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Respiratory > Pleural Diseases > Flashcards

Pleural Diseases Flashcards

1
Q

What is the lung pattern on the image? What is a likely diagnosis?

A

Nodular interstitial pattern - Pulmonary metastasis

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2
Q

What is the most likely reason the cardiac silhouette and the diaphragm are not clearly visible?

A

Pleural effusion - opacity, fissure lines and lungs away from walls

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3
Q

A lucent space between the cardiac silhouette and the sternum is visible. What condition does this appearance indicate?

A

Pneumothorax

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4
Q

On the DV view, what is the lucent area in the left thorax?

A

Pneumothorax

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5
Q

What is the oblong soft tissue opacity visible on the left side of the cardiac silhouette on the DV view?

A

Collapsed lung

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6
Q

What is the location of the mass visible in this radiograph?

A

Mediastinum

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7
Q

What are the three most common cranial mediastinal tumours in the dog?

A

Thymoma - Lymphoma/lymphosarcoma - Haemangiosarcoma

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8
Q

What are possible cause(s) of the radiographic signs in this lateral view?

A

Diaphragmatic hernia and consolodated lung

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9
Q

What is your diganosis of this image? How did they obtain this image?

A

Diaphragmatic hernia - Barium meal

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10
Q

Why are the two vessels below the trachea in the cranial thoracic cavity visible?

A

Pneumomediastinum

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11
Q

What is your diagnosis and why?

A

Diaphragmatic hernia - Tubular gas filled structures, lack of cranial diaphragmatic outline

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12
Q

What is your diagnosis? Why?

A

Pleural effusion - Normally can’t see aerated lung on ultrasonography, black colour consistent with fluid

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13
Q

What is the pathogenesis of Equine Pleuropneumonia?

A

Mixed bacterial infections of commensal upper tract bacteria - Infection after suppression of pulmonary defence - Inhalation of bacteria to produce cranioventral distribution

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14
Q

What is equine pleuropneumonia associated with mainly? Why?

A

Long transport of horses - Head tied up so gravity can’t help with mucocilary escalator

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15
Q

What are the clinical signs of acute equine pleuropneumonia?

A

Pyrexia - Lethargy - Slight nasal discharge - Shallow breathing - Guarded cough

Ongoing - Nostril flare - Tachycardia - Increased pulse height - Toxic mucous membranes

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16
Q

What are the clinical signs of chronic equine pleuropeumonia?

A

Intermittent fever - Weight loss - Ventral & limb oedema (hypoproteinaemic)

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17
Q

In a physical exam of a horse with equine pleuropneumonia, what would you expect to find?

A

Ventral dullness on percussion

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18
Q

What is the most useful diagnostic tool with equine pleuropeumonia? Why?

A

Ultrasonography - confirms presence of pleural fluid as well as giving volume, location and character estimation

19
Q

What do bubbles in ultrasonography in a horse with pleuropneumonia indicate?

A

Presence of anaerobic bacteria

20
Q

How would you sample fluid in equine pleuropneumonia? Why?

A

Transtracheal aspirate - Make sure the sample isn’t contaminated by upper airway bacteria

21
Q

What are the four aims of equine pleuropneumonia treatment?

A

1) Remove excess fluid
2) Antibiotics
3) Anti-inflammatory and Analgesics
4) Supportive care

22
Q

What is a thoracocentesis?

A

Drainage of fluid from the thorax

23
Q

What are the potential complications of equine pleuropneumonia?

A

Pulmonary abscess (cranial mediastinal) - Pleural adhesion - Bronchopleural fistula - Constructive pericarditis - Lamenitis - Diahrroea

24
Q

What is it called when an animal is reluctant or unable to lie in lateral recumbency?

A

Orthopnoea

25
Q

What would displace the apex beat on palpation?

A

Lesion or ruptured diaphragm

26
Q

When doing further investigation of suspected pleural effusion, what do you need to establish?

A

Establish the presence of pleural fluid - Obtain a sample to relieve breathlessness and assist in diagnosis

27
Q

When performing a thoracocentesis, what must you remember to do?

A

Maintain a closed system

28
Q

What should you collect the pleural fluid in for a) cytology b) biochemistry?

A

a) EDTA tube
b) Plain tube

29
Q

What five things should you analyse in the pleural fluid?

A

Cytology (for predominant cell type) - Gram Stain (type of bacteria) - Total protein - Triclyceride and cholesterol levels (chylous fluid) - Bacterial culture and sensitivity

30
Q

What is pneumothorax indicated by in a radiograph?

A

Dark space around the lung - Lung lobes collapsed and more dense

31
Q

What is the most effective way to manage pleural effusion?

A

Treating the undelying disease

32
Q

Give six examples of underlying causes of pleural effusion?

A

Lung lobe torsion - Righ-sided heart failure - Neoplastic effusion - Transudate due to hypoproteinaemia - FIP - Diaphragmatic hernia

33
Q

What is the difference between pleural effusion and pyothorax?

A

Pyothorax is very similar apart from the higher protein and viscous nature of the pleural fluid

34
Q

What treatment would you use for pyothorax?

A

Thoracocentesis and Systemic antibiotics

35
Q

Describe two more aggressive methods of managing pyothorax

A

Implant indwelling drains within pleural space with systemic antibiotics

Exploratory thoracotomy

36
Q

When would exploratory thoracotomy be the only viable option for treatment of pyothorax?

A

When there is a migrating foreign body - Extension of disease from a region of the lung

37
Q

What is Chylothorax a result of?

A

Failure of intestinal lymph to drain normally via thoracic duct into the venous circulation

38
Q

What is the most common cause of chylothorax?

A

Idiopathic

39
Q

What would be in the pleural effusion of a patient with Chylothorax?

A

Triglyceride and Cholesterol

40
Q

What medical management can be used to treat Chylothorax?

A

Low fat diet and Rutin (50mg/kg every 8-12 hours)

41
Q

What does surgical therapy of Chylothorax involve?

A

Identification and ligation of all branches of thoracic duct and providing alternate route of drainage

42
Q

What are the three possible methods of managing pneumothorax?

A

Resting the animal if pneumothorax is small - If respiratory distress then drainage of pleural air - If recurring then surgical exploration

43
Q
A

Respiratory (7 decks)

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