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Cardiovascular > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

What are the 5 broad classifications (morphologic) of pneumonia?

A 
Bronchopneumonia
Lobar pneumonia
Bronchointerstitial pneumonia
Interstitial pneumonia
Multifocal pneumonia
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2
Q

What is the usual route of infection for bronchopneumonia? What is the usual causative agent (i.e bacteria, virus, fungus)

A

Inhalation of bacteria

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3
Q

Where in the bronchial tree does inflammation localise to in bronchopneumonia? Why?

A

The junction of the distal bronchioles and alveoli

Because of the sudden reduction in air velocity and multiple points of branching

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4
Q

What is the usual distribution of bronchopneumonia in the lung?

A

Cranioventral

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5
Q

What is one exception to the usual distribution of bronchopneumonia in the lung? Where is it instead?

A

Pneumonia caused by parasitic lungworm (verminous) is usually dorsocaudal. e.g Metastrongylus in pigs

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6
Q

In which species is bronchopneumonia less likely to resolve? Why?

A

Cattle and pigs

Distinct lobular septa inhibiting exudate drainage and inflammatory cell clearance

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7
Q

What histological factor is significant in distinguishing bronchopneumonia from bronchointerstitial pneumonia?

A

Damage to the pulmonary interstitium

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8
Q

What type of inflammation is typical of bronchopneumonia?

A

Suppurative

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9
Q

What are three possible consequences of chronic bronchopneumonia?

A

Atelectasis > degeneration and fibrosis of collapsed parenchyma
Pulmonary abscessation
Alveolar emphysema

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10
Q

What are three common causes of bronchopneumonia? Where might these organisms have come from?

A

Streptococcus spp.
Staphylococcus spp.
Bordetella bronchiseptica

All are commensal organisms of the URT that take advantage of respiratory tract compromised by viral infection, noxious gas exposure, cold air etc

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11
Q

What are two important distinguishing features of Lobar pneumonia related to bronchopneumonia?

A

Lobar is more rapidly progressive and severe

Typically lobar involves an entire lobe of lung, or more

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12
Q

What is the usual distribution of lobar pneumonia in the lung?

A

Cranioventral

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13
Q

What is the exception to the usual distribution of lobar pneumonia? Where is it located?

A

Pneumonia caused by Actinobacillus pleuropneumoniae in pigs

Usually dorsocaudal

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14
Q

What sort of inflammation is usual for lobar pneumonia? Which other condition commonly occurs at the same time?

A 
Fibronecrotising
Fibrinous pleuritis ( = 'pleuropneumonia' )
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15
Q

How much exudate can you squeeze from a lobar pneumonia sample at post mortem?

A

Not much - airways are mostly blocked by fibrin

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16
Q

How do you get ‘sequestrae’ in lobar pneumonia? What significance might this have for the resolution of the disease?

A

Erosion of pulmonary artery by inflammation > thrombosis and loss of blood supply > ischaemia and necrosis of dependent tissue > fibrosis. Causative organism can remain in these sequestra

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17
Q

Why does the animal commonly die in lobar pneumonia when only 20 - 40% of lung function is lost?

A

Because the causative organism toxins are released into the blood > toxaemia

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18
Q

What are three potential causes of lobar pneumonia?

A 
Mannheimia haemolytica (ruminants)
Pasteurella multocida (cattle and sheep)
Actinobacillus pleuropneumoniae (pigs)
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19
Q

What is the usual distribution of bronchointerstitial pneumonia?

A

Cranioventral

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20
Q

What is the usual route of infection for bronchointerstitial pneumonia?

A

Aerogenous (inhaled)

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21
Q

What is the major distinguishing feature of this pneumonia from bronchopneumonia? Can they be differentiated grossly?

A

No - need histopath to tell them grossly

Bronchointerstitial has damage to the alveolar walls (see lymphocytes accumulate within)

22
Q

What are three potential causes of bronchointerstitial pneumonia?

A

Parainfluenza viruses - cattle and sheep
Influenza viruses - horses and pigs
Paramyxovirus such as canine distemper in dogs

23
Q

What is the most common cause of bronchoninterstitial pneumonia in Australia? Does this come under another category of pneumonia as well?

A

Mycoplasma infection

- counts as enzootic pneumonia

24
Q

Which species is enzootic pneumonia an issue in? What age group? When is the risk period?

A

Calves, lambs and pigs in intensively farmed enterprises

Infection typically occurs as maternal immunity wanes

25
Q

What is one potential combination of causative organisms for enzootic pneumonia in calves?

A

Bovine respiratory syncytial virus (primary)

+ Mycobacterium bovis

26
Q

What is one potential combination of causative organisms for enzootic pneumonia in lambs?

A

Mycoplasma spp. + Bordetella parapertussis

27
Q

What is one potential combination of causative organisms for enzootic pneumonia in young pigs?

A

M. hyopneumoniae (primary)

+ Pasteurella multocida (secondary)

28
Q

Give three histological features you might expect to see in a sample of enzootic pneumonia

A

Mucoid metaplasia of the respiratory epithelium
Aggregation of lymphocytes and plasma cells in the alveolar septa
Aggregation of lymphocytes around the pulmonary vessels (cuffing)

29
Q

What are the three possible cell types that were initially damaged in the development of interstitial pneumonia?

A

Vascular endothelial cells of alveolar capillaries
Type I pneumocytes
Type II pneumocytes (less common)

30
Q

What is the usual route of infection for interstitial pneumonia?

A

Haematogenous

31
Q

What is the gross appearance of interstitial pneumonia in the early stages?

A

Lungs oedematous, heavy, wet, rubbery (rather than firm)

32
Q

If the entire lung isnt involved in interstitial pneumonia, what is the next most common distribution?

A

Dorsocaudal

33
Q

What is the significance of a hyaline membrane?

A

Means the permeability of the local capillaries has been increased enough to permit fibrinogen through.

34
Q

What is a reasonably common feature of interstitial pneumonia in cattle? What causes it?

A

Interstitial emphysema due to increased inspiration and expiration pressures

35
Q

What are three potential causes of acute interstitial pneumonia in specific species?

A

Hendra virus - horses
Ascaris suum - pigs
Paraquat toxicity - dogs

36
Q

What are three potential causes of acute interstitial pneumonia in any species?

A

DIC
Uraemia
Aspiration of gastric acid (mongastrics)

37
Q

What are three potential causes of chronic interstitial pneumonia?

A

FIP in cats
Dirofilaria immitis microfilaria infestation in dogs
Aurolostrongylus abstrusus infestation in cats
Pyrrolizidine alkaloid plant consumption (e.g crolataria) in horses

38
Q

Which sort of pneumonia is ‘fog fever’ classified as?

A

Acute interstitial pneumonia

39
Q

Briefly explain the pathogenesis of fog fever

A

Ingestion of lush green pastures > L-tryptophan in grass is metabolised to 3-methylindole in the rumen > 3-MI travels in the blood to the lung > taken up by type II pneumocytes and metabolised into highly toxic compound > bronchiolar epithelial necrosis and severe pulmonary oedema +/- interstitial emphysema +/- subcutaneous emphysema

40
Q

In which region of the lung does multifocal pneumonia usually start?

A

Cranioventral

41
Q

What is the usual route of infection for multifocal pneumonia?

A

Haematogenous

42
Q

What are three potential lesions that multifocal bacterial pneumonia could evolve into?

A

Granulomas
Pyogranulomas
Abscesses

43
Q

What is one common cause of suppurative multifocal pneumonia?

A

Arcanobacterium pyogenes in cattle

44
Q

What is one potential cause of caeseous multifocal pneumonia?

A

Corynebacterium pseudotuberculosis

45
Q

What are three potential causes of granulomatous or pyogranulomatous multifocal pneumonia ?

A

Aspergillus spp.
Cryptococcus neoformans
Rhodococcus equi

46
Q

What are two potential causes of parasitic multifocal pneumonia?

A

E. granulosis (the hydatid cyst stage) esp. in sheep

F. hepatica in cattle

47
Q

Why can aspirating stomach contents cause sudden death in monogastrics?

A

Laryngospasm
Acute diffuse pulmonary oedema
Vagal reflex > bradycardia or asystole

48
Q

What sort of inflammation is typical of aspirating rumenal contents? why?

A

Severe, gangrenous lobar pneumonia

Due to presence of putrefactive bacteria in the fluid

49
Q

What is the difference between exogenous and endogenous lipid pneumonia? Are they distinguishable grossly?

A

Exogenous due to aspiration of supplementary oils. Lipid seen outside the cell only on histopath

Endogenous due defect in surfactant production or clearance; lipid always inside the macrophages and giant cells

The two are not distinguishable grossly
- good history + histopath

50
Q

Which type of oils are safest for laxative therapy in cats?

A

vegetable oils - largely non-irritant if aspirated

Cardiovascular (8 decks)

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