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SA Respiratory > Pathologies underpinning clinical disease > Flashcards

Pathologies underpinning clinical disease Flashcards

1
Q

Clinical signs of URT disease

A

Nasal discharge

Sneezing

Difficulty breathing

Loss of appetite

Head shaking/pawing at face

Facial deformity

Other systemic signs

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2
Q

Aetiologies in URT disease

A

congenital malformation
infections
toxins
trauma
tumours
metabolic/nutritional
hypersensitivity/allergy
iatrogenic
idiopathic

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3
Q

Rhinitis

A

Inflammation of the nasal passages

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4
Q

Viral sinusitis/rhinitis

A

Often remains localised
Discomfort without serious disease
Occasionally more serious disease

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5
Q

Signs of acute rhinitis

A

Serous nasal discharge
Hyperaemia and oedema: reddened mucosa
Exudation of serum and neutrophils

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6
Q

Signs of chronic rhinitis

A

Mucopurulent nasal discharge
oedema
proliferation of mucosa: thickening
exudation of neutrophils and mucus
infiltration by lymphocytes and plasma cells

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7
Q

Bacterial rhinitis/sinusitis

A

Contributes to inflammation

Exudate becomes purulent

regression takes about 1-2 weeks

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8
Q

Fungal rhinitis/sinusitis

A

Aspergillus fumigatus

Discharge often dark/bloody, can be smelly

induces a glanulomatous plaque or nodule

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9
Q

Parasitic sinusitis/rhinitis

A

Linguatula serrata

Zoonotic

Pentastomida family - ‘degenerate’ parasite

tongue shaped

indirect lifecycle

embeds forebody into nasal mucosa

generally asymptomatic

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10
Q

Allergic rhinitis

A

hay fever in man, which is an immediate hypersensitivity reaction mediated by IgE antibody

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11
Q

Fungal rhinitis radiography

A

Areas of decreased opacity
unilateral or bilateral conchal destruction
punctate lucencies may be seen in surrounding bone
may see poorly circumscribed mass in caudal nasal chamber and frontal sinuses
frontal sinus involvement may occur with thickening or lysis of the frontal bones

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12
Q

Benign neoplasms in URT

A

osteoma
chondroma
haemagioma
nasal polyps
cysts
progressive ethmoid haematoma

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13
Q

Features of BOAS

A

Soft palate too long - mild trauma during respiration so becomes swollen and oedematous

may overlap with epiglottis

can have eversion of laryngeal saccules

stenotic nares

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14
Q

Clinical signs of pharyngeal disease

A

Gagging, retching, choking

cough

discomfort/pain

difficulty swallowing, eating, anorexia

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15
Q

Nasopharyngeal polyps

A

in the cat

may also obstruct the nasal passages or may occlude the pharynx

have a fibroblastic core with many lymphocytes and plasma cells

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16
Q

Clinical sign of laryngeal disease

A

Difficulty breathing, asphyxia, death

Difficulty eating

Reduced performance on exercise, exercise intolerance

change in vocalisation

noise on inspiration/expiration

coughing

snorinng

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17
Q

Laryngeal oedema

A

common feature of any acute inflammation

potential for obstruction of the laryngeal orifice (narrowest part)

Can cause sudden death

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18
Q

Laryngeal paralysis

A

in horses often unilateral (roaring)

in dogs often bilateral

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19
Q

Causes of laryngeal paralysis

A

Idiopathic neuronal degeneration (most common)

Hypothyroidism (dogs)

Congenital abnormalities of the recurrent laryngeal nerve and brainstem (young age)

Secondary compression or inflammation of recurrent laryngeal nerve

Toxins

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20
Q

Where is mucus secreted from in the bronchioles

A

non-ciliated Clara cells

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21
Q

Clinical signs of pathology in the conducting airways

A

Difficulty breathing

cough

respiratory noise (ausculatation)

exercise intolerance

reduced production performance

nasal discharge?

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22
Q

Hypoplastic trachea

A

diameter of the trachea is relatively narrow compared with the size of the dog and other parts of the respiratory system

may occur alone or be part of a broader complex of Brachycephalic Obstructive Airway Disease (BOAS

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23
Q

Tracheal collapse

A

toy and miniature breeds of dog

dorsoventral flattening of the trachea accompanied by widening of the dorsal tracheal membrane

defect involves the entire length of the trachea

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24
Q

Tracheal stenosis

A

narrowing of the tracheal lumen and is often segmental

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25
Q

Peri-tracheal masses

A

abscesses
neoplasia
goitre
lymphadenopathy

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26
Q

Obstruction of the trachea

A

masses
foreign bodies
mucus
exudates
froth
congestion and oedema
aspiration of vomitus
Oslerus (Filaroides) osleri

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27
Q

Oslerus (Filaroides) osleri

A

Metastrongyle - but atypical

adult found in nodule at tracheal bifurcation

Transmission for bitch to pups (horizontal rare)

often asymptomatic but can lead to dry, debilitating cough

use anthelmintics to diagnose

28
Q

Tracheitis

A

inflammation of the trachea

rarely found alone

usually accompanies URT infections

29
Q

Bronchitis

A

more common than tracheitis

30
Q

Canine infectious respiratory disease/canine infectious tracheo-bronchitis/ kennel cough

A

Highly transmissible

Contact with (kennelled) dogs

Complex aetiology

Various infectious agents identified

Prolonged, non-productive harsh cough; can persist >3 weeks

Usual outcome is recovery but chronic bronchitis/bronchopneumonia can occur - lesions are neither specific nor always significant (catarrhal/mucopurulent tracheobronchitis)

Requires prolonged treatment (tetracycline x 4 wks)

Vaccine.. Effective?

31
Q

Acute bronchitis

A

not common

usually diffuse when significant

often due to virus infection

secondary bacterial infection can make it worse

leads to loss of cilia and lysis of infected cells

32
Q

Chronic bronchitis

A

chronic coughing, inflammatory changes in the bronchi, thickening of lamina propria

sometimes focal nodules of granulation tissue

hypersecretion of mucus

can terminate in type 2 respiratory failure

33
Q

Bronchiectasis

A

when bronchus has been subjected to prolonged inflammation

dilation of the the bronchus

increased intrabrochial pressure by copious purulent exudate, traction on the damaged bronchus by surrounding tuissue

chronic cough and foul odour to breath

34
Q

Ciliary dyskinesia

A

autosomal-recessive congenital disease

genetic defect is of one of the dynein genes

outer and/or inner dynein arms that give cilia their motility

primary defects consist of absent inner dynein arms, absent radial spokes and absence of the central microtubules

results in immotile cilia or dysplastic cilia

Failure of ciliary clearance means that respiratory infections are more likely to become established

35
Q

Allergic bronchial disease

A

Bronchospasm causes a reduction in the diameter of the conducting airways and hence an increased resistance

In humans bronchospasm commonly occurs due to a Type 1 hypersensitivity reaction (asthma)

Feline allergic bronchitis - on radiogrpahs the inflamed lower airways look like mini doughnuts in normally black lung tissue
recurrent airway obstruction (COPD, heaves)

36
Q

Bronchial neoplasia

A

Bronchial carcinoma is the most common - develops in the epithelial cells of the bronchial MM

metastasizes in the bronchial LNs

37
Q

Acute viral pneumonia

A

acute epithelial pneumonias

acute inflammation in the bronchioles and alveoli with accompanying striking changes in the epithelia of these structures

necrosis of type I alveolar epithelium

Canine distemper, parainfluenza virus, feline calicivirus, FIP

affected lungs are pink/red, oedematous, smooth appearance

38
Q

Parainfluenza virus (type 2 in dogs)

A

proliferation of alveolar and bronchiolar epithelium

eosinophilic cytoplasmic inclusion bodies

39
Q

Adenovirus

A

Bronchiolar epithelial necrosis
basophilic and eosinophilic intranuclear inclusion bodies

40
Q

Feline calicivirus

A

Proliferation of alveolar epithelium (type II pneumocytes)

41
Q

FIP virus

A

necrotising vasculitis
alveolar oedema

42
Q

Feline coronavirus pneumonia (feline infectious peritonitis virus)

A

Causes focal necrotising vasculitis

43
Q

Acute exudative (bacterial) pneumonia

A

lesion involves bronchioles and alveoli in an acute inflammatory reaction

congestion of the bronchiolar walls and infiltration of their lumen by neutrophils

neighbouring alveoli also become congested and have oedema fluid and neutrophils

Initially the lesion has a patchy (lobular) distribution in an area of lung

Continuing spread, however, means that lobular areas of consolidation are eventually produced

44
Q

Chronic pneumonia

A

develops as an insidious onset chronic non-suppurative reaction in the lungs, or as a sequel to unresolved or complicated acute pneumonias

fibrosis - reduced lung compliance
thickening of alveolar walls - impaired gas diffusion from alveoli

45
Q

Aspiration pneumonia

A

appearance of an acute necrotising exudative pneumonia

bacteria capable of causing tissue necrosis that become trapped in the small bronchioles

If not particularly virulent bacteria involved then causes granulomatous pneumonia with large numbers of multinucleated giant cells forming around the aspirated material

lipid pneumonia occurs when substances such as liquid paraffin are aspirated into the lungs, alveoli become filled with macrophages that have foamy cytoplasm

46
Q

Hypostatic pneumonia

A

In recumbent animals an area of congestion and oedema may become established at a site in the lower lung dictated by gravity

47
Q

Acute diffuse alveolar damage (DAD)

A

affects all the lobes of the lungs diffusely

primarily due to damage to the alveolar walls

early exudative phase characterised by extensive alveolar congestion and oedema and hyaline membrane formation

develops acute respiratory distress and may die in respiratory failure

second proliferative phase develops in which the early lesions are taken over by hyperplasia of alveolar type II pneumocytes in the alveolar walls

48
Q

Pulmonary oedema

A

Accumulation of fluid in the lungs

Massive pulmonary oedema affecting more or less all of the lungs may develop in diffuse alveolar damage (DAD)

most common cause is (acute) left-sided heart failure

severe pulmonary oedema lungs are red, heavy and swollen due to congestion and excess fluid

invariably fatal due to respiratory failure

49
Q

Acute left sided heart failure

A

the blood pressure at the venous end of the pulmonary capillaries may rise to in excess of the osmotic pressure

fluid therefore passes into the interstitium of the lung

Within a matter of minutes the whole lung can become saturated with oedema fluid

similar scenario occurs in moderate/severe chronic left-sided heart failure, over a longer time scale

50
Q

Irritant gases

A

e.g. ammonia, chlorine or sulphur dioxide

cause pulmonary oedema if inhaled in quantity

increased permeability which allows fluid and plasma proteins to pass out

loss of plasma protein into the alveoli lowers the effective colloid osmotic pressure and further aggravates the development of oedema

51
Q

Causes of pulmonary oedema

A

left sided congestive heart failure

iatrogenic fluid overload

hypoalbuminaemia (liver disease, nephrotic syndrome, protein losing enteropathy)

pulmonary vascular damage

pulmonary epithelial damage

52
Q

Neurogenic pulmonary oedema

A

can be produced in rats and rabbits by injecting a small volume of a fibrin-forming mixture of plasma proteins into the subarachnoid cistern

53
Q

Allergic pulmonary oedema

A

marked increase in respiratory rate due to the development of massive acute pulmonary oedema

pathogenesis is not known

54
Q

Pulmonary hypertension

A

occurs when the blood pressure in the pulmonary artery rises above the normal

develops from diseases of the heart or lungs that elevate pulmonary vascular resistance and it may be classified into primary and secondary forms

55
Q

Primary pulmonary hypertension

A

due to intrinsic changes in the pulmonary arterial system causing increased resistance to blood flow through the lungs

exemplified by high altitude disease in which the low partial pressure of oxygen in the inspired air causes reflex pulmonary arterial vasoconstriction

56
Q

Secondary pulmonary hypertension

A

passive:
- results from chronic left heart failure elevating the pressure in the pulmonary veins

obstructive:
- follows progressive diminution of the vascular bed in the lungs from embolism, destructive emphysema or chronic pneumonia

hyperkinetic:
- due to blood entering the pulmonary circulation in greater volume or at a higher pressure than usual and exists, for example, in young animals with large ventricular septal defects

57
Q

Allergic asthma

A

caused by a hypersensitivity reaction in bronchial system

Generalised airway obstruction follows from bronchospasm associated with mucus secretion, oedema of bronchial walls and a cellular infiltration containing many eosinophils

Most cases are due to a type I hypersensitivity reaction in the bronchial system mediated by IgE

58
Q

Primary pulmonary neoplasia

A

relatively uncommon in domestic animals

usually adenocarcinomas

locally invasive

some metastasize, occasionally to bone

59
Q

Secondary pulmonary neoplasia

A

arising from many and varied sites elsewhere in the body

mammary carcinoma: cats, dogs
thyroid carcinoma: cats
haemangiosarcoma: dogs

60
Q

Hypertrophic osteopathy

A

Maries disease

occurs in some cases of pulmonary neoplasia (primary or secondary)

61
Q

Pleurisy

A

inflammation of the pleura

classified according to the nature of the inflammatory exudate

Fibrinous pleurisy may involve the entire surface of a pleural cavity to be localised to an underlying area of inflammation

When there is a large volume of pleural fluid, the adjacent lung collapses

may resolve completely or become organised to form fibrous adhesions

62
Q

Empyema (pyothorax)

A

collection of pus within a pleural cavity and is associated with purulent pleurisy

lung adjacent to the empyema will collapse, will not reinflate even after the pus is drained from the thoracic cavity

E.g. pyogranulomatous pleuritis caused by Nocardia asteroides in dogs (blood stained pus with sulphur granules); feline infectious peritonitis (FIP) due to feline coronavirus infection in the cat that can present as a “dry” (pyogranulomatous) or “wet” (effusive) form

63
Q

Pneumothorax (air)

A

may accumulate either bilaterally or unilaterally in the pleural cavities and cause pulmonary collapse

usually due to either penetrating injuries of the chest wall or apparently spontaneous rupture of the pulmonary tissue

torn area acts like a one-way valve allowing air to enter the pleural space during inspiration and trapping it there during expiration

most frequently seen in dogs or cats that have been involved in car accidents

64
Q

Hydrothorax (sterile fluid)

A

fluid is sterile and the serous membranes look normal

collects in the ventral part of the thorax first and collapses the lower part of the lungs

may be found in animals with congestive heart failure, anaemia, tumour masses at the thoracic inlet compressing the thoracic duct (e.g. thymic lymphoma in the cat) and tumour metastases on parietal pleura (e.g. bronchial carcinoma)

65
Q

Chylothorax

A

accumulation of chylous fluid (lymph rich in triglycerides) in the thoracic cavity

due to rupture of major lymph vessels in the thoracic cavity

66
Q

Nocardia asteroides

A

Uncommon, in dogs more than cats

route of infection - penetrating wound or possibly inhaled?

Chronic suppurative pneumonia and pleurisy

refractory to antimicrobials

pyogranulomas with ‘sulfur granules’

gram +ve, acid fast bacterium, aerobic

67
Q

Diaphragmatic rupture

A

occurs occasionally in dogs and cats with traumatic injuries especially following road accidents

torn at its attachment to the ribs or less frequently near its centre

mobile abdominal organs such as the stomach, small intestines or lobes of the liver pass into the thorax where they compress the lungs, causing respiratory difficulty

SA Respiratory (6 decks)

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