobe, obtain both lateral views - Early pneumonia = interstitial pattern

Answer 153

- Empirical treatment – PO doxycycline as it penetrates into airways - Aspiration pneumonia – chemical pneumonitis = no antibiotics, IV amoxycillin-clavulanic acid

Answer 154

IV fluoroquinolones + ampicillin or clindamycin Treat gram positive bacteria and anaerobes De-escalation as soon as possible

Answer 155

- Oxygen supplementation if hypoxic - Fluid therapy as dehydration impairs mucociliary defences - Nebulisation increased mucus fluidity - Bronchodilators? - Treat any gastro-oesophageal reflux disease and oesophagitis with omeprazole and metoclopramide or cisapride

Answer 156

- Usually in young dogs - Husky and Malamute are predisposed - Previous positive response to steroids

Answer 157

- Immunological hypersensitivity to an allergen - Eosinophilic inflammation of the lungs and the bronchi

Answer 158

- Imaging - broncho-interstitial pattern - Bronchoscopy – bronchial wall thickening, lots of green mucus, bronchiectasis - BAL – eosinophilic inflammation - Negative faecal parasitology

Answer 159

Glucocorticoids

Answer 160

Old dogs, Westies, bull terriers

Answer 161

Cough and exercise intolerance, with/without cyanosis Auscultation – inspiratory crackles, with/without right sided heart murmur

Answer 162

Interstitial pattern No alveolar pattern Often cor pulmonae/enlarged right side of the heart due to pulmonary hypertension

Answer 163

Sildenafil for pulmonary hypertension

Answer 164

Can be asymptomatic Cough Haemoptysis Systemic signs

Answer 165

Primary pulmonary neoplasm with metastasis to the digits, often present for foot issue/lameness

Answer 166

- CT more sensitive than radiographs - FNA and lung histopathology – risks of seeding tumours

Answer 167

- Acute onset cough and respiratory distress - Progresses to secondary pneumonia with/without pulmonary abscess

Answer 168

Bronchoscopic removal Occasional surgery

Answer 169

Laryngeal paralysis

Answer 170

Chronic bronchitis

Answer 171

Tracheal collapse

Answer 172

Congestive heart failure

Answer 173

Weight loss Harness Avoid excitement Bronchodilators Lomotil

Answer 174

Fenbendazole

Answer 175

Weight loss Harness Avoid irritants Bronchodilators Corticosteroids

Answer 176

Refer for surgery

Answer 177

Theophylline. Terbutaline is used more commonly in cats, especially pre-bronchoscopy and is human licensed.

Answer 178

Doxycycline. Good airway penetration due to lipid solubility and broad spectrum activity including mycoplasmas and is given orally.

Answer 179

Terbutaline

Answer 180

Bleeding and neurological signs

Answer 181

Increased respiratory effort (deeper breaths) without dyspnoea.

Answer 182

Difficulty in breathing while laying down. Cats often sit or stand to facilitate breathing with elbows abducted and neck extended.

Answer 183

- Cough receptors in the large airways and low density cough receptors in nose, sinuses, pharynx, pleura. - Mechanical receptors to mucus and foreign bodies and chemical receptors to acid and heat.

Answer 184

Enlarged left atrium Pulmonary oedema causes tachypnoea

Answer 185

- Exacerbate airway inflammation and irritation - Emphysema - Pneumothorax - Weakness and exhaustion - Dissemination of infections

Answer 186

Working/outdoors lifestyle – airway FB CKCS (and others) – mitral valve disease Brachycephalic breeds – BOAS Toy breed dogs – tracheal collapse Siamese cat – feline asthma/chronic bronchitis Westie – idiopathic pulmonary fibrosis

Answer 187

Obstructive and inspiratory dyspnoea

Answer 188

Restrictive and mixed (inspiratory and expiratory) dyspnoea

Answer 189

- Coughing vs panting - Reverse sneezing - Gagging - Retching - Change in sound of bark/purr/meow - Cough – initiating factors, productive or non-productive, sound

Answer 190

Open-mouth Cyanosis Anxious expression Orthopnoea

Answer 191

Cranial mediastinal compressibility Thoracic cavity trauma/deformities Tracheal pinch

Answer 192

Obstructive disorders: Laryngeal paralysis Tracheal collapse BOAS

Answer 193

Obstructive disorders: Luminal - mucus or FB) Mural - mass or bronchospasm, feline asthma, chronic bronchitis

Answer 194

Restrictive disorder/reduced lung capacity Pneumonia Haemorrhage Oedema

Answer 195

Restrictive disorder/reduced lung volume = pleural effusion Obstructive disorder = mediastinal mass

Answer 196

- Haematological disorders (tachypnoea): decreased oxygen carrying capacity - anaemia or methaemoglobinaemia - Metabolic disorders (tachypnoea): compensatory mechanism to acidosis (DKA) - muscular weakness (hypokalaemia) - Neurological disorders of the brain, spinal cord, peripheral nerves

Answer 197

- Dynamic obstruction of URT causing stertor - Nasal/nasopharynx - BOAS, polyp, foreign body, tumour

Answer 198

- Dynamic URT obstruction causing stridor - Larynx - Laryngeal paralysis, laryngeal collapse

Answer 199

- Dynamic LRT obstruction - Wheezes - Intrathoracic airways - Tracheal collapse, bronchial collapse, asthma, EBP

Answer 200

- Laboured breathing - Airway obstruction - Mass, tracheal collapse

Answer 201

- Crackles, wheezes - Pulmonary parenchyma - Pneumonia, pulmonary oedema, pulmonary fibrosis

Answer 202

- Muffled lung sounds - Pleural space disease - Pleural effusion, pneumothorax

Answer 203

- Imaging of pleural space disease - Laryngeal examination - Bronchoscopy - Haematology – neutrophilia, eosinophilia, thrombocytopenia - Biochemistry - Test for lungworm - BAL - Tracheal wash - Lung FNA

Answer 204

Interstitial diffuse

Answer 205

Interstitial nodular

Answer 206

During assessment Easy and well tolerated Need someone to hold tube FiO2 of 25-40%

Answer 207

Easy May not tolerate Useful for recumbent patient FiO2 of 50-60%

Answer 208

Designed for humans Easy to place but often dislodge

Answer 209

Longer term supplementation requirement Well tolerated Easy access Easy to place More invasive and time consuming Unilateral FiO2 40% Bilateral FiO2 50%

Answer 210

Risk of hyperthermia CO2 build up Humidity FiO2 30-40%

Answer 211

Well tolerated Best suited to small patients Depends on design Monitor humidity FiO2 60%

Answer 212

Upper airway mechanical ventilation Upper airway obstruction FiO2 100%

Answer 213

- Listen for noises - Nasal discharge - Facial deformity - Pain - Nasal planum depigmentation - Assess airflow bilaterally - Assess regional lymph nodes - Retropulsion of the eyeballs/exophthalmia - Dental disease? - Ophthalmic disease?

Answer 214

- Foreign body - Nasal tumour - early course and older patients - Aspergillus – early course, younger dogs, nasal depigmentation, dolichocephalic breeds, epistaxis - Chronic rhinitis

Answer 215

- Chronic rhinitis – idiopathic - URT viruses – vaccination, ocular signs - Aspergillus - advanced - Nasal tumour – advanced, absent to reduced nasal airflow, CNS signs

Answer 216

Idiopathic Unclear role of bacterial and viral infections

Answer 217

Sneezing Nasal discharge Increased URT noises Usually bilateral Often preserved nasal airflow

Answer 218

Tumour and fungal rhinitis

Answer 219

Underlying allergic, irritant, immune-mediated process

Answer 220

Sneezing Snorting Mucoid/mucopurulent nasal discharge Bilateral (can be unilateral) Possible airflow obstruction Possible post-nasal drip causing coughing

Answer 221

Sneezing Gagging Pawing at the face Progression to purulent nasal discharge and foul smelling

Answer 222

Meso/dolichocephalic dog breeds – aspergillosis fumigatus Brachycephalic cats – sino-orbital, aspergillus felis

Answer 223

Mucopurulent nasal discharge or epistaxis Unilateral or bilateral Sneezing Nasal pain Nasal depigmentation Uncommonly stertor, facial deformity, CNS signs

Answer 224

Chronic nasal discharge Sneezing Dyspnoea Reduced airflow Stertor Facial distortion Pain Ocular discharge/exophthalmia

Answer 225

Tests for bleeding disorders Serology for fungal disease Viral testing in cats Swabs Imaging Rhinoscopy

Answer 226

Full oral examination use bitch spay hook to the lift the soft palate, otoscope may help visualisation Dental probing

Answer 227

- Foreign bodies - Tooth root abscesses/dental disease - Turbinate destruction - Nasal bone invasion - Increased soft tissue opacity - Check sinuses

Answer 228

- Steam/nebulise - Mucolytics - bromhexine - Saline drops meloxicam - Doxycyline 6 week course - Antivirals: famciclovir for FHV - Antihistamines - if allergy associated - Glucocorticoids – if no bacterial/viral component

Answer 229

- Minimise exposure to irritants/allergens - Doxycycline - Meloxicam - Glucocorticoids - Humidification/nebulization - Antihistamines - Hypoallergenic diet - Azithromycin

Answer 230

Radiotherapy is usually best treatment, except chemotherapy for lymphoma Surgery is unrewarding Meloxicam – analgesia, inhibition tumour growth

Answer 231

- Mechanical debridement endoscopically – may require trephination to access frontal sinuses - Topical antifungal - Non-invasive catheter soaks with clotrimazole: - Trephination

Answer 232

- Use foley catheters in the nasopharynx and rostral nasal cavity - Restricts the drug to the nasal cavity

Answer 233

- Flushing with saline then clotrimazole flush - Installation of clotrimazole cream

Answer 234

When bronchial cartilage is weakened and collapses inwards

Answer 235

Respiratory noise mild to severe with/without gastrointestinal signs

Answer 236

Obesity Excitement Hot weather

Answer 237

- Oesophagitis or megaoesophagus - Gastric or hiatal hernia - Upper GI issues can lead to secondary intestinal dysfunction - Reflex - Regurgitation - Vomiting or haematemesis

Answer 238

- Mild - snoring, reverse sneezing - Severe - cyanosis, collapse - Sucking air in rather than breathing passively - Stertor - Paroxysmal stertor = reverse sneezing - Stridor – more high pitched sound than stertor

Answer 239

Orthopaedic – luxated patellae to spinal deformities Ophthalmological – corneal ulcers Dermatological – skin fold pyoderma

Answer 240

- Nares – sides of the nostrils sucked in as they breathe in - Tonsils – can evert - Soft palate – can be thickened - Laryngeal saccules – can become thickened - Aberrant turbinates – restricts air even more - Trachea – English bulldogs can have hypoplastic tracheas

Answer 241

Nasopharyngeal hyperplasia Macroglossia Bronchial collapse

Answer 242

Alar fold excision/nares resection/rhinoplasty – typically a vertical wedge is removed

Answer 243

Soft palate resection/shortening

Answer 244

Removing everted saccules, always bilateral. There is an argument to leave alone unless causing obstruction as may risk increased airway swelling.

Answer 245

The negative intra-thoracic pressure caused by the restriction to airflow from the upper airway anatomy pulls the stomach through the oesophageal hiatus (normal opening in the diaphragm the oesophagus passes through).

Answer 246

Gastroesophageal reflex disease

Answer 247

Always consider medical treatment first, with/without combined airway surgery. Gastrointestinal signs typically improve or resolve post BOAS surgery but may need medical management peri-operatively.

Answer 248

Airway swelling > severe dyspnoea Aspiration Progression > laryngeal collapse

Answer 249

Severe dyspnoea Syncope Severe respiratory noise

Answer 250

1 = saccule eversion 2 = partial cuneiform collapse 3 = complete collapse

Answer 251

BOAS surgery Laryngoplasty Permanent tracheostomy Partial arytenoidectomy (laser ablation) Cuneiformectomy

Answer 252

Geriatric onset laryngeal paralysis polyneuropathy/polyneuropathies are often immune-mediated. When we see a polyneuropathy that’s when we see progressive hindlimb weakness and dysphagia as well

Answer 253

Caudal tonsillar crypt as well as overlap of soft palate with epiglottis

Answer 254

Most common aetiologies are degenerative, idiopathic and immune-mediated

Answer 255

Cervical and thoracic radiography - to rule out other things Laryngoscopy

Answer 256

Unilateral arytenoid lateralisation via cricoarytenoid sutures (tie back)

Answer 257

- Haemorrhage leading to airway obstruction - Cartilage fracture or suture failure may be associated with barking post operatively - Aspiration pneumonia, so soft food initially not wet/liquid - Wound issues, such as infection or seroma

Answer 258

Degenerative

Answer 259

Cough Honk Stertor Progression

Answer 260

Inspiratory stertor suggests extra-thoracic airway obstruction Expiratory stertor suggests intra-thoracic airway obstruction

Answer 261

Tracheomalacia with/without bronchomalacia causing cartilage weak, the trachea collapses inwards, isn’t a rigid tube. This causes dynamic obstruction of the upper airway

Answer 262

- Coughing from collapse causes inflammation - Inflammatory cycle means you can get sudden deterioration after an infection such as kennel cough

Answer 263

Fluoroscopy Radiography Bronchoscopy

Answer 264

Grade I collapse 25% loss of lumen Grade II collapse 50% loss of lumen Grade III collapse 75% loss of lumen Grade IV collapse total loss of lumen

Answer 265

Medical management in severe cases – stabilisation, as per any respiratory distress case, with oxygen

Answer 266

Avoided, high rates of complication and can’t cure, only improve

Answer 267

Used if refractory or unresponsive to medical management, severe collapse or medically unstable dogs. Extraluminal prosthesis Intraluminal stenting

Answer 268

Intraluminal stenting or euthanasia

Answer 269

Creation of a temporary stoma in the trachea by placement of a tracheostomy tube.

Answer 270

Laryngeal oedema Extra luminal obstruction Cervical swelling

Answer 271

Should not be same size as trachea, should be 75% the width of the trachea

Answer 272

- Coupage every 4-6h after nebulisation - Cuff – if cuffed, readjust every 4 hours to avoid mucosal damage - Cannula – every 2-4h, - Suction – every 4-6h - Stoma cleaning every 4-6h

Answer 273

- May have trouble sleeping - Patient interference/accidental/coughing - Blockages common - Vagal response, coughing, stimulation of gag reflex upon suction - Aspiration pneumonia - Tracheal infection - Tracheal necrosis - Tracheal stenosis - Pneumomediastinum - Pneumothorax - Subcutaneous emphysema

Answer 274

Creation of a permanent stoma in the trachea by removing a section of tracheal rings ventrally and suturing mucosa to skin

Answer 275

Laryngeal collapse Neoplasia Severe crushing trauma

Answer 276

Side tabs that allow for simple suturing of narrow bore chest drains to skin

Answer 277

Procedure involving the puncture of the pleural space for diagnostic and/or therapeutic purposes. Avoid lateral recumbency

Answer 278

Depends on imaging/unilateral or bilateral

Answer 279

Ventral for low volume liquid, middle for more volume and dorsal for air as it rises

Answer 280

- When thoracocentesis is not enough - For drainage of large quantity of fluid or air from the chest - Recurrent pneumothorax - Ongoing formation of fluid/air - Fluid too thick to be removed via a butterfly

Answer 281

- Lots of different sizes available - Versatile, good for air or fluid, large bore means less likely to block - Robust/don’t collapse - Once learned, easy to place - Most transparent so easy to monitor for stuff that could clog the tube

Answer 282

- Typically need a GA to place - Likely to have higher complication rate than narrow bore though published evidence minimal - Needs careful training - Need to learn a good suture technique for anchoring (2nd technique to learn) - Less comfy than narrow-bore

Answer 283

- No GA - Easy to place - Easy to secure - Versatile - More comfy

Answer 284

- May not cope with pleural fluid/block - Smaller sizes difficult, can be overlong meaning either too much inside the chest (prone to kinking) or too much outside (vulnerable to patient interference) - Not as rigid means can end up in weird placement - May not be able to do the normal SQ tunnel in a large patient as introducer catheters not that long

Answer 285

- Wound management – ointments, gels to reduce air leaks, early signs of infection around incisions - Tube management – regular checks of sutures, connectors to reduce risk of failure of the drain, flushing as required - Body bandage – for increased comfort, reduce infection and reduce risk of patient interference - Nursing care and hospitalisation

Answer 286

Failure to place Failure to drain after placement Patient interference Iatrogenic

Answer 287

- Ongoing treatment via the drain - Clinically significant production of fluid/air

Answer 288

- Complications - Resolution of issue - Ongoing need for drainage

Answer 289

Better for thick pleural effusions

Answer 290

Intercostal/lateral thoracotomy – left/right (depends on target structure), intercostal space Sternotomy

Answer 291

Sternotomy is used when either disease is bilateral or you can’t be sure which side of the chest might be affected. Not so good for anatomical structures in the dorsal thorax.

Answer 292

- Exploration - Debridement - With/without repair - With/without foreign body removal - With/without lung lobectomy - Flushing – remove infection, remove necrotic tissue, check for air leaks post lobectomy

Answer 293

- Pleural effusion - Pneumothorax - Lung-associated – pulmonary atelectasis, re-expansion pulmonary oedema, lung lobe torsion - Post-operative pain - Phrenic nerve injury

Answer 294

Shock Dyspnoea

Answer 295

Infection Inflammation Delayed healing Ongoing effusion/pneumothorax

Answer 296

- Herniation - Depends on size of tear - Dyspnoea may be improved if animal thorax raised to allow abdominal organs to leave the chest - Tachypnoea and orthopnoea - Concurrent ortho injuries

Answer 297

Circumferential or radial or both

Answer 298

Stabilise with oxygen, analgesia, IVFT Laparotomy – explore, reposition abdominal content or remove if badly torsed/devitalised, with/without repair, debride as necessary, chest drain

Answer 299

Organs will become adhesed to pleura within a week or so

Answer 300

Cats idiopathic – bites, extension from pulmonary abscesses Dogs – foreign bodies, oesophageal tars, pulmonary infections

Answer 301

Lethargy Inappetence PUO Dyspnoea Mild or severe

Answer 302

Systemic antibiotics Chest drain with/without lavage Good option in cats

Answer 303

Sternotomy: explore, remove, debride, flush and then post-op medical management, typically done early in dogs because of the percentage of foreign bodies

Answer 304

- Non-response to medical therapy/relapse - Inflammation – pleuritis/pleural fibrosis, SIRS - Thromboembolism - Surgical complications

Answer 305

Foreign bodies Chronic bronchopneumonia Penetrating wounds Vascular obstruction Neoplasia

Answer 306

Non-specific – lethargy, inappetence, PUO Respiratory – dyspnoea, coughing

Answer 307

Idiopathic Neoplastic

Answer 308

Cardiac tamponade

Answer 309

Imaging Pericardiocentesis

Answer 310

Repeat pericardiocentesis Pericardiectomy This does not stop the effusion from forming, it prevents the cardiac tamponade and converts into pleural effusion, but this is rarely large enough volume to cause an issue

Answer 311

- Recurrence both after draining and surgery – if window removed - Long standing effusion causes adhesions

Answer 312

- Non-productive cough/dyspnoea - Non-specific weight loss - Distal limb pain - None 25% - Hypertrophic pulmonary osteopathy occasionally seen with paraneoplastic syndrome, painful

Answer 313

Space occupying lesion With/without pleural effusion With/without paraneoplastic syndromes None

Answer 314

Sudden onset dyspnoea No history of trauma None Lethargy Anorexia Exercise intolerance) Progressive = tachypnoea, orthopnoea, coughing Peracute = tension pneumothorax

Answer 315

- Conservative management via intermittent thoracocentesis/indwelling chest tube, but typically pneumothorax continues to reform - Surgery thoracoscopy or sternotomy, remove affected lung lobes depending on how many affected

Answer 316

Surgical complications Staple failure Recurrence

Answer 317

Retching/gagging Hypersalivation Inappetence

Answer 318

Radiography Oesophagoscopy

Answer 319

- Conservative medical treatment during endoscopy with/without fluoroscopy. Retrieval via mouth, or pushed into stomach - Surgical – lateral thoracotomy, chest drain

Answer 320

- Oesophageal damage – oesophagitis, perforation/tear, stricture (balloon dilation) - Surgical complications - Suture dehiscence - Feeding tube

Answer 321

Peritoneal pericardial diaphragmatic hernia

Answer 322

None Intermittent vague signs Gastrointestinal Respiratory Cardiac - tamponade, pericardial effusion

Answer 323

- None if small/asymptomatic - Surgery = exploratory laparotomy to explore/replace with/without remove contents - Restore normal division between pericardium, diaphragm and abdominal cavity

Answer 324

- Adhesions within the pericardium - Pericarditis - Organ damage - Surgical complications

Answer 325

Retrovirus

Answer 326

Aerosol so needs close contact

Answer 327

Over 6 months

Answer 328

Epithelial cells produce large amounts of mucoid fluid

Answer 329

- Little until so much lung affected that respiration becomes affected - Severe weight loss - Hyperpnoea, coughing - Fluid crackles on auscultation Animals can live 3-6 months after initial clinical signs

Answer 330

- Wheelbarrow test = 50-500ml fluid - Fluid production is pathognomonic

Answer 331

- Lungs are larger - Heavier than normal with areas of solid grey tumour - PCR test may be available in the future

Answer 332

Probe at 6-7th intercostal space

Answer 333

Slaughter affected animals Minimise close contact

Answer 334

A lentivirus (a slow virus) affecting the lungs (Maedi) and nervous system (Visna) of sheep

Answer 335

Inhalation Milk and colostrum Not placental, ova or semen

Answer 336

- Tachypnoeic on exercise and later at rest - Dry cough - Worsen over 6-12 months

Answer 337

Large heavy lungs Grey coloured

Answer 338

Blood testing allows identification

Answer 339

There is no vaccine, no cure and the disease is fatal

Answer 340

Caprine arthritis encephalitis

Answer 341

CLA bacterial infection caused by corynebacterium pseudotuberculosis

Answer 342

- Rams often neglected outside of tupping season - Related to malnutrition

Answer 343

Damage to lungs from pathogens such as mycoplasma when lungs abscesate following bacterial infection

Answer 344

3-4 weeks of antibiotic therapy

Answer 345

Weight loss

Answer 346

Mannheimia haemolytica - commonest in UK Bibersteinia trehalosi

Answer 347

- Under 2 months = hyperacute septicaemia - Older lambs = pleurisy and pericarditis - Adults = pneumonia

Answer 348

- Acute systemic disease - 6 to 12 months old - Find dead or recumbent - Frothy discharge from mouth - Morbidity rarely exceeds 5%

Answer 349

Find dead Dull, pyrexic and hyperpnoeic Adventitious respiratory sounds Ocular and nasal discharges Coughing Mouth breathing Frothing at the mouth

Answer 350

- Poor ventilation in housing - Overcrowding when housed - Unhygienic conditions (high ammonia) too little bedding or v soiled bedding - Recent handling/transportation - Inadequate nutrition - Concurrent disease - Extremes in weather conditions - Mixing age groups (lambs> adults)

Answer 351

Antimicrobial therapy - oxytetracycline, penicillin, amoxycillin If severely affected can use NSAID

Answer 352

Vaccination: - Ovipast plus - M.haemolytica and B trehalosi, lambs from 3 weeks old - Heptavac P - inject pregnant ewes colostral protection for 3 to 4 weeks

Answer 353

- Associated with systemic pasteurellosis (speticaemia) - Most common cause of death in lambs age 4-10 months - Store lambs often affected, as farmers often only vaccinate replacements

Answer 354

- Asymptomatic excretors - Consolidation of the cranio-ventral lung lobes - Bronchiolar epithelial hyperplasia

Answer 355

- Apical and cardiac lobes - Consolidation and proliferative bronchiolitis

Answer 356

Mycoplasma ovipneumoniae = enzootic pneumonia

Answer 357

Chronic, often subclinical Housed Morbidity often 40% within a group Chronic cough Reduced weight gains Hyperpnoea Mucopurulent nasal discharge

Answer 358

Antibiotics Oxytetracycline Tylosin Tilmicosin Lincocin

Answer 359

Reduce stocking density Ensure adequate ventilation Group according to age and size

Answer 360

Coughing Tachypnoea Weight loss

Answer 361

Baermann technique (larvae)

Answer 362

Anthelmintics, no vaccine in the UK

Answer 363

- Sporadic - In rams, especially in texels

Answer 364

Hereditary predisposition Laryngeal oedema Chronic suppuration of the arytenoid cartilage

Answer 365

Respiratory stridor Sudden onset Inspiratory distress Upper respiratory tract noise

Answer 366

Tracheotomy Corticosteroids Antibiotics - prolonged course

Answer 367

- Stress risk factors - Immunity of calves - Pathogens able to take advantage of conditions

Answer 368

Organisms they carry in them already can become pathogenic when the calf becomes stressed and the immune system is affected. Many are part of a commensal flora of the RT so isolating a pathogen does not necessarily mean you have isolated the pathogenic causal organism

Answer 369

- Calf lungs relatively inefficient due to their position - Problems especially with R apical and cardiac lobes - Build-up of fluid and debris - Cattle lung small for size of animal

Answer 370

Calf source Colostrum Housing Temperature Damp, humidity, ventilation, dust Nutrition, water Fear, anxiety Castration, dehorning Management

Answer 371

Para-influenza 3 (PI3) Bovine Respiratory Syncytial Virus (BRSV) Bovine Herpes Virus 1 (BHV-1/ IBR) BVD/MD Virus Coronavirus Mycoplasma species Histophilus somni Mannheimia haemolytica Pasteurella multocida

Answer 372

- Take advantage of intensification - Acts via a neuraminidase receptor to penetrate the mucociliary layer

Answer 373

Live and intranasal vaccines available

Answer 374

- Both live and inactivated vaccines available - Intranasal vaccine

Answer 375

- Found in nasopharyngeal - Responsible for the permanent damage to lungs (consolidation) that can occur in enzootic pneumonia - M. haemolytica – potent leukotoxin, specific for ruminant phagocytes

Answer 376

- Pulse often >120/min - Febrile – a key sign - Anorexia variable - Coughing a major sign, exercise if necessary, deep cough - Nasal discharge clear and then mucopurulent - Dull depressed, ears down, may have neck extended

Answer 377

Calves suddenly brought inside Exclude Dictyocaulus viviparus White Muscle Disease Calf Diphtheria Salmonellosis Inhalation or aspiration pneumonia Congenital heart disease Acute neonatal respiratory distress Acute pneumonia Histophilus somni

Answer 378

- Vitamin E deficiency - Can get respiratory involvement - Very weak - Often frothy and bloody nasal discharge

Answer 379

Sudden onset Very dull Anorexic Pyrexic Pain

Answer 380

If extensive get necrotising pneumonia and death If less severe need prompt antibiotic treatment to save

Answer 381

- Commonest is ventricular septal defect - Pulmonary oedema - Loud systolic heart murmur

Answer 382

- Type II pneumonocytes not producing surfactant - Severe dyspnoea soon after birth - Harsh adventitious sounds - No heart murmur but tachycardia

Answer 383

Febrile Anorexic Severe pneumonia Can die Often history of carrier animal entering herd

Answer 384

- First line antibiotics – oxytetracycline, nuflor (florfenicol), resflor (florfenicol and flunixin) - NSAIDs - Steroids – dexamethasone, with great care as these are so immunosuppressive they will affect calves immune response but not part of primary treatment plan

Answer 385

- Preventing risk factors with housing - ridge ventilation, smoke testing - Vaccines

Answer 386

- Displacement of lung tissue and/or pleural effusion - Reduced compressibility of the cranial thorax (cats)

Answer 387

Thoracocentesis and fluid analysis FNA cytology or Tru-cut biopsy

Answer 388

Traumatic Spontaneously – blebs, bullae, chronic airway disease

Answer 389

No lung sounds audible Hyper-resonant percussion

Answer 390

Inspiratory dyspnoea Rapid shallow breathing No URT noise Muffled heart and lung sounds Dullness on percussion

Answer 391

Everted laryngeal saccules Hyperplastic soft palate Hyperplastic tonsils Laryngeal collapse Stenotic nares

Answer 392

Give an injection of a drug to stimulate breathing – GA may be too heavy

Answer 393

Doxopram IV

Answer 394

Due to passive movement of the larynx as the dog breathes out

Answer 395

If this was in winter instead of hot day, potentially has aspiration pneumonia so would administer antibiotics, but on a hot day is likely to be heat stroke.

Answer 396

Unilateral arytenoid lateralisation /laryngoplasty Lowest complication and highest success rate

Answer 397

Concurrent oesophageal dysfunction Which tieback technique is used

Answer 398

Dyspnoea not alleviated by conservative management and stomach in the thorax (stomach through a small hole will start to produce gas in the thorax so then you have a GDV in the thorax, can’t stabilise because it is just going to get worse.)

Answer 399

Lung bullae or bleb

Answer 400

Treatment of traumatic pneumothorax is usually conservative – unusual to be on 1 it of lung, usually on both, but traumatic rupture may be relatively small so chest drain may be able to restore vacuum.

Answer 401

Better with surgical treatment than conservative

Answer 402

Distant metastases Histopathological grade Presence of a cough Presence of local metastases Tumour sensitivity to radiation

Answer 403

Lateral thoracotomy

Answer 404

Surgical management due to an infection associated with ana underlying foreign body

Answer 405

Conservative management due to an infection form an underlying pneumonia or an infection spread to the thorax via the bloodstream

Answer 406

Sternotomy

Answer 407

Parasitic Bronchitis/Dictyocaulus viviparus) Shipping Fever IBR (BHV1) Bovine Farmers Lung Fog Fever/acute interstitial pneumonia Dusty feed Contagious Bovine Pleuropneumonia

Answer 408

Acute exudative pneumonia Chronic suppurative pneumonia Diffuse fibrosing alveolitis Caudal vena cava thrombosis

Answer 409

Milk allergy Tumours Pulmonary abscess Tuberculosis

Answer 410

- Especially a problem of weaned suckled calves - Peak incidence September-December - Most outbreaks within 4 weeks of housing

Answer 411

Weaning Transport Mixing Housing Diet change

Answer 412

Mannheimia haemolytica (esp. A1) Pasteurella multocida Histophilus somni

Answer 413

- Initiating agent of pneumonia pasteurellosis but in young calves it is usually secondary to a viral infection - Strains A1 and A6 - Present in nasal cavity of healthy calves

Answer 414

- Tracheobronchial/broncho-alveolar lavage - Lung lesions at postmortem examination - Tonsillar and nasal isolates (not always pathogenic strains) - Isolation difficult from animals treated with antibiotics - Serology can be performed – paired samples

Answer 415

Dull Anorexic Tachypnoeic Pyrexia Nasal discharge Adventitious lung sounds and coughing

Answer 416

Fibrinous pleurisy is present

Answer 417

Colonises lesions induced by other agents as a secondary pathogen

Answer 418

Readily isolated from lung lesions of untreated animals – isolates form URT may not be significant

Answer 419

- Present in URT and LRT of some healthy cattle - Thromboembolic mengioencephalitis – rare in UK

Answer 420

Isolated from calf pneumonias Difficult to isolate

Answer 421

- History - Clinical Signs - Nasopharyngeal swabs – culture, can isolate but may not be the organism causing the disease - Broncho-alveolar lavage or tracheal wash – culture, may not be diagnostic - Postmortem examination - Serology – will give some historical perspective but not what will have caused disease at the time

Answer 422

- Decreased stress, housing design, management - Vaccination before they are weaned (pre-conditioning)

Answer 423

The respiratory form of BHV-1

Answer 424

- Spread by aerosol route - Requires close animal contact, slow spread within a group

Answer 425

Latent infection in the trigeminal nerve ganglia Stress leads to recrudescence

Answer 426

Cough due to inflammation Decreased appetite = decreased growth rate Dull Pyrexia Nasal discharge Necrotic plaques on mucosa = halitosis Ocular discharge/conjunctivitis Retropharyngeal and submandibular lymphadenopathy Decreased milk yield Drooling saliva Upper airway noise Rhinitis Pharyngitis Abortion

Answer 427

- Antibiotics to control secondary infection - Vaccination in outbreak - Never give corticosteroids to not immunosuppress these cattle

Answer 428

Management Closed herd

Answer 429

- Live, temperature sensitive - Rapid protection within 48-96 hours - Vaccine virus spread - Useful even in the face of an outbreak - Live intranasal vaccines produced nasal gamma-IFN

Answer 430

Glycoprotein-E-deletion, so are able to distinguish between animals that have been vaccinated and have antibody and animals that have any other type of antibody.

Answer 431

Improve immunity Reduce shedding

Answer 432

- Photosensitisation - Infectious bovine keratoconjunctivitis - FMD - Mucosal disease

Answer 433

Clinical picture Virus isolation using fluorescent antibodies Antibody titre

Answer 434

- Transmission via aerosols - Spread within the animal via cell-associated viraemia

Answer 435

Latent infection of trigeminal (and sciatic) ganglia

Answer 436

- Focal areas of epithelial cell necrosis causes reduced ciliary clearance - Viral infection causes increase in divalent cations, which favour colonisation of the lungs by bacteria - Impaired macrophage, neutrophil and lymphocyte function

Answer 437

Inflamed nasal mucosa

Answer 438

- Serology – paired sample - Immunofluorescent antibody staining - Virus isolation from nasal/nasopharyngeal, ocular/conjunctival and bronchoalveolar lavage swabs - Immunohistochemistry - PCR - ELISA on bulk milk

Answer 439

- Extrinsic allergic alveolitis - An allergic disease of cattle and man - Hypersensitivity to fungal spores and bacterial antigens due to exposure of moudly food

Answer 440

Frequent coughing Hyperpnoea Reduced milk yield Weight loss Cow still bright Exercise intolerance May result in cor pulmonale or diffuse fibrosing alveolitis

Answer 441

Sudden onset Dyspnoea Tachypnoea Milk yield disappears Anorexic

Answer 442

History Clinical picture Specific antibodies to Saccharopolyspora

Answer 443

Removing source (stop feeding hay or wet straw and move animals onto silage) Could treat acute cases with corticosteroids to dampen down the immune response but this is likely to cause abortion

Answer 444

Congestion, oedema, interstitial emphysema and epithelialisation of alveoli Naturally occurring amino acid in pasture converted to pneumotoxin: L-tryptophan > indole acetic acid > 3-methyl indole, which causes a toxic affect that damages the lung.

Answer 445

Severe: - Acute distress - Gross dyspnoea - Respiratory grunt - Salivation, often froth at the mouth Mild - dull, some tachypnoea

Answer 446

Treatment empirical with NSAIDs Move herd when you can and carefully and restrict grazing to reduce their intake of L-tryptophan

Answer 447

Many conditions including chronic bronchopneumonia, bronchiectasis, multiple lung abscessation. Common end stage condition in a small number of animals

Answer 448

Weight loss/poor growth Cough Variable temperature, intermittently febrile Variable adventitious lung sounds especially cranioventral Thoracic pain Halitosis if necrotising

Answer 449

No long term response to treatment Best culled rather than treated

Answer 450

Aetiology unknown, but probably repeated allergic reaction

Answer 451

Persistent cough Tachypnoea Hyperpnoea Exercise intolerance Weight loss Bright thin cows Widespread squeaks/crackles often over whole of both lung fields Decreased resonance Increased lung weight at PME

Answer 452

May lead to Cor pulmonale and develop right sided heart failure

Answer 453

No treated

Answer 454

Blood is coming up form the trachea and not the nasal cavities

Answer 455

Cough Weight loss over a few weeks Tachypnoeic Shallow breathing Coughing Thoracic pain Hepatomegaly in 50% of cases

Answer 456

1. Young adults being fed a high concentrate diet 2. Ruminal acidosis resulting in rumenitis/damage to the wall of the rumen 3. Bacteria get in to the hepatic portal vein and cause abscesses in the liver 4. Septic thrombus in caudal vena cava causes septic thromboembolus in the pulmonary arteries and lung 5. Aabscesses causing an embolic suppurative pneumonia as they spread through the lung 6. If one of these pulmonary abscesses breaks through into the airway, form an aneurism 7. If this breaks into the airway and ruptures, you get acute haemorrhage and haemoptysis 8. This will be arterial oxygenated blood that will be very fresh and red.

Answer 457

No treatment invariably fatal – cull

Answer 458

Exotic notifiable disease Differential for pneumonia pasteurellosis