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Respiratory Diseases > Unit 1 > Flashcards

Unit 1 Flashcards

1
Q

What are the defense functions that the respiratory epithelium specifically has

A

A basement membrane, goblet cells to produce mucous, ciliated cells, Type 1 and 2 alveolar cells

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2
Q

What makes up the mucociliary apparatus

A

A gel layer, a sol layer, ciliated cells, goblet cells, and BALT

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3
Q

Give some examples of things that can negatively impact the mucociliary apparatus

A

Dehydration, low humidity, anesthesia, aerosols, airway disease, Infections, having head tied up (LA), congenital defects

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4
Q

What is the difference between type 1 and 2 alveolar cells

A

Type 1- “lining” cells- make up >95% of the surface area of the alveoli
Type 2- secrete surfactants but can also proliferate/differentiate into type 1

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5
Q

What are the roles of the alveolar macrophages

A

They phagocytize organisms/particles (major innate immunity effector)
Immune system recruitment
cytokine production

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6
Q

What is BALT

A

bronchiole alveolar lymphoid tissue- local secondary lymphoid tissue
can orchestrate acquired immune responses

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7
Q

What is lactoferrin

A

an antimicrobial peptide produced by serous cells and neutrophils that inhibits bacterial growth by sequestering iron and producing peroxide to attack LPS (kills gram negs)

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8
Q

What is lysozyme

A

an antimicrobial peptide produced by serous cells, neutrophils, macrophages, and epithelial cells that attacks peptidoglycan (kills gram positives)

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9
Q

What are pattern recognition receptors

A

receptors on the membrane/in cytosol of white blood cells and epithelial cells that recognize specific substances that indicate infection or injury and activate immune responses

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10
Q

What are pathogen- associated molecular patterns (PAMPs) and give an example

A

A PRR that uses something on an infectious organism to recognize the intruder
ex. TLR-4–> bacterial LPS

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11
Q

What are damage- associated molecular patterns (DAMPs) and give an example

A

A PRR that recognizes non-infectious host or “self” problems
ex. DNA following tissue injury

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12
Q

What is the primary location of action of IgA

A

the nasal cavity and upper airway (URT and mucosal surfaces)

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13
Q

What is the primary location of action of IgG

A

Lower airway/alveoli
pulmonary interstitium

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14
Q

What does stertor sound like

A

snoring, snorting, snuffling
aka Uga!

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15
Q

What are the broad causes for stertor

A

excess extra-thoracic tissues or accumulation of secretions, can occur with inhale or exhale

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16
Q

Where may you think the disease is localized to if an animal has stertor

A

to the nasal passages or nasopharynx

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17
Q

What does stridor sound like and when does it occur (in regards to inspiration or expiration)

A

intense, high-pitched wheezing primarily during inspiration

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18
Q

what is the most concerning breath sound

A

stridor (= “die”dor)

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19
Q

give me 4 differentials for stridor

A

laryngeal paralysis or collapse, upper tracheal collapse, laryngeal/tracheal obstruction (fb, mass, swelling)

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20
Q

What causes crackles and give some differentials

A

The snapping open of small airways that have collapsed or accumulated fluid/debris
ex. from pulmonary edema or fibrosis, pneumonia, pulmonary hemorrhage, atelectasis

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21
Q

what is the timing of wheezes

A

early expiration or end inspiration

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22
Q

What are some differentials for wheezes

A

asthma, lower airway obstruction, anaphylaxis

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23
Q

what is the normal respiratory rate for a dog and cat

A

dog- 18-34, cat- 16-40

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24
Q

What is the location associated with obstructive inspiratory dyspnea and give some differentials

A

extra-thoracic obstruction
laryngeal/tracheal obstruction- laryngeal paralysis, tracheal collapse, mass

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25
Q

What are the locations associated with obstructive expiratory dyspnea and give some differentials

A

intra-thoracic- asthma, bronchitis
parenchymal lung disease- interstitial pneumonia, pneumonitis

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26
Q

What causes restrictive dyspnea

A

pleural space disease- pneumothorax, pleural effusion

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27
Q

What is a A-line vs. a B-line

A

A-lines are horizontal lines caused by reverberation artifact from air in the lungs
B-lines are vertically oriented “comet tail” appearing artifact meaning there is a wet or infiltrated lung

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28
Q

Briefly explain how pulse oximetry works

A

It measures unabsorbed light and emits red and infrared lights (oxygenated blood absorbs infrared and deoxygenated absorbed red light)

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29
Q

What is hypoxemia defined as in terms of SpO2 and PaO2

A

when SpO2 is 93% or less and PaO2 is less than or equal to 80 mmHg

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30
Q

In what animals is open mouthed breathing really bad

A

horses and cats

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31
Q

A horse has periodic unilateral epistaxis that isn’t too bad. What might he have

A

ethmoid hematoma

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32
Q

A 1 week old piglet is sneezing and has tear staining and nasal discharge. What might he have

A

atrophic rhinitis

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33
Q

Which pathogen causes non progressive and progressive atrophic rhinitis

A

non progressive- bordatella bronchiseptica
progressive- pasturella multocida

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34
Q

What disease causes turbinate atrophy in piglets

A

progressive atrophic rhinitis

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35
Q

What are secondary causes of bacterial sinusitis

A

tooth root abscess (in the rostral or caudal maxillary sinuses, premolars most common)

masses

iatrogenic- dehorning, nasogastric reflux (horses under anesthesia)

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36
Q

What are clinical signs associated with retropharyngeal abscess

A

dysphagia, excessive salivation, stertor

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37
Q

What are the common causes of retropharyngeal abscesses in cows and sheep/goats

A

cattle- iatrogenic- dose syringe or coarse feed
sheep/goats- caseous lymphadenitis (from corynebacterium pseudoturberculosis

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38
Q

What are causes of retropharyngeal abscesses in horses

A

Pharyngeal trauma- eating stemmy hay or nasogastric tube placement
Strangles

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39
Q

A horse farm calls you because they have a horse with fever, depression, mucopurulent nasal discharge, and a swollen guttural pouch. After examining the horse and treating it what recommendation should you make

A

This is likely strangles and is highly contagious so the horse should be isolated from others and the farm should not allow any horses to enter or leave (in the state if Georgia this is reportable and the farm will be quarantined) also any shared equipment should be thoroughly cleaned and sanitized

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40
Q

What 2 traits does streptococcus equi equi have to help it succeed

A

m-protein which helps to resist phagocytosis and is immunogenic
Polysaccharide capsule to help with attachment and resist phagocytosis

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41
Q

What is the most common lymph node to abscess with strangles

A

submandibular

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42
Q

What are some nerve issues strangles can cause

A

dysphagia, facial paralysis, Horner’s

43
Q

What is the gold standard for strangles diagnosis

A

aerobic culture (not normal flora)

44
Q

What are some immune-mediated complications following strangles

A

Purpura hemorrhagica
myositis
myocarditis
glomerular nephritis

45
Q

At what stage of strangles should you not treat it with antibiotics

A

when it is in the lymphadenopathy stage (not early or late). Will stop them from being able to develop immunity for the future and once antibiotics were stopped the Strangles would likely come back

46
Q

what is the risk with using the strangles vaccine

A

it can still cause purpura hemorrhagica

47
Q

when is the only recommended time to use the strangles MLV IN and what precaution should be considered in regards to giving it

A

only if there is a significant risk of infection
You should remember the horse might sneeze some of the vaccine out and it can infect and cause an abscess if there is any little cut on the horse (so don’t give any other vaccines that day)

48
Q

A horse has a history of periodic epistaxis and then one day the owner comes to the barn to discover the horse is dead from severe bilateral epistaxis. What likely happened

A

The horse likely had guttural pouch mycosis

49
Q

What may you see on endoscopy of a horse with guttural pouch mycosis

A

gray/white/yellow/black fibronecrotic fungal plaques over an artery or maybe blood clots

50
Q

What is the best course of treatment for guttural pouch mycosis

A

obstruct the carotid artery on the affected side

51
Q

Which breeds are more prone to laryngeal hemiplegia

A

Taller breeds

52
Q

What occurs during laryngeal hemiplegia and what side is more commonly affected

A

The arytenoid cartilage is not abducted properly during inspiration, the left side is more commonly affected
Can be from any injury to the vagus or recurrent laryngeal nerve

53
Q

Which equine herpes virus can cause more systemic issues (lymphocyte associated viremia)

A

EHV-1

54
Q

What is EHV pathogenesis

A

Vascular endothelial cells
-vasculitis and tissue necrosis

55
Q

How do you diagnose EHV

A

Viral isolation or PCR on the Buffy coat or nasal swab/wash

56
Q

When do you want to vaccinate horses for EHV

A

At risk horses every 6 months and pregnant mares (killed vaccine) at 5,7,9 months of gestation

57
Q

What are the clinical signs of equine influenza virus

A

Cough, fever, nasal discharge, inappetance in any aged horse

58
Q

What is the pathogenesis for EIV

A

Viral replication—> cell death—> lesions in lower airway and impaired mucocilliary clearance—> prime set up for secondary bacterial infections

59
Q

T/F there isn’t a vaccine for EIV

A

False

60
Q

How long should you rest horses who have had EIV

A

One week for every 1 day of fever

61
Q

What virus causes fever, conjunctivitis, abortions, fatal pneumonia in foals, and has carrier stallions

A

Equine arteritis virus

62
Q

Which equine virus causes mild respiratory signs and submandibular lymphadenopathy

A

Equine rhinitis virus

63
Q

Which virus causes fatal respiratory disease in SCID Arabian foals

A

Equine adenovirus

64
Q

What is the distribution of pneumonia

A

Cranioventral

65
Q

How are pleuropneumonia and bronchiopneumonia different

A

Bronchiopneumonia affects the lungs while pleuropneumonia affects that and the pleural space (causing pleural effusion and fibrin)

66
Q

Name some risk factors for pneumonia in horses

A

Travel (esp. head tied), general anesthesia, esophageal obstruction (choke)

67
Q

What is the most common isolate for pneumonia in horses

A

Streptococcus equi zooepidemicus

68
Q

What disease can have clinical signs of pleurodynia (pleural pain, which may look like laminitis because the horse doesn’t want to walk) and pectoral edema

A

Pneumonia

69
Q

What is the best way to diagnose pneumonia

A

Transtracheal aspirate

70
Q

What is the treatment for pneumonia

A

Broad spectrum oral or parenteral antibiotics (penicillin, gentamicin, metronidazole, enrofloxacin)

Supportive care

Anti-endotoxin therapy (meglumine, polymixin B, low dose flumixin)

71
Q

What bacteria affects foals ages 3 weeks to 6 months and can also cause swollen joints, yellow eyes

A

Rhodococcus Equi

72
Q

Where can Rhodococcus equi be found (like on cytology)

A

Intracellularly in the alveolar macrophages

73
Q

How do you get a presumptive and definitive diagnosis for R. Equi

A

Presumptive- signalment and leukocytosis + hyperfibrinogenemia, imaging

Definitive- Transtracheal aspirate or PCR for vap A

74
Q

How do you treat Rhodococcus equi

A

Macrolide + rifampin

(Macrolides- erythromycin, azithromycin, clarythromicin)

75
Q

What are important side effects with the drugs used to treat Rhodococcus equi

A

Macrolides- hyperthermia and fatal diarrhea in adults
Rifampin- stains all body secretions orange-red

76
Q

Describe the 2 forms of equine asthma syndrome

A

Recurrent airway obstruction aka severe equine asthma, typically >7 years old, coughing and tachypnea at rest, heave line

Inflammatory airway disease aka mild to moderate equine asthma, young/any age, no clinical signs at rest usually cough with exercise

77
Q

What would you see on a bronchioalveolar lavage of a horse with asthma

A

Increased neutrophils and maybe eosinophils and mast cells, maybe mucus and Curschmann’s spirals

78
Q

What would you see on radiographs of a horse with heaves (RAO)

A

Bronchointerstitial pattern

79
Q

What is the most important management for equine asthma

A

Environmental- limit airborne allergens

80
Q

What are the two medical mainstays of treatment for equine asthma

A

Steroids and bronchodilators

81
Q

A horse who lives with a donkey presents coughing and with nasal discharge but doesn’t have a fever. What are you thinking it could be?

A

Lungworms- dictyocaulus arnfieldi

82
Q

How do you diagnose lungworms

A

Baermann for species with larval shedding or fecal flotation to ID eggs

Infection often not patent in horses

83
Q

What are the lung worm types for cattle and pigs

A

Cattle- Dictyocaulus viviparus
Pigs- Metastrongylus apri

84
Q

What is the treatment for lung worms

A

Avermectin anthelmintics

85
Q

You see a cow with blood pouring out of its nose and mouth, what type of pneumonia can cause this and how

A

Metastatic pneumonia from rumen acidosis causing a liver abscess which has septic emboli with go to the lungs causing a pulmonary aneurism

86
Q

What are important pathogens for bronchiopneumonia in cattle (bacterial and viral- just the ones highlighted in class)

A

Viral- BRSV, coronavirus
Bacterial- Mannheimia haemolytica (also mycobacteria bovis)

87
Q

In a calf with bronchopneumonia what might you see

A

Fever, lethargy, depression, increased respiratory effort

88
Q

Which is the most common cause of morbidity in stocker/feedlot calves

A

Respiratory disease/shipping fever

89
Q

T/F recently castrated feedlot bulls are at a higher risk of developing bronchiopneumonia

A

True

90
Q

How can you reduce the risk of BRD

A

Feeding high quality nutrition (waste or saleable milk or >4L of milk per day)

Administration of vaccines to dry cows prior to calving

Reducing stress and over crowding

91
Q

T/F Mannheimia haemolytica has few serotypes because they are all pathogenic

A

False, there are 12 serotypes and only some are pathogenic

92
Q

Describe 2 virulence factors that Mannheimia haemolytica has that help it cause damage

A

Leukotoxin which helps it bind to neutrophils to cause necrosis and has the neutrophils release their own digestive enzymes causing damage
LPS which also binds to neutrophils and can cause more neutrophils to be recruited, the activation of neutrophils, and endothelial cell activation

93
Q

You are called out to a feedlot because several of their bulls are sick and a few have died. You do a necropsy and see lungs covered in fibrin and are necrosed. What disease is this likely to be

A

Mannheimia haemolytica

94
Q

What is the gold standard treatment for M. haemolytica

A

Antibiotics- the best are tulathromycin, fluoroquinolones (enrofloxacin and danofloxacin), and florfenicol

95
Q

You go out to a farm who has suddenly had a cow die from severe epistaxis and hemoptysis causing exsanguination. What disease could have caused this and what is your recommendation for the farmer

A

Metastatic pneumonia secondary to septic emboli causing thrombosis of the vena cava as a sequalae to rumen acidosis from improper rations high in fermentable carbohydrates

The farmer needs to get a more balanced ration

96
Q

What would you look for on ultrasound if a cow might have metastatic pneumonia

What would you see on necropsy

A

On ultrasound you would find the caudal vena cava and see if it is dilated (not a triangular shape but round) which shows dilation because of a thrombotic occlusion

On necropsy you would see intrapulmonary hemorrhage (really bloody lungs)

97
Q

How can you treat metastatic pneumonia

A

Prognosis is usually pretty poor, the best thing to do is nutritional management to prevent the loss of more cows

98
Q

You are called out to a farm because a cow is standing there gasping for air/ has a loud grunt on expiration. It also happens to be springtime. What disease are you concerned about?

A

Interstitial pneumonia or “fog fever”

99
Q

Other than lush pastures what are some other causes of interstitial pneumonia in cows

A

BRSV infection, Perilla mint ketone, 4-ipomeanol (moldy sweet potatoes)

100
Q

What is the best thing to do if a farm has cows dying of fog fever

A

Carefully remove unaffected animals from the pasture, no specific treatment for animals showing clinical signs

101
Q

You are called out to another feedlot (gosh they have a lot of unhealthy cattle). There are some calves around 12 months old that have a moist cough and seem to be in a lot of pain, they are also dyspneic with stertor. What disease are you concerned about

A

Necrotic laryngitis

102
Q

What is the pathophysiology of necrotic laryngitis

A

Ulcers develop on the larynx from viral infections causing coughing or swallowing and erosion of the membranes which then allows F. Necrophorum (a respiratory commensal) to invade and necrose the arytenoid cartilage

103
Q

Quick! You rush out to a farm for a 6 month old calf that is struggling to breath. When you get there he has stertor to his breathing and you think it could be necrotic laryngitis. Being the smart vet you are you know the calf needs steroids and antimicrobials but what can you do to help it breathe now?!

A

A tracheostomy can help until the steroids have time to kick in

Respiratory Diseases (1 decks)

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