Acute Respiratory Infection and Pneumonia

Question 1

Give an example of two reflexes which prevent organisms entering the respiratory tract

Answer 1

• Cough reflex

- Epiglottic reflex

Question 2

What is Humoral Immunity?

Answer 2

Immunity associated with antibody production, mainly via B lymphocytes

Question 3

What is the main antibody in the Upper airway?

Answer 3

IgA

Question 4

What is Cell Mediated Immunity?

Answer 4

Immunity mediated by T lymphocytes

Question 5

State several risk factors for Pneumonia

Answer 5

• Altered consciousness i.e. strokes / seizures (compromises epiglottic closure)
• Cigarette smoking
• Alcohol
• Septicaemia
• Immunosupression
• Intubation
• Drugs
• Congenital i.e. Kartagener’s syndrome

Question 6

Define Commensalism

Answer 6

A relationship between two organisms where one benefits and the other is unaffected

Question 7

State one nasal-passage resident bacteria which can become pathogenic under certain conditions

Answer 7

Staphylococcus aureus

Question 8

State four pharynx / larynx resident bacteria which can become pathogenic under certain conditions

Answer 8

• Staphylococcus aureus
• Streptococcus pneumoniae
• Haemophilus Influenzae
• Neisseria meningitidis

Question 9

State 3 examples of bacteria which can cause typical pneumoniae. How are they treated?

Answer 9

• Streptococcus pneumoniae
• Haemophilus influenzae
• Staphylococcus aureus

Treated by Beta-lactam ABX

Question 10

State 3 examples of viruses which can cause pneumoniae

Answer 10

Influenza A
Influenza B
Respiratory Syncytial virus

Question 11

State an example of a Fungi which causes pneumoniae

Answer 11

Pneumocystis jirovecii (Immunocompromised / HIV patients)

Question 12

Bronchitis is an inflammatory condition of what?

Answer 12

Tracheo-bronchial tree

Question 13

What are the three main aetiological agents which cause Bronchitis?

Answer 13

Influenza
Adenovirus
Rhinovirus / Coronavirus

Are all viruses

Question 14

What is the mechanism of action of Salbutamol

Answer 14

Bronchodilator, beta-2 agonist

Question 15

What would a CXR of pneumonia show?

Answer 15

Shadowing / consolidation

Question 16

State three bacteria which cause atypical pneumonia. How are they treated? Why/

Answer 16

Mycoplasma pneumonia
Chlamydia pneumonia
Legionella pneumophila

Are treated by Macrolides, because they do not have a cell wall

Question 17

How can pneumonia be classified based on acquisition?

Answer 17

Community Acquired (CAP)
Hospital Acquired (HAP)
Ventilator Acquired (VAP)

Question 18

How can pneumonia be classified based on the region of the lungs it can infect? What is the most common?

Answer 18

• Bronchopneumonia (bronchioles and alveoli) - MOST COMMON
• Atypical / Interstitial pneumonia (interstitum)
• Lobar pneumonia (lobes)

Question 19

What is the most common cause of bacteria which causes Pneumonia?

Answer 19

Streptococcus pneumoniae

Question 20

Typical Community Acquired Pneumonia is common in what group of people?

Answer 20

Elderly patients

Question 21

Atypical Community Acquired Pneumonia is common in what group of people?

Answer 21

Older children / young adults

Question 22

Which Gram-negative bacteria resides in stagnant water?

Answer 22

Legionella pneumophila

Question 23

Legionella pneumonphila can cause two syndromes - what are they?

Answer 23

• Legionnaire’s disease (pneumonia)

- Pontiac fever

Question 24

Which microbe causes Ventilator Acquired Pneumonia?

Answer 24

Staphylococcus aureus

Question 25

What does Kartagener’s syndrome cause?

Answer 25

Defects in cillia - risk factor for Pneumonia

Question 26

Outline the four steps of pathophysiology in Lobar pneumonia

Answer 26

1. Congestion
2. Red hepatisation
3. Grey hepatisation
4. Resolution