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Plunkett Emergency > Respiratory Emergencies > Flashcards

Respiratory Emergencies Flashcards

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1
Q

What is a common history for respiratory problems?

A

Sudden signs of distress
Chewing on something prior to problem
Found being strangulated with leash, collar, etc

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2
Q

What physical exam signs are noted with respiratory problems?

A 
Inspiratory stridor
Inspiratory dyspnea
Ptyalism
Cyanosis
Tachypnea
Pawing at face/ mouth
Anxiety/ distress
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3
Q

What are differentials for respiratory emergencies?

A 
Laryngeal foreign body
Neoplasia
Brachycephalic airway syndrome
NP polyps 
Laryngeal polyps 
Chronic laryngitis 
Cervical mass (abscess, lymph nodes, rattlesnake envenomation)
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4
Q

What are good sedatives to give for respiratory emergencies?

A

Acepromazine

Butorphanol

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5
Q

Are diuretics useful for respiratory emergencies?

A

No

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6
Q

What should you do prior to a tracheostomy?

A

Insert a large-bore catheter attached to oxygen distal to the tracheostomy site

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7
Q

What is the prognosis for tracheal/ tracheobronchial obstructions?

A

Good to grave

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8
Q

What is the common signalment for laryngeal paralysis?

A

Large breed, older dogs (Labs, Goldens, Saint Bernards, Siberian Huskies, Irish Setters) >7 YO
Males > Females
Can sometimes happen in cats

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9
Q

What is the cause of laryngeal paralysis

A

The recurrent laryngeal nerve innervates the cricorarytenoideus dorsalis, causing ab/adduction of arytenoid cartilage

Denervation leads to muscle atrophy and narrowing/ obstruction of the glottis

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10
Q

What are differentials for laryngeal paralysis?

A 
Idiopathic (most common)
Congenital (seen 4-18 mo Bulldogs, Bouvier, Huskies, Malamutes, Bull Terriers)
Trauma
 Iatrogenic
Abscess
Extrathoracic neoplasia
Parasitic
Hypothyroidism
Neuro dz
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11
Q

What diagnostics are useful for laryngeal paralysis?

A

Laryngeal exam with light sedation (can use Doxapram 1 mg/kg IV to help stimulate)

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12
Q

What are management options for laryngeal paralysis?

A 
Medical:
Stress control
Weight control
Temperature control
Useful for mild cases
Will progress to more sever disease overtime

Surgical:
Tie-back
Best long-term prognosis
Has 10-20% complication rate

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13
Q

What condition can occur secondary to laryngeal paralysis?

A

Hyperthermia

Life-threatening anxiety

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14
Q

What is the common signalment for tracheal collapse?

A

Small breed dogs such as Yorkies

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15
Q

What are causes of collapsing trachea?

A 
Unknown but suspected to be:
Congenital malformation
Hypocellular tracheal cartilage
Chronic lower airway disease
Extratracheal masses
Trauma
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16
Q

What history is common with tracheal collapse?

A

Goose-honk cough
Cyanosis
Collapse
Intermittent cough that worsens with excitment

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17
Q

What imaging tools are useful for diagnosing collapsing trachea?

A

Cervical and thoracic radiographs
Fluoroscopy
Bronchoscopy

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18
Q

What are treatment options and prognosis for tracheal collapse?

A 
Medical:
Weight and stress management
Anti-inflammatory pred dose
Antitussive (torb or hydrocodone)
Glucosamine/ chondroiton
Can use bronchodilators (theophylline, aminophylline, terbutaline)
Has good outcome but can still progress

Surgical:
Use if medical does not work
Has several complications

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19
Q

What is aspiration pneumonitis?

A

Acute lung injury secondary to inhalation of irritants

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20
Q

What is aspiration pneumonia?

A

Colonization of bacteria in the lung from injury or inhalation of foreign materials
Usually occurs secondary to another condition
Uncommon in cats

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21
Q

What are causes of aspiration pneumonia?

A 
Altered mentation
Esophageal disorders
GI issues
Persistent vomiting
Iatrogenic
22
Q

What labwork findings are noted with aspiration pnuemonia?

A

Leukocytosis +/- left shift

23
Q

What is the prognosis for aspiration pneumonia?

A

Causes serious morbity or mortality
Good to grave
One lobe affected typically good

24
Q

What is a pulmonary thromboembolism (PTE)?

A

Occlusion one or more pulmonary vessel by blood clot, septic emboli, fat, neoplasia, or parasite

25
Q

How is PTE diagnosed

A

CT angiography - Gold standard
Rads: normal or show hyperlucent regions, alveolar infiltrates, loss of pulmonary artery definition
CBC/ Chem: non-diagnostics
U/A can be useful
Clotting times: not diagnostic, D-dimers can be useful

26
Q

What is the prognosis for PTE?

A

Guarded to poor

27
Q

What is noncardiogenic pulmonary edema?

A

Occurs as a consequence of primary lung disease such as drowning, electrocution, smoke inhalation, aspiration, oxygen toxicity, blunt traum
Caused by increased pulmonary vascular permeability

28
Q

What radiograph findings are noted with noncardiogenic pulmonary edema?

A

Interstitial or mixed interstitial to alveolar pattern

Bilateral in caudodorsal lung region

29
Q

What is the prognosis for noncardiogenic pulmonary edema?

A

Always guarded

30
Q

What are acute lung injury (ALI) and acute respiratory distress syndrome (ARDS)?

A

Life threatening consequences of serious illnesses
Occurs when inflammatory cells and inflammatory mediators injure the pulmonary microvascular endotherlium –> leads to protein-rich edema leaking into chest cavity

31
Q

What causes ALI and ARDS?

A

Primary lung injury such as drowning, electrocution, smoke inhalation, gastric content aspiration, oxygen toxicity, trauma

32
Q

What radiograph findings are noted with ALI and ARDS?

A

Bilateral caudodorsal infiltrates

33
Q

What are differentials for ALI and ARDS?

A

Pulmonary edema
Noncardiogenic pulmonary edema
Fungal pneumonia
Diffuse primary or metastatic neoplasia

34
Q

What is the prognosis for ALI and ARDS?

A

Fair to grave

35
Q

What is feline chronic bronchial disease/ feline asthma?

A

Hyperresponsiveness of the lower airways to inhaled allergens and results in increased bronchial secretions and bronchospasms

36
Q

What history is noted with feline asthma?

A

Coughing/ wheezing/ tachypnea
Open mouth breathing and anxiety
Exposure to allergens (smoke, perfume, dust, cat litter, pollen)

37
Q

What findings on noted on thoracic radiographs?

A 
Increased interstitial densities and peribronchial markings
Overinflation
Diaphragm straightening
Lung hyperlucency
Aerophagia
38
Q

What are differentials for feline asthma?

A

Cardiac disease
Acute/ chronic bronchitis
Infectious pneumonia
Pulmonary neoplasia

39
Q

What is the prognosis for feline asthma?

A

Guarded to fair depending on how long it has been going on for

40
Q

What are maintenance drugs for feline asthma?

A 
Terbutaline sulfate
Albuterol sulfate
Prednisolone
Theophylline extended release
Fluticasone
41
Q

What is pleural effusion?

A

Abnormal accumulation of fluid in the space between the visceral and parietal pleura

42
Q

What physical exam findings are noted with pleural effusion?

A

Short, shallow, rapid breathing
Muffled heart and lung sounds
Ascites
Jugular distension

43
Q

What radiographs signs are noted with pleural effusion?

A

Loss of cardiac silhouette
Pleural fissure lines
Scalloping around lung lobes

44
Q

What should you do if a patient is not stable prior to radiographs?

A

Thoracocentesis +/- ultrasound-guided

45
Q

What are differentials for transudate/ modified transudate for pleural effusion?

A 
Liver/ kidney disease
PLE
Heart failure
Fluid overload
Neoplasia 
PTE
Diaphragmatic hernia
46
Q

What are differentials for non-septic exudate for pleural effusion?

A 
Neoplasia
Lung-lobe torsion
Diaphragmatic hernia
Renal disease
Pancreatitis
FIP
FeLV
47
Q

What are differentials for purulent exudate for pleural effusion?

A

Septic pleuritis

Foreign body

48
Q

What are differentials for chylous exudate for pleural effusion?

A 
Ruptured thoracic duct
Obstructed thoracic duct
Lymphoma
Heart failure
Heartworm
Idiopathic
49
Q

What are differentials for hemorrhagic exudate for pleural effusion?

A

Neoplasia
Trauma
Coagulopathy

50
Q

What is the prognosis for pleural edema?

A

Fair to guarded depending on underlying cause

51
Q

What is the difference between canine and feline pyothorax?

A

Canine should have an exploratory thoracotomy

Feline should be managed medically

Plunkett Emergency (8 decks)

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