SAM II Exam I Material - Respiratory Flashcards Preview

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Flashcards in SAM II Exam I Material - Respiratory Deck (98)
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1

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]

2

Non-cardiogenic pulmonary edema results from overexpansion of extracellular fluid volume due to 4 general mechanisms. What are those four mechanisms?

  1. Vascular overload (excessive IV fluid administration)/increased hydrostatic pressure
  2. Decreased plasma oncotic pressure (low albumin)
  3. Increased permeability of the alveolar‐capillary membrane
  4. Lymphatic obstruction

3

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**

4

In general, what is the only primary lung tumor that is responsive to chemotherapy?

lymphoma

5

T/F: In the case of pleural effusion, thoracocentesis is both diagnostic and therapeutic

True

6

In a very general sense, what is the most common cause of pneumonia in dogs?

bacteria

7

What are the two most common types of nasal neoplasias in cats?

lymphoma and adenocarcinoma

**lymphoma is the most common in the cat**

8

T/F: Canine chronic bronchitis is most common is old, small breed dogs

True

Small breed dogs, terriers, and med sized dogs: WHWT and cockers; Mid – old age > 6 years usually; Overweight

9

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

False

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.

10

What are the most common clinical signs associated with nasal mites (Pneumonyssus caninum)?

sneezing, reverse sneezing

11

What is the hallmark sign associated with feline herpesvirus?

ulcerative keratitis

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!

12

T/F: Nasal discharge is almost always a sign of local disease within the nasal cavity

True

Exceptions: eosinophilic bronchopneumopathy (EBP), bacterial pneumonia & coagulopathies

13

What area of the lung is primarily affected with aspiration pneumonia?

right middle lung lobe

although other lungs can be affected

14

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.

15

In the case of collapsing trachea, corticosteroids as a single dose can be given to decrease tracheal inflammation. What drug is recommended?

dexamethasone

Dexamethasone lasts ~48 hours and is ~7x more potent than prednisone ​

16

How long does it take for pulmonary contusions to show up on radiographs? 

~2-12 hours after trauma

17

What fluid characteristics would you expect to see associated with a pleural effusion caused by lymphorrhagia?

predominantly lymphocytic

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

18

__________ is the treatment of choice for most malignant nasal tumors

radiation

  • 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

19

protein-poor transudate in the pleural cavity is most frequenty caused by:

hypoalbuminemia

20

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?

  • Bordetella
  • 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​

21

An overflow of tears onto the face is termed:

epiphora

This is a possible sequela of feline herpesvirus due to fibrosis of lacrimal ducts.

This condition may also occur while studying for SAM II

22

These normal lung sounds sound like the “rustling of leaves” and are heard over peripheral airways:

vesicular sounds

Inspiration is slightly loud & longer than expiration. They indicate normal air‐filled lungs

23

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

24

Upper respiratory or lower respiratory sign?

nasal discharge

upper respiratory

25

T/F: Canine Chronic Bronchitis is usually self-limiting and dogs recover within a year after initial signs

False

canine chronic bronchitis is irreversible and progressive; incurable.

26

What is the typical signalment associated with ciliary dyskinesia?

young purebred dog with recurrent respiratory tract infections/signs

27

What is the mortality rate associated with cases of ALI/ARDS?

~100%

**There have been 2 reported cases that have survived**

28

What diagnostic modality provides us with a definitive diagnosis in the case of progressive interstitial fibrosis?

lung biopsy

Lung aspirate is sometimes helpful & less invasive than lung biopsy​

29

protein-rich transudate in the pleural cavity is most frequenty caused by:

heart failure

The lungs contain lymph that is higher in protein and thus fluid escaping from the capillary beds here has higher protein content.

30

T/F: When performing thoracic radiographs to help diagnose pulmonary neoplasia, sixteen-thousand views should be taken

False

Three views should suffice

  • Thoracic radiography: Take right & left laterals & VD: 3 view “met check”
    • Primary neoplasia:

      • 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
    • Metastatic neoplasia

      • 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