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LAM I > Test 2 > Flashcards

Test 2 Flashcards

1
Q

Trace air through the horse’s respiratory tract starting at the nares

A

Nares > nasal passage > ethmoid > nasopharynx > guttural pouch > larynx > trachea

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2
Q

2 distinct circulations in respiratory tract

A

Pulmonary and bronchial

Pulmonary – low pressure, high volume, oxygenation of blood. Resting PAP = 25-30mmHg, exercise PAP = 125mmHg
Bronchial – high pressure, low volume, distribution of pulmonary tissues. Resting = 100mmHg, exercise = 220mmHg

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3
Q

Why do we rebreathe horses?

A

increase rate + depth of respiration, used to elicit or accentuate abnormal lung sounds

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4
Q

Which mainstem bronchi is larger?

A

Right

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5
Q

How can you tell which ethmoid turbinate you are looking at?

A

The first most superficial comes from the lateral side

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6
Q

Which is the most relevant test in diagnosis of upper airway diseases and involvement?

A

Endoscopy

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7
Q

T/F: Radiographs are good to evaluate pulmonary disease while US is good to evaluate thoracic disease.

A

TRUE

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8
Q

Transtracheal wash

A

sterile
focal, infectious diseases
can culture sample

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9
Q

Bronchoalveolar lavage

A

non-sterile
diffuse, non-infectious diseases
cannot culture sample

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10
Q

Upper airway disease

A

unilateral or bilateral nasal discharge
inspiratory component
lung sounds are normal

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11
Q

lower airway disease

A

bilateral nasal discharge
expiratory component
lung sounds = abnormal

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12
Q

Most common cause of epistaxis

A

trauma (nasogastric intubation

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13
Q

Guttural Pouch Mycosis

A

young horses
minor bouts of hemorrhage then unpredictable major bleeding episode, bilateral epistaxis
usually internal carotid artery, also external carotid artery +/- maxillary artery
CS: epistaxis and dysphagia
Treatment: if not bleeding - topical + systemic antifungals (temporary indwelling catheters), if bleeding, surgical (occlude both ends of vessel bc Circle of Willis)
complication - blindness

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14
Q

Progressive Ethmoid Hematoma

A

old, male, thoroughbred
CS: unilateral epistaxis, mild, spontaneous, intermittent
Dx: endoscopy, rads, CT
Tx: laser ablation (transendoscopically preferred), cauterize while you cut, medical can use formalin (necrosis, desiccate lesion)

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15
Q

Exercise induced pulmonary hemorrhage

A

INTENSITY, not duration of exercise
Capillary stress theory - high intrathoracic pressure, inflammation, bronchial angiogenesis, pulmonary fibrosis
CS: poor performance, epistaxis in only 1-10%
Dx: endoscopy for direct observation of blood in tracheobronchial tree –> 30-90mins post race, can see up to 7 days, graded 0-4. Hemosiderophages in secretions
Tx: LASIX (furosemide)

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16
Q

what condition of epistaxis do you see hemosiderophages?

A

EIPH

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17
Q

top Ddx for old horse with bilateral epistaxis

A

ethmoid hematoma

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18
Q

Top Ddx for young horse with unilateral epistaxis

A

guttural pouch mycosis

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19
Q

Airway epithelium takes ______ to heal

A

7 weeks

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20
Q

Clara cells

A

terminal + resp bronchioles, source of surfactant like substance which aids in maintaining patency of airway

21
Q

_______ is a constant component of cough

A

bronchoconstriction

22
Q

maximal expiratory flow maneuver

A

forceful inspiration -> compression: close glottis -> expression: rib cage, abdomen, diaphragm -> relaxation

23
Q

Specific lung sounds for pneumonia, pleuropneumonia, pleural effusion

A

pneumonia - increased lung sounds, crackles, wheezes
Pleuropneumonia - ventral dull sound
pleural effusion - cardiac sounds larger area than normal bc better sound conduction

24
Q

Equine influenza

A 
young-3yr olds
crowding, transport, stress
major cause resp distress
aerosolized >35 feet
destroy ciliated epithelium
25
Q

Equine herpesvirus

A

young-3yr olds
destroy ciliated epithelium
EHV-1 - resp + repro
EHV 4 - resp + neuro
CS: conjunctivitis, lymphadenopathy, edema, vasculitis, polysynovitis
EHV5 - equine multi nodular pulmonary fibrosis

26
Q

Bacterial causes of cough

A

Aerobic - streptococcus zooepidemicus

Anaerobic - bacterioides fragillis (treat with metronidazole)

27
Q

Most common secondary organism of fungal pneumonia

A

aspergillus spp.

28
Q

Equine multinodular pulmonary fibrosis

A

Diffuse bronchointerstitial lung pattern with multiple coalescing circular nodules throughout lung field
US - multiple circular hypo echoic masses
Tx: corticosteroids, NSAIDs, antivirals, antifibrotic agents
EHV5

29
Q

Foal pneumonia Ddx for <1 month vs 1-6 months

A

<1 month - meconium aspiration, aspiration pneumonia, iatrogenic, surfactant inactivation, equine viral arteritis, EHV

1-6m - S. zooepidemicus or R. equi, resp viruses

30
Q

Foal pneumonia

A

Dx: rads allow evaluate deep parenchyma, lung consolidation

Tx; antimicrobials against most common bacteria based on C/S

31
Q

two diseases encompassed by the term “equine asthma”

A

inflammatory airway disease (IAD) and recurrent airway obstruction (RAO)

32
Q

Inflammatory airway disease (IAD)

A

young, non-seasonal
CS: occasional cough, poor performance, normal RR, tracheobronchial fluid accumulation, normal lung
Inflammation of lower airway as response to possible allergens
BAL - neutrophilia >10%, mast cells >5%, eosinophils >5%
Tx: improves spontaneously or with minor treatments

33
Q

Recurrent airway obstruction (RAO)

A

old animals, seasonal
CS: regular cough, increased RR, accentuated expiratory effort (heave line), abnormal lung sounds w/ rebreathing bag
environmental source
goblet cell hyperplasia, over inflation alveoli
suppurative, non-septic inflammation, neutrophilia >25%, no change in mast cell or eosinophil numbers
endoscopy: distal airways edematous + inflamed
Tx: environmental management is most important, bronchodilators, corticosteroids (dexamethasone, prednisOLONE)

34
Q

T/F: Prednisone is drug of choice to treat RAO

A

NO, use PREDNISOLONE. prednisone –> treatment failure

35
Q

Guttural pouch empyema

A

Strep zooepidemicus, strep equi var equi
CS: intermittent nasal discharge, lymphadenitis, parotid swelling, dysphagia, chondroids
Dx: rads, endoscopy + culture
Tx: penicillins, flush pouches w/ retention catheter (LRS then Abs, acetylcysteine to dissolve concretions), Sx - drain then heal by second intention

36
Q

Strangles

A

highly contagious, young horses, gets into guttural pouch via retropharyngeal LN
strep equi var equi
CS: high fever w/ depression, purulent yellow green discharge, respiratory distress
Pathophysiology - organism infects macrophages in upper resp tract, replicates in pharynx (fever w/o any other CS), engulfed by macrophages, to regional LN -> rupture + drainage
highest environmental contamination - water sources
day 7-14 (LN rupture) = most contagious
Dx: C/S, PCR

37
Q

How do you treat bastard strangles?

A

let disease run its course, if complicated give penicillin

38
Q

Purpura hemorrhagica

A

leukocytoplastic vasculitis - neutrophilic infiltration of venues
CS: hot and painful edema in all 4 limbs
Tx: steroids (is immune mediated), penicillin (for infection) hydrotherapy on limbs to avoid skin slough

39
Q

Pleuropneumonia

A

pleural effusion assoc w/ pneumonia secondary to abscessation
CS: fever, resp dz, weight loss if chronic, pectoral edema (depending on drainage)
Dx: pulmonary sounds absent ventrally, louder dorsally, straight line across thorax, crackles and wheezes
CBC: early - early fibrinogen, CBC of ill endotoxic horse; later - elevated fibrinogen, neutrophilic leukocytosis

40
Q

Rhodococcus equi

A

gram +, intracellular facultative aerobic
subacute to chronic bronchopneumonia
foals 1-6m
MC in dry season, inhalation
Rads: abscessation, miliare, broncho-pneumonia, interstitial
Tx: erythromycin estolate, rifampin

41
Q

Foal pneumonia associated with rad patterns:abscessation, miliare, broncho-pneumonia, interstitial

A

Rhodococcus equi

42
Q

Special pneumonia that we treat with erythromycin estolate and rifampin

A

rhodococcus equi

43
Q

What shows remarkable sensitivity as indicator of myonecrosis?

A

creatine kinase (CK)

44
Q

CK vs AST

A
  • elevations in CK and AST reflect recent or active myonecrosis
  • CK remains persistently elevated - myonecrosis likely ongoing
  • elevated AST with normal or decreasing CK - myonecrosis not continuing
45
Q

Positive hemastix test

A

urinalysis

in absence of hemolysis or RBC in urine - highly suggestive of myoglobinuria

46
Q

Exercise challenge

A

measure CK pre and post work out (4-6h)
slow trot
increase >5x indicative of exertional rhabdomyolysis

47
Q

Biopsy of muscle

A

pathological alterations that cant be seen in formalin fixed tissue but can be seen with histochemical stains
local anesthetic SQ, 1 inch square sample minimum

48
Q

Sweeney

A

atrophy of supra scapular muscles due to denervation bc damage of supra scapular nerve

LAM I (8 decks)

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