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Flashcards in Pulmonary Parenchymal Disorders Deck (125):
1

With lung disease, there is often difficulty with breathing on what phase?

Expiratory

2

There is an increase in what with reference to breathing with lung disease?

Rate and effort

3

If a cough is not due to a non-cardiogenic cause, what is done?

Take a radiograph

4

If abnormal lungs are seen on a radiograph, what does this indicate?

Lower airways and pulmonary parenchyma

5

If normal lungs are seen on a radiograph with a non-cardiogenic cough, what does this indicate?

Tracheal disorders

6

An inflammatory disorder of lung parenchyma is known as what?

Pneumonia

7

What are 5 possible causes of pneumonia?

- Bacterial
- Aspiration
- Viral
- Fungal
- Parasitic

8

What is the most common cause of pneumonia if dogs?

Bacteria

9

What is a type of diagnostic test that helps to distinguish between different pneumonia etiologies?

Radiographic patterns

10

What is pneumonia often characterized by?

Soft, ineffectual cough

11

What are 3 respiratory clinical signs seen with pneumonia?

- Difficulty breathing on expiration
- Tachypnea
- Cyanosis if severe

12

What are 2 other clinical signs seen with pneumonia?

- Nasal discharge
- Exercise intolerance

13

What are 3 common systemic signs of pneumonia?

- Fever
- Lethargy
- Poor appetite

14

Is primary bacterial pneumonia more common in dogs or cats?

Dogs

15

Is primary bacterial pneumonia seen more in young or old dogs?

Young dogs

16

What are 2 common causes of bacterial pneumonia in dogs?

- Bordetella
- Pasteurella

17

Inflammation and consolidation of lung tissue can be seen with what respiratory condition?

Bacterial pneumonia

18

Is secondary bacterial pneumonia seen more in young or old dogs?

Old dogs

19

If there is a history of recent sedation or anesthesia, the organism responsible is more likely to be what?

Resistant to antibiotics

20

What type of lung pattern can be seen with early pneumonia?
What is the classic pattern seen?

- Interstitial pattern
- Alveolar pattern

21

Lung patterns are often seen in what part of the lungs?

Cranioventral distribution

22

What are 3 other things to look at on a thoracic radiograph that could be primary causes for pneumonia?

- Foreign body
- Megaesophagus
- Other thoracic disease

23

Radiographic changes of pneumonia lag behind what?

Clinical signs

24

What are 2 changes seen on a hemogram with bacterial pneumonia?

- Neutrophilic leukocytosis with left shift
- Monocytosis if chronic

25

Bacterial pneumonia can results in sepsis which can result in what 2 conditions?

- ALI
- ARDS

26

What type of treatment for bacterial pneumonia should be begun pending culture results?

Empirical treatment with antibiotics

27

Broad coverage over what four quadrants is seen with empirical use of antibiotics?

- Gram positive
- Gram negative
- Anaerobes
- Mycoplasma

28

When treating bacterial pneumonia, start with what form of antibiotic and then switch to what form?

- Injectable
- Oral

29

How long should antibiotics be given for when treating bacterial pneumonia?

4-8 weeks

30

What are 2 things that can be used to mobilize airway secretions through nebulization?

- Sterile saline
- Gentamicin (works on gram negative)

31

What might nebulization cause?
What should be used before nebulization?

- Bronchoconstriction
- Bronchodilator

32

What are 3 forms of supportive care that can be given with bacterial pneumonia?

- IV fluids
- Oxygen and coupage
- Bronchodilators

33

What is coupage?

Percussion therapy used in dogs with pneumonia to dislodge mucus.

34

What are 5 possible causes of mycotic pneumonia?

- Blastomycosis
- Histoplasmosis
- Coccidiomycosis
- Cryptococcosis
- Aspergillosis

35

Inappetence, weight loss, fever, lameness, enlarged lymph nodes, draining tracts, chorioretinitis or anterior uveitis are systemic signs of what?

Mycotic pneumonia

36

What are 2 diagnostic techniques that can be used for detecting mycotic pneumonia?

- Cytology/histology
- Urine/serum antigens

37

What are 3 drugs that can be used to treat mycotic pneumonia?

- Itraconazole
- Amphotericin B
- Ketaconazole

38

What fungal organism is common in Arizona?
In the Ohio River Valley?

- Coccidiomycosis
- Blastomycosis, Histoplasmosis

39

What fungal organism can cause GI signs?

Histoplasmosis

40

How can cryptococcus be diagnosed?

Serum antigen titer

41

How can the causes of Valley Fever be diagnosed?

Urine antigen titer

42

How long do you treat for mycotic pneumonia?

4-12+ months

43

What are 2 oral medications that can be given to treat mycotic pneumonia?
Which one costs more?

- Fluconazole and Itraconazole
- Itraconazole

44

What are 2 side effects seen with fluconazole and itraconazole?

- Inappetence
- Elevation of liver enzymes

45

What is a drug that can be used for mycotic pneumonia but is nephrotoxic?
Which form is less nephrotoxic?

- Amphotericin B
- Lipid-complex form

46

What does the success of treatment for mycotic pneumonia depend on?

How disseminated the infection is at time of diagnosis.

47

There is a more guarded prognosis with mycotic pneumonia with what?

CNS involvement

48

There is an increased chance of what during the first week of treatment?

Worsening of respiratory signs.

49

How effective is the treatment of blastomycosis and cryptococcosis?

80% effective

50

What form of histoplasmosis has a guarded prognosis?

Disseminated form

51

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)

52

What is the name of the parasite that can cause parasitic pneumonia known as the cat lungworm?

Aleurostrongylus abstrusus

53

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

54

What type of clinical signs can be seen with an Aleurostrongylus abstrusus infection?

Subclinical or have same clinical signs as feline asthma.

55

What might be seen on a CBC with feline lungworm?

Eosinophilia

56

What can be seen on chest x-rays with feline lungworm?

Diffuse nodular densities in the caudal lobes.

57

What are 2 drugs that can be used to treat feline lungworm?

- Fenbendazole
- Ivermectin

58

What clinical signs can be seen with Paragonimus pneumonia?

Subclinical or cough, wheeze, difficulty breathing.

59

Flukes form what within the lungs?

Cysts

60

What can happen if the cysts formed during Paragonimus pneumonia rupture?

Pneumothorax

61

What might be seen on chest x-rays with Paragonimus pneumonia?

Air-filled cysts

62

What can be seen on a CBC with Paragonimus pneumonia?

Eosinophilia

63

What are 3 signalments for Idiopathic pulmonary fibrosis?

- Terriers (West Highland White Terrier)
- Middle aged to older
- Some cats

64

Chronic fibrosis of lung interstitium characterized by infiltration of fibroblasts with collagen deposits in the alveolar septa is known as what?

Idiopathic pulmonary fibrosis

65

What is another name for idiopathic pulmonary fibrosis?

Progressive interstitial fibrosis

66

Does idiopathic pulmonary fibrosis have a fast or slow onset?

Slow onset

67

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

68

What is a hallmark finding heard on a physical exam with progressive interstitial fibrosis?

Inspiratory crackles

69

What is seen on radiograph with progressive interstitial fibrosis?

Generalized or diffuse interstitial pattern

70

What will be seen on an arterial blood gas reading with severe progressive interstitial fibrosis?

Hypoxemia

71

What diagnostic technique gives a definitive diagnosis for progressive interstitial fibrosis?

Lung biopsy

72

Combination of what 2 treatments can be used to alleviate the signs of chronic bronchitis associated with progressive interstitial fibrosis?

- Corticosteroids
- Bronchodilators

73

What is the prognosis for progressive interstitial fibrosis?

Guarded

74

What can progressive interstitial fibrosis lead to?

Progressive respiratory failure

75

What are 2 examples of primary causes of pulmonary neoplasia?

- Adenocarcinoma (alveolar or bronchogenic)
- Squamous cell carcinoma

76

What is the most common primary pulmonary neoplasia?

Adenocarcinoma

77

What type of pulmonary neoplasia is more common, primary or metastatic?

Metastatic

78

What are 6 examples of metastatic pulmonary neoplasias?

- Adenocarcinoma
- Osteosarcoma
- Chondrosarcoma
- Hemangiosarcoma
- Melanoma (oral/digital)
- Squamous cell carcinoma

79

What are 3 examples of multicentric sources of pulmonary neoplasia?

- Lymphoma
- Malignant histiocytosis
- Mastocytoma

80

What is the common signalment for pulmonary neoplasia?

Older dogs and cats

81

What are 4 possible clinical respiratory signs that can be seen with pulmonary neoplasia?

- Cough
- Labored breathing
- Increased RR
- Hemoptysis

82

What is hemoptysis?

Coughing up blood

83

What are 3 types of abnormal lung sounds that can be heard with pulmonary neoplasia?

- Crackles
- Wheezes
- Muffled sounds

84

What are 6 non-respiratory clinical signs that can be seen with pulmonary neoplasia?

- Weight loss
- Inappetence
- Lameness
- Dysphagia
- Regurgitation
- Edema of head/neck from venous obstruction

85

How many thoracic radiographic views should be taken?

3 views

86

What is the treatment for primary pulmonary neoplasia with a single nodule?

Surgery if single nodule

87

What is the treatment for metastatic or multicentric pulmonary neoplasia?
What about if it is lymphoma?

- Treat primary mass
- Chemotherapy

88

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

89

Which has a better prognosis: adenocarcinoma or squamous cell carcinoma?

Adenocarcinoma

90

Which has a better prognosis: no lymph node involvement or lymph node involvement?

No lymph node involvement

91

Accumulation of fluid in alveoli or pulmonary interstitium is known as what?

Pulmonary edema

92

What needs to be determined concerning the origins of pulmonary edema?

Cardiogenic or non-cardiogenic

93

If the origin of pulmonary edema is cardiogenic, what should be detected on physical exam?

Murmur or arrhythmia

94

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

95

With non-cardiogenic pulmonary edema, accumulated fluid interferes with what?

Ventilation and perfusion

96

What are 3 possible progressions of non-cardiogenic pulmonary edema?

- Acute Lung Injury (ALI)
- Acute Respiratory Distress Syndrome (ARDS)
- Respiratory failure

97

What are 3 examples of pulmonary insults that can lead to the increased alveolar-capillary membrane permeability seen with non-cardiogenic pulmonary edema?

- Aspiration
- Upper airway obstruction
- Smoke

98

What are 5 examples of non-pulmonary insults that can lead to the increased alveolar-capillary membrane permeability seen with non-cardiogenic pulmonary edema?

- Sepsis
- Electric shock
- CNS disease
- Pancreatitis
- DIC

99

What would you hear on thoracic auscultation with non-cardiogenic pulmonary edema?

Crackles

100

What are 2 things you would expect to see on thoracic radiographs with non-cardiogenic pulmonary edema?

- Bilateral alveolar pattern
- Caudodorsal lung fields affected

101

What are 3 forms of treatment for non-cardiogenic pulmonary edema?

- Aggressive control of primary disease
- Cage rest and oxygen
- Supportive care

102

What are 3 forms of supportive care for non-cardiogenic pulmonary edema?

- Sedation
- Cautious fluid therapy
- Positive ventilation in severe cases

103

What is the prognosis with permeability edema pathogenesis of non-cardiogenic pulmonary edema?

Guarded

104

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

105

Pulmonary inflammation and edema resulting in acute respiratory failure is known as what?

Acute lung injury

106

A severe manifestation of acute lung injury is known as what?

Acute respiratory distress syndrome

107

Acute lung injury and acute respiratory distress syndrome are most commonly sequela of what 3 conditions?

- Sepsis
- Shock
- Bacterial pneumonia

108

Clinical signs of ALI and ARDS may be delayed for how long after inciting event?

1-4 days

109

Progressive hypoxemia, respiratory distress and cyanosis can indicate what 2 conditions?

- Acute lung injury
- Acute respiratory distress syndrome

110

Are ALI and ARDS primary or secondary syndromes?

Secondary

111

What is the current mortality rate for ALI/ARDS?

Close to 100%

112

Various degrees of respiratory distress and crackles with severe consolidation are seen with what?

Pulmonary contusions

113

How long can it take for lung changes to take to show up, especially on radiographs?

2-12 hours

114

How long should pulmonary contusions be monitored for?

24-48 hours

115

Inflammation of the lungs thought to be caused by a hypersensitivity to some unknown antigen is known as what?

Eosinophilic bronchopneumopathy

116

What is a breed predisposition for eosinophilic bronchopneumopathy?

Siberian husky

117

What age range is eosinophilic bronchopneumopathy seen in with dogs?

Young to middle aged dogs

118

Lack of what is seen with eosinophilic bronchopneumopathy?

Lack of response to antibiotics

119

Harsh crackles, expiratory wheezes and a moist productive cough elicited on tracheal palpation are seen with what condition?

Eosinophilic bronchopneumopathy

120

An increase in what 2 types of WBCs can be seen with eosinophilic bronchopneumopathy?

- Neutrophils
- Eosinophils

121

Eosinophilic bronchopneumopathy can have what percentage eosinophil population?

Greater than 20-25%

122

What are 3 potential signs of eosinophilic bronchopneumopathy that can be seen on radiographs?

- Diffuse broncho-interstitial pattern
- Alveolar infiltrates
- Bronchiectasis

123

How is eosinophilic bronchopneumopathy treated?

Find and treat underlying cause.

124

What is the treatment for pulmonary thromboembolism?

Oxygen and treat underlying disease.

125

What is the prognosis for pulmonary thromboembolism?

Poor to grave