Lecture 17: Disease of the Lower RT (Specht) Flashcards Preview

Cardiopulmonary (Estrada-Fall 2014) > Lecture 17: Disease of the Lower RT (Specht) > Flashcards

Flashcards in Lecture 17: Disease of the Lower RT (Specht) Deck (39):
1

Bacterial pneumonia more common in dogs/cats?

dogs

2

routes on infection for bacterial pneumonia

inhalation
aspiration
hematogenous spread

3

bacterial pneumonia CS

Can be acute/chronic/mild/severe
-coughing and dyspnea*
-fever
-nasal d/c
-cyanosis
-crackles
-non-specific anorexia, dehydration, weight loss

4

Dx of bacterial pneumonia

-inflammatroy leukogram
-interstitial or alveolar pattern in rads
-TTW/BAL/pulmonary aspirate positive culture***

5

Tx of bacterial pneumonia

-Abx (based on culture/sensitivity!) until at least 2 weeks after complete resolution of all clinical/rad signs
-supportive care (hydration, nutrition, turning)
-O2
-nebulization, coupage, mild exercse to loosen phlegm

6

prog. of bacterial pneumonia

-fair to good
-affected by severity, underlying conditions, complications

7

2 main causes of viral pneumonia

canine distemper, flu

8

tx of viral pneumonia

supportive care
tx of 2ary bacterial infections

9

route of infect./CS of fungal pneumonia

inhalation, hematogenous
CS: cough, dyspnea, lethargy, weight loss, anorexia

10

dx of fungal pneumonia

-rads show diffuse interstitial pattern or hilar lymphadenopathy
-cytology/culture/histo (i.e. TTW, BAL, pulmonary aspirate) have pyogranulomatous/eosinophilic inflamm. + organisms assoc. with macs**
-serology possible

11

tx/prog. of fungal pneumonia

Tx: antifungals 1-2 mo. after resolution, oxygen therapy, +/- steroids
Prog: fair to poor, requires long-term tx

12

aspiration pneumonitis

-occurs when foreign material enters the lungs
-can be 2ary to v, dysphagia, megaesophagus, force-feeding, feeding tubes, etc.
-can be followed by 2ary bact. infection

13

dx of aspiration pneumonia

classic: alveolar pattern in R middle lung lobe on rads**
+/- megaesophagus
-cytology/cutlure

14

tx of aspiration pneumonia

-symptomatic care (O2, nebulization, coupage, exercise)
-abx only if no improvement, inflammatory leukogram worsens, fever develops, or animal has been on H2 blockers or proton pump inhibitors

15

prog. of aspiration pneumonia

depends...mild to fatal

16

number 1 differential for asthma**

pronounced expiratory effort

17

feline bronchitis (asthma)

dz char. by wheezing, coughing, dyspnea due to spontaneous bronchoconstriction

18

contributing factors of asthma

-bronchospasm
-bronchial smooth m./epithelial hypertrophy
-inc. mucus prod. or dec. clearance
-inflamm. exudate w/n lumen or of airway walls
-fibrosis
-emphysema
-airway hypersensitivity

19

only potential difference between asthma and bronchitis

asthma may have more eos in wash than bronchitis

20

CS of feline bronchitis

-young/middle aged
-small airway obstruction --> sudden dyspnea; cough/wheezing/crackles, inc. expiratory effort
-slowly progressive pathology
-exacerbated by env. changes

21

Dx of feline bronchitis (asthma)

-history, CS, PE**
-TXR: bronchial wall thickening/pulm. hyperinflation
-TW/BAL cytology (inflammaotry, cultures usually negative)
-HW Ag and Ab tests
-Fecal

22

Tx of feline bronchitis

-airway management
-env. mod.
-long-term corticosteroids
-bronchodilators

23

Prog. of feline bronchitis

-poor for complete cure
-fair to good for control of CS
-sudden death possible

24

canine chronic bronchitis

long-term airway inflamm. probably assoc. with irritants, recurrent infection, allergies. Targets overweight, small to medium breedsover 5 yo

25

CS of canine chronic bronchitis

-progressively worsening dry cough exacerbated by excitement
+/- wheezes, crackles

26

Dx of canine chronic bronchitis

TXR:
-prominent bronchial pattern +/- interstitial
-bronchiectasis if severe
-R sided cardiomegaly if severe (cor pulmonale)
Tracheal wash:
-cytology: nonspecific inflamm., excess mucous
-culture: generally negative
Bronchoscopy:
-membranes hyperemic, edematous, excess mucous, small airway collapse

27

Tx of canine chronic bronchitis

focused on relieving CS, not curing**
-glucocorticoids
-bronchodilators
-cough suppressants
-antibiotics

28

Pulmonary Thromboembolism

thrombosis or embolism causes perfusion/ventilation mismatch (increased V/Q)**
-dec. cardiac output, inc. pulmonary resistance, bronchoconstriction
-loss of surfactant, infarction

29

virchow's triad

describes the three broad categories of factors that are thought to contribute to thrombosis:

Hypercoagulability
Hemodynamic changes (stasis, turbulence)
Endothelial injury/dysfunction

30

Dz assoc. with pulmonary thromboembolism

-hyperadrenocorticism
-pancreatitis
-sepsis
-IMHA
-trauma/surgery
-DIC
-Protein-losing nephropathy

31

CS of pulmonary thromboembolism

SUDDEN ONSET** of resp. distress, dyspnea, tachypnea
+/- increased breath sounds
tachycardia
shock, hemoptysis, syncope, collapse, death

32

Dx of pulmonary thromboembolism

-presumptive
-coag. panels
-TXR: usually do NOT rule out PTE***, but may wee hypovascular regions/blunted pulmonary vessels
-angiography, scintigraphy

33

Tx of PTE

-supportive care
-anticoagulants
-fibrinolytic meds (streptokinase, TPA)

34

Prog. of PTE

-guarded/poor
-depends on severity
-risk of sudden death

35

Chars. of pulmonary/bronchial neoplasia

-1ary neoplasia RARE
-common site of mets
-older animals
-variable CS: cough, tachypnea, dyspnea, pleural space problems, hypertrophic osteodystrophy

36

Dx/Tx/Prog. of pulmonary/bronchial neoplasia

Dx: imaging for localization (rads, CT, bronchoscopy), cytology/biopsy for defin. dx
Tx: sx, chemo, radiation, palliative tx (alleviating pain)
Prog: complete excision possible

37

eosinophilic bronchopneumonopathy

-wide spectrum of disorders char. by severe eosinophilic infiltration
-variable CS

38

eosinophilic bronchopneumonopathy Dx/Tx/Prog.

Dx: R/O other causes, +/-eosinophilia in peripheral blood, cytology/biopsy with eos infiltration
Tx: steroids
Prog: variable

39

bronchiectasis

-permanent dilation of bronchi
-complication of chronic resp. dz such as chronic bronchitis
-extremely susceptible to infection
-sx removal possible
-prognosis guarded to poor