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SAM 2 > Pulmonary Parenchymal Disorders > Flashcards

Pulmonary Parenchymal Disorders Flashcards

1
Q

With lung disease, there is often difficulty with breathing on what phase?

A

Expiratory

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2
Q

There is an increase in what with reference to breathing with lung disease?

A

Rate and effort

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3
Q

If a cough is not due to a non-cardiogenic cause, what is done?

A

Take a radiograph

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4
Q

If abnormal lungs are seen on a radiograph, what does this indicate?

A

Lower airways and pulmonary parenchyma

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5
Q

If normal lungs are seen on a radiograph with a non-cardiogenic cough, what does this indicate?

A

Tracheal disorders

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6
Q

An inflammatory disorder of lung parenchyma is known as what?

A

Pneumonia

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7
Q

What are 5 possible causes of pneumonia?

A
  • Bacterial
  • Aspiration
  • Viral
  • Fungal
  • Parasitic
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8
Q

What is the most common cause of pneumonia if dogs?

A

Bacteria

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9
Q

What is a type of diagnostic test that helps to distinguish between different pneumonia etiologies?

A

Radiographic patterns

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10
Q

What is pneumonia often characterized by?

A

Soft, ineffectual cough

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11
Q

What are 3 respiratory clinical signs seen with pneumonia?

A
  • Difficulty breathing on expiration
  • Tachypnea
  • Cyanosis if severe
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12
Q

What are 2 other clinical signs seen with pneumonia?

A
  • Nasal discharge

- Exercise intolerance

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13
Q

What are 3 common systemic signs of pneumonia?

A
  • Fever
  • Lethargy
  • Poor appetite
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14
Q

Is primary bacterial pneumonia more common in dogs or cats?

A

Dogs

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15
Q

Is primary bacterial pneumonia seen more in young or old dogs?

A

Young dogs

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16
Q

What are 2 common causes of bacterial pneumonia in dogs?

A
  • Bordetella

- Pasteurella

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17
Q

Inflammation and consolidation of lung tissue can be seen with what respiratory condition?

A

Bacterial pneumonia

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18
Q

Is secondary bacterial pneumonia seen more in young or old dogs?

A

Old dogs

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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

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20
Q

What type of lung pattern can be seen with early pneumonia?

What is the classic pattern seen?

A
  • Interstitial pattern

- Alveolar pattern

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21
Q

Lung patterns are often seen in what part of the lungs?

A

Cranioventral distribution

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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
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23
Q

Radiographic changes of pneumonia lag behind what?

A

Clinical signs

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24
Q

What are 2 changes seen on a hemogram with bacterial pneumonia?

A
  • Neutrophilic leukocytosis with left shift

- Monocytosis if chronic

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25
Q

Bacterial pneumonia can results in sepsis which can result in what 2 conditions?

A
  • ALI

- ARDS

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26
Q

What type of treatment for bacterial pneumonia should be begun pending culture results?

A

Empirical treatment with antibiotics

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27
Q

Broad coverage over what four quadrants is seen with empirical use of antibiotics?

A
  • Gram positive
  • Gram negative
  • Anaerobes
  • Mycoplasma
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28
Q

When treating bacterial pneumonia, start with what form of antibiotic and then switch to what form?

A
  • Injectable

- Oral

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29
Q

How long should antibiotics be given for when treating bacterial pneumonia?

A

4-8 weeks

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30
Q

What are 2 things that can be used to mobilize airway secretions through nebulization?

A
  • Sterile saline

- Gentamicin (works on gram negative)

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31
Q

What might nebulization cause?

What should be used before nebulization?

A
  • Bronchoconstriction

- Bronchodilator

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32
Q

What are 3 forms of supportive care that can be given with bacterial pneumonia?

A
  • IV fluids
  • Oxygen and coupage
  • Bronchodilators
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33
Q

What is coupage?

A

Percussion therapy used in dogs with pneumonia to dislodge mucus.

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34
Q

What are 5 possible causes of mycotic pneumonia?

A
  • Blastomycosis
  • Histoplasmosis
  • Coccidiomycosis
  • Cryptococcosis
  • Aspergillosis
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35
Q

Inappetence, weight loss, fever, lameness, enlarged lymph nodes, draining tracts, chorioretinitis or anterior uveitis are systemic signs of what?

A

Mycotic pneumonia

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36
Q

What are 2 diagnostic techniques that can be used for detecting mycotic pneumonia?

A
  • Cytology/histology

- Urine/serum antigens

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37
Q

What are 3 drugs that can be used to treat mycotic pneumonia?

A
  • Itraconazole
  • Amphotericin B
  • Ketaconazole
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38
Q

What fungal organism is common in Arizona?

In the Ohio River Valley?

A
  • Coccidiomycosis

- Blastomycosis, Histoplasmosis

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39
Q

What fungal organism can cause GI signs?

A

Histoplasmosis

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40
Q

How can cryptococcus be diagnosed?

A

Serum antigen titer

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41
Q

How can the causes of Valley Fever be diagnosed?

A

Urine antigen titer

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42
Q

How long do you treat for mycotic pneumonia?

A

4-12+ months

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43
Q

What are 2 oral medications that can be given to treat mycotic pneumonia?
Which one costs more?

A
  • Fluconazole and Itraconazole

- Itraconazole

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44
Q

What are 2 side effects seen with fluconazole and itraconazole?

A
  • Inappetence

- Elevation of liver enzymes

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45
Q

What is a drug that can be used for mycotic pneumonia but is nephrotoxic?
Which form is less nephrotoxic?

A
  • Amphotericin B

- Lipid-complex form

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46
Q

What does the success of treatment for mycotic pneumonia depend on?

A

How disseminated the infection is at time of diagnosis.

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47
Q

There is a more guarded prognosis with mycotic pneumonia with what?

A

CNS involvement

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48
Q

There is an increased chance of what during the first week of treatment?

A

Worsening of respiratory signs.

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49
Q

How effective is the treatment of blastomycosis and cryptococcosis?

A

80% effective

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50
Q

What form of histoplasmosis has a guarded prognosis?

A

Disseminated form

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51
Q

What is the recovery rate for coccidiomycosis?

How long do medications need to be given for?

A
  • 60% recovery rate

- 6-12 months or longer (sometimes lifetime)

52
Q

What is the name of the parasite that can cause parasitic pneumonia known as the cat lungworm?

A

Aleurostrongylus abstrusus

53
Q

What is the name of the fluke that can cause parasitic pneumonia in both dogs and cats?
What type of eggs does it produce?

A
  • Paragonimus kellicoti

- Operculated egg

54
Q

What type of clinical signs can be seen with an Aleurostrongylus abstrusus infection?

A

Subclinical or have same clinical signs as feline asthma.

55
Q

What might be seen on a CBC with feline lungworm?

A

Eosinophilia

56
Q

What can be seen on chest x-rays with feline lungworm?

A

Diffuse nodular densities in the caudal lobes.

57
Q

What are 2 drugs that can be used to treat feline lungworm?

A
  • Fenbendazole

- Ivermectin

58
Q

What clinical signs can be seen with Paragonimus pneumonia?

A

Subclinical or cough, wheeze, difficulty breathing.

59
Q

Flukes form what within the lungs?

A

Cysts

60
Q

What can happen if the cysts formed during Paragonimus pneumonia rupture?

A

Pneumothorax

61
Q

What might be seen on chest x-rays with Paragonimus pneumonia?

A

Air-filled cysts

62
Q

What can be seen on a CBC with Paragonimus pneumonia?

A

Eosinophilia

63
Q

What are 3 signalments for Idiopathic pulmonary fibrosis?

A
  • Terriers (West Highland White Terrier)
  • Middle aged to older
  • Some cats
64
Q

Chronic fibrosis of lung interstitium characterized by infiltration of fibroblasts with collagen deposits in the alveolar septa is known as what?

A

Idiopathic pulmonary fibrosis

65
Q

What is another name for idiopathic pulmonary fibrosis?

A

Progressive interstitial fibrosis

66
Q

Does idiopathic pulmonary fibrosis have a fast or slow onset?

A

Slow onset

67
Q

What are 2 common clinical signs seen with idiopathic pulmonary fibrosis?
What are 2 other signs that can be seen as the disease progresses?

A
  • Respiratory distress, tachypnea

- Cough, weight loss in cats

68
Q

What is a hallmark finding heard on a physical exam with progressive interstitial fibrosis?

A

Inspiratory crackles

69
Q

What is seen on radiograph with progressive interstitial fibrosis?

A

Generalized or diffuse interstitial pattern

70
Q

What will be seen on an arterial blood gas reading with severe progressive interstitial fibrosis?

A

Hypoxemia

71
Q

What diagnostic technique gives a definitive diagnosis for progressive interstitial fibrosis?

A

Lung biopsy

72
Q

Combination of what 2 treatments can be used to alleviate the signs of chronic bronchitis associated with progressive interstitial fibrosis?

A
  • Corticosteroids

- Bronchodilators

73
Q

What is the prognosis for progressive interstitial fibrosis?

A

Guarded

74
Q

What can progressive interstitial fibrosis lead to?

A

Progressive respiratory failure

75
Q

What are 2 examples of primary causes of pulmonary neoplasia?

A
  • Adenocarcinoma (alveolar or bronchogenic)

- Squamous cell carcinoma

76
Q

What is the most common primary pulmonary neoplasia?

A

Adenocarcinoma

77
Q

What type of pulmonary neoplasia is more common, primary or metastatic?

A

Metastatic

78
Q

What are 6 examples of metastatic pulmonary neoplasias?

A
  • Adenocarcinoma
  • Osteosarcoma
  • Chondrosarcoma
  • Hemangiosarcoma
  • Melanoma (oral/digital)
  • Squamous cell carcinoma
79
Q

What are 3 examples of multicentric sources of pulmonary neoplasia?

A
  • Lymphoma
  • Malignant histiocytosis
  • Mastocytoma
80
Q

What is the common signalment for pulmonary neoplasia?

A

Older dogs and cats

81
Q

What are 4 possible clinical respiratory signs that can be seen with pulmonary neoplasia?

A
  • Cough
  • Labored breathing
  • Increased RR
  • Hemoptysis
82
Q

What is hemoptysis?

A

Coughing up blood

83
Q

What are 3 types of abnormal lung sounds that can be heard with pulmonary neoplasia?

A
  • Crackles
  • Wheezes
  • Muffled sounds
84
Q

What are 6 non-respiratory clinical signs that can be seen with pulmonary neoplasia?

A
  • Weight loss
  • Inappetence
  • Lameness
  • Dysphagia
  • Regurgitation
  • Edema of head/neck from venous obstruction
85
Q

How many thoracic radiographic views should be taken?

A

3 views

86
Q

What is the treatment for primary pulmonary neoplasia with a single nodule?

A

Surgery if single nodule

87
Q

What is the treatment for metastatic or multicentric pulmonary neoplasia?
What about if it is lymphoma?

A
  • Treat primary mass

- Chemotherapy

88
Q

What is the overall prognosis for pulmonary neoplasia?

What is the exception?

A
  • Guarded to poor

- Benign mass restricted to one lobe which might be removable

89
Q

Which has a better prognosis: adenocarcinoma or squamous cell carcinoma?

A

Adenocarcinoma

90
Q

Which has a better prognosis: no lymph node involvement or lymph node involvement?

A

No lymph node involvement

91
Q

Accumulation of fluid in alveoli or pulmonary interstitium is known as what?

A

Pulmonary edema

92
Q

What needs to be determined concerning the origins of pulmonary edema?

A

Cardiogenic or non-cardiogenic

93
Q

If the origin of pulmonary edema is cardiogenic, what should be detected on physical exam?

A

Murmur or arrhythmia

94
Q

What are the 4 general mechanisms behind non-cardiogenic pulmonary edema?

A
  • Vascular overload/increased hydrostatic pressure
  • Decreased plasma oncotic pressure
  • Increased alveolar-capillary membrane permeability
  • Lymphatic obstruction
95
Q

With non-cardiogenic pulmonary edema, accumulated fluid interferes with what?

A

Ventilation and perfusion

96
Q

What are 3 possible progressions of non-cardiogenic pulmonary edema?

A
  • Acute Lung Injury (ALI)
  • Acute Respiratory Distress Syndrome (ARDS)
  • Respiratory failure
97
Q

What are 3 examples of pulmonary insults that can lead to the increased alveolar-capillary membrane permeability seen with non-cardiogenic pulmonary edema?

A
  • Aspiration
  • Upper airway obstruction
  • Smoke
98
Q

What are 5 examples of non-pulmonary insults that can lead to the increased alveolar-capillary membrane permeability seen with non-cardiogenic pulmonary edema?

A
  • Sepsis
  • Electric shock
  • CNS disease
  • Pancreatitis
  • DIC
99
Q

What would you hear on thoracic auscultation with non-cardiogenic pulmonary edema?

A

Crackles

100
Q

What are 2 things you would expect to see on thoracic radiographs with non-cardiogenic pulmonary edema?

A
  • Bilateral alveolar pattern

- Caudodorsal lung fields affected

101
Q

What are 3 forms of treatment for non-cardiogenic pulmonary edema?

A
  • Aggressive control of primary disease
  • Cage rest and oxygen
  • Supportive care
102
Q

What are 3 forms of supportive care for non-cardiogenic pulmonary edema?

A
  • Sedation
  • Cautious fluid therapy
  • Positive ventilation in severe cases
103
Q

What is the prognosis with permeability edema pathogenesis of non-cardiogenic pulmonary edema?

A

Guarded

104
Q

If signs of non-cardiogenic pulmonary edema are due to fluid overload and if renal function is intact, how does this affect prognosis?

A

Prognosis is better

105
Q

Pulmonary inflammation and edema resulting in acute respiratory failure is known as what?

A

Acute lung injury

106
Q

A severe manifestation of acute lung injury is known as what?

A

Acute respiratory distress syndrome

107
Q

Acute lung injury and acute respiratory distress syndrome are most commonly sequela of what 3 conditions?

A
  • Sepsis
  • Shock
  • Bacterial pneumonia
108
Q

Clinical signs of ALI and ARDS may be delayed for how long after inciting event?

A

1-4 days

109
Q

Progressive hypoxemia, respiratory distress and cyanosis can indicate what 2 conditions?

A
  • Acute lung injury

- Acute respiratory distress syndrome

110
Q

Are ALI and ARDS primary or secondary syndromes?

A

Secondary

111
Q

What is the current mortality rate for ALI/ARDS?

A

Close to 100%

112
Q

Various degrees of respiratory distress and crackles with severe consolidation are seen with what?

A

Pulmonary contusions

113
Q

How long can it take for lung changes to take to show up, especially on radiographs?

A

2-12 hours

114
Q

How long should pulmonary contusions be monitored for?

A

24-48 hours

115
Q

Inflammation of the lungs thought to be caused by a hypersensitivity to some unknown antigen is known as what?

A

Eosinophilic bronchopneumopathy

116
Q

What is a breed predisposition for eosinophilic bronchopneumopathy?

A

Siberian husky

117
Q

What age range is eosinophilic bronchopneumopathy seen in with dogs?

A

Young to middle aged dogs

118
Q

Lack of what is seen with eosinophilic bronchopneumopathy?

A

Lack of response to antibiotics

119
Q

Harsh crackles, expiratory wheezes and a moist productive cough elicited on tracheal palpation are seen with what condition?

A

Eosinophilic bronchopneumopathy

120
Q

An increase in what 2 types of WBCs can be seen with eosinophilic bronchopneumopathy?

A
  • Neutrophils

- Eosinophils

121
Q

Eosinophilic bronchopneumopathy can have what percentage eosinophil population?

A

Greater than 20-25%

122
Q

What are 3 potential signs of eosinophilic bronchopneumopathy that can be seen on radiographs?

A
  • Diffuse broncho-interstitial pattern
  • Alveolar infiltrates
  • Bronchiectasis
123
Q

How is eosinophilic bronchopneumopathy treated?

A

Find and treat underlying cause.

124
Q

What is the treatment for pulmonary thromboembolism?

A

Oxygen and treat underlying disease.

125
Q

What is the prognosis for pulmonary thromboembolism?

A

Poor to grave

SAM 2 (9 decks)

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