3. pulomnary diseases

Question 1

pulmonary parenchymal diseases

Answer 1

pneumonia - infectious/aspiration 
eosinophilic bronchopneumopathy 
pulmonary edema 
pulmonary contusion 
smoke inhalation 
ARDS
pulmonary fibrosis 
lung lobe torsion 
pulmonary thromboembolism 
pulmonary neoplasia

Question 2

classification of pneumonia

Answer 2

location: bronchopneumonia, pneumonia, interstitial pneumonia, lobar
origin:
- infectious: bacterial, viral, fungal, parasitic
- non infectious: aspiration, idiopathic
duration
chronic, acute, subacute

Question 3

bacterial pneumonia causes

Answer 3

secondary to:
viral pneumonia
laryngeal dysfunction 
aspiration 
defect cough reflex 
poor mucociliary clearance 
decreased epithelial layer protection

Question 4

bacterial pneumonia symptoms

Answer 4

lethargy, fever, dyspnoea
coughing, hemoptysis, nasal discharge
exercise intolerance

Question 5

bacterial pneumonia diagnosis

Answer 5

blood: wbc may be increased
xray: alveolar pattern, (bronchiectasis, Megaoesophagus, mass)
bronchoscopy: mass, foreign body, broncho-esophageal fistula,
BAL: cytology

Question 6

bacterial pneumonia pathogens

Answer 6

e. coli, klebsiella, bordatella, pasteurella, pseudomonas, mycoplasma

Question 7

bacterial pneumonia treatment

Answer 7

AB
bronchodilators 
saline nebulization 
lobectomy?
NO antitussives if pus, blood etc

Question 8

viral pneumonia pathogens

Answer 8

DISTEMPER
CHV, CPIV, CIV, CRCoV
FIP, FHV

Question 9

viral pneumonia distemper

Answer 9

exposure (inhalation, PO)
- replication in macrophages
- viremia -> several tissues - lung
bronchopneumonia, enteritis, encephalitis

Question 10

viral pneumonia, signs, diagnosis, treat

Answer 10

mucopurulent occulonasal discharge, fever, lethargy 
PCR (blood, urine) 
xray - interstitial, alveolar pattern 
supportive treatment 
ab, fluid, bronchodilators 
antiseizure if needed

Question 11

fungal pneumonia pathogens

Answer 11

histoplasma 
asperguillus 
blastomyces 
cryptococcus 
pneumocystis

Question 12

fungal pneumonia diagnosis, therapy

Answer 12

BAL: cytology, microbiology
PCR. blood, feacal
itraconazole
fro pneumocystis PotSA trimetoprim sulfa

Question 13

aspiration pneumonia causes, severity of injury

Answer 13

megaesophagus, laryngeal and pharyngeal dysfunction
neuromuscular problem
tracheal tubing
brachycephal airway issue

severity depend on aspirated material
- ph, toxicity, volume
obstruction, inflammation, necrosis, hemorrhage

Question 14

aspiration pneumonia signs

Answer 14

cough, acute onset of respiratory distress, fever, lethargy

cat: wheezes

Question 15

aspiration pneumonia diagnosis

Answer 15

history of vomit and regurgitation

radiography: interstitioalveolar pattern in cranioventral and medial lung lobes
bronchoscopy: BAL for cyto and microbiology
blood: leukocytosis

Question 16

aspiration pneumonia therapy

Answer 16

resp distress:
O2 therapy, fluid therapy (nb edema), remove object
antibiotics
NO steroids!!!!!!

Question 17

eosinophilic bronchopneumopathy

Answer 17

idiopathic chronic inflammation

inflammatory disease, unknownn etiology (hypersensitivity to a endogenous or environmental atg)

Question 18

eosinophilic bronchopneumopathy clinical signs

Answer 18

coughing, gagging, difficult breathing
crackling
nasal discharge

Question 19

eosinophilic bronchopneumopathy diagnosis

Answer 19

xray: different lung patterns, nodules/masses - eosinophilic granulomatosis
bronchscopy: yellow-green mucous, mucosal thickening, many eosinophils
blood: peripheral eosinophilia

Question 20

eosinophilic bronchopneumopathy therapy

Answer 20

gcc at immunosuppressive doses

Question 21

pulmonary edema etiology

Answer 21

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

Question 22

pulmonary edema types

Answer 22

non cardiogenic: ARDS, upper airway obstruction

cardiogenic: CHF (left side heart)

Question 23

pulmonary edema symptoms, auscultation

Answer 23

dyspnoe, cyanosis, coughing

lung: inspiratory crackle
heart: heart murmur without sinus tachycardia = pulmonary > cardiogenic

Question 24

pulmonary edema radiography

Answer 24

cardiogenic: interstitial pattern, cardiomegaly, bigger pulmonary veins
non cardiogenic: absence of enlargement of heart and veins

Question 25

pulmonary edema treatment

Answer 25

furosemide oxygen therapy sedation: acepromasine

Question 26

smoke inhalation causes, causing

Answer 26

heat, hot air, particles, toxic gases | causing: hypovolemic shock, pain, burns

Question 27

smoke inhalation etiology

Answer 27

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

Question 28

smoke inhalation clinical signs

Answer 28

smell of smoke, burns upper airway stridor, cyanosis, ocular and nasal discharge some can be wo symptoms in beginning, but then ARDS, infection, edema

Question 29

smoke inhalation treatment

Answer 29

``` observation for 24-48 hours oxygen therapy fluid (nb edema) bronchodilators AB? analgesics steroids? ```

Question 30

ARDS

Answer 30

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

Question 31

ARDS secondary to

Answer 31

sepsis, pancreatitis, aspiration, shock, pneumonia

Question 32

ARDS phases

Answer 32

early phase: proteinaceous fluid | later: inflammatory cells, hyalin membrane, fibrosis

Question 33

ARDS clinical signs, diagnosis

Answer 33

anxiety, cyanosis, expiratory crackle, wheeze | non cardiogenic edema, edema protein/ plasma protein

Question 34

ARDS treatment

Answer 34

underlying disease, oxygen therapy, (fluid), furosemide, gcc?

Question 35

pulmonary fibrosis what

Answer 35

alveolar septal fibrosis, interstitial fibrosis, epithelial hyperplasia, focal calcification chronic and progressive pulmonary signs

Question 36

pulmonary fibrosis diagnosis

Answer 36

xray: diffuse interstitial pattern echocardiography: moderate to severe pulmonary hypertension biopsy: tell us diagnosis

Question 37

pulmonary fibrosis treatment

Answer 37

no effective treatment, symptomatic | gcc, antitussives, bronchodilators

Question 38

lung lobe torsion

Answer 38

torison -> venous congestion -> exudation - anemia, necrosis respiratory distress, tachypnoea, hypotension, shock x ray: rounding of lobe bronchoscopy: see torsion shock therapy, remove fluid, surgery

Question 39

pulmonary thromboembolism general

Answer 39

secondary to: HW, IMHA, neoplasia, DIC | abnormal cat exchange - pulmonary embolism

Question 40

pulmonary thromboembolism clinical signs, diag, treat

Answer 40

acute resp distress, tachypnoea, cyanosis diagnosis: pulmonary angiography! D-dimer, antithrombin 3, blood gas, X-ray treatment: thrombolytic therapy (tissue plasminogen activator, surgery)

Question 41

pulmonary neoplasia

Answer 41

metastatic > primary (carcinoma, osteosarcoma) | chronic cough, exercise intolerance, weight loss, respiratory distress

Question 42

pulmonar neoplasia diagnosis treatment

Answer 42

x ray: false neg(small, hidden by other structures), false pos (eosinophilic pneumopathy nodules) BIOPSY!! treat: lobectomy if primary