Unit 3 - Approach to the Coughing Patient Flashcards Preview

Small Animal Medicine > Unit 3 - Approach to the Coughing Patient > Flashcards

Flashcards in Unit 3 - Approach to the Coughing Patient Deck (37)
Loading flashcards...
1
Q

The coughing mechanism is a _____ mechanism that works with the mucociliary apparatus.

A

protective

2
Q

What medical history must you obtain when determining the cause of coughing?

A

Duration, progression, associations (time of day), triggers, character of cough, and other systemic signs

3
Q

What are potential triggers for a cough?

A

the owner is a smoker, perfume/air fresheners, household cleaners, dusty kitty litter, and house construction

4
Q

What environmental exposure can cause a cough?

A

boarding/grooming, obtained from a shelter, outdoors/travel history, walks, dog parks, show/agility competitor, heartworm prevention, other sick animals in the house

5
Q

When determining the cause of a cough, what should you look for/do on the PE?

A

tracheal and cervical palpation, nasal discharge, changes in weight, fundic examination, skin lesions, cardiac abnormalities, lymphadenopathy, and rectal examination

6
Q

What does a non-productive cough sound like?

A

usually loud, harsh, and paroxysmal

7
Q

What is a goose-honk most commonly associated with?

A

upper airway disease - trachea and mainstem bronchi

8
Q

What is a productive cough?

A

when sputum is expectorated from the lower airways

9
Q

What is productive cough most commonly associated with?

A

lower airway disease or pulmonary parenchymal disease

10
Q

How does a productive cough sound like?

A

it is typically softer in volume - a huff - can be confused with vomiting

11
Q

Coughing is _____ in cats, so it should be persued ______.

A

uncommon, aggressively

12
Q

What is coughing most commonly associated with in cats?

A

lower airway disease (asthma is the most common)

13
Q

How do you know if a cough is cardiogenic in nature?

A

It is classically worse at night, there is exercise intolerance and tachypnea at rest, and there is perihilar edema on radiographs that is responsive to furosemide

14
Q

What are the locations where non-cardiogenic coughs come from?

A

upper (large) airway, lower (small) airway, parenchymal, and less commonly pleural space

15
Q

What are the infectious causes of upper airway coughs?

A

infectious tracheobronchitis, parasitic (filaroides), or hilar lymph node enlargement

16
Q

Are upper airway coughs typically productive or non-productive?

A

non-productive

17
Q

What are the non-infectious causes of upper airway coughs?

A

tracheal collapse, compressive masses, or foreign bodies

18
Q

What can cause lower airway cough?

A

inflammatory airway disease or smoke/chemical irritant inhalation

19
Q

What are the causes of inflammatory airway disease?

A

canine chronic bronchitis, feline lower airway disease, eosinophilic bronchopneumopathy

20
Q

What are the infectious causes of parenchymal disease cough?

A

bacterial pneumonia, fungal disease, heartworm infection, parasitic, or Toxoplasma

21
Q

What are the non-infectious causes of parenchymal disease cough?

A

neoplasia, lung lobe torsion, and non-cardiogenic pulmonary edema

22
Q

What are the common ‘first tier’ tests for diagnosing underlying causes of cough?

A

CBC, throacic rads, fecal examination, heartworm testing, and cytology (skin lesions, nasal discharge, and lymph nodes)

23
Q

What are common ‘second tier’ tests for diagnosing underlying causes of cough?

A

Cardiac evaluation, chemistry panel, urinalysis, airway sampling (for type of pneumonia), advanced imaging, lung aspirate/biopsy, bronchoscopy, and thoracotomy

24
Q

What does TTW stand for?

A

transtracheal wash

25
Q

What does ETW stand for?

A

endotracheal wash

26
Q

When is TTW or ETW indicated?

A

for diffuse disease

27
Q

How do you perform TTW or ETW?

A

Place a catheter to the level of the carina, insert saline (patient must be able to cough), recover the saline for cytology and culture

28
Q

What is BAL and when is it indicated?

A

Bronchoalveolar lavage - indicated for localized disease - scope is used to perform this

29
Q

If you decide to do empiric antibiotic therapy, what guidelines should you follow?

A

limit to one course, discontinue 1-2 weeks prior to sampling airways, informed client consent (may complicate future diagnosis/tx if unsuccessful)

30
Q

What is an antitussive?

A

a drug used to prevent or relieve a cough

31
Q

What are the most effective antitussives (general)?

A

opioids

32
Q

What opoids can be used for antitussives?

A

butorphanol, hydrocodone, loperamide, diphenoxylate

33
Q

What is combined with hydrocodone to prevent human abuse?

A

anti-cholinergics

34
Q

When wouldn’t you use an antitussive?

A

the vast majority of lower airway coughs - contraindicated in causes of pneumonia

35
Q

What condition do we use antitussives in?

A

collapsing trachea cases

36
Q

What abnormal breath sound will you hear with a cardiogenic cough?

A

crackles

37
Q

What other disease process, aside from CHF, can cause a cardiogenic cough?

A

advanced mitral valve disease, specifically causing cardiomegaly, that causes the left atrium to push on the mainstem bronchi

Decks in Small Animal Medicine Class (100):