Respiratory Exam 1

Front 1

What consists of the upper respiratory system?

Back 1

nares to thoracic inlet

Front 2

What consists of the lower respiratory system?

Back 2

intrathoracic trachea to alveoli

Front 3

What is the typical sign of a animal with upper respiratory disease?

What two sounds can you hear without a stethescope?

Back 3

-increased inspiratory effort

-stridor
-stertor

Front 4

What is stridor?

What does it indicate?

Back 4

shrill, harsh sounding inspiration noise

-indicates disease of the oropharynx, larynx, or trachea

Front 5

What is stertor?

What doe it indicate?

Back 5

snoring type of respiratory noise

-indicates disease of the nasopharynx

Front 6

How can you determine the patency of the nares?

Back 6

wisp or glass slide test

Front 7

What are clinical signs of lower respiratory tract disease?

Back 7

-increased expiratory effort
-+/- orthopnea
-abnormal thoracic auscultation and/or percussion

Front 8

Are bronchovesicular sounds normal? What do they sound like?

Back 8

yes
-usually low-pitched sounds that are louder on inspiration

Front 9

What do diminished or absent bronchovesicular sounds mean?

Back 9

-intrathoracic mass
-pleural space disease
-atelectasis
-obesity
-reduced respiratory effort

Front 10

What do decreased bronchovesicular sounds mean?

Back 10

-referred upper airway noise
-tachypnea
-heavy interstitial or alveolar infiltrate
increased airway resistance

Front 11

What do moist crackles imply?

Back 11

-inspiration popping

-imply pneumonia, edema, or hemorrhage = fluid in alveoli

(fluid can only be blood, pus, or water)

Front 12

What do dry crackles imply?

Back 12

-expiratory, higher pitched than moist crackles

-imply small airway disease

Front 13

What do wheezes or rhonchi sound like and what do they imply?

Back 13

continuous, musical sounds

-imply narrowing or obstruction of large or small airways

Front 14

What do pleural friction rubs sound like a what do they imply?

Back 14

rhythmical, dry grating noise

-indicates pulmonary parenchymal or pleural space disease

Front 15

How do you define sneezing?

Back 15

explosive, expiratory outflow

Front 16

Sneezing localizes disease to what areas?

Back 16

nasal cavity, pharynx, or sinus

Front 17

Paroxysmal sneezing means what?

Back 17

virus, FB, or trauma

Front 18

Intermittent sneezing means what?

Back 18

intranasal lesion

Front 19

What is reverse sneezing?

Back 19

paroxysmal, noisy, labored inspiratory effort

Front 20

What does reverse sneezing localize disease to?

Back 20

nasopharynx

Front 21

What is reverse sneezing sometimes associated with?

Back 21

orthopnea and abduction of elbows

Front 22

The presence of nasal discharge normal = what?

What are the exceptions to the rule?

Back 22

sinonasal disease

-aspiratrion pneumonia, extranasal epistaxis

Front 23

What are the 4 physical characteristics to nasal discharges?

Back 23

1 - lateralitiy - unilateral or bilateral
2 - volume - copious or scant
3 - frequency - intermittent or continuous
4 - physical appearance of discharge (serous, mucoid, mixed, hemorrhagic)

Front 24

What does bilateral serous discharge usually mean?

Back 24

acute viral infection, allergic rhinitis, parasitic rhinitis

Front 25

What does mucoid unilateral or bilateral discharge mean?

Back 25

mycotic rhinitis

Front 26

What does a mucopurulent unilateral or bilateral discharge mena?

Back 26

secondary!!!!! bacterial rhinitis
-NOT primary

Front 27

What does extranasal (bilateral) epistaxis mean?

Back 27

coagulopathy, vasculitis, hypertension

Front 28

What does intranasal (unilateral or bilateral) epistaxis mean?

Back 28

neoplasia, trauma, FB

Front 29

When is a snot exam helpful?

Back 29

Only to confirm cryptococcal infections

Front 30

What do you do before you perform a nasal biopsy?

Back 30

diagnostic imaging

Front 31

Extranasal epistaxis caused by vascultitis could be caused by?

Back 31

RMSF or Ehrilichia

Front 32

Rhinoscopy is performed after diagnostic imaging and is used to look for waht?

Back 32

-nasopharyngeal masses - neoplasia
-turbinate atrophy/plaques = aspergillosis

Front 33

When is rhinotomy used?

Back 33

-last resort procedure - all other diagnostics failed
-sometimes needed to remove a foreign body

Front 34

What are the clinical signs of cleft palate?

Back 34

sneezing, nasal discharge, cough, pneumonia

Front 35

What are clinical signs of nasal foreign bodies?

Back 35

acute, paroxysmal sneezing
-nasal discharge
(acute = serous to hemorrhagic that is unilateral)
(chronic = mucopurulent discharge that is unilateral or bilateral)

Front 36

True or false - both primary and secondary bacterial rhinitis can happen in dogs.

Back 36

False - it is ALWAYS secondary to underlying disease (foreign body, tooth root abcess, fungal rhinitis, feline upper respiratory disease complex, nasal neoplasia)

Front 37

What is bacterial rhinitis's response to antibiotics?

Back 37

transient - will come back after antibiotics are stopped

Front 38

What are the 3 varieties of chronic, non-infectious rhinitis?

Back 38

-according to cell infiltrate

1 -l ymphoplasmocytic rhinitis
2 - eosinophilic (allergic) rhinitis
3 - hyperplastic rhinitis

Front 39

What is the typical signalment of a an animal with lymphoplasmocytic rhinitis?

Back 39

-dogs>>>cats
-middle aged
-immune or allergic etiology

Front 40

What is teh discharge of a lymphoplasmocytic rhinitis?

Back 40

mucoid to mucopurulent
-lymphs/plasma cells on nasal biopsy

Front 41

What is the treatment for lymphoplasmacytic rhinitis?

Back 41

-eliminate allergens
-prednisone
-treat secondary bacterial rhinitis
-antihistamines
-prolonged therapy sometimes necessary

Front 42

What is the cause of allergic rhinitis?

What is the treatment?

Back 42

type I hypersensitivity

-ID and eliminate allergens
-prednisone
-antihistamines

Front 43

What is the discharge associated with allergic rhinitis?

Back 43

chronic serous to mucoid nasal discharge

Front 44

What type of virus is feline viral rhinotracheitis (FVR)?

Back 44

feline herpes virus I

Front 45

How is FVR tranmitted?

Back 45

direct contact with infected cat or fomites
-shed in secretions for several days
-2-6 day incubation

Front 46

What are acute clinical signs of FVR?

Back 46

-paroxysmal sneezing
-inappetance, fever
-oculonasal discharge
-ulcerative keratitis
-pneumonia
-abortions - rare

Front 47

How do you form a definative diagnosis for FVR?

Back 47

- history and clinical signs
-VI and PCR

Front 48

What are chronic sequele to FVR?

Back 48

- chronic carrier (80%) with intermittent shedding (stress)
-rhinosinusitis
-keratitis
-lacrimal gland fibrosis

Front 49

What is the treatment plan for FVR?

Back 49

-outpatient
-restore/maintain hydration
-clean exudates
-decongestants
-systemic antibiotics
-topical opthalmics

-prevention, isolation, sanitation

Front 50

Is calcicivirus resistant to disinfection?

Back 50

yes - it is non-enveloped

Front 51

What is the mode of transmission of calicivirus?

Back 51

same as FVR (with 2-4 day incubation)

Front 52

What are the clinical signs to calicivirus?

Back 52

inappetance, depression, fever
oculonasal discharge
oral ulceration
pneumonia
lameness

Front 53

What are chronic sequele to feline calicivirus?

Back 53

-rhinosinusitis
-gingivitis/stomatitis
-continual viral shedding
-nasopharyngeal polyps

Front 54

The cough is a protective mechanism of what?

Back 54

the lower airway
-it is a clinical sign

Front 55

What are potential causes of cough in a young animal?

Back 55

congenital or infectious

Front 56

What are potential causes of cough in a middle-aged animal?

Back 56

chronic bronchial disease or infectious

Front 57

What are potential causes of cough in a geriatric dog?

Back 57

-acquired heart disease
-neoplasia
-chronic bronchial disease

Front 58

What are potential causes of cough in a brachycephalic breed?

Back 58

airway obstruction

Front 59

What are potential causes of cough in a small/toy breed?

Back 59

tracheal collapse

Front 60

What are potential causes of cough in a large breed?

Back 60

laryngeal paralysis

Front 61

What are potential causes of cough in a working dog?

Back 61

FB, parasites, fungal infections

Front 62

The duration of a cough can help you determine the cause. What might an acute, self-limiting cough be caused by?

Back 62

viral, kennel cough

Front 63

The duration of a cough can help you determine the cause. What might an chronic, persistent cough be caused by?

Back 63

lower airway disease

Front 64

The duration of a cough can help you determine the cause. What is the difference between a cardiac cough and a respiratory cough?

Back 64

respiratory - long duration
cardiac - 2--3 weeks duration

Front 65

A non-productive cough means what?

Back 65

upper airway problem

Front 66

A productive cough means?

Back 66

lower airway disease

Front 67

The temporal occurence of a cough can tell you a lot about the disease. What can you tell if the cough is in the morning?

Back 67

chronic bronchial disease

Front 68

The temporal occurence of a cough can tell you a lot about the disease. What can you tell if the cough is exercise/stress related?

Back 68

tracheal collapse, kennel cough

Front 69

The presence of systemic signs suggest waht?

Back 69

lower airway or cardiogenic cough

Front 70

The temporal occurence of a cough can tell you a lot about the disease. What can you tell if the cough is during eating/drinking?

Back 70

larygeal paralysis, megaesophagus, collapsing trachea

Front 71

What does inspiratory dyspnea mean?

Back 71

upper airway disease
stertor, stridor, voice change

Front 72

What does expiratory dyspnea mean?

Back 72

lower airway disease - bronchi, alveoli

Front 73

What does restrictive breathing mean?

Back 73

rapid, shallow respiration
-pleural, thoracic wall, or diaphragmatic disease

Front 74

Crackles on auscultation can mean what?

Back 74

edema, pneumonia, bronchitis

Front 75

What are the two types of laryngeal paralysis?

Back 75

-congenital (many breeds)
-acquired (middle age to older, large/giant breeds, idiopathic)

Front 76

What type of respiratory distress is seen with laryngeal paralysis?

Back 76

inspiration pattern with stridorous respiration

Front 77

How do you diagnose laryngeal paralysis?

Back 77

-laryngoscopy with light anesthesia
-observe larygneal movement
-bilateral paralysis required for clinical signs in dogs

Front 78

What is a treatment plan for dogs with laryngeal paralysis?

Back 78

-supportive (cage rest, exercises restriction, oxygen supplementation)
-test for hypothyroidism (thyroid supplementation)
-surgical --> arytenoid lateralization is most popular (unilateral procedure)

Front 79

Which way does the trachea collapse with tracheal collapse and how many grades of severity are there?

Back 79

dorsoventral collapse
-grades I -IV

Front 80

What is the signalment and clinical signs for dogs with tracheal collapse?

Back 80

-middle age to older
-small or toy breeds
-obese
-chronic goose honk cough with cyanosis during stress

Front 81

What is a concurrent, unrelated clinical finding of dogs with tracheal collapse?

Back 81

heart murmurs

Front 82

What are medical treatment options for dogs with tracheal collapse?

Back 82

-cough suppressants
-weight loss
-chest harness
-bronchodilators
-antibiotics
-prednisone

Front 83

Tracheal hypoplasia is a common finding in what type of dogs?

Back 83

brachycephalic and chondrodystrophic breeds

Front 84

Tracheal hypoplasia causes what type of dyspnea and what type of clinical signs?

Back 84

inspiratory and expiratory dyspnea

-exercise intolerance, respiratory distress, ill-thrift puppy, recurrent respiratory infections

Front 85

What can tracheal hypoplasia lead to?

Back 85

pulmonary hypertension

Front 86

What is the treatment for tracheal hypoplasia?

Back 86

no definitive treatment, many animals will tolerate this condition

Front 87

What are the primary etiologic agents of canine infectious tracheobronchitis?

Back 87

-virus - parainfluenza virus
-bacteria - Bordatella bronchiseptica

also - adenovirus 1 and 2 and mycoplasma spp.

Front 88

What is the incubation of canine infectious tracheobronchitis and how is it spread?

Back 88

-3-7 days
-respiratory secretions, fomites, dog shows and kennels

Front 89

What are clinical signs with the uncomplicted form of canine infectious tracheobronchitis?

Back 89

-vaccinated dogs
-upper airway only
-dry, hacking cough
-serous oculonasal discharge
-cough on tracheal palpation
-increased bronchovesicular sounds

Front 90

What are clinical signs with the complicted form of canine infectious tracheobronchitis?

Back 90

-young, poorly vaccinated
-bronchopneumonia
-inappetance, fever
-lethargy
-mucopurulent discharge
-moist cough
-pulmonary crackles

Front 91

How is the complicated form of canine infectious tracheobronchitis diagnosed?

Back 91

-inflammatory CBC
-radiographs (interstitial alveolar disease)
-TTW (septic, purulent inflammation)

Front 92

How do you treat the uncomplicated form of infectious tracheobronchitis?

Back 92

-self-limiting
-resolves in <2 weeks
-restrict exercise
-cough suppressants if severe
-maybe antibiotics

Front 93

What is the treatment for the complicated form of infectious tracheobronchitis?

Back 93

-systemic antibiotics (culture and sensitivity)
-treat min of 2 weeks or one week beyond cure
-empirical drug therapy (clavamox, doxycycline, TMS)
-medicated nebulization

Front 94

What is an empirical drug therapy for the complicated form of canine infectious tracehobronchitis?

Back 94

clavamox
doxycycline
TMS

Front 95

How do you prevent canine tracheobronchitis?

Back 95

avoid exposure
-vaccination - parenteral or intranasal
-sanitation - bleech
-ventilation - 12 cycles/hour in kennels

Front 96

What disorders can contribute to brachycephalic airway syndorme?

Back 96

-stenotic nares
-elongated soft palate
-everted larygeal saccules
hypoplastic trachea

Front 97

What are the 4 general mechanisms by which pleural effusions are determined?

Back 97

1 - Decreased oncotic pressure - hypoalbuminemia
2 - increased capillary hydrostatic pressure - congestive heart failure
3 - increased endothelial permeability - vasculitis
4 - lymphatic obstruction or dysfunction - cylothorax, neoplastic obstruction

Front 98

What are clinical signs of pleural effusion?

Back 98

-respiratory distress --> tachypnea, orthopnea, restrictive breathing pattern
-open-mouth breathing
-cough - uncommon
-cyanosis

Front 99

On PE, what do thoracic auscultations sound like with pneumothorax?

Back 99

-muffled heart sounds
-increased dorsal lung sounds
-decreased ventral lung sounds

Front 100

How do you confirm pleural effusion?

Back 100

thoracic radiograph --> perform a thoracocentesis first if clinical exam suggest pleural effusion and animal is in distress

Front 101

What 3 samples do you collect of a thoracocentesis?

Back 101

1 - 2-4 ml in EDTA
2 - direct smear
3 - 1 ml in sterile container - culture

Front 102

What do you evaluate pleural fluid for?

Back 102

-physical attributes (color, turbidity, odor, particulate matter)
-biochemisty (TP, SG)
-cell counts (RBC, PCV, WBC)

Front 103

What are causes of inflammatory effusion? (> 50% PMNs)

Back 103

-FIP
-pyothorax
-chronic cylothorax
-neoplasia
-lung lobe torsion

Front 104

How do you tell if an effusion is septic?
What is the cause?

Back 104

-degenerate PMNs
-IC bacteria
-pyothorax

Front 105

How do you tell if an effusion is neoplastic?

Back 105

-cytologic Dx of lymphoma only
-mesothelial cells appear similar to spithelial neoplasia and are found normally in pleural fluid
-confirm with mass biopsy

Front 106

Bacteria are present in what type of pleural effusion?

Back 106

exudate

Front 107

Which pleural effusion has the least number of WBC, protein, SG and does not have bacteria?

Back 107

transudate

Front 108

What are causes of modified transudates?

Back 108

CHF
neoplasia
lung lobe torsion
diaphragmatic hernia

Front 109

What does a modified transudate look like?

Back 109

colorless to serosanguinous

Front 110

What is the treatment for a modified transudate?

Back 110

treat the disease

Front 111

What are causes of hemothorax?

Back 111

-trauma-rib fracture, penetrating wounds
-coagulopathy
-neoplasia - HSA
-lung lobe torsion

Front 112

What are treatments of hemothorax?

Back 112

treat primary disease
blood product transfusion

Front 113

What are rounds of infection for a pyothorax and what are the anaerobes and aerobes that can cause it?

Back 113

-penetrating wounds and migrating grass awns
-anaerobes = Bacteroides, Fusobacterium
-aerobes = Step, E.coli, Actinomyces, Nocardia

Front 114

What is treatment for a pyotorax?

Back 114

-thoracostomy tubes
-thoracic lavage
-antimicrobial therapy --> based on culture, broad spectrum, long-term several months in dogs

Front 115

What is unique about centrifusion of cylothorax?

Back 115

does NOT clear on centrifugation

Front 116

What does cylothorax look like on cytology?

Back 116

acute - small lymphocyte
chronic - can be lymphs or non-degenerate PMNs

Front 117

What are causes of cylothorax?

Back 117

-trauma
-neoplasia - lymphoma
-cardiac diseases
-dirofilariasis
-lung lobe torsion
-diaphragmatic hernia
-caval thrombosis
-idiopathic (60-70%)

Front 118

What are the 2 types of pneumothorax?

Back 118

traumatic - open or closed (caused by penetrating wounds or trauma)

non-traumatic (spontaneous) - closed (lung is the source of the air leakage)

Front 119

What can cause non-traumatic pneumothorax?

Back 119

-rupture of pulmonary neoplasm
-rupture of cystic pulmonary structure (parasitic or idiopathic bulla)
-COPD

Front 120

What are the roentgen signs of pneumothrox? (5)

Back 120

-retraction of pleura away from the chest wall
-radiolucent space between lung and chest wall
-dorsal displacement of the heart
-atelectasis of lung
-lung margins don't extend to chest wall

Front 121

What is the treatment of traumatic and spontaneous pneumotorax?

Back 121

traumatic - most resolve spontaneously with only intermittent thoracocentesis

spontaneous - thoracostomy tubes and surgery is often needed

Front 122

What does the mediastinum contain?

Back 122

all intrathoracic organs except the lungs

Front 123

What is the etiology of pneumomediastinum?

Back 123

trauma to lower airways, esophagus or marginal alveoli

penetrating trauma to pharyn or cervial region

mediastinitis (esophageal perforation, gas forming bacteria infection)

Front 124

What are clinical signs of pneumomediastinum?

Back 124

often asymptomatic

Front 125

What is the treatment for pneumomediastinum?

Back 125

-usually resolves w/out treatment in 2 weeks if uncomplicated

Front 126

What is a pulmonary contusion?

Back 126

traumatic leakage of blood into the lung
-causes ventilation/perfusion mismatch

Front 127

What clinical sign is seen with pulmonary contusions?

Back 127

-pulmonary crackles
-respiratory distress
-evidence of concurrent injury

Front 128

What lung pattern is seen with pulmonary contusions on a radiograph?

Back 128

interstitial or alveolar pattern - localized

Front 129

What is treatment for pulmonary contusions?

Back 129

-monitor
-supportive care (oxygen, analgesics)
-stabilize patient
-treat concurrent injury

Front 130

What is canine chronic bronchitis and what does it cause?

Back 130

-inflammatory disease of bronchial walls (thickens airways walls and increases mucus)
-causes chronic obstructive pulmonary disease (COPD)

Front 131

What are potential sequel of COPD?

Back 131

-emphysema
-bronchiectasis
-pneumonia

Front 132

What are clinical findings of canine chronic bronchitis?

Back 132

-small breeds
-6-8 years old
-chronic cough greater than 2 months
-exercise intolerance
-audible wheezes (expiratory)
-concurrent tracheal collapse and or mitral valve insufficiency

Front 133

What is the lung pattern for canine chronic bronchitis on radiographs?

Back 133

dougnuts and train tracks - bronchial pattern

Front 134

What is seen on bronchoscopy with canine chronic bronchitis?

Back 134

-increased mucus
-mucopurlent exudate
-hyperemic bronchial walls
-+/- airway collapse

Front 135

What is the treatment for canine chronic bronchitis?

Back 135

1 - eliminate predisposing factors
2 - maintain hydration
3 - weight reduction if obese
4 - medical therapies (prednisone --> anti-inflammatory course, tapering course, ID maintenance dose)

Front 136

What medical therapy should you avoid with canine chronic bronchitis?

Back 136

cough suppressants

Front 137

Name three different bronchodilators you could use with canine chronic bronchitis?

Back 137

-theo-dur
-terbutaline
-albuterol

Front 138

Alpha receptors do what -
Beta receptors do what -

Back 138

bronchocontrict and increase mucus

bronchodilate and decrease mucus

Front 139

What is feline bronchial asthma caused by?

Back 139

type I hypersensitivity

Front 140

What is feline bronchial asthma?

Back 140

-a reversible airway obstruction where there is difficult with expiration (trap air)

Front 141

What are clinical signs of feline bronchial asthma?

Back 141

-bronchocontriction
-smooth muscle hypertrophy
-inflammation
-excessive mucous

Front 142

What is the pattern for feline bronchial asthma on rads?

Back 142

bronchial pattern
-atelectasis of right middle lobe
-diaphragmatic flattening

Front 143

What is characteristic of a hemogram of feline bronchial asthma?

Back 143

-eosinophilia - 25%
-must rule out parasites

Front 144

What is the emergency treatment of feline bronchial asthma?

Back 144

-AVOID stress
-O2 supplementation (O2 cage, blow-by)
-rapid acting parenteral steroids
-bronchodilator
-atropinization
-epinephrine - rare

Front 145

What is therapy for chronic feline bronchial asthma?

Back 145

-oral steroids (prednisone)
-repositol steroids (only if patient is fractious)
-bronchodilators (theopyline or terbutaline)

Front 146

What are clinical findings of aspiration pneumonia?

Back 146

-cough
-respiratory distress
-chronic, recurrent pneumonia
-pulmonary crackles
-asymptomatic

Front 147

What are the lung patterns you should look for with aspiration pneumonia and what else should you look for?

Back 147

-dependent, bronchoalveolar pattern
-examine for megaesophagus

Front 148

What is seen with bacterial pneumonia - primary and secondary infections?

Back 148

primary - bordatella and Strep
seondary - pasteurella, bordatella (cats); E-coli, Staph, Pseudomonas (dogs)