Lower Respiratory Flashcards
What clinical signs can be seen with lower airway disease?
Cough Exercise intolerance Weakness Cyanosis Synope Fever Anorexia Weight loss Depression Rare but vomiting
How do you divide coughing?
Productive
Non-productive
What does productive mean?
Usually inflammation or infectious of the airways or alveoli.
What is hemoptysis and what is it commonly caused by?
Hemoptysis is coughing up blood and commonly occurs with heartworm disease or pulmonary neoplasia
Coughing cats the suspicion for what diseases are high?
Bronchitits
Lung worms
Heartworms.
Animals with severe respiratory distress but a clear thorax usually are dealing with?
Lagging pathology
PTE
Mineralized nodules are seen in what disease?
Histoplasmosis
Cystic/cavitary pulmonary lesion in a cat?
Paragonimus
Neoplasia
Traumatic bulla
Abscess, granuloma
What type of 99mTc is used for mucocillar clearnace?
99mTc - Albumin
Chronic bronchitis is commonly seen in what dogs?
Terriers
Cocker spaniels
Poodles
What other common problem is seen with ciliary diskensia?
Low sperm motility
What percentage of cats get pneumonia via hematogenous spread?
50% of all pneumonias according to one 2003 study
Diagnosis of distemper?
Conjunctival scrapings
What is one thing that can be done to look for gas if concerned for an abscess?
Horizontal beam…. a lateral will not show gas very well.
Histoplasmosis is commonly seen in what other organ besides the lungs and GI in cats?
Eyes - Chorioretinitis
Miliary lung pattern in dogs is created by what etiologies?
Fungal Neoplasia Parasitic Atypical bacterial (mycobacterial) Eosinophilic
What intestinal parasite is likely to have transient pneumonia secondary to larvae migration?
Toxocara canis - seen in puppies
What are the four common lung worms?
Capillaria aerophila - rare
Paragonimus - flukes (Great lakes, Midwest, southern US)
Aelurostrongylus - cats
Crenosoma vulpis - foxes and dogs (Atlantic canada and europe
What lungs does paragonimus usually reside?
Caudal lung lobes - causing granulmas
More common in cats
Paragonimus can cause what if the cyst ruptures?
Pneumothorax.
Aelurostrongylus can mimic what other parasite?
HW - causing pulmonary arterial enlargement
Idiopathic interstitial pneumonia generally denotes inflammation of what?
Alevolar septa
interstitial pneumonia has what differential list?
Idiopathic Eosinophilic Systemic lupus Allergic Toxins (smoking) Neoplasia
What needs to be excluded to make the diagnosis of idipathic pulmonary fibrosis?
Drugs/Toxins
Environmental exposures
Collagen vascular diseases
What is the histopathologic difference between idiopathic pulmonary fibrosis in cat/humans and dogs?
Dogs deposit collagen with no fibroblastic foci.
Pulmonary fibrosis requires a what for definitive diagnosis?
Biopsy.
Predominant carcinomas of the lungs?
Adenocarcinoma
Bronchoalveolar carcinoma
SCC
How can primary lung tumors cause anemia?
Erode the vessels and cause bleeding.
Pulmonary hypertension is what?
Pulmonary systolic pressure >30mmHg - needs cardiac catheterization for definitive diagnosis
Doppler echocardiography can estimate pulmonary artery pressure where?
Pulmonary or tricuspid valvular insufficiency
Three ways to cause pulmonary hypertension?
Venous obstruction
Increased pulmonary blood flow by congential lesion
Increased vascular resistance.
Increased vascular resistance can happen due to?
Response to V/Q (ventilation and perfusion) mismatch.
Chronic lung disease
PTE
HW
Endothelial dysfunction
Vascular remodeling - VenoOcclusive disease
What does A-a gradient mean?
Alveoli-arteriol gradient. The amount of oxygen in the alveoli vs in the blood. It tells you how well the transfer of blood is happening.
Ex. High A-a gradient when there is a PTE or right to left shunt. High Alveoli concentration of O2 but low arteriol.
What is V/Q mismatch?
When ventilation does not match perfusion… ex PTE, chronic lung disease.
Why are the lungs a common place for PTEs?
Slow flow area.
Etiologies that predispose animals to PTE?
Trauma Surgery Hyperviscosity Neoplasia Cushings IMHA Hyperlidemia Glomerulopathies Pancreatitis Cardimyopathies.
Where do most PTEs occur?
Caudal lungs
Radiographic signs of a PTE?
Blunted arteries Wedge shaped alveolar or interstitial patterns Hyperlucent lungs Right sided heart enlargement Mild pleural effusion
Etiologies for pulmonary edema
Hypoalbuminemia Toxins - Cisplatin in cats, snake venom Uremia Pancreatitis PTE Neurogenic - Seizures and head trauma.
What other clinical signs are seen with ciliary dyskansia?
Sperm motility
Earing loss
Hydrocephalus
What is Kartaganders consist of?
Ciliary dyskansia
rhinosinusitis
Bronchiectasis
Situs inversus
MPA to Aorta ratio for hypertension on CT?
> 1.6 is considered hypertension
Other weird reason for pulmonary hypertension?
Chronic PTE
Where are most PTEs located?
Caudal lungs
Specific thrombus window and level is?
100 WL and 700WW
What is another reason for airtrapping and dilated bronchi see on CT besides bronchial disease?
PTE
Tracheal in cats is rare and likely secondary to what?
Other obstructive disease…. trauma, FB
Oslerus osleri is seen in what age of dog?
YOUNG 2 yo or less
What are the common mycotic diseases?
Blastomycosis
Histoplasmosis
Coccidiodmycosis
What CT sign is indicative of pulmonary fibrous?
Honeycombing
What is the number 1 mediastinal mass in cats?
Lymphoma
Others include
Thyroid carcinoma
thymoma
parathyroid carcinoma
Common cause for pyothorax?
idiopathic
When to check a pyothorax on rads?
1-2 days to ensure chest is empty.
The day of removal of chest tube
1 week after removal and 1 month after removal.
Easy ddx for panting or tachypneic dog?
Systemic hypertension
