Respiratory Distress Flashcards
What are the five mechanisms by which hypoxemia occurs?
decreased inspired [O2]
hypoventilation
diffusion barriers
anatomic shunting
ventilation (V) / perfusion (Q) mismatch
Extrathoracic airway obstruction most commonly leads to _____.
inspiratory distress
longer I:E ration d/t longer inspiratory phase
Intrathoracic airway obstruction most commonly leads to ______.
expiratory distress
Late inspiratory crackles are heard with what conditions?
pulmonary edema
lung, pleural or chest wall tumors
interstitial pneumonia
Early-inspiratory/expiratory crackles heard with what type of conditions?
Obstructive lung diseases
bronchopneumonia
Inspiratory wheezes are associated with ______ airway obstruction.
extrathoracic
Expiratory wheezes are associated with _____ airway obstructions. Name conditions associated with this.
intrathoracic
e.g. chronic obstructive pulmonary disease, intrathoracic airway collapse, stenosis or mass obstruction
In pneumothorax, if the animal is standing, the ____area typically auscults dull, while the
_____ area auscults normal.
dorsal
ventral
In pleural effusion, if the animal is standing, the _____ area typically auscults dull, while the _____ area auscults normal.
Ventral
dorsal
What are the normal arterial blood gas values for dogs/cats breathing room air (PaO2, PaCO2, HCO3, pH)?
A PaO2 value of less than ___ mmHg is considered dangerous and treatment should be initiated
urgently.
60
How do you determine the A-a (alveolar:arterial) gradient and what is the normal value?
150- 1.1 (PaCO2-PaO2)
normal= <15-27
What is the normal FIO2: PaO2?
400-500
A normal value on the SPO2 rules out hypoxia. T/F
FALSE***
With regards to laryngeal paralysis, which structure fails to abduct during inspiration and creates an upper airway obstruction?
arytenoid cartilage
Causes of laryngeal paralysis? Most common?
Idiopathic - most common
trauma
tumors (cervical and thoracic)
polyneuropathies/myopathies (hypothyroidism, hypoadrenocorticism, and myasthenia gravis)
What are the classic signs of laryngeal paralysis?
Bark change***
respiratory distress- stridor
In which dogs is laryngeal paralysis most common?
older large breed dogs
Does laryngeal function typically return after the primary disease is addressed resulting in laryngeal paralysis?
NO
Brachycephalic syndrome complex consists of what abnormalities? Which can be corrected surgically (star next to them in the answer)?
- elongated soft palate*
- stenotic nares*
- Everted laryngeal saccules & laryngeal collapse*
- Hypoplastic trachea
Which diseases have been associated with PTE?
● Sepsis
● Disseminated intravascular
coagulation
● Pancreatitis
● Neoplasia
Hyperadrenocorticism
● Hypothyroidism
● Protein-losing nephropathy
● Immune-mediated hemolytic anemia,
cardiac disease
● Heartworm disease
What is the primary concern for anticoagulant therapy for PTE?
bleeding
If a patient being treated with heparin begins bleeding, what drug can be administered that neutralizes heparin?
Protamine sulphate
What molecule needs to be present to sufficient amounts for heparin to work in the body?
Antithrombin III
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?
Increased expiratory effort and time
Expiratory wheezes
+/- crackles
What is the standard treatment for feline bronchitis (asthma)?
Long-term corticosteroids (short acting)
environmental modification
Bronchodilators if cannot use steroids
What are some possible causes of non-cardiogenic edema?
neurogenic causes, electrocution, upper airway obstruction, vasculitis, ARDS, allergic reactions, inhalation of toxins
What is the common radiographic findings seen with non-cardiogenic pulmonary edema?
diffuse alveolar
what are the two pathologic mechanisms that result in pulmonary damage from near drowning?
Aspiration pneumonia
Water dilution of pulmonary surfactant leading to alveolar collapse and reduced compliance
What is the treatment for near-drowning cases?
● Oxygen supplementation
● Bronchodilators
● Mechanical ventilation (evaluate serial blood gases)
● Supportive care for pneumonia
● +/- antibiotics
What is the movement of the larynx with laryngeal paralysis on the sedated exam?
Arytenoids closed during inspiration and open only
slightly during expiration
What are the radiographic signs associated with feline bronchitis?
bronchial pattern
hyperinflation- hyperlucency
aerophagia
What is the prognosis for feline asthma?
poor for cure
good for control of clinical signs
sudden death is possible
