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91 Cards in this Set
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What are the sequellae to stenotic nares in brachycephalic airway syndrome?
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Elongated soft palate
Everted laryngeal nut-saccules Hypoplastic trachea (which I still can't believe is a true sequel...maybe tracheal collapse instead???) |
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T or F:
Everted saccules and english bulldogs have a poor prognosis in brachycephalic airway syndrome. |
True
|
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Which of the following describe laryngeal paralysis?
a) often idiopathic b) usually unilateral c) arytenoid tie-forward treatment d) often seen with DDSP e) presents with cyanosis, stridor, and hypothermia |
a) often idiopathic
b) usually unilateral (note: use arytenoid tie back (lateralization); aspiration pneumonia sequel; presents w/HYPERthermia) |
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What is the most common cause of infectious laryngitis in the dog? Cat?
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Dog (bordatella)
Cat (FHV; Calici) |
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Which clinical sign is seen with laryngitis in the dog, cat, or both?
Cough Ptyalism Oral ulcers Fever Gag/Retch Voice change |
Cough (DOG)
Ptyalism (CAT) Oral ulcers (CAT) Fever (CAT>dog) Gag/Retch (DOG>cat) Voice change (DOG) |
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What are the primary differentials for laryngitis in the dog? The cat?
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Dog (cardiac, airway, parenchymal dz)
Cat (asthma & pneumonia) |
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Choose tracheal collapse, tracheal hypoplasia, or BOTH:
Involves congenital cartilage dysfunction Complete tracheal rings Cough is most common Cx Signs seen in older animals |
(COLLAPSE) Involves congenital cartilage dysfunction
(HYPO) Complete tracheal rings (COLLAPSE) Cough is most common Cx (COLLAPSE) Signs seen in older animals |
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Choose tracheal collapse, tracheal hypoplasia, or BOTH:
Cannot be directly treated Congenital disease Cor pulmonale Minis and toy breeds Cervical tracheal collapse on inspiration |
(HYPO) Cannot be directly treated
(BOTH) Congenital disease (BOTH) Cor pulmonale (COLLAPSE) Minis and toy breeds (COLLAPSE) Cervical tracheal collapse on inspiration |
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How is tracheal hypoplasia diagnosed?
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Imaging (trachea is <50% of laryngeal os; or laryngeal lumen at cricoid cartilage)
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Which agents are chiefly responsible for infectious tracheobronchitis in dogs?
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Canine parainfluenza virus
Canine adenovirus 2 Bordatella bronchiseptica (also Mycoplasma cynos) |
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Which agent associated with infectious tracheobronchitis causes the following?
a) Purulent bronchitis b) Virus that infects all airways c) G- aerobe d) Intracellular/extracellular bacteria e) Rarely causes pathology alone f) Virus only colonizes upper airways |
(MYCOPLASMA) Purulent bronchitis
(CAV-2) Virus that infects all airways (B. bronchiseptica) G- aerobe (B. bronchiseptica) Intracellular/extracellular bacteria (CAV-2) Rarely causes pathology alone (CPiV) Virus only colonizes upper airways |
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T or F:
Most infectious tracheobronchitis is characterized only by a long-lasting cough. |
True!
|
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How is infectious tracheobronchitis usually treated?
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Hydration & nutrition
Abx (tetracyclines) O2 Bronchodilators |
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Which organisms do infectious tracheobronchitis vaccines protect against? How are they preferentially administered?
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B. bronchiseptica
CPiV CAV-2 (Intra-nasal; can give to young pups) |
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Intranasal infxs tracheobronchitis vaccines can be given to puppies ____ weeks of age. Prophylactic vaccination before kenneling should be given _______ prior.
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3 wk pups
5d prior to kenneling |
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Which of the following are associated with ciliary dyskinesia?
a) cats>dogs b) situs inversus c) recurrent respiratory infection d) ablation of respiratory cilia e) spermatic abnormalities |
b) situs inversus
c) recurrent respiratory infection e) spermatic abnormalities (Dogs>cats) |
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What is the hallmark diagnostic of canine chronic bronchitis? What diagnostic technique is used?
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NEUTROPHILS!!!! (increased neutrophils by TTW or BAL)
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Which of the following are NOT true regarding chronic canine bronchitis?
a) typically affects mid-aged to older brachycephalics b) polycythemia c) fat cocker spaniels are the poster-children d) barrel-shaped chest e) infection is a common component |
a) typically affects mid-aged to older brachycephalics (usually small-breed dogs)
e) infection is a common component (uncommon) |
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Which layer becomes thickened in canine chronic bronchitis?
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Muscularis layer
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What 2 findings provide radiographic evidence of bronchiectasis and hyperinflation?
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Flat diaphragm
Hyperlucent lung fields |
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Which 4 respiratory conditions are associated with cor pulmonale?
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Tracheal hypoplasia
Tracheal collapse Canine chronic bronchitis Pneumocystis carinii pneumonia (occasionally) |
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How is canine chronic bronchitis treated chronically?
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Remove underlying causes!
Anti-inflammatory |
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How is canine chronic bronchitis treated acutely?
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O2
Bronchodilators Anti-inflammatories Nebulization Coupage |
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What is the common signalment for feline asthma?
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young to middle aged Siamese cats
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A reversible bronchospasm is the characteristic of...
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...feline asthma
|
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Which two cell types are important in feline asthma? How do these cells affect one another?
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Cytokines released by T lymphocytes increase eosinophil survival, activity, and recruitment
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Which of the following are common characteristics of feline asthma?
a) peripheral eosinophilia b) dyspnea c) cough d) eosinophilic infiltrate e) barrel-chest |
b) dyspnea
d) eosinophilic infiltrate e) barrel-chest (note: only 20% have peripheral eosiniphilia; cough is more in bronchitis) |
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How does feline asthma and bronchitis differ?
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Eosinophilic infiltrate in asthma, neutrophilic in bronchitis.
Dyspnea in asthma; cough in bronchitis. |
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T or F:
Acute feline bronchitis and asthma are treated the same way. |
True!
Injectable bronchodilators, glucocorticoids, and O2 |
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Which of the following do NOT work for the chronic treatment of feline asthma?
a) Oral glucocorticoids b) Ad hoc inhaled bronchodilators c) Antihistamines d) Inhaled glucocorticoids e) Cyproheptidine |
c) Antihistamines
e) Cyproheptidine |
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Which novel treatment for feline asthma impacts eosinophil numbers and response? What is a side effect of this?
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Tyrosine kinase inhibitors (profound proteinuria)
|
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Which novel treatment of feline asthma downregulates T cell response?
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Immunotherapy (increases anti-IgE antibodies, reduces lymphocyte production and T cells)
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What is the end result of chronic bronchitis?
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Bronchiectasis
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If you see dilated, non-tapering airways via radiography and "meaty" airways via bronchoscopy, what is the most likely diagnosis?
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Bronchiectasis
|
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Where are acquired bronchoesophageal fistulae commonly found in the dog? The cat?
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Dog (R middle or R caudal lung lobe)
Cat (L caudal lobe) |
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How are bronchoesophageal fistulae treated? What is the prognosis?
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Sx repair and removal of affected lobe; good prognosis!
|
|
T or F:
Similarly to nasal tumors, most tumors of the larynx and trachea are malignant. |
True!
|
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Which laryngeal/tracheal tumors are most common in the dog? The cat?
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Dog (Adenocarc, undifferentiated, osteo/chondrosarc)
Cat (LSA, carcinoma, SCC, undifferentiated) |
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Which of the following are the common G+ causes of bacterial pneumonia in dogs and cats?
a) Pseudomonas b) Streptococcus c) Bacteroides d) Pseudomonas e) Enterococcus |
b) Streptococcus
e) Enterococcus (also staph) |
|
Which of the following are the common G- causes of bacterial pneumonia in dogs and cats?
a) Pseudomonas b) Staphylococcus c) Bacteroides d) Pasteurella e) Bordatella |
a) Pseudomonas
d) Pasteurella e) Bordatella (also E. coli, Klebsiella) |
|
Which of the following are the common anaerobic causes of bacterial pneumonia in dogs? Cats?
a) Clostridium b) Staphylococcus c) Bacteroides d) Mycoplasma e) Bordatella |
a) Clostridium (dog)
c) Bacteroides (dog) d) Mycoplasma (cat) |
|
T or F:
Most bacterial infections of the lungs are from native flora. |
True!
|
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Where do most bacterial pulmonary infections begin and why?
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Bronchoalveolar region
(small particles deposited here; no mucus, no macrophages, narrow airways can be plugged) |
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What are the most common causes of bacterial pneumonia in dogs? Cats?
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Dogs (gram negative)
Cats (Strept and mycoplasma) |
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Radiographically, what is the distribution of bacterial pneumonia?
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CRANIOVENTRAL
|
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How long should antibiotics be given with bacterial bronchopneumonia?
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2-4 weeks PAST SIGNS
|
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What are some bacterial factors allowing for colonization of the lower airways?
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Endotoxins/exotoxins
Adhesion proteins Capsules Synergism |
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What factors contribute to bacterial pneumonia persistence?
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Neoplasia
Abscessation Foreign Body |
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What factors are associated with a poor prognosis for bacterial pneumonias?
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Thrombocytopenia
Hypoalbuminemia Sepsis SARDS |
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What are the 3 phases of aspiration pneumonia? How long does each last?
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Initial phase (chemical burn +/- airway obstruction, 4 hrs)
Inflammatory phase (1-2d or more if particulate matter) Bacterial colonization phase |
|
What is the earliest phase of aspiration pneumonia associated with each of the following:
a) Bronchoconstriction and increased capillary permeability. b) fever and lung lobe consolidation c) hypotension d) edema e) hypoxia and V/Q mismatch |
(INITIAL) Bronchoconstriction and increased capillary permeability.
(INFLAMMATORY) fever and lung lobe consolidation (INFLAMMATORY) hypotension (INITIAL) edema (INITIAL) hypoxia and V/Q mismatch |
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Which bacteria commonly colonize during aspiration in dogs?
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E. coli, Klebsiella, Pasteurella, Strept
|
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What are some defenses against viral pneumonias?
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Mucociliary apparatus
Opsonization Complement Cytokines (interferon) Lymphocytes & Alveolar macs |
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Choose CDV, Canine influenza, or BOTH:
Replicates in lymphatics Sick puppies! CNS signs RNA virus Purulent nasal discharge |
(CDV) Replicates in lymphatics
(CDV) Sick puppies! (CDV) CNS signs (BOTH) RNA virus (BOTH) Purulent nasal discharge |
|
Choose CDV, Canine influenza, or BOTH:
Core vaccination High morbidity/low mortality GI disease Respiratory disease 5 yr booster Aerosol/fomite transmission |
(CDV) Core vaccination
(FLU) High morbidity/low mortality (CDV) GI disease (BOTH) Respiratory disease (CDV) 5 yr booster (BOTH) Aerosol/fomite transmission |
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Which are good tests for CDV?
a) Immunofluorescence b) VI c) PCR d) antibody ELISA e) antigen ELISA |
b) VI
c) PCR e) antigen ELISA (Note - positive immunofluorescence in epithelial tissues is diagnostic too) |
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How is canine influenza diagnosed?
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PCR or VI
|
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Basophilic inclusion bodies are associated with which canine virus? Eosinophilic inclusions?
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Basophilic (CAV-2)
Eosinophilic (CDV) |
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Name the anti-fungal that is associated with each of the following:
Interact w/mammalian P450 Has the most side effects GI effects Water soluble Not metabolized by liver |
(ITRA/KETOCONAZOLE) Interact w/mammalian P450
(KETO) Has the most side effects (ITRA/KETO/Amphotericin B) GI effects (FLU) Water soluble (FLU) Not metabolized by liver |
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Name the anti-fungal that is associated with each of the following:
Aspergillus is resistant Thrombocytopenia Hepatotoxic Available IV Nephrotoxic |
(Amphotericin B) Aspergillus is resistant
(Ketoconazole) Thrombocytopenia (Keto/Itraconazole) Hepatotoxic (Fluconazole/Amphotericin) Available IV (Amphotericin) Nephrotoxic |
|
Choose the fungus associated with:
River valleys Great lakes Southwest Northwest |
(Histoplasmosis) River valleys
(Blasto) Great lakes (Coccidiodes) Southwest (Crypto) Northwest |
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Which of the following is NOT common to the 4 fungal pneumonias?
a) develop in macrophages b) hypercalcemia c) interstitial lung pattern d) good serology tests available e) anemia |
c) interstitial lung pattern (blasto/histo mostly)
d) good serology tests (only crypto/coccidiodes) |
|
Which fungal infections commonly get worse when treated?
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Histo/Blasto
|
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For which fungal infections do there exist good serologic tests? Which has a urine ELISA?
|
Crypto/Coccidiodes (serology - crypto is antigen & coccidio is antibody)
Blasto (nonspecific urine ELISA) |
|
Which parasite is associated with each of the following?
Causes interstitial disease Dog can be the only host Mollusk intermediate Peripheral eosinophilia Earthworm intermediate Forms giant cysts in lungs |
(Filaroides hirthi) Causes interstitial disease
(Oslurus osleri) Dog is only host (Aelurostrongylus abstrusus, P. kellicotti & Crenosoma vulpis) Mollusk intermediate (Capillaria aerophila & C. vulpis) Peripheral eosinophilia (C. aerophila) Earthworm intermediate (Paragonimus kellicotti) Forms giant cysts in lungs |
|
Which parasite is associated with each of the following?
Found in bronchi and trachea Metastrongylid of cats Infects dogs and cats Crayfish intermediate Only in nasopharynx |
(Oslerus osleri& Capillaria aerophila) Found in bronchi and trachea
(Aelurostrongylus abstrusus) Metastrongylid of cats (Cuterebra, Paragonimus kellicotti & C. aerophila) Infects dogs and cats (P. kellicotti) Crayfish intermediate (Cuterebra) Only in nasopharynx |
|
Which respiratory parasites are not treated with ivermectin? Which is more sensitive to fecal evaluation?
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No ivermectin (Paragonimus kellicotti & Capillaria aerophila)
Fecal Baerman (Crenosoma vulpis) |
|
What is the common signalment for eosinophilic pneumonia?
|
Female cats
Maybe rottweilers |
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You have an indoor female cat with vomiting, diarrhea, weight loss and very high eosinophil count. Fecals and Baermann are negative. What is your top differential, your treatment, and prognosis?
|
Hypereosinophilic syndrome
Tx: glucocorticoids Prognosis - guarded to poor |
|
What is the most common cause of parasitic eosinophilic pneumonia in the dog? The cat?
|
Heartworm for both!
|
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Which of the following are true regarding Pneumocystis carinii?
a) ubiquitous protozoan b) treat w/sulfonamides c) causes lymphopenia, eosinophilia, polycythemia d) causes dz in immunodeficient e) normal flora of dogs and cats |
b) treat w/sulfonamides
d) causes dz in immunodeficient e) normal flora of dogs and cats (note: NOT a protozoan, coccidian, or fungi; causes lymphocytosis) |
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What is the end result of chronic inflammation in the pulmonary parenchyma?
|
Idiopathic pulmonary fibrosis
|
|
Which of the following clinical signs are not seen with idiopathic pulmonary fibrosis?
a) cough b) crackles c) bronchitis d) cyanosis e) tachypnea |
a) cough
(no cough until very late in the disease) |
|
T or F:
Metastatic neoplasia is more common than primary lung tumors in both dogs and cats. |
True!
|
|
What are the 4 causes of transudates (eg: starling's forces)?
|
Increased hydrostatic pressure
Decreased oncotic pressure Increased permeability Decreased lymphatic return |
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Which types of thoracic fluids are characterized by degenerative neutrophils?
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Pyo/Chylothorax
|
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What test can you do to prove an effusion is chylothorax?
|
Chylothorax has triglycerides>serum triglycerides
|
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What are additional tests to prove a pyothorax?
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In a pyothorax:
Glucose <10 pH <6.9 |
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What is the definition of pulmonary hypertension (eg: what pressures constitute PH)?
|
>30mmHg systolic
>20mmHg diastolic |
|
T or F:
Pulmonary venous drainage is normally affected by right heart diseases. |
False-o-rino!!
|
|
What drug is used for acute treatment of pulmonary thromboembolism? Chronic?
|
Acute (low molecular wt heparin)
Chronic (warfarin) |
|
What are the components of ARDS?
|
Acute respiratory distress
Bilateral pulmonary infiltrates Normal pulmonary arterial pressure PaO2:FIO2 <200 |
|
T or F:
Dogs get chylothorax more than cats. |
False!
Cats>dogs |
|
How is chylothorax treated?
|
Treat underlying dz
Decrease dietary fat Thoracocentesis Surgery (shunts, omentalization, etc) |
|
Which bacteria classically cause pyothorax in cats? How is this treated?
|
Nocardia and Pasteurella
Tx: explore, debride, thoracostomy & lavage (ABX DON'T WORK) |
|
What are the major causes of hemothorax?
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Trauma
Coagulopathy (rodenticide) Neoplasia |
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What is the most common form of mediastinal disease?
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Pneumomediastinum
|
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What are the best antitussives?
|
Centrally-acting (Butorphanol and hydrocodone)
|
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Which of the following bronchodilators are good for respiratory rescue?
a) epinephrine b) theophylline c) albuterol d) terbutaline e) isoproterenol |
c) albuterol
d) terbutaline |
|
Which of the following bronchodilators are good for long-term use?
a) epinephrine b) theophylline c) albuterol d) terbutaline e) isoproterenol |
b) theophylline
d) terbutaline |
|
What are indications for hyperbaric O2 therapy?
|
CO toxicity
Wound healing (improves circulation and prevents anaerobic growth) |
