Unit 3 - Approach to the Coughing Patient Flashcards Preview

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Flashcards in Unit 3 - Approach to the Coughing Patient Deck (37)
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1

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

protective

2

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

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

3

What are potential triggers for a cough?

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

4

What environmental exposure can cause a cough?

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

5

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

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

6

What does a non-productive cough sound like?

usually loud, harsh, and paroxysmal

7

What is a goose-honk most commonly associated with?

upper airway disease - trachea and mainstem bronchi

8

What is a productive cough?

when sputum is expectorated from the lower airways

9

What is productive cough most commonly associated with?

lower airway disease or pulmonary parenchymal disease

10

How does a productive cough sound like?

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

11

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

uncommon, aggressively

12

What is coughing most commonly associated with in cats?

lower airway disease (asthma is the most common)

13

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

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

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

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

15

What are the infectious causes of upper airway coughs?

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

16

Are upper airway coughs typically productive or non-productive?

non-productive

17

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

tracheal collapse, compressive masses, or foreign bodies

18

What can cause lower airway cough?

inflammatory airway disease or smoke/chemical irritant inhalation

19

What are the causes of inflammatory airway disease?

canine chronic bronchitis, feline lower airway disease, eosinophilic bronchopneumopathy

20

What are the infectious causes of parenchymal disease cough?

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

21

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

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

22

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

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

23

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

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

24

What does TTW stand for?

transtracheal wash

25

What does ETW stand for?

endotracheal wash

26

When is TTW or ETW indicated?

for diffuse disease

27

How do you perform TTW or ETW?

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

What is BAL and when is it indicated?

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

29

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

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

30

What is an antitussive?

a drug used to prevent or relieve a cough

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