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Respiratory > Pleural Diseases > Flashcards

Pleural Diseases Flashcards

1
Q

What is the most common finding consistent with pleural disease?

A

Dyspnoea

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2
Q

Why do patients with pleural disease show increased resp rate and effort?

A

Breathing on a small volume of remaining lung function

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3
Q

What is orthopnoea?

A

Sternal position assumed to ease breathing

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4
Q

Suggest some historical and clinical signs that might indicate pleural disease..

A 
Pyrexia with septic effusion
Clinical signs associated with hypoproteinaemia (e.g. chronic diarrhoea)
Trauma 
Bleeding with coagulopathy
Signs associated with neoplasia
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5
Q

Describe a physical examination of a patient with pleural disease…

A 
Increased resp rate and effort
May have rapid, shallow resp
Orthopnoea
Dullness on percussion of ventral thorax
REsonance of percussion of dorsal thorax
Displacement of the apex beat
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6
Q

What is the most important diagnostic procedure once presence of a pleural effusion have been confirmed?

A

Thoracocentesis

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7
Q

Outline the key technical aspects of thoracocentesis…

A

Maintain a closed system
Maintain sterility
Avoid damage to the heart

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8
Q

By what are pleural transudates caused?

A

Hypoproteinaemia

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9
Q

By what are pleural modified transudates caused by?

A 
Venous obstruction
RSHF
Neoplasia
Lung lobe torsion
Diaphragmatic hernia
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10
Q

How does chylothorax arise?

A

Damage to the thoracic duct results in drainage of intestinal lymph into thoracic cavity

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11
Q

Why does chylothorax appear grossly milky?

A

High triglycerides

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12
Q

What is the predominant cell type in chylothorax?

A

Lymphocyte

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13
Q

What does a haemothorax indicate?

A

Coagulopathy
Trauma
Neoplasia

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14
Q

What is a pneumothorax, how does it occur?

A

Air in the pleural cavity, usually spontaneous or secondary to trauma

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15
Q

Describe the effect of pleural fluid on radiography…

A

Obscures detail

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16
Q

Outline the pathogenesis of equine pleuropneumonia…

A

Mixed bacterial infection
Organisms usually normal pharynx flora
Inhalation of bacterial with subsequent extension into pleural space
Suppression of pulmonary mechanisms (e.g. MCE, macrophages)

17
Q

Outline the major organisms responsible for equine pleuropneumonia…

A 
Beta-haemolytic streps
E. coli
Klebsiella
Pasteurella
Bordetella
18
Q

On what are the clinical signs of equine pleuropneumonia dependent?

A

Amount of fluid
Pathogen
Extent of parenchymal disease
Chronicity

19
Q

Outline the clinical signs associated with early acute equine pleuropneumonia

A 
Pyrexia
Lethargy
Slight nasal discharge
Shallow breathing
Guarded cough
Painful, stilted gait
Pleurodynia
20
Q

What is pleurodynia?

A

Pleuritic pain in the chest

21
Q

Outline the clinical signs associated with late-stage acute equine pleuropneumonia..

A 
Nostril flare
Tachycardia
Increased jugular pulse height
Toxic mm
Guarded, soft, moist cough
Foetid nasal dischargw
22
Q

Outline the clinical signs associated with chronic equine pleuropneumonia…

A

Intermittent fever
Weight loss
Ventral and limb oedema

23
Q

Outline diagnostics for equine pleuropneumonia

A 
History, CS and PE
Haemotology
Ultrasonography
Thoracocentesis
TTA
24
Q

Outline the aims of treatment for equine pleuropneumonia

A

Remove excess pleural fluid (surgical)
AB therapy - Pen & gent, metronidazole
NSAIDS/analgesia opiates
Supportive care - oxygen, bronchodilators, fluids, nutrition

25
Q

Outline the options available for medical therapy of a chylothorax…

A

Reduce formation of intestinal lymph

Enhance reabsorption of fluid from pleura

26
Q

Outline the options for surgical treatment of chylothorax…

A

Identify and ligate thoracic duct
Redistribute pleural fluid
Enhance absorption
Pleurodesis

27
Q

What is pleurodesis?

A

Attempt to get pleura to adhere together to remove the space for fluid to form

Respiratory (16 decks)

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