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Pulmonary > SA- problem based approach > Flashcards

SA- problem based approach Flashcards

1
Q

What are the two segments of the URT

A

Rostral to nasopharynx; pharynx, larynx, cervical trachea

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2
Q

What defines the LRT

A

Pulmonary airways and parenchyma

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3
Q

Eupnea

A

normal breathing

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4
Q

hyperpnea

A

increased depth or force of airflow

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5
Q

hyperventilation

A

(exchanging more air in a time period) faster and/or deeper

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6
Q

What is the typical cause of bradypnea

A

Brain issues

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7
Q

Hypopnea

A

Shallow, decreased

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8
Q

Apnea

A

Cessation greater than 10 seconds

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9
Q

Hypoventilation

A

Slower and/or more shallow

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10
Q

Orthopnea

A

dyspnea while laying down

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11
Q

Apneustic

A

Deep long inspiration then breath holding and rapid exhalation

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12
Q

Ataxic/agonal

A

Irregular shifts of hyper and hypoventilation and apnea- DYING!

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13
Q

Cousmal

A

Air hunger- swallowing air

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14
Q

What is it called when abdomen and thorax are moving in opposition to each other

A

Paradoxic breathing

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15
Q

What are the usual causes of paradoxic breathing

A

diaphragmatic hernia or paralysis

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16
Q

Decribe flail chest

A

Segment of chest wall moves independently from others- usually rib fractrue

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17
Q

Two normally auscultable sounds

A

Bronchial- normal turbulent air flow in trachea; vesicular- lower area normal sounds that are longer and more intense on inspiration

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18
Q

Audible abnormal sounds

A

Stertor, stridor, wheeze

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19
Q

Stertor (describe)

A

Snoring produced by partial obstruction of upper airway

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20
Q

Stridor (describe)

A

High pitched, harsh, vibratory, from partial obstruction at upper trachea

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21
Q

Stridor (locations)

A

Larynx, caudal oropharynx, cervical trachea

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22
Q

Stertor (locations)

A

Only mouth/nasal/nasopharynx

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23
Q

Wheeze

A

In cats on inspiration

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24
Q

Laryngeal paralysis will cause what audible sound

A

Stridor (also could be caused by tumor)

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25
Q

What causes crackles

A

Fluid! Air passing through fluid or forcing open a collapsed airway/alveolar wall

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26
Q

What causes wheezes

A

Continuous whistling from air turbulence in lower airways from obstruction or narrowed airway

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27
Q

When do crackles occue (I vs E)

A

Both

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28
Q

When do wheezes occur (I vs E)

A

Typically expiratory

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29
Q

Where do wheezes originate

A

Typically below carina but def. below the larynx

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30
Q

What is an end expiratory grunt

A

Push to get air out by contracting diaphragm

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31
Q

What is the difference between pleural rubs and crackles

A

Happen at the same time of inspiration every time, less diffuse than crackles, lungs catching due to decreased fluid or fibrin

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32
Q

What is the snare drum sound

A

Pleural rubs

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33
Q

What is the classic presentation of fluid in the chest

A

Sounds dorsally but not ventrally

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34
Q

What do sounds ventrally but not dorsally indicate

A

Air accumulation in lungs

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35
Q

Which region is this associated with - epistaxis

A

Nose/nasopharynx

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36
Q

Which region is this associated with - sneezing

A

Nose/nasopharynx

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37
Q

Which region is this associated with - stertor

A

Nose/nasopharynx

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38
Q

Which region is this associated with - facial asymmetry

A

Nose/nasopharynx

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39
Q

Which region is this associated with - stridor

A

URT obstruction

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40
Q

Which region is this associated with - coughing

A

URT obstruction below larynx or LRT

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41
Q

Which region is this associated with - I >E

A

URT obstruction

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42
Q

Which region is this associated with - exercise intolerance

A

URT or LRT

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43
Q

Which region is this associated with - hyperthermia

A

URT

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44
Q

Which region is this associated with - Tachypnea, dyspnea, distress

A

URT or LRT

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45
Q

Which region is this associated with - wheezing

A

LRT bronchi, bronchioles

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46
Q

Which species gets polyps in the nasal/nasoph

A

Cats

47
Q

What species is more predisposed to aspergillosis

A

Dogs

48
Q

Cause of cat cough

A

Rare, but if: asthma, HWDz, bronchitis

49
Q

Lower airway- cat vs dog

A

feline asthma, canine chronic bronchitis

50
Q

Pleural space disease cats vs dogs

A

CHF- cats- pleural space edema dogs- alveolar edema

51
Q

Tracheal collapse symptoms in large dog is likely

A

Chronic bronchitis

52
Q

Signalment for blastomycoses or pyothorax

A

Hunting dogs

53
Q

Spontaneous pneumothorax- Signalment

A

Huskies

54
Q

Pneumocystis/protozoal pneumonia- signalment

A

Doxies

55
Q

Younger or older? Polyps

A

Younger

56
Q

Younger or older? viral infection

A

Younger

57
Q

Younger or older? Fungal infection

A

Older

58
Q

Younger or older? Allergic rhinitis

A

older

59
Q

Younger or older? Immune mediated

A

Older

60
Q

Rule outs for cough

A

regurg/vomiting, reverse sneeze, HWDz

61
Q

Chronic or acute? fungal

A

Chronic

62
Q

Chronic or acute? viral/bacterial

A

Acute

63
Q

Chronic or acute? CHF

A

Acute

64
Q

Ocular retropulsion tests for

A

Nasal/nasoph

65
Q

Observing abdominal movements and postural changes - for:

A

Airway or pulmonary disease

66
Q

Increased time/effort of inspiration- tx

A

Bypass upper airway, tap chest

67
Q

Increased time/effort of expiration- tx

A

bronchodilators, steroids

68
Q

Characterize cough

A

Productive, dry, moist, harsh, soft; spasmodic, paroxysmal; induced/spontaneous

69
Q

Characterize wheezes

A

Sonorous- low pitch; sibilant- high pitch

70
Q

Causes of respiratory distress

A

Lack of oxygen delivery from obstruction, cardiac, hematologic

71
Q

True airway distress localizes issue to :

A

Larynx or lower

72
Q

Head/neck extension posture, inspiratory component localized:

A

Laryngeal/ upper airway

73
Q

Tachycardia, murmur, pulse abnormalities significant enough to cause distress- primary ddx

A

Cardiac disease

74
Q

Iatrogenic pathology of decreased O2

A

Environmental O2

75
Q

Squeeze cat cranial thorax- cant compress =

A

Mass

76
Q

Where are cough receptors found

A

URT and large airways primarily

77
Q

Why can cough occur when URT not primary affected

A

movement of secretions, compression,

78
Q

Two causes of cardiac cough

A

Chamber enlargement compressing airway (should have murmur);

79
Q

True respiratory distress only occurs if lesion is

A

At or below larynx

80
Q

Muffled lung sounds indicate

A

pleural space disease

81
Q

Expiratory effort- localized

A

Intrathoracic lesions

82
Q

Inspiratory effort- localized

A

Extrathoracic lesions

83
Q

First test performed for chronic respiratory distress

A

HWT! Ab in dogs, Ab/Ag in cats

84
Q

How are FELV and FIV linked to respiratory issues

A

Cause cancers or immumosuppressive opportunistic infections - no primary respiratory component

85
Q

What parasite tests should be done?

A

Baermann with float, +/- direct smear

86
Q

Most common infectious disease test

A

PCR

87
Q

What will blood gas test tell

A

Severity of disease - pulmonary dz vs hypoventilation (disease must be severe to be appreciated)

88
Q

What does pulse ox measure

A

% Hg molecules saturated with O2- not total content

89
Q

What is a limitation of pulse ox

A

Anemia or toxicity (usually CO2) poisoning will look like 100% - but actual carrying ability decreased

90
Q

FiO2: PaO2 ideal

A

> 400 nomral
3-4 mild-moderate
below 3 - severe

91
Q

Pulse ox reading 90 - corresponding PaO2

A

65 - tissue damage (FiO2 of 300)

92
Q

Normal room air PaO2

A

97-99

93
Q

Danger level for PaO2 and corresponding pulse ox

A

60 or below; pulse ox - 88

94
Q

Fatal level of PaO2 and corresponding pulse ox

A

50 or below (pulse ox 80)- need intervention! O2 to assisted ventilation

95
Q

Intervention point of PaO2 and pulse ox

A

50 / 80

96
Q

Primary reason for angiography

A

PTE or lung perfusion

97
Q

Primary reason for fluoroscopy

A

dynamic collapse

98
Q

Primary reason for CT

A

Bone

99
Q

Primary reason for MR

A

Soft tissue

100
Q

When would an oropharyngeal exam be indicated

A

CS localized to URT - teeth, palate, masses, etc. REQUIRE ANESTHESIA

101
Q

3 types of nasal cytology

A

FNA/impression smear, FNA of local lymph nodes, nasal flush sample - not a great test (bacteria normal

102
Q

When is nasal cytology most useful

A

Fungal rhinitis or neoplasia

103
Q

What are the only things that can be diagnosed via rhinoscopy

A

Foreign body or nasal mites

104
Q

Best nasal test for specific diagnosis

A

Nasal biopsy

105
Q

What is bronchoscopy

A

Direct visualization of airways that facilitates sample collection from LRT

106
Q

What is obtained in tracheal wash

A

Cells and fluid from large airways that bypasses normal oral flora

107
Q

What diseases should use a tracheal wash for dx

A

Large airway and severe diffuse alveolar

108
Q

What is the only tracheal wash that doesnt require anesthesia

A

TTW

109
Q

What are the two main techniques for bronchoalveolar lavage

A

Bronchoscopy guided and endotracheal lavage

110
Q

What cells should predominate in normal respiratory secretions

A

mononuclear cells

111
Q

What do neutrophils in a TW indicate

A

inflammation or infection

112
Q

What do eosinophils in a TW indicate

A

allergic or parasitic infection

113
Q

Normal or abnormal: organisms within phagocytes

A

Abnormal especially if one species predominates

Pulmonary (4 decks)

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