Respiratory Cvt Xv Board Review 2015

Front 1

Diagnosis of pulmonary hypertension in veterinary medicine is generally defined as what

Back 1

a. Elevated systolic pulmonary artery pressure as estimated by noninvasive Doppler echocardiography
2.

Front 2

What is the most common cause for PH in dogs

Back 2

a. Left-sided heart failure
3.

Front 3

Does tracheal collapse cause pulmonary hypertension

Back 3

a. Yes
4.

Front 4

What is the gold standard for diagnosis of PH in humans

Back 4

a. Right-sided heart catheterization
5.

Front 5

What are the common clinical signs of pulmonary hypertension

Back 5

a. Cough, exercise intolerance, tachypynea, respiratory distress, and syncope
6.

Front 6

Why would dogs with PH have a diastolic murmur

Back 6

a. Pulmonic insufficiency
7.

Front 7

Diastolic pulmonary artery pressures can be estimated with what

Back 7

a. Pulmonic insufficiency
8.

Front 8

How can pulmonary flow profiles be used to detect pulmonary hypertension

Back 8

a. A ratio of less than 0.31 between acceleration and deceleration time of pulmonary flow has a sensitivity and specificity of 73% and 87% for predicting PH
9.

Front 9

How can response to therapy be seen in dogs with PH

Back 9

a. Improvement in exercise capacity, reduced respiratory rate, reduction or elimination of exertional collapse or syncope (not see changes on echo to be sensitive)
10.

Front 10

What is the disadvantage of using calcium channel blockers to treat PH

Back 10

a. Vasodilation is not specific for the just the lungs and can see systemic hypotension (diltaizem and amlodipine)
11.

Front 11

What are adverse effects associated with sildenafil

Back 11

a. Lethargy, clear nasal discharge, erect ears, and cutaneous flushing
12.

Front 12

What are the benefits from sildenafil

Back 12

a. Improved pulmonary gas exchange, increased myocardial contractility, reduced ventricular afterload, facilitated action of natriuretic peptide, blunted adrenergic stimulation
13.

Front 13

Which two causes of PH are associated with an improved outcome compared to others

Back 13

a. Heartworm disease, cardiac disease (cor pulmonale is associated with a poor prognosis)
14.

Front 14

Pulmonary thromboemboli most likely result from disturbance of which of Virchow’s triad factors

Back 14

a. Hypercoagulability because they are venous clots (why anticoagulants are most helpful)
15.

Front 15

Arterial thromboemboli most likely result from disturbance of which of Virchow’s triad factors

Back 15

a. Endothelial damage (why antiplatelet drugs are more helpful)
16.

Front 16

How is oxygen therapy of benefit in patients with a PTE

Back 16

a. Improve arterial partial pressure of oxygen (many times can be below 70 and causing respiratory difficulty); dilate pulmonary vessels, reduce pulmonary hypertension, and improve right ventricular function
17.

Front 17

What are the primary differences between unfractionated heparin and low molecular weight heparin

Back 17

a. UFH binds to anti-IIa more than LMWH and has more effects of platelet binding than does LMWH so more at risk for bleeding. UFH is cleared more rapidly because of its increased molecular weight so it has more varied activity and binds to plasma proteins which can vary response. UFH can be monitored with aPTT. UFH is the gold standard therapy in people. LMWH targets anti-Xa more than anti-IIa so can monitor with anti-Xa factor and has less effects on platelet binding and vascular permeability
18.

Front 18

Why is the effect of warfarin not immediate

Back 18

a. Because effects vitamin-K dependent factors (vitamin K antagonist) and newly synthesized inactive coagulation factors must first replace their functional counterparts, why heparin generally overlaps warfarin therapy for a few days
19.

Front 19

What drug when administered to patients with IMHA has been shown to improve survival in dogs

Back 19

a. Ultra-low-dose aspirin
20.

Front 20

Thromboxane A2 is produced how by platelets

Back 20

a. Cox-1 (counterbalanced by prostacyclin which is made by COX-1 and COX-2) so low dose is recommended to spare COX-2
21.

Front 21

What is the normal intrapleural pressure

Back 21

a. -5 cmH20-

Hint 21

Promotes lung expansion and venous return
22.

Front 22

What is an open pneumothorax

Back 22

a. Wound connecting the chest cavity and the outside air
23.

Front 23

When are chest tubes warrented in patients with a pneumothorax

Back 23

a. Severe signs at presentation, marked air leakage (over 1 L) with no end in sight, recurrent pneumothorax in 24 hour period; 3 strikes you are out policy
24.

Front 24

What is flail chest

Back 24

a. 2 or more fractures in 3 or more ribs, moves paradoxically during respiration and is invariably associated with sever underlying pulmonary contusion
25.

Front 25

What is a spontaneous pneumothorax

Back 25

a. Pneumothorax that is not associated with trauma but can be a primary issue or secondary to lung disease
26.

Front 26

When is CT generally recommended in spontaneous pneumothorax

Back 26

a. When atypical signalment or concerns about neoplasia
27.

Front 27

What are common causes for pneumothorax in a cat

Back 27

a. Neoplasia or heartworm disease
28.

Front 28

What is a common risk of “blood patching or pleurodesis” in humans

Back 28

a. Pyothorax
29.

Front 29

Name all of the 6 causes for a chylous effusion

Back 29

a. Idiopathic, neoplasia, heart disease, heartworm, lung lobe torsion, trauma
30.

Front 30

Are bilateral or unilateral pleural effusions more common in dogs and cats

Back 30

a. Bilateral because of incomplete mediastinum
31.

Front 31

Which intercostal space is most recommended for Thoracocentesis and which side

Back 31

a. Right, 7th or 8th intercostal space at the costochondral junction; needle placement just cranial to the rib to avoid vessels at the caudal right
32.

Front 32

What complication is most worrisome in cases of chronic pleural effusion

Back 32

a. Re-expansion pulmonary edema
33.

Front 33

Which breed of dog is predisposed to lung lobe torsions

Back 33

a. Afghan hounds; right middle lung lobe is most frequently affected
34.

Front 34

How does SIRS cause a modified transudate

Back 34

a. Increased endothelial permeability
35.

Front 35

What ratio of albumin to globulins make FIP more likely

Back 35

a. Less than 0.8
36.

Front 36

What are the most common bacterial isolates from a feline pyothorax

Back 36

a. Peptostreptococcus, bacteriodes, Fusobacterium, and prevotella (anaerobic); pasturella and actinomyces (aerobic)
37.

Front 37

What are the most common bacterial isolates in canine pyothorax

Back 37

a. Same as cats but has addition of E. Coli
38.

Front 38

How does the thoracic duct differ in cats vs. dogs

Back 38

a. In cats courses along the left caudal mediastinum and in dogs, courses along the right side dorsal to the aorta
39.

Front 39

How do benzopyrones work

Back 39

a. Improvement of macrophage function and increasing chyle reabsorption from the pleural space
40.

Front 40

What is considered a contraindication of surgery in chylothorax by most surgeons

Back 40

a. Fibrosing pleuritis
41.

Front 41

What parasitic diseases can cause Eosinophilic pulmonary disease in dogs

Back 41

a. Angiostrongylus vasorum larvae, Oslerus osleri, Filaroides hirthi, Crenosoma vulpis, and paragonomis kellicotti
42.

Front 42

What type of immune response is suspected in the pathogenesis of Eosinophilic bronchopneumopathy

Back 42

a. T cell type 2 with CD4+; tissue damage via upregulation of matrix metalloproteinase 8, 9, 13
43.

Front 43

What breeds are predisposed

Back 43

a. Huskies and malamutes
44.

Front 44

What is not recommended therapeutically for dogs with EBP

Back 44

a. Long acting steroids
45.

Front 45

What are ancillary therapies tried and can be used in dogs with this condition

Back 45

a. Cyclosporine, hyposensitization therapy
46.

Front 46

Are inflammatory polyps of the nasal turbinates the same as nasopharyngeal polyps

Back 46

a. No, feline mesenchymal hamartomas, usually cats under 1 year of age and removal of abnormal turbinate is successful
47.

Front 47

Which treatment option has the best reported success for nasopharyngeal stenosis

Back 47

a. Balloon dilation
48.

Front 48

What are nasopharyngeal cysts typically made from

Back 48

a. Thyroglossal duct or rathke’s cleft-> congenital malformation, remove cyst (flush, traction, surgical debridement)
49.

Front 49

What is the most common nasopharyngeal neoplasia

Back 49

a. Lymphoma
50.

Front 50

What gastrointestinal issues are associated with brachycephalic syndrome

Back 50

a. GERD, pyloric mucosal hyperplasia/atony/stenosis, gastric and duodenal inflammation
51.

Front 51

When should surgery be performed for the gastrointestinal issues

Back 51

a. Severe hiatal hernias
52.

Front 52

When Eosinophilic infiltrates are seen in cats with rhinitis, what should be suspected

Back 52

a. Herpesvirus
53.

Front 53

Radiation therapy for nasal neoplasia in cats will offer what kind of MST

Back 53

a. 9-23 months- nasal lymphoma
54.

Front 54

What are some of the early radiation side effects

Back 54

a. Mucositis, conjunctivitis, moist desquamation of skin
55.

Front 55

What are some late radiation side effects

Back 55

a. Bone necrosis, cataracts, KCS
56.

Front 56

What parasite might be seen on cytology of nasal discharge in a dog

Back 56

a. Eucoleus boehmi (capillaria)
57.

Front 57

What causes the bony destruction of turbinates in dogs with Aspergillus fumigatus

Back 57

a. Host inflammatory response
58.

Front 58

Neoplastic nasal tumors in dogs will metastasize where

Back 58

a. Lungs and regional lymph nodes
59.

Front 59

What is the MST for dogs that undergo RT for nasal tumors

Back 59

a. 16-23 months
60.

Front 60

Xeromycteria-dry nose (neurogenic dry eye

Back 60

)
a. Otitis media leads to loss of parasympathetic innervation to lateral nasal gland and causes hyperkeratosis, dry nasal planum and thick nasal secretions
61.

Front 61

Canine infectious respiratory disease complex can include what viruses

Back 61

a. Herpesvirus, Adenovirus, Coronavirus, Parainfluenza virus, and Influenza virus
62.

Front 62

What bacteria are included in canine infectious respiratory disease complex

Back 62

a. Mycoplasma, streptococcus equi zooepidemicus, and bordetella
63.

Front 63

Nebulization with amikacin is likely effective when what bacteria is present and resistant to current treatment

Back 63

a. Bordetella
64.

Front 64

How do opiates suppress coughing in dogs

Back 64

a. Depress the cough center in the medulla either through mu or kappa receptors and cause sedation
65.

Front 65

Butorphanol is an agonist for what receptor

Back 65

a. Kappa
66.

Front 66

Morphine is an agonist for what receptor

Back 66

a. Mu
67.

Front 67

How is hydrocodone different from codeine

Back 67

a. More potent
68.

Front 68

Stimulation of B-2 receptors will cause smooth muscle in the bronchioles to relax how

Back 68

a. Increases the release of cAMP which reduces calcium concentration and allows muscle to relax
69.

Front 69

What other two benefits do beta agonists convey in addition to bronchodilation

Back 69

a. Stabilizing effect on mast cells and increased mucociliary clearance
70.

Front 70

How is Terbutaline different from isoproterenol and albuterol

Back 70

a. All beta adrenergic agonists but Terbutaline is longer activng than isoproterenol. Terbutaline is available for injectable or oral formulations. Albuterol is similar to Terbutaline but cannot be given injectably. Can be given as a tablet, liquid, or as an inhaled drug
71.

Front 71

What are the most common adverse effects of beta-agonists

Back 71

a. Tachycardia, muscle tremors, twitching, hyperthermia , hypokalemia, can inhibit uterine motility so avoid in pregnant patients
72.

Front 72

What is the downside of chronic use of beta agonists

Back 72

a. Can get tolerance due to beta receptor down regulation.
73.

Front 73

How do methylxanthines work

Back 73

a. Adenosine receptor antagonism –adenosine triggers bronchoconstriction in asthmatic individuals. Also likely inhibits Phosphodiesterase III and IV
74.

Front 74

What drugs inhibit the metabolism of theophylline

Back 74

a. Cimetidine, Enrofloxacin, and erythromycin
75.

Front 75

What are the side effects of methylxanthines

Back 75

a. CNS stimulation, mild urinary diuresis, and cardiac stimulation