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Small Animal Medicine > Unit 3 - Nasal and Large Airway Disease > Flashcards

Unit 3 - Nasal and Large Airway Disease Flashcards

1
Q

Excessive mucus in the nasal cavity will cause which abnormal respiratory sound?

A

stertor

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2
Q

Disease narrowing the intrathoracic trachea could cause which kind of dyspnea?

A

obstructive expiratory

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3
Q

You are evaluating a 10 year old MN domestic shorthair cat for a chronic cough that has not responded to antibiotics. Chest radiographs show diffuse abnormalities. You recommend airway sampling next. What airway sampling options for this patient?

A

Endotracheal wash or bronchoalveolar wash (not necessary)

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4
Q

What clinical findings are consistent with nasal disease?

A

sneezing, nasal discharge, stertor, pawing/rubbing face, masses/facial distortion, nasal planum ulceration, seizures, mentation changes

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5
Q

What can cause unilateral nasal discharge?

A

neoplasia, tooth root abscess, foreign body, fungal, and trauma

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6
Q

What can cause bilateral nasal discharge?

A

inflammatory rhinitis, systemic disease, neoplasia, fungal, viral, or trauma

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7
Q

What is serous/serosanguineous nasal discharge often associated with?

A

viral, allergic, or inflammatory rhinitis

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8
Q

What does sanguineous discharge typically indicate?

A

the process is progressive and erosive

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9
Q

What does mucopurulent nasal discharge typically indicate?

A

a secondary bacterial infection

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10
Q

What can cause hemorrhagic nasal discharge?

A

severely erosive disease or systemic disease

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11
Q

What erosive disease can cause hemorrhagic nasal discharge?

A

neoplasia or aspergillosis

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12
Q

What systemic disease can cause hemorrhagic nasal discharge?

A

coagulopathy or hypertension

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13
Q

When doing a PE to determine the underlying cause of nasal discharge, what should you examine?

A

visual exam mouth/nose, palpate bones/muscle, ocular retropulsion, nasal patency, fundic exam, lymph node palpation, and neurologic exam

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14
Q

What ‘first tier’ diagnostic testing should be done for nasal discharge?

A

CBC, cytology, thoracic rads, coagulation profile, and blood pressure

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15
Q

What ‘second tier’ diagnostic testing should be done for determining the underlying cause of nasal discharge?

A

anesthetized oral examination, nasal CT, and rhinoscopy with biopsy

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16
Q

When measuring instruments for rhinoscopy, what should you measure the instrument to?

A

the medial canthus of the eye

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17
Q

What are the most common nasal diseases in dogs?

A

lymphoplasmacytic rhinitis, aspergillosis, and neoplasia

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18
Q

What are the most common nasal diseases in cats?

A

viral rhinitis, chronic rhinosinusitis, and nasopharyngeal polyps

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19
Q

What breeds typically get lymphocytic-plasmacytic rhinitis?

A

dolicephalics - Daschunds and Whippets

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20
Q

What clinical signs are associated with lymphocytic-plasmacytic rhinitis?

A

chronic nasal discharge, nasal congestion (stertor), and sneezing

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21
Q

How common is lympho-plasmacytic rhinitis?

A

It is approximately 1/3 of canine nasal disease referrals

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22
Q

How is lympho-plasmacytic rhinitis diagnosed?

A

It is based on diagnosis of exclusion - nasal biopsy, rule out infectious causes with culture

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23
Q

What is important to know about the treatment of lympho-plasmocytic rhinitis?

A

it is difficult to manage and you will not be able to cure it

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24
Q

What is the treatment of choice for lympho-plasmacytic rhinitis?

A

anti-inflammatories (immunomodulatory antibiotic and NDSAID), anti-histamines, and possibly itraconazole

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25
Q

What causes fungal rhinitis?

A

cryptococcus neoformans and Aspergillus fumigatus

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26
Q

What forms of Cryptococcus neoformans infections occur in cats?

A

nasal, cutaneous, and CNS

27
Q

What forms of Cryptococcus neoformans infections occur in dogs?

A

Disseminated disease (more common) and subclinical nasal disease

28
Q

How is Cryptococcus diagnosed?

A

organism identification (cytology, histopathology, culture) or antigen assay

29
Q

How is Cryptococcus neoformans infection treated?

A

Fluconazole and Amphotericin B + 5-flucytosine (cats) or fluconazole

30
Q

What breeds typically get Aspergillus fumigatus infections?

A

german shepherd and other dolicocephalic breeds

31
Q

What clinical signs are associated with Aspergillus fumigatus infections?

A

Nasal discharge (serous to mucopurulent +/- epistaxis), nasal planum depigmentation, sneezing, nasal pain, systemic signs, rarely neurologic signs

32
Q

How is nasal aspergillus diagnosed?

A

CT and rhinoscopy + cytology/histopath

33
Q

How is nasal aspergillus treated?

A

topical clotrimazole (treatment of choice), topical enilconazole, +/- debulking sinus/trephination, +/- systemic azole therapy

34
Q

What is the prognosis of sino-orbital aspergillosis in cats?

A

it is poor

35
Q

What can cause feline upper respiratory disease complex?

A

Herpesvirus, Calicivirus, Chlamydia felis, Mycoplasma, and Bordatella bronciseptica

36
Q

What percentage of URI cases are due to feline herpesvirus?

A

up to 38%

37
Q

What percentage of URI cases are due to Calicivirus?

A

up to 36%

38
Q

What is the difference between shedding in herpes virus and calicivirus?

A

Calicivirus sheds continuously and Herpes virus sheds intermittently

39
Q

How is feline viral rhinitis diagnosed?

A

signs + bacterial/viral isolation; culture and sensitivity and PCR

40
Q

How is feline viral rhinitis managed?

A

stress avoidance, relative isolation, long-term(L-lysine or Famciclovir)

41
Q

How do you manage a feline viral rhinitis patient that is partially anorexic?

A

Provide smelly or warm food, clean nose, and use antibiotics as needed

42
Q

How do you manage a feline viral rhinitis patient that is systemically ill?

A

fluid and nutritional support and antibiotics as need (doxycycline is the preferred)

43
Q

What neoplasias can be seen in the nose and what is the most common?

A

Adenocarcinoma (most common), sarcomas, and lymphoma

44
Q

Nasal neoplasias are locally invasive, what does that cause?

A

bone destruction and CNS signs

45
Q

What is the treatment of choice for nasal neoplasia?

A

radiation therapy

46
Q

What can cause canine infectious tracheobronchitis (kennel cough)?

A

Bordatella bronchiseptica, Canine Parainfluenza virus, and Canine adenovirus type-2

47
Q

How do kennel cough patients present?

A

younger dogs, history of recent exposure, and paroxysmal, non-productive, harsh cough

48
Q

How is kennel cough treated?

A

In most cases, it is mild and self limiting. If there is a persistent non-productive cough you an treat with antitussives +/- an anti-inflammatory. In severe or prolonged cases, antibiotics is indicated

49
Q

How is kennel cough prevented?

A

DHPP and Bordatella vaccines

50
Q

What is tracheal collapse?

A

progressive degeneration of cartilage rings

51
Q

If tracheal collapse occurs at the cervical trachea, what phase of breathing does it happen in?

A

inspiration

52
Q

If tracheal collapse occurs at the thoracic trachea, what phase of breathing does it happen in?

A

expiration

53
Q

What is the signalment for tracheal collapse?

A

Middle age to older dogs, small/toy breed dogs, goose-honk cough, and exercise intolerance

54
Q

How is tracheal collapse diagnosed?

A

clinical signs, physical exam, radiographs, fluoroscopy, and bronchoscopy

55
Q

What is the gold standard for tracheal collapse diagnosis?

A

bronchoscopy

56
Q

What is a grade 1 tracheal collapse?

A

Collapses less than 25%

57
Q

What is a grade 2 tracheal collapse?

A

Collapses 25-50%

58
Q

What is a grade 3 tracheal collapse?

A

Collapses 50-75%

59
Q

What is a grade 4 tracheal collapse?

A

complete collapse

60
Q

What is the management method of choice for tracheal collapse?

A

antitussives

61
Q

What other management methods can be used for tracheal collapse?

A

anti-inflammatories, sedatives, weight loss, supportive, and stenting of tracheal rings

62
Q

Why can bronchodilators be a bad management choice for tracheal collapse?

A

they would act on the bronchiolar smooth muscle and not the trachea which can decrease lower airway pressure

63
Q

What is the viscious cycle of tracheal collapse?

A

collapse causes inflammation and cough then coughing causes tracheal inflammation, then inflammation perpetuates the cough.. And it just continue - you may need to break the cycle of inflammation to relieve the cough

Small Animal Medicine (100 decks)

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