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PTH560 Pathology > Exam 2 - respiratory infections > Flashcards

Exam 2 - respiratory infections Flashcards

1
Q

What are the two classifications of Pneumonia

A

-community acquired (CAP)
(typical and atypical)

-nosocomial (aka hospital acquired)

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2
Q

typical CAP: most commonly caused by

A

bacterial: strep pneumoniae

- in top 10 causes of death in US

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3
Q

Typical CAP: bronchopneumonia

A
  • bronchitis -> pna
  • locations = lower lobes, RML
  • patchy consolidations (microabscesses)
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4
Q

Typical CAP: lobar pneumonia

A

consolidation of lobe (complete or incomplete)

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5
Q

typical CAP: pathogenesis

A

most common: microaspiration of oropharyngeal contents during sleep

second most common: aerosol inhalation

uncommon: blood stream infection

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6
Q

typical CAP: clinical findings

A
  • sudden high fever
  • productive cough
  • CP
  • tachycardia

Consolidation signs =

  • dullness to percussion
  • inspiratory crackles
  • bronchial breath sounds
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7
Q

typical CAP: chest X-ray (CXR), labs

A
  • screen
  • patchy infiltrates (bronchopneumonia)
  • lobar consolidation

labs: gram + stain, leukocytosis, blood cultures

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8
Q

Nosocomial pneumonia: risk factors

A
  • **respirators = most common
  • underlying disease
  • antibiotics
  • immunosuppression
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9
Q

Nosocomial pna bugs

A

Gram (-) = pseudomonas, E.coli

Gram (+) = staph. aureus

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10
Q

Rhinovirus

A

most common cause of common cold

transmission: hand-to-eye/nose

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11
Q

Coxsackievirus

A

-acute chest syndrome

fever, pleuritis

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12
Q

Parainfluenza

A

-most common cause of CROUP!!

CXR: steeple sign (mucosal edema in trachea)

treatment: cold water humidifiers, aerosolized racemic epinephrine

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13
Q

Cytomegalovirus (commonly cause, pathology, treatment)

A
  • common cause of pna in immunocompromised
  • pathology: enlarged macrophages and pneumocytes
  • Treatment: anti-virals
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14
Q

What are the 2 classifications of influenza?

A
  • Type A (most common, worldwide epidemics)

- Type B (major outbreaks)

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15
Q

Hemagglutinins vs neuraminidase

A
  • hemagglutinins: protein on virus. how it binds to cells in nasal passages
  • neuraminidase: disolves mucus. facilitates release of virus
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16
Q

Influenze: clinical findings and associations

A

clinical finding: fever, headache, cough, muscle/chest pain

associations:
- guillain-barre syndrome
- Reye syndrome

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17
Q

Influenza treatment

A
  • prevention = vaccinate
  • neuraminidase inhibitors
    (i. e., tamiflu - within 48 hrs of sx)
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18
Q

Rubeola: Measles (pathology and clinical findings)

A
  • patho: Warthin-Finkeldey multinucleated giant cells

- clinical findings: Koplik spots in mouth before rash, rash, fever, cough, conjunctivitis, nasal mucus)

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19
Q

Respiratory syncytial virus

A
  • **Most common cause of pna and bronchiolitis in infants
  • winter illness
  • pathology = fusion protein
  • you want to vaccinate high risk kids
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20
Q

Mycoplasma pneumoniae

A
  • most common cause of atypical pna (***“walking pna”)
  • patient pop = teens, military recruits
  • symptoms: insidious onset, low-grade fever
  • other pathology = cold agglutinins in blood
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21
Q

Chlamydia trachomatis

A

***NEWBORN PNA (infected during birth)

-symptoms: afebrile, choppy cough, conjunctivitis, wheezing

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22
Q

Coxiella burnetii

A
  • associated with: birthing process of infected animals, milking, handling of animal waste (vets, dairy farmers)
  • clinical findings: atypical PNA, myocarditis, hepatitis
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23
Q

Streptococcus pneumoniae

A
  • most common cause of typical CAP
  • Gram (+) diplococcus
  • rapid onset of sx = productive cough, consolidation signs
24
Q

Staphylococcus aureus

A
  • Common pts: influenza, measles, CF, IVDA
  • yellow sputum

pathology: Gram (+), ABSCESSES!!!, pneumatoceles, hemorrhagic pulmonary edema

25
Q

Bacillus anthracis: classifications

A

Cutaneous anthrax

  • direct contact with contaminated animal products
  • eschar formation with central necrosis

Pulmonary anthrax

  • “first sign is death”
  • inhalation of spores
  • findings = necrotizing PNA, meningitis, splenomegaly
26
Q

Bacilus anthracis (pathology)

A
  • Gram (+) rod

- EXOTOXINS!!: edema factor, lethal factor, protective antigen

27
Q

Bordetella pertussis

A

WHOOPING COUGH!!!

patho:
- Gram (-) rod
- droplet transmission
- bacteria pili attach to cilia in resp tract
- toxin (blahhhh)

28
Q

Haemophilus influenzae

A

***most common bacterial cause of COPD exacerbations

  • Gram (-) rod
    causes: epiglottitis, sinusitis, otitis media, conjunctivitis
29
Q

Moraxella catarrhalis

A
  • common cause of typical PNA (especially elderly!)
  • major cause of COPD exacerbations
  • also causes (chronic bronchitis, sinusitis, otitis media

-Gram (-) diplococcus

30
Q

Pseudomonas aeruginosa

A

“respirator PNA” ***

  • most common cause of nosocomial PNA in CF
  • green sputum
  • vessel invasion (pulmonary infarctions)
31
Q

Klebsiella pneumoniae

A
  • typical PNA
  • patho (gram (-) rod
  • elderly nursing home pts
  • ALCOHOLICS**
  • blood-tinged sputum
32
Q

Legionella pneumophilia (main info)

A

-atypical PNA
-sources (moist places)
-patho: **“Water loving bacteria”*
Gram (-)

risk factors: EtOH, smokers, immunosuppression

33
Q

Legionella pneumophilia: clinical findings and screens

A
  • clinical findings: high fever, dry cough, flu like sx

- screen: *****antigens in urine!

34
Q

Yersinia pestis (the plague): transmission and reservoir

A

Transmission

  • rat flea bite!!**
  • person to person via droplet

reservoir
-***ground squirrels

35
Q

Yersinia pestis: the plague (pathology)

A
  • V and W antigens: provide protection and macrophages cannot kill it
  • Gram (-) rod
36
Q

Yersinia pestis: the plague (classifications)

A
  • bubonic (most common, rat flea bite, infected lymph nodes, drain to surface)
  • pneumonic (aerosol transmission)
  • septicemic
37
Q

Mycobacterium tuberculosis

A
  • TB
  • strict aerobe
  • **ACID-FAST
  • resides in phagosomes of macrophages
  • produces CORD FACTOR (protein that prevents lysosome fusion, provides virulence)
38
Q

TB screening

A
  • purified protein derivative
  • intradermal skin test
  • CANNOT differentiate active vs inactive

-(+) test detected bacterium cell wall protein

39
Q

Primary TB

A

location: * upper lower lobes and lower upper lobes!!!*

40
Q

Secondary TB

A
  • reactivation of primary TB
  • location: ** apices of lungs! (greatest O2 saturation)
  • cavitary lesion (release of cytokines by memory T cells)
41
Q

TB: clinical findings

A
  • fever
  • night sweats
  • weight loss
  • hemoptysis
  • bronchiectasis
  • scar carcinoma
42
Q

Extrapulmonary TB

A
  • kidneys = most common
  • adrenals = addison disease
  • vertebrae = Pott disease
43
Q

TB diagnosis and treatment

A

Diagnosis: screen

treatment: triple therapy
* Treat 9-12 months!!!**

44
Q

Cryptococcus neoformans: what and where you find

A
  • fungus (budding yeast)
  • environmental locations:
  • Pigeon waste, windows, bridges, near buildings
45
Q

Cryptococcus neoformans: clinical findings

A
  • lung disease (granulomatous inflammation, caseation)

- infects (immunocompetent and immunocompromised)

46
Q

Aspergillus fumigatus: structure

A

-fungus (fruiting body)

Asperilloma: **fungus ball!

47
Q

Aspergillus fumigatus: pathology

A
  • invades vessels***

- necrotizing PNA***

48
Q

Mucor species

A
  • fungus (wide angled, no septa)
  • pulmonary vessel invasion
  • in people with DIABETES!!!***
49
Q

Coccidioides immitis

A
  • fungus (*SPHERULES)
  • found in: **deserts (valley fever) and earthquakes **
  • pulmonary granulomatous inflammation
  • flu-like symptoms and erythema nodosum
50
Q

Histoplasma capsulatum

A
  • most common systemic fungal infection
  • yeast found in macrophages
  • -locations: mississippi river valley!!!!!*
51
Q

Blastomyces dermatitidis

A
  • yeast with broad-based buds
  • found in *great lakes
  • associated with outdoor activities
  • skin lesions similar to SCC
52
Q

Pneumocystis jiroveci

A
  • similar to fungi in structure
  • ***most common pathogen causing PNA in AIDS
  • patho: produces cysts, produces tropozoites
53
Q

P. jiroveci clinical findings

A
  • fever
  • dyspnea
  • hypoxemia
  • intra-alveolar exudates
54
Q

Causes of lung abscesses (4)

A
  • oropharyngeal material aspiration
  • bacterial PNA
  • septic emboli
  • obstructive lung tumor
55
Q

Aspiration

A
  • **most common cause of lung abscess
  • risk factors (alcohol, LOC, dental work)

Pathogens: mixed aerobic and anaerobic (anaerobes 60%)

56
Q

Lung abscess: gross pathology

A

-size and location vary

aspiration abscesses generally on Right side

57
Q

Lung abscess **

A
  • productive cough (foul sputum)*
  • CXR: cavitation with air fluid level
  • treatment: abx and bronchoscopy

PTH560 Pathology (15 decks)

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