Test 42 pneumonia

Question 1

clinical signs of pulmonary parachymal disease

Answer 1

Increased resp. rate and effort
Restrictive respiratory pattern
Harsh BV sounds or crackles
Nasal discharge
Cough (productive)
Signs of hypoxemia

Question 2

diagnostics for pulmonary parenchymal disease

Answer 2

Physical exam and history
CBC/chem screen
Thoracic radiographs
CT
Tracheal wash
Bronchoscopy +/- BAL
Lung aspirates
Lung biopsy

Question 3

normal defense mechanism of the respiratory system

Answer 3

Nasopharynx
Mucociliary escalator
Cough reflex
Bronchus-associated lymphoid tissue and IgA
Alveolar macrophages
Pulmonary lymphatics and lymph nodes

Question 4

underlying conditions that predispose patient to aspiration pneumonia

Answer 4

Pharyngeal/laryngeal dysfunction
Megaesophagus
Cleft palate
Abnormal mentation
Recumbency, debilitation
Sedation or anesthesia

Question 5

three phases of aspiration pneumonia

Answer 5

1st - low pH of GI contents causes injury and bronchoconstriction

2nd - inflammation occurs, results in edema

3rd - bacteria in aspirated material cause 2ndary bacterial pneumonia

Question 6

clinical signs of bacterial pneumonia

Answer 6

wide range

From intermittent coughing and mild exercise intolerance to dyspnea, cyanosis, and septic shock

Other signs that may or may not be present

• Nasal discharge
• Productive cough
• Fever
• Leukocytosis (↑WBC)

Question 7

routes of infection for bacterial pneumonia

Answer 7

inhaltion- most common
hematogenous- uncommon in dogs and cats

Question 8

pneumonia usually presents as — on xrays if caused by inhalation

Answer 8

cranioventral alveolar pattern (air bronchograms, can’t see vessels, opacity)

Question 9

what are some bacteria that can cause bacterial pneumonia

Answer 9

primary: bordetella (kennel cough)

opportunists: gram + and gram - aerobic (ecoli, pasteruella ect. )

Question 10

Bordetella do what to cells and cause what clinical signs —

Answer 10

attach to columnar epith cells- cause ciliary stasis = stays in airway for long time

adult dogs: upper airway signs (hacking cough)

puppies: can cause bronchopneumonia

kennel cough

Question 11

what meds for mycoplasma? why these meds

Answer 11

mycoplasma have NO cell wall

Sensitive to fluoroquinolones, macrolides, tetracyclines, and chloramphenicol

Can be normal flora in dog lungs, but
not cats

Question 12

when to do tracheal wash for pt with suspected bacterial pneumonia

Answer 12

before starting antibiotics

Question 13

Answer 13

trans tracheal wash

used in larger breeds

Question 14

Answer 14

endotracheal wash

Question 15

treatment of bacterial pneumonia

Answer 15

• Broad-spectrum antibiotics until C+S results → IV if patient is critical
• O2 supplementation → Cage, nasal, mask, flow-by
• IV fluid therapy
• nebulization/coupage
• bronchodilation (more common for aspiration pneumonia)
• mucolytics

Question 16

Answer 16

pneumonia

alveolar pattern- air bronchograms

Question 17

3 month old bulldog, productive cough, difficulty breathing, high temp, pale, ↑HR and resp, harsh lung sounds and crackles cranioventrally

DDX
how to treat

Answer 17

pneumonia:
infectious: bordetella
aspiration
viral: distemper, flu

endotracheal wash + bacteria

treatment:
IV fluids
broad spectrum AB
nebulization and coupage
bronchodilators
O2 cage

Question 18

what are common causes of viral pneumonia

Answer 18

Distemper
Canine influenza
Pneumovirus
COVID-19?

Question 19

clinical signs of distemper
what will xray show
how to diagnose

Answer 19

viral pneumonia

1st: conjunctivitis and dry cough → productive cough, GI (vomiting) and neuro signs (head tilt)

then progresses to 2ndary bacterial penumonia

thoracic Xray: diffuse interstitial pattern → alveolar pattern as disease worsens

diagnosis: fluroescent Ab testing on conjunctival epithelial cells

poor prognosis

Question 20

how to diagnose distemper

Answer 20

fluroescent Ab testing on conjunctival epithelial cells

Question 21

canine flu clinical signs

Answer 21

Mild (most common) – soft or dry cough, ± nasal d/c

Severe – high fever, clinical signs of pneumonia, affects 5- 8%, mortality rate up to 5%

Question 22

diagnosis of canine flu

Answer 22

serology
PCR

Question 23

how to prevent canine flu

Answer 23

vaccinate dogs that go around other dogs

Question 24

how to test for pneumovirus

Answer 24

primarly seen in shelter
Includes parainfluenza and distemper

PCR to test within 3 days of clinical onset, results in 3-5 days

patchy pneumonia

Question 25

toxoplasma gondii is common in —-

Answer 25

immuno suppressed cats (FeLV/FIV)

Question 26

rads of toxoplasma gondii

Answer 26

fluffy interstitial to nodular alveolar pattern

Question 27

treatment of toxoplasma gondii

Answer 27

cause protozoal pneumonia in immunosuppresed cats

Xray- fluffy interstitial to nodular alveolar pattern

Treatment – clindamycin or sulfa drugs lifelong

Question 28

most common fungal pneumonias are by — fungi

Answer 28

Histoplasmosis, Blastomycosis, and Coccidiomycosis

found in the middle: histo and blasto
texas border: cocc

Question 29

diagnosis of fungal pneumonia

Answer 29

• Thoracic rads – diffuse interstitial pattern (miliary) to nodular, hilar lymphadenopathy
• Trach wash, BAL, lung aspirates, lung bx – identification of organism
• Fungal cultures
• Serology (PCR)

Question 30

dog from the texas border

Answer 30

fungal pneumonia- diffuse interstitial pattern (miliary) to nodular, hilar lymphadenopathy

Coccidiomycosis – Southwestern US
and Mexico

Question 31

treatment of fungal pneumonia

Answer 31

Antifungals - toxic side effects, expensive
Require treatment for 4-6 months or
more

Currently used antifungals: Itraconazole, Fluconizole, Amphotericin B

Question 32

— causes fungal pneumonia in immocompromised Cavaliers and dachsounds

Answer 32

Pneumocystis carnii
Rare in dogs, not reported in cats