Respiratory System Intro & Nasal Disease Flashcards
Oxygen levels in the blood, lungs and/or tissues is low
Hypoxia
Insufficient oxygenation of the blood
Hypoxemia
Respiratory stimulant when
PaO2 is less than _________
(normal 90 – 110 mmHg)
< 50 mmHg
A term used to describe increased CO2 levels, respiratory stimulant
Hypercapnia
Bluish to red-purple color in the tissues, due to increased amounts of deoxygenated or reduced hemoglobin
Cyanosis
T/F:
An animal with cyanosis will have abnormal
hematocrit values
FALSE!
Hematocrit is NORMAL in animals with cyanosis
Arterial SaO2 must = 73 and
pulse ox must =78%
(PaO2 39 - 44mmHg)
before _____ is found
cyanosis
An animal experiencing difficult or labored breathing
is said to have
Dyspnea
High pitched inspiratory noise due to
rapid flow of air passed a rigid obstruction
like a paralyzed or collapsed larynx
Stridor
Low pitched inspiratory noise
like a gurgling or snoring sound
produced as air passes a soft tissue obstruction
Stertor
The sensation of breathlessness/ difficulty breathing in the recumbent position (or when not upright), relieved by sitting or standing.
The animal will adopt a strange position, like sternal recumbency with elbows abducted, the neck extended and open mouth breathing.
Orthopnea
Where is the location?
Nasal discharge
Upper airways
Where is the location?
Sneezing/reverse sneezing
Upper airways
Where is the location?
Increased effort in inspiration
Upper airways
Where is the location?
Audible sounds (stridor/stertor)
Upper airways
Where is the location?
Inability to breathe if mouth is closed
Upper airways
Where is the location?
Pawing at face
Upper airways
Where is the location?
Cough (hallmark sign, but DDX is heart disease!)
Lower airways
Where is the location?
Respiratory distress
Lower airways
Where is the location?
Increased effort in expiration
Lower airways
Where is the location?
Crackles and wheezes audible on auscultation
Lower airways
Adventitial Sounds (Parenchymal Disease):
Snapping open of the airways
that have closed due to
fluid in or around them
CRACKLES
Adventitial Sounds (Parenchymal Disease):
causes by airflow through a narrow opening – airways are constricted/ narrowed
Wheezes
Adventitial Sounds (Parenchymal Disease):
loud sharp sound over hilus at end of expiration indicates collapse of the intrathoracic trachea, carina or mainstem bronchi
Snaps
Adventitial Sounds (Parenchymal Disease):
The sound heard with tracheal collapse
Goose Honks
Adventitial Sounds (Parenchymal Disease):
creaking/ grating sound due to roughened pleural surfaces rubbing against each other
Pleural friction rubs
Name the 5 adventitial sounds heard on pulmonary
auscultation indicating parenchymal disease
Crackles
Wheezes
Snaps
Goose Honks
Pleural Friction Rubs
The following describe which pleural disease?
Lung sounds are auscultated dorsally
Lungs floating in fluid
Muffled sounds ventrally
Heart sounds are reduced
Pleural Effusion
The following describe which pleural disease?
Absence of lung sounds dorsally due to compression
Only present in the ventral field
Pneumothorax
What structures are evaluated with
Bronchoscopy?
Larynx
Trachea
Bronchi
T/F:
Local anesthesia and a cuffed ETT are
required when performing a Nasal Flush
FALSE!
GENERAL anesthesia and a cuffed ETT
are required for Nasal Flush
What is the alternative to Nasal Flushing?
Cytobrush
What are the indications for a BAL
(Bronchoalveolar Lavage)?
Lung disease involving
small airway
alveoli
and/or
interstitium
Transtracheal vs. Endotracheal Wash/Aspirate
Which is better for a medium or large dog?
TT
Transtracheal vs. Endotracheal Wash/Aspirate
Which is better for cats?
Endotracheal
Transtracheal vs. Endotracheal Wash/Aspirate
Which requires general anesthesia?
Endotracheal
What is the landmark for a transtracheal wash/ aspirate?
Cricothyroid Ligament
Which procedure is indicated if
you suspect a nasal foreign body?
Nasal Flush
Which procedure is indicated if
you suspect airway or parenchymal disease?
Transtracheal or Endotracheal Wash/Aspirate
Which procedure is indicated if you suspect
an intrathoracic lesion in contact with thoracic wall
or
diffuse disease?
Transthoracic Lung Aspiration
Which procedure is indicated in the treatment
of Pyothorax
or
Pneumothorax when air is constantly accumulating?
Chest Tube
Which category of drug
may allow dose reduction of glucocorticoids
in some cases of allergic bronchitis?
Bronchodilators
This category of drug is used
mainly in dogs with a
dry and non-productive cough
due to airway collapse or irritant tracheitis
Antitussives
T/F:
Antitussives are good to use
in order to alleviate
all coughs
FALSE!
AVOID Antitussives in MOIST coughs!
This respiratory therapy improves
hydration of the lower airways
and
is a way to administer some antibiotics
Nebulization followed by Coupage
What are the indications for oxygen therapy?
To treat hypoxemia (PaO2 < 90%)
and
To decrease workload of the heart and lungs
What are the clinical signs of nasal disease?
Nasal discharge
Sneezing
Pawing at face/pain
Respiratory difficulty upon inspiration
Stertor (noisy respiration)
A dog presents with the following:
- Sudden onset
- Acute sneezing
- Gagging/reverse sneezing
- Pawing at the nose
- Discharge that is serous, mucoid, and/or purulent
What is your diagnosis?
Nasal foreign body
What are the 2 congenital causes of
nasal discharge?
- Ciliary Dyskinesia
- Nasopharyngeal Stenosis
Infectious Rhinitis- Feline Upper Respiratory Disease Complex
What are the 2 most common agents?
- Feline herpesvirus (FHV)*
- Feline calicivirus (FCV)*
Infectious Rhinitis- Feline Upper Respiratory Disease Complex:
Which agent is shed during times of stress?
Feline herpesvirus (FHV)
What are the less common potential agents of infectious rhinitis in cats?
FHV and FCV (90%)
- Chlamydophila felis*
- Mycoplasma spp.*
- Coronavirus*
- Bordetella spp.*
A cat presents with infectious rhinitis and
is displaying the following clinical signs:
Ulcerative keratitis
Punctate or Dendritic ulcers
What is your primary differential?
FHV
A cat presents with infectious rhinitis
and is displaying the following clinical signs:
Ulcers on nose, tongue, and/or hard palate
Pneumonia
Lameness
What is your primary differential?
FCV
A cat presents with infectious rhinitis
and is displaying the following clinical signs:
Ulcers on nose, tongue, and/or hard palate
Conjunctivitis
Chemosis
What is your primary differential?
Chlamydophila felis
The outer surface of the eye (conjunctiva) may look like a big blister.
It can also look like it has fluid in it.
When severe, the tissue swells so much that eyes cannot close properly
The word for this condition is ________
Chemosis
How is
Feline Herpesvirus (FHV) - Rhinotracheitis
spread?
Direct contact
Fomites
Feline Herpesvirus (FHV) - Rhinotracheitis
is shed in which 3 secretions?
Ocular
Nasal
Pharyngeal
What kind of nasal discharge would you
expect to see with FHV?
Serous then mucopurulent
due to secondary bacterial infection
Which agent of infectious rhinitis establishes
lifelong latency?
FHV
Where does FHV most commonly establish
lifelong latency?
Trigeminal nerve ganglia
What are the most common sequelae
associated with FHV?
Chronic rhinitis/sinusitis
Chronic conjunctivitis
Epiphora
Fibrosis of the lacrimal ducts is known as
Epiphora
______% of recovered cats become
carriers and shed FHV when stressed
80%
FHV causes damage to the ______
which predisposes the animal to
secondary bacterial infections in the nasal cavity
turbinates
T/F:
There is a vaccine for FHV which
prevents cats from contracting most strains
FALSE!
It does NOT prevent infection, it only
REDUCES THE SEVERITY of infection
Which route of administration for the
FHV vaccination
can be blocked by maternal antibodies
and does NOT prevent a carrier state
Parenteral (IV or IM)
Which route of administration for the
FHV vaccination is
Useful in outbreaks
NOT blocked by maternal antibodies
May prevent a carrier state
Intranasal
T/F:
Calicivirus is a DNA-virus with many isolates
and a high mutation rate
FALSE!
It is an RNA-virus
Which agent of infectious rhinitis in cats can
be shed up to 75 days post-infection
in about half of all recovered cats?
Calicivirus
The incubation period of Calicivirus
is short, lasting ______ days
2 - 4 days
Which agent of infectious rhinitis in cats is described
by the following:
Pneumonia is more common
Can result in GI signs
Can cause lameness
Calicivirus
What are the 2 syndromes associated with
Feline Calicivirus?
Limping Kitten Syndrome
Virulent Hemorrhagic Systemic Syndrome
Which agent of infectious rhinitis is
an intracellular bacteria?
Chlamydophila felis
What are the hallmark signs of Chlamydophila felis?
Conjunctivitis and Chemosis
How can you confirm the diagnosis of
Chlamydophila felis with cytology?
Seeing intracytoplasmic inclusion bodies
on a conjunctival swab
Which topical decongestant is preferred
for the treatment of congestion
associated with Cat Flu?
Phenylephrine
What type of nasal discharge are you likely to see
with Bacterial Rhinitis?
Mucopurulent to purulent
T/F:
Bacterial Rhinitis is a primary disease process
characterized by mucopurulent or purulent
nasal discharge
FALSE!
It is almost always a SECONDARY disease process!
What type of rhinitis is seen secondary to the following:
- Foreign body
- Tooth root abscess
- Chronic viral infection
- Fungal infection
- Neoplasia
Bacterial Rhinitis
A dog presents with sneezing and nasal ulceration with depigmentation
What is your primary differential?
Aspergillus fumigatus
Fungal Rhinitis!
T/F:
In cases of aspergillosis, you should perform
a CT/MRI BEFORE performing a nasal flush
or rhinoscopy
TRUE
T/F:
Radiographs are the most helpful tool
for diagnosis of fungal rhinitis
FALSE!
Rads cannot distinguish between
fungal rhinitis and neoplasia
CT/MRI is more helpful!
What do you expect to see upon
rhinoscopy in a dog with aspergillosis?
White plaques!
What do you expect to see on cytology
in a dog with aspergillosis?
Hyphae
What is the best place to take a sample
for a C/S (culture and sensitivity) in the
case of Aspergillus nasal infection?
From the white plaques!
(NOT the nasal discharge!)
The treatment for fungal rhinitis in dogs
is debridement using conazoles.
When is debridement contraindicated?
If the cribriform plate is damaged!
What treatment is used in dogs with
cribriform plate osteolysis (damage)
with fungal rhinitis, where debridement is
contraindicated?
Systemic antifungal meds!
(Itraconazole)
What agent of fungal rhinitis affects cats and dogs
and is commonly found in pigeon droppings?
C. neoformans var gattii
Submandibular lymphadenopathy and
chorioretinitis are clinical signs associated
with this agent of fungal rhinitis
Cryptococcus neoformans
A serum titer is a very reliable method for
diagnosis of this agent of fungal rhinitis
Cryptococcus neoformans
Which agent of fungal rhinitis is seen in
nasal discharge?
Cryptococcus neoformans
What is the agent of parasitic rhinitis in
dogs only, and is not found in cats?
Pneumonyssus caninum
This is a mite that parasitizes the naropharynx
of dogs and can be treated with
Ivermectin
Pneumonyssus caninum
- Chronic inflammatory rhinitis*
- characterized by a cell infiltration*
- into the nasal mucosa*
- in the absence of any obvious underlying etiology*
LPR (Lymphoplasmacytic Rhinitis)
What method is used to obtain a definitive diagnosis
of LPR?
Histopathology on biopsy samples
In LPR, nasal mucosa can be
red, edematous, and bleeding.
What changes are seen in the turbinates?
Turbinates are atrophied or destroyed!
Which off-label treatment is used in the
tx of LPR?
Maropitant (Cerenia)
Cerenia, used for the tx of LPR,
blocks __________ from binding to tissues
by antagonizing the receptors for tachykinins
which are released from degranulating mast cells
(and other inflammatory cells)
Substance P
Which type of dogs are predisposed to
nasal neoplasia?
Dolichocephalic breeds
When comparing fungal rhinitis to nasal neoplasia,
in which situation would airflow most likely be
NORMAL?
Fungal rhinitis
This is the reason that there is decreased nasal
cavity airflow in nasal neoplasia
The Mass Effect
What is the best method for diagnosing
nasal neoplasia?
Rhinoscopy with biopsy
________ is required to plan treatment
for nasal neoplasia
Histopathology
What is the most common type of cancer
seen in cases of nasal neoplasia?
Adenocarcinoma
What is the treatment of choice for most
nasal neoplasias?
Radiation
Chemotherapy is useful in the treatment
of this type of nasal neoplasia
Lymphoma
Which has a better prognosis?
Adenocarcinomas or Squamous Cell Carcinomas?
Adenocarcinomas
Which has a better prognosis?
Nasal sarcomas or undifferentiated carcinomas
Sarcomas!
Adenocarcinoma and SCC are the most
common types of nasal neoplasia
in __________
DOGS
What are the 2 most common types of
nasal neoplasia seen in Cats?
Adenocarcinoma
Lymphoma
This is an immotile ciliary syndrome that is
rare but seen in many dog breeds.
It is inherited via an autosomal recessive trait.
Primary Ciliary Dyskinesia (PCD)
What respiratory condition is often seen
in cases of PCD?
Bronchopneumonia
What condition is seen in cases of PCD
in regards to brain and spinal cord ciliary
dysfunction?
Hydrocephalus
Many animals with this condition
are infertile, due to
sperm immotility
PCD
This syndrome can be seen in some dogs
with PCD and is characterized by
Situs Inversus
(chronic sinusitis, bronchiectasis,
and reversal of internal organs)
Kartagener Syndrome
A young, purebred dog presents with recurrent respiratory tract infections/signs.
This is the classic presentation of
PCD
