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FA2 Respiratory > Lecture 13 10/21/24 > Flashcards

Lecture 13 10/21/24 Flashcards

1
Q

What are the predisposing factors for bacterial pneumonia?

A

-viral resp. diseases
-athletic events
-recent long trailer rides
-immunologic compromise
-anesthesia
-pharyngeal/laryngeal dysfunction
-esophageal obstruction
-EIPH

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2
Q

When does bacterial pneumonia occur?

A

-when bacteria are aspirated
-when bacterial infection is secondary to viral disease

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3
Q

Which gram-pos. species are associated with bacterial pneumonia?

A

-Strep. zooepidemicus
-Strep. pneumoniae
-Staph. aureus

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4
Q

Which gram-neg. species are associated with bacterial pneumonia?

A

E. coli
-Klebsiella pneumoniae
-Pasteurella spp.
-Actinobacillus spp.

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5
Q

Which anaerobes are associated with bacterial pneumonia?

A

-Clostridium
-Fusobacterium
-Bacteroides fragilis

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6
Q

What are the clinical signs of bacterial pneumonia?

A

-fever
-depression
-anorexia
-exercise intolerance
-tracheal sounds
-coughing
-nasal discharge
-resp distress
-weight loss

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7
Q

What sounds can be heard on auscultation in bacterial pneumonia patients?

A

-crackles/alveoli snapping open
-wheezes/air passing over fluid
-absence of breath sounds

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8
Q

What clinical pathology data is associated with bacterial pneumonia?

A

-hyperfibrinogenemia
-neutrophilia +/- left shift
-neutropenia in gram-neg infections
-hyperglobulinemia

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9
Q

What changes on blood gas are seen with bacterial pneumonia?

A

-low pH/acidosis
-low pO2/hypoxia
-increased pCO2/resp. acidosis
-potentially increased pHCO3/metabolic alkalosis (compensatory)

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10
Q

Which procedures are used to diagnose bacterial pneumonia?

A

-endoscopic examination
-transtracheal wash/bronchoalveolar lavage
-cytology and culture

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11
Q

What changes can be seen on radiographs with bacterial pneumonia?

A

-increased bronchial and/or interstitial patterns
-air bronchograms

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12
Q

What findings on ultrasound can be indicative of bacterial pneumonia?

A

-comet tails
-abscesses
-consolidation
-hepatisation
-pleural fluid

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13
Q

What are the types of treatment for bacterial pneumonia?

A

-primary: directed at causative agent
-secondary: directed at response to causative agent
-supportive: directed at total patient

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14
Q

What is the primary treatment for bacterial pneumonia?

A

-antimicrobial therapy
-based on culture/sensitivity, knowledge of common organisms, or trial and error

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15
Q

What must be considered when using antibiotics for bacterial pneumonia treatment?

A

-dose, duration, interval, and route
-continue treatment until symptoms attenuate for 7-10 days
-understand common microbial agents
-broad vs narrow spectrum
-adverse side effects of the drugs
-frequently monitoring clinical signs

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16
Q

Which antibiotics are first choice for bacterial pneumonia and used in a hospital setting?

A

-aminoglycosides
-beta-lactams
-cephalosporins

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17
Q

Which antibiotics are second choice for bacterial pneumonia and used for at home therapy?

A

-tetracyclines
-potentiated sulfonamides

18
Q

Which antibiotics are the “big guns” for bacterial pneumonia treatment?

A

-fluoroquinolones
-macrolides
-chloramphenicol

19
Q

Which antibiotic is used for anaerobic bacterial pneumonia?

A

metronidazole

20
Q

When should antibiotic therapy be changed?

A

-temp. spikes after 24-48 hours
-no improvement in clinical signs
-adverse side effects occur
-lab support indicates resistance

21
Q

What are the goals of secondary treatment for bacterial pneumonia?

A

-reduce/eliminate airway obstruction
-reduce/eliminate undesirable inflammatory reaction
-improve alveolar-vascular oxygen exchange
-provide immune enhancement

22
Q

What are the components of secondary treatment for bacterial pneumonia?

A

-mucolysis and expectoration
-bronchodilation
-copage/breaking up mucus
-anti-inflammatory therapy
-immunologic enhancement
-oxygen therapy via insufflation

23
Q

What are the supportive therapies for bacterial pneumonia?

A

-rest
-stress reduction
-nutrition
-adequate ventilation
-hydration

24
Q

Which viruses are involved in viral pneumonia?

A

-EHV1
-EHV4
-EHV5
-equine influenza virus
-equine viral arteritis

25
Q

What are the primary pathogens for fungal pneumonia?

A

-Blastomyces dermatitidis
-Coccidioides immitis
-Cryptococcus neoformans
-Histoplasma capsulatum
-Aspergillus spp.
-Pneumocystis carinii

26
Q

What is important about Pneumocystis carinii?

A

it is an opportunist; if it is causing infection, it indicates that there is immune deficiency

27
Q

What are the contributing factors to fungal pneumonia?

A

-exposure to large numbers of mycotic organisms in environment
-stabling of horses in moist environment
-prolonged administration of antibiotics
-immunosuppression
-neoplasia

28
Q

What are the clinical signs of fungal pneumonia?

A

-chronic cough
-anorexia and weight loss
-exercise intolerance
-nasal discharge
-non-responsive to antibiotics
-pleural effusion
-tachypnea/resp distress

29
Q

What are the findings on transtracheal wash that indicate fungal pneumonia?

A

-degenerate neutrophils
-yeast
-bacteria

30
Q

Why must TTW and BAL be interpreted carefully when evaluating for fungal pneumonia?

A

fungi can be picked up incidentally from the nose and skew results

31
Q

What findings on radiographs can indicate fungal pneumonia?

A

-circular masses
-accentuated interstitial pattern
-pleural effusion

32
Q

How is fungal pneumonia treated?

A

months of antifungal medication

33
Q

Which antifungals are used to treat fungal pneumonia?

A

-amphotericin B
-natamycin
-azoles, but not well absorbed in horses

34
Q

Which parasite is able to cause pneumonia in horses?

A

Dictyocaulus arnfieldi

35
Q

What are the characteristics of Dictyocaulus arnfieldi?

A

-donkeys and mules are asymptomatic carriers
-occurs in foals more than adults
-should always ask if horses are housed with donkeys/mules

36
Q

What is the pathogenesis of Dictyocaulus arnfieldi?

A

-prepatent period of 2-4 months
-can have donkey-horse or horse-horse transmission
-adults live in airways and cause inflammation

37
Q

What must occur in order for horses to acquire Dictyocaulus arnfieldi?

A

they must be on pasture, since the parasite has environmental requirements

38
Q

How do earthworms contribute to Dictyocaulus arnfieldi spread?

A

earthworms can ingest the larvae and move across the pasture without harming the larvae

39
Q

How does the fungus Pilobolus contribute to Dictyocaulus arnfieldi spread?

A

fungus develops on manure piles and disperses the larvae with its spores

40
Q

What are the clinical signs of Dictyocaulus arnfieldi?

A

-possibly asymptomatic
-chronic cough
-bilateral nasal discharge
-increased resp rate and effort
-crackles and wheezes
-similar signs to asthma

41
Q

How is Dictyocaulus arnfieldi diagnosed?

A

-TTW/BAL to look for eosinophils
-ID of parasite in sediment of centrifuged mucus
-Baermann fecal exam

42
Q

How is Dictyocaulus arnfieldi treated and prevented?

A

-ivermectin or moxidectin
-separate horses from donkeys and other known carriers

FA2 Respiratory (24 decks)

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