Class 6 - Respiratory 2 Flashcards
Pneumonia
Inflammation of the lungs. Can be infection (bacterial/viral) that affects one or both lungs
Pneumonia Incidence
Very common, worldwide leading cause of death. Viral m/c in children, Bacterial m/c in adults
Pneumonia Risk Factors
Smoking, acute respiratory infections, chronic bronchitis, illness, age (young or old)
Community acquired pneumonia
Streptococcus (m/c), haemophilus influenza
Hospital-acquired pneumonia
Staphylococcus aureus
Alveolar pneumonia
involves alveoli
Interstitial pneumonia
involves septa
Bronchopneumonia
limited to segmental bronchi
Lobar pneumonia
widespread or diffuse
Pneumonia upper respiratory flora
Streptococcus, Staphylococcus, Haemophilus
Pneumonia Enteric Saphrophytes
*
* Candida albicans (rare)
Pneumonia Extraneous pathogens
- Mycobacterium tuberculosis, viruses
Pneumonia routes of infection Inhalation
pathogens in air droplets
Pneumonia routes of infection Aspiration
Of infected secretion from URT, infected particles from GI
Pneumonia routes of infection Hematogenous
Spread from sepsis
Pneumonia Clinical Manifestations
chest pain, productive cough, brown/green sputum, dyspnea, headache, chills, fever
Pneumonia Diagnosis
- Culture, chest films, physical examination
Pneumonia Treatment
Antibiotics, rest, fluids, medications, vaccinations
Pneumonia Complications Pleuritis
pus can fill pleural cavity (empyema). Lungs cannot expand during inspiration (fibrosis), leading to restrictive lung disease
Pneumonia Complications Abscesses
Highly virulent bacteria, destroys lung parenchyma. Pus causes destruction of walls, leads to bronchial dilation.
Pneumonia Complications Chronic Inflammation
Pneumonia unresponsive to treatment, destruction of lung parenchyma and fibrosis - looks like honeycomb lungs on x-ray
Pneumocystis Jirovecii Pneumonia (PCP)
- Idiopathic, often fatal fungal pneumonia
Pneumocystis Jirovecii Pneumonia (PCP) Risk factors
immunosupression , chemo, transplantation, malnutrition
Pneumocystis Jirovecii Pneumonia (PCP) Diagnosis/Treatment
culture lab tests, antifungal meds
Legionnaires Disease
Rare pneumonia infectious disease, causes massive consolidation (fluid in lungs) and necrosis of lung tissue. Treatment - antibiotics
Pulmonary TB
Infectious, inflammatory disease of lungs that may involve lymph nodes and other organs
Primary Pulmonary TB
- Infection usually aymptomatic
Secondary Pulmonary TB
When primary infection becomes active cause of lower resistance
Pulmonary TB Incidence
2 billion cases worldwide, highest in SE asia, africa, eastern europe
Pulmonary TB Etiology
- Mycobacterium tuberculosis
Pulmonary TB Risk Factors
Immunocompromised, elderly, overcrowding, drugs, malnutrition, poor health
Pulmonary TB cause of increased risk of advanced disease
smoking
Pulmonary TB Pathogenesis
Granulomas with caseous necrosis (Type IV HS reaction)
Pulmonary TB Ghon Complex
- X ray of lymph node involvement, fibrosis
Pulmonary TB Clinical manifestations
Hymoptysis (blood cough) , Productive cough, weight loss, fever, night sweats, fatigue
Pulmonary TB diagnosis
History, PE, Tuberculin skin test, culture sputum
Pulmonary TB treatment
Medications
Lung Abscess
accumulation of purulent exudate within the lung. Usually complication of pneumonia
Lung Abscess Etiology
poor oral hygiene, alcohol, drugs, altered consciousness, older patients. M/c due to aspiration are anaerobic bacteria
Lung Abscess Pathogenesis
Inflammation, tissue necrosis, usually ruptures into bronchus. Erodes bronchial walls and patients get bad breath
Lung Abscess Clinical Manifestations
Productive cough, foul-smelling sputum, fever, chills,
Lung Abscess Diagnosis
*
* X-ray, sputum analysis, imaging
Lung Abscess Treatment
Antibiotics, percussion, good nutrition, drainage
Chronic Obstructive Pulmonary Disease
Chronic airflow limitation that is not fully reversible
COPD Types
Chronic bronchitis, emphysema
Chronic bronchitis diagnosis
Productive cough lasting at least 3 months per year for 2 consecutive years
Emphysema
Destruction of lung parenchyma and pathological accumulation of air in lungs
COPD Etiology/risk factors
*
* Smoking, age, genetics
Pathogenesis of Chronic Bronchitis
Inflammation and bronchoconstriction. Increased mucus production, leading to increased infection risk
COPD clinical manifestation
Productive cough, SOB, cor pulmonale, malaise, recurrent infection
Pathogenesis of Emphysema
Destruction of elastin protein causes narrowing or collapse of bronchioles which traps air in lungs
Emphysema Blebs and bullae
Blebs (small pockets of trapped air) Bullae (large pockets of trapped air)
Emphysema Clinical Manifestation
Exertional dyspnea, thin, barrel chest, tachypnea, anxiety, wheezing, cough
COPD Diagnosis
History, physical exam, pulmonary function tests, x-ray, CT, blood tests
COPD Treatment
Quit smoking, medications, airways clearance, exercise, avoiding irritants, diet, oxygen, surgery
COPD Prognosis
Poor, mortality rate 10 years after diagnosis >50%
Bronchiectasis
Obstructive lung disease characterized by irreversible destruction and dilation of airways – Generally with chronic bacterial infections and cystic fibrosis
Bronchiectasis Etiology/Risk factors
Cystic Fibrosis, any condition producing of narrowed lumen of bronchioles (tb, viral, pneumonia)
Bronchiectasis Pathogenesis
Frequent infections/inflammation causing mucus and fibrosis
Bronchiectasis Clinical Manifestations
persistent coughing, dyspnea, fatigue, weight loss
Bronchiectasis Treatment
Bronchodilators, Antibiotics, Corticosteroids, hydration, surgery
Bronchiectasis Diagnosis
Imaging, history, clinical manifestation, genetic testing
