Pneumonia

Question 1

What are the 3 distribution patterns of pneumonia?

Answer 1

• lobar pneumonia - spreading occurs from alveolus to alveolus - dense consolidation on rads
• bronchopneumonia - characterized by lower airway inflammation and alveolar disease - spread through the airways - patchy distribution on rads
• interstitial pneumonia - inflammation starts in the interstitium - if severe can spread into alveoli

Question 2

What size of particles typically gets deposit in the bronchoalveolar junction?

Answer 2

0.5-3 micrometer

Question 3

List the most common bacterial isolates in canine pneumonia (tracheal samples)

Answer 3

• Pasteurella
• Enterbacteriacea
• Staphylococcus
• Streptococcus
• Bordetella bronchiseptica (puppies common!)
• Anaerobic bacteria
• Mycoplasma

Question 4

What are risk factors for severe lung damage from aspiration

Answer 4

pH < 1.5
particulate matter
high volume
osmolality

Question 5

What are common enteric bacteria cultured from SA aspiration pneumonia lungs?

Answer 5

• E. coli
• Enterococcus
• Klebsiella

Question 6

What influenca subtypes commonly cause disease in dogs. What complication occurs when they’re superinfected with bacteria?

Answer 6

H3N8
H3N2

Hemorrhagic Bronchopneumonia

Question 7

What are the most common pathogens cultured from patients with FB pneumonia?

Answer 7

Pasteurella
Actinomyces
Nocardia
Streptococcus
+ anaerobes

Question 8

Where do inhaled FB typically show on radiographs?

Answer 8

FB usually dislodge in the accessory and right or left caudal lung broncho - with caudodorsal, focal or lobar alveolar pattern

Question 9

What distribution does A vasorum parasitic infection show on xrays?

Answer 9

unique: peripheral alveolar pattern

Question 10

What pattern does mycotic pneumonia show on xrays?

Answer 10

reticulonodular “snowstorm” pattern
or focal

Question 11

How sensitive is transtracheal wash for the diagnosis of bacterial pneumonia?

Answer 11

45-70%

Question 12

What can be done to reduce the risks from fine-needle lung aspirates?

Answer 12

keep the patient with the aspirated side down, lateral recumbency for 60 min (20 if anesthetized) after the procedure

Question 13

Name 3 biomarkes, evaluated in human CAP

Answer 13

• CRP
• Interleukin-6
• procalcitonin

Question 14

What is the proposed risk/complication from giving bronchodilators to patients with pneumonia?

Answer 14

• suppressing coughing
• increase spreading
• worsening V/Q - increase perfusion of poorly ventilated lungs

Question 15

What is the proposed mechanism of beta-agonists helping with pneumonia?

Answer 15

• reduced mucosal edema
• downregulates cytokine release

Question 16

What is the proposed mechanism of methylxanthine bronchodilators helping in pneumonia?

Answer 16

• increases mucociliary transport
• inhibits degranulation of mast cells
• decreased microvascular permeability and leakage