The primary rule out for a patient with a sudden onset of severe expiratory dyspnea and no major changes on thoracic radiographs is:
pulmonary thomboembolism [PTE]
Non-cardiogenic pulmonary edema results from overexpansion of extracellular fluid volume due to 4 general mechanisms. What are those four mechanisms?
Vascular overload (excessive IV fluid administration)/increased hydrostatic pressure
Decreased plasma oncotic pressure (low albumin)
- Increased permeability of the alveolar‐capillary membrane
- Lymphatic obstruction
What is the major difference between ALI and ARDS?
degree of hypoxemia
- ALI: pulmonary inflammation & edema resulting in acute respiratory failure
- ARDS: Severe manifestation of ALI
**ALI/ARDS: most commonly a sequela of sepsis, shock, or bacterial pneumonia**
In general, what is the only primary lung tumor that is responsive to chemotherapy?
T/F: In the case of pleural effusion, thoracocentesis is both diagnostic and therapeutic
In a very general sense, what is the most common cause of pneumonia in dogs?
What are the two most common types of nasal neoplasias in cats?
lymphoma and adenocarcinoma
**lymphoma is the most common in the cat**
T/F: Canine chronic bronchitis is most common is old, small breed dogs
Small breed dogs, terriers, and med sized dogs: WHWT and cockers; Mid – old age > 6 years usually; Overweight
T/F: On CT, If you observe destruction of the nasal septum, frontal sinuses or cribriform plate, or extension of disease into the nasopharynx or periorbital region, this animal likely has lymphoplasmacytic rhinitis
Destruction of the nasal septum, frontal sinuses or cribriform plate, or extension of disease into the nasopharynx or periorbital region are not expected with LPR and should prompt investigation into the presence of fungal rhinitis or neoplastic disease
Given that it is an idiopathic disease, the lack of specific findings is important. Dogs should have no funduscopic lesions, no lymphadenopathy, no facial or palate deformities, and healthy teeth and gums, etc.
What are the most common clinical signs associated with nasal mites (Pneumonyssus caninum)?
sneezing, reverse sneezing
What is the hallmark sign associated with feline herpesvirus?
Clinical signs for FHV: sneezing, inappetence, fever, oculonasal discharges (serous, then mucopurulent due to secondary bacterial infections), ulcerative keratitis (punctate or dendritic ulcers) is hallmark sign!
T/F: Nasal discharge is almost always a sign of local disease within the nasal cavity
Exceptions: eosinophilic bronchopneumopathy (EBP), bacterial pneumonia & coagulopathies
What area of the lung is primarily affected with aspiration pneumonia?
right middle lung lobe
although other lungs can be affected
What fluid characteristics would you expect to see associated with a pleural effusion caused by hemorrhage (bleeding masses, coagulopathies, trauma)?
These effusions are red, often contain protein & cell concentrations compatible with peripheral blood
The composition of a hemorrhagic effusion will change with time: As cells are phagocytized & degraded, the number of RBCs will decrease.
In the case of collapsing trachea, corticosteroids as a single dose can be given to decrease tracheal inflammation. What drug is recommended?
Dexamethasone lasts ~48 hours and is ~7x more potent than prednisone
How long does it take for pulmonary contusions to show up on radiographs?
~2-12 hours after trauma
What fluid characteristics would you expect to see associated with a pleural effusion caused by lymphorrhagia?
These effusions are lymphocyte predominant. As they become chronic or with repeated drainage, inflammation occurs resulting in more neutrophils (non‐degenerate) and macrophages.
Chylous effusions contain chylomicrons and are classic “milky” effusions
__________ is the treatment of choice for most malignant nasal tumors
- However feline nasal lymphoma responds well to standard lymphoma chemotherapeutic protocols
- Some require surgery and/or chemotherapy or radiation. Surgical debulking before or after radiotherapy may yield best option (mean survival time 12 months) but depends on tumor type.
- Surgery alone: No significant increase in survival time: 3‐6 months
protein-poor transudate in the pleural cavity is most frequenty caused by:
The local humane society has contacted you about an outbreak of upper respiratory signs in dogs. One dog died overnight. You did necropsy and found blood in trachea and hemorrhagic mottled lungs. Which disease would you be most concerned about?
- Canine herpes virus
- Kennel cough
- Influenza Type A H3N8
- Canine distemper
Influenza Type A H3N8
Because this is a rather newly emerging disease, almost all dogs, regardless of breed or age, are susceptible to infection and have no immunity. Virtually all dogs that are exposed to the virus become infected and nearly 80% show clinical signs of disease. Fortunately, most affected dogs have the mild form
An overflow of tears onto the face is termed:
This is a possible sequela of feline herpesvirus due to fibrosis of lacrimal ducts.
This condition may also occur while studying for SAM II
These normal lung sounds sound like the “rustling of leaves” and are heard over peripheral airways:
Inspiration is slightly loud & longer than expiration. They indicate normal air‐filled lungs
Non-cardiogenic pulmonary edema results from overexpansion of extracellular fluid volume due to 4 general mechanisms. Which of the four mechanisms is considered the most serious cause?
Increased permeability of the alveolar‐capillary membrane
The most serious cause, permeability of membrane, causes protein‐rich fluid to flood the alveoli. It can result from:
Pulmonary insults, including
- Aspiration of gastric contents
- Severe upper airway obstruction
- Inhalant injury
- Extrapulmonary disorders, such as sepsis, electric shock, central nervous system disease, pancreatitis, disseminated intravascular coagulation
- Pulmonary insults, including
Upper respiratory or lower respiratory sign?
T/F: Canine Chronic Bronchitis is usually self-limiting and dogs recover within a year after initial signs
canine chronic bronchitis is irreversible and progressive; incurable.
What is the typical signalment associated with ciliary dyskinesia?
young purebred dog with recurrent respiratory tract infections/signs
What is the mortality rate associated with cases of ALI/ARDS?
**There have been 2 reported cases that have survived**
What diagnostic modality provides us with a definitive diagnosis in the case of progressive interstitial fibrosis?
Lung aspirate is sometimes helpful & less invasive than lung biopsy
protein-rich transudate in the pleural cavity is most frequenty caused by:
The lungs contain lymph that is higher in protein and thus fluid escaping from the capillary beds here has higher protein content.
T/F: When performing thoracic radiographs to help diagnose pulmonary neoplasia, sixteen-thousand views should be taken
Three views should suffice
Thoracic radiography: Take right & left laterals & VD: 3 view “met check”
- Usually focal single‐ or multiple‐mass lesions o lobar consolidation
- Diffuse pulmonary infiltrate can also be found
- Dog: Right caudal lobe more commonly affected
- Cat: Left caudal lobe more often involved
- Multiple, discrete, interstitial nodules of variable sizes or
- Diffuse interstitial pattern
- May find lymphadenopathy, pleural effusion
- Cat: Ill defined nodules or diffuse, patchy, mixed alveolar patterns
- Primary neoplasia: