Pulmonary Parenchymal Disorders Flashcards
1
Q
With lung disease, there is often difficulty with breathing on what phase?
A
Expiratory
2
Q
There is an increase in what with reference to breathing with lung disease?
A
Rate and effort
3
Q
If a cough is not due to a non-cardiogenic cause, what is done?
A
Take a radiograph
4
Q
If abnormal lungs are seen on a radiograph, what does this indicate?
A
Lower airways and pulmonary parenchyma
5
Q
If normal lungs are seen on a radiograph with a non-cardiogenic cough, what does this indicate?
A
Tracheal disorders
6
Q
An inflammatory disorder of lung parenchyma is known as what?
A
Pneumonia
7
Q
What are 5 possible causes of pneumonia?
A
- Bacterial
- Aspiration
- Viral
- Fungal
- Parasitic
8
Q
What is the most common cause of pneumonia if dogs?
A
Bacteria
9
Q
What is a type of diagnostic test that helps to distinguish between different pneumonia etiologies?
A
Radiographic patterns
10
Q
What is pneumonia often characterized by?
A
Soft, ineffectual cough
11
Q
What are 3 respiratory clinical signs seen with pneumonia?
A
- Difficulty breathing on expiration
- Tachypnea
- Cyanosis if severe
12
Q
What are 2 other clinical signs seen with pneumonia?
A
- Nasal discharge
- Exercise intolerance
13
Q
What are 3 common systemic signs of pneumonia?
A
- Fever
- Lethargy
- Poor appetite
14
Q
Is primary bacterial pneumonia more common in dogs or cats?
A
Dogs
15
Q
Is primary bacterial pneumonia seen more in young or old dogs?
A
Young dogs
16
Q
What are 2 common causes of bacterial pneumonia in dogs?
A
- Bordetella
- Pasteurella
17
Q
Inflammation and consolidation of lung tissue can be seen with what respiratory condition?
A
Bacterial pneumonia
18
Q
Is secondary bacterial pneumonia seen more in young or old dogs?
A
Old dogs
19
Q
If there is a history of recent sedation or anesthesia, the organism responsible is more likely to be what?
A
Resistant to antibiotics
20
Q
What type of lung pattern can be seen with early pneumonia?
What is the classic pattern seen?
A
- Interstitial pattern
- Alveolar pattern
21
Q
Lung patterns are often seen in what part of the lungs?
A
Cranioventral distribution
22
Q
What are 3 other things to look at on a thoracic radiograph that could be primary causes for pneumonia?
A
- Foreign body
- Megaesophagus
- Other thoracic disease
23
Q
Radiographic changes of pneumonia lag behind what?
A
Clinical signs
24
Q
What are 2 changes seen on a hemogram with bacterial pneumonia?
A
- Neutrophilic leukocytosis with left shift
- Monocytosis if chronic
25
Bacterial pneumonia can results in sepsis which can result in what 2 conditions?
- ALI
| - ARDS
26
What type of treatment for bacterial pneumonia should be begun pending culture results?
Empirical treatment with antibiotics
27
Broad coverage over what four quadrants is seen with empirical use of antibiotics?
- Gram positive
- Gram negative
- Anaerobes
- Mycoplasma
28
When treating bacterial pneumonia, start with what form of antibiotic and then switch to what form?
- Injectable
| - Oral
29
How long should antibiotics be given for when treating bacterial pneumonia?
4-8 weeks
30
What are 2 things that can be used to mobilize airway secretions through nebulization?
- Sterile saline
| - Gentamicin (works on gram negative)
31
What might nebulization cause?
| What should be used before nebulization?
- Bronchoconstriction
| - Bronchodilator
32
What are 3 forms of supportive care that can be given with bacterial pneumonia?
- IV fluids
- Oxygen and coupage
- Bronchodilators
33
What is coupage?
Percussion therapy used in dogs with pneumonia to dislodge mucus.
34
What are 5 possible causes of mycotic pneumonia?
- Blastomycosis
- Histoplasmosis
- Coccidiomycosis
- Cryptococcosis
- Aspergillosis
35
Inappetence, weight loss, fever, lameness, enlarged lymph nodes, draining tracts, chorioretinitis or anterior uveitis are systemic signs of what?
Mycotic pneumonia
36
What are 2 diagnostic techniques that can be used for detecting mycotic pneumonia?
- Cytology/histology
| - Urine/serum antigens
37
What are 3 drugs that can be used to treat mycotic pneumonia?
- Itraconazole
- Amphotericin B
- Ketaconazole
38
What fungal organism is common in Arizona?
| In the Ohio River Valley?
- Coccidiomycosis
| - Blastomycosis, Histoplasmosis
39
What fungal organism can cause GI signs?
Histoplasmosis
40
How can cryptococcus be diagnosed?
Serum antigen titer
41
How can the causes of Valley Fever be diagnosed?
Urine antigen titer
42
How long do you treat for mycotic pneumonia?
4-12+ months
43
What are 2 oral medications that can be given to treat mycotic pneumonia?
Which one costs more?
- Fluconazole and Itraconazole
| - Itraconazole
44
What are 2 side effects seen with fluconazole and itraconazole?
- Inappetence
| - Elevation of liver enzymes
45
What is a drug that can be used for mycotic pneumonia but is nephrotoxic?
Which form is less nephrotoxic?
- Amphotericin B
| - Lipid-complex form
46
What does the success of treatment for mycotic pneumonia depend on?
How disseminated the infection is at time of diagnosis.
47
There is a more guarded prognosis with mycotic pneumonia with what?
CNS involvement
48
There is an increased chance of what during the first week of treatment?
Worsening of respiratory signs.
49
How effective is the treatment of blastomycosis and cryptococcosis?
80% effective
50
What form of histoplasmosis has a guarded prognosis?
Disseminated form
51
What is the recovery rate for coccidiomycosis?
| How long do medications need to be given for?
- 60% recovery rate
| - 6-12 months or longer (sometimes lifetime)
52
What is the name of the parasite that can cause parasitic pneumonia known as the cat lungworm?
Aleurostrongylus abstrusus
53
What is the name of the fluke that can cause parasitic pneumonia in both dogs and cats?
What type of eggs does it produce?
- Paragonimus kellicoti
| - Operculated egg
54
What type of clinical signs can be seen with an Aleurostrongylus abstrusus infection?
Subclinical or have same clinical signs as feline asthma.
55
What might be seen on a CBC with feline lungworm?
Eosinophilia
56
What can be seen on chest x-rays with feline lungworm?
Diffuse nodular densities in the caudal lobes.
57
What are 2 drugs that can be used to treat feline lungworm?
- Fenbendazole
| - Ivermectin
58
What clinical signs can be seen with Paragonimus pneumonia?
Subclinical or cough, wheeze, difficulty breathing.
59
Flukes form what within the lungs?
Cysts
60
What can happen if the cysts formed during Paragonimus pneumonia rupture?
Pneumothorax
61
What might be seen on chest x-rays with Paragonimus pneumonia?
Air-filled cysts
62
What can be seen on a CBC with Paragonimus pneumonia?
Eosinophilia
63
What are 3 signalments for Idiopathic pulmonary fibrosis?
- Terriers (West Highland White Terrier)
- Middle aged to older
- Some cats
64
Chronic fibrosis of lung interstitium characterized by infiltration of fibroblasts with collagen deposits in the alveolar septa is known as what?
Idiopathic pulmonary fibrosis
65
What is another name for idiopathic pulmonary fibrosis?
Progressive interstitial fibrosis
66
Does idiopathic pulmonary fibrosis have a fast or slow onset?
Slow onset
67
What are 2 common clinical signs seen with idiopathic pulmonary fibrosis?
What are 2 other signs that can be seen as the disease progresses?
- Respiratory distress, tachypnea
| - Cough, weight loss in cats
68
What is a hallmark finding heard on a physical exam with progressive interstitial fibrosis?
Inspiratory crackles
69
What is seen on radiograph with progressive interstitial fibrosis?
Generalized or diffuse interstitial pattern
70
What will be seen on an arterial blood gas reading with severe progressive interstitial fibrosis?
Hypoxemia
71
What diagnostic technique gives a definitive diagnosis for progressive interstitial fibrosis?
Lung biopsy
72
Combination of what 2 treatments can be used to alleviate the signs of chronic bronchitis associated with progressive interstitial fibrosis?
- Corticosteroids
| - Bronchodilators
73
What is the prognosis for progressive interstitial fibrosis?
Guarded
74
What can progressive interstitial fibrosis lead to?
Progressive respiratory failure
75
What are 2 examples of primary causes of pulmonary neoplasia?
- Adenocarcinoma (alveolar or bronchogenic)
| - Squamous cell carcinoma
76
What is the most common primary pulmonary neoplasia?
Adenocarcinoma
77
What type of pulmonary neoplasia is more common, primary or metastatic?
Metastatic
78
What are 6 examples of metastatic pulmonary neoplasias?
- Adenocarcinoma
- Osteosarcoma
- Chondrosarcoma
- Hemangiosarcoma
- Melanoma (oral/digital)
- Squamous cell carcinoma
79
What are 3 examples of multicentric sources of pulmonary neoplasia?
- Lymphoma
- Malignant histiocytosis
- Mastocytoma
80
What is the common signalment for pulmonary neoplasia?
Older dogs and cats
81
What are 4 possible clinical respiratory signs that can be seen with pulmonary neoplasia?
- Cough
- Labored breathing
- Increased RR
- Hemoptysis
82
What is hemoptysis?
Coughing up blood
83
What are 3 types of abnormal lung sounds that can be heard with pulmonary neoplasia?
- Crackles
- Wheezes
- Muffled sounds
84
What are 6 non-respiratory clinical signs that can be seen with pulmonary neoplasia?
- Weight loss
- Inappetence
- Lameness
- Dysphagia
- Regurgitation
- Edema of head/neck from venous obstruction
85
How many thoracic radiographic views should be taken?
3 views
86
What is the treatment for primary pulmonary neoplasia with a single nodule?
Surgery if single nodule
87
What is the treatment for metastatic or multicentric pulmonary neoplasia?
What about if it is lymphoma?
- Treat primary mass
| - Chemotherapy
88
What is the overall prognosis for pulmonary neoplasia?
| What is the exception?
- Guarded to poor
| - Benign mass restricted to one lobe which might be removable
89
Which has a better prognosis: adenocarcinoma or squamous cell carcinoma?
Adenocarcinoma
90
Which has a better prognosis: no lymph node involvement or lymph node involvement?
No lymph node involvement
91
Accumulation of fluid in alveoli or pulmonary interstitium is known as what?
Pulmonary edema
92
What needs to be determined concerning the origins of pulmonary edema?
Cardiogenic or non-cardiogenic
93
If the origin of pulmonary edema is cardiogenic, what should be detected on physical exam?
Murmur or arrhythmia
94
What are the 4 general mechanisms behind non-cardiogenic pulmonary edema?
- Vascular overload/increased hydrostatic pressure
- Decreased plasma oncotic pressure
- Increased alveolar-capillary membrane permeability
- Lymphatic obstruction
95
With non-cardiogenic pulmonary edema, accumulated fluid interferes with what?
Ventilation and perfusion
96
What are 3 possible progressions of non-cardiogenic pulmonary edema?
- Acute Lung Injury (ALI)
- Acute Respiratory Distress Syndrome (ARDS)
- Respiratory failure
97
What are 3 examples of pulmonary insults that can lead to the increased alveolar-capillary membrane permeability seen with non-cardiogenic pulmonary edema?
- Aspiration
- Upper airway obstruction
- Smoke
98
What are 5 examples of non-pulmonary insults that can lead to the increased alveolar-capillary membrane permeability seen with non-cardiogenic pulmonary edema?
- Sepsis
- Electric shock
- CNS disease
- Pancreatitis
- DIC
99
What would you hear on thoracic auscultation with non-cardiogenic pulmonary edema?
Crackles
100
What are 2 things you would expect to see on thoracic radiographs with non-cardiogenic pulmonary edema?
- Bilateral alveolar pattern
| - Caudodorsal lung fields affected
101
What are 3 forms of treatment for non-cardiogenic pulmonary edema?
- Aggressive control of primary disease
- Cage rest and oxygen
- Supportive care
102
What are 3 forms of supportive care for non-cardiogenic pulmonary edema?
- Sedation
- Cautious fluid therapy
- Positive ventilation in severe cases
103
What is the prognosis with permeability edema pathogenesis of non-cardiogenic pulmonary edema?
Guarded
104
If signs of non-cardiogenic pulmonary edema are due to fluid overload and if renal function is intact, how does this affect prognosis?
Prognosis is better
105
Pulmonary inflammation and edema resulting in acute respiratory failure is known as what?
Acute lung injury
106
A severe manifestation of acute lung injury is known as what?
Acute respiratory distress syndrome
107
Acute lung injury and acute respiratory distress syndrome are most commonly sequela of what 3 conditions?
- Sepsis
- Shock
- Bacterial pneumonia
108
Clinical signs of ALI and ARDS may be delayed for how long after inciting event?
1-4 days
109
Progressive hypoxemia, respiratory distress and cyanosis can indicate what 2 conditions?
- Acute lung injury
| - Acute respiratory distress syndrome
110
Are ALI and ARDS primary or secondary syndromes?
Secondary
111
What is the current mortality rate for ALI/ARDS?
Close to 100%
112
Various degrees of respiratory distress and crackles with severe consolidation are seen with what?
Pulmonary contusions
113
How long can it take for lung changes to take to show up, especially on radiographs?
2-12 hours
114
How long should pulmonary contusions be monitored for?
24-48 hours
115
Inflammation of the lungs thought to be caused by a hypersensitivity to some unknown antigen is known as what?
Eosinophilic bronchopneumopathy
116
What is a breed predisposition for eosinophilic bronchopneumopathy?
Siberian husky
117
What age range is eosinophilic bronchopneumopathy seen in with dogs?
Young to middle aged dogs
118
Lack of what is seen with eosinophilic bronchopneumopathy?
Lack of response to antibiotics
119
Harsh crackles, expiratory wheezes and a moist productive cough elicited on tracheal palpation are seen with what condition?
Eosinophilic bronchopneumopathy
120
An increase in what 2 types of WBCs can be seen with eosinophilic bronchopneumopathy?
- Neutrophils
| - Eosinophils
121
Eosinophilic bronchopneumopathy can have what percentage eosinophil population?
Greater than 20-25%
122
What are 3 potential signs of eosinophilic bronchopneumopathy that can be seen on radiographs?
- Diffuse broncho-interstitial pattern
- Alveolar infiltrates
- Bronchiectasis
123
How is eosinophilic bronchopneumopathy treated?
Find and treat underlying cause.
124
What is the treatment for pulmonary thromboembolism?
Oxygen and treat underlying disease.
125
What is the prognosis for pulmonary thromboembolism?
Poor to grave
