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78 Cards in this Set
- Front
- Back
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Which of the following are susceptible to Penicillin?
a) S. equi zooepidemicus b) R. equi c) Pasteurella multocida d) Gram + bacteria e) Gram - bacteria |
a) S. equi zooepidemicus
c) Pasteurella multocida d) Gram + bacteria |
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Which of the following are resistant to TMS?
a) Streptococci b) Gram positive c) Staphylococci d) Gram negative |
a) Streptococci
d) Gram negative |
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Which antibiotic is indicated for most gram negative organisms?
a) Gentamicin b) TMS c) PPG d) Ceftiofur |
a) Gentamicin
d) Ceftiofur (broad spectrum) |
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T or F:
Viral respiratory disease in horses often manifests as a serous nasal discharge. |
False!
Viral can be mucopurulent |
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Which of the following would likely have mucopurulent discharge?
a) viral disease b) horse with heaves c) guttural pouch mycoses d) choke |
a) viral disease
b) horse with heaves (note - mycosis would be serosanguinous and choke would have feed) |
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What are some causes of serosanguinous nasal discharge in horses?
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Exercise-induced pulmonary hemorrhage
Ethmoid hematomas (unilateral) Guttural pouch mycoses Pulmonary abscess that have eroded into pulmonary vessels |
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Absence of lung noises is evidence of...
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...consolidation!
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When should a rebreathing bag NOT be used in an equine respiratory assessment?
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When horse is already compromised
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Radiating heart sounds on thoracic auscultation is evidence of...
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...pleural effusion
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Which of the following are true regarding crackles?
a) explosive b) musical c) often mistaken as murmur d) inspiratory e) expiratory |
a) explosive
d) inspiratory (crackles are short, explosive nonmusical sounds, typically inspiratory) |
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Which of the following are true regarding wheezes?
a) explosive b) musical c) often mistaken as murmur d) inspiratory e) expiratory |
b) musical
d) inspiratory e) expiratory (wheezes are musical and can be inspiratory or expiratory) |
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Which of the following are true regarding pleural friction rubs?
a) explosive b) musical c) often mistaken as murmur d) inspiratory e) expiratory |
c) often mistaken as murmur
(resemble creaking or rubbing of new leather; more common in cattle) |
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In lung pathology, ultrasound is the best at evaluating which structures?
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Pleural surface and pleural space
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Which of the following would NOT cause a comet tail on thoracic ultrasound?
a) pulmonary edema b) hemothorax c) pneumothorax d) pulmonary edema e) superficial pulmonary abscess |
c) pneumothorax
e) superficial pulmonary abscess (note - hemothorax may be all swirly) |
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In horses, pulmonary abscesses are commonly due to...
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Rhodococcus
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What is your main goal when evaluating a respiratory condition? What is your big rule-out?
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Determine if it is UPPER or LOWER (thoracic involvement).
Want to rule out PNEUMONIA |
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Nasopharyngeal swab in horses is good for:
a) S. equi b) R. equi c) S. zooepidemicus d) EHV e) none of the above |
a) S. equi
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If you see toxic neutrophils on a transtracheal wash, what is going on? How about healthy neutrophils? Eosinophils? Hemosiderocytes?
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Toxic = sepsis
Healthy = COPD (in Schlipf-land) Eosinophil = COPD, parasitism Hemosiderocytes = previous lung hemorrhage (EIPH) |
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You cultured multi-drug resistant Pseudomonas from your tracheal aspirate. What gives?
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Endoscope inhabitant!
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Heaves is best diagnosed by:
a) BAL b) TTW c) Tracheal aspiration via endoscope d) Pleurocentesis |
a) BAL
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How does heaves cytology appear?
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Lots of neutrophils
Mucus Curschmann’s spirals |
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Which of these are better for cytology than for culture?
a) BAL b) TTW c) Tracheal aspiration via endoscope d) Pleurocentesis |
a) BAL
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What are your main differentials for a pleural effusion in a horse? How does cytology differ between the two?
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Bacterial pneumonia (degenerate neutrophils)
LSA (lymphocytes) |
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T or F:
Bacteroides spp. are common anaerobes implicated in pleuropneumonia. |
True
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What are normal values for the following in a BAL?
Alveolar macs Lymphs Epithelials Neuts Mast Eosinophils |
Alveolar macs (60-80%)
Lymphs (20-35%) Epithelials (few) Neuts (<5%) Mast (<2%) Eosinophils (<1%) |
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T or F:
Fungi rarely cause lower airway disease in horses and are rarely seen in tracheal cytology. |
False!
They are common contaminants |
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What are the common equine respiratory viruses?
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Influenza
Herpes Viral arteritis Adenovirus Rhinovirus Hendravirus |
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Which are not true regarding equine respiratory viruses?
a) incubation can be short or long b) most classic signs are similar c) characterized by explosive outbreaks in susceptible horses d) a major economic impact to the equine industry |
a) incubation can be short or long
(incubation is SHORT) |
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Which type of equine influenza has the most antigenic drift? Which kind is the most common?
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Type A2 for both
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What is the most important aspect of equine influenza treatment?
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REST AFTER FEVER BREAKS (3-4 wks)
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Which viral disease often affects standardbreds? Arabians?
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SDBs (EVA)
Arabians (SCID foals - Equine Adenovirus) |
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What are the most common types of EHV causing respiratory diseases? What other organ systems does EHV affect?
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EHV 1 and 4 most common
Also affects repro (abortions) and neuro (spinal cord vasculitis and myeloencephalitis) |
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Which viral disease most commonly results in edema?
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EVA (limb, ventral, eyelid edema)
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Which viral disease is often fatal in foals? In adults?
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Foals (Equine influenza and EHV)
Adults (Hendravirus |
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Which virus is often associated with abortions?
a) Equine influenza b) EHV c) Equine rhinovirus d) EVA e) EAV |
EHV and EVA
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Vaccination against EHV in the dam should be performed when?
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5, 7, and 9 months gestation
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Lymphadenopathy without abscessation is common in...
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...Equine influenza
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Choose the newborn or the older foal for each condition below:
Acute bronchointerstitial pneumonia Persistent pulmonary hypertension Idiopathic/transient tachypnea Rhodococcus equi pneumonia |
Acute bronchointerstitial pneumonia (older)
Persistent pulmonary hypertension (neonate) Idiopathic/transient tachypnea (neonate) Rhodococcus equi pneumonia (older) |
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Why is ID of respiratory dz in foals difficult?
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Greater toleration of hypoxemia
Cough uncommon Nasal discharge uncommon Resp rate/rhythm don't reflect O2 or CO2 status Auscultation misleading Rectal temp is misleading |
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Ideal diagnostics in foal respiratory disorders include which two tests?
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Arterial blood gas (from dorsal metatarsal a.)
Thoracic rads |
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T or F:
In a foal with chronic hypercapnia, you would expect a lower pH. |
False!
ACUTE hypercapnia leads to more dramatic pH changes |
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Which are NOT common organisms involved with foal neonatal bacterial pneumonia?
a) Klebsiella b) E. coli c) Mycoplasma d) Pasteurella e) Actinobacillus f) Salmonella |
c) Mycoplasma (NOOOOOO)
f) Salmonella (less common) |
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Which test is the best when diagnosing neonatal bacterial pneumonia?
a) BAL b) Tracheal aspirate c) arterial blood gas d) thoracic rads e) blood culture |
e) blood culture (or placental/amniotic culture) is best to ID the organism!
Tracheal aspirate is DANGEROUS, BAL not necessary |
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How is neonatal bacterial pneumonia treated?
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Penicillin + Aminoglycoside (amikacin)
Sternal position O2 therapy |
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What is the most common blood gas derangement in neonatal bacterial pneumonia?
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Mild to moderate hypoxemia
Normal to reduced PaCO2 |
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T or F:
If a foal has viral pneumonia, it's gonna die. |
Pretty much true.
EHV is most common and is fatal in foals |
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Which two fungal organisms are implicated in neonatal pneumonia?
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Histoplasma capsulatum
Candida spp. |
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How is histoplasmosis diagnosed in neonates? How is it contracted? How is it treated?
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Dx (AGID, TTW, or BAL)
Contracted d/t placentitis Tx (really none in neonates) |
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How is meconium aspiration treated? What is the complication?
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Clear nasal passage
Apply gentle suction Broad spectrum abx NT intubation if in distress (complication is GOOD if uncomplicated) |
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Which of the following are true regarding milk aspiration?
a) one of the most common issues b) usually due to tube feeding c) associated w/DDSP d) Associated with Se deficiency e) indicative of pre-partum asphyxia |
a) one of the most common issues
c) associated w/DDSP d) Associated with Se deficiency |
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T or F:
Neonatal respiratory distress syndrome is pretty uncommon. |
True
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Immature lung + undeveloped surfactant =
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Neonatal respiratory distress syndrome
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What are lab findings with respiratory distress syndrome foals?
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Severe respiratory acidosis
Secondary, hypoxia-induced pulmonary hypertension Reduced Cardiac Output Tissue hypoxia Alvaolar pattern on rads |
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How is respiratory distress syndrome in foals treated?
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Mechanical ventilation
Inhaled NO Exogenous surfactant |
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How are most premature/dysmature foal respiratory conditions treated?
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Humidified nasal O2
Resp stimulants (doxopram/caffeine) Broad spectrum abx |
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Which breeds are predisposed to idiopathic tachypnea?
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Thoroughbreds
Clydesdales Arabians |
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What are lab findings in idiopathic tachypnea? How is it treated? Prognosis?
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Normal lab values!
Cool w/body clipping, alcohol baths, fans (often treated w/abx) Spontaneous recovery! |
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What is the common signalment for EIPH? Where are lesions found?
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Racehorse (thoroughbred);
Blood in trachea; most bleeding in caudodorsal lungs |
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How can EIPH be prevented?
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Ha! I'll bet you said furosemide...if you did then you're WRONG! Furosemide only reduces severity!
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Which is the most acceptable hypothesis describing EIPH pathogenesis?
a) Pressure waves generated during exercise cause caudodorsal trauma b) Precipitated by lower airway inflammatory dz c) Functional upper airway obstruction during exercise increases negative pressure across alveolar/capillary membrane d) Increased pulmonary vascular pressure increases pressure across alveolar/capillary membrane |
d) Increased pulmonary vascular pressure increases pressure across alveolar/capillary membrane
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Which thoracic neoplasm may be seen in young horses?
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LSA
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What is the most common bacterium isolated from older foals with bronchopneumonia?
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S. equi zooepidemicus
(R. equi on some farms) |
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Which of the following DO NOT commonly cause bronchopneumonia in older foals?
a) Klebsiella b) Salmonella c) Pseudomonas d) S. equi equi e) Enterobacter |
d) S. equi equi (more upper resp)
e) Enterobacter (this is more young foals) (note: Salmonella is in older foals, not in younger foals) |
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Which bronchopneumonial bacterial agent is the most devastating?
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R. equi
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T or F:
Mycoplasma and fungi play a fairly insignificant role in older foal pneumonia. |
True!
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Which are common findings in older foal pneumonia?
a) Left shift neutrophilia b) increased fibrinogen c) normal CBC/fibrinogen d) neutropenia e) lymphopenia |
b) increased fibrinogen
c) normal CBC/fibrinogen (also leukocytosis w/mature neutrophilia) |
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What lab value can measure the reasponse to bacterial pneumonia treatment?
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Fibrinogen
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Which of the following would be appropriate for R. equi bronchopneumonia?
a) TMS b) Ceftiofur c) Penicillin d) Erythromycin e) Rifampin |
d) Erythromycin
e) Rifampin |
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T or F:
Penicillins have a good broad spectrum. |
False!
Gram positive, beeyotch! |
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What treatment is good for bronchopneumonia with thick secretions or non-productive cough?
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Nebulization
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Which of the following describe R. equi?
a) a gram negative b) affects foals 3wks to 6 mos c) ulcerative enterocolitis d) foals can be infected anytime e) serology is useful in diagnosis |
b) affects foals 3wks to 6 mos
c) ulcerative enterocolitis (note: R. equi is G+, non-penicillin responsive, infects foals soon after birth, and serology doesn't help) |
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What is the hallmark lesion of R. equi pneumonia?
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Severe multifocal lung abscesses
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Which of the following are extrapulmonary manifestations of R. equi?
a) osteomyelitis b) septic arthritis c) liver abscesses d) corneal edema e) mesenteric lymphadenopathy |
a) osteomyelitis
d) corneal edema e) mesenteric lymphadenopathy (also ulcerative enterocolitis, colonic lymphadenopathy, immune mediated synovitis, uveitis, skin abscesses) |
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T or F:
R. equi is an intracellular organism. |
True! Infects alveolar macs.
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What is R. equi treated with? What is a major side effect?
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Erythromycin + rifampin; (may cause hyperthermia, fatal colitis in dams, diarrhea)
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T or F:
Previous infection with R. equi has a profound effect on performance. |
False!
If they make it to the track, they do OK. |
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Which of the following is the most important in preventing R. equi pneumonia?
a) vaccination b) hyperimmune plasma transfusion c) cell-mediated immunity d) adequate passive transfer |
c) cell-mediated immunity
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You see a febrile, 3 month old foal in acute acute respiratory distress, has diffuse crackles/wheezes, and loss of serosal detail on thoracic rads. What should you treat it with?
a) Erythromycin + rifampin b) 10d course of TMS c) Corticosteroids d) Ivermectin e) benign neglect |
c) Corticosteroids (this is acute, bronchointerstitial pneumonia)
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