Clin Med - Respiratory 2

drraythe's version from 2016-03-15 03:21

Lower Respiratory Dzs

Question Answer
Lower Respiratory dzs incld which structures?From the trachea down (trachea, bronchi, bronchioles, alveoli, interstitium, vasculature, pleural space)
**What is the MOST COMMON CLINICAL SIGN OF LOWER RESP DZ? (what are some other signs?)COUGH!!!!! (other signs seen might be: Respiratory distress, Exercise intolerance, Weakness, Cyanosis, Syncope, Fever, Anorexia, Weight loss & Depression)
In what way is the cough generally protective?Expel material (it is an explosive release), Inflammation & can be triggered by compression
What are the 2 categories you can describe a cough as?Productive vs unproductive
What's hemoptysis?Coughing of blood. MIGHT happen in lower resp dz
What's 1 way you can check for tracheal dz/ see if there has been a problem w/ coughing even if they aren't coughing in the vet office?You can see if there is a problem if there is an INDUCIBLE cough-that is to say, w/ light compression of trachea-run fingers up & down it-you will get a cough response.
What does it mean if the dog has a Goose honk cough? what should you tell the owner to do?Means there is Tracheal collapse-use a harness instead of a neck collar
What does it mean if the animal has a Harsh & paroxysmal cough (violent cough attack)?Probably Bronchitis
What does it mean if the animal has a soft cough?Might be Pneumonia or Pulmonary Edema
What are 2 reasons you can have a PRODUCTIVE cough w/ edema fluid?CHF
Non-cardiogenic pulmonary edema
8 reasons you can have a PRODUCTIVE cough w/ mucus or exudate?Canine Infectious Tracheobronchitis
Canine Chronic Bronchitis
Idiopathic feline bronchitis
Allergic bronchitis
Bacterial bronchitis or pneumonia
Parasitic infxn
Aspiration pneumonia
Fungal pneumonia
What are the 2 major reasons an animal would have Hemoptysis (a productive cough of blood)? (some other reasons?)MAJOR reasons:
Pulmonary neoplasia*
(could also be: Fungal, Foreign bodies, Severe CHF, TBE, Torsions, Bleeding disorders, DIC)
Kennel cough affects which structures?Aka Canine Infectious trachea & bronchi
Bacterial & Mycoplasmal infxns can affect what structures?Trachea & bronchi
Oslerus osleri → what is this? what does it do?It's a parasite, you will see eggs in the trachea/bronchi (usually right at the carina)
Bronchial compression can happen in what 3 situations?Left atrial enlargement
Hilar Lymphadenopathy
Aspiration pneumonia affects the pulmonary parenchyma → WHERE specifically do you see it the most?R MIDDLE LUNG LOBE is the poster child for aspiration pneumonia. Its the-2-nd branch of R main stem bronchus, but 1st 1 on bottom of the tube so thats the 1 shit goes down (gravity works)
What does a bronchiolar pattern on rads look like?If bronchioles get enlarged, thats tramlines & doughnuts
How can a bronchiole pattern turn into an alveolar pattern, when alveoli are impermeable to water?Alveoli is impermeable to water (cant diffuse into it) but bronchus is - so once gets to level of bronchiole, then it comes in bronchiole & spills into alveoli
Infectious Parenchymal dzs → 4 VIRAL czs?Canine Influenza
Canine Distemper
Infectious Parenchymal dzs → 3 FUNGAL czs?Blastomycosis
Infectious Parenchymal dzs → 5 PARASITIC czs?Heartworm
Paragonimus (flatworm)
Aelurostrongylus (nematode)
Capillaria (nematode)
Crenosoma (nematode lungworm)
Infectious Parenchymal dzs → bacterial czs?Basically ANY bacteria, can be mycoplasma too
Which protozoa can lead to infectious parenchymal dz?Toxoplasmosis
For diagnostics of lower resp dz, what should you be looking at in the 1st "observation" stage?Look at resting rate, effort, pattern (inspiratory, expiratory, if there is an abdominal component)
How can a pneumonia affect the CBC? how often?50% of the time there will be a neutrophilia & left shift. This, of course, means 50% of the time there wont be!!
What 2 things can you use to test how well the lower resp tract is fxning?Pulse Oximetry/SpO2, or ABG (arterial blood gas)
7 things you can pick up on SEROLOGY which might explain the lower resp dz?Heartworm
Blastomycosis (can also pick this up on urine Ag)
Feline Coronavirus (+/-PCR)
Canine Influenza
You can do a FECAL FOR LOWER RESP PROBS!!!! What 3 types of fecal exams can you do?Floatation
Baermann (for lungworm larvae)
Why might you use Echocardiography for lower resp dz?Pulmonary hypertension
What does the SPO2& Oxygen Hb Dissociation Curve tell you?Plots PO2 (partial pressure of O2) against SO2 (saturation of O2 in Hg) & shifting to the left means there Hb has a ↑er affinity for O2 & a shift to the right means there is lower affinity
Arterial Blood Gas lets you measure what? what can you calc? Which tells you about what?Measure PaO2, PaCO2, HCO3 & pH
From this you can calculate the A-a gradient & this tells you about the possible V/Q mismatch (ventilation/perfusion)
What's a caution you should know about imaging for dyspnea or cough?Any cz of these may show up normal on rads, esp in early stages.
What are 4 things which can cz dyspnea, which you can pick up on a radiograph?PTE (pulmonary thromboembolism), Acute aspiration, hemorrhage & foreign bodies
What are 6 things which can cz cough, which you can pick up on a radiograph?Canine infectious Tracheobronchitis
Canine Chronic Bronchitis
Collapsing Trachea
Feline Bronchitis
Acute FB
+/-GERD (Gastroesopheal Reflux Dz)
Canine chronic bronchitis will cz what pattern on rads?Bronchial pattern
Feline bronchitis/asthma will cz what pattern on rads?Bronchial pattern
Allergic bronchitis will cz what pattern on rads?Bronchial pattern
Canine infectious tracheobronchitis will cz what pattern on rads?Bronchial pattern
Bacterial & mycoplasma infxn will cz what pattern on rads?Bronchial pattern (Bact, Bronchial)
Parasites will cz what pattern on rads?Bronchial pattern (P is a upside down b...sort of) or interstitial
Infxns can cz what patter on rads? (What kinda infxns?)Interstitial Patterns! basically any infxn -
Neoplasia will cz what pattern on rads?Interstitial
Eosinophilic Lung dz will cz what pattern on rads?Interstitial
Idiopathic pulmonary fibrosis will cz what pattern on rads?Interstitial
Hemorrhage will cz what pattern on rads?Interstitial or alveolar
What are 2 types of interstitial patters you can see on rads?Reticular (net like) or Nodular/Miliary
Alveolar pattern looks like what?Black trees in a snowstorm - AKA AIR-BRONCHOGRAM (air is visible in & ↑lighting bronchus)
What 3 things can cz an alveolar pattern on rads?Pulmonary Edema, Severe Inflammatory dz, Hemorrhage
Severe Inflammatory dz can be czd by what 2 things? How will it look on rads?Show up as Alveolar Pattern, can be czd by Bacterial pneumonia or Aspiraton pneumonia
Pulmonary Edema will cz what kinda pattern on rads?Alveolar pattern
Hemorrhage → what pattern does this cz on rads? what are some reasons you'd see hemorrhage in the lungs?ALVEOLAR pattern, see in:
Contusions, PTE (pulmonary thromboembolism)
Neoplasia (note: neoplasia by itself czs interstitial patterns, but HEMORRHAGE czd by neoplasia czs alveolar pattern)
Fungal pneumonia
Computed Tomography/MRI is super good for seeing what kinda things?Bullae/blebs (big outpockets of air that go into interstitium of lungs-they can rupture & then you have hole in lung open to inside of chest.) & also <3mm masses
Fluoroscopy can diagnose what 2 things?Dynamic tracheal collapse & correct placement of stents
Why might you use angiography?PTE (pulmonary thromboembolism)
**Transtracheal/endotracheal wash - which is for small animals & which is for large animals?TRANStracheal for LARGE ANIMALS (their tracheas are big enough to go across)
ENDOtracheal for SMALL ANIMALS (tiny tracheas need an ET tube for you to even get down there)
**Explain a Transtracheal washAcross trachea, down, shoot in sterile saline & suck it back up. sterile! for LARGE animals
**Explain a endotracheal washWash fluid through ET tube & pull it back up. NOT sterile, for small animals
**Which is sterile-a transtracheal wash or an endotracheal wash?TRANSTRACHEAL bc going in from trachea which is sterile. (endotracheal has to go up & down through whole resp system including mouth-not sterile)
*Explain a Transthoracic aspiration/biopsyYou stick a needle through side of thorax into lungs-she seemed leery about this one
**Bronchoscopy-is this for small or large animals? explain how it works. is it sterile or not?SMALL ANIMAL PROCEDURE! done through bronchoscope! shoot sterile saline into guided area via camera. DIRECTED PULMONARY SAMPLING through BAL (bronchioalveolar lavage) through scope. BAL IS STERILE IF YOU CLEAN SCOPES BEFORE & AFTER
**What are some things you can do w/ bronchoscopy?You can do a visual inspection (there is a camera-guided scope)
You can do a Bronchoalveolar lavage (lets you do cytology & culture)
You can do Bronchial brushing (cells are taken from the inside of the airway mucosa or bronchial lesions), as well as do a Transbronchial biopsy
Why would you do a Thoracotomy/scopy?For a biopsy
If you suspect Pleural Space dz/Effusions, what should you do?A TAP!!!
What are some things you can do w/ a pleural effusion tap?Cytology & culture, check for cholesterol (if it's chylous)
***Right sided heart failure will cz what kinda fluid type in the plural space?Pure & modified transudates
***Pericardial dz will cz what kinda fluid type in the plural space?Pure & modified transudates
***Hypoalbuminemia will cz what kinda fluid type in the plural space?Pure & modified transudates
***Neoplasia will cz what kinda fluid type in the plural space?Pure & modified transudate & non-septic exudates & hemorrhagic effusions
***Diaphragmatic hernia will cz what kinda fluid type in the plural space?Pure & modified transudate & non-septic exudates
***FIP will cz what kinda fluid type in the plural space?Non-septic exudates
***Lung lobe torsion will cz what kinda fluid type in the plural space?Non-septic exudates & hemorrhagic effusion
***Pyothorax will cz what kinda fluid type in the plural space?Septic exudates
*****Brachycephalic Airway Syndrome HAS WHAT 3 COMPONENTS? (what 2 other things may be present?)(1)Stenotic nares
(2) Elongated soft palate
(3) Everted laryngeal saccules
There might also be (+/-) hypoplastic trachea, +/-end stage laryngeal collapse
How can you dx BAS ((brachycephalic airway syndrome)?Know Breed, CS, PE & laryngeal exams & imaging (Thoracic radiography)

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