43. CVD/Respiratory Disorders Flashcards
Define
Pneumonia
Infection that inflames air sacs in one or both lungs, which may fill with fluid
Define
Ischaemic Stroke
Stroke caused by occlusion of a blood vessel by thrombus
Definition
Infection that inflames air sacs in one or both lungs, which may fill with fluid
Pneumonia
Definition
Stroke caused by occlusion of a blood vessel by thrombus
Ischaemic Stroke
What causes the infarct damage seen in a stroke?
Infarct damage is caused by immediate necrosis and/or delayed apoptosis.
What is the pharmacological, surgical and endogenous repair treatments for stroke?
Pharmacological: t-PA or aspirin
Surgical: Endovascular surgery
Endogenous repair/regeneration: Rehabilitation
What is the most common cause of death for individuals who have previously suffered from a stroke?
Cerebrovascular disease (i.e. another stroke)
What is the most common complication post stroke?
Pneumonia
What percentage of stroke survivors get pneumonia? What percentage of these individuals die?
20-30% of survivors get pneumonia
10% death rate
Why are stroke victims susceptible to pneumonia?
Lowered immunity
Hospital acquired infections
Decreased gas exchange
Why is the immune system suppressed following stroke?
Shuts down to limit cytokine induced cell death
What happens to the amount of bacteria in a mouses lungs following stroke?
Increases after 24 hours
What have mice models taught us about bacteria and lungs following stroke?
- Ischaemic stroke causes a time dependent increase in bacteria in the lungs (& blood)
- Ischaemic stroke casues thickening of alveolar walls and neutrophil infiltration
- Evidence of E. coli pneumonia
How do we know that the bacteria that enters the lungs following stroke isn’t externally acquired?
Germ-free mice who have had a stroke show no increase in bacterial load in the lungs
Does the bacterial loading in the lungs following stroke found in animal models translate to humans?
Yes
Why does gut bacteria end up in the lungs following stroke?
Increased peripheral sympathetic action causes gut dysbiosis and the movement of bacteria into the blood and lungs
What effects does sympathetic nervous system inhibition have on bacterial loading in the lungs of mice stroke survivors?
Decreases the bacteria increasing survival rates
What effect does anitbiotic therapy have on mice stroke survivors?
Antibacterial Therapy Reduces Functional Deficits and Infarct Volume 4-7 Days After MCAO
Antibacterial Therapy Reduces Mortality and Lung Infections After MCAO
What effect does antibiotic therapy have on human stroke survivors?
Decreased UTIs
No effect on pneumonia (don’t know why)
