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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
Paroxysmal cough
a sudden intermittent condition
26
Tracheal disorders
``` Tracheal collapse Hypoplastic trachea infectious tracheobronchitis Canine infectious influenza Perihilar lymphadenopathy Heart bas tumor ```
27
Panting
dissipates heat normal in a dog associated with stress or respiratory distress in cats
28
Dyspnea
difficult or labored breathing
29
Tachypnea
Increased respiratory rate | May or may not be associated with respiratory distress
30
Orthopnea
Difficulty breathing when not in the upright position | Animals will stand with their forelimbs abducted
31
What is orthopnea common with?
Pleural disease
32
What is the cause of Respiratory Distress?
``` Insufficient oxygen in inspired air Insufficient ventilation Insufficient circulation Insufficient erythrocytes Abnormal or low hemoglobin concentrations ```
33
What are the causes of cyan colored mucous membranes?
``` Lack of oxygen Abnormal hemoglobin - toxins Cardiac disease Pulmonary disease Cardiopulmonary arrest ```
34
What are normal lung sounds?
bronchovesicular
35
Where are Bronchial lung sounds heard?
loudest over the hilus during expiration
36
Where are vesicular lung sound heard?
loudest on inspiration at the periphery of the lungs, normal air filling lungs "rustling of leaves" very soft sounds
37
Crackles
snapping open of the airways that have closed due to fluid in or around them
38
Wheezes
causes by airflow through a narrow opening - airways are constricted/narrowed
39
Snaps
loud snap over hilus at end of expiration indicates collapse of the intrathoracic trachea, carina or mainstem bronchi
40
Goose honks
sound with tracheal collapse
41
Pleural friction rubs
creaking/grating sound due to roughened pleural surfaces rubbing against each other
42
Pleural disease
Pleural effusion | Pneumothorax
43
Pleural effusion
Lungs sounds are auscultated dorsally Lungs floating in fluid Muffled sounds ventrally Heart sounds are also reduced
44
Pneumothorax
Absence of lung sounds dorsally due to compression | likely present in the ventral field
45
How do you distinguish between a fluid or air density?
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
46
When is Rhinoscopy performed?
after imaging
47
When would you perform a Nasal Flush?
Foreign body suspect
48
What does Bronchoscopy evaluate?
Larynx Trachea Bronchi
49
What are the indications for a Bronchoalveolar lavage?
Lung Disease involving small airway
50
What is a landmark for Transtracheal wash and aspirate?
Cricothyroid ligament
51
What are the indications for a Transthoracic lung aspiration?
Intra-thoracic mass lesions in contact with thoracic wall
52
What is a chest tube used to treat?
Pyothorax
53
Bronchodilators
usually for bronchitis
54
When do you use anti-tussives?
in dogs with dry & non-productive cough due to airway collapse or irritant tracheitis
55
Nebulization
improves hydration of lower airways
56
What are the indications for oxygen?
to treat hypoxemia | to decrease workload of heat and lungs
57
What are the methods for oxygen treatment?
Face mask Nasal catheter Cage Intratracheal
58
What are the differential diagnosis for nasal discharge?
Neoplasia Rhinitis Nasal Foreign Body Dental Disease/ oronasal fistulas Trauma Congenital: Cilliary dyskinesis or Nasopharyngeal stenosis Systemic disorder: Coagulopathy or Pneumonia
59
What is the most common neoplasia of the nose?
Nasal Adenocarcinoma
60
What are the potential infectious agents that cause Feline upper respiratory disease complex?
``` Feline herpes virus Feline calicivirus Chlamydophila felis Mycoplasma spp. Coronavirus Bordetella spp ```
61
What do you see with Feline Herpes virus?
Ulcerative keratitis | punctate or dendritic ulcers
62
What do you see with Calicivirus?
ulcers on the nose, tongue, or hard palate, pneumonia, lameness
63
What do you see with Chlamydophila felis?
conjunctivitis with chemosis
64
How is feline herpes virus spread?
Direct contact | fomites
65
Where is Feline herpes virus shed?
Ocular secretions Nasal secretions pharyngeal secretions
66
How do you diagnose Feline Herpes virus?
Clinical signs viral isolation PCR
67
Epiphora
Fibrosis of the lacrimal ducts
68
What is the treatment for Feline Herpes Virus?
Topical antivirals: Idoxuridine, trifluridine, cidofovir Oral antivirals: Famciclovir, acyclovir Supportive care
69
What is the route for the Feline herpes virus vaccine?
Parental | Intranasal
70
Parental Feline Herpes Virus Vaccine
blocked by maternal antibodies does not prevent a carrier state
71
Intranasal Feline Herpes Virus Vaccine
Not blocked by maternal antibodies
72
Calicivirus
High mutation rate | Direct transmission or via fomites
73
What is the incubation period of Calicivirus?
2-4 days
74
What are the clinical signs of Calicivirus?
Oral and nare ulcers | Feline viral rhinotracheitis
75
How is FCV different from FHV?
Pneumonia is more common with FCV FCV can result in gastrointestinal signs FCV can cause lameness Causes polyarthritis
76
What are two other syndromes associated with FCV?
Limping Kitten syndrome | Virulent hemorrhagic systemic syndrome
77
What are the clinical signs of Limping Kitten Syndrome?
Lameness Ulcers on paws sore joints polyarthritis
78
Virulent hemorrhagic syndrome
``` Edema Hepatitis diarrhea pustular dermatitis hemorrhagic cystitis ```
79
What is the treatment for Feline Calicivirus?
Supportive: Antibiotics, Nursing care/rehydration
80
What is the sequelae to Feline Calicivirus?
Chronic rhinitis/sinusitis/conjunctivitis | Carrier state
81
Why is Interferon helpful with Feline Calicivirus?
It switches on the TH1 cell mediated response
82
What are the clinical signs of Chlamydophila felis?
Conjunctivitis | Chemosis
83
How do you diagnose Chlamydophila felis?
PCR | Cytology
84
What is the treatment for Chlamydophila felis?
Topical tetracylines or erythromycin | Systemic signs require oral doxycycline and azithromycin
85
How do you prevent Chlamydophila felis?
Vaccination
86
What is the treatment for cat flu?
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
87
What type of nasal discharge comes with bacterial rhinitis?
Mucopurulent or purulent nasal discharge
88
What causes Fungal rhinitis in dogs?
Aspergillus fumigatus
89
What causes fungal rhinitis in cats and dogs?
Cryptococcus neoformans var. neoformans
90
Where is Cryptococcus neoformans var. neoformans found?
Pigeon droppings
91
Where is Cryptococcus neoformans var gattii found?
eucalyptus trees
92
What does aspergillus cause in the dog?
Sneezing unilateral/bilateral nasal discharge Facial distortion Turbinate destruction Nasal ulceration and depigmentation
93
What do you see on Rhinoscopy with Nasal Aspergillosis?
White plaques
94
What do you see on Tissue biopsy or cytology with Nasal Aspergillosis?
Hyphae
95
What is the treatment for Nasal Aspergillosis?
Debridement | Infused 1% clotrimazole or 2% eniloconazole into nasal cavity for 1 hour
96
What is the risk assocaited with treatment of aspergillosis?
Aspiration pneumonia | neurologic signs
97
What is a contraindication for treatment of aspergillosis?
damages cribiform plate
98
What are the systemic fungal medications used for the treatmetnt of Aspergillosis?
Itraconazole Posaconazole Vorixonazole
99
What is the transmission of Pneumonyssus caninum?
Direct
100
Where do Pneumonyssus caninum live?
Nasal cavities | Sinuses
101
How do you diagnose Pneumonyssus caninum?
Visualize the mites in nasopharynx or nasal cavity
102
What is the treatment for Pneumonyssus caninum?
Ivermectin Milbemycin Selamectin
103
Lymphoplasmacytic rhinitis
Chronic inflammatory rhinitis characterized by lymphocytic and plasmacytic infiltration into the nasal mucosa in the absence of any obvious underlying etiology
104
What are the clinical signs of Lymphoplasmacytic rhinitis?
Unilateral or bilateral nasal discharge but can be seroud or even hemorrhagic sneezing ocular discharge reverse sneezing stertor
105
How do you diagnose Lymphoplasmacytic rhinitis?
CT/MRI Destruction of the nasal septum, frontal sinus, cribiform plate Rhinoscopy Biopsy
106
What do you see on Rhinoscopy with Lymphoplasmacytic rhinitis?
Hyperaemic edematous mucosa easily traumatised and bleeds turbinates are atrophied or destroyed
107
What is the treatment for Lymphoplasmacytic rhinitis?
``` avoid any smoke Nasal steroids Long term doxycycline Long term itraconazole Saline nasal flushes or hypertonic saline Maropitant ```
108
Substance P
a neuropeptide secreted by nerves and inflammatory cells
109
What is the mechanism of action for Cerenia?
Blocks substance P
110
What are the clinical signs of Nasal neoplasia?
``` 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 ```
111
Epiphora
discharge from the eye
112
How do you diagnose Nasal neoplasia?
``` Fine needle aspirates of draining lymph nodes Radigraphy CT/MRI Nasal discharge cytology Rhinoscopy Nasal biopsy ```
113
What is treatment of Nasal Neoplasia?
Surgery Radiation Chemotherapy
114
What is the treatment of choice for most nasal neoplasia?
Radiation
115
What is chemotherapy useful in the treatment of?
Lymphoma
116
What is the prognosis for nasal neoplasia?
3-6 months
117
What are the most common nasal neoplasia in dogs?
Adenocarcinoma | Squamous cell carcinoma
118
What are the most common nasal neoplasia in cats?
Lymphoma | Adenocarcinoma
119
Ciliary dyskinesia
Immotile ciliary syndrome Inherited autosomal recessive trait Poor clearance of mucous from the airways chronic mucous plugging and inflammation
120
What are the clinical signs of Primary ciliary dyskinesia?
rhinosinusitis bronchitis bronchopneumonia bronchiectasis
121
How do you diagnose Primary Ciliary dyskinesia?
Biopsy or brush swab Culturing Electron microscopy
122
T/F? Nasal Neoplasia can result in exophthalmia, facial distortion, and sneezing?
True
123
T/F? The main clinical sign associated with nasal mites is sneezing?
True
124
T/F? Nasal aspergillus does not respond to systemic antifungal therapy?
False
125
T/F? "Wisp of cotton" in front of nares could indicate obstructive process if "wisp" does not move with dog's breath?
True
126
What are the clinical signs of Tracheobronchial disease?
``` Cough Retch/gag Wheezing Inspiratory sounds Tachypnea Respiratory distress Cyanosis ```
127
What pathogens are responsible for Canine infectious respiratory disease complex?
``` Parainfluenza virus Canine adenovirus Mycoplasma spp. Bordetella spp. Canine distemper virus Canine respiratory coronavirus canine herpes virus canine influenza virus ```
128
Bordetella spp. mechanism of action
Attaches to the cilia of bronchial epithelium and interferes with motility resulting in mucous accumulation and inflammation
129
Transmission of Canine infectious respiratory disease complex?
Spread in respiratory secretion and fomites
130
What is the incubation of Canine infectious respiratory disease complex?
3-7 days
131
What is the clinical sign of Canine infectious respiratory disease complex?
Coughing
132
Clinical signs of Uncomplicated Canine infectious respiratory disease complex?
Non-sick animals that involves the upper airways. Cough elicited on tracheal palpation. Seroud oculonasal discharge gagging and retching can be found
133
Clinical signs of complicated Canine infectious respiratory disease complex?
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
How do you diagnose Canine infectious respiratory disease complex?
``` Hemogram Thoracic radiographs Transtracheal wash cytology culture PCR panels for upper respiratory viruses and bacteria ```
135
What is the treatment for uncomplicated Canine infectious respiratory disease complex?
Restrict exercise use doxycycline if bordetella is suspected usually resolves within 2 weeks Cough Suppressants
136
What is the treatment for complicated Canine infectious respiratory disease complex?
``` Restrict exercise Systemic antibiotics for 2 weeks - Doxycycline Nebulisation Cough supressants Bronchodilators ```
137
What are the side effects of Enrofloxacin in cats?
Retinal damage or brain damage in cats and cartilage damage in puppies
138
What are the side effects of Penicillin?
Anaphylaxis Skin reaction GI disease (Vomiting and diarrhea)
139
How do you prevent Canine infectious respiratory disease complex?
Avoid places where the dog could be infected Vaccination Sanitation Ventilation in kennels
140
What are the different types of vaccination for Canine infectious respiratory disease complex?
Parenteral vaccination | Intranasal vaccination
141
How is Canine influenza transmitted?
Direct contact | Fomites
142
What are the clinical signs of Canine Influenza?
``` Coughing Sneezing Nasal discharge Fever Hemorrhagic pneumonia ```
143
How do you diagnose Canine Influenza?
PCR Serology Viral Isolation
144
What are the two forms of Canine Influenza?
Mild/uncomplicated | Severe/complicated
145
What are the clinical signs of Severe/complicated Canine Influenza?
Pyrexia | Hemorrhagic pneumonia
146
What is the treatment for Canine Influenza?
Supportive care NSAIDs Systemic antibiotics
147
What is the prevention of Canine Influenza?
Vaccination isolate sick and exposed dogs change clothes/wash hands
148
What is the life cycle of Oslerus osleri?
Larvae are ingested Molt in the small bowel and migrate to the lungs, bronchi and trachea Cream colored nodules in the trachea
149
What are the clinical signs of Oslerus osleri?
Coughing Wheezing dyspnea
150
How do you diagnose Oslerus Osleri?
Radiographs Bronchoscopy tracheal/bronchial brushes or biopsies fecal examination
151
What is the treatment for Oslerus Osleri
Fenbendazole | Ivermectin
152
What animals are predisposed to Tracheal collapse?
Middle aged to older dogs | Toy or small breed dogs
153
Tracheal collpase
Weak cartilage with flattening of tracheal rings, resulting in mechanical irritation, edema, and inflammation
154
What is the clinical signs of Tracheal collapse?
``` Goose honking cough Exacerbated by excitement, exercise and eating Elicited with tracheal palpation causes cyanosis and collapse/syncope hepatomegaly cardiac murmur ```
155
What is the best diagnostic tool for tracheal collapse?
Bronchoscopy
156
What are the problems with a stint for tracheal collapse?
Can Fail Predisposed to infection Expensive
157
What is the treatment for tracheal collapse?
``` Sedation Oxygen therapy Cough suppressant Corticosteroid intubation Antibiotics for secondary infection ```
158
What should you avoid in tracheal collapse?
Avoid neck collars Avoid excitement Avoid dust, smoke, pollens, carpet powders
159
What are the surgical interventions for tracheal collapse?
Extraluminal stents | Endoluminal stents
160
Canine chronic bronchitis
Inflammation of the bronchial walls that results in thickened walls, increased mucous which results in obstruction of small airways
161
What are the clinical signs of Canine Chronic bronchitis?
Daily cough for longer than 2 months Expiratory wheezes audible crackles exercise intolerance
162
What is the long term sequelae to Canine chronic bronchitis?
Emphysema bronchiesctasis pneumonia
163
What is the signalment for Canine Chronic bronchitis?
Obese Small breeds usually less than 6 years old
164
What is used for diagnosis for Canine Chronic bronchitis?
radiographs bronchoscopy bronchial cytology culture
165
What is the treatment for Canine Chronic bronchitis?
``` Eliminate triggers Keep hydrated Reduce weight if obese Prednisolone Bronchodilators Antibiotics Avoid cough suppressants ```
166
Bronchiectasis
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
What is the differential list for Felines presenting with a cough, wheeze, or respiratory distress?
``` Pulmonary parasites Heartworm Bacterial or viral bronchitis Toxoplasmosis Idiopathic pulmonary fibrosis Neoplasia - carcinoma Aspiration pneumonia Idiopathic feline bronchitis/asthma Chronic bronchitis ```
168
Asthma
Bronchial constriction
169
What are the clinical signs of Idiopathic feline bronchitis?
``` Chronic or intermittent cough acute respiratory distress Open mouth breathing audible wheezing Wheezes Crackles Increased expiratory effort ```
170
How do you diagnose Idiopathic feline bronchitis?
First tier: Radiograph CBS Fecal examination Second tier: Transtracheal wash/bronchoscopy Cytology/culture
171
What can be found on Radiographs for Idiopathic feline bronchitis?
Bronchial pattern Reticular interstitial and patchy alveolar opacities Hyperinflation flattening of the diaphragm
172
Air-trapping
constriction of small airways does not allow inspired to be exhaled and lungs overinflate
173
What do you find on bronchoscopy for Idiopathic feline bronchitis?
Mucosal hyperemia Increased mucous Perform broncho-alveolar lavage
174
What do you see on cytology with Idiopathic feline bronchitis asthma?
increased eosinophils or neutrophils and mixed inflammation
175
What do you see on cytology with Idiopathic feline bronchitis in infectious patients?
degenerative neutrophils and/or intracellular bacteria
176
What is the treatment for Idiopathic feline bronchitis?
No stress oxygen rich environment Rapid acting corticosteroid Bronchodilator choices: albuterol, terbutaline
177
What is the long term management for Idiopathic feline bronchitis?
1. Environmental management: Improve indoor air quality r Eliminate potential allergens/irritants 2. Anti-inflammatories - glucocorticoids
178
What are the advantages of Metered Dose inhaler?
Minimize systemic corticosteroid side effects Easier to treat high drug concentration delivered to the lungs
179
What are the disadvantages of Metered Dose Inhaler?
Increase risk of dental disease Re-emergence of a latent herpesvirus infection Local dermatitis
180
What are other possible long-term treatment for Idiopathic feline bronchitis?
Oral bronchodilator: Terbutaline or Albuterol oral | Antibiotics: Doxycycline, Chloramphenicol, or azithromycin
181
What is the prognosis for Idiopathic feline bronchitis?
Long term medical treatment needed | If untreated: permanent changes of chronic bronchitis with irreversible damage (fibrosis) and emphysema
182
Feline chronic bronchitis
Chronic airway inflammation typically in older cats
183
What is Feline chronic bronchitis characterized by?
Neutrophilic inflammation Mucosal edema Mucus gland hypertrophy Excessive mucus production
184
What are the clinical signs of Feline Chronic bronchitis?
Same as asthma | Coughing daily
185
What does the management of Feline Chronic Bronchitis focus on?
Control of inflammation using glucocorticoids
186
What are the clinical signs of Pulmonary disease?
``` Difficulty breathing Increased rate and effort Coughing Exercise intolerance abnormal pulmonary sounds abnormal posture - Orthopnea ```
187
What is the most common cause of Inflammatory disease in dogs?
Bacterial
188
What is pneumonia characterized by?
soft ineffectual cough
189
What are the clinical signs of pneumonia?
``` soft ineffectual cough dyspnea tachypnea cyanosis nasal discharge exercise intolerance pyrexia lethargy anorexia ```
190
What are the most common bacteria in primary bacterial pneumonia in young dogs?
Bordetella spp. | Pasteurella spp.
191
How do you diagnose Bacterial pneumonia?
Hematology - left shift neutrophilic leucocytosis and Monocytosis Thoracic radiographs - interstitial pattern, alveolar pattern Transtracheal/endotracheal wash cytology culture Bronchoscopy with bronchoalveolar lavage
192
What do you find on cytology with Bacterial pneumonia?
Degenerative neutrophils/monocytes | Intracellular bacteria
193
What can bacterial pneumonia result in?
Sepsis which can lead to ALI and ARDS
194
What is the treatment for Bacterial pneumonia?
Antibiotics: Begin with injectable therapy and then change to oral medications Nebulisation: sterile saline + gentamycin Supportive Care: IV fluids, oxygen theapy, and coupage
195
What are the Respiratory clinical signs for Mycotic pneumonia?
``` Abnormal respiratory pattern Tachypnea Cough Exerrcise intolerance Systemic signs: inappetance, weight loss, fever, lameness, lymphadenopathy, chorioretinitis or anterior uveitis, draining fistula tracts ```
196
How do you diagnose Mycotic pneumonia?
Urine or serum antigen titers | Cytology/histopathology (biopsy)
197
What is the treatment for Mycotic pneumonia?
Depends on fungal sensitivity Polyene antifungals: amphotericin B Triazoles: itraconazole, posaconazole, voriconazole, fluconazole Imidazoles: clotrimazole, ketaconazole
198
What is the geographic location for Coccidiomycosis?
Arizona
199
What is the geographic location for Blastomycosis/ Histoplasmosis?
Ohio River Valley area
200
Where do you take cytology for mycotic pneumonia?
``` Lymph nodes draining lesions TTW ETW BAL pulmonary aspirate ```
201
What is the treatment for Mycotic pneumonia?
Oral medications: Itraconazole, Posaconazole, Voriconasole IV/SC medications: Amphotericin B Lipid complex form
202
What is the side effect of Amphotericin B?
Nephrotoxic
203
What is the problem with treatment for mycotic pneumonia?
Expensive and long term - 4 to 12 months
204
What is the prognosis for Mycotic pneumonia?
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
What is the geographic location for Blastomycosis?
Mississippi, Missouri and Ohio river valley area
206
What is the mode of infection for Blasto?
Inhalation of spores
207
What are the clinical signs of Blasto?
``` No clinical signs Fever Emaciated Lymphadenopathy Dry harsh cough exercise intolerance ocular lesions skin lesions: areas of redness to granulomas bone lesions ```
208
How do you diagnose Blasto?
Radiographs Hematology: Chronic anemia, leukocytosis, left shift, lymphopenia, hyperglobulinemia, hypercalcemia Cytology or Histopathology Serology: AGID test, Radioimmunoassay, ELISA, PCR
209
What are the pathological findings of Blasto?
Pyogranulomatous lesions
210
What is the treatment for Blasto?
Amphotericin B IV | Triazole - Itraconozole
211
Where is Histoplasmosis found?
In bird or bat feces
212
What are the clinical signs of Histoplasmosis disseminated disease in cats?
``` Mental depression weight loss fever anorexia pale mucous membranes dyspnea tachypnea abnormal lung sounds ```
213
What are the clinical signs of Histoplasmosis disseminated disease in dogs?
``` Inappetance weight loss fever unresponsive to antibiotics dyspnea coughing abnormal lung sounds ```
214
What laboratory findings do you find with Histo?
Chronic anemia Thrombocytopenia Hypoalbuminemia
215
How do you diagnose Histo?
Radiographs Ultrasound Cytology Histopathology
216
Where do you find Histo?
in mononuclear-phagocyte system
217
What is the therapy of choice for Histo?
Itraconazole
218
What is the treatment for Histo?
Itraconazole Fluconazole Voriconazole and posaconazole Amphotericin B
219
Where do you find Cryptococcus?
Avian droppings
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What are the clinical findings of Cryptococcus in cats?
``` Chronic infection Bilateral nasal discharge snuffly Firm to flocuant swelling over the bridge of the nose Lymphadenopathy Neurological signs ```
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What are the clinical findings of Cryptococcus in dogs?
neurological signs
222
How do you diagnose Cryptococcosis?
``` 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
What is the treatment for Cryptococcus?
Surgery Amphotericin B (8-9 months) Itraconazole
224
Where do you find Coccidiomycosis?
Dry environment - SW USA | "Valley Fever"
225
What are the clinical signs of Coccidiomycosis for dogs?
``` Dry harsh cough hilar lymphadenopathy diffuse pulmonary interstitial disease fever anorexia weight loss weakness lameness ```
226
What is the clinical signs of Coccidiomycosis in cats?
``` Dry harsh cough hilar lymphadenopathy diffuse pulmonary interstitial disease fever anorexia weight loss weakness lameness ``` Cutaneous lesions!!
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How do you diagnose Coccidiomycosis?
``` 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
What is the treatment for Coccidiomycosis?
3-6 months of Ketoconazole, Itraconazole, or fluconazole
229
What is the prognosis for Coccidiomycosis?
Good for respiratory disease | Poor for disseminated disease
230
Where do you find aelurostrongylus abstrusus?
Feces
231
What kind of egg do Paragonimus kellicoti have?
Operculated egg
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How do you find on hematology for aelurostrongylus abstrusus?
Eosinophilia
233
What do you find on Thoracic radiographs for aelurostrongylus abstrusus?
DIffuse nodular densities in the caudal lobes
234
What do you find on TTW/BAL with aelurostrongylus abstrusus?
Increased number of eosinophils and or larvae
235
What is the treatment for aelurostrongylus abstrusus?
Fenbendazole (for 10 days) | Ivermectin ( given once every 2 weeks)
236
What are the clinical signs for Paragonimus spp.?
Cough Wheeze respiratory distress
237
What do you find in the lungs with Paragonimus spp. ?
Cysts in the lungs
238
What happens if the cysts of Paragonimus spp. rupture?
pneumothorax
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How do you diagnose Paragonimus spp.?
CBC: eosinophilia Thoracic radiographs with cysts present TTW/BAL Fecal float with operculated egg
240
What is the life cycle for Paragonimus spp. ?
Egg is shed in the feces and then eaten by a snail and then a crustacean which is eaten by the Dog
241
Idiopathic pulmonary fibrosis - progressive interstitial fibrosis
Chronic fibrosis of the lung interstitium characterized by infiltration of fibroblasts
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What is the signalment for Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?
Middle or older Terrier - West Highland Terrier
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What are the clinical signs of Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?
Respiratory distress tachypnea Coughing increased with progression Weight loss in cats
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How do you diagnose Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?
``` Inspiratory crackles on auscultation Thoracic radiographs: generalized or diffuse interstitial pattern Arterial blood gas: Hypoxemia TTW/BAL Lung FNA aspirate Lung biopsies ```
245
What provides a definitive diagnosis for Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?
Lung biopsies
246
What is the treatment for Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?
Corticosteroids | Cyclophosphamide or azathioprine
247
What is the prognosis of Idiopathic pulmonary fibrosis - progressive interstitial fibrosis?
Guarded | Progressive respiratory failure
248
What is the primary pulmonary neoplasia?
Adenocarcinoma | Squamous cell carcinoma
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What are the metastatic pulmonary neoplasia?
Adenocarcinoma Osteosarcoma/chondrosarcoma Hemangiosarcoma/ oral or digital melanoma
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What are the multicentric pulmonary neoplasia?
Lymphoma
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What are the clinical signs for Pulmonary neoplasia?
``` Crackles wheezes muffled sunds cough dyspna tachypnea hemoptysis weight loss lameness dysphagia regurgitation edema of the head/neck ```
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How do you diagnose pulmonary neoplasia?
Thoracic radiogaphs | Cytology: FNA, Bronchoscopy, Biopsy
253
What is the treatment for pulmonary neoplasia?
Surgical removal | Chemotherapy
254
What is the prognosis for pulmonary neoplasia?
Guarded to poor | Solitary mass or benign mass - good with surgical removal
255
What are the prognostic factors for pulmonary neoplasia?
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
Pulmonary edema
Accumulation of fluid in alveoli or pulmonary interstitium
257
What are the four mechanisms of Non-cardiogenic pulmonary edema?
Vascular overload/ increased hydrostatic pressure Decreased plasma oncotic pressure Increased alveolar capillary membrane permeability Lymphatic obstruction
258
What do you see on thoracic radiographs with Non-cardiogenic pulmonary edema?
Bilateral Alveolar pattern
259
What is the treatment for Non-cardiogenic pulmonary edema?
``` Aggressive control of primary disease Cage rest oxygen therapy supportive care PPV if required ```
260
What is the prognosis for Non-cardiogenic pulmonary edema?
Guarded with permeabiluty edema pathogenesis | Better when there is no fluid overload or renal function is intact
261
ALI
Acute Lung Injury
262
Acute Lung Injury - ALI
pulmonary inflammation and edema resulting in acute respiratory failure
263
ARDS
Acute Respiratory distress syndrome
264
Acute Respiratory distress syndrome - ARDS
severe manifestation of ALI, Hypoxemia is worse
265
What is ALI/ARDS most commonly secondary to?
Sepsis systemic inflammatory distress syndrome shock bacterial pneumonia
266
What do you find on Thoracic auscultation with Pulmonary contusions?
Crackles
267
What is the concurrent pathology with trauma from Pulmonary contusions?
``` Pneumothorax/hemothorax Herniation Myocarditis Rib fractures hypotension ```
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What is the treatment for Pulmonary contusions?
Oxygen therapy IV fluids Pain medication for trauma
269
Eosinophilic bronchopneumopathy
Inflammation of the lungs - thought to be due to hypersensitivity to some unknown antigen
270
What are the possible causes of Eosinophilic bronchopneumopathy?
``` Heartworm Lung parasites drugs inhaled allergens neoplasia fungal or bacterial infections ```
271
What is the signalment for Eosinophilic bronchopneumopathy?
Young or middle aged Siberian Huskies
272
What are the clinical signs of Eosinophilic bronchopneumopathy?
Harsh cough Progressive respiratory difficulty exercise intolerance nasal discharge or anorexia/lethargy
273
How do you diagnose Eosinophilic bronchopneumopathy?
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
What is the treatment for Eosinophilic bronchopneumopathy?
Fenbendazole | Corticosteroids
275
What is Pulmonary Thromboembolism (PTE) associated with?
``` Heartworm Immune-mediated hemolytic anemia Nephrotic syndrome Hyperadrenocorticism - hypercoagulability Pancreatitis DIC Endocarditis ```
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What is the treatment for Pulmonary Thromboembolism (PTE)?
``` Oxygen supplementation No stress treat underlying diease Bronchodilators Prednisolone in IMHA and heartworm ```
277
What is the prognosis for Pulmonary Thromboembolism (PTE)?
Poor to grave
278
What are the respiratory signs of Pleural effusion and pneumothorax?
``` Rapid shallow breathing Dyspnea Open mouth breathing Cyanosis Exercise intolerance anorexia and lethargy ```
279
What do you find on physical exam with Pleural effusion and pneumothorax?
Pyrexia Barrel-shaped chest with pneumothorax Muffled heart sounds and diminished/muffled lung sounds ventrally
280
What causes Dorsal increased lung sounds?
Pleural effusion
281
What causes Dorsal decreased lung sounds?
pneumothorax
282
Pleural effusion
Accumulation of excessive amounts of fluid within the pleural space (cavity)
283
What causes an accumulation of Transudate of fluid within the pleural space (cavity)?
Congestive Heart Failure
284
What causes an accumulation of exudate of fluid within the pleural space (cavity)?
Pyothorax
285
What causes an accumulation of hemorrhage of fluid within the pleural space (cavity)
Trauma
286
What are mechanisms of fluid accumulation?
Decreased oncotic pressure - hypoalbuminemia Increased hydrostatic pressure - CHF Increased capillary membrane permeability - inflammation due to FIP, neoplasia, pyothorax Lymphatic malfunction - obstruction or lymphanglectasia
287
What is the treatment for Pleural effusion?
Thoracocentesis
288
What is the cause of pyothorax in dogs?
Secondary to inhaled foreign bodies or penetrating injury, pneumonia
289
What is the cause of pyothorax in cats?
Secondary to penetrating bite wounds, oropharyngeal aspiration or URTI
290
How do you diagnose Pyothorax?
Cytology - degenerative neutrophils/bacteria | Culture
291
What is the treatment for Pyothorax?
Drainage and lavage through thoracotomy tube Lavage Long term antibiotics based on culture or cytology
292
What antibiotic treats anaerobes?
Metronidazole
293
What antibiotics are used to treat Gram negatives from cat bites?
Enrofloxacin
294
What can cause accumulation of Chyle in pleural space?
``` Trauma Neoplasia Cardiac disease Thoracic duct lymphangiectasia Inflamamtion Lung lobe torsion Idiopathic ```
295
What color is Chyle?
White to pink opaque
296
How do you diagnose Chylothorax?
Thoracocentesis
297
What is the treatment for Chylothorax?
Thoracic drainage Low fat diet Rutin Ligation of thoracic duct
298
Rutin
decreases inflammation in the lymphatics and increases reabsorption of fat from the macrophages
299
What is the sequale to chylothorax?
Restrictive pleuritic
300
What would the pleural fluid look like with FIP?
High protein content with some macrophages in the fluid
301
What is the most common tumor affecting the pleural space?
Mesothelioma
302
What does Chronic inflammation result in?
hyperplastic changes to mesothelial cells
303
What is the most common etiology of pneumothorax?
Traumatic (blunt force trauma)
304
What is the cause of Non-traumatic/spontaneous closed pneumothorax?
``` Tumors abscesses pneumonia paragonimus chronic bronchitis asthma heartworm idiopathic bullae formation ```
305
What is the cause of traumatic open pneumothorax?
Gunshots Bites stab wounds rib fractures
306
What is the cause of traumatic closed pneumothorax?
HBC | complication of lung aspirate
307
How do you diagnose pneumothorax?
Thoracocentesis | Imaging
308
What are the findings on a radiographs for pneumothorax?
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
What is the treatment of pneumothorax?
Emergency thoracocentesis Analgesia Oxygen therapy surgical intervention
310
What are the indications for chest tube or drain?
Pyothorax | Pneumothorax
311
Transudate
Transparent, low proteins and cells
312
Modified transudate
serosanguinous suggest an obstructive effusion: CHF, lung lobe torsion, neoplasia, diaphragmatic hernia
313
Exudate
red to brown to yellow to opaque | suggestive of inflammation, high proteins and cells
314
Septic exudate
pyothorax
315
Non-septic exudate
``` FIP Chylothorax Bilothorax neoplasia lung torsions ```

RUSVM Small Animal Medicine I 2016 (9 decks)

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