Flashcards
Respiratory medicine
Cards in this deck (61)
- 1What are main clinical problems of nasal disorders?Sneezing + reverse sneezing
Nasal discharge
Epistaxis
Nasal asymmetry
Facial pain and deformity
+/- eye ball eversion - 2What two broad categories can epistaxis be caused by?Local disease
Systemic disease - coagulopathy, hypertension - 3What would you examine in a physical examination of the nasal passages?Air flow - cotton
Palpation - pain, asymmetry, LNs, eye retropulsion
Dental and oral exam - 4What may prevent palpation of the pterygoid bones at the base of the soft palate?Soft palate polyps
- 5How would you radiograph the nasal passages and why?VD - less superimposition of structures
- 6When would you culture nasal discharge?If diabetic = Pseudomonas loves sugar
If copious green pus or other suspicious discharge - 7How would you biopsy the nasal structures?Biting = bleeding
Forced flush best - high pressure saline, requires GA and must hold eyes in - 8What other diagnostic tests may you use for nasal disease?Rhinoscopy
Arterial blood pressure
CBC, biochemistry, urinalysis
Cytology - 9How would you attempt treatment for adenocarcinoma of the nasal passages?Curettage
+/- chemotherapy or radiotherapy - 10How would you attempt SCC of the nasal passages/structures?Cryotherapy
Excision
Euthanasia - 11How would you diagnose nasal cryptococcus?CS - mucopurulent discharge, facial distortion
Cytology - thick capsule
Biopsy - culture, histology
Positive latex agglutination - 12What are CS for aspergillosis of nasal passages?Pain on palpation - architectual destruction by immune cells + caustic discharge
Mucopurulent +/- bloody discharge
Ulceration of nares - 13Diagnosis of aspergillosis of nasal structures?Signalment (young dolicocephalic males)
Chonchae destruction - radiography
Rhinoscopy
Histology or cytology - branching septate hyphae
Culture - 14What is the treatment for aspergillosis?Endoscopic debridement
2 dose clotrimazole intra-nasal under GA for 1 hour 2-3 weeks apart
Oral itraconazole 2-3 months - 15Which dog breeds are prone to laryngeal paralysis?Large breeds - labrador, Afghan hounds
- 16What are CS for laryngeal paralysis?Altered voice
Coughing or retching
Stridor
Exacerbated by exercise, hot weather, excitement/stress - 17What tests are available for diagnosing laryngeal paralysis?Radiography
Laryngoscopy
CBC, biochemistry, urinalysis, T4
Electromyography
Anti-nuclear antibodies - neuropathy
Anti-Ach antibody test (MA) - 18How can you diagnose nasopharyngeal polyps?Cannot palpate pterygoid bones
- 19What are indications for trans-tracheal washes?Coughing
Bronchial pattern (radiography) - 20What forms of trans-tracheal washes are there?Percutaneous - between rings or via cricothyroid ligament
Endotracheal via ET tube - 21What is the method for trans-tracheal washes?1 ml/kg BW of warm saline
--> inject into trachea/bronchi
Coupage the chest
Suck back (will only get a small portion back) - 22What are indications for bronchoscopy and broncho-alveolar lavage?Examine airways
Remove FBs
Diagnosis
Cytology, histology, and microbiology - 23Contraindications for bronchoscopy/broncoalveolar lavage?Unresponsive hypoxia
Hypercapnia
Coagulopathies - 24What are advantages of bronchoalveolar lavageGet most of the volume back
Area selection
Quantitative information - cell counts, bacterial culture - 25What are disadvantages of BA lavage?Expensive
Invasive
Limitations to cytology - 26Method of BA lavage?Advance broncoscope and wedge into smallest bronchus
Flood with saline and suck most back - 27CS of infectious tracheobronchitis/kennel cough?Coughing (sudden, dry, paroxysmal)
Retching up foam
Rarely fever, pneumonia - 28Diagnosis of kennel coughHistory of risk factor 3-10 days prior
Trans-tracheal wash - 29Describe the aetiology for collapsed tracheaGradual ring weakening
Dorsal ligament laxity/redundancy - 30CS of collapsed tracheaOlder toy breed dogs
Honking, non-productive cough - 31Diagnosis of collapsed tracheaEndoscopy
Fluoroscopy
Radiography
- Extra-thoracic collapse on inspiration
- Intra-thoracic collapse on expiration - 32Feline bronchitis diagnosisRadiography - bronchial pattern
Haemogram, history, PE
Faecal parasitology + heartworm test
Trans-tracheal wash or BA lavage - 33Signalment for chronic canine bronchitisOlder small breed dogs
- 34CS of canine chronic bronchitis2+ months of harsh coughing
- 35Complications of canine chronic bronchitis?Bronchiectasis --> bronchial collapse
- 36Diagnosis of canine chronic bronchitisSignalment + history
Radiography - bronchial pattern
Trans-tracheal wash or BAL - 37What are differentials for canine chronic bronchitis?Collapsing trachea
Mitral insufficiency + LA enlargment
Concurrent bacterial infection
Allergic bronchitis - 38When and how would you diagnose viral pneumonia?In an outbreak
Ag detection + PCR
Serology
Viral isolation - 39What bacteria are commonly isolated from bacterial pneumonia?E.coli
Strep
Staph
Pasteurella
Bordetella
Klebsiella - 40How would you diagnose pulmonary neoplasia?CS - weight loss, anorexia, sudden pneumothorax, pulmonary haemorrhage, MARIE'S DISEASE (hypertrophic osteopathy)
Radiography - nodules
FNA - pneumothorax complication - 41Pathogenesis of Marie's disease in pulmonary neoplasia?Influences vagus nerve --> hind limb bone deposition --> painful swelling
- 42What are causes of pulmonary thromboembolism?Dirofilariasis
Heart disease
Surgery
Nephrotic syndrome - protein loss = hypercoagulable
Cushing's
IMHA
Neoplasia
Sepsis or DIC - 43How would you diagnose pulmonary TE?CS - acute severe dyspnoea, poor response to oxygen, loud/split S2
CT + contrast dye - find obstruction
Radiographs normal - 44What are causes of non-cardiogenic pulmonary oedema?Fluid overload
Near-drowning
Increased vascular permeability - electric shock, inhaled toxins, snake bite, cisplatin
Head trauma - 45How would you diagnose and treat non-cardiogenic pulmonary oedemaExclusion diagnosis
Supportive care - 46What are CS of pleural/medistinal diseases?Shallow tachypnoea
Decreased lung sounds
+/- chest distension, fluid line on percussion
Cyanosis, coughing, fever - 47How would you diagnose pleural/medistinal disorders?Chest percussion - fluid line, air, + auscultation
Palpate cranial mediastinum (masses, cats)
Auscultation - 48What causes pleural transudate?Congestive heart failure (R side/biventricular)
Hypoalbuminaemia - 49What can cause a pleural modified transudate?Long-standing transudate
Neoplasia
Diaphragmatic hernia - 50What can cause pleural exudation?Infection
Neoplasia
Auto-immune disease
Pancreatitis - 51What can cause chylothorax?Cardiomyopathy - venous distension --> more lymph production to avoid ascites
Idiopathic rupture - 52What can cause pyothorax?Penetration
Local infection
Systemic infection
Ruptured abscess - 53Aetiology of pneumothoraxParasites
Trauma
Invasive tumours
Bullae - spontaneous rupture - 54How can you classified pneumothorax?Tension - mediastinal shift
Spontaneous vs traumatic
--> Traumatic better prognosis/sealing - 55What sequelae can occur with cranioventral mediastinal masses?Recurrent laryngeal nerve compression --> megaoesophagus, laryngeal paralysis
Obstructed venous return --> head/forelimb oedema + thrombosis - 56What are examples of extra-pleural and extra-mediastinal disease?Diaphragmatic rupture
Chest wall trauma
Chest wall neoplasia (ribs splayed on rads)
Rectus excavatum
Peritoneal-pericardinal hernia
Hiatal hernia - 57Describe air bronchogramsAlveolar pattern - parenchymal filled with fluid, bronchi air-filled
- 58Describe bronchial lung patternRing shadows, thickened bronchial walls and tram tracks
- 59Describe interstitial lung patternIncreased lung opacity
- nodular (structured)
- Unstructured, no BV differentiation - 60Describe vascular patternEnlarged BVs
- 61Describe radiographical appearance of bronchiectasisEnlarged bronchi, don't taper peripherally/may end bluntly
Information
- Description
- Nasal disorders Pharyngeal and laryngeal disorders Tracheal and bronchial disorders Pulmonary parenchymal disorders Pleural, body wall, and mediastinal disorders
- Created by
- Alinta Kalns
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