Respiratory Distress

Question 1

What are the five mechanisms by which hypoxemia occurs?

Answer 1

decreased inspired [O2]

hypoventilation

diffusion barriers

anatomic shunting
ventilation (V) / perfusion (Q) mismatch

Question 2

Extrathoracic airway obstruction most commonly leads to _____.

Answer 2

inspiratory distress

longer I:E ration d/t longer inspiratory phase

Question 3

Intrathoracic airway obstruction most commonly leads to ______.

Answer 3

expiratory distress

Question 4

Late inspiratory crackles are heard with what conditions?

Answer 4

pulmonary edema

lung, pleural or chest wall tumors

interstitial pneumonia

Question 5

Early-inspiratory/expiratory crackles heard with what type of conditions?

Answer 5

Obstructive lung diseases

bronchopneumonia

Question 6

Inspiratory wheezes are associated with ______ airway obstruction.

Answer 6

extrathoracic

Question 7

Expiratory wheezes are associated with _____ airway obstructions. Name conditions associated with this.

Answer 7

intrathoracic

e.g. chronic obstructive pulmonary disease, intrathoracic airway collapse, stenosis or mass obstruction

Question 8

In pneumothorax, if the animal is standing, the ____area typically auscults dull, while the
_____ area auscults normal.

Answer 8

dorsal

ventral

Question 9

In pleural effusion, if the animal is standing, the _____ area typically auscults dull, while the _____ area auscults normal.

Answer 9

Ventral

dorsal

Question 10

What are the normal arterial blood gas values for dogs/cats breathing room air (PaO2, PaCO2, HCO3, pH)?

Answer 10

Question 11

A PaO2 value of less than ___ mmHg is considered dangerous and treatment should be initiated
urgently.

Answer 11

60

Question 12

How do you determine the A-a (alveolar:arterial) gradient and what is the normal value?

Answer 12

150- 1.1 (PaCO2-PaO2)

normal= <15-27

Question 13

What is the normal FIO2: PaO2?

Answer 13

400-500

Question 14

A normal value on the SPO2 rules out hypoxia. T/F

Answer 14

FALSE***

Question 15

With regards to laryngeal paralysis, which structure fails to abduct during inspiration and creates an upper airway obstruction?

Answer 15

arytenoid cartilage

Question 16

Causes of laryngeal paralysis? Most common?

Answer 16

Idiopathic - most common

trauma

tumors (cervical and thoracic)

polyneuropathies/myopathies (hypothyroidism, hypoadrenocorticism, and myasthenia gravis)

Question 17

What are the classic signs of laryngeal paralysis?

Answer 17

Bark change***

respiratory distress- stridor

Question 18

In which dogs is laryngeal paralysis most common?

Answer 18

older large breed dogs

Question 19

Does laryngeal function typically return after the primary disease is addressed resulting in laryngeal paralysis?

Answer 19

NO

Question 20

Brachycephalic syndrome complex consists of what abnormalities? Which can be corrected surgically (star next to them in the answer)?

Answer 20

1. elongated soft palate*
2. stenotic nares*
3. Everted laryngeal saccules & laryngeal collapse*
4. Hypoplastic trachea

Question 21

Which diseases have been associated with PTE?

Answer 21

● Sepsis

● Disseminated intravascular
coagulation

● Pancreatitis

● Neoplasia
Hyperadrenocorticism

● Hypothyroidism

● Protein-losing nephropathy

● Immune-mediated hemolytic anemia,
cardiac disease

● Heartworm disease

Question 22

What is the primary concern for anticoagulant therapy for PTE?

Answer 22

bleeding

Question 23

If a patient being treated with heparin begins bleeding, what drug can be administered that neutralizes heparin?

Answer 23

Protamine sulphate

Question 24

What molecule needs to be present to sufficient amounts for heparin to work in the body?

Answer 24

Antithrombin III

Question 25

A 6 year old DSH presents for an acute episode of labored breathing. The feline has had similar episodes in the past but not this severe. You suspect feline bronchitis (asthma). What findings on PE would you expect to find?

Answer 25

Increased expiratory effort and time

Expiratory wheezes

+/- crackles

Question 26

What is the standard treatment for feline bronchitis (asthma)?

Answer 26

Long-term corticosteroids (short acting)

environmental modification

Bronchodilators if cannot use steroids

Question 27

What are some possible causes of non-cardiogenic edema?

Answer 27

neurogenic causes, electrocution, upper airway obstruction, vasculitis, ARDS, allergic reactions, inhalation of toxins

Question 28

What is the common radiographic findings seen with non-cardiogenic pulmonary edema?

Answer 28

diffuse alveolar

Question 29

what are the two pathologic mechanisms that result in pulmonary damage from near drowning?

Answer 29

Aspiration pneumonia

Water dilution of pulmonary surfactant leading to alveolar collapse and reduced compliance

Question 30

What is the treatment for near-drowning cases?

Answer 30

● Oxygen supplementation
● Bronchodilators
● Mechanical ventilation (evaluate serial blood gases)
● Supportive care for pneumonia
● +/- antibiotics

Question 31

What is the movement of the larynx with laryngeal paralysis on the sedated exam?

Answer 31

Arytenoids closed during inspiration and open only
slightly during expiration

Question 32

What are the radiographic signs associated with feline bronchitis?

Answer 32

bronchial pattern

hyperinflation- hyperlucency

aerophagia

Question 33

What is the prognosis for feline asthma?

Answer 33

poor for cure

good for control of clinical signs

sudden death is possible