Flashcards in Pulmonary Parenchymal Disorders Deck (125):
With lung disease, there is often difficulty with breathing on what phase?
There is an increase in what with reference to breathing with lung disease?
Rate and effort
If a cough is not due to a non-cardiogenic cause, what is done?
Take a radiograph
If abnormal lungs are seen on a radiograph, what does this indicate?
Lower airways and pulmonary parenchyma
If normal lungs are seen on a radiograph with a non-cardiogenic cough, what does this indicate?
An inflammatory disorder of lung parenchyma is known as what?
What are 5 possible causes of pneumonia?
What is the most common cause of pneumonia if dogs?
What is a type of diagnostic test that helps to distinguish between different pneumonia etiologies?
What is pneumonia often characterized by?
Soft, ineffectual cough
What are 3 respiratory clinical signs seen with pneumonia?
- Difficulty breathing on expiration
- Cyanosis if severe
What are 2 other clinical signs seen with pneumonia?
- Nasal discharge
- Exercise intolerance
What are 3 common systemic signs of pneumonia?
- Poor appetite
Is primary bacterial pneumonia more common in dogs or cats?
Is primary bacterial pneumonia seen more in young or old dogs?
What are 2 common causes of bacterial pneumonia in dogs?
Inflammation and consolidation of lung tissue can be seen with what respiratory condition?
Is secondary bacterial pneumonia seen more in young or old dogs?
If there is a history of recent sedation or anesthesia, the organism responsible is more likely to be what?
Resistant to antibiotics
What type of lung pattern can be seen with early pneumonia?
What is the classic pattern seen?
- Interstitial pattern
- Alveolar pattern
Lung patterns are often seen in what part of the lungs?
What are 3 other things to look at on a thoracic radiograph that could be primary causes for pneumonia?
- Foreign body
- Other thoracic disease
Radiographic changes of pneumonia lag behind what?
What are 2 changes seen on a hemogram with bacterial pneumonia?
- Neutrophilic leukocytosis with left shift
- Monocytosis if chronic
Bacterial pneumonia can results in sepsis which can result in what 2 conditions?
What type of treatment for bacterial pneumonia should be begun pending culture results?
Empirical treatment with antibiotics
Broad coverage over what four quadrants is seen with empirical use of antibiotics?
- Gram positive
- Gram negative
When treating bacterial pneumonia, start with what form of antibiotic and then switch to what form?
How long should antibiotics be given for when treating bacterial pneumonia?
What are 2 things that can be used to mobilize airway secretions through nebulization?
- Sterile saline
- Gentamicin (works on gram negative)
What might nebulization cause?
What should be used before nebulization?
What are 3 forms of supportive care that can be given with bacterial pneumonia?
- IV fluids
- Oxygen and coupage
What is coupage?
Percussion therapy used in dogs with pneumonia to dislodge mucus.
What are 5 possible causes of mycotic pneumonia?
Inappetence, weight loss, fever, lameness, enlarged lymph nodes, draining tracts, chorioretinitis or anterior uveitis are systemic signs of what?
What are 2 diagnostic techniques that can be used for detecting mycotic pneumonia?
- Urine/serum antigens
What are 3 drugs that can be used to treat mycotic pneumonia?
- Amphotericin B
What fungal organism is common in Arizona?
In the Ohio River Valley?
- Blastomycosis, Histoplasmosis
What fungal organism can cause GI signs?
How can cryptococcus be diagnosed?
Serum antigen titer
How can the causes of Valley Fever be diagnosed?
Urine antigen titer
How long do you treat for mycotic pneumonia?
What are 2 oral medications that can be given to treat mycotic pneumonia?
Which one costs more?
- Fluconazole and Itraconazole
What are 2 side effects seen with fluconazole and itraconazole?
- Elevation of liver enzymes
What is a drug that can be used for mycotic pneumonia but is nephrotoxic?
Which form is less nephrotoxic?
- Amphotericin B
- Lipid-complex form
What does the success of treatment for mycotic pneumonia depend on?
How disseminated the infection is at time of diagnosis.
There is a more guarded prognosis with mycotic pneumonia with what?
There is an increased chance of what during the first week of treatment?
Worsening of respiratory signs.
How effective is the treatment of blastomycosis and cryptococcosis?
What form of histoplasmosis has a guarded prognosis?
What is the recovery rate for coccidiomycosis?
How long do medications need to be given for?
- 60% recovery rate
- 6-12 months or longer (sometimes lifetime)
What is the name of the parasite that can cause parasitic pneumonia known as the cat lungworm?
What is the name of the fluke that can cause parasitic pneumonia in both dogs and cats?
What type of eggs does it produce?
- Paragonimus kellicoti
- Operculated egg
What type of clinical signs can be seen with an Aleurostrongylus abstrusus infection?
Subclinical or have same clinical signs as feline asthma.
What might be seen on a CBC with feline lungworm?
What can be seen on chest x-rays with feline lungworm?
Diffuse nodular densities in the caudal lobes.
What are 2 drugs that can be used to treat feline lungworm?
What clinical signs can be seen with Paragonimus pneumonia?
Subclinical or cough, wheeze, difficulty breathing.
Flukes form what within the lungs?
What can happen if the cysts formed during Paragonimus pneumonia rupture?
What might be seen on chest x-rays with Paragonimus pneumonia?
What can be seen on a CBC with Paragonimus pneumonia?
What are 3 signalments for Idiopathic pulmonary fibrosis?
- Terriers (West Highland White Terrier)
- Middle aged to older
- Some cats
Chronic fibrosis of lung interstitium characterized by infiltration of fibroblasts with collagen deposits in the alveolar septa is known as what?
Idiopathic pulmonary fibrosis
What is another name for idiopathic pulmonary fibrosis?
Progressive interstitial fibrosis
Does idiopathic pulmonary fibrosis have a fast or slow onset?
What are 2 common clinical signs seen with idiopathic pulmonary fibrosis?
What are 2 other signs that can be seen as the disease progresses?
- Respiratory distress, tachypnea
- Cough, weight loss in cats
What is a hallmark finding heard on a physical exam with progressive interstitial fibrosis?
What is seen on radiograph with progressive interstitial fibrosis?
Generalized or diffuse interstitial pattern
What will be seen on an arterial blood gas reading with severe progressive interstitial fibrosis?
What diagnostic technique gives a definitive diagnosis for progressive interstitial fibrosis?
Combination of what 2 treatments can be used to alleviate the signs of chronic bronchitis associated with progressive interstitial fibrosis?
What is the prognosis for progressive interstitial fibrosis?
What can progressive interstitial fibrosis lead to?
Progressive respiratory failure
What are 2 examples of primary causes of pulmonary neoplasia?
- Adenocarcinoma (alveolar or bronchogenic)
- Squamous cell carcinoma
What is the most common primary pulmonary neoplasia?
What type of pulmonary neoplasia is more common, primary or metastatic?
What are 6 examples of metastatic pulmonary neoplasias?
- Melanoma (oral/digital)
- Squamous cell carcinoma
What are 3 examples of multicentric sources of pulmonary neoplasia?
- Malignant histiocytosis
What is the common signalment for pulmonary neoplasia?
Older dogs and cats
What are 4 possible clinical respiratory signs that can be seen with pulmonary neoplasia?
- Labored breathing
- Increased RR
What is hemoptysis?
Coughing up blood
What are 3 types of abnormal lung sounds that can be heard with pulmonary neoplasia?
- Muffled sounds
What are 6 non-respiratory clinical signs that can be seen with pulmonary neoplasia?
- Weight loss
- Edema of head/neck from venous obstruction
How many thoracic radiographic views should be taken?
What is the treatment for primary pulmonary neoplasia with a single nodule?
Surgery if single nodule
What is the treatment for metastatic or multicentric pulmonary neoplasia?
What about if it is lymphoma?
- Treat primary mass
What is the overall prognosis for pulmonary neoplasia?
What is the exception?
- Guarded to poor
- Benign mass restricted to one lobe which might be removable
Which has a better prognosis: adenocarcinoma or squamous cell carcinoma?
Which has a better prognosis: no lymph node involvement or lymph node involvement?
No lymph node involvement
Accumulation of fluid in alveoli or pulmonary interstitium is known as what?
What needs to be determined concerning the origins of pulmonary edema?
Cardiogenic or non-cardiogenic
If the origin of pulmonary edema is cardiogenic, what should be detected on physical exam?
Murmur or arrhythmia
What are the 4 general mechanisms behind non-cardiogenic pulmonary edema?
- Vascular overload/increased hydrostatic pressure
- Decreased plasma oncotic pressure
- Increased alveolar-capillary membrane permeability
- Lymphatic obstruction
With non-cardiogenic pulmonary edema, accumulated fluid interferes with what?
Ventilation and perfusion
What are 3 possible progressions of non-cardiogenic pulmonary edema?
- Acute Lung Injury (ALI)
- Acute Respiratory Distress Syndrome (ARDS)
- Respiratory failure
What are 3 examples of pulmonary insults that can lead to the increased alveolar-capillary membrane permeability seen with non-cardiogenic pulmonary edema?
- Upper airway obstruction
What are 5 examples of non-pulmonary insults that can lead to the increased alveolar-capillary membrane permeability seen with non-cardiogenic pulmonary edema?
- Electric shock
- CNS disease
What would you hear on thoracic auscultation with non-cardiogenic pulmonary edema?
What are 2 things you would expect to see on thoracic radiographs with non-cardiogenic pulmonary edema?
- Bilateral alveolar pattern
- Caudodorsal lung fields affected
What are 3 forms of treatment for non-cardiogenic pulmonary edema?
- Aggressive control of primary disease
- Cage rest and oxygen
- Supportive care
What are 3 forms of supportive care for non-cardiogenic pulmonary edema?
- Cautious fluid therapy
- Positive ventilation in severe cases
What is the prognosis with permeability edema pathogenesis of non-cardiogenic pulmonary edema?
If signs of non-cardiogenic pulmonary edema are due to fluid overload and if renal function is intact, how does this affect prognosis?
Prognosis is better
Pulmonary inflammation and edema resulting in acute respiratory failure is known as what?
Acute lung injury
A severe manifestation of acute lung injury is known as what?
Acute respiratory distress syndrome
Acute lung injury and acute respiratory distress syndrome are most commonly sequela of what 3 conditions?
- Bacterial pneumonia
Clinical signs of ALI and ARDS may be delayed for how long after inciting event?
Progressive hypoxemia, respiratory distress and cyanosis can indicate what 2 conditions?
- Acute lung injury
- Acute respiratory distress syndrome
Are ALI and ARDS primary or secondary syndromes?
What is the current mortality rate for ALI/ARDS?
Close to 100%
Various degrees of respiratory distress and crackles with severe consolidation are seen with what?
How long can it take for lung changes to take to show up, especially on radiographs?
How long should pulmonary contusions be monitored for?
Inflammation of the lungs thought to be caused by a hypersensitivity to some unknown antigen is known as what?
What is a breed predisposition for eosinophilic bronchopneumopathy?
What age range is eosinophilic bronchopneumopathy seen in with dogs?
Young to middle aged dogs
Lack of what is seen with eosinophilic bronchopneumopathy?
Lack of response to antibiotics
Harsh crackles, expiratory wheezes and a moist productive cough elicited on tracheal palpation are seen with what condition?
An increase in what 2 types of WBCs can be seen with eosinophilic bronchopneumopathy?
Eosinophilic bronchopneumopathy can have what percentage eosinophil population?
Greater than 20-25%
What are 3 potential signs of eosinophilic bronchopneumopathy that can be seen on radiographs?
- Diffuse broncho-interstitial pattern
- Alveolar infiltrates
How is eosinophilic bronchopneumopathy treated?
Find and treat underlying cause.
What is the treatment for pulmonary thromboembolism?
Oxygen and treat underlying disease.