Respiratory - Nasopharyngeal Diseases + Rhinitis

Question 1

Embryologically, the lumen of the ______ is an extension of the pharynx.

Answer 1

middle ear

Question 2

Where does olfaction occur?
A) nasal entrance
B) meatus nasopharynges
C) olfactory chamber
D) nasopharynx

Answer 2

C - olfactory chamber

Question 3

What is a polyp

Answer 3

fibromuscular connective tissue arising from mucosal lining of nasopharynx, auditory tube, or middle ear
more common in cats than dogs

Question 4

Sneezing

Answer 4

expiratory, usually associated with nasal or sinus disease

Question 5

Reverse sneezing

Answer 5

inspiratory, usually associated with nasopharyngeal, caudal nasal, or sinus disease

Question 6

Treatment of polyps

Answer 6

traction avulsion + corticosteroids

ventral bulla osteotomy if bulla involvement

Question 7

Foreign body

Answer 7

onset of clinical signs may be acute
Diagnosed by direct visualization, endoscopy or CT
Treated - dislodge and extract

Question 8

Nasopharyngeal stenosis

Answer 8

causes: regurgitation (esp under anesthesia), chronic inflammation, post surgical scarring, trauma, congenital anomaly, mass
diagnosed by endoscopy or CT
treated by balloon dilation

Question 9

Most common causes of feline fungal rhinitis

Answer 9

cryptococcus

also aspergillus, rhinosporidium

Question 10

Clinical signs of feline fungal rhinitis

Answer 10

sneezing and nasal discharge
polypoid masses in nares, ulcers and nodules on planet or bridge
decreased or absent nasal airflow, exophthalmos, facial asymmetry, starter, mass/ulcer in pterygopalatine fossa
enlarged lymph nodes, neuro signs

Question 11

Diagnosis of feline fungal rhinitis

Answer 11

cytology and culture of nasal discharge
serology
CT
thoracic rads
rhinos copy with biopsy - PCR to differentiate Aspergillus spp.
dental probing + dental rads to rule out a dental cause of rhinitis

Question 12

Treatment of feline fungal rhinitis caused by cryptococcus

Answer 12

oral fluconazole until antigen latex agglutination test is 0, recheck 1m after, then lifelong monitoring because relapse is common
debunk granulomas if obstruction is severe

Question 13

Treatment of feline fungal rhinitis caused by Aspergillus

Answer 13

oral posaconazol or itraconazole

if disease confined to nasal cavity, also topical treatment and decried plaques

Question 14

Cause of chronic rhinosinusitis in cats?

Answer 14

unknown

Question 15

Which is FALSE regarding diagnosing chronic rhinosinusitis in cats?
A) CRS is a diagnosis of exclusion
B) bacterial culture is a must
C) laryngoscopy, rhinos copy, and biopsy of other tissues is useful to rule out other causes
D) dental probing to rule out tooth root abscess

Answer 15

B - bacterial culture is controversial

Question 16

Treatment of CRS

Answer 16

1. antibiotic - based on deep culture or Hx (doxy)
2. anti-inflammatory - NSAID (meloxicam or piroxicam), or glucocorticoid (red)
   also antiviral - lysine to reduce FHV-1, femciclovir
   adjunct tx for nasal discharge (nasal flush, humidification, N-acetylcysteine)

Question 17

Feline Neoplasia

Answer 17

CS - upper airway obstruction, decreased nasal airflow, epistaxis, sneezing, ocular and CNS signs
lymphoma, adenocarcinoma, SCC, undifferentiated carcinoma, fibrosarcoma

Question 18

causes of fungal rhinosinusitis in dogs

Answer 18

most common - aspergillus fumigatus

also - penicillium, rhinosporidium seeberi, cryptococcus neoforms (rare)

Question 19

Clinical signs of nasal aspergillosis in dogs

Answer 19

nasal discharge, sneezing, may see epistaxis, facial pain, depigmentation, ulceration may be present

Question 20

Which is FALSE regarding the treatment of nasal aspergillosis in dogs?
A) negative serology rules out aspergillosis
B) see significant destruction of turbinates and cavitation on a CT
C) rhinoscopy to visualize and debride fungal plaques
D) see branching hyphae with cytology

Answer 20

A - negative serology doesn’t rule out aspergillosis

Question 21

Treatment of nasal aspergillosis in dogs

Answer 21

topical infusion if cribriform plate is intact of clotrimzole or enilconazole, oral antifungal added if local bone or soft tissue invaded
oral anti fungal if cribriform plate is not intact - itraconazole or terbinafine for 3-6m

Question 22

Causes of idiopathic lymphoplasmacytic rhinitis (ILPR)

Answer 22

aberrant immune response
inhaled allergens and irritants
hypersensitivity to native organisms

Question 23

Signalment of animals that get ILPR

Answer 23

young to middle aged dolichocephalic and mesaticephalic large breeds and dachshunds

Question 24

Clinical signs of ILPR

Answer 24

nasal discharge, mucoid or mucupurulent, epistaxis possible

excessive mucus or edema may obstruct airflow

Question 25

Which is FALSE regarding ILPR diagnosis?
A) it is a diagnosis of exclusion
B) history: see lymphoplasmacytic infiltrate
C)CT scan is normal
D) rhinos copy - erythema and edema of mucosa

Answer 25

C - can be normal but can show turbinate lysis and mucus accumulation

Question 26

Treatment of ILPR?

Answer 26

avoid smoke and other allergens

long term antibiotic with immunmodulatory effects + NSAID - doxy or azithromycin + piroxicam

Question 27

Canine neoplasia

Answer 27

1/3 of chronic nasal disease in dogs
CS: upper airway obstruction, decreased nasal airflow, epistaxis, sneezing
adenocarcinoma, lymphoma, undifferentiated carcinoma

Question 28

Ddx for nasal discharge and sneezing

Answer 28

advanced dental disease - rot abscess and/or oronasal fistula
nasal foreign body
nasal regurgitation