3. pulomnary diseases Flashcards
pulmonary parenchymal diseases
pneumonia - infectious/aspiration eosinophilic bronchopneumopathy pulmonary edema pulmonary contusion smoke inhalation ARDS pulmonary fibrosis lung lobe torsion pulmonary thromboembolism pulmonary neoplasia
classification of pneumonia
location: bronchopneumonia, pneumonia, interstitial pneumonia, lobar
origin:
- infectious: bacterial, viral, fungal, parasitic
- non infectious: aspiration, idiopathic
duration
chronic, acute, subacute
bacterial pneumonia causes
secondary to: viral pneumonia laryngeal dysfunction aspiration defect cough reflex poor mucociliary clearance decreased epithelial layer protection
bacterial pneumonia symptoms
lethargy, fever, dyspnoea
coughing, hemoptysis, nasal discharge
exercise intolerance
bacterial pneumonia diagnosis
blood: wbc may be increased
xray: alveolar pattern, (bronchiectasis, Megaoesophagus, mass)
bronchoscopy: mass, foreign body, broncho-esophageal fistula,
BAL: cytology
bacterial pneumonia pathogens
e. coli, klebsiella, bordatella, pasteurella, pseudomonas, mycoplasma
bacterial pneumonia treatment
AB bronchodilators saline nebulization lobectomy? NO antitussives if pus, blood etc
viral pneumonia pathogens
DISTEMPER
CHV, CPIV, CIV, CRCoV
FIP, FHV
viral pneumonia distemper
exposure (inhalation, PO)
- replication in macrophages
- viremia -> several tissues - lung
bronchopneumonia, enteritis, encephalitis
viral pneumonia, signs, diagnosis, treat
mucopurulent occulonasal discharge, fever, lethargy PCR (blood, urine) xray - interstitial, alveolar pattern supportive treatment ab, fluid, bronchodilators antiseizure if needed
fungal pneumonia pathogens
histoplasma asperguillus blastomyces cryptococcus pneumocystis
fungal pneumonia diagnosis, therapy
BAL: cytology, microbiology
PCR. blood, feacal
itraconazole
fro pneumocystis PotSA trimetoprim sulfa
aspiration pneumonia causes, severity of injury
megaesophagus, laryngeal and pharyngeal dysfunction
neuromuscular problem
tracheal tubing
brachycephal airway issue
severity depend on aspirated material
- ph, toxicity, volume
obstruction, inflammation, necrosis, hemorrhage
aspiration pneumonia signs
cough, acute onset of respiratory distress, fever, lethargy
cat: wheezes
aspiration pneumonia diagnosis
history of vomit and regurgitation
radiography: interstitioalveolar pattern in cranioventral and medial lung lobes
bronchoscopy: BAL for cyto and microbiology
blood: leukocytosis
aspiration pneumonia therapy
resp distress:
O2 therapy, fluid therapy (nb edema), remove object
antibiotics
NO steroids!!!!!!
eosinophilic bronchopneumopathy
idiopathic chronic inflammation
inflammatory disease, unknownn etiology (hypersensitivity to a endogenous or environmental atg)
eosinophilic bronchopneumopathy clinical signs
coughing, gagging, difficult breathing
crackling
nasal discharge
eosinophilic bronchopneumopathy diagnosis
xray: different lung patterns, nodules/masses - eosinophilic granulomatosis
bronchscopy: yellow-green mucous, mucosal thickening, many eosinophils
blood: peripheral eosinophilia
eosinophilic bronchopneumopathy therapy
gcc at immunosuppressive doses
pulmonary edema etiology
fluid accumulation in interstitial, alveoli, interalveolar septum
1: increased hydrostatic pressure in lung: left heart fail, increased infusion
2: decreased plasma oncotic pressure. hypoalbuminemia
3: increased vascular permeability
4: impaired lymphatic drainage
5: decreased transpulmonary pressure: upper air obstruction
pulmonary edema types
non cardiogenic: ARDS, upper airway obstruction
cardiogenic: CHF (left side heart)
pulmonary edema symptoms, auscultation
dyspnoe, cyanosis, coughing
lung: inspiratory crackle
heart: heart murmur without sinus tachycardia = pulmonary > cardiogenic
pulmonary edema radiography
cardiogenic: interstitial pattern, cardiomegaly, bigger pulmonary veins
non cardiogenic: absence of enlargement of heart and veins
pulmonary edema treatment
furosemide
oxygen therapy
sedation: acepromasine
smoke inhalation causes, causing
heat, hot air, particles, toxic gases
causing: hypovolemic shock, pain, burns
smoke inhalation etiology
acute phase:
tissue injury-increased capillary permeability- edema, tissue hypoxia. CO gas inhibit Hb binding to oxygen- hypoxia
later phase:
decreased edema, increased mucosal secretion, decreased mucociliar clearance, secondary infections
smoke inhalation clinical signs
smell of smoke, burns
upper airway stridor, cyanosis, ocular and nasal discharge
some can be wo symptoms in beginning, but then ARDS, infection, edema
smoke inhalation treatment
observation for 24-48 hours oxygen therapy fluid (nb edema) bronchodilators AB? analgesics steroids?
ARDS
acute respiratory distress syndrome
acute hyperemic respiratory failure caused by lung injury and increased capillary permeability
special form of pulmonary edema
severe inflammation or tissudamage is the background
cytochrome storm
ARDS secondary to
sepsis, pancreatitis, aspiration, shock, pneumonia
ARDS phases
early phase: proteinaceous fluid
later: inflammatory cells, hyalin membrane, fibrosis
ARDS clinical signs, diagnosis
anxiety, cyanosis, expiratory crackle, wheeze
non cardiogenic edema, edema protein/ plasma protein
ARDS treatment
underlying disease, oxygen therapy, (fluid), furosemide, gcc?
pulmonary fibrosis what
alveolar septal fibrosis, interstitial fibrosis, epithelial hyperplasia, focal calcification
chronic and progressive pulmonary signs
pulmonary fibrosis diagnosis
xray: diffuse interstitial pattern
echocardiography: moderate to severe pulmonary hypertension
biopsy: tell us diagnosis
pulmonary fibrosis treatment
no effective treatment, symptomatic
gcc, antitussives, bronchodilators
lung lobe torsion
torison -> venous congestion -> exudation - anemia, necrosis
respiratory distress, tachypnoea, hypotension, shock
x ray: rounding of lobe
bronchoscopy: see torsion
shock therapy, remove fluid, surgery
pulmonary thromboembolism general
secondary to: HW, IMHA, neoplasia, DIC
abnormal cat exchange - pulmonary embolism
pulmonary thromboembolism clinical signs, diag, treat
acute resp distress, tachypnoea, cyanosis
diagnosis: pulmonary angiography! D-dimer, antithrombin 3, blood gas, X-ray
treatment: thrombolytic therapy (tissue plasminogen activator, surgery)
pulmonary neoplasia
metastatic > primary (carcinoma, osteosarcoma)
chronic cough, exercise intolerance, weight loss, respiratory distress
pulmonar neoplasia diagnosis treatment
x ray: false neg(small, hidden by other structures), false pos (eosinophilic pneumopathy nodules)
BIOPSY!!
treat: lobectomy if primary
