43. CVD/Respiratory Disorders

Question 1

Define

Pneumonia

Answer 1

Infection that inflames air sacs in one or both lungs, which may fill with fluid

Question 2

Define

Ischaemic Stroke

Answer 2

Stroke caused by occlusion of a blood vessel by thrombus

Question 3

Definition

Infection that inflames air sacs in one or both lungs, which may fill with fluid

Answer 3

Pneumonia

Question 4

Definition

Stroke caused by occlusion of a blood vessel by thrombus

Answer 4

Ischaemic Stroke

Question 5

What causes the infarct damage seen in a stroke?

Answer 5

Infarct damage is caused by immediate necrosis and/or delayed apoptosis.

Question 6

What is the pharmacological, surgical and endogenous repair treatments for stroke?

Answer 6

Pharmacological: t-PA or aspirin

Surgical: Endovascular surgery

Endogenous repair/regeneration: Rehabilitation

Question 7

What is the most common cause of death for individuals who have previously suffered from a stroke?

Answer 7

Cerebrovascular disease (i.e. another stroke)

Question 8

What is the most common complication post stroke?

Answer 8

Pneumonia

Question 9

What percentage of stroke survivors get pneumonia? What percentage of these individuals die?

Answer 9

20-30% of survivors get pneumonia

10% death rate

Question 10

Why are stroke victims susceptible to pneumonia?

Answer 10

Lowered immunity

Hospital acquired infections

Decreased gas exchange

Question 11

Why is the immune system suppressed following stroke?

Answer 11

Shuts down to limit cytokine induced cell death

Question 12

What happens to the amount of bacteria in a mouses lungs following stroke?

Answer 12

Increases after 24 hours

Question 13

What have mice models taught us about bacteria and lungs following stroke?

Answer 13

• 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

Question 14

How do we know that the bacteria that enters the lungs following stroke isn’t externally acquired?

Answer 14

Germ-free mice who have had a stroke show no increase in bacterial load in the lungs

Question 15

Does the bacterial loading in the lungs following stroke found in animal models translate to humans?

Answer 15

Yes

Question 16

Why does gut bacteria end up in the lungs following stroke?

Answer 16

Increased peripheral sympathetic action causes gut dysbiosis and the movement of bacteria into the blood and lungs

Question 17

What effects does sympathetic nervous system inhibition have on bacterial loading in the lungs of mice stroke survivors?

Answer 17

Decreases the bacteria increasing survival rates

Question 18

What effect does anitbiotic therapy have on mice stroke survivors?

Answer 18

Antibacterial Therapy Reduces Functional Deficits and Infarct Volume 4-7 Days After MCAO

Antibacterial Therapy Reduces Mortality and Lung Infections After MCAO

Question 19

What effect does antibiotic therapy have on human stroke survivors?

Answer 19

Decreased UTIs

No effect on pneumonia (don’t know why)