The Blue Patient: Approach to Respiratory Emergencies in Small Animals

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1. Anxiety will increase oxygen utilisation in the body. Which one of the medications below is least indicated to be used in dyspnoeic patients? *

1 point

Butorphanol 0.1-0.4 mg/kg

Acepromazine 0.01-0.025 mg/kg

Diazepam (0.2-0.5 mg/kg

Midalozam (0.1-0.5 mg/kg

Morphine (0.2 mg/kg)

2. Heat stroke and dyspnoea are often concurrent. Which of the methods listed below is NOT indicated as a management tool for this condition? *

1 point

Anxiolysis

Dexamethasone IV

Ice packs packed around the patient

Wet the cat and fans on the patient

Eventual GA and entubation if dyspnoea worsens

3. Which one of the statements below regarding respiratory sounds is INCORRECT? *

1 point

Inspiratory dyspnoea is more common in dogs than cats with upper airway disease.

Stertor is a snore sound and involves the nasal and nasopharyngeal regions.

Stridor is a “roaring” sound and is associated with tracheal collapse.

Upper airway disease can be dynamic and intermittent.

Complete obstruction can cause no audible sound.

4. Which of the statements regarding lower airway disease is INCORRECT? *

1 point

Lower airway disease include conditions affecting the bronchi.

History of a cough is present in these patients.

Wheezes are often heard with lower airway disease.

The breathing pattern has a longer inspiratory phase than expiratory phase.

Crackles can be auscultated in same cases with lower airway disease.

5. Which of the statements below regarding breathing patterns is CORRECT? *

1 point

Parenchymal disease requires decreased inspiratory pressures due to decreased compliance.

Elasticity and compliance of the ribs and normal lung tissue allows expiration to be a passive process.

Normally expiration and inspiration phases are equal.

Inspiration causes a respiratory sinus arrhythmia in normal dogs.

Bronchial disease causes increased inspiratory effort.

6. Pleural space disease is most likely identified by which of the following breathing patterns? *

1 point

Shallow breathing

Costo-abdominal breathing

Panting

Increased expiratory effort

Increased inspiratory effort

7. Bronchial disease is best described by which one of the following descriptions? *

1 point

Tramlines and donuts on the radiograph, history of a cough, increased expiratory effort.

Air bronchograms, history of a cough, increase inspiratory effort.

Tramlines and donuts on the radiograph, increased inspiratory effort, stridor.

Calcification of bronchial walls on the radiographs, increased inspiratory effort, history of a cough.

Loss of detail in lungs on radiographs, history of a cough, increased expiratory effort.

8. The TFAST is basically a quick ultrasound to assess the thoracic cabity, mainly used in trauma cases. Which one of the following statements regarding its use is INCORRECT? *

1 point

Normal lungs have a hyperechoic line moving backward and forward at the lung margin (glide sign).

Pneumothorax is diagnosed on the absence of the glide sign – i.e. a static hyperechoic line.

The presence of pulmonary oedema is noted by an increase in B-lines (comet tails) at the lung margin.

Pleural effusion is seen as a hypoechoic line/ accumulation beneath the ribs.

Pneumothorax will cause increased B lines (comet tails) at the lung margin.

9. In an emergency situation, thoracocentesis can be preformed based on clinical and ausculation findings only. Which one of the following concepts listed below is INCORRECT? *

1 point

Pneumothorax will quite severely muffle the lung sounds on auscultation.

The patient will have asynchronous respiration with a pleural effusion.

In very distressed patients the procedure will need to be performed with them in sternal position or sitting.

You will need to remove the majority of the fluid/ air to stabilise the patient.

You can provide anxiolysis with butorphanol.

10. Which one of the conditions below has not been noted to mimic respiratory disease? *

1 point

Chest wall disease (trauma, rib fractures, pain)

Partial complex seizures

Metabolic acidosis with respiratory compensation (”blowing” off C02)

Stressed cats (panting)

Paracetamol toxicity in cats

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