Bacterial Pneumoniae Flashcards
Respiratory tract infections are more frequent than infection of any other organ in the body.
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Bacterial pneumonia and complications
Pneumonia can be defined as any ______ of the _______.
infection
lung parenchyma
Bacterial pneumonia and complications
Pneumonia results when the _______ are impaired or whenever ______ of the host is lowered
defense mechanisms
resistance
Factors affecting resistance of host includes:
(acute or chronic?) diseases,
________ deficiency,
treatment with ________ drugs
_____penia,
unusually _____ infections.
Chronic
immunologic
immunosuppressive
leuco
virulent
Airways clearing mechanism could be impaired following:
loss of _____ reflex
injured _______ apparatus
interference with _________ of ________ action of alveolar macrophages
pulmonary _______ and ________
accumulation of ________
cough
mucociliary
phagocytic or bactericidal
congestion and oedema
secretion
loss of cough reflex (______,______\, drugs, ________ disorder or chest pain)
injured mucociliary apparatus (cigarette smoke, ______ gases, _________ syndrome)
coma, anaesthesia
neuromuscular
Corrosive ; immotile cilia
interference with phagocytic or bactericidal action of alveolar macrophages (alcohol, tobacco smoke, _______ or _______________)
accumulation of secretion (_______ and __________)
anoxia, or oxygen intoxication
cystic fibrosis and bronchial obstruction
one type of pneumonia predisposes to another type
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one type of pneumonia predisposes to another type PARTICULARLY in debilitated patients.
The portal of entry for most pneumonia is __________ and many chronic diseases acquire _______ pneumonia.
respiratory tract
terminal
Classification of pneumonia based on clinical settings
___________ acquired ____ pneumonia
____________ acquired ____ pneumonia
_______ Pneumonia
___________ pneumonia
_________ pneumonia
_________ Pneumonia and Lung Abscess
Pneumonia in _____________
Community; acute
Community; atypical
Nosocomial
Aspiration
Chronic
Necrotizing
Immunocompromised host
Community – Acquired Acute Pneumonia
____________
______________
__________________
___________
______________
Enterobacteriaceae (________ sp.)
Streptococcus pneumonia
Haemophilus influenza
Moraxella catarrhalis
Staphylococcus aureus
Legionella pneumophilia
kliebsiella
B. Community-Acquired Atypical Pneumonia
_________ pneumoniae
_________ spp (c. pneumonae, c. psittaci, c.
trachmatis)
Coxiella burnetti (__-fever)
Viruses (_________ virus, ______ virus, _______ A and B, ____virus, _____ virus)
Mycoplasma
Chlamydia
Q
Respiratory syntical; parainfluenza
influenza; SARS; adeno
Nosocomial Pneumonia
Gram-________ rods belonging to ________
_______________
negative; enterobacteriaeciae
Staphyllococus aureus
• Bacterial infection typically follows an ——————- infection.
upper respiratory tract viral
Bacterial pneumonia
• Risk factors include
:-________ of ages
•(acute or Chronic?) diseases
•Congenital or acquired __________
Decreased or absent ________ (SCD or post splenectomy)
Extreme
Chronic
immune deficiencies
splenic function
Bacterial pneumonia
The alveoli are filled with ___________, thus causing ________ of the lung tissue.
inflammatory exudates
consolidation
_________ pneumonia –
• It is the most common cause of community- acquired acute pneumonia.
Streptococcus
Streptococcus pneumonia –
• Although it responds to _______-based treatment, ________ should be performed prior to drug administration.
penicillin; antibiotic sensitivity
Streptococcus pneumonia –
• Examination of gram stained _____ shows numerous bacteria containing ______-shaped ___________.
sputum
lancet
diplococci
Pneumococcal vaccines are available for the high risk patients.
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Haemophilus Influenzae –
• It is a pleomorphic, gram-________ bacteria.
• It is a major cause of life-threatening (acute or chronic?) (upper or lower?) respiratory tract infections and _______ in young children.
negative
Acute ; lower
meningitis
Haemophilus Influenzae –
• It is a common cause of _____-acquired pneumonia in (children or adults?) .
community
adults
Haemophilus Influenzae –
• The bacterium has _____ on its surface that facilitates binding to the respiratory _____ and produces ______ that degrades _______.
pilli
epithelium
protease
IgA
Haemophilus Influenzae –
has a capsule that prevents ________ by ________ and ______ by host cells.
opsonization
complements
phagocytosis
Haemophilus Influenzae –
It causes _____ media, _____, and ______pneumonia.
• It is also a common cause of _________ before the advent of vaccine.
• In older adults, it may cause septicaemia, endocarditis, pyelonephritis, cholecystitis and suppurative arthritis.
otitis; sinusitis; broncho
suppurative meningitis
___________________–
The organism is also the commonest cause of acute exacerbation of COPD.
Haemophilus Influenzae
Moraxella Catarrhalis –
• Along with the ________ and _______, it is one of the three most common cause of _______ in children.
Streptococcus and Haemophilus
otitis media
Moraxella Catarrhalis –
• It is the (first, second , or third?) most common cause of acute exacerbation of COPD.
Second
___________________–
• It is the most frequent cause of gram-negative bacteria pneumonia.
Kliebsiella Pneumoniae
Kliebsiella Pneumoniae
It afflicts _______ and ———— people (particularly _________).
debilitated and malnourished
alcoholics
Psuedomonas Aeruginosa –
• It causes _______ infection.
• It is frequently associated with _______ and _______ patients.
nosocomial
cystic fibrosis and neutropenic
Legionella Pneumophilia –
• It is an agent of ________ disease.
• It flourishes in _______ environment.
Legionnaires
aquatic
Legionella Pneumophilia –
• It is commonly seen in patients with cardiac, renal, immunologic and haematologic diseases.
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Two gross pattern are recognized in bacterial pneumonia -
_________ ———- pneumonia and ______ pneumonia
lobular; broncho
lobar
Lobar pneumonia is a/an (acute or chronic?) bacterial infection resulting in _________ ———— of a (small or large?) portion of a lobe or _________.
Acute
fibrinosupurative consolidation
Large
an entire lobe
Four stages are recognized in lobar pneumonia,
_________
____________
___________
____________
Congestion
red hepatization
gray hepatization
resolution.
Stages of lobar pneumonia
In congestive stage, the lung is (light or heavy?) , ______ and (white or red?) .
There is vascular ________, _______fluid with few _______ and numerous ______.
Heavy
Boggy; red
engorgement
intra alveolar
neutrophils; bacteria
Stages of lobar pneumonia
Red hepatization is characterized by massive ____________ with _____,_____,______ filling the alveolar spaces.
The lobes appear (airy or airless?) , (white or red?) and (loose or firm?) with a _______-like consistency, hence the term hepatization.
confluent exudation
red cells, neutrophils and fibrin
Airless; red ; firm
liver
Stages of lobar pneumonia
Gray hepatization follows with progressive ________________ and the persistence of _____________ producing a ______________, (wet or dry?) surface.
disintegration of red cells
fibrosuppurative exudates
graying brown
Dry
Stages of lobar pneumonia
The final stage is _______ in which the ______ within the alveoli undergoes progressive _______ to produce a __________ ingested by ________.
resolution; exudates
enzymatic digestion
granular debri; macrophages
In the resolution stage of lobar pneumonia, _________ reaction to the underlying _______ may be present (pleuritis).
Pleural fibrinous
inflammation
Bronchopneumonia
produces _______ of ______ of acute
suppurative inflammation.
It may involve _____ but it is normally _________ and frequently ______ and _______
patchy areas
consolidation
one lobe; multilobar
bilateral and basal.
Bronchopneumonia
It appears as slightly (elevated or depressed?) , (wet or dry?) , granular, _______ to _____ lesion with (poorly or well?) delimited margin.
Elevated
Dry; gray-red to yellow
Poorly
Bronchopneumonia
The histology shows ___________ – rich exudates that fill the bronchi, bronchioles and adjacent alveolar spaces.
neutrophil
Complication of Pneumonia
________ formation – common with type ____ pneumonia &________.
________
organization - convert part of a lung to _________
________ dissemination – heart valve, pericardium, brain, kidneys, joints, spleen.
Abscess; 3; Kliebsiella
empyema
solid form
bacteraemic
Pneumonia: Clinical Course
abrupt onset of (low or high?) fever, chills
_____ productive of _____ sputum
___________ occasionally
High
cough; mucopurulent
haemoptysis
Complication of Pneumonia
______ formation
________
______________
Abscess
organization
bacteraemic dissemination
Three patterns of pneumoniae
• ______
•_________
•___________
Lobar
Bronchopneumonia
Interstitial (atypical)
Lobar Pneumonia
• Bacteria acquired in ______
•__________ to alveolus
• Enter alveolar type ___ cells
• Pneumococci multiply in alveolus
• Invade ________
• Pass from one alveolus to next through the __________
•________/_________ of lobes
nasopharynx
Aerosolized
II; alveolar epithelium
pores of Cohn
Inflammation/consolidation
Lobar Pneumonia
Can involve entire lung
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Answer with either stage ,1,2,3,or 4
Pneumococci alive
Alveolar capillaries dilate
Lobes look red
Gray, firm lobe
Enzymes digests exudate
Dying pneumococci
RBCs disintegrate
Return to normal
Exudate of bacteria develops
2
1
2
3
4
3
3
4
1
Interstitial Pneumonia
• Inflammatory infiltrate of _________ only
• More (indolent or aggressive ?) course
alveolar walls
indolent
Atypical Pneumonia
Respiratory distress is (common or rare?)
___________ on chest X-Ray
“_________ pneumonia”
Rare
Interstitial infiltrates
Walking
E. coli is a more common cause of adult or neonate pneumonia
Neonate
Group B strep is a more common cause of adult or neonate pneumonia
Neonate
Bad bugs cause ______ class of pneumonia
Nosocomial acquired
Community Acquired PNA
Uncomplicated
No ________
No recent ______
Low community rates resistance
Azithromycin, Clarithromycin, or Doxycycline
_______ to _______ course
Patient should be afebrile 48-72 hrs and clinically stable
co-morbidities
antibiotic use
Low ; Three to five day
