respiratory Flashcards

1
Q

Treatment for the life threatening Hyperkalaemia?

A
  • Calcium
  • Insulin/dextrose
  • Terbutaline
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2
Q

What is the progression of CKD clincial signs?

A
  • None
  • PU/PD and/or wieght loss –> uraemic syndrome +/- anaemia
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3
Q

What are teh goals of Oxygen therapy?

A
  • SpO2 >95%
  • PaO2 >80mmHg
  • Less work to breath
    • Less distress
  • Resolution of cyanosis
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4
Q

What are the indications to when to intubate and ventilate?

A
  • Severe hypoemia despite O2 supplementation
    • PaO2 < 60mmHg, SpO2 <90%
  • Severe hypercapnea
    • PaCO2 = >60mmHg
  • Increased work of breathing and sustained respiratory distress
    • You think they might die.
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5
Q

What Diagnostics if we have a urethral Obstruction?

A
  • Imaging of the bladder and urethra
    • Rads
    • US
  • Urinalysis and Culture&S
    • Often hypersthenuric >1.030Dogs, >1.035Cats
      • Struvite = alkaline
      • CaOxalate = Acidic
  • Treatment Goals
    • Address life threating hyperkalaemia (Prior to sedation/anaesthesia)
      • Calcium Gluconate (protect mypocardium)
      • Insulin + Glucose/dextrose
      • Sodium bicarb
      • Ternutaline
    • Unblock
    • IV fluid diuresis
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6
Q

If a dogs Nasal planum has become depigmentation what could cause this?

Mucopurulent nasal discharge

unilateral

Epistaxix

A

Aspergillosis fumigatus (Fungal rhinosinusitis ) DOGS

Turbinate loss

Whife fungle plaques

Treatment- Clotrimazole cream & Oral antifungal meds

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7
Q

What causes the noise Stridor in dogs?

A

Laryngeal paresis

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8
Q

What is Brachycephalic obstructive airway syndrome? (BOAS)

A
  • Stenotic nares
  • Hypoplastic trachea
  • Elongated soft palate
  • Large Tongue
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9
Q

Localise the lesion

  • Nasal Discharge
  • REverse Sneeezing
  • Stridor
  • Cough
A
  • Nasal Discharge
    • Nasal passage disease
  • REverse Sneeezing
    • Nasopharyngeal
  • Stridor
    • Laryngeal or tracheal disease
  • Cough
    • Airways, lungs
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10
Q

If an animal has Hypercalcaemia what could be causing this ?

Treat as an emergency why?

A
  • Hypercalcaemia
    • PTH related peptide associated tumors
      • Lymphoma (mainly t cell)
      • Anal Sac adenocarcinoma
      • Multiple myeloma
      • Squamous Cell Carcinoma
      • Mammary gland carcinoma
      • Thyroid carcinoma
  • Cause irreversible nephrocalcinosis leading to renal failure

Treatment

  • IV fluids diuresis
  • Frusemide
  • Glucocorticoids
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11
Q

What drugs can you use if a dog is anxious with a urt obstruction?

A
  • Anxiolysis
    • Acepromaziine
    • Butorphanol
    • Trazadone
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12
Q

What are some causes of acute kidney injury?

A
  • Ethylene Glycol
  • Lilly Ingestion (Cats only)
  • Grapes and Raisins
  • NSAIDS
  • Iatrogenic
    • Aminoglycosides eg gentamicin
    • ACE inhibitors (used for cardiac disease)
  • Bacterial Pyelonephritis
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13
Q

If we have a dog with suspected urethral Obstruction (Lower urinary tract signs & Large inexpressible urinary bladder) what are teh 3 diagnostic tests we need to do?

A
  • Bloods
    • Potassium (High can be bad if anaesthesia)
    • BUN/Creatinine
    • Acid-Base status
  • ECG
    • Due to changes to hyperkalaemia
  • Access underlying/concurrent disease
    • Full Bloods
  • Determine the cause of Uurethral Obstruction
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14
Q

How do you treat Prostatitis in intact dogs/

A
  • Treat at least 4 weeks if acute, 4-6 weeks chronic
  • Choose antimicrobials that penetrate the prostrate
    • Fluoroquinolones eg enrofloxacin, pradofloxacin
  • MUST ALSO NEUTER the dog surgically or chemically
    • Surgical is faster reolution
    • Treat with abx 5-7days
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15
Q

MCV on bloods stands for

MCHC

A
  • Mean Corpuscular volume
    • microcytic
    • Normocytic
    • Macrocytic
  • MCHC
    • Hypochromic
    • Hyperchromic
    • Normochromic
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16
Q

What are the most common lower respiratory bacterial pathogens in dogs and cats?

A
  • Dogs
    • Bordertella bronchiseptica, mycoplasma spp
  • Cats
    • Bordetella bronchisptica, pasteurella spp, Mycoplasma spp
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17
Q

DDX for Sneezing/nasal discharge

A
  • Infectious
    • Fungal (aspergillus (dog) , Cryptococcus (Cat)
    • Bacterial rhinitis
    • Cat flu
    • Nasal mites
  • Immune mediated
    • allergic
    • Lymphoplasmacytic (chronic) rhinitids
  • Neoplasia
  • Foreign body
  • tooth abscess
  • Polyp
  • Stricture
18
Q

FCov and FIP

A
  • FIP
    • Diagnosis
      • Acheive a high degree of clinical suspicion (<2yrs multicat envrion with stress and jaunce)
      • Rule out more readily diagnosable disease
      • Mutation PCR
      • immunocytochemistry of organ biopsies
    • Management
      • Pred
19
Q

What are teh therapeutic interventions in CKD chronic care?

A
  1. Provision of adequare and appropriate nutrition
  2. Maintenance of water/electrolyte and acid balance
  3. Amelioration of clinical signs (Cats Amlodipine; Dogs Benazepril)
  4. Slowing the rate of pregression of renal disease through renoprotective therapies
20
Q

What are teh 3 mechanisms that cause polyuria?

A
  1. Reduced medullary hypertonicity
  2. Absence of or interference with ADH function
  3. Osmotic diuresis (eg. glucose in urine)
21
Q
  • What is this?
  • Signament
  • Cx
  • Diagnosis
  • Therapy
A
  • What is this? - Cryptococcsis
  • Signament -
    • Cat - young adult
    • Dog - Young large breed
  • CS
    • Cat - URT signs, Skin lesions
    • Dog - Sneezing, nasal discharge, CNS signs, GI involvement
  • Diagnosis
    • Cytology
    • Cryptococcal antigen titres (LCAT)(serum)
    • Histo
    • Fungal Culture
  • Therapy
    • Long term systemic antifungal
      • Fluconazole
      • Amphotericin B
    • Treat till antigen = Zero
22
Q

What level of water intake for cats and dogs = Polydipsia

WHat is the output that is classed Polyuria?

A
  • Polydipsia
    • Dog
      • 100mL/kg/day
    • Cat
      • 50mL/kg/day
  • Polyuria
    • Dog and Cat
      • 50mL/kg/day
23
Q

What is the differences in presentation and treatment of canine and feline lymphoma.

A
  • Dogs
    • p53 mutations
    • 80-85% Stage 3 or 4 - 80 Medium-High grade; 70-80% B-Cell immunophenotype
    • Treatment Multiagent Chemo responce rate 80%
  • Cats
    • Most common neoplasia of cats
    • FeLV, FIV, Genetic predisposition, Chronic inflammation eg IBD
    • 75% cases are ill (dogs only 10-20%)
    • Leukaemia and stage 5 rare
    • Phenotype 70%B; 66% Medium grade
    • Cytology of LN may be insufficient
24
Q

WHat initial treatment would you give an animal with LRT problems? (Narrowed bronchail lumen from bronchospasm, diffuse bronchomalacia

Oedema of the bronchial wall(anaphalaxis)

A
  • O2
  • Bronchodilator trial (injectable or enhaled)
    • albuterol
    • terbutaline
  • Adrenaline IM for anaphylaxis
  • When Stable
    • BAL or TTW
    • Thoracic rads
    • Heartworm test (Cats)
  • Tx
    • Bronchiodilators
    • Corticosteroids
    • Deworming with Fenbendazole (cats)
25
Q

What are the applications of chemotherapy?

A
  • Primary Chemotherapy
  • Adjuvant Chemotherapy
  • Neo-adjuvant Chemotherapy
  • Palliative Chemotherapy
  • Radiation sensitiser
26
Q

If an animal has expiratory distress with wheezes (louder on expiration where is the lesion?

A

Lower Respiratory tract obstruction

27
Q

FeLV

Transmission ANy contact

A
  • Testing
    • POC test detect p27 antigen
    • Detection of provirus DNA by pcr
  • Vaccination 80% effective
28
Q

What are teh IRIS stages of CKD?

A
  • Stage 1
    • Diminished renal reserve but no clincial signs
  • Stage 2
    • Mild Azotaemia and few clinicl signs
  • Stage 3 & 4
    • Moderate to severe azotaemia with progressive uraemic signs
29
Q

What is Kennel cough now called?

A

Canine Infectious Respiratory disease Complex (CIRDC)

  • Highly contagious respiratory infection
    • High morbidity, low mortality
  • Young dogs -
  • In contact with coughing dogs
  • Paroxysmal cough/retching active healthy dog
  • Fever, anorexia, lethargy possible
  • CS 3-10 days after exposure
  • Can progress to pneumonia..
  • Viral
    • Canine Parainfluenza virus
  • Bacterial
    • Bordetella bronchisptica, Mycoplasma spp
    • Can be primary or secondary
  • Treatment
    • Persistant cough >7 days
      • Doxycycline 7-10days
    • If fail to respone 3 view chest rads
    • Endo tracheal wash
30
Q

Pulmonary ausculaton

Describe

Bronchial

Vesicular

and

Bronchovesicular

sounds

A
  • Bronchial - trachea and large airways
    • “Wind Blowing (High pitch)
    • Expiration louder and longer than inspiration
  • Vesicular - peripheral airways
    • Rustling of leaves (Low Pitch)
    • inspiration slightly louder and longer than expiration
  • Bronchovesicular - intermediate lung regions
    • Mostly expiratory - louder as move towards large airways
    • Freq termed harsh sounds
    • Can indicate early lung disease or congestive heart failure if exaggerated
31
Q

Where do you do a thoracocentesis?

A

Betweent the 7th and 9th intercostal space

  • Air
    • Dorsal 1/3 of the thorax
  • Fluid
    • Ventral 1/3
    • Analysis
      • Specigic Gravity
      • Cell count & Morph
      • Protien quantification
      • Gram stain
      • C&S
32
Q

If you hear crackles what DDX?

If you hear Wheeze what DDX?

A
  • Crackles
    • Pneumonia, bronchitis, fibrosis and severe pulmonary oedema
  • Wheeze
    • Airway Disease
33
Q

FIV

Rota virus transmitted in bite and fight wounds

High risk Male intact roaming cat

A
  • Low BCS
  • Patchy alopecia
  • Lymphopenia on bloods
  • Demodex (opportunisitc)
  • Testing
    • POC Inhouse FIV test if positive do a second with a different brand test.
    • Detection of provirus DNA by PCR
  • Vaccination felovax 56% effective
34
Q

What is the difference between

Hypoxia

Hypoxaemia

Hypoventilation

A
  • Hypoxia
    • Decrease cellular oxygen
  • Hypoxaemia
    • Decreased Pa02
  • Hypoventilation
    • Increase PaCO2
35
Q

If an animal has epistaxis what are the DDx’s for

Systemic Causes

Local Disorders

A
  • Systemic Causes
    • Bleeding disorer
      • Platelet number or function
      • defect in coag cascade
    • Hypertension
    • Polycythemia
    • Hyperviscosity
    • Systemic vasculitis
  • Local Disorders
    • Inflammatory disease
      • Fungal infection
      • Immune-mediated/allergi rhinitis
      • Local vasculitis
    • Neoplasie
    • Foreign bodies
    • dental disease
36
Q

DDX for Poly dipsia

A
  • Polydipsia (usually compensaion for increased water loss due to polyuria)
    • Psychogenic poly dipsia
    • Endocrine disorders
      • Hyperadrenocorticism in dogs
      • Hyperthryoidsim in cats
    • Hepatic encephalopathy
    • Rare hypothalamic lesion
    • Drug therapy
37
Q

WHat are teh major Dysuria DDx’s for dogs?

A
  • Bacterial cyctitis
  • Prostatic disease
  • Urolithiasis
  • Bladder or urethral neoplasia
  • Urinary tract Obstruction
38
Q

What are teh 6 hallmarks of cancer cells?

A
  • Self-sufficency in growth signals
  • Insensitiivity to anti-growth signals
  • the ability to evade apoptosis
  • Limitless replicative potential
  • Susteaind angiogenisis
  • The capacity to evade tissues and metastasise
39
Q

What do the following Breathing Patterns indicate?

  • Inspiratory distress
  • Expiratory distress
  • Mixed Inspiratory and expiratory distress
  • Paradoxical breathing
A
  • Inspiratory distress
    • With Stridor (Noisy) - Upper airway obstruction
    • Quiet - Pleural space disease vs adbominal enlargement
  • Expiratory distress
    • Lower Airway obstruction
  • Mixed Inspiratory and expiratory distress
    • Pulmonary parenchymal disease
    • Pleural cavity disease
  • Paradoxical breathing
    • Focal - flail chest
    • Generalise - Pleural cavity disease
40
Q

If an animal has Inspiratory distress and has an externallu audible noise where is the lesion?

A

Upper Respiratory Tract Obstruction

41
Q

What are some DDx’s for space occupying disorders of the pleural cavity?

A
  • Pneumothorax
  • Pyothorax
  • Chylothorax
  • Hydrothorax
  • Haemothorax
  • Neoplastic effusion
  • Feline Infectious peritonitis
  • Diaphragmatic hernia
  • Cranial mediastinal mass
    • CM lymphoma, thymoma, abscess, cyst, foreign body
  • Thoracic wall eg haemangiosarcoma