Respiratory Flashcards
What is the only vein in the body that carries oxygenated blood (back to the heart)
The pulmonary vein!
what is hypoxia
low levels of oxygen in blood, lungs and/or tissues
what is hypoxemia
insufficient oxygenation of the blood
what is the level of PaO2 have to be in order to stimulate respiratory center
<50mmHg (normal = 90-110)
what is hypercapnia
increased CO2 levels
more sensitive respiratory stimulant! than decr. O2 level
name 2 conditions that can cause hypocapnia
hyperventilation
metabolic acidosis
what is cyanosis
bluish→red-purple color of tissues
lots of deoxygenated hemoglobin
dog may have normal hematocrit
Arterial SaO2 73-78% (on pulse ox)
PaO2 will be 39-44 mmHg
before clinical cyanosis found!
what is dyspnea
difficult or labored breathing
Oxygen support is needed before doing anything (e.g. diagnostics)!
what is tachypnea
what are some causes?
rapid breathing
physiological: exercise
pathological: pain, metabolic acidosis, incr CO2 levels (2°)
1° causes: heart failure, pulmonary edema, pleural effusion, pneumonia
what is stridor
high pitched inspiratory noise
- rapid flow of air over rigid obstruction e.g paralyzed/collapsed larnyx*
- http://www.youtube.com/watch?v=075DT9lUWOk*
what is stertor
http://www.youtube.com/watch?v=Y5grnFVgU_Q
low pitched inspiratory noise
gurgling/snoring produced as air passes over soft tissue obstruction
what is orthopnea
shortness of breath when lying down
assume the position! sternal recumbancy, elbows abducted, neck extended & open mouth breathing
how does signalment help with dx resp dz?
helps to narrow down ddx
ciliary dyskinesia - generally younger animals
neoplasia - generallly older animals
breed skull differences:
brachycephalic
mesocephalic
dolicocephalic
what is difference between acute & chronic
acute = fast onset & progression <7 days
chronic = 6-8 weeks duration
sub acute = between acute & chronic
what might indicate the problem is located in upper airway
Nasal discharge
sneezing/reverse sneeze
Incr. inspiratory effort
stridor/stertor
inability to breathe if mouth closed
pawing/rubbing at face
how could you tell if there is bilateral airflow
glass slide technique
piece of cotton
what might indicate problem is in lower airways
Cough (hallmark sign but beware heart dz!)
resp. distress
Incr. expiratory effort
Crackles & wheezes
Remember a cough is always respiratory issue unless it is….
heart disease!
when doing a thoracic auscultation, where are lung sounds loudest?
hilus of lungs (bifurcation of trachea)
where is hilus of lungs
above the heart
why would knowing that hilus is above heart important
because in heart dz with L atrial enlargement, it compresses the L mainstem bronchi causing a cough!
what is heard on periphery of lungs
vesicular sounds (very quiet)
What are the steps for a PE for nasal dz
Facial palpation: pain, symmetry, norm ocular retropulsion
Oral exam: hard palate, soft palate
Evidence of nasal discharge
How would your characterize nasal discharge?
Serous, mucoid, mucopurulent purulent, hemorrhagic
Unilateral vs bilateral
Persistant vs intermittent
How would acute nasal disease discharge often present vs chronic disease discharge?
Acute often accompanied by sneezing
Chronic often purulent to hemorrhagic
what is a cough
Forceful expiratory effort/protective reflex
hallmark of tracheal or pulmonary dz (lower airway) or cardiac failure
What can trigger cough?
how classified?
irritant receptors, inflammatory products, excessive secretions, airway compression or collapse
non-productive vs productive, harst/intermittent or paroxysmal
what is panting
dissipates heat- can be normal in dog but can be a sign of respiratory distress also
In cats IS stress or respiratory distress
Causes of dyspnea
insufficient oxygen in inspired air
insufficient ventilation
insufficient circulation
insufficient erythrocytes
abnormal/low hemoglobin
define bacteriocidal
killas of bacteria
define bacteriostatic
inhibits bacterial reproduction
which ABs inhibit folic acid metabolism
trimethroprim sulfonamides
which ABs disrupt cytoplasmic membrane structure
polymyxins daptomycin
which ABs inhibit DNA gyrase
quinolones
which ABs interfere with RNA elongation
actinomycin
which ABs disrupt DNA directed RNA polymerase
rifampin
which ABs inhibit 50s protein synthesis
erythromycin (macrolides) chloramphenicol clindamycin lincomycin
which ABs inhibit 30s protein synthesis
tetracylines streptomycin gentamicin kanamycin amikacin nitrofurans
which ABs inhibit tRN A synthesis
muprocin
what type of ABs are penicillins? -cidal or -static? type of bacteria effective against? side effects?
Beta lactams bacteriocidal G(+) aerobic bacteria, some anaerobes Add clavulanic acid to protect vs lactamase Newer generations have extended spectrum of activity Rare: v/d, allergic reaction
what type of ABs are cephalosporins? -cidal or -static? type of bacteria effective against? side effects?
bacteriocidal broad spectrum of activity newer generations cover more G(-) bacteria v/d, allergic reactions
what type of ABs are aminoglycosides, -cidal or -static? Name 2. type of bacteria effective against? side effects?
bacteriocidal & bacteriostatic gentamycin, amikacin G(-) & (+) aerobes & some facultative anerobes nephrotoxicity, ototoxicity
what type of bacteria are polymyxins effective against? application limits? side effects?
most G(-) bacteria (Pasteurella, Escherichia, Shigella, Salmonella, Bordetella, Klebsiella, Pseudomonas) topical only Pemphigus vulgaris
what type of ABs is chloramphenicol -cidal or -static? type of bacteria effective against? side effects?
bacteriostatic broad-spectrum more toxic to cats than dogs
what type of ABs are tetracyclins? -cidal or -static? type of bacteria effective against? side effects?
bacteriostatic aerobic & anaerobic G(+) & G(-) bacteria, mycobacteria, spirochetes, mycoplasms, rickettsiae, chlamydiae & some protozoa doxycycline, oxytetracycline esophagitis (post tableting), hepatotoxicity, occasionally anaphylaxis (parental administration)
what type of ABs are macrolides & lincosamides? -cidal or -static? type of bacteria effective against? side effects?
bacteriocidal G(+) bacteria (chlamydophila, mycoplasma, heliobacter, campylobacter) & some rickettsiae Erythromycin, azithromycin, tylosin, lincomycinclindamycin (also does anaerobes & some protozoa) very low, v/d, pseudomembranous colitis
what type of ABs are nitroimidazoles? -cidal or -static? type of bacteria effective against? side effects?
metronidazole/ ronidizole anaerobic bacteria & protozoa neurological abnormalities (little dogs & puppies affected more, delayed onset of side effects)
what type of ABs are nitrofurans? -cidal or -static? type of bacteria effective against? side effects?
bacteriocidal & bacteriostatic G(-) organisms rapidly absorbed & rapidly excreted in urine (not used for systemic) urinary infections nausea/vomiting
what type of ABs are sulphonamides? -cidal or -static? type of bacteria effective against? side effects?
bacteriostatic Streptococcus, Bacillus, Corynebacterium, Nocardia, Campylobacter, Pasteurella, chlamydiae (Enterococcus, Pseudomonas, Serratia, Klebsiella generally resistant!) Ineffective in presence of pus, necrotic tissue or blood containing PABA relatively common, hepatic dz, renal dz/uroliths, KCS, immune-complex reactions/hypersensitivities
what type of ABs are quinolones? -cidal or -static? type of bacteria effective against? side effects?
bacteriocidal esp G(-) & G(+) organisms enrofloxacin, marbofloxacin, orbifloxacin, prodofloxacin, ciprofloxacin, norfloxacin primary excreted in bile CNS (seizures, retinal blindness (cats)), cartilage damage in puppies
