Chronic Pulmonary Infection Flashcards
what are the risk factors for the development of CPI?
immunodeficiency
immunosuppression
abnormal innate host defence
repeated insult
what are the types of immune deficiency that are risk factors for the development of CPI?
congenital
acquired
IgA deficiency
why is IgA deficiency associated with recurrent infections?
because it sits in the bronchial mucosa
what are the immunosuppressants that are risk factors for the development of CPI?
drugs
malignancy
what are the types of abnormal that are risk factors for the development of CPI?
damaged bronchial mucosa
abnormal cilia
abnormal secretions
what are the types of repeated insult that are risk factors for the development of CPI?
aspiration
indwelling material
what causes IgA deficiency?
hypogammaglobulinaemia : its a rare condition and means that there is an increased risk of acute and chronic infection
what is the commonest cause of immunodeficiency?
CVID - you get recurrent chest infections
what are the types of immunodeficiency?
IgA deficiency
CVID
specific polysaccharide antibody deficiency (SPAD)
hyposplenism
immune paresis
HIV
why do we need antibodies that are sensitive to the polysaccharide coat - the problem in SPAD
many pathogens have a polysaccharide coat
where are antibodies made/
spleen
what is the commonest pathogen
pneumococcus
why may people have hyposplenism?
results from sickle cell disease as they get infarcts in their spleen
what happens in immune paresis
the immune system was fine but is now paralysed in some way
what problems give you immune paresis?
myeloma, lymphoma, metastatic malignancy
what happens in myeloma?
you get lots of one type of antibody
which therapies are immunosuppressive ?
steroids
azathioprine
methotrexate
cyclophosphamide
monoclonal antibodies
chemotherapy
what monoclonal antibodies are there
infliximab - TNF alpha
Rituximab : CD20
leflunomide
what can cause damaged bronchial mucosa?
smoking
recent pneumonia or viral infection - because mucosa is damaged
malignancy
what can cause abnormal cilia ?
kartagener’s syndrome
youngs’ syndrome
what causes abnormal secretions
CF- mucus is very thick
channelopathies
what causes recurrent aspiration indult?
NG feeding
poor swallowing
pharyngeal pouch
what causes indwelling material ?
NG tube in the wrong place
chest drain
inhaled foreign body
what are the forms of chronic infection
intrapulmonary abscess
empyema
chronic bronchial sepsis
CF
bronchiectasis
