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Respiratory inflammatory conditions Flashcards

1
Q

Where is the primary site of injury for interstitial pneumonia?

A

Alveolar epithelium and capillary endothelium

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2
Q

What are the causes of interstitial pneumonia?

A

viruses, bacteria, protozoa, helminths, irritants, allergy and toxins

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3
Q

What are the two route of entry for interstitial pneumonia?

A
  • inhalation

- haematogenous

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4
Q

How is interstitial pneumonia usually distributed in the lungs?

A

Diffuse

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5
Q

How would a lung with interstitial pneumonia appear grossly?

A
  • heavy, rubbery, elastic texture
  • red, grey mottled surface
  • lack of visible exudate
  • lungs fail to collapse on opening thorax
  • Costal impression on pleural surface – where the ribs would have been when the lungs over expanded
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6
Q

What are the 3 phases of the acute response for interstitial pneumonia?

A
  1. Injury to type 1 pneumocytes or capillary endothelium
  2. Exudative response
  3. Proliferative phase
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7
Q

What occurs in the exudative response?

A
  • Expansion of the interstitial tissue: oedema and inflammatory exudate
  • Leakage of fluid and plasma proteins into the alveolar space
  • May see hyaline membrane formation
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8
Q

What is the hyaline membrane?

A

A high protein density fluid made up of plasma proteins and surfactant which coats the alveolar spaces

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9
Q

What cells would be found in interstitial tissue?

A

Macrophages
Fibroblasts
Blood vessels

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10
Q

What occurs in the proliferative phase of interstitial pneumonia?

A
  • Macrophage population expands, these phagocytose and remove the exudate
  • Type II pneumocytes proliferate to replace lost type I cells
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11
Q

What are the functional consequences of acute interstitial pneumonia?

A

Disruption of alveolar walls
Oedema and exudate
= Hypoxia

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12
Q

How does acute interstitial pneumonia resolve?

A
  • alveolar macrophages remove alveolar fluid and cells

- type II pneumocytes differentiate into type I

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13
Q

Give examples of causes of acute interstitial pneumonia

A
  • Viruses e.g. distemper
  • Migrating parasites
  • Type III hypersensitivity reaction
  • Toxins e.g. tryptophan
  • Inhaled smoke
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14
Q

Give examples of causes of chronic interstitial pneumonia

A
  • Infections e.g. Ovine lentivirus
  • Hypersensitivity reaction
  • Toxins
  • Irritants
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15
Q

If interstitial pneumonia injury persists which 4 chronic changes occur?

A
  • interstitial fibrosis
  • chronic inflammatory cells
  • persistence of type II pneumocytes
  • smooth muscle hyperplasia around bronchioles
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16
Q

Which cells are present in chronic interstitial pneumonia?

A

Fibroblasts
Lymphocytes
Plasma cells
Macrophages

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17
Q

Which cells are present in acute interstitial pneumonia?

A

Proliferative type II cells
Macrophages
Exudate

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18
Q

What are the functional consequences of chronic interstitial pneumonia?

A
  • thickened alveolar walls, which decreases lung compliance

- Increased respiratory effort

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19
Q

Which agents produce lesions that have features of both bronchopneumonia + interstitial pneumonia? (bronchointerstitial pneumonia)

A

Pneumotropic viruses

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20
Q

What are the consequences of thickened alveolar walls in chronic interstitial pneumonia?

A
  • Reduced airspaces
  • Impaired diffusion
  • Reduced gas exchange
    = hypoxia
    = pulmonary hypertension
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21
Q

What is the route of entry and distribution of embolic pneumonia?

A 
ROE = Haematogenous 
Distribution = random disseminated foci
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22
Q

What are the 3 common causes of embolic pneumonia?

A
  • Hepatic abscesses
  • Right heart valve endocarditis
  • Joint/naval infections
23
Q

What follows on sequalae to embolic pneumonia?

A
  • Formation of abscesses
  • Fibrosis and resolution
  • Chronic pneumonia
  • Rupture => pyothorax
24
Q

Granulomatous inflammation is dominated by which 2 cells?

A

Macrophages and multinucleated giant cells

25
Which types of agents cause Granulomatous inflammation ?
- Ones that persist in tissues | - Induce chronic inflammation
26
What are the routes of entry and distribution of Granulomatous inflammation?
``` ROE = inhalation and haematogenous Distribution = variable, nodular foci ```
27
How do multinucleated giant cells form?
Fusion of macrophages in an attempt to phagocytose an agent more effectively
28
Give some examples of causes of Granulomatous inflammation
- Bacteria: Mycobacteria e.g. TB - Parasites: migrating lungworm or heartworm - Viruses: Feline infectious peritonitis - Fungi - Foreign bodies
29
What kind of exudate will be seen grossly in Granulomatous inflammation?
Caseous = cheese like
30
Bacteria causing Granulomatous inflammation will stain what colour with Ziehl-Neelson?
Purple | Gram +ve
31
Give examples of primary lung tumours (these are rare)
- Bronchioalveolar squamous cell carcinoma | - Papillary adenocarcinoma
32
How does neoplasia spread in/around the lung?
By not only metastasis but also locally within the lung through spread along the airways - spread by friable tumour fragments in the airflow along bronchi and bronchioles
33
What is the favourable environment for pulmonary adenomatosis?
Housing sheep intensively overwinter - ovine pulmonary carcinoma
34
How is pulmonary adenomatosis induced?
Retroviral induced neoplasia - aerosol infection
35
How do the cells of pulmonary adenomatosis appear?
Predominantly cuboidal or columnar cells resembling type II pneumocytes.
36
How do the lungs of a sheep with pulmonary adenomatosis appear grossly?
- Lungs are heavy, with small grey to white nodules | - Copious amount of mucoid fluid
37
Why is metastatic spread to the lungs causing secondary neoplasia very common?
The lungs have a good blood supply and a fine capillary network
38
Give 3 examples of tumours that can be deposited in the lung
- Mammary tumours - Osteosarcoma - Haemangiosarcoma
39
Describe the pleural cavity and its role in the body
- Surround the lungs which are under partial pressure | - When the ribs expand outwards, the pressure is reduced and the lungs are drawn outwards
40
What is a pneumothorax?
The partial pressure in the pleural cavity has been dispersed, so the pleural pressure is the same as outside and the lungs collapse
41
How would a radiograph of a pneumothorax appear?
A lateral chest radiograph shows the lung size to be greatly reduced
42
What are some causes of a pneumothorax?
- Spontaneous rupture of abscess, emphysematous bulla - Traumatic rupture or perforation of lung or trachea - Penetrating injury of the thoracic wall
43
Pleural effusions all inhibit?
Lung expansion
44
What is a hydrothorax?
Oedema/transudate (low protein density fluid) in the pleural space
45
What are the causes of a hydrothorax?
- heart failure - hypoproteinaemia - intrathoracic tumours
46
What is a haemothorax?
Blood in the pleural space
47
What are the causes of a haemothorax?
- trauma and rupture of blood vessels - erosion of blood vessels by tumours - clotting disorders
48
What is a chylothorax?
Lymph in the pleural space
49
What are the causes of a chylothorax?
- traumatic rupture or neoplastic erosion of the thoracic duct wall - heart disease - congenital abnormality to the thoracic duct
50
What is a pyothorax?
Pus in the pleural space
51
What are the causes of a pyothorax?
Penetrating injury | Lung abscess rupture
52
What is the name given to inflammation of the pleural cavity/
Pleuritis
53
What are the causes of pleuritis?
- pneumonia - bacteria - pyothorax - FIP virus

Y3 Respiratory Pathology (5 decks)

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