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72 Cards in this Set
- Front
- Back
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How do you discern upper from lower respiratory disease with tachypnea?
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Tough to do!
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What are some differentials to consider when you see hyperpnea?
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Metabolic acidosis
Pain Fever Respiratory disease |
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What is flail chest?
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When an area of the chest moves in/out with breathing (d/t several rib fractures)
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What is Cheyne-Stokes breathing? When is it seen?
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Slow breathing then fast and repeat
d/t head trauma or CHF |
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Which of the following is not congruent with stridor?
a) laryngeal mass b) airway collapse c) nasopharyngeal mass d) laryngeal edema e) laryngeal paralysis |
c) nasopharyngeal mass (would cause STERTOR)
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Which of the following are true regarding vesicular sounds?
a) normal sounds b) easier to hear in a dog than in a cat c) expiration is often louder d) abnormal respiratory sounds e) a type of adventitial sound |
a) normal sounds
b) easier to hear in a dog than in a cat (also inspiration is louder) |
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Which of the following are true regarding bronchovesicular sounds?
a) normal sounds b) easier to hear in a dog than in a cat c) expiration is often louder d) abnormal respiratory sounds e) may indicate lung consolidation |
d) abnormal respiratory sounds
e) may indicate lung consolidation (just increased vesicular sounds) |
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Which of the following are true of crackles?
a) musical and continuous b) indicative of fluid c) inspiration is often louder d) abnormal respiratory sounds e) a type of adventitial sound |
b) indicative of fluid
c) inspiration is often louder d) abnormal respiratory sounds e) a type of adventitial sound |
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Which of the following are true of wheezes?
a) musical and continuous b) indicative of fluid c) inspiration is often louder d) abnormal respiratory sounds e) a type of adventitial sound |
a) musical and continuous
d) abnormal respiratory sounds e) a type of adventitial sound (note - expiration is louder) |
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What is a pathognomonic sign of feline asthma on a DV radiograph?
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Atelectic R middle lung lobe
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Which of the following is NOT indicative of tracheal disease?
a) cough b) gag/retch c) fever d) voice change e) stridor |
d) voice change
e) stridor |
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Which of the following are NOT indicative of pharyngeal/laryngeal disease?
a) gag/retch b) voice change c) dyspnea d) cough e) stertor/stridor |
All of them are indicative!!!
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Which of the following are NOT signs of bronchial/bronchiolar disease?
a) crackles/wheezes b) cough c) gag/retch d) stridor/stertor e) dyspnea |
c) gag/retch
d) stridor/stertor |
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Which of the following are NOT signs of parenchymal disease?
a) tachypnea b) muffled lung sounds c) cyanosis d) crackles/wheezes e) cough |
d) crackles/wheezes
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Which of the following are NOT signs of pleural disease?
a) muffled heart sounds b) muffled lung sounds c) referred sounds d) dyspnea e) cough |
ALL of them can be indicative!
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Which of the following are NOT indicative of heart failure?
a) cough b) murmur c) sinus arrthymia and dyspnea d) cyanosis e) weak femoral pulse |
c) sinus arrthymia and dyspnea (usually indicative of respiratory disease)
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What do you think when the mediastinal structures are well outlined? If they're ill defined?
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Well-outlined = pneumomediastinum
Ill-defined = mediastinal effusion |
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What is your minimum database for respiratory disease?
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CBC/Chem/UA/Fecal
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Choose relative or absolute polycythemia...
...dehydration. |
Relative
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Choose relative or absolute polycythemia...
...normal EPO levels. |
Absolute (primary; polycythemia vera)
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Choose relative or absolute polycythemia...
...increased EPO and hypoxia. |
Absolute (secondary; appropriate response)
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Choose relative or absolute polycythemia...
...increased EPO only. |
Absolute (secondary; inappropriate response)
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T or F:
Only dogs really cough with heart disease. |
True!
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Which lung pattern has prominent airways, donuts, and train tracks?
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Bronchial
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Which lung pattern has air bronchograms?
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Alveolar
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Which lung pattern looks all grayed out?
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Interstitial
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Which imaging modality is best for imaging the skull?
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CT
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Describe normal bronchial cytology in a dog with regard to:
RBCs Neutrophils Macrophages Lymphocytes Eosinophils |
0 RBCs
10-15% Neutrophils 70% Macrophages 2-10% Lymphocytes 0-10% Eosinophils |
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Describe normal bronchial cytology in a cat with regard to:
RBCs Neutrophils Macrophages Lymphocytes Eosinophils |
0 RBCs
10-15% Neutrophils 70% Macrophages 2-10% Lymphocytes <25% Eosinophils |
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What are some normal gram negative respiratory flora in small animals?
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Pasteurella
Enterobacter Pseudomonas E. coli Klebsiella Bordetella Simonsiella |
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Which bacterium may cause primary respiratory disease in cats?
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Bordetella
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Under which conditions would you call for an anaerobic culture?
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Pleural effusion
Consolidation Abscess |
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How does failure to chill an ABG sample impact data?
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Low glucose, high lactic acid = low pH
Low O2 and high CO2 |
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How does over-heparinization impact ABG data?
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Increased O2 and low CO2.
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Which values in an ABG indicate degree of ventilation? Oxygenation? Acid/base?
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Ventilation (paCO2)
Oxygenation (paO2, saO2, Hb) Acid/base (pH, HCO3) |
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Diagnose the following:
a) low pH, high paCO2 b) low pH, low HCO3 c) high pH, low paCO2 d) high pH, high HCO3 |
a) low pH, high paCO2 (respiratory acidosis)
b) low pH, low HCO3 (metabolic acidosis) c) high pH, low paCO2 (respiratory alkalosis) d) high pH, high HCO3 (metabolic alkalosis) |
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Which of the following are causes of respiratory acidosis?
a) hypoxemia b) restrictive disease c) inadequate ventilation d) airway obstruction e) CNS dz |
b) restrictive disease
c) inadequate ventilation d) airway obstruction (also resp center depression, CP arrest, NM dz, pulmonary dz) |
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Which of the following are causes for metabolic acidosis?
a) Hyperaldosteronism b) EG poisoning c) Uremic crisis d) Diarrhea e) Hyperthyroid |
b) EG poisoning
c) Uremic crisis d) Diarrhea (also DKA, Lactate, Addison's, RTA) |
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Which of the following are causes for respiratory alkalosis?
a) Hypoadrenocorticism b) Hyperthyroid c) Oral NaHCO3 d) Sepsis e) Diuretics |
b) Hyperthyroid
d) Sepsis (also hypoxemia, CNS dz, drugs, heat stroke, pain, fever) |
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Which of the following are causes of metabolic alkalosis?
a) DKA b) Vomiting c) Hyperaldosteronism d) Uremic crisis e) Diuretics |
b) Vomiting
c) Hyperaldosteronism e) Diuretics (also oral NaHCO3) |
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How can the ventilation/perfusion inequality in respiratory disease be assessed? What value is normal for this metric?
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Use alveolar/arterial gradient;
Normal values should be <15 |
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How can appropriate oxygen response be assessed (the quick-and-dirty method)? What are normal values for this?
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PaO2/FIO2;
Normal >400 (adequate is >300) |
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What value measures ventilation?
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ETCO2
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What does 98% pulse ox reading equal in Pa O2? 96%? 91%?
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98% = ~100mmHg
96 = 80mm 91 = 60% |
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Which of the following constitute part of the diffusion barrier?
a) Interstitium b) Basement membrane c) capillary endothelium d) ciliated epithelium e) red blood cell |
a) Interstitium
b) Basement membrane c) capillary endothelium e) red blood cell (also alveolar fluid, alveolar epithelium, capillary basement membrane, and plasma) |
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What are the 6 causes of hypoxemia?
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Low inspired oxygen
Hypoventilation Diffusion impairment V/Q mismatch Shunt Abnormal hemoglobin |
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Which of the following would result in a low V/Q mismatch?
a) shunt b) airway obstruction c) consolidation d) CO poisoning e) atelectasis |
a) shunt
c) consolidation e) atelectasis |
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Which of the following are causes of hypoventilation?
a) anesthesia b) methemoglobinemia c) thromboembolism d) obstruction e) abnormal hemoglobin |
a) anesthesia
d) obstruction (also NM dz, obstruction, pleural dz, pulmonary dz) |
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What are causes of high V/Q mismatch?
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Thromboembolism
Heart failure Hypotension |
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Which 2 viruses are major causes of feline upper respiratory infections?
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Feline herpes and caliciviruses
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Which of the following is NOT true regarding feline calicivirus?
a) ss RNA virus b) it is part of core vaccination c) vaccine does not prevent disease d) usually subclinical to mild signs e) often characterized by oral vesicles and ulcers |
ALL ARE TRUE!!!
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Which of the following is NOT true regarding feline herpesvirus?
a) ss RNA virus b) it is part of core vaccination c) vaccine does not prevent disease d) usually subclinical to mild signs e) often characterized by oral vesicles and ulcers |
a) ss RNA virus (dsDNA)
d) usually subclinical to mild signs (cats usually kinda sick) |
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T or F:
Pathogenic feline calicivirus affects kittens more than adults. |
False! Adults>kittens
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What are signs of pathogenic calicivirus in cats?
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Pneumonia, head/forelimb edema, ulcers, hemorrhage, icterus
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Choose FHV, Calici, or BOTH for the following:
a) core vaccination only decreases disease severity b) reinfection is rare c) commonly see ulcers d) bony osteolysis e) epithelial tropism |
a) BOTH - core vaccination only decreases disease severity
b) FHV - reinfection is rare c) CALICI - commonly see ulcers d) FHV - bony osteolysis e) BOTH - epithelial tropism |
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Choose B. bronchiseptica, C. felis or BOTH for the following:
a) often self-limiting b) non-core vaccine c) treated w/tetracycline d) intracellular bacteria e) conjunctivitis |
a) C. felis - often self-limiting
b) BOTH - non-core vaccine c) BOTH - treated w/tetracycline d) C. felis - intracellular bacteria (although later on B. bronchiseptica is listed as intracellular under infxs tracheobronchitis) e) C. felis - conjunctivitis |
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Choose B. bronchiseptica, C. felis or BOTH for the following:
a) normal flora b) possibly zoonotic c) associated w/catteries d) occasional respiratory signs e) can shed for a long time |
a) B. bronchiseptica - normal flora
b) BOTH - possibly zoonotic c) BOTH - associated w/catteries d) C. felis - occasional respiratory signs e) BOTH - can shed for a long time |
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Choose A. fumigatus, Cryptococcosis, or BOTH:
a) dogs > cats b) normal flora c) topical treatment is ideal d) can use nasal discharge for culture/cytology e) younger cats |
a) ASPER - dogs > cats
b) ASPER - normal flora c) ASPER - topical treatment is ideal d) CRYPTO - can use nasal discharge for culture/cytology e) CRYPTO - younger cats |
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Choose A. fumigatus, Cryptococcosis, or BOTH:
a) assoc w/immunodeficiency b) usually treated systemically c) epistaxis d) sneezing, stertor, anorexia, facial deformity e) hematogenous CNS involvement |
a) BOTH - assoc w/immunodeficiency
b) CRYPTO - usually treated systemically c) BOTH (asper>crypto) - epistaxis d) BOTH - sneezing, stertor, anorexia, facial deformity e) CRYPTO - hematogenous CNS involvement |
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Which anti-fungals are used to treat aspergillosis? Cryptococcosisis?
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Asper (topical enilconalzole or clotrimazole; systemic itraconazole)
Crypto (systemic fluconazole; maybe ketoconazole) |
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T or F:
Mesaticephalic and dolichocephalic dog breeds are more predisposed to nasal neoplasia and nasal fungal infections. |
True! They got more nose for pathology!
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T or F:
Malignant tumors are more common in the nose than in the sinus in dogs. |
True!
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What are the most common nasal tumors of the dog? Cat?
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Dog (Adeno, undifferentiated, SCC then fibro/chondrosarcomas)
Cat (LSA, adenocarcinma, undifferentiated) |
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How are the following nasal tumors treated?
Osteo/chondrosarcoma Lymphoma Other tumors |
Osteo/chondrosarcoma (Sx DEBULK if benign/multilobulated)
Lymphoma (CHEMO) Other tumors (RADIATION) |
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T or F:
Most nasal tumors are not malignant. |
False!
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Which of the following are NOT true regarding lymphoplasmacytic rhinitis?
a) Likely an autoimmune etiology b) Cats>Dogs c) Epistaxis/dyspnea are the most common signs d) pre-treat w/tetracycline before biopsy e) bilateral rhinoscopy is key to diagnosis |
b) Cats>Dogs (NO!)
c) Epistaxis/dyspnea are the most common signs (NO! - these are less common signs) (note - often empirical abx pre-treatment is needed to remove neutrophils for accurate histopath) |
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Reverse sneezing is often associated with...
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...parasitic rhinitis!
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Which of the following are susceptible to ivermectin?
a) Pneumonyssus caninum b) Capillaria aerophila c) Lungutala serrata d) Cuterebra |
ALL OF EM`
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Which are true regarding nasopharyngeal polyps?
a) cat>dog b) removal via bulla osteotomy c) often presents with stridor d) can cause vestibular dz or Horner's syndrome e) usually occur in the auditory tube or middle ear |
a) cat>dog
e) usually occur in the auditory tube or middle ear (Note: often presents w/STERTOR, removal by polypectomy but ipsilateral bulla osteotomy is recommended to prevent recurrence; does cause vestibular dz but Horner's is a sequel to treatment so don't do it unless its recurrent) |
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You see a 2 yo male DSH with marked stertor, mucopurulent nasal discharge, dyspnea and a depressed soft palate. What is your #1 ddx?
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Nasopharyngeal polyp
(maybe choanal atresia, FB, nasopharyngeal stenosis) |
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How can the following be ruled-out with an epistaxis case?
- thrombocytopenia - coagulopathy - hypertension - vasculitis - hyperviscosity - uremia |
CBC - thrombocytopenia
PT, PTT - coagulopathy BP - hypertension PE, tick serology - vasculitis CBC/chem - hyperviscosity Chem (azotemia) - uremia |
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What are the non-respiratory or non-nasal rule-outs for epistaxis in dogs/cats?
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Thrombocytopenia
Coagulopathy Uremia Vasculitis Hyperviscosity |
