Parenchymal Disease Flashcards
(20 cards)
What structures are located within the respiratory zone of the respiratory tract?
Respiratory bronchioles
Alveolar ducts
Alveolar sacs
Alveoli
What clinical signs are associated with respiratory zone pathology?
Restrictive pattern (low TV, fast RR)
Dull crackles (coarse = low pitch = lower airway)
Dull to absent bronchovesicular sounds
Hypoxemia
Respiratory fatigue
Systemic illness
Fever
Moist cough
What are the indications for initiating mechanical ventilation?
Severe hypoxemia despite oxygen supplementation (PaO2 < 60mmHg, SpO2 < 90%)
Severe hypoventilation despite therapy (PaCO2 > 60 mmHg)
Respiratory fatigue
Severe hemodynamic compromise
What is the physiology of positive pressure ventilation?
5 - 10 cmH20
Prevent alveolar and small airway collapse
Recruit collapsed alveoli
What are the consequences of respiratory zone inflammation?
Airway and alveolar flooding: surfactant loss, stiff lungs, increased WOB, increased oxygen consumption
Hypoxemia: oxygen debt, respiratory failure
Systemic inflammation: thrombosis, organ dysfunction, leaky vessels
What are differentials for respiratory zone pathology?
What diagnostics can be done to rule out/in pulmonary hemorrhage?
PT/PTT
Platelet count
What diagnostics can be done to rule out/in pneumonia?
Lung POCUS (right middle)
What diagnostics can be done to rule out/in strangulation and noncardiogenic pulmonary edema?
Lung POCUS (bilateral caudodorsal)
What diagnostics can be done to rule out/in anticoagulant rodenticide?
PT/PTT
What diagnostics can be done to rule out/in ALI or ARDS?
Echocardiogram
Thoracic radiographs/CT
What are 2 differential diagnoses for bilateral wet lungs in the caudodorsal and perihilar lung regions? How can you distinguish those 2 differentials?
Cardiogenic pulmonary edema
Noncardiogenic pulmonary edema
Distinguish with cardiac POCUS
What are causes of increased permeability pulmonary edema?
ALI/ARDS
Inhaled toxins
Barotrauma
What is a of mixed cause pulmonary edema?
Negative pressure: airway obstruction
What is the onset, risk factors, and other characteristics of ARDS?
Acute onset (<72h)
Risk factors: pneumonia, sepsis, shock, trauma
Pulmonary capillary leak: bilateral diffuse infiltrates (lungs are wet everywhere)
Hypoxemia: P/F < 200-300
Diffuse pulmonary inflammation (dx with TTW, BAL)
What is a normal PaO2 for an animal receiving supplemental oxygen?
How do you assess hypoxemia in a patient receiving supplemental oxygen (40%)?
PaO2/FiO2
What is a normal P/F ratio?
500 = normal
<300 = not grat
<200 = really bad
< 100 = terrible
How do you assess hypoxemia in a patient breathing room air?
Aa gradient
What is a normal Aa gradient?
< 10 = normal
10 - 20 = mild lung pathology
20 - 30 = moderate lung pathology
>30 = severe lung pathology
