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clinical respiratory > Dz of the Pulmonary Parenchyma > Flashcards

Dz of the Pulmonary Parenchyma Flashcards

1
Q

where does gas exchange occur in the lungs?

A
  • alveolar airspaces
  • capillary network
  • supporting interstitial tissue
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2
Q

what inflammatory or infectious diseases of the parenchyma are there?

A
  • pneumonitis/pneumonia
  • eosinophilic bronchopneumopathy
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3
Q

non-cardiogenic pulmonary oedema (part of ARDS) occurs where?

A

lung parenchyma

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4
Q

What is an idiopathic disease of the lung parenchyma?

A

pulmonary fibrosis

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5
Q

What is pneumonitis?

A

Inflammation of the lung

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6
Q

What is pneumonia?

A

infectious inflammation of the lung

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7
Q

Infectious pneumonia/pneumitis is caused by…

A

Virus, bacteria, fungi, parasites
Can be hospital or community acq’d

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8
Q

Non-infectious causes of pneumonia/pneumitis include…

A

aspiration, smoke, allergy

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9
Q

pneumonia/pneumitis can be either focal or…

A

diffuse

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10
Q

What infecious agents can cause bacterial pneumonia?

A
  • Primary - Bordetella, mycoplasma
  • opportunists
  • Mixed
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11
Q

What are common origins of bacterial pneumonia?

A

airways, hematogenous

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12
Q

What are clinical signs of bacterial pneumonia?

A
  • cough - soft & productive
  • tachypnea, dyspnea
  • pyrexia
    • non-specific signs (lethargy, dull, hypo/anorexia)
  • restrictive breathing pattern, crackles
  • other clinical signs associated w/ underlying cause
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13
Q

How do you diagnose bacterial pneumonia?

A
  • hematology - Leukocytosis
  • Rads, CT, U/S
  • BAL for cytology & culture +/- mycoplasma PCR
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14
Q

How do you treat bacterial pneumonia?

A
  • Antibiotics - Doxycycline or Amoxi-clav (IV or oral)
  • Culture/susceptibility
  • nebulisation & coupage
  • Avoid anti-tussives, glucocorticoids
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15
Q

Fungal pneumonia is likely caused by what fungi?

A
  • Aspergillus spp.
  • Pneumocystis carini
  • Histoplasma capsulatum
  • Coccidoides immitis
  • Bastomyces dermatitiditis
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16
Q

What are 2 common species that cause aspergillosis?

A
  • Aspergillus tereus
  • Aspergillus deflectus
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17
Q

What is unique about GSD’s and aspergillosis?

A

They have a mucosal immunity defect

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18
Q

Pulmonary lesions can commonly also be seen…

A

on bone, spine, other sites

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19
Q

Clinical signs for aspergillosis depend on…

A

affected organs

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20
Q

How do you diagnose aspergillosis?

A
  • ID fungal agent
  • Cytology & culture: FNA, BAL, urine
  • Detection of galactomannan antigens
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21
Q

Pneumocystosis is caused by what organism?

A

Pneumocystis carini

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22
Q

Pneumocystosis commonly occurs in what breeds?

A
  • dachshund, ckcs
  • usually young
  • mucosal immunity defect
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23
Q

What clinical signs are present in pneumocystosis?

A
  • severe signs
  • pyrexia absent
  • similar to pneumonia
24
Q

How do you diagnose pneumocystosis?

A
  • BAL
  • organisms are not easily recovered
  • treat for pneumonia w/ no pyrexia
25
Q

Parasitic Lung Disease has variable signs. What are they?

A
  • exercise intolerance
  • cough
26
Q

How do you diagnose parasitic lung disease?

A
  • fecal parasitology
  • BAL
  • specific testing
  • response to therapy?
27
Q

What clinical signs occur with Angiostrongylus vasorum infection?

A
  • Direct inflammation of the lungs (C, dyspnea, exercise intolerance)
  • Bleeding diathesis (coagulopathy - hyperfibrinolysis, multifactorial)
  • Neurological (bleeding in CNS?)
28
Q

What initial diagnostic tests can be used for diagnosing Angiostrongylus vasorum?

A
  • Hematology (look for eosinophilia, anemia, thrombocytopenia)
  • clotting times
  • TEG
  • rads/CT
29
Q

How do you make a definitive diagnosis of Angiostrongylus vasorum?

A
  • Modified Fecal (Baermann)
  • Angiodetect
  • Invasive tests (RARE to perform)
30
Q

How do you treat Angiostrongylus vasorum?

A
  • Deworming (Fenbendazole, Milbemycin oxime, Moxidectin)
  • Plasma transfusion in bleeding dogs
31
Q

What clinical signs are common with Aelurostrongylus abstrusus infection?

A
  • Asymptomatic
  • mild C
  • severe - bronchopneumonia, pleural effusion, pneumothorax, death
32
Q

What diagnostic tests can be used to diagnose Aelurostrongylus abstrusus?

A
  • Rads - miliary interstitial pattern, alveolar pattern if severe
  • Definitive parasite ID –> fecal analysis, PCR on BAL
  • BAL - eosinophilic, larvae may be present
33
Q

How do you treat Aelurostrongylus abstrusus?

A

Txt: Fenbendazole, Milbemycin oxime, Moxidectin

34
Q

Eosinophilic bronchopneumopathy is due to

A

eosinophilic infiltrate in the lungs causing an autoimmune infection in dogs

35
Q

What are clinical signs of eosinophilic bronchopneumopathy?

A
  • Harsh cough
  • dyspnea
  • tachypnea
  • exercise intolerance
  • nasal discharge - concomitant eosinophilic rhinitis
  • crackles & wheezes
36
Q

How do you diagnose eosinophilic bronchopneumopathy?

A
  • Signalment (Siberian huskies, Alaskan malamutes, Rotties), often young females
  • hematology: +/- eosinophilia
  • Imaging: Rads/CT
  • bronchoscopy
  • BAL
  • Absence of parasites or neoplasia –> imaging, fecal, other parasite tests
37
Q

How do you treat eosinophilic bronchopneumopathy?

A
  • Glucocorticoids (IC, long-term)
  • Fenbendazole to exclude parasites
  • May need to treat a secondary bacterial infection
38
Q

Cardiogenic pulmonary oedema causes an increase in…

A

hydrostatic pressure

39
Q

Non-cardiogenic pulmonary oedema causes

A
  • increased vascular permeability
  • pulmonary vasoconstriction
  • less likely: reduced oncotic pressure
40
Q

ARDS is a complication of…

A

other systemic dz

41
Q

ARDS has what prognosis?

A

Poor

It is an EMERGENCY

42
Q

What clinical signs are present in ARDS?

A
  • Acute respiratory distress: restrictive breathing pattern, tachypnea, dyspnea
  • Crackles - caudodorsal aspect
  • Signs of underlying cause
43
Q

How do you diagnose ARDS?

A
  • Pulmonary oedema (do rads)
  • exclude cardiac dz (do echo)
  • ID underlying cause (Hx, blood analysis, Dx imaging)
44
Q

What treatment is required for ARDS?

A
  • supportive txt (Oxygen therapy, positive pressure ventilation, avoid stress - sedate)
  • treat underlying condition
  • furosemide –> limited benefits
45
Q

What is the most common primary lung tumour?

A

Adenocarcinoma

46
Q

What paraneoplastic signs are present in primary lung tumours?

A
  • +/- hypertrophic osteopathy
  • +/- lung-digit syndrome (cats)
47
Q

Metastatic lung tumours usually consist of…

A

multiple nodules

48
Q

The lung tumours are common sites for…

A

metastasis

49
Q

What clinical signs are common in metastatic lung tumours?

A
  • weight loss, lethargy, panting, +/- signs related to primary site, C is rare, some asymptomatic
50
Q

How do you diagnose metastatic lung tumours?

A
  • imaging: rads/ct
  • cytology, Bx for Definitive Dx
51
Q

If there is a primary tumour, how do you treat?

A
  • Sx removal
52
Q

If there is mets, how do you treat?

A
  • depends on primary tumour
  • Sx if a single mass is involved
  • Chemo depending on types of neoplasia
53
Q

Idiopathic pulmonary fibrosis occurs in which breeds most commonly?

A

Westies
Staffies

54
Q

What clinical signs are part of idiopathic pulmonary fibrosis?

A
  • advanced dz at diagnosis usually
  • slow progression
  • exercise intolerance
  • cough
  • panting
  • Dyspnoea
  • cyanosis
  • Cardiopulmonary auscultation (crackles, R-sided apical systolic murmur leading to pulmonary hypertension)
55
Q

How do you diagnose idiopathic pulmonary fibrosis?

A
  • Signalment: Westies, Staffies
  • Imaging
  • BAL
  • Echo
  • Bx - rarely done
56
Q

How do you treat idiopathic pulmonary fibrosis?

A
  • Progressive & not curable (symptomatic & complications)
  • Prednisone –> suspected concurrent inflammation
  • antitussives, bronchodilators (Theophylline)
  • Sildenafil (pulmonary hypertension)
  • No anti-fibrotic drugs shown to be effective
57
Q

What is the prognosis of idiopathic pulmonary disease?

A

Poor, Death w/i 11 months from Dx

clinical respiratory (7 decks)

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