Test 3: 38 resp xray con

Question 1

what kind of pattern

Answer 1

bronchial pulmonary pattern

Eosinophilic bronchopneumopathy

Question 2

Answer 2

unstructured interstitial pulmonary pattern

Question 3

what kind of pattern

Answer 3

unstructured interstitial pattern: hazy/fog

Question 4

unstructured interstitial pattern look like

Answer 4

hazy

• generalized increase in pulmonary opacity
• Unsharp outline of pulmonary vessels and airway walls
• Decreased sharpness of the cardiac and diaphragmatic borders (difficult to recognize)

Question 5

what kind of pattern

Answer 5

normal- left
interstitial- right

Question 6

unstructured intersitial pattern DDx

Answer 6

Diffuse
“Disease in transition”
* Edema, Pneumonia, Hemorrhage
Less severe → Interstitial pattern
More severe → Alveolar pattern

• Pneumonitis/pneumonia
  Fungal pneumonia (esp. coccidioides), Viral pneumonia (e.g. Distemper), Septicemia, Metabolic (Uremia), Inhalant, Toxic
• Lymphoma – esp. dogs

Fibrosis: Pathologic (Westies); Older animals (age-related)
Eosinophilic pneumonia: Allergic, Heartworm

Focal
* Disease in transition → Edema, Pneumonia, Hemorrhage
* Partial lung atelectasis

Pulmonary thromboembolism
Hemorrhage
Bronchial foreign body

Question 7

what kind of pattern and ddx

Answer 7

interstitial pattern
lymphoma- big lymph nodes

Question 8

what type of pattern

Answer 8

right caudal lobe: intersitial- can still see vessels

left caudal lobe- alveolar- can not see vessels, can see air bronchiogram

cardiogenic pulmonary edema
left sided cardiomegaly- left auricular bulge

Question 9

what kind of pattern?

Answer 9

intersitial and alveolar pneumonia

Question 10

what kind of pattern

Answer 10

nodular intersitial pattern- can see > 3-5 mm nodules

Question 11

DDX for pulmonary nodules

Answer 11

• Metastatic pulmonary neoplasia
• Granulomatous disease →Heartworm, Fungal disease

Fluid-filled bullae, Cysts, Hematomas, Abscesses
(“CHANG” = Cyst, hematoma, abscess, neoplasia, granuloma)

Question 12

pumonary nodule can be confused with

Answer 12

end on vessels- nodules should be larger than adjacent vessels
osseous metaplasia- heterotopic bone- small relatively opaque for their size- well defined
cutaneous nodules- sharp outline, position, opaque

Question 13

pumonary nodules or end on vessel

Answer 13

Question 14

compare nodules

Answer 14

Question 15

what kind of pattern

Answer 15

miliary intersititial pattern

fungal infection- blastomycosis

Question 16

Answer 16

Question 17

most — patterns are due to chronic bronchitis, eosinophilic bronchopneumopathy, parasitic bronchitis or feline asthma

Answer 17

bronchial

Question 18

Disease in transition (edema, pneumonia, hemorrhage) – so distinguishing — from — is not always the deal breaker in terms of ddx

Answer 18

unstructured interstitial from alveolar

Question 19

DDX for mass

Answer 19

• Neoplasia (e.g., primary pulmonary)
• Granuloma
• Abscess

Hematoma
Cyst (fluid-filled)

Question 20

vascular lung pattern will have

Answer 20

Enlarged pulmonary veins
Enlarged pulmonary arteries
Enlarged pulmonary arteries and veins

Question 21

some causes of increased radiolucency

Answer 21

Artifacts And Extrapulmonary Disease

• Increased radiographic contrast/decreased brightness
• Hypovolemia
• Pneumothorax
• Emaciation
• Iatrogenic over-inflation during anesthesia

Question 22

ddx for focal pulmonary hyperlucency

Answer 22

• Bulla / Bleb – very thin to no wall
  Bulla = air-filled spaces within the lung from destruction and confluence of adjacent alveoli
  Bleb = similar but just under visceral pleural surface
• Cavitary mass – thick wall
   Neoplasia
   Granuloma
   Paragonimus cyst
   Abscess
   Hematoma / Traumatic bulla

Bronchial cyst – thin wall
Local reduction in blood supply → Pulmonary thromboembolism

Question 23

Answer 23

bullae- thin walled

pulmonary hyperlucency

Question 24

ddx of cavitary mass

Answer 24

hyperlucency with thick wall

Neoplasia
 Granuloma
 Paragonimus cyst
 Abscess
 Hematoma / Traumatic bulla

Question 25

what do you see on xray with pleural effusion

Answer 25

fluid in pleural space pleural fissure lines lung lobe retraction → rounding of lung margins silhouette sign

Question 26

what is this outlining

Answer 26

pleural fissure lines pleural effusion- fluid dissects between the lung lobes at the normal anatomic boundaries

Question 27

Answer 27

Question 28

the caudal lung lobe of a cat will --- and can be confused with ---

Answer 28

retract away from ribs at lumbophrenic angle pleural effusion- mild > 4 vertebral bodies abnormal

Question 29

Answer 29

pleural effusion retraction from ribs rounded heart in silhouetted fissure lines

Question 30

ddx for unilateral or asymmetric pleural effusion

Answer 30

* Inflammatory disease- pyothorax * Anatomically complete mediastinum * Chylothorax * Focal lung disease → Neoplasia, Lung love torsion

Question 31

in older dogs --- can be confused with pleural fissure lines

Answer 31

age related pleural fissure thickening

Question 32

signs of pneumothorax on xray

Answer 32

lung lobe margin retraction radiolucent pleual space with no pulmonary vessels cardiac silhouette seperated from sternum by gas

Question 33

Answer 33

pneumothorax Lung lobe margin retraction Radiolucent pleural space – Devoid of pulmonary vessels

Question 34

Answer 34

**pneumothorax** Lung lobe margin retraction Radiolucent pleural space – Devoid of pulmonary vessels **Cardiac silhouette separated from sternum by air**

Question 35

Answer 35

**tension pneumothorax** Mediastinal shift **away** from unilateral tension pneumothorax Over-distension of the thorax / pleural space  Widened intercostal spaces  Ribs perpendicular to spine

Question 36

causes of pneumothorax

Answer 36

**Traumatic** (e.g. hit by car with lung tissue rupture or penetrating injury) **Spontaneous**  Bulla rupture (dog)  Rupture of lung neoplasm, abscess, infarct  Lung rupture from lung disease such as feline asthma, pneumonia  Migrating foreign body  Extension of pneumomediastinum

Question 37

pneumo?

Answer 37

no - just normal deep chested dog- can see vessels in space below heart if you zoom