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Pulmonary > 2.1.3 Infectious Disease of the Lung > Flashcards

2.1.3 Infectious Disease of the Lung Flashcards

1
Q

How could you distinguish between lobar pneumonia and bronchopneumonia on a histologic slide?

A

If the bronchi were filled with pus, it would be called bronchopneumonia. If it is in the alveoli, it is lobar pneumonia, by definition.

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2
Q

What is the most common organism to cause pneumonia?

A

Streptococcus pneumoniae

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3
Q

What is this an image of?

A

Lobar pneumonia

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4
Q

What are complications associated with TB?

A
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5
Q

Who is at risk for Pneumocystis jirovecii infection?

A

HIV patients with <200 CD4 count

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6
Q

What is this an image of?

A

Pneumocystis jirovecii

Also know that a BAL can be a good diagnostic test for this

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7
Q

What is this an image of?

A

Lung that has a hole in it after infection and liquefactive necrosis.

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8
Q

How would lobar pneumonia show up on a CXR?

A

It would show up as a tissue density on a chest X-Ray.

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9
Q

Why is it important to get a patient with pneumonia on antibiotics as soon as possible?

A

To prevent scarring of the lung tissue

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10
Q

What are some of the complications of pneumonia?

A
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11
Q

What are the different clinical classifications of aspergillosis? *Important

A
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12
Q

What are the stages of lobar pneumonia?

A
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13
Q

What is the most frequent cause of gram-negative bacterial pneumonia?

A

Klebsiella pneumoniae

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14
Q

What is this an image of?

A

Pneumocystis jirovecii - silver stain

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15
Q

What is this an image of? (Hint: Lab studies make this disease worse than the patient is presenting)

A

Legionella CXR - affecting the RUL

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16
Q

Walking pneumonia

Patient seems pretty fine

What bacteria are these characteristics of?

A

Mycoplasma pneumoniae

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17
Q

What is this an image of?

A

Lobar pneumonia - notice how nearly every alveoli is filled with pus.

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18
Q

What is this an image of?

A

This is a CXR of a lobar pneumonia

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19
Q

What is this an image of?*

A

Aspergillosis (Blood vessel invasion/thrombosis)

Aspergillus will invade blood vessels, and cause thrombosis and infarction, and those infarcts can occur anywhere in the body, not just the lung

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20
Q

What is the most common way that organisms are introduced to the lower respiratory tract?

A

Aspiration of flora from the oropharynx

21
Q

What are the important characteristics of legionella pneumophilia?

A

It is an intracellular organism, requiring antimicrobial drugs with good cytoplasmic penetration. Biochemical abnormalities may seem more severe than patient presents. Requires special media to grow

22
Q

What is this an image of?

A

Klebsiella pneumoniae

Notice the abcess formation

23
Q

Patient has a Staphylococcus aureus infection, and presents with this CXR. What is a common cause that he got it?

A

This is bilateral Staph pneumonia. It is most likely cause by IV drug abuse

24
Q

What is this an image of?

A

Interstitial pneumonia - CT Scan

25
Q

What are the characteristics of community-acquired pneumonia?

A

Community-acquired acute pneumonia refers to lung infection in otherwise healthy individuals that is acquired from the normal environment (in contrast to hospital acquired pneumonia). It may be bacterial or viral.

Rarely seen either resolves or progresses to cause lobar pneumonia

Neutrophilic reaction and abundant sputum

RLL is the most common area affected

26
Q

Gram stain positive

Most common source of community acquired pneumonia

What are these characteristic of?

A

Strep pneumo

27
Q

What is this an image of and what caused it? *Very important

A

Invasive Aspergillosis that caused a lung infarct -

28
Q

What population does Klebsiella pneumoniae most often afflict?

A

Debilitated and malnourished people, particularily alcoholics

29
Q

What is this an image of?

A

CXR of TB - Miliary TB

30
Q

Bacteria most associated with lung necrosis and abcess formation

Drug users

A

Staph aureus

31
Q

What are the clinical features of Haemophilus influenzae?

A

Gram-negative

Mainly a problem with children

Common cause of COPD exacerbation

32
Q

What is this an image of?

A

Legionella - IF sputum staining

33
Q

What is this an image of and what is the stain?

A

Legionella - Dieterle stain

34
Q

What are the types of pneumonia?

A

Community-Acquired pneumonia

Atypical pneumonia

Bronchial pneumonia

Lobar pneumonia

35
Q

What can be used to make a diagnosis of pneumonia?

A

Most Important - Presentation of clinical symptoms and/or the presence of infiltrate on CXR or CT Scan. Blood cultures are also helpful

Less important - sputum culture

36
Q

What are these images of?

A

Hemorrhagic Tracheobronchitis - Influenza A

37
Q

What is the most likely population to aspirate?

A

Institutionalized (nursing home patients) patients are more likely to aspirate

They also have an altered oral flora, which can include many gram negative and anaerobic organisms

38
Q

What are the characteristics of atypical pneumonia?

A

Low grade fever, patchy consolidation and has a non-productive cough

39
Q

What is this an image of?*

A

Aspergillus niger

40
Q

What is this an image of?

A

S. pneumoniae - sputum gram stain

41
Q

What is circled in this image?*

A

Aspergilloma - There is no invasion of tissue by the fungus. It respects the boundaries of the previously existing abscess cavity.

42
Q

What is this an image of?

A

This is an aspergilloma - it exists within a previously existing space, most likely an old abcess

43
Q

What is the difference between these two images?

A

Left - bronchopneumonia

Right - Lobar pneumonia

44
Q

In a patient with pneumocystis jirovecii infection and a normal immune system, how will the infection present?

A

It will tend to be asymptomatic in a patient with normal immune system

45
Q

What is this an image of?

A

TB - gross finding

Notice - Caseous necrosis and cavitation in advanced TB

46
Q

What is the difference between primary TB and secondary TB?

A
47
Q

What is this an image of?

A

Cytomegalovirus - Owl eye inclusion in the nucleus. Immunocompromised host

48
Q

What is the difference between these two images?

A

Left - Normal ciliated columnar epithelium

Right - rhinovirus infected epithelium

Pulmonary (42 decks)

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