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RUSVM Small Animal Medicine I 2016 > Respiratory Disease > Flashcards

Respiratory Disease Flashcards

1
Q

Hypoxia

A

Oxygen levels in the blood, lungs, and/or tissues is low

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2
Q

Hypoxemia

A

Insufficient oxygenation of the blood

Respiratory stimulant when PaCO2 Less than 50mmHg

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3
Q

Hypercapnia

A

Increased CO2 levels, respiratory stimulant

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4
Q

Cyanosis

A

Bluish to red-purple color in the tissues, due to increase amounts of deoxygenated or reduced hemoglobin
Arterial SaO2 73 and 78% pulse ox (PaO2 39-44mmHg) before cyanosis is found

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5
Q

Dyspnea

A

Difficult or labored breathing

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6
Q

What should you avoid with Dyspnea?

A

Avoid excessive stress or struggling

Avoid dorsal recumbency for radiographs

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7
Q

What should you do for an animal with dyspnea?

A

give oxygen immediately

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8
Q

Stridor

A

High pitched inspiratory noise

rapid flow of air passed a rigid obstruction, paralyzed/collapsed larynx

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9
Q

Stertor

A

Low pitched inspiratory noise - gurgling or snoring sound produced as air passes soft tissue obstruction

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10
Q

Orthopnea

A

Shortness of breath when lying down - adopt a strange position
Sternal recumbency with elbows abducted, the neck extended and open mouth breathing

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11
Q

What age of animals usually has Ciliary dyskinesia?

A

Young animals

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12
Q

What is the hallmark sign of Lower airway disease?

A

Cough

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13
Q

What do you see with upper airway disease?

A 
Nasal discharge
Sneezing/reverse sneezing 
increased effort in inspiration 
Audible sounds (Stridor/Stertor) 
Inability to breath if mouth is closed
Pawing/rubbing at face
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14
Q

What do you see with Lower airway disease?

A

Cough
Respiratory distress
Increased effort on expiration
Crackles and wheezes audible on auscultation

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15
Q

What are the characteristics of discharge?

A 
Serous 
Mucoid
Mucopurulent 
purulent 
hemorrhagic
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16
Q

What accompanies acute nasal disease?

A

sneezing

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17
Q

What accompanies chronic nasal disease?

A

purulent to hemorrhagic discharge

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18
Q

Sneezing

A

Protective mechanisms of the upper airways

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19
Q

What is the hallmark of a tracheal or pulmonary disease or cardiac failure?

A

Cough

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20
Q

Cough

A

Forceful expiratory effort/protective reflex

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21
Q

What are triggers of coughing?

A

Irritant receptors
inflammatory products
excessive secretions
airway compression or collapse

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22
Q

What are the classifications of coughs?

A

Dry/non productive
Moist/ productive
Harsh/ intermittent or paroxysmal

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23
Q

Wet cough

A

coughs and then swallows

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24
Q

Dry cough

A

coughs but does not swallow the product of the cough

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25
Q

Paroxysmal cough

A

a sudden intermittent condition

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26
Q

Tracheal disorders

A 
Tracheal collapse 
Hypoplastic trachea
infectious tracheobronchitis
Canine infectious influenza
Perihilar lymphadenopathy 
Heart bas tumor
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27
Q

Panting

A

dissipates heat
normal in a dog
associated with stress or respiratory distress in cats

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28
Q

Dyspnea

A

difficult or labored breathing

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29
Q

Tachypnea

A

Increased respiratory rate

May or may not be associated with respiratory distress

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30
Q

Orthopnea

A

Difficulty breathing when not in the upright position

Animals will stand with their forelimbs abducted

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31
Q

What is orthopnea common with?

A

Pleural disease

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32
Q

What is the cause of Respiratory Distress?

A 
Insufficient oxygen in inspired air 
Insufficient ventilation 
Insufficient circulation 
Insufficient erythrocytes 
Abnormal or low hemoglobin concentrations
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33
Q

What are the causes of cyan colored mucous membranes?

A 
Lack of oxygen 
Abnormal hemoglobin - toxins
Cardiac disease
Pulmonary disease
Cardiopulmonary arrest
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34
Q

What are normal lung sounds?

A

bronchovesicular

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35
Q

Where are Bronchial lung sounds heard?

A

loudest over the hilus during expiration

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36
Q

Where are vesicular lung sound heard?

A

loudest on inspiration at the periphery of the lungs, normal air filling lungs “rustling of leaves” very soft sounds

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37
Q

Crackles

A

snapping open of the airways that have closed due to fluid in or around them

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38
Q

Wheezes

A

causes by airflow through a narrow opening - airways are constricted/narrowed

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39
Q

Snaps

A

loud snap over hilus at end of expiration indicates collapse of the intrathoracic trachea, carina or mainstem bronchi

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40
Q

Goose honks

A

sound with tracheal collapse

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41
Q

Pleural friction rubs

A

creaking/grating sound due to roughened pleural surfaces rubbing against each other

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42
Q

Pleural disease

A

Pleural effusion

Pneumothorax

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43
Q

Pleural effusion

A

Lungs sounds are auscultated dorsally
Lungs floating in fluid
Muffled sounds ventrally
Heart sounds are also reduced

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44
Q

Pneumothorax

A

Absence of lung sounds dorsally due to compression

likely present in the ventral field

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45
Q

How do you distinguish between a fluid or air density?

A

Use your finger/small mallet to strike the chest cavity and listen to the sound
Fluid gives a dull sound
Pneumothorax will give an increased resonance

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46
Q

When is Rhinoscopy performed?

A

after imaging

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47
Q

When would you perform a Nasal Flush?

A

Foreign body suspect

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48
Q

What does Bronchoscopy evaluate?

A

Larynx
Trachea
Bronchi

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49
Q

What are the indications for a Bronchoalveolar lavage?

A

Lung Disease involving small airway

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50
Q

What is a landmark for Transtracheal wash and aspirate?

A

Cricothyroid ligament

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51
Q

What are the indications for a Transthoracic lung aspiration?

A

Intra-thoracic mass lesions in contact with thoracic wall

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52
Q

What is a chest tube used to treat?

A

Pyothorax

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53
Q

Bronchodilators

A

usually for bronchitis

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54
Q

When do you use anti-tussives?

A

in dogs with dry & non-productive cough due to airway collapse or irritant tracheitis

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55
Q

Nebulization

A

improves hydration of lower airways

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56
Q

What are the indications for oxygen?

A

to treat hypoxemia

to decrease workload of heat and lungs

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57
Q

What are the methods for oxygen treatment?

A

Face mask
Nasal catheter
Cage
Intratracheal

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58
Q

What are the differential diagnosis for nasal discharge?

A

Neoplasia
Rhinitis
Nasal Foreign Body
Dental Disease/ oronasal fistulas
Trauma
Congenital: Cilliary dyskinesis or Nasopharyngeal stenosis
Systemic disorder: Coagulopathy or Pneumonia

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59
Q

What is the most common neoplasia of the nose?

A

Nasal Adenocarcinoma

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60
Q

What are the potential infectious agents that cause Feline upper respiratory disease complex?

A 
Feline herpes virus
Feline calicivirus
Chlamydophila felis
Mycoplasma spp. 
Coronavirus
Bordetella spp
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61
Q

What do you see with Feline Herpes virus?

A

Ulcerative keratitis

punctate or dendritic ulcers

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62
Q

What do you see with Calicivirus?

A

ulcers on the nose, tongue, or hard palate, pneumonia, lameness

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63
Q

What do you see with Chlamydophila felis?

A

conjunctivitis with chemosis

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64
Q

How is feline herpes virus spread?

A

Direct contact

fomites

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65
Q

Where is Feline herpes virus shed?

A

Ocular secretions
Nasal secretions
pharyngeal secretions

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66
Q

How do you diagnose Feline Herpes virus?

A

Clinical signs
viral isolation
PCR

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67
Q

Epiphora

A

Fibrosis of the lacrimal ducts

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68
Q

What is the treatment for Feline Herpes Virus?

A

Topical antivirals: Idoxuridine, trifluridine, cidofovir
Oral antivirals: Famciclovir, acyclovir
Supportive care

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69
Q

What is the route for the Feline herpes virus vaccine?

A

Parental

Intranasal

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70
Q

Parental Feline Herpes Virus Vaccine

A

blocked by maternal antibodies does not prevent a carrier state

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71
Q

Intranasal Feline Herpes Virus Vaccine

A

Not blocked by maternal antibodies

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72
Q

Calicivirus

A

High mutation rate

Direct transmission or via fomites

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73
Q

What is the incubation period of Calicivirus?

A

2-4 days

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74
Q

What are the clinical signs of Calicivirus?

A

Oral and nare ulcers

Feline viral rhinotracheitis

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75
Q

How is FCV different from FHV?

A

Pneumonia is more common with FCV
FCV can result in gastrointestinal signs
FCV can cause lameness
Causes polyarthritis

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76
Q

What are two other syndromes associated with FCV?

A

Limping Kitten syndrome

Virulent hemorrhagic systemic syndrome

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77
Q

What are the clinical signs of Limping Kitten Syndrome?

A

Lameness
Ulcers on paws
sore joints
polyarthritis

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78
Q

Virulent hemorrhagic syndrome

A 
Edema
Hepatitis
diarrhea
pustular dermatitis
hemorrhagic cystitis
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79
Q

What is the treatment for Feline Calicivirus?

A

Supportive: Antibiotics, Nursing care/rehydration

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80
Q

What is the sequelae to Feline Calicivirus?

A

Chronic rhinitis/sinusitis/conjunctivitis

Carrier state

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81
Q

Why is Interferon helpful with Feline Calicivirus?

A

It switches on the TH1 cell mediated response

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82
Q

What are the clinical signs of Chlamydophila felis?

A

Conjunctivitis

Chemosis

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83
Q

How do you diagnose Chlamydophila felis?

A

PCR

Cytology

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84
Q

What is the treatment for Chlamydophila felis?

A

Topical tetracylines or erythromycin

Systemic signs require oral doxycycline and azithromycin

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85
Q

How do you prevent Chlamydophila felis?

A

Vaccination

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86
Q

What is the treatment for cat flu?

A
  1. Outpatient treatment if possible
  2. Keep warm and hydrated
  3. Remove crusts
  4. Humidify air
  5. Topical decongestants for 1 to 2 days
  6. systemic antibiotics for secondary infection
  7. Topical ophthalmic solutions
  8. Oral antivirals
  9. Interferon
  10. Lysine
  11. Anti-inflammatories
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87
Q

What type of nasal discharge comes with bacterial rhinitis?

A

Mucopurulent or purulent nasal discharge

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88
Q

What causes Fungal rhinitis in dogs?

A

Aspergillus fumigatus

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89
Q

What causes fungal rhinitis in cats and dogs?

A

Cryptococcus neoformans var. neoformans

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90
Q

Where is Cryptococcus neoformans var. neoformans found?

A

Pigeon droppings

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91
Q

Where is Cryptococcus neoformans var gattii found?

A

eucalyptus trees

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92
Q

What does aspergillus cause in the dog?

A

Sneezing unilateral/bilateral nasal discharge
Facial distortion
Turbinate destruction
Nasal ulceration and depigmentation

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93
Q

What do you see on Rhinoscopy with Nasal Aspergillosis?

A

White plaques

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94
Q

What do you see on Tissue biopsy or cytology with Nasal Aspergillosis?

A

Hyphae

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95
Q

What is the treatment for Nasal Aspergillosis?

A

Debridement

Infused 1% clotrimazole or 2% eniloconazole into nasal cavity for 1 hour

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96
Q

What is the risk assocaited with treatment of aspergillosis?

A

Aspiration pneumonia

neurologic signs

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97
Q

What is a contraindication for treatment of aspergillosis?

A

damages cribiform plate

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98
Q

What are the systemic fungal medications used for the treatmetnt of Aspergillosis?

A

Itraconazole
Posaconazole
Vorixonazole

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99
Q

What is the transmission of Pneumonyssus caninum?

A

Direct

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100
Q

Where do Pneumonyssus caninum live?

A

Nasal cavities

Sinuses

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101
Q

How do you diagnose Pneumonyssus caninum?

A

Visualize the mites in nasopharynx or nasal cavity

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102
Q

What is the treatment for Pneumonyssus caninum?

A

Ivermectin
Milbemycin
Selamectin

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103
Q

Lymphoplasmacytic rhinitis

A

Chronic inflammatory rhinitis characterized by lymphocytic and plasmacytic infiltration into the nasal mucosa in the absence of any obvious underlying etiology

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104
Q

What are the clinical signs of Lymphoplasmacytic rhinitis?

A

Unilateral or bilateral nasal discharge but can be seroud or even hemorrhagic
sneezing ocular discharge
reverse sneezing
stertor

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105
Q

How do you diagnose Lymphoplasmacytic rhinitis?

A

CT/MRI
Destruction of the nasal septum, frontal sinus, cribiform plate
Rhinoscopy
Biopsy

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106
Q

What do you see on Rhinoscopy with Lymphoplasmacytic rhinitis?

A

Hyperaemic
edematous mucosa
easily traumatised and bleeds
turbinates are atrophied or destroyed

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107
Q

What is the treatment for Lymphoplasmacytic rhinitis?

A 
avoid any smoke
Nasal steroids
Long term doxycycline
Long term itraconazole 
Saline nasal flushes or hypertonic saline 
Maropitant
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108
Q

Substance P

A

a neuropeptide secreted by nerves and inflammatory cells

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109
Q

What is the mechanism of action for Cerenia?

A

Blocks substance P

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110
Q

What are the clinical signs of Nasal neoplasia?

A 
Nasal discharge
Decreased airflow 
Dysphagia
Sneezing 
facial deformity 
epiphora 
exophthalmos
dyspnea
open mouth breathing 
hard palate abnormalities 
Neurological signs if the cribiform plate is invaded
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111
Q

Epiphora

A

discharge from the eye

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112
Q

How do you diagnose Nasal neoplasia?

A 
Fine needle aspirates of draining lymph nodes
Radigraphy 
CT/MRI
Nasal discharge cytology
Rhinoscopy 
Nasal biopsy
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113
Q

What is treatment of Nasal Neoplasia?

A

Surgery
Radiation
Chemotherapy

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114
Q

What is the treatment of choice for most nasal neoplasia?

A

Radiation

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115
Q

What is chemotherapy useful in the treatment of?

A

Lymphoma

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116
Q

What is the prognosis for nasal neoplasia?

A

3-6 months

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117
Q

What are the most common nasal neoplasia in dogs?

A

Adenocarcinoma

Squamous cell carcinoma

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118
Q

What are the most common nasal neoplasia in cats?

A

Lymphoma

Adenocarcinoma

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119
Q

Ciliary dyskinesia

A

Immotile ciliary syndrome
Inherited autosomal recessive trait
Poor clearance of mucous from the airways
chronic mucous plugging and inflammation

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120
Q

What are the clinical signs of Primary ciliary dyskinesia?

A

rhinosinusitis
bronchitis
bronchopneumonia
bronchiectasis

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121
Q

How do you diagnose Primary Ciliary dyskinesia?

A

Biopsy or brush swab
Culturing
Electron microscopy

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122
Q

T/F? Nasal Neoplasia can result in exophthalmia, facial distortion, and sneezing?

A

True

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123
Q

T/F? The main clinical sign associated with nasal mites is sneezing?

A

True

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124
Q

T/F? Nasal aspergillus does not respond to systemic antifungal therapy?

A

False

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125
Q

T/F? “Wisp of cotton” in front of nares could indicate obstructive process if “wisp” does not move with dog’s breath?

A

True

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126
Q

What are the clinical signs of Tracheobronchial disease?

A 
Cough 
Retch/gag
Wheezing
Inspiratory sounds
Tachypnea
Respiratory distress
Cyanosis
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127
Q

What pathogens are responsible for Canine infectious respiratory disease complex?

A 
Parainfluenza virus
Canine adenovirus
Mycoplasma spp.
Bordetella spp. 
Canine distemper virus 
Canine respiratory coronavirus 
canine herpes virus
canine influenza virus
128
Q

Bordetella spp. mechanism of action

A

Attaches to the cilia of bronchial epithelium and interferes with motility resulting in mucous accumulation and inflammation

129
Q

Transmission of Canine infectious respiratory disease complex?

A

Spread in respiratory secretion and fomites

130
Q

What is the incubation of Canine infectious respiratory disease complex?

A

3-7 days

131
Q

What is the clinical sign of Canine infectious respiratory disease complex?

A

Coughing

132
Q

Clinical signs of Uncomplicated Canine infectious respiratory disease complex?

A

Non-sick animals that involves the upper airways. Cough elicited on tracheal palpation. Seroud oculonasal discharge gagging and retching can be found

133
Q

Clinical signs of complicated Canine infectious respiratory disease complex?

A

Sick animasl that involves both the upper and lower airways. The cough is moist. The oculonasal discharge is more mucopurulent. May develop into bronchopneumonia

134
Q

How do you diagnose Canine infectious respiratory disease complex?

A 
Hemogram 
Thoracic radiographs
Transtracheal wash
cytology 
culture 
PCR panels for upper respiratory viruses and bacteria
135
Q

What is the treatment for uncomplicated Canine infectious respiratory disease complex?

A

Restrict exercise
use doxycycline if bordetella is suspected
usually resolves within 2 weeks
Cough Suppressants

136
Q

What is the treatment for complicated Canine infectious respiratory disease complex?

A 
Restrict exercise 
Systemic antibiotics for 2 weeks - Doxycycline
Nebulisation 
Cough supressants
Bronchodilators
137
Q

What are the side effects of Enrofloxacin in cats?

A

Retinal damage or brain damage in cats and cartilage damage in puppies

138
Q

What are the side effects of Penicillin?

A

Anaphylaxis
Skin reaction
GI disease (Vomiting and diarrhea)

139
Q

How do you prevent Canine infectious respiratory disease complex?

A

Avoid places where the dog could be infected
Vaccination
Sanitation
Ventilation in kennels

140
Q

What are the different types of vaccination for Canine infectious respiratory disease complex?

A

Parenteral vaccination

Intranasal vaccination

141
Q

How is Canine influenza transmitted?

A

Direct contact

Fomites

142
Q

What are the clinical signs of Canine Influenza?

A 
Coughing 
Sneezing
Nasal discharge 
Fever
Hemorrhagic pneumonia
143
Q

How do you diagnose Canine Influenza?

A

PCR
Serology
Viral Isolation

144
Q

What are the two forms of Canine Influenza?

A

Mild/uncomplicated

Severe/complicated

145
Q

What are the clinical signs of Severe/complicated Canine Influenza?

A

Pyrexia

Hemorrhagic pneumonia

146
Q

What is the treatment for Canine Influenza?

A

Supportive care
NSAIDs
Systemic antibiotics

147
Q

What is the prevention of Canine Influenza?

A

Vaccination
isolate sick and exposed dogs
change clothes/wash hands

148
Q

What is the life cycle of Oslerus osleri?

A

Larvae are ingested
Molt in the small bowel and migrate to the lungs, bronchi and trachea
Cream colored nodules in the trachea

149
Q

What are the clinical signs of Oslerus osleri?

A

Coughing
Wheezing
dyspnea

150
Q

How do you diagnose Oslerus Osleri?

A

Radiographs
Bronchoscopy
tracheal/bronchial brushes or biopsies
fecal examination

151
Q

What is the treatment for Oslerus Osleri

A

Fenbendazole

Ivermectin

152
Q

What animals are predisposed to Tracheal collapse?

A

Middle aged to older dogs

Toy or small breed dogs

153
Q

Tracheal collpase

A

Weak cartilage with flattening of tracheal rings, resulting in mechanical irritation, edema, and inflammation

154
Q

What is the clinical signs of Tracheal collapse?

A 
Goose honking cough 
Exacerbated by excitement, exercise and eating 
Elicited with tracheal palpation 
causes cyanosis and collapse/syncope
hepatomegaly 
cardiac murmur
155
Q

What is the best diagnostic tool for tracheal collapse?

A

Bronchoscopy

156
Q

What are the problems with a stint for tracheal collapse?

A

Can Fail
Predisposed to infection
Expensive

157
Q

What is the treatment for tracheal collapse?

A 
Sedation 
Oxygen therapy 
Cough suppressant 
Corticosteroid 
intubation 
Antibiotics for secondary infection
158
Q

What should you avoid in tracheal collapse?

A

Avoid neck collars
Avoid excitement
Avoid dust, smoke, pollens, carpet powders

159
Q

What are the surgical interventions for tracheal collapse?

A

Extraluminal stents

Endoluminal stents

160
Q

Canine chronic bronchitis

A

Inflammation of the bronchial walls that results in thickened walls, increased mucous which results in obstruction of small airways

161
Q

What are the clinical signs of Canine Chronic bronchitis?

A

Daily cough for longer than 2 months
Expiratory wheezes
audible crackles
exercise intolerance

162
Q

What is the long term sequelae to Canine chronic bronchitis?

A

Emphysema
bronchiesctasis
pneumonia

163
Q

What is the signalment for Canine Chronic bronchitis?

A

Obese Small breeds usually less than 6 years old

164
Q

What is used for diagnosis for Canine Chronic bronchitis?

A

radiographs
bronchoscopy
bronchial cytology
culture

165
Q

What is the treatment for Canine Chronic bronchitis?

A 
Eliminate triggers
Keep hydrated
Reduce weight if obese
Prednisolone
Bronchodilators
Antibiotics
Avoid cough suppressants
166
Q

Bronchiectasis

A

Damage to the bronchial structure resulting in a thickened wall and dilation of the structure
Mucous cannot be cleared so it builds up
dilation of the bronchial tree is irreversible caused by the destruction of the muscle ad elastic tissue

167
Q

What is the differential list for Felines presenting with a cough, wheeze, or respiratory distress?

A 
Pulmonary parasites
Heartworm 
Bacterial or viral bronchitis
Toxoplasmosis 
Idiopathic pulmonary fibrosis 
Neoplasia - carcinoma
Aspiration pneumonia 
Idiopathic feline bronchitis/asthma 
Chronic bronchitis
168
Q

Asthma

A

Bronchial constriction

169
Q

What are the clinical signs of Idiopathic feline bronchitis?

A 
Chronic or intermittent cough 
acute respiratory distress
Open mouth breathing 
audible wheezing
Wheezes
Crackles
Increased expiratory effort
170
Q

How do you diagnose Idiopathic feline bronchitis?

A

First tier:
Radiograph
CBS
Fecal examination

Second tier:
Transtracheal wash/bronchoscopy
Cytology/culture

171
Q

What can be found on Radiographs for Idiopathic feline bronchitis?

A

Bronchial pattern
Reticular interstitial and patchy alveolar opacities
Hyperinflation
flattening of the diaphragm

172
Q

Air-trapping

A

constriction of small airways does not allow inspired to be exhaled and lungs overinflate

173
Q

What do you find on bronchoscopy for Idiopathic feline bronchitis?

A

Mucosal hyperemia
Increased mucous
Perform broncho-alveolar lavage

174
Q

What do you see on cytology with Idiopathic feline bronchitis asthma?

A

increased eosinophils or neutrophils and mixed inflammation

175
Q

What do you see on cytology with Idiopathic feline bronchitis in infectious patients?

A

degenerative neutrophils and/or intracellular bacteria

176
Q

What is the treatment for Idiopathic feline bronchitis?

A

No stress
oxygen rich environment
Rapid acting corticosteroid
Bronchodilator choices: albuterol, terbutaline

177
Q

What is the long term management for Idiopathic feline bronchitis?

A
  1. Environmental management: Improve indoor air quality r Eliminate potential allergens/irritants
  2. Anti-inflammatories - glucocorticoids
178
Q

What are the advantages of Metered Dose inhaler?

A

Minimize systemic corticosteroid side effects
Easier to treat
high drug concentration delivered to the lungs

179
Q

What are the disadvantages of Metered Dose Inhaler?

A

Increase risk of dental disease
Re-emergence of a latent herpesvirus infection
Local dermatitis

180
Q

What are other possible long-term treatment for Idiopathic feline bronchitis?

A

Oral bronchodilator: Terbutaline or Albuterol oral

Antibiotics: Doxycycline, Chloramphenicol, or azithromycin

181
Q

What is the prognosis for Idiopathic feline bronchitis?

A

Long term medical treatment needed

If untreated: permanent changes of chronic bronchitis with irreversible damage (fibrosis) and emphysema

182
Q

Feline chronic bronchitis

A

Chronic airway inflammation typically in older cats

183
Q

What is Feline chronic bronchitis characterized by?

A

Neutrophilic inflammation
Mucosal edema
Mucus gland hypertrophy
Excessive mucus production

184
Q

What are the clinical signs of Feline Chronic bronchitis?

A

Same as asthma

Coughing daily

185
Q

What does the management of Feline Chronic Bronchitis focus on?

A

Control of inflammation using glucocorticoids

186
Q

What are the clinical signs of Pulmonary disease?

A 
Difficulty breathing 
Increased rate and effort
Coughing 
Exercise intolerance
abnormal pulmonary sounds
abnormal posture - Orthopnea
187
Q

What is the most common cause of Inflammatory disease in dogs?

A

Bacterial

188
Q

What is pneumonia characterized by?

A

soft ineffectual cough

189
Q

What are the clinical signs of pneumonia?

A 
soft ineffectual cough 
dyspnea
tachypnea
cyanosis
nasal discharge
exercise intolerance
pyrexia 
lethargy 
anorexia
190
Q

What are the most common bacteria in primary bacterial pneumonia in young dogs?

A

Bordetella spp.

Pasteurella spp.

191
Q

How do you diagnose Bacterial pneumonia?

A

Hematology - left shift neutrophilic leucocytosis and Monocytosis
Thoracic radiographs - interstitial pattern, alveolar pattern
Transtracheal/endotracheal wash
cytology
culture
Bronchoscopy with bronchoalveolar lavage

192
Q

What do you find on cytology with Bacterial pneumonia?

A

Degenerative neutrophils/monocytes

Intracellular bacteria

193
Q

What can bacterial pneumonia result in?

A

Sepsis which can lead to ALI and ARDS

194
Q

What is the treatment for Bacterial pneumonia?

A

Antibiotics: Begin with injectable therapy and then change to oral medications
Nebulisation: sterile saline + gentamycin
Supportive Care: IV fluids, oxygen theapy, and coupage

195
Q

What are the Respiratory clinical signs for Mycotic pneumonia?

A 
Abnormal respiratory pattern 
Tachypnea
Cough 
Exerrcise intolerance
Systemic signs: inappetance, weight loss, fever, lameness, lymphadenopathy, chorioretinitis or anterior uveitis, draining fistula tracts
196
Q

How do you diagnose Mycotic pneumonia?

A

Urine or serum antigen titers

Cytology/histopathology (biopsy)

197
Q

What is the treatment for Mycotic pneumonia?

A

Depends on fungal sensitivity
Polyene antifungals: amphotericin B
Triazoles: itraconazole, posaconazole, voriconazole, fluconazole
Imidazoles: clotrimazole, ketaconazole

198
Q

What is the geographic location for Coccidiomycosis?

A

Arizona

199
Q

What is the geographic location for Blastomycosis/ Histoplasmosis?

A

Ohio River Valley area

200
Q

Where do you take cytology for mycotic pneumonia?

A 
Lymph nodes
draining lesions 
TTW
ETW
BAL 
pulmonary aspirate
201
Q

What is the treatment for Mycotic pneumonia?

A

Oral medications: Itraconazole, Posaconazole, Voriconasole
IV/SC medications: Amphotericin B
Lipid complex form

202
Q

What is the side effect of Amphotericin B?

A

Nephrotoxic

203
Q

What is the problem with treatment for mycotic pneumonia?

A

Expensive and long term - 4 to 12 months

204
Q

What is the prognosis for Mycotic pneumonia?

A

Depends on how disseminated the infection is
Poorer prognosis if the CNS is involved
80% of Blastomycosis or cryptococus is effectively treated
60% with coccidiomycosis recover

205
Q

What is the geographic location for Blastomycosis?

A

Mississippi, Missouri and Ohio river valley area

206
Q

What is the mode of infection for Blasto?

A

Inhalation of spores

207
Q

What are the clinical signs of Blasto?

A 
No clinical signs 
Fever
Emaciated 
Lymphadenopathy
Dry harsh cough 
exercise intolerance
ocular lesions 
skin lesions: areas of redness to granulomas
bone lesions
208
Q

How do you diagnose Blasto?

A

Radiographs
Hematology: Chronic anemia, leukocytosis, left shift, lymphopenia, hyperglobulinemia, hypercalcemia
Cytology or Histopathology
Serology: AGID test, Radioimmunoassay, ELISA, PCR

209
Q

What are the pathological findings of Blasto?

A

Pyogranulomatous lesions

210
Q

What is the treatment for Blasto?

A

Amphotericin B IV

Triazole - Itraconozole

211
Q

Where is Histoplasmosis found?

A

In bird or bat feces

212
Q

What are the clinical signs of Histoplasmosis disseminated disease in cats?

A 
Mental depression 
weight loss 
fever anorexia 
pale mucous membranes 
dyspnea 
tachypnea
abnormal lung sounds
213
Q

What are the clinical signs of Histoplasmosis disseminated disease in dogs?

A 
Inappetance
weight loss
fever 
unresponsive to antibiotics 
dyspnea 
coughing
abnormal lung sounds
214
Q

What laboratory findings do you find with Histo?

A

Chronic anemia
Thrombocytopenia
Hypoalbuminemia

215
Q

How do you diagnose Histo?

A

Radiographs
Ultrasound
Cytology
Histopathology

216
Q

Where do you find Histo?

A

in mononuclear-phagocyte system

217
Q

What is the therapy of choice for Histo?

A

Itraconazole

218
Q

What is the treatment for Histo?

A

Itraconazole
Fluconazole
Voriconazole and posaconazole
Amphotericin B

219
Q

Where do you find Cryptococcus?

A

Avian droppings

220
Q

What are the clinical findings of Cryptococcus in cats?

A 
Chronic infection 
Bilateral nasal discharge
snuffly
Firm to flocuant swelling over the bridge of the nose 
Lymphadenopathy 
Neurological signs
221
Q

What are the clinical findings of Cryptococcus in dogs?

A

neurological signs

222
Q

How do you diagnose Cryptococcosis?

A 
Hematology
Cytology: Nasal swab, nasal wash, FNA, BAL, pleural fluid, CSF, urine 
Tissue biopsy
Fungal isolation
Serology: Serum and CSF
Latex agglutination procedure Test 
PCR
223
Q

What is the treatment for Cryptococcus?

A

Surgery
Amphotericin B (8-9 months)
Itraconazole

224
Q

Where do you find Coccidiomycosis?

A

Dry environment - SW USA

“Valley Fever”

225
Q

What are the clinical signs of Coccidiomycosis for dogs?

A 
Dry harsh cough
hilar lymphadenopathy 
diffuse pulmonary interstitial disease
fever
anorexia 
weight loss
weakness
lameness
226
Q

What is the clinical signs of Coccidiomycosis in cats?

A 
Dry harsh cough
hilar lymphadenopathy 
diffuse pulmonary interstitial disease
fever
anorexia 
weight loss
weakness
lameness

Cutaneous lesions!!

227
Q

How do you diagnose Coccidiomycosis?

A 
Hematology: Non-regenerative anemia, left shift neutrophilia and monocytosis, eosinophilia 
Thoracic radiographs: diffuse interstitial pattern, Milliary to nodular interstitial densities, Solitary nodules, Hilar lymphadenopathy
Imaging: Ultrasound, MRI
Cytology or Histopathology 
Fungal culture
Serology 
Latex agglutination 
AGID test 
ELISA test
228
Q

What is the treatment for Coccidiomycosis?

A

3-6 months of Ketoconazole, Itraconazole, or fluconazole

229
Q

What is the prognosis for Coccidiomycosis?

A

Good for respiratory disease

Poor for disseminated disease

230
Q

Where do you find aelurostrongylus abstrusus?

A

Feces

231
Q

What kind of egg do Paragonimus kellicoti have?

A

Operculated egg

232
Q

How do you find on hematology for aelurostrongylus abstrusus?

A

Eosinophilia

233
Q

What do you find on Thoracic radiographs for aelurostrongylus abstrusus?

A

DIffuse nodular densities in the caudal lobes

234
Q

What do you find on TTW/BAL with aelurostrongylus abstrusus?

A

Increased number of eosinophils and or larvae

235
Q

What is the treatment for aelurostrongylus abstrusus?

A

Fenbendazole (for 10 days)

Ivermectin ( given once every 2 weeks)

236
Q

What are the clinical signs for Paragonimus spp.?

A

Cough
Wheeze
respiratory distress

237
Q

What do you find in the lungs with Paragonimus spp. ?

A

Cysts in the lungs

238
Q

What happens if the cysts of Paragonimus spp. rupture?

A

pneumothorax

239
Q

How do you diagnose Paragonimus spp.?

A

CBC: eosinophilia
Thoracic radiographs with cysts present
TTW/BAL
Fecal float with operculated egg

240
Q

What is the life cycle for Paragonimus spp. ?

A

Egg is shed in the feces and then eaten by a snail and then a crustacean which is eaten by the Dog

241
Q

Idiopathic pulmonary fibrosis - progressive interstitial fibrosis

A

Chronic fibrosis of the lung interstitium characterized by infiltration of fibroblasts

242
Q

What is the signalment for Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?

A

Middle or older Terrier - West Highland Terrier

243
Q

What are the clinical signs of Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?

A

Respiratory distress
tachypnea
Coughing increased with progression
Weight loss in cats

244
Q

How do you diagnose Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?

A 
Inspiratory crackles on auscultation 
Thoracic radiographs: generalized or diffuse interstitial pattern 
Arterial blood gas: Hypoxemia 
TTW/BAL 
Lung FNA aspirate
Lung biopsies
245
Q

What provides a definitive diagnosis for Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?

A

Lung biopsies

246
Q

What is the treatment for Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?

A

Corticosteroids

Cyclophosphamide or azathioprine

247
Q

What is the prognosis of Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?

A

Guarded

Progressive respiratory failure

248
Q

What is the primary pulmonary neoplasia?

A

Adenocarcinoma

Squamous cell carcinoma

249
Q

What are the metastatic pulmonary neoplasia?

A

Adenocarcinoma
Osteosarcoma/chondrosarcoma
Hemangiosarcoma/ oral or digital melanoma

250
Q

What are the multicentric pulmonary neoplasia?

A

Lymphoma

251
Q

What are the clinical signs for Pulmonary neoplasia?

A 
Crackles 
wheezes
muffled sunds
cough 
dyspna
tachypnea
hemoptysis 
weight loss
lameness
dysphagia 
regurgitation 
edema of the head/neck
252
Q

How do you diagnose pulmonary neoplasia?

A

Thoracic radiogaphs

Cytology: FNA, Bronchoscopy, Biopsy

253
Q

What is the treatment for pulmonary neoplasia?

A

Surgical removal

Chemotherapy

254
Q

What is the prognosis for pulmonary neoplasia?

A

Guarded to poor

Solitary mass or benign mass - good with surgical removal

255
Q

What are the prognostic factors for pulmonary neoplasia?

A

Benign is better than malignant
Primary better than metastatic
Adenocarcinoma better than SCC
Small tumors are better than large tumors
Tumors involving one lobe better than multiple lobes

256
Q

Pulmonary edema

A

Accumulation of fluid in alveoli or pulmonary interstitium

257
Q

What are the four mechanisms of Non-cardiogenic pulmonary edema?

A

Vascular overload/ increased hydrostatic pressure
Decreased plasma oncotic pressure
Increased alveolar capillary membrane permeability
Lymphatic obstruction

258
Q

What do you see on thoracic radiographs with Non-cardiogenic pulmonary edema?

A

Bilateral Alveolar pattern

259
Q

What is the treatment for Non-cardiogenic pulmonary edema?

A 
Aggressive control of primary disease
Cage rest
oxygen therapy 
supportive care
PPV if required
260
Q

What is the prognosis for Non-cardiogenic pulmonary edema?

A

Guarded with permeabiluty edema pathogenesis

Better when there is no fluid overload or renal function is intact

261
Q

ALI

A

Acute Lung Injury

262
Q

Acute Lung Injury - ALI

A

pulmonary inflammation and edema resulting in acute respiratory failure

263
Q

ARDS

A

Acute Respiratory distress syndrome

264
Q

Acute Respiratory distress syndrome - ARDS

A

severe manifestation of ALI, Hypoxemia is worse

265
Q

What is ALI/ARDS most commonly secondary to?

A

Sepsis
systemic inflammatory distress syndrome
shock
bacterial pneumonia

266
Q

What do you find on Thoracic auscultation with Pulmonary contusions?

A

Crackles

267
Q

What is the concurrent pathology with trauma from Pulmonary contusions?

A 
Pneumothorax/hemothorax
Herniation 
Myocarditis
Rib fractures
hypotension
268
Q

What is the treatment for Pulmonary contusions?

A

Oxygen therapy
IV fluids
Pain medication for trauma

269
Q

Eosinophilic bronchopneumopathy

A

Inflammation of the lungs - thought to be due to hypersensitivity to some unknown antigen

270
Q

What are the possible causes of Eosinophilic bronchopneumopathy?

A 
Heartworm 
Lung parasites
drugs
inhaled allergens
neoplasia
fungal or bacterial infections
271
Q

What is the signalment for Eosinophilic bronchopneumopathy?

A

Young or middle aged Siberian Huskies

272
Q

What are the clinical signs of Eosinophilic bronchopneumopathy?

A

Harsh cough
Progressive respiratory difficulty
exercise intolerance
nasal discharge or anorexia/lethargy

273
Q

How do you diagnose Eosinophilic bronchopneumopathy?

A

thoracic auscultation: Harsh, crackles, expiratory wheezes, Tracheal palpation may elicit a moist productive cough
Hematology: increased neutrophils and eosinophils
Thoracic radiographs: DIffuse bronchointerstitial pattern, alveolar infiltrates, bronchiectasis
Cytology: TTW, BAL, endotracheal wash with eosinophils predominate

274
Q

What is the treatment for Eosinophilic bronchopneumopathy?

A

Fenbendazole

Corticosteroids

275
Q

What is Pulmonary Thromboembolism (PTE) associated with?

A 
Heartworm 
Immune-mediated hemolytic anemia 
Nephrotic syndrome 
Hyperadrenocorticism - hypercoagulability 
Pancreatitis
DIC 
Endocarditis
276
Q

What is the treatment for Pulmonary Thromboembolism (PTE)?

A 
Oxygen supplementation 
No stress
treat underlying diease
Bronchodilators
Prednisolone in IMHA and heartworm
277
Q

What is the prognosis for Pulmonary Thromboembolism (PTE)?

A

Poor to grave

278
Q

What are the respiratory signs of Pleural effusion and pneumothorax?

A 
Rapid shallow breathing
Dyspnea
Open mouth breathing 
Cyanosis
Exercise intolerance
anorexia and lethargy
279
Q

What do you find on physical exam with Pleural effusion and pneumothorax?

A

Pyrexia
Barrel-shaped chest with pneumothorax
Muffled heart sounds and diminished/muffled lung sounds ventrally

280
Q

What causes Dorsal increased lung sounds?

A

Pleural effusion

281
Q

What causes Dorsal decreased lung sounds?

A

pneumothorax

282
Q

Pleural effusion

A

Accumulation of excessive amounts of fluid within the pleural space (cavity)

283
Q

What causes an accumulation of Transudate of fluid within the pleural space (cavity)?

A

Congestive Heart Failure

284
Q

What causes an accumulation of exudate of fluid within the pleural space (cavity)?

A

Pyothorax

285
Q

What causes an accumulation of hemorrhage of fluid within the pleural space (cavity)

A

Trauma

286
Q

What are mechanisms of fluid accumulation?

A

Decreased oncotic pressure - hypoalbuminemia
Increased hydrostatic pressure - CHF
Increased capillary membrane permeability - inflammation due to FIP, neoplasia, pyothorax
Lymphatic malfunction - obstruction or lymphanglectasia

287
Q

What is the treatment for Pleural effusion?

A

Thoracocentesis

288
Q

What is the cause of pyothorax in dogs?

A

Secondary to inhaled foreign bodies or penetrating injury, pneumonia

289
Q

What is the cause of pyothorax in cats?

A

Secondary to penetrating bite wounds, oropharyngeal aspiration or URTI

290
Q

How do you diagnose Pyothorax?

A

Cytology - degenerative neutrophils/bacteria

Culture

291
Q

What is the treatment for Pyothorax?

A

Drainage and lavage through thoracotomy tube
Lavage
Long term antibiotics based on culture or cytology

292
Q

What antibiotic treats anaerobes?

A

Metronidazole

293
Q

What antibiotics are used to treat Gram negatives from cat bites?

A

Enrofloxacin

294
Q

What can cause accumulation of Chyle in pleural space?

A 
Trauma 
Neoplasia
Cardiac disease
Thoracic duct lymphangiectasia
Inflamamtion 
Lung lobe torsion 
Idiopathic
295
Q

What color is Chyle?

A

White to pink opaque

296
Q

How do you diagnose Chylothorax?

A

Thoracocentesis

297
Q

What is the treatment for Chylothorax?

A

Thoracic drainage
Low fat diet
Rutin
Ligation of thoracic duct

298
Q

Rutin

A

decreases inflammation in the lymphatics and increases reabsorption of fat from the macrophages

299
Q

What is the sequale to chylothorax?

A

Restrictive pleuritic

300
Q

What would the pleural fluid look like with FIP?

A

High protein content with some macrophages in the fluid

301
Q

What is the most common tumor affecting the pleural space?

A

Mesothelioma

302
Q

What does Chronic inflammation result in?

A

hyperplastic changes to mesothelial cells

303
Q

What is the most common etiology of pneumothorax?

A

Traumatic (blunt force trauma)

304
Q

What is the cause of Non-traumatic/spontaneous closed pneumothorax?

A 
Tumors
abscesses
pneumonia 
paragonimus
chronic bronchitis
asthma 
heartworm 
idiopathic bullae formation
305
Q

What is the cause of traumatic open pneumothorax?

A

Gunshots
Bites
stab wounds
rib fractures

306
Q

What is the cause of traumatic closed pneumothorax?

A

HBC

complication of lung aspirate

307
Q

How do you diagnose pneumothorax?

A

Thoracocentesis

Imaging

308
Q

What are the findings on a radiographs for pneumothorax?

A

Absence of pulmonary vasculature to chest wall
Dorsal displacement of the heart and trachea
Retraction of the lung from the chest wall
Increased density in collapse lobe

309
Q

What is the treatment of pneumothorax?

A

Emergency thoracocentesis
Analgesia
Oxygen therapy
surgical intervention

310
Q

What are the indications for chest tube or drain?

A

Pyothorax

Pneumothorax

311
Q

Transudate

A

Transparent, low proteins and cells

312
Q

Modified transudate

A

serosanguinous suggest an obstructive effusion: CHF, lung lobe torsion, neoplasia, diaphragmatic hernia

313
Q

Exudate

A

red to brown to yellow to opaque

suggestive of inflammation, high proteins and cells

314
Q

Septic exudate

A

pyothorax

315
Q

Non-septic exudate

A 
FIP
Chylothorax
Bilothorax
neoplasia
lung torsions

RUSVM Small Animal Medicine I 2016 (9 decks)

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