Lung disease- alveolar disease Flashcards
List 4 clinical signs of pulmonary parenchymal disease
Increased inspiratory/expiratory effort
+/- cough
+/- hemoptysis (coughing up blood) - not that common
Collapse/syncope or cyanosis
Sometimes see minimal signs even though severe pathology present (esp cats)
Define haemoptysis
coughing up blood
Where are cough receptors present: alveoli or airways
airways
there are no cough receptors in the alveoli
What do crackles on lung ausultation tell you
that air is being dragged through fluid
List 5 clinical signs of aspirations pneumonia
cough
harsh/ reduced lung sounds
tachypnoea
pyrexia
check oxygenation
Where does aspiration pneumonia commonly like to occur
in the cranial lung lobes
common in patients that have been vomiting
What do radiographs show when we have aspirational pneumonia
alveolar infiltrate (patchy or focal)
How to you confirm diagnosis of aspiration pneumonia
BAL- cytology, check for neutrophils/ toxic neutrophils
You suspect aspiration pneumonia and confirm the diagnosis with BAL and cytology. What antibiotics will you treat with?
Ideally based on C and S
Broad spectrum antibiotics as often not sure what we’re dealing with
Need to penetrate, dissolve in blood-bronchus barrier- lipophilic antibiotics penetrate this best
List 7 Examples of alveolar disease
Aspiration pneumonia
pulmonary oedema (cardio vs non-cardio)
pulmonary haemorrhage
eosinophilic lung disease
pulmonary parasites
pulmonary neoplasia- primary/ metastatic
infectious pneumonias
Describe how you would treat aspiration pneumonia
supportive care: oxygen therapy, antibiotics
Treat any underlying cause
Consider anti-acid medication if frequent occurence
Metoclopramide to improve motility and increase lower oesophageal sphincter tone
What is pulmonary oedema
when there is fluid accumulation in the interstitium and subsequently in the alveoli at a rate that exceeds removal
What (physiologic) conditions can pulmonary oedema be a consequence of
Increase hydrostatic pressure
reduced oncotic pressure
increased vascular permeability
impaired lymphatic drainage
What are the two types of pulmonary oedema and what types of fluid are formed in each?
Cardiogenic - due to increased hydrostatic pressure; fluid is building up behind the failing heart - fluid formed is low-protein
Non-cardiogenic - the result of lung damage that increases vascular permeability and so protein leaks out - fluid formed is high protein
List 6 Possible causes of non-cardiogenic pulmonary oedema
most commonly: pulmonary epithelial injury
Choking
Near-drowning
Electric shock
Head trauma
smoke inhalation
SIRS
