Small Animal Medicine Ii - Midterm

Front 1

what are five rule-routs for unilateral nasal mucopurulent discharge in a dog?

Back 1

1. neoplasia
2. fungal rhinitis
3. oronasal fistula
4. foreign body
5. early 2ndary bacterial infection

Front 2

what are some diagnostic tests that can be done for a unilateral nasal discharge?

Back 2

1. nasal airflow
2. cytology
3. CBC/chem/UA
4. nasal and oral rads
5. rhinoscopy
6. histopathology
7. ± culture
8. fungal titers

Front 3

how do you interpret Aspergillus hyphae on a nasal smear?

Back 3

may or may not be an incidental finding, depending on clinical signs. Aspergillus is a common surface contaminant on the nasal mucosa of dogs

Front 4

what is the main pathologic lesion of Aspergillosis in dogs?

Back 4

destruction of nasal turbinates

Front 5

how does immunosuppression relate to Nasal Aspergillosis in dogs?

Back 5

it does not

Front 6

what facial shapes of dogs predisposes them to Aspergillosis?

Back 6

mesaticephalic and dolichocephalic

Front 7

what is the three presenting clinical signs of nasal Aspergillosis in dogs?

Back 7

1. UNILATERAL mucopurulent nasal discharge with INTERMITTENT EPISTAXIS
2. nasofacial discomfort (pain)
3. depigmentation of nares due to licking (they lick because it is painful)

Front 8

what bones are NOT affected by nasal Aspergillosis and thus differentiates this disease radiographically from neoplasia?

Back 8

no lysis or deviation of vomer or frontal bones

Front 9

what are the radiographic signs of nasal Aspergillosis in the dog?
- location and laterality of lesions
- 3 Roentgen signs
- DDx from osteosarcoma or other bone neoplasia

Back 9

- unilateral or bilateral; caudal nasal cavity and frontal sinuses
1. loss of nasal turbinates
2. increase in soft tissue or fluid density
3. multiple, well-defined lytic zones
'- no lysis or deviation of vomer or frontal bones

Front 10

what is the best imaging modality to assess the cribriform plate?

Back 10

CT

Front 11

what does nasal Aspergillosis in the dog look like under rhinoscopy?

Back 11

- turbinate destruction
- white/gray mats, plaques, or granulomas

Front 12

comment on serology for nasal Aspergillosis:
- indication
- specificity
- response to treatment

Back 12

- indicated as a supportive diagnostic only
- false positives, so not too specific
- CANNOT use to assess response because titers do not drop significantly

Front 13

what are two topical medications used for nasal Aspergillosis? Which is the most effective and why?

Back 13

1. clotrimazole
2. enilconazole - better because it gives off vapors that are equally effective as topical, so it hits all parts of nasal cavity; expensive

Front 14

what is the basic commonly-used procedure for using Clotrimazole or Enilconazole to treat nasal Aspergillosis in the dog?

Back 14

1. anesthesia
2. multiple tube placement
3. infusion for 1 hour
'- may take several treatments
- may require sinus trephination

Front 15

how long after treatment with Clotrimazole or Enilconazole do clinical signs associated with nasal Aspergillosis typically resolve?

Back 15

2 weeks

Front 16

what are two alternatives to anesthesia/tube placement/1 hour infusion for dogs with nasal Aspergillosis?

Back 16

1. trephination and placement of tubes into sinuses and nasal cavities; infusion of enilconazole or clotrimazole BID x 7-10 days.
2. If topical is too risky (e.g., disruption of cribriform plate), systemic itraconazole for 2-3 months up to 1 year

Front 17

what surgical procedure can improve topical antifungal therapy for nasal Aspergillosis?

Back 17

debulking

Front 18

what are two long-term complications of canine nasal Aspergillosis?

Back 18

1. meningoencephalitis (rare)
2. chronic bacterial rhinitis

Front 19

which agent most commonly causes fungal rhinitis in cats?

Back 19

Cryptococcus neoformans

Front 20

what are three common presenting complaints that suggest feline Cryptococcosis?

Back 20

1. facial swelling/deformity
2. sneezing
3. mucopurulent ± hemorrhagic nasal discharge - either unilateral or bilateral

Front 21

in feline Cryptococcosis, what clinical sign indicated a prognosis that is:
- guarded?
- grave?

Back 21

- guarded: ophthalmic lesions (nervous tissue involvement)
- grave: CNS signs

Front 22

what are 8 clinical signs of feline Cryptococcosis?

Back 22

1. facial swelling/deformity
2. sneezing
3. mucopurulent ± hemorrhagic nasal discharge - either unilateral or bilateral
4. ulcerative lesion on nasal planum
5. granulomatous lesion from the nares
6. submandibular lymphadenopathy
7. ophthalmic lesions (NB: Px guarded)
8. CNS signs (grave)

Front 23

what do ocular lesions look like in feline Cryptococcosis?

Back 23

fungal plaques on the retina

Front 24

what are 2 clin path diagnostic tests to confirm feline Cryptococcosis?

Back 24

1. cytology - FNA of lesion/nasal discharge
2. serology - cryptococcal capsular antigen titer

Front 25

what is a diagnostic to rule-in neurological feline cryptococcosis?

Back 25

positive titer of CSF

Front 26

what are three antifungals used to treat feline cryptococcosis?

Back 26

1. fluconazole (slower, less $)
2. itraconazole (faster, more $)
3. ketoconazole

Front 27

treating feline cryptococcosis with antifungals:
- minimum time
- when do you stop
- how long can this take?

Back 27

- minimum 2 months
- Tx one month beyond resolution or until titer is negative
- prolonged Rx in some (1 year)

Front 28

in feline cryptococcosis, comment on using serology for monitoring response to therapy.

Back 28

titer may be used to monitor response to therapy

Front 29

feline cryptococcosis prognosis:
- overall
- how does magnitude of titer correlate?
- 3 negative prognostic indicators

Back 29

- overall, good
- MAGNITUDE OF TITER IS NOT PROGNOSTIC
- FeLV/FIV cats, ocular lesions, and CNS lesions are negative prognostic indicators

Front 30

what age group of animals are most predisposed to nasal neoplasia?

Back 30

older animals (> 8 years)

Front 31

what general breed class of dogs is overrepresented for nasal neoplasia?

Back 31

dolichocephalic breeds

Front 32

how commonly are nasal tumors malignant?

Back 32

most: 80-90%

Front 33

what are the three most common BASIC types of nasal neoplasias?

Back 33

1. epithelial (carcinomas)
2. mesenchymal (sarcomas)
3. discrete round cell tumors

Front 34

what are the 3 most common types of nasal carcinomas?

Back 34

1. adenocarcinoma (dogs)
2. SCC
3. undifferentiated carcinoma

Front 35

what are the 3 most common types of nasal sarcomas?

Back 35

1. chondrosarcoma
2. fibrosarcoma
3. undifferentiated sarcoma

Front 36

what are the 3 most common types of nasal discrete round cell neoplasms?

Back 36

1. lymphoma (cats)
2. transmissible venereal tumor (rare)
3. mast cell tumor (rare)

Front 37

what are 9 clinical signs of nasal neoplasia?

Back 37

1. unilateral to bilateral nasal discharge
2. sneezing
3. nasofacial deformities
4. ex- or enophthalmia
5. open mouth breathing
6. oral deformity
7. dysphagia
8. stertor
9. CNS signs

Front 38

what is a radiographic indicator that may help to distinguish nasal fungal infection from nasal neoplasia?

Back 38

if there is bony lysis of the vomer/fontal bone, that suggests neoplasia over fungal rhinitis

Front 39

what two diagnostics are used to stage nasal neoplasia?

Back 39

1. evaluation of local lymph nodes
2. thoracic radiographs

Front 40

for which type of nasal neoplasias is radiation indicated? How does radiation therapy affect prognosis in most cases?

Back 40

- carcinomas and sarcomas
- palliative, not curative

Front 41

for which two types of nasal neoplasias is chemotherapy indicated?

Back 41

1. lymphoma
2. mast cell tumor

Front 42

what are three basic factors that affect the median survival time of nasal neoplasia?

Back 42

1. tumor type (aCA, sarcoma > SCC, undifferentiated)
2. clinical stage (mets → lungs and extensive local invasion shorten time)
3. species (cats tolerate better than dogs)

Front 43

Blastomycosis:
- genus and species
- morphology
- species it infects

Back 43

- Blastomyces dermatitidis
- dimorphic
- mostly dogs

Front 44

what is the basic pathogenesis of systemic Blastomycosis in the dog?

Back 44

1. spore inhalation
2. pulmonary infection
3. hematogenous dissemination

Front 45

Generally, what system is most affected by blastomycosis in dogs?

Back 45

respiratory

Front 46

what are 4 respiratory signs of blastomycosis in dogs?

Back 46

1. coughing
2. tachypnea/dyspnea
3. increased broncho-vesicular sounds: crackles, wheezes
4. exercise intolerance

Front 47

besides respiratory signs, what are six other clinical signs of blastomycosis in dogs?

Back 47

1. inappetence, weight loss
2. lameness
3. draining skin lesions
4. fever
5. ocular signs
6. lymphadenopathy

Front 48

what are two ocular signs of blastomycosis in the dog?

Back 48

1. lesions on the retina
2. corneal neovascularization

Front 49

blastomycosis in dogs:
- erythrogram
- leukogram
- 2 blood chem abnormalities

Back 49

- RBC: normochromic, normocytic, non-regenerative anemia
- WBC: leukocytosis, lymphopenia
- chem: hyperglobulinemia (polyclonal), hypercalcemia

Front 50

what pulmonary radiographic pattern is consistent with canine blastomycosis?

Back 50

diffuse interstitial pattern

Front 51

cytology of blastomycosis in the dog:
- size of yeast
- appearance of yeast

Back 51

- 5-20 μm
- thick, refractile, double-wall

Front 52

comment on serology in the diagnosis of canine blastomycosis?
- reliability
- samples

Back 52

- it is reliable
- blood, urine

Front 53

what is the major histopathological lesion of canine blastomycosis?

Back 53

granulomatous inflammation

Front 54

what are three drugs used to treat blastomycosis in the dog?

Back 54

1. itraconazole (used most often)
2. fluconazole
3. Amphotericin B

Front 55

what is the trade-off between using itraconazole and fluconazole when treating fungal infections systemically?

Back 55

- itraconazole is more potent and thus has a shorter course; however it is expensive
- fluconazole is less potent, so course of treatment is longer, but overall, it is less expensive than using itraconazole

Front 56

canine blastomycosis prognosis:
- what % of dogs are treated successfully
- how long after clinical presentation do animals usually die?
- comment on relapses

Back 56

- 80% are treated successfully
- most deaths occur within the first 7 days
- relapses depend on the severity of lung disease; some patients require prolonged treatment of 6 months or more

Front 57

Histoplasmosis
- genus and species
- morphology
- species it infects

Back 57

- Histoplasma capsulatum
- dimorphic
- dogs and cats

Front 58

what is the basic pathogenesis of systemic Blastomycosis in the dog?

Back 58

1. microconidia inhalation
2. pulmonary infection
3. hematogenous dissemination

Front 59

what are 7 clinical signs of Histoplasmosis?

Back 59

1. respiratory signs (cough, dyspnea)
2. lymphadenopathy
3. hepatosplenomegaly
4. weight loss (vomiting, diarrhea)
5. icterus (note that hepatic infection is common)
6. fever
7. ophthalmic lesions

Front 60

what blood abnormality can fulminant hepatic disease caused by Histoplasma cause?

Back 60

DIC

Front 61

laboratory findings of histoplasmosis:
- erythron
- leukogram
- bone marrow

Back 61

- erythron: non-regenerative anemia
- leukogram: ± cytopenias
- bone marrow infiltration (±)

Front 62

what pulmonary radiographic pattern is consistent with histoplasmosis?

Back 62

diffuse miliary to nodular interstitial pattern

Front 63

in histoplasmosis, what does the liver look like on ultrasound

Back 63

grossly enlarged with a moth-eaten appearance to the parenchyma

Front 64

cytology of histoplasmosis:
- size of yeast
- appearance of yeast

Back 64

- 3-4 μm
- intracellular organism with a halo

Front 65

comment on serology in the diagnosis of canine histoplasmosis?
- reliability
- samples

Back 65

not useful

Front 66

what are three drugs used to treat blastomycosis in the dog?

Back 66

1. itraconazole (used most often)
2. fluconazole
3. Amphotericin B

Front 67

in what 5 tissues can you isolate Histoplasma for diagnostic purposes?

Back 67

1. intestinal/rectal mucosa
2. spleen
3. liver
4. bone marrow
5. lung
6. lymph nodes

Front 68

prognosis of Histoplasmosis with:
- disseminated disease
- pulmonary disease

Back 68

- disseminated: guarded to grave
- pulmonary: good to fair

Front 69

what are 2 complications of using systemic Amphotericin B to treat fungal infections? What are 2 routes of administration?

Back 69

- CNS signs, nephrotoxicity
- administer IV or SQ

Front 70

Coccidiomycosis
- genus and species
- species it infects

Back 70

- Coccidioides immitis
- mostly dogs

Front 71

what is the basic pathogenesis of systemic Blastomycosis in the dog?

Back 71

1. inhalation of mycelial arthrospores
2. spore transformation in lung to spherule
4. hematogenous and lymphatic dissemination

Front 72

what are 6 clinical signs of coccidiomycosis in dogs?

Back 72

1. weight loss, fever
2. inappetence
3. lymphadenopathy (marked, localized)
4. lameness (painful bone swelling)
5. draining cutaneous lesions
6. ophthalmic signs

Front 73

what is the main laboratory finding of coccidiomycosis in dogs?

Back 73

± hyperglobulinemia

Front 74

what two pulmonary radiographic patterns are consistent with histoplasmosis?

Back 74

1. diffuse miliary to nodular interstitial pattern
2. HILAR LYMPHADENOPATHY

Front 75

comment on fungal culture for diagnosis of coccidiomycosis in dogs?

Back 75

don't do it because they are very dangerous to humans

Front 76

what is the most useful blood test to diagnose coccidiomycosis?

Back 76

serology

Front 77

what are 3 drugs used systemically to treat coccidiomycosis in dogs?

Back 77

1. ketoconazole
2. itraconazole
3. fluconazole

Front 78

prognosis of coccidiomycosis
- % that improve
- % overall recovery rate
- how long do you have to treat?

Back 78

- 90% improve
- 60% recover
- treat for a minimum of 1 year

Front 79

what is the genus and species of feline lungworm?

Back 79

Aelurostrongylus abstrusus

Front 80

where in the cat does Aelurostrongylus abstrusus like to hang out?

Back 80

(feline lungworm)
terminal bronchioles and alveoli

Front 81

in symptomatic cases of feline lungworm, what are some clinical signs?

Back 81

- dry, non-productive cough
- wheezes, dyspnea

Front 82

what are four ways to diagnose Aelurostrongylus abstrusus (feline lungworm)?

Back 82

1. Hemogram showing eosinophilia
2. Thoracic radiographs
3. transtracheal wash - recovery of eosinophils
4. fecal flotation to detect larvae

Front 83

what are two drugs used to treat feline lung worms and their route of administration?

Back 83

1. ivermectin PO or SC (note SC burns very badly, but is safe)
2. fenbendazole PO

Front 84

what is the genus and species of the dog lung fluke?

Back 84

Paragonimus kellicotti

Front 85

Paragonimus kellicotti:
- common name
- where does it like to hang out?

Back 85

- dog lung fluke
- resides in CYSTIC STRUCTURES in the pulmonary parenchyma

Front 86

what are three thoracic radiographic signs of the dog lung fluke, Paragonimus kellicotti?

Back 86

1. pulmonary cysts
2. secondary inflammation
3. PNEUMOTHROAX (consequence of cyst)

Front 87

what are two drugs used to treat canine lung flukes?

Back 87

1. fenbendazole
2. praziquantel

Front 88

who most commonly gets primary pulmonary neoplasias?

Back 88

dogs >> cats

Front 89

what are the three most common primary pulmonary neoplasias in dogs and which is most common?

Back 89

1. adenocarcinoma (most common)
2. SCC
3. bronchoalveolar carcinoma

Front 90

what are the six most common secondary (metastatic) pulmonary neoplasias?

Back 90

1. thyroid carcinoma
2. mammary carcinoma
3. osteosarcoma
4. chondrosarcoma
5. hemangiosarcoma
6. malignant melanoma

Front 91

what are 5 respiratory clinical signs of pulmonary neoplasia?

Back 91

1. cough (most frequent)
2. hemoptysis
3. dyspnea/tachypnea
4. exercise intolerance
5. crackles, wheezes

Front 92

what are the two most common non-respiratory clinical signs of pulmonary neoplasia?

Back 92

1. cancer cachexia
2. lameness (hypertrophic pulmonary osteoarthropathy)

Front 93

how do primary and secondary pulmonary neoplasia most commonly differ in their radiographic presentation?

Back 93

- primary: single nodule/mass in the lung
- secondary: multiple

Front 94

what are the three most common laboratory findings of pulmonary neoplasia?

Back 94

1. hypercalcemia
2. hyperglobulinemia
3. proteinuria

Front 95

what are three methods to obtain samples from the lung to diagnose possible pulmonary neoplasia?

Back 95

1. ultrasound-guided FNA
2. thoracotomy
3. TTW/BAL (if airways involved)

Front 96

what two diagnostic techniques are used to stage pulmonary neoplasia?

Back 96

1. ultrasound
2. bone marrow

Front 97

what are two common paraneoplastic conditions of pulmonary neoplasia?

Back 97

1. hypertrophic pulmonary osteoarthropathy
2. lung-digit syndrome

Front 98

how is primary pulmonary neoplasia treated?

Back 98

lung lobectomy

Front 99

what are 2 ways in which secondary pulmonary neoplasia is treated?

Back 99

1. metastasectomy if < 3 nodules; palliative
2. chemotherapy; variable response

Front 100

(an idiopathic) condition characterized by chronic cough, wheezes, exercise intolerance/dyspnea and is caused by an immune-mediated hypersensitivity reaction in the lungs

Back 100

eosinophilic pneumonia

Front 101

define eosinophilic pneumonia

Back 101

(an idiopathic) condition characterized by chronic cough, wheezes, exercise intolerance/dyspnea and is caused by an immune-mediated hypersensitivity reaction in the lungs

Front 102

what are 3 typical clinical signs of eosinophilic pneumonia?

Back 102

1. CHRONIC cough ± productive
2. exercise intolerance/dyspnea
3. crackles, wheezes

Front 103

what are three radiographic signs of eosinophilic pneumonia?

Back 103

1. interstitial or alveolar pattern
2. hilar lymphadenopathy
3. pulmonary vascular change

Front 104

what is the predominate finding on a hemogram or lung diagnostic procedure such as TTW, BAL, or lung aspirate, of eosinophilic pneumonia?

Back 104

eosinophils

Front 105

if you suspect eosinophilic pneumonia, what are two ancillary tests that you should perform?

Back 105

1. fecal (rule out lungworms or lung flukes)
2. heartworm test

Front 106

what drug is used to treat eosinophilic pneumonia?

Back 106

prednisone

Front 107

what are 3 risk factors for pulmonary thromboembolism?

Back 107

1. vascular stasis
2. endothelial damage
3. hypercoagulability

Front 108

what is the pathogenic factor that leads to hypoxemia and hypocapnia with pulmonary thromboembolism?

Back 108

V/Q mismatch

Front 109

what are 8 diseases that can cause pulmonary thromboembolism?

Back 109

1. cardiac disease
2. IMHA
3. DIC
4. pancreatitis
5. sepsis
6. Hyperadrenocorticism (Cushing's or iatrogenic)
7. neoplasia
8. hypoalbuminemia

Front 110

what is the major clinical sign of pulmonary thromboembolism?

Back 110

PERACUTE onset of SEVERE DYSPNEA

Front 111

what should be high on your rule-out list if an animal presents with dyspnea, but there are no changes on thoracic radiographs?

Back 111

pulmonary thromboembolism

Front 112

if a pulmonary thromboembolism shows up on a radiograph, what will it look like?

Back 112

a wedge-shaped region in the lung that is more radioopaque than the rest of the lung field

Front 113

what is the first-line treatment for pulmonary thromboembolism?

Back 113

oxygen therapy

Front 114

what are the two first-line treatments for a cat presenting with acute respiratory distress?

Back 114

1. oxygen
2. sedation

Front 115

in treating a cat with acute respiratory distress, what do you have to always keep in mind when performing diagnostic tests on the animal?

Back 115

minimize stress, or they could collapse and die. Use minimal handling (e.g. thoracocentesis >> radiographs for suspected pleural effusion)

Front 116

increased respiratory effort on inspiration indicates what type of respiratory disease?

Back 116

restrictive

Front 117

what are 6 etiologies for pleural neoplasia?

Back 117

1. mediastinal LSA
2. mesothelioma
3. primary lung tumor
4. metastatic tumors
5. HSA
6. thymoma

Front 118

what are six ways to diagnostic tests for pleural neoplasia?

Back 118

1. laboratory tests
2. radiographs
3. ultrasound
4. pleural fluid characteristics
5. aspiration/biopsy (lung aspirate, mediastinal mass, ± u/s guidance)
6. histology (mesothelioma, because this tumor does not exfoliate well)

Front 119

what are two ways to treat pleural lymphosarcoma?

Back 119

1. combination chemotherapy
2. radiation

Front 120

what are three ways to treat pleural metastatic tumors?

Back 120

1. chemotherapy - systemic, intra-cavitary
2. intermittent thoracocentesis
3. metastasectomy

Front 121

what are one way to treat pleural mesothelioma?

Back 121

- intracavitary chemotherapy (note: poor Px for this disease)

Front 122

what are three ways to treat pleural thymoma?

Back 122

1. surgical excision
2. combination chemotherapy
3. radiation

Front 123

what is the most common etiology of chylothorax?

Back 123

idiopathic

Front 124

besides idiopathic (the most common cause), what are 7 other etiologies of chylothorax?

Back 124

1. trauma (rare)
2. neoplasia
3. cardiac disease (e.g. HCM in cats)
4. dirofilariasis
5. lung lobe torsion
6. diaphragmatic hernia
7. caval thrombosis

Front 125

pleural fluid characteristics of chylothorax:
- what type of transudates are most common? (2)
- what are two common cell types that are found in the fluid?

Back 125

- modified transudate or exudate
- cells: small lymphocytes and NON-DEGENRATE neutrophils

Front 126

what are 2 ways in which triglycerides can be used to diagnose chylothorax? What is one limitation of these calculations?

Back 126

1. [TG in pleural fluid] > [TG in serum]
2. pleural cholesterol/pleural TG < 1
- note that [TG] can be low with anorexia

Front 127

how is secondary chylothorax treated?

Back 127

- treat primary cause, if possible
- if not treatable, repeated thoracocentesis PRN

Front 128

what are two common surgical procedures to treat chylothorax if medical Rx fails?

Back 128

1. thoracic duct ligation (20-60% success)
2. pleuroperitoneal drainage

Front 129

what are four ways in which idiopathic chylothorax is managed medically?

Back 129

1. dietary modification - low fat (↓ volume of fat in thoracic duct)
2. supplement MCT (questionable efficacy, supposedly bypasses intestinal lacteals)
3. intermittent thoracocentesis
4. supplementation with Rutin™ PO TID

Front 130

what are 3 mechanisms by which Rutin™ is proposed to manage chylothorax?

Back 130

1. ↓ lymphatic leakage
2. ↑ lymphatic protein removal
3. ↑ lymphatic macrophage phagocytosis

Front 131

using Rutin™ to treat chylothorax, what is the success rate in:
- resolving effusion?
- reducing (improving) effusion?

Back 131

- resolves 25%
- reduces (improves) 25%

Front 132

in what manifestations of chylothorax is surgery contraindicated?

Back 132

restrictive pleuritis that is chronic and inflammatory and/or persistent respiratory distress post-thoracocentesis

Front 133

what are six causes of spontaneous pneumothorax?

Back 133

1. idiopathic pulmonary bullae
2. rupture of pulmonary parasitic cyst
3. neoplasia
4. abscess, pneumonia
5. heartworm disease
6. bronchial disease

Front 134

what are the three classifications of pneumothorax and the definition of each one (in parentheses, some examples of causes)?

Back 134

1. open - free communication between pleural space and environment (gun shot, bite/stab wounds, rib fractures)
2. closed - no communication between pleural space and external environment (e.g. traumatic injury/rupture of airways or lung parenchyma)
3. tension - flap of skin or soft tissue acts as a one-way valve in an open or closed pneumothorax (e.g. air enters pleural space on inspiration, but not expiration)

Front 135

what are three clinical signs of traumatic pneumothorax?

Back 135

1. history of trauma
2. other contusions/injury
3. acute dyspnea

Front 136

what are four clinical signs of spontaneous pneumothorax?

Back 136

1. anorexia, weight loss
2. exercise intolerance
3. cough
4. acute dyspnea

Front 137

what are five radiographic signs of pneumothorax?

Back 137

1. retraction of pleura away from chest wall
2. radiolucent space between lung and chest wall
3. dorsal displacement of heart
4. atelectasis of lung
5. lung margins don’t extend to the chest wall

Front 138

what are four basic ways to treat traumatic or spontaneous pneumothorax?

Back 138

1. cage rest
2. intermittent thoracocentesis
3. thoracostomy tube
4. ± surgery

Front 139

in traumatic/spontaneous pneumothorax, how long does a minor pleural lesion take to heal (e.g. with cage rest)

Back 139

24-48 hours

Front 140

what are three indications for thoracostomy tube in pneumothorax?

Back 140

1. rapid air accumulation
2. if frequent thoracocentesis is needed
3. spontaneous pneumothorax (very often)

Front 141

what are two indications for surgery to treat pneumothorax?

Back 141

1. persistent pneumothorax > 3 days
2. imaging evidence of air leakage (e.g. gaping hole in the lung)