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Respiratory (PATH) > Diseases of the lung parenchyma > Flashcards

Diseases of the lung parenchyma Flashcards

1
Q

What are the two types of pneumocytes (alveolocytes) and what do they do?

A

Type I - gas exchange

Type II - produce surfactant

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2
Q

Can type I and type II cells differentiate?

A

Type I - fully differentiated

Type II - can differentiate into more type I or type II if tissue damaged

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3
Q

How do the shape of type I and type II cells differ?

A

Type I - thin, squamous cells

Type II - more cuboidal

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4
Q

Blocks of alveoli form lobules. The degree of collateral ventilation is poor in cattle/pigs/sheep - why is this?

A

Cattle/sheep/pigs have thick complete septa in-between lobules

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5
Q

Do horses have good collateral ventilation?

A

Ok as incomplete thick septa between lobules

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6
Q

Do carnivores/rabbits/rodents have good collateral ventilation?

A

Yes as no distinct septa between lobules

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7
Q

Developmental abnormalities of the lung parenchyma are rare. Give examples of this

A

Agenesis of lung lobe
Ectopic lung tissue
Congenital melanosis

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8
Q

What are 2 abnormalities of inflation?

A

Atelactasis

Emphysema

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9
Q

What is atelectasis?

A

Collapse or closure of lung

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10
Q

What can cause atelectasis?

A

Internal obstruction of airway
External compression of airway or lung
Pneumothorax
Defective surfactant production

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11
Q

What is hypostatic atelectasis?

A

Atelectasis due to recumbency

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12
Q

What is emphysema?

A

Over-inflation of the lungs

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13
Q

What causes emphysema?

A

Forced respiratory effort e.g. pneumonia or COPD

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14
Q

With emphysema, are both inhalation and exhalation affected?

A

No - can inhale normally

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15
Q

What problems does emphysema cause during exhalation?

A

Expiratory effort puts pressure on lobule and bronchiole
Collapses partially obstructed airways - cannot expel air properly
Lobule remains partially expanded

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16
Q

What is the effect of emphysema on the lung parenchyma?

A

Damage
Loss of area for gas exchange
Can rupture alveolar walls

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17
Q

Emphysema can cause rupture of alveolar walls. What are the consequences of this? (3)

A

Loss of elasticity - early airway collapse, increased dead space
Loss of pulmonary capillaries - reduced perfusion
Fibrosis of alveolar walls (horse only)

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18
Q

Alveolar wall rupture due to emphysema can cause fibrosis of the remaining walls in horses. What are the consequences of this?

A

Inhibits gas exchange
Reduced compliance
Greater respiratory effort

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19
Q

Give 3 examples of circulatory disturbances of the lung parenchyma

A

Pulmonary oedema
Pulmonary embolism
Pulmonary haemorrhage

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20
Q

Pulmonary oedema is common and caused by many diseases. What are the symptoms of this?

A 
Dyspnoea 
Tachypnoea 
Hypoxia 
Cyanosis (if severe) 
Moist cough
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21
Q

How do lungs with pulmonary oedema appear (grossly)?

A 
Lungs heavy
Enlarged interlobular space
Appear wet, ooze fluid 
Increased fluid in pleural cavity 
Foamy fluid in upper airways
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22
Q

How do lungs with pulmonary oedema appear histologically?

A

Faintly pink stained

Eosinophilic homogenous material

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23
Q

Pulmonary oedema usually does not cause the alveoli to flood. Why is this? (2)

A

Alveolar epithelium more permeable than capillary endothelium
Interstitial fluid drained by lymphatics

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24
Q

Pulmonary oedema is common with many diseases, but what actually causes it to occur? (2)

A

Damaged alveolar epithelium or

Increased interstitial volume

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25
Q

Damage to the alveolar epithelium can cause oedema. What can cause damage to the epithelium?

A

Infectious agents
Toxins
Irritants

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26
Q

How does damage to the alveolar epithelium by infectious agents, toxins and irritants cause oedema?

A

Increase capillary permeability
Increase hydrostatic pressure
Increase pulmonary interstitial fluid
Causes inflammation, passive congestion and circulatory overload

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27
Q

How can hypoproteinaemia or over-transfusion lead to pulmonary oedema?

A

Reduced capillary osmotic pressure
Reduced drainage of interstitial fluid
Blockage of lymphatics by inflammation or tumours

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28
Q

What is a pulmonary embolism?

A

Fragments of tissue within blood stream blocking lung capillaries
Can be tumour cells, fat, air thromboemboli (blood clot)

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29
Q

Why is the lung a common place to have a pulmonary embolism?

A

Has fine capillary network

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30
Q

What are the effects of a pulmonary embolism?

A

Depends on site and nature

Can cause infarction - if blockage of major vessel

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31
Q

What are the sequelae (resulting pathological changes) from a sterile thromboemboli?

A

Fibrinolytic breakdown of thrombus OR

Fibrotic scarring

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32
Q

What are the sequelae (resulting pathological changes) from an infected thromboemboli?

A

Vasculitis OR
Thrombosis OR
Abscess

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33
Q

What are common sources of an infected thromboemboli?

A

Joint ill/navel ill
Liver abscesses
Right heart bacterial endocarditis

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34
Q

How does a hepatic abscess cause a thromboemboli?

A

Hepatic abscess causes venal canal thrombosis

Pulmonary septic thrombolemboli, arteritis and aneurysm formation

35
Q

What is an aneurysm? When can these be fatal?

A

Weakening of vascular wall, creates a bulge

If ruptures, causes a fatal haemorrhage

36
Q

What are the causes of pulmonary haemorrhage?

A 
Pulmonary thromboembolism 
Trauma 
Inflammation 
Abscesses/tumours 
Exercise induced haemorrhage
37
Q

Which animals are most likely to experience an exercised induced pulmonary haemorrhage (EIPH)?

A

Racehorses

Unknown cause

38
Q

What is a symptom of EIPH in racehorses? Is this a fatal condition?

A

Epistaxis

Can be fatal

39
Q

Inflammation of the alveoli is called pneumonia. What are the 4 types of this?

A

Bronchopneumonia
Interstitial pneumonia
Embolic pneumonia
Granulomatous pneumonia

40
Q

What is the entry route for bronchopneumonia?

A

Inhalation

Of bacteria, aspiration of food/GI contents, mycoplasmas, viruses

41
Q

Give examples of pathogen that can cause bronchopneumonia

A 
Pasteurella (milk inhalation) 
Bordatella bronchiseptica 
E.coli 
Streptococcus 
Mycoplasma
Distemper
42
Q

Where are the lesions caused by bronchopneumonia? Why?

A

Cranioventral

Due to gravity, variations in defence mechanisms, deposition of organisms

43
Q

Describe the pathogenesis of bronchopneumonia

A

Inhaled pathogen causes injury at bronchiolar-alveolar junction
Causes inflammatory response
Alveoli and bronchioles fill with exudate
Infection and inflammation spreads to adjacent lung

44
Q

What are the 2 subdivisions of bronchopneumonia? Which is more severe?

A

Suppurative
Fibrinous - severe inflammation
(Can get both occurring at same time)

45
Q

What causes fibrinous bronchopneumonia?

A

Inhalation of high irritant material

46
Q

How does the exudate differ between suppurative and fibrinous bronchopneumonia?

A

Suppurative - purulent or mucopurulent exudate

Fibrinous - fibrinous exudate

47
Q

How does the distribution differ between suppurative and fibrinous bronchopneumonia?

A

Suppurative - confined to lobules

Fibrinous - spreads rapidly between lobules

48
Q

What is bovine shipping fever properly known as?

A

Bovine pneumonic pasteurellosis

49
Q

What type of pneumonia does bovine pneumonic pasteurellosis (shipping fever) cause? Is it acute or chronic?

A

Acute

Fibrinous bronchopneumonia

50
Q

Bovine pneumonic pasteurellosis typically affects which cattle?

A

Recently weaned suckled calves

51
Q

What bacteria causes bovine pneumonic pasteurellosis?

A

Mannheimia haemolytica

52
Q

What does bovine pneumonic pasteurellosis cause?

A

Acute fibrinous bronchopneumonia

Toxaemia

53
Q

What are the sequela of bovine pneumonic pasteurellosis?

A 
Resolution 
Chronic pneumonia 
Bronchiolitis obliterates 
Bronchiectasis 
Abscess formation 
Pleuritis 
Death
54
Q

What can cause acute interstitial pneumonia?

A

Distemper
Salmonellosis
Lungworm
Smoke

55
Q

What can cause chronic interstitial pneumonia?

A

Ovine lentivirus
Farmer’s lung (hypersensitivity to fungal spores)
Toxins
Asbestos

56
Q

What are the entry routes for interstitial pneumonia?

A

Haematogenous or inhalation

57
Q

What is the distribution of interstitial pneumonia?

A

Mainly diffuse

Can be caudodorsal

58
Q

How do lungs with interstitial pneumonia appear grossly?

A

Heavy, rubbery, elastic texture
Red/grey and mottled
Lack of visible exudate

59
Q

When opening the thorax post-mortem, what is a sign of interstitial pneumonia?

A

Lungs fail to collapse when opening thorax

Leaves costal impression on pleura

60
Q

What are the 3 phases of acute response to interstitial pneumonia?

A

Injury
Exudative phase
Proliferative phase

61
Q

What happens in the first phase of the acute response to interstitial pneumonia?

A

Injury to type I pneumocytes or capillary endothelium

62
Q

What happens in the second phase of the acute response to interstitial pneumonia?

A

Exudative phase - oedema and inflammatory exudate leake into alveolar space

63
Q

What happens in the final phase of the acute response to interstitial pneumonia?

A

Proliferative phase - macrophage population expands to phagocytose exudate
Type II pneumocytes proliferate to replace type I cells

64
Q

With acute interstitial pneumonia, what microscopic changes happen if injury persists?

A

Interstitial fibrosis
Chronic inflammatory cells
Persistance of type II pneumocytes
Smooth muscle hyperplasia

65
Q

What are the consequences of acute interstitial pneumonia?

A

Disruption of alveolar walls - oedema and exudate

Causes hypoxia

66
Q

What are the consequences of chronic interstitial pneumonia?

A

Same as acute - disrupted alveolar walls, oedema and exudate, hypoxia
AND thickened alveolar walls (increased effort, decreased compliance, tachypnoea)

67
Q

What are the consequences of thickened alveolar walls?

A

Impaired diffusion and gas exchange
Hypoxia which leads to vasoconstriction
Pulmonary hypertension

68
Q

What is the entry route for embolic pneumonia?

A

Haematogenous

69
Q

What is the distribution of embolic pneumonia?

A

Random, disseminated foci

70
Q

What are some causes of embolic pneumonia?

A

Hepatic abscesses
Right heart valve endocarditis
Joint/navel ill
Bacteria - staph aureus, strep equi

71
Q

What are the sequelae of embolic pneumonia?

A

Formation of abscesses
Fibrosis and resolution
Chronic pneumonia
Or rupture into thorax (prothorax, pneumothorax)

72
Q

What are some causes of granulomatous pneumonia?

A 
Mycobacteria 
Parasites (lungworm) 
Viral (FIP) 
Fungi 
Foreign bodies
73
Q

What are the routes of entry for granulomatous pneumonia?

A

Inhalation or haematogenous

74
Q

What is the distribution of granulomatous pneumonia?

A

Variable, nodular foci

75
Q

Secondary lung tumours are very common. Why?

A

Good blood supply

Fine capillary network

76
Q

Give 2 examples of primary lung tumours seen in epithelial tissues

A

Carcinoma

Adenocarcinoma

77
Q

What are the 2 types of carcinoma seen in the lung?

A

Bronchioalveolar

Squamous cell

78
Q

What are the 2 types of adenocarcinoma seen in the lung?

A

Papillary

Acinar

79
Q

Give 2 examples of primary lung tumours seen in mesenchymal tissues

A

Chondrosarcoma

Granual cell tumour (neuroendocrine)

80
Q

What is pulmonary adenomatosis also known as?

A

Ovine pulmonary carcinoma

Driving sickness

81
Q

What is pulmonary adenomatosis?

A

Retroviral induced neoplasia

Causes multi centric bronchioalveolar carcinoma

82
Q

What shape cells are seen in pulmonary adenomatosis?

A

Cuboidal or columnar cells

resemble type II cells

83
Q

How do the lungs appear grossly with pulmonary adenomatosis?

A

Heavy
Small grey to white nodules
Lots of mucoid fluid

84
Q

What is the wheelbarrow test used to identify? What is this test?

A

Pulmonary adenomatosis

Hindquarters raise when head is simultaneously lowered

Respiratory (PATH) (6 decks)

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