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Cardiopulmonary (Estrada-Fall 2014) > Lecture 17: Disease of the Lower RT (Specht) > Flashcards

Lecture 17: Disease of the Lower RT (Specht) Flashcards

1
Q

Bacterial pneumonia more common in dogs/cats?

A

dogs

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2
Q

routes on infection for bacterial pneumonia

A

inhalation
aspiration
hematogenous spread

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3
Q

bacterial pneumonia CS

A

Can be acute/chronic/mild/severe

  • coughing and dyspnea*
  • fever
  • nasal d/c
  • cyanosis
  • crackles
  • non-specific anorexia, dehydration, weight loss
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4
Q

Dx of bacterial pneumonia

A
  • inflammatroy leukogram
  • interstitial or alveolar pattern in rads
  • TTW/BAL/pulmonary aspirate positive culture***
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5
Q

Tx of bacterial pneumonia

A
  • Abx (based on culture/sensitivity!) until at least 2 weeks after complete resolution of all clinical/rad signs
  • supportive care (hydration, nutrition, turning)
  • O2
  • nebulization, coupage, mild exercse to loosen phlegm
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6
Q

prog. of bacterial pneumonia

A
  • fair to good

- affected by severity, underlying conditions, complications

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7
Q

2 main causes of viral pneumonia

A

canine distemper, flu

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8
Q

tx of viral pneumonia

A

supportive care

tx of 2ary bacterial infections

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9
Q

route of infect./CS of fungal pneumonia

A

inhalation, hematogenous

CS: cough, dyspnea, lethargy, weight loss, anorexia

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10
Q

dx of fungal pneumonia

A
  • rads show diffuse interstitial pattern or hilar lymphadenopathy
  • cytology/culture/histo (i.e. TTW, BAL, pulmonary aspirate) have pyogranulomatous/eosinophilic inflamm. + organisms assoc. with macs**
  • serology possible
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11
Q

tx/prog. of fungal pneumonia

A

Tx: antifungals 1-2 mo. after resolution, oxygen therapy, +/- steroids
Prog: fair to poor, requires long-term tx

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12
Q

aspiration pneumonitis

A
  • occurs when foreign material enters the lungs
  • can be 2ary to v, dysphagia, megaesophagus, force-feeding, feeding tubes, etc.
  • can be followed by 2ary bact. infection
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13
Q

dx of aspiration pneumonia

A

classic: alveolar pattern in R middle lung lobe on rads**
+/- megaesophagus
-cytology/cutlure

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14
Q

tx of aspiration pneumonia

A
  • symptomatic care (O2, nebulization, coupage, exercise)
  • abx only if no improvement, inflammatory leukogram worsens, fever develops, or animal has been on H2 blockers or proton pump inhibitors
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15
Q

prog. of aspiration pneumonia

A

depends…mild to fatal

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16
Q

number 1 differential for asthma**

A

pronounced expiratory effort

17
Q

feline bronchitis (asthma)

A

dz char. by wheezing, coughing, dyspnea due to spontaneous bronchoconstriction

18
Q

contributing factors of asthma

A
  • bronchospasm
  • bronchial smooth m./epithelial hypertrophy
  • inc. mucus prod. or dec. clearance
  • inflamm. exudate w/n lumen or of airway walls
  • fibrosis
  • emphysema
  • airway hypersensitivity
19
Q

only potential difference between asthma and bronchitis

A

asthma may have more eos in wash than bronchitis

20
Q

CS of feline bronchitis

A
  • young/middle aged
  • small airway obstruction –> sudden dyspnea; cough/wheezing/crackles, inc. expiratory effort
  • slowly progressive pathology
  • exacerbated by env. changes
21
Q

Dx of feline bronchitis (asthma)

A
  • history, CS, PE**
  • TXR: bronchial wall thickening/pulm. hyperinflation
  • TW/BAL cytology (inflammaotry, cultures usually negative)
  • HW Ag and Ab tests
  • Fecal
22
Q

Tx of feline bronchitis

A
  • airway management
  • env. mod.
  • long-term corticosteroids
  • bronchodilators
23
Q

Prog. of feline bronchitis

A
  • poor for complete cure
  • fair to good for control of CS
  • sudden death possible
24
Q

canine chronic bronchitis

A

long-term airway inflamm. probably assoc. with irritants, recurrent infection, allergies. Targets overweight, small to medium breedsover 5 yo

25
Q

CS of canine chronic bronchitis

A

-progressively worsening dry cough exacerbated by excitement

+/- wheezes, crackles

26
Q

Dx of canine chronic bronchitis

A

TXR:
-prominent bronchial pattern +/- interstitial
-bronchiectasis if severe
-R sided cardiomegaly if severe (cor pulmonale)
Tracheal wash:
-cytology: nonspecific inflamm., excess mucous
-culture: generally negative
Bronchoscopy:
-membranes hyperemic, edematous, excess mucous, small airway collapse

27
Q

Tx of canine chronic bronchitis

A

focused on relieving CS, not curing**

  • glucocorticoids
  • bronchodilators
  • cough suppressants
  • antibiotics
28
Q

Pulmonary Thromboembolism

A

thrombosis or embolism causes perfusion/ventilation mismatch (increased V/Q)**

  • dec. cardiac output, inc. pulmonary resistance, bronchoconstriction
  • loss of surfactant, infarction
29
Q

virchow’s triad

A

describes the three broad categories of factors that are thought to contribute to thrombosis:

Hypercoagulability
Hemodynamic changes (stasis, turbulence)
Endothelial injury/dysfunction
30
Q

Dz assoc. with pulmonary thromboembolism

A
  • hyperadrenocorticism
  • pancreatitis
  • sepsis
  • IMHA
  • trauma/surgery
  • DIC
  • Protein-losing nephropathy
31
Q

CS of pulmonary thromboembolism

A

SUDDEN ONSET** of resp. distress, dyspnea, tachypnea
+/- increased breath sounds
tachycardia
shock, hemoptysis, syncope, collapse, death

32
Q

Dx of pulmonary thromboembolism

A
  • presumptive
  • coag. panels
  • TXR: usually do NOT rule out PTE***, but may wee hypovascular regions/blunted pulmonary vessels
  • angiography, scintigraphy
33
Q

Tx of PTE

A
  • supportive care
  • anticoagulants
  • fibrinolytic meds (streptokinase, TPA)
34
Q

Prog. of PTE

A
  • guarded/poor
  • depends on severity
  • risk of sudden death
35
Q

Chars. of pulmonary/bronchial neoplasia

A
  • 1ary neoplasia RARE
  • common site of mets
  • older animals
  • variable CS: cough, tachypnea, dyspnea, pleural space problems, hypertrophic osteodystrophy
36
Q

Dx/Tx/Prog. of pulmonary/bronchial neoplasia

A

Dx: imaging for localization (rads, CT, bronchoscopy), cytology/biopsy for defin. dx
Tx: sx, chemo, radiation, palliative tx (alleviating pain)
Prog: complete excision possible

37
Q

eosinophilic bronchopneumonopathy

A
  • wide spectrum of disorders char. by severe eosinophilic infiltration
  • variable CS
38
Q

eosinophilic bronchopneumonopathy Dx/Tx/Prog.

A

Dx: R/O other causes, +/-eosinophilia in peripheral blood, cytology/biopsy with eos infiltration
Tx: steroids
Prog: variable

39
Q

bronchiectasis

A
  • permanent dilation of bronchi
  • complication of chronic resp. dz such as chronic bronchitis
  • extremely susceptible to infection
  • sx removal possible
  • prognosis guarded to poor

Cardiopulmonary (Estrada-Fall 2014) (9 decks)

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