Respiratory Medicine (Basics) Flashcards

1
Q

What is the medical term for increased respiratory effort?

A

Dyspnoea

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2
Q

what is the normal RR of a dog/cat?

A

20-30bpm

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3
Q

In which direction do the EXTERNAL intercostal muscles run?

A

caudoventrally

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4
Q

In which direction do the INTERNAL intercostal muscles run?

A

cranioventrally

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5
Q

Which muscles contract on inspiration?

A

Diaphragm

External intercostals

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6
Q

What are the two things which lung compliance depends on?

A

Surface Tension in alveoli

Elasticity of lungs/thoracic cage

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7
Q

When is resistance in the LOWER airways greater?

A

Expiration

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8
Q

When is resistance in the UPPER airways greater?

A

Inspiration

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9
Q

Which receptors are responsible for sympathetic innervation of the Respiratory tract?

A

B2 adrenoreceptors

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10
Q

What is the formula for minute volume?

A

Tidal vol x RR

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11
Q

What gaseous abnormality will HYPOventilation lead to?

A

Hypercapnia & hypoxia

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12
Q

What is the net parasympathetic effect on the resp blood supply?

A

Vasodilation

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13
Q

What are the 3 mechanisms to reduce acidosis?

A

Buffering
Lungs
Kidneys

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14
Q

What are the 3 broad classes of sensory receptor found in the airway?

A

Rapidly Adapting
Slowly Adapting
C-fibres

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15
Q

Where are Rapidly Adapting Receptors found and what do they respond to?

A

Intrapulmonary airways
URT = mechanical
Bronchi = chemical

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16
Q

What actions can Rapidly Adapting Receptors initiate?

A

PARASYMP: bronchoconstriction and mucus secretion
Reflexes: cough, expiration, tachypnoea etc

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17
Q

Where are Slowly Adapting Receptors found and what do they respond to?

A

In bronchioles and alveoli.

Mechanical Forces.

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18
Q

What actions can Slowly Adapting Receptors initiate?

A

Hering-Breuer Reflex

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19
Q

What do C fibres respond to?

A

noxious chemical/mehcanical stimuli

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20
Q

What actions can C Fibres initiate?

A

bronchoconstriction
mucus secretion
apnoea/shallow breaths
cough

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21
Q

Where in the brain is the cough centre located?

A

Medulla oblongata and pons

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22
Q

Which nerve sends impulses to the diaphragm?

A

Phrenic

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23
Q

Which two nerves send impulses to the larynx as part of the cough reflex?

A

Vagus

Recurrent Laryngeal

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24
Q

Which nerve is afferent for the sneeze reflex?

A

Trigeminal

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25
Q

What is Type 1 respiratory failure?

A

Hypoxia with Normo/hypocapnia

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26
Q

What is Type 2 Respiratory Failure?

A

Hypoxia with HYPERcapnia

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27
Q

What is Type 1 respiratory failure caused by?

A

Parenchymal Disease

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28
Q

What is Type 2 Respiratory Failure caused by?

A

Airway obstruction

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29
Q

Which type of respiratory failure responds to oxygen supplementation?

A

Type 1.

Hypercapnia in Type 2 may be worsened by O2 supp.

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30
Q

What are the 7 different groups of drugs which work on the respiratory system?

A
  1. Surfactants
  2. Anti-Tussives
  3. Drugs affecting Bronchial Diameter
  4. Mucolytics
  5. Expectorants
  6. Decongestants
  7. Drugs affecting Respiratory Centre
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31
Q

Which receptors mediate bronchodilation?

A

B2 adrenoreceptor

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32
Q

Which receptors mediate bronchoconstriction?

A

Muscarinic

33
Q

Give 4 examples of non-selective adrenoreceptor antagonist.

A

Adrenaline
Noradrenaline
Ephedrine
Isoprotenerol

34
Q

Which B2 agonist agent is the most selective?

A

Terbutaline (loses this at high doses)

35
Q

Which selective B2 agonist agent is metabolised in the liver?

A

Albuterol

36
Q

Which selective B2 agonist is only given orally?

A

Clenbuterol

37
Q

Which 4 conditions are CIed with adrenoreceptor agonist use?

A

BP abnormalities
Tachycardia
Hypokalaemia
Seizures

38
Q

Which drugs are CIed in patients with asthma & why?

A

Beta Blockers - cause bronchoconstriction

39
Q

What are the 4 effects of anticholinergics on the lungs?

A

Bronchodilation
Reduced inflammation
Pulmonary Vasoconstriction
Reduced Mucus Production

40
Q

Which receptor do anticholinergics antagonise?

A

M3

41
Q

What are the SEs of anticholinergics?

A

Tachycardia
Dry MMs
Decreased GI motility
Hypertension

42
Q

Which anticholinergic is used in veterinary practice?

A

Ipratropium

43
Q

How do methylxanthines increase bronchial diameter?

A

PDE Inhibitor

44
Q

Which methylxanthine(s) do we use in veterinary practice?

A

Theophylline

45
Q

What are the most common SE’s of methylxanthines and why?

A

CNS side effects - cross BBB easily

46
Q

Which drug class is most effective as an anti-tussive?

A

Opioids - Codeine and Butorphanol

47
Q

Which is the most effective anti-tussive?

A

Butorphanol

48
Q

What are two commonly used mucolytics in veterinary practice?

A

N acetylsysteine

Bromhexine HCl

49
Q

Which mucolytic may cause bronchoconstriction and airway irritation?

A

N-acetylcysteine

50
Q

Which mucolytic increases alveolar capillary permeability?

A

Bromhexine HCl

51
Q

Which mucolytic is given orally/IM?

A

Bromhexine HCl

52
Q

Which mucolytic is nebulised?

A

N-acetylcysteine

53
Q

Which class of drug is used as a decongestant in veterinary medicine?

A

Sympathomimetics

54
Q

Give 3 examples of decongestant used in veterinary medicine.

A

Ephedrine
Pseudoephedrine
Phenylephrine

55
Q

Which is the only respiratory stimulant used in veterinary medicine?

A

Doxopram

56
Q

How does Doxopram hydrochloride work?

A

Increased sensitivity of chemoreceptors –> inc RR and TV

57
Q

Why shouldn’t opioids be used alongside doxopram?

A

Convulsions

58
Q

Why shouldn’t doxopram be given to patients with arrhythmias?

A

Increases adrenaline –> precipitates arrhythmias

59
Q

What is the difference between nasal discharge in acute and chronic Dz?

A

Acute: serous
Chronic: Mucopurulent

60
Q

What causes fungal rhinitis in the dog and cat?

A

Dog: Aspergillus
Cat: Cryptococcus

61
Q

What are the clinical signs of fungal rhinitis?

A

Pain
Depigmentation/ulceration of nares
Mucopurulent to sanguineous discharge

62
Q

What 3 ways can we apply topical antifungals to cases of fungal rhinitis?

A

Non-surgical flush
1h surgical flush
10-14d catheter flush

63
Q

What are the two main presentations of nasal neoplasia?

A

Destructive (epistaxis)

Obstructive (snorting)

64
Q

How is inflammatory rhinitis treated?

A

Antibiotics
Mucolytics
Steroids
Diet Trial

65
Q

What is the main differential for acute onset violent sneezing?

A

Nasal FB

66
Q

What is the most common nasal FB in the cat and how is it treated?

A

Grass blade in nasopharynx: retract SP and retrieve with foreceps

67
Q

What are the 4 primary factors predisposing dogs to BOAS?

A

Relative oversize of SP
Stenotic Nares
Tracheal hypoplasia
Laryngeal Hypoplasia

68
Q

What are the 4 secondary factors predisposing dogs to BOAS?

A

Eversion of laryngeal ventricles
Tonsillar Enlargement
Laryngeal/Tracheal collapse

69
Q

How would you manage a dog in acute episodes of BOAS?

A
Oxygen
Cool, quiet environment
Sedate
Steroids
GA + intubate
70
Q

What does BOAS surgery consist of?

A

SP resection
Remove saccules
Nasoplasty
Tonsillectomy

Poss permanent tracheostomy

71
Q

Which disease causes altered phonation, gagging when eating and inspiratory stridor?

A

LAryngeal Paralysis

72
Q

What is the Tx for laryngeal paralysis?

A

Laryngeal tieback (arytenoid lateralisation)

73
Q

Which dogs are predisposed to tracheal collapse?

A

TOy breeds

74
Q

What are the 4 grades of tracheal collapse?

A

25% decrease of tracheal diameter with each grade inc

75
Q

What surgery can be used to treat tracheal collapse?

A

Intraluminal stenting

76
Q

What is the maximum number of tracheal rings that may be removed in tracheal resection?

A

5-6

77
Q

Give 4 indications for a lung lobectomy

A

Lobe torsion
Local abscess/ cyst/neoplasia
Severe lung trauma
Broncho-oesophageal fistula

78
Q

What are the 3 indications for a tube thoracostomy?

A

Thoracotomy Post-Op care
Ongoing Pneumothroax
Large Volume PLeural effusion

79
Q

How are rib fractures treated?

A

conservative management