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Year 3 respiratory > resp pathology > Flashcards

resp pathology Flashcards

1
Q

What type of fluid is this and what is this condition called?

A

-sero-sanguinous transudate

hydrothorax

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2
Q

what can cause a hydrothorax?

A

CHF

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3
Q

What has hapenned to the dark areas of lung?

A

congested and deflation (atelectasis)

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4
Q

what diseases can cause congestion and atelectasis?

A

thoracic cavity tumour

pneumothorax

haemothorax

pyothorax

abscess

inhaled fb / food

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5
Q

What is the major abnormality present in image A?

A

emphysema - diffuse alveolar and interstitial

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6
Q

What major abnormality is seen in image B?

A
  • flooding of alveoli with protein rich fluid
  • widened interlobular septa with fibrin
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7
Q

what cattle disease can cause emphsema and alveoli flooding with protein rich fluid?

A

Acute bovine pulmonary oedema and emphysema (fog fever)

  • lush autumn grass has tryptophan which converts to a pneumotoxin in the rumen
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8
Q

name 4 features of the upper and lower resp tract that protect the lung from airborne infections?

A
  • mucociliary escalator
  • mucus
  • nasal cavity with turbulent air flow
  • resident alveolar macrophages
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9
Q

what area of the resp tract is most vulnerable to infection?

A

where cilia end before alveoli

(bronchoalveolar junction)

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10
Q

What portion of the lung is affected and what has hapenned to it?

A
  • Cranioventral distribution on each lobe
  • dark bit = consolidation and congestion (chronic pneumonia)
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11
Q

what is the condition shown?

A

bronchiolectasis = permenant bronchiole dilation

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12
Q

What is illustrated in image B?

A

artery and bronchiole infiltrated in wall and lumen by inflammatory cells

neutrophils and purulent exudate stretch the bronchiole and fix it as dilated

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13
Q

How do the changes in image A develope from the changes in image B?

A

-damaged smooth muscle so stay dilated

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14
Q

what is the blue material that is asteriksed within the airway lumen?

A

thick mucous plugging the airways

can also see excess goblet cells and hyperplasia of the wall so reduced cilia so cant clear mucous

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15
Q

This is from a stabled horse with a chronic history of dyspnoea and coughing. What is the most likley diagnosis?

A

RAO

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16
Q

How can you alleviate the symptoms of RAO?

A
  • soak hay
  • good hay quality
  • change bedding to mats
  • turn horse out
  • mucolytics
  • bronchiodilators
  • expectorants
  • NSAIDs, steroids, anti-histamines
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17
Q

What is the obvious abnormality and what do we call this in neonates?

A
  • light and dark patchy appearance
  • primary partial atelectasis
  • it has taken a few breaths as some areas inflated
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18
Q

What is the difference between the two images?

A

Top = normal

Bottom = pink protein rich exudate - oedema

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19
Q

What can cause pulmonary oedema?

A

LS HF

brain injury

symp stimulation

tryptophan

smoke

paraquat

iatrogenic - excess fluids

barbiturate euthanasia

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20
Q

A = normal

B and C = abnormal

c= more magnified

What is the difference in B and C?

A
  • pink exudate and no air in alveoli
  • neutrophils present
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21
Q

What two patterns of pneumonia are characterised by the changes in B and C?

A

bronchopneumonia - infl cells in air space, inhaled

Embolic - from blood

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22
Q

Describe the gross appearance of the lungs

A

Large variably sized cream - yellow nodules

Granuloma or abscess

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23
Q

what is the difference in cell type between a granuloma and abscess?

A

Granuloma - macrophage

Abscess - neutrophil

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24
Q

What does image A show?

A

necrotic centre with viable macrophages then lymphocytes then capsule

  • a granuloma
  • dark foci = dystrophic mineralisation due to necrosis
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25
Q

What cell is indicated by the asterisk in image B?

A

multinuclear giant cell

(fused macrophages)

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26
Q

How can you confirm Tb presence?

A

ziehl - neelson stain - see magenta bits in macrophages

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27
Q

What are the pathological changes with Tb?

A

giant cells

granulomas

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28
Q

What pigment do all these lesions have in common?

A

Melanosis

-flat nodule

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29
Q

what is the gross abnormality?

A

Mucopurulent exudate

diffuse redenning (hyperaemia / congestion / haemorrhage)

sulphur granules in exudate

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30
Q

what is the most likely undelrying cause?

A

Norcardia or actinomyces as make sulphur granules

  • from environment from cat fight wound
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31
Q

What has hapenned and what is this condition called?

A

Atrophic rhinitis

  • bilateral concha loss, smaller turbinates and wonky snouth
  • tear staining
  • more prone to secondary infection
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32
Q

What pathogens cause atrophic rhinitis and how do they work?

A
  • pasturella multocida - activates osteoclast
  • bordatella bronchiseptica - inhibits osteoblasts
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33
Q

Describe the macroscopic changes in the lung? What are 3 possible causes?

A

White nodules on very dark red lung - atelectasis

  • neoplasia
  • granuloma
  • abscess
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34
Q

What is the underlying cause?

A

Glandular (cells stuck to neighbouring cells and forming lines) neoplasia

  • adenocarcinoma
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35
Q

what is the most likely parasite causing this infection?

A

Dictycalus viviparus

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36
Q

what is the likley immune status of this calf to the parasite?

A

Been exposed before as formed a type 4 hypersensitivity granuloma

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37
Q

What defence function to the nasal chambers play?

A

remove particles

humidify and warm

sneeze with noxious stimulie

38
Q

what defence function do the pharynx/larynx play?

A

cough if particles aspirated

epiglottis blocks off trachea

39
Q

in what environment can resident alveolar macrophages increase in number

A

dusty environment

40
Q

Where are lung mets common from?

A

mammary

haemangiosarcomas

osteosarcomas

41
Q

what is hypertrophic pulmonary osteopathy?

A

paraneoplastic disease where space occupying lung lesions can cause periosteal thickening of long bones

42
Q

What is primary atelectasis?

A

failure of lung tissue to expand at birth

43
Q

what is secondary atelectaiss?

A

collapse of a previously ventilated lung

44
Q

What is unusual about cattle lungs?

A

thick fibrous septae between lobes so lack collateral ventilation

45
Q

what 2 things can cause secondary atelectasis?

A

1) Compression - mass, pneumothorax etc, recumbency
2) obstruction - exudate

46
Q

what is emphysema?

A

excessive air in lungs

47
Q

what is alveolar emphysema?

A

permenant abnormal enlargement of airspaces distal to the terminal bronchioles, often from alveolar wall destruction by neutrophil elastace (RAO eg)

48
Q

what is interstitial emphysema?

A

septal lymphatic are dilated with air secondary to forced expiration (pneumonia eg)

49
Q

what is compensatory emphysema?

A

adjacent to an area of consolidation

50
Q

what to pigments can affect the lungs?

A

melanin

anthracosis - carbon in alveolar macrophages

51
Q

What are 5 circulatory disorders affecting the lungs?

A

hyperaemia

congestion

oedema

haemorrhage

thrombosis/embolism/infarction

52
Q

what is hyperaemia?

A

increase blood flow into tissue (acute infl eg)

53
Q

what does dark red lung tissue indicate?

A

hyperaemia

54
Q

what is congestion?

A

decreased blood flow from a tissue (cardiac failure eg)

55
Q

what does grey/blue lung tissue indicate?

A

congestion

56
Q

what are 4 causes of oedema?

A

cardiogenic (press overload)

neurogenic (brain damage)

excess fluid therapy

damage to endothelium/epithelium

57
Q

How does oedema fluid appear with H and E?

A

pale pink as protein rich

58
Q

what are normal factors resisting oedema?

A
  • tight junction between alveolar ep and capillaries
  • intra-alveolar pressure > interstitial pressure
  • lymphatic drainage
59
Q

What are the 3 things contributing to a thrombus?

A

endothelial injury

abnormal blood flow

hypercoagulation

60
Q

What is thrombosis?

A

obstruction of vessels by blood during life

61
Q

what is an embolism?

A

detachment of thrombi, lodged in small vessels

62
Q

What are the 6 types of pneumonia?

A

broncho -

lobar -

broncho-interstial -

interstitial -

embolic -

granulomatus -

63
Q

what causes broncho-pneumonia?

A

bacterial inf

aspiration pneumonia

*from airways

64
Q

What is the normal distribution of broncho-pneumonia?

A

cranioventral lung

65
Q

how does bronchopneumonia spread between lobes?

A

airway / necrosis of alveoli +septa

66
Q

what are the possible sequelae of broncho-pneumonia?

A

resolution

abscess

pleuritis and adhesion

death from hypoxaemia

chronic and get bronchiectasis

67
Q

what is bronchiectasis?

A

permenant dilation of some bronchi due to irreversible damage to bronchi wall

68
Q

what causes lobal pneumonia?

A

highly toxic bacteria

aspiration

69
Q

what does lobar pneumonia normally infect?

A

entire lobes

(common in cats as incomplete lobulation and septation)

70
Q

what causes broncho-interstitial pneumonia?

A

mycoplasma

virus

71
Q

what is the pathogenesis of broncho-interstitial pneumonia?

A

infl in bronchioles – lymphocytic proliferation – lymphoid cuffing of airways

72
Q

What can cause interstitial pneumonia?

A

-haematogenous damage

73
Q

what distribution does interstitial pneumonia have?

A

diffuse

74
Q

what are 2 toxins that can cuase interstitial pneumonia?

A
  • paraquat
  • tryptophan
75
Q

what can cause embolic pneumonia?

A

endocarditis, hepatic abscess, phlebitis

76
Q

what is the distribution of embolic pneumonia?

A

focal

77
Q

what can cause granulomatus pneumonia?

A

mycobacteria

funghi

78
Q

What are A-F?

A

A = ciliated ep cell

B = type 1 ep cells (pneumocyte)

C= type 2 ep cells

D=alveolar capillary

E=alveolar macrophage

F=Clara cell

79
Q

This is from a cat’s nose with persistent unilateral nasal discharge

What is the mass composed of? what is the diagnosis?

A

diffuse proliferation of subepithelial connective tissue overlain by an intact ep

inflammatory polyp

80
Q

Lung from a horse with long term resp difficulty. Diagnosis?

A

RAO

chronic aggregation of plasma cells, lymphocytes and eosinophils around bronchioles with emphysema

81
Q

Lung from a young intensively housed calf with unresolving pneumonia

How did the infection enter the lungs?

What is the difference in the damaged areas of each lung?

A
  • entered by inhalation as accumulated in lower cranioventral lobes
  • furthest left lung - chronic as pale and nodular. Will be firm and consolidated. Bronchiectasis and fibrosis cause the pallor and nodularity

Middle lobe - sub-acute = darker red due to blood leakage. Slightly undulating surface from infl cells filling and expanding alveoli and bronchioles

Right lobe = acute = dark red from hyperaemia. Surface is shiny and moist and smooth

82
Q

Lung from a 6mo calf that died in resp distress.

What is S and is it what caused death? How was S formed?

A

S = bull of emphysema

  • a secondary lesions to bronchopneumonia obstructing air outflow by accumulating exudate
  • as cattle have fibrous interlobar septa trapped air can penetrate the alveolar walls and enter interstitial tissue forming air pockets
83
Q

What pattern is this?

A

Nodular interstitial

84
Q

What pathology is shown here?

A

Pleural effusion

  • cardiac silhouette and diaphrgam not visible
  • increased opacity
  • fissure lines
  • lung edges away from thoracic wall
85
Q

What pathology is shown here?

A

Pneumothorax

  • elevation of cardiac silhouette
  • no vessel or bronchi
  • area of lucency on left side if collapsed lung
86
Q

What pathology is shown here?

A

cranial mediastinal mass

  • trachea deviated to left
87
Q

What are the 3 most common dog cranial mediastinal tumours?

A

thymoma

lymphoma

haemangiosarcoma

88
Q

what pathology is present here?

A

Diaphragmatic hernia

89
Q

What pathology is present here?

A

pneumomediastinum

  • as two vessels below trachea re visible when they shouldnt be
  • aorts appears better marginated than normal due to surrounding gas
90
Q

What pathology is shown here? what else is abnormal?

A

Diaphragmatic hernia

Sternal fracture with some new bone formation

91
Q

What pathology is shown here?

A

pleural effusion

  • black anechoic area at location of lung on both sides of cranial mediastinum which is consistent with fluid

Year 3 respiratory (11 decks)

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