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Chest > Infection > Flashcards

Infection Flashcards

1
Q

What is the M/C type of pheumonia?

A

Streptococcus pneumonia (40%)

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2
Q

What is the M/C community acquired infection?

A

steptococcus pneumonia

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3
Q

What location does streptococcus pneumonia like to affect?

A

lower lobes

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4
Q

True or false: cavitations are common in streptococcus pneumonia.

A

False – they are rare!

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5
Q

Where does streptococcus pyogens like to occur in the chest?

A

lower lobes

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6
Q

What is the M/C type of bronchopneumonia?

A

Staphylococcus aureus

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7
Q

What pop’n is more likely to get staphylococcus aureus pneumonia?

A

Hospitalized & debilitated patients, spread from endocarditis and intravenous drug users.

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8
Q

True or false: air bronchograms are rare in staphylococcus aureus.

A

True. Remember this is a BRONCHOpneumonia so airways are filled.

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9
Q

Which organism is acquired through contact with infected goats/meat & decaying soil/organic matter and can present with hemorrhagic pneumonia?

A

Bacillus anthracis

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10
Q

What is a key radiographic feature of bacillus anthracis pneumonia?

A

Mediastinal widening from lymphadenopathy – they get enlarged lymphnodes.

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11
Q

Bulging interlobar fissures and current jelly sputum are M/C seen in which chest infection?

A

Klebsiella (Friedlander’s) pneumonia

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12
Q

What pop’n is most commonly infected by Klebsiella pneumonia?

A

Older, alcoholic men & debilitated hospitalized patients

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13
Q

What is the M/C location for Klebsiella pneumonia?

A

Unilateral, posterior aspect of upper lobe or superior portion of lower lobe.

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14
Q

Which pneumonia causes round pneumonia in kids?

A

Streptococcal pneumonia

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15
Q

Mycotic aneurysms of abdominal aorta are M/C found with which organism?

A

Salmonella

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16
Q

Haemophilus influenza M/C affects which population?

A

Kids btwn age 2 months and 3 years.

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17
Q

Where within the chest does haemophilus influenza affect?

A

Bilateral & lower lobes

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18
Q

Pneumonia from which organism has a high mortality rate?

A

Pseudomonas aeruginosa

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19
Q

Where does pneumonia from pseudomonas aeruginosa most commonly affect and how does it present on CT?

A

Bilateral & lower lobes

Tree-in-bud or centrilobular nodules.

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20
Q

Which chest infection presents with a shaggy heart sign?

A

Pertussis (bordetella pertussis)

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21
Q

What is the pathomechanism of pertussis?

A

Abundant intraluminal mucus production causing partial or complete airway obstruction.

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22
Q

What is the differential for a shaggy heart sign?

A

1) Asbestosis (eg. interstitial lung disease)
2) Pertussis
3) Pleural thickening (benign or malignant)

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23
Q

Which chest condition is the “steeple sign” affiliated with?

A

Pertussis or croup

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24
Q

What is aspiration pneumonia?

A

Aspiration of foreign bodies producing airway obstruction –> leads to atelectasis, air trapping, distal pneumonitis or bronchiectasis

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25
Q

What are the predisposing risk factors for aspiration pneumonia?

A

alcohol intoxication, altered consciousness, dysphagia, neuromuscular disorder

26
Q

True or False: Non-tuberculous mycobacterium is less indolent than M tuberculosis?

A

False - it is more

27
Q

Atypical mycobacterial infection M/C affects what part of the lungs?

A

Upper lobe

28
Q

What are the radiographic features of non-tb mycobacterium?

A

Similar to TB (eg. nodular opacities, focal consolidation, cavitaion, fibrosis etc.)

29
Q

What is the difference from how you acquire an atypical mycobacterial infection vs TB?

A

Atypical –> From the natural environment (eg. water, soil and dust)
TB –> Airborne respiratory disease

30
Q

What are the 2 stages of pulmonary tuberculosis?

A

Primary & postprimary

31
Q

Which pop’n of patients are most likely to get lymph node involvement with primary pulmonary TB?

A

Children & immuno-compromised adults

32
Q

What is a renke complex?

A

lymphadenopathy with Ghon focus

33
Q

How common is it to see mediastinal lymph node calcification in primary TB?

A

33%

34
Q

What is postprimary TB?

A

Reactivation of infected regions when host defenses are impaired.

35
Q

What is the cause of bronchogenic spread of postprimary TB?

A

Spillage of caseous material from cavities into bronchus

36
Q

What does the presence of cavitation in postprimary TB indicate?

A

Worsening infection

37
Q

Parenchymal involvement in primary TB calcifies in what % of cases?

A

20%

38
Q

What historical procedure involved the removal of the ribs as a form to treat TB?

A

Thoracoplasty

39
Q

What historical procedure involved creating a cavity and then stuffing golf balls etc. in the thorax to forcefully collapse the lung as a treatment for TB?

A

Plombage

40
Q

Which infection is endemic to The San Joaquin Valley?

A

Coccidioidomycosis

41
Q

What is the prognosis of pulmonary coccidioidomycosis? What is a clinical presentation of this condition?

A

It is usually self-limiting (~3 weeks).

Clinical:

  • mostly asymptomatic (60%)
  • erythmatous rash
42
Q

What are the 4 types of pulmonary coccidioidomycosis?

A

a) Primary/Acute
b) Persistent
c) Chronic progressive
d) Disseminated (<1%)

43
Q

What are some of the obvious differences btwn acute and persistent (or even chronic) coccidioidomycosis?

A

Acute = calcified; rarely cavitates

Persistent and chronic = rarely calcifies; cavitates quickly

44
Q

What is valley fever?

A

When coccidioidomycosis presents with erythema nodosum and arthralgia.

45
Q

What areas are endemic to histoplasmosis?

A

Ohio, Mississippi, St. Lawrence River valleys

46
Q

What are the clinical features of pulmonary histoplasmosis?

A

Asymptomatic (95-99%)

47
Q

What are the radiographic features of histoplasmosis and where does it commonly occur?

A
  • Multiple, well-defined calcified nodules resembling miliary TB
  • occurs in lower lobes
48
Q

What is fibrosing mediastinitis and what are the top 3 common causes for it?

A

Extension of granulomatous disease to involve the mediastinal tissues causing extensive fibrosis.

M/C/C = histoplasmosis, TB and sarcoidiosis

49
Q

Moniliasis (candidiasis) pneumonia M/C occur in which pop’n?

A

Immuno-compromised patients (particularly lymphoma or leukemia)

50
Q

Invasive aspergillosis M/C invades which anatomy?

A

Invasion of pulmonary vasculature (aka Angioinvasive aspergillosis)

51
Q

“Finger-in-glove” appearance occurs in which conditions?

A

Asthma, allergic aspergillosis (usually with a hx of asthma) & cystic fibrosis

52
Q

What is the M/C/C of aspergilloma? What is the 2nd M/C/C?

A 
1st = cavitary disease from prior TB
2nd = sarcoidosis
53
Q

Actinomycosis normally exists where in the respiratory system?

A

Oropharynx

54
Q

AIDS and transplate patients are risk patients for developing which pneumonia?

A

Pneumocystic jiroveci

55
Q

Which infection can cause mandibular osteomyelitis following dental extraction?

A

Actinomycosis

56
Q

Which bacterial organisms are gram positive?

A
  • streptococcus pneumonia
  • streptococcus pyogens
  • straphylococcus aureus
  • bacillus anthracis
57
Q

Which bacterial organisms are gram negative?

A
  • Friedlander’s (klebsiella) pneumonia
  • escherichia coli
  • salmonella
  • proteus
  • haemophilus influenzae
  • pseudomonas aeruginosa
  • bordetella pertussis
  • aspiration pneumonia
58
Q

Infants with congenital heart disease or pulmonary brochodysplasia are “at risk” patients for which type of respiratory virus?

A

Respiratory syncytial virus (RSV)

59
Q

Giant cell (multinucleated giant cells) pneumonia can be see in which pulmonary infections?

A
  • Measles virus
  • parainfluenza
  • RSV infections
60
Q

Echinococcosis can be asymptomatic unless______

A

They rupture – then sx occur.

61
Q

What is the sign of camalote?

A

aka. Water lily sign = ruptured echinococcal cyst into bronchial tree.

62
Q

Which chest infection affects cystic fibrosis patients and patients on mechanical respirators?

A

Pseudomonas aeruginosa

Chest (12 decks)

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