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66 Cards in this Set

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Dz of what part of the resp. system would be suspected in an animal with:
a relatively SLOW resp. rate & increased effort on INSPIRATION?
upper airways (extrathoracic large airways): larynx, pharynx, extrathoracic trachea
Dz of what part of the resp. system would be suspected in an animal with:
a relatively SLOW resp. rate & increased effort on EXPIRATION?
intrathoracic large airways: trachea, major bronchi
Dz of what part of the resp. system would be suspected in an animal with:
a RAPID resp. rate & increased effort on EXPIRATION?
OBSTRUCTIVE dz of pulmonary parenchyma: small airways, alveoli, interstitium
What are some localizing signs for the nasal cavity?
nasal d/c
sneezing
"congestion"
facial deformity
Dz of what part of the resp. system would be suspected in an animal with:
a RAPID resp. rate & increased effort on INSPIRATION?
RESTRICTIVE dz of pulmonary parenchyma: small airways, alveoli, interstitium

OR

pleural cavity: pleura, pleural space, mediastinum
Stertor is associated w/ what part of respiratory system?
pharynx
Stridor is associated w/ what part of respiratory system?
larynx
Reverse sneezing is associated w/ what part of respiratory system?
pharynx
Voice change is associated w/ what part of respiratory system?
larynx
Dz of what part of the resp. system would be suspected in an animal with:

a. loud, harsh cough
b. soft cough
a. large airways
b. pulmonary parenchyma or pleura
What are some signs that localize resp. dz to the pleural cavity?
↓ lung sounds on auscultation
pronounced abdominal excursions
non-localizing signs may be only signs
RAPID resp. rate
↑ effort during INSPIRATION
What are some signs that localize resp. dz to the pulmonary parenchyma?
cough
crackles
wheezes
RAPID resp. rate
obstructive dz: ↑ effort during EXPIRATION (listen for wheezes)
restrictive dz: ↑ effort during INSPIRATION
ddx for serous nasal discharge
may be normal, indicative of URI, or may precede development of mucopurulent d/c
ddx for mucopurulent nasal discharge
implies inflammation

most intranasal dz results in inflammation & 2º bacterial infection, making this sign a common presentation for most nasal dz

significant or prolonged bleeding in assoc. w/ mucopurulent d/c usually assoc. w/ neoplasia or mycotic infection
causes of unilateral nasal discharge
FBs, polyps, & tooth root abscessation

neoplasia can cause unilateral d/c initially but may progress to bilateral following destruction of nasal septum
primary bacterial infection of the nasal cavity is _____________, but secondary bacterial infection is _____________.
very rare

very common
What is the 1st phase of the diagnostic approach to chronic nasal discharge?
non-invasive testing

hx & PE, incl. facial palpation & oral exam
thoracic rads: often unremarkable
other tests depending on top ddx
What is the 2nd phase of the diagnostic approach to chronic nasal discharge?
imaging: general anesthesia required
nasal rads, CT, MRI
rhinoscoppy
causes of facial deformity
most common: neoplasia & cryptococcosis (cats)
other:
Rhinosporidiosis: fungal infection in dogs --> fleshy mash protruding from nostrils (very uncommon)
carnassial tooth root abscess
occ. FB rxn, bone sequestration, other “benign” processes
causes of persistent, paroxysmal sneezing
nasal FBs (dogs > cats) & feline URI commonly assoc. w/ acute onset, persistent sneezing

less common causes: canine nasal mite (Pneumonyssoides caninum), exposure to irritating aerosols
ddx for acute nasal cavity signs in cats
viral infection (FHV, FCV): very common
foreign body: uncommon
more serious dz: requires systemic evaluation, work up as for chronic nasal d/c
ddx for acute nasal cavity signs in dogs
foreign body
kennel cough
influenza
ddx for nasal cavity dz in cats
URI: herpes, calicivirus
nasopharyngeal polyps
nasal tumors: LSA, adenocarcinoma
nasal mycosis: crypto, aspergillosis (rare)
bacterial rhinitis: usually secondary complication
allergic rhinitis
nasal foreign body
ddx for nasal cavity dz in dogs
nasal tumor: adenocarcinoma, SCC, undifferentiated carcinoma
nasal FB
kennel cough/influenza
nasal mycosis: aspergillosis, crypto (less common)
bacterial rhinitis: usually secondary complication
nasal mites
lymphoplasmacytic rhinitis
allergic rhinitis
ddx for laryngeal dz
more common in dogs than in cats

laryngeal paralysis
neoplasia
obstructive laryngitis
laryngeal collapse
web formation
trauma
FB
extraluminal mass
acute laryngitis
ddx for pharyngeal dz in dogs
brachycephalic airway syndrome
elongated soft palate
FB
neoplasia
abscess
granuloma
extraluminal mass
ddx for pharyngeal dz in cats
LSA
nasopharyngeal polyps
FB
neoplasia
abscess
granuloma
extraluminal mass
top 2 ddx for hemoptysis
HW dz
pulmonary neoplasia
top 3 ddx for cats that cough
bronchitis
lung parasites
HW dz
What is the 1st step of the diagnostic approach to lower resp. tract dz?
hx, PE, thoracic rads, +/- CBC
ddx for bronchial pattern on thoracic rads
-feline bronchitis (idiopathic)
-allergic bronchitis
-bacterial bronchitis
-canine chronic bronchitis (idiopathic)
-pulmonary parasites, esp. Aelurostrongylus, Capillaria, Oslerus
ddx for alveolar pattern on thoracic rads
pulmonary edema

severe inflammatory dz
-bacterial pneumonia
-aspiration pneumonia

hemorrhage
-pulmonary contusion
-thromboembolic dz
-neoplasia
-mycotic infection
-systemic coagulopathy

any of the ddx for interstitial patterns can occ. cause alveolar signs w/ severe inflammation, edema, or hemorrhage
ddx for interstitial pattern on thoracic rads
mild pulmonary edema

infection
viral: canine distemper
bacterial: abscess*
protozoal: Toxoplasmosis
mycotic: Blastomycosis*, Histoplasmosis*, Coccidiomycosis*

foreign body*
parasites
pulmonary infiltrates w/ eosinophils (incl. eosinophilic granuloma*)
misc. inflammatory dz*
neoplasia
mild hemorrhage

* = nodular
for nodular:
if fluffy: inflammation, edema
if well defined: old, inactive (ex. scarring), neoplasia
vascular pattern on thoracic rads

a. ddx for enlarged aa.
b. ddx for enlarged vv.
c. ddx for enlarged aa. & vv.
d. ddx for small aa. & vv.
a. HW dz, PTE, pulmonary hypertension
b. L heart failure
c. L --> R shunt
d. CV shock, hypovolemia, pulmonic stenosis, hyperinflation of lungs (feline bronchitis, allergic brnochitis)
ddx for consolidated lung lobe(s) on thoracic rads
lung lobe torsion

neoplasia

severe, localized bacterial pneumonia: FB, aspiration

granuloma: parasitic, fungal, FIP
What is step 2 of the diagnostic approach to lower resp. tract dz?
non-invasive tests: blood tests, fecal, PCR, specialized imaging
What is step 3 of the diagnostic approach to lower resp. tract dz?
pulmonary specimen collection
tracheal wash

a. site of collection
b. cytologic findings in health
c. indications
a. large airways
b. primarily resp. epithelial cells, few other inflammatory cells (occ. MPs)
c.
-bronchial & alveolar dz
-b/c of safety, may consider for ANY lung dz
-not good for interstitial or local processes
d.
bronchoalveolar lavage (BAL)

a. site of collection
b. cytologic findings in health
c. indications
a. small airways, alveoli, sometimes interstitium
b. < 400-500 nucleated cells/ul (mostly alveolar MPs)
c.
-alveolar or interstitial lung dz
-routinely done during bronchoscopy
-non-bronchoscopic (NB-BAL) can be done in practice
transthoracic lung aspiration (LA)

a. site of collection
b. cytologic findings in health
c. indications
a. interstitium, alveoli when flooded
b. mostly alveolar MPs
c.
-solid masses adjacent to body wall
-diffuse interstitial lunge dz: could do NB-BAL or LA
tracheal wash

a. advantages
b. disadvantages
c. complications
a. simple, cheap, no special equipment, complications rare, volume adequate for cytology & culture
b. airway must be involved for specimen to be representative
c. rare: tracheal laceration, SQ emphysema, pneumomediastinum
BAL

a. advantages
b. disadvantages
a. minimal expertise, cheap, no special equipment, large volume of lung sampled, high quality cytologic sample (good if carcinoma is a top ddx), large volume for analysis
b. not recommended for animals in resp. distress (causes transient hypoxemia), general anesthesia required
transthoracic lung aspirate

a. advantages
b. disadvantages
a. simple, cheap, no special equipment (though U/S ↑ yield & ↓ risk), excellent representation w/ little risk for masses adj. to body wall
b. potential for complications (pneumothorax, hemothorax, pulmonary hemorrhage), relatively small areas of lung sampled, specimen adequate for cytology only, specimen is blood contaminated
thoracotomy & lung bx

a. site of collection
b. indications
c. advantages
d. disadvantages
a. small airways, alveoli, interstitium
b.
-localized process where excision may be therapeutic as well as diagnostic
-any progressive dz not diagnosed by less invasive means
c. highest quality specimen, potential therapeutic benefit w/ focal dz, large sample
d. expensive, requires expertise & general anesthesia, major sx procedure
ddx for tracheal or bronchial dz: dogs
-canine infectious tracheobronchitis (kennel cough)
-collapsing trachea
-allergic bronchitis
-canine chronic bronchitis
-Oslerus osleri
-canine influenza
ddx for tracheal or bronchial dz: cats
-feline (idiopathic) bronchitis
-allergic bronchitis
ddx for pulmonary parenchymal dz: dogs
-bacterial pneumonia
-Capillaria
-Paragonimus
-PIE
-eosinophilic pulmonary granulomatosis
-aspiration pneumonia
-neoplasia
-lymphomatoid granulomatosis
-pulmonary contusion
-PTE
-pulmonary edema
ddx for pulmonary parenchymal dz: cats
-bacterial pneumonia
-Toxoplasmosis
-Capillaria
-Paragonimus
-Aelurostrongylus
-aspiration pneumonia
-neoplasia
-pulmonary contusion
-PTE
-pulmonary edema
What is the diagnostic approach to dz of the pleural cavity or mediastinum?
hx, PE, thoracic rads, thoracocentesis & fluid analysis
causes of pure or modified transudates
R heart dz, pericardial dz
neoplasia
diaphragmatic hernia
hypoalbuminemia
causes of nonseptic exudates
FIP
neoplasia
diaphragmatic hernia
lung lobe torsion
causes of septic exudates
= pyothorax

idiopathic
penetrating wounds
FB
extension of bacterial pneumonia
causes of chylous effusions
= chylothorax

idiopathic
congenital
trauma
neoplasia
cardiac or pericardial dz
HW dz
lung lobe torsion
diaphragmatic hernia
causes of hemorrhagic effusions
trauma
systemic bleeding disorder
neoplasia (ex. HSA)
lung lobe torsion
What are some disorders of the pleural cavity &/or mediastinum?
pneumothorax
mediastinal masses (ex. LSA: cats)
pneumomediastinum
pyothorax
chylothorax
emergency tx of extrathoracic (upper) airway obstruction

a. most common causes
b. tx
a. laryngeal paralysis, brachycephalic airway syndrome
b.
-sedation w/ ace or morphine (brachycephalic dogs)
-O2 cage
-minimize stress
-short acting corticosteroids (dex, pred)
-if unsuccessful - place ET tube (use Propofol)
-ift unsuccessful - transtracheal catheter
emergency tx of intrathoracic large airway obstruction

a. most common causes
b. tx
a. rare: collapse of mainstem bronchi &/or intrathoracic trachea as a result of chronic bronchitis
b. sedation, O2 supplementation, minimize stress as for extrathoracic airway obstruction
emergency tx of pulmonary parenchymal dz
tx of choice: O2 therapy
bronchodilators: obstructive dz
diuretics: pulmonary edema
glucocorticoids: dec. inflammation
broad spectrum ABs: sepsis, bacterial or aspiration pneumonia
emergency tx of pleural space dz

a. most common causes
b. tx
a. pleural effusion, pneumothorax
b.
needle thoracocentesis
O2 by mask if needed
traumatic pneumothorax

a. dx
b. emergency tx
a. thoracocentesis, rads
b.
-remove air thru thoracocentesis, cover open chest wounds w/ airtight seal
-continuing production of air treated w/ thoracic drainage tube
-surgical repair of leak may be needed
diaphragmatic hernia

a. dx
b. tx
a. rads (may need contrast)
b.
-surgical repair of diaphragm
-if in severe resp. distress, pick animal up & try to shake viscera back into abdomen
rib fractures/flail chest

a. dx
b. tx
a. rads
b.
-control pain, stabilize fractured segment w/ external splint
-severe damage to chest wall may require surgical repair
diaphragmatic paralysis

a. dx
b. tx
a. rads (inspiratory: 1 side of diaphragm goes down, other stays in place)
b. rest & time
pulmonary contusions

a. dx
b. tx
a. blood gas, rads (not reliable during 1st 6 hours post-injury)

b.
-rest, ↑ inspired oxygen concentration, monitor fluid volumes, analgesics
-severe cases need to placed on respirator to ↑ positive pressure
hemothorax

a. dx
b. tx
a. thoracocentesis, rads
b.
-chest tube drainage (if significant amt. present), volume replacement, transfusion, autotransfusion
-emergency thoracotomy indicated if there is continuing hemorrhage & shock can’t be controlled
PTE: tx
respiratory support & heparin