L8: Suppurative Lung Diseases

Question 1

Def of Lung Abscess

Answer 1

• A localized pus containing cavity, in the lung, due to necrotizing lung infection leading to destruction of lung parenchyma.

Question 2

Etiology of Lung Abscess

Answer 2

Question 3

Etiology of Lung Abscess

• Aspiration of infected material from the oropharynx

Answer 3

• The most common cause of lung abscess
• As in periodontal or nasal sinus infection, neurological and esophageal diseases

Question 4

Etiology of Lung Abscess

• Pre-existing Lung Disease

Answer 4

bronchogenic cyst

Question 5

Etiology of Lung Abscess

• Hematogenous Spread

Answer 5

from intra- or extrathoracic sites.

Question 6

Etiology of Lung Abscess

• Necrotizing (cavitating) Pneumonia

Answer 6

• Staph aureus
• Klebsiella
• Pseudomonas aeuroginosa
• Anaerobic organisms.

Question 7

Etiology of Lung Abscess

• Inhalation of an infected material (uncommon source)

Answer 7

• Contaminated respiratory equipment such as nebulizers or ventilators.

Question 8

Causative Organism of Lung Abscess

Answer 8

Question 9

Types of Lung Abscess

Answer 9

Question 10

CP of Acute Lung Abscess

Answer 10

Question 11

CP of Acute Lung Abscess

• Symptoms

Answer 11

Question 12

CP of Acute Lung Abscess

• Signs

Answer 12

Question 13

CP of Chronic Lung Abscess

Answer 13

Question 14

CP of Chronic Lung Abscess

• Symptoms

Answer 14

Question 15

CP of Chronic Lung Abscess

• Signs

Answer 15

• Less toxemic manifestations
• Digital Clubbing

Question 16

Complications of Lung Abscess

Answer 16

Question 17

INVx in Lung Abscess

Answer 17

Question 18

INVx in Lung Abscess

• Rads

Answer 18

Question 19

INVx in Lung Abscess

• X-Ray

Answer 19

Question 20

INVx in Lung Abscess

• CT Chest

Answer 20

• for suspected bronchial carcinoma.

Question 21

INVx in Lung Abscess

• Labs

Answer 21

Question 22

INVx in Lung Abscess

• Sputum Ex

Answer 22

• Gram- stain and culture
• Ziehl- Neelsen staining to exclude TB
• Fungal culture.

Question 23

INVx in Lung Abscess

• Sputum Cytology

Answer 23

For malignant cells.

Question 24

INVx in Lung Abscess

• CBC

Answer 24

• Leucocytosis
• Anemia.

Question 25

INVx in **Lung Abscess** - Bronchoscopy

Answer 25

Question 26

TTT of **Lung Abscess**

Answer 26

Question 27

TTT of **Lung Abscess** - Acute Abcess

Answer 27

Question 28

TTT of **Acute Lung Abscess** - Antibiotics

Answer 28

Question 29

Antibiotics in TTT of **Acute Lung Abscess** - duration

Answer 29

- Must be extended for at least 4 weeks with changing the type of antibiotics according to the culture and sensitivity results.

Question 30

Antibiotics in TTT of **Acute Lung Abscess** - Regimen

Answer 30

Question 31

Antibiotics in TTT of **Acute Lung Abscess** - Examples

Answer 31

Question 32

Antibiotics in TTT of **Acute Lung Abscess** - When to switch?

Answer 32

- Once the patient has defervesced, Consider switching to an equivalent oral regimen.

Question 33

TTT of **Acute Lung Abscess** - Anti-fungal or anti-TB drugs

Answer 33

- Can be given if there are evidence of fungal or mycobacterial infections.

Question 34

TTT of **Acute Lung Abscess** - Postural Drainage

Answer 34

an important item in the management of lung abscess

Question 35

TTT of **Acute Lung Abscess** - Symptomatic TTT

Answer 35

Analgesics for pain and Expectorants.

Question 36

TTT of **Acute Lung Abscess** - Others

Answer 36

Rest, good nutrition with high protein diet.

Question 37

TTT of **Chronic Lung Abscess**

Answer 37

Question 38

TTT of **Chronic Lung Abscess** - Medical

Answer 38

Continued for another 6 weeks.

Question 39

TTT of **Chronic Lung Abscess** - Surgery

Answer 39

Indicated in chronic situation with: - Failure to respond to medical management. - Suspected neoplasm, or congenital lung malformation - Others life-threatening complications like uncontrolled hemoptysis.

Question 40

Prevention of **Lung Abscess**

Answer 40

Question 41

Def of **Empyema with BPF**

Answer 41

- Pus in the pleural space or infected pleural fluid with fistula (opening) between the pleural space and the bronchial tree. - It may be loculated or free.

Question 42

Etiology of **Empyema with BPF**

Answer 42

Question 43

Types of **Empyema with BPF**

Answer 43

Empyema may be acute or chronic (> 3 months)

Question 44

Common Pathogens in **Empyema with BPF**

Answer 44

Question 45

CP of **Empyema with BPF**

Answer 45

Question 46

CP of **Empyema with BPF** - Symptoms

Answer 46

Question 47

CP of **Empyema with BPF** - Signs

Answer 47

- Digital Clubbing - Pleural Rub

Question 48

INVx of **Empyema with BPF**

Answer 48

Question 49

INVx of **Empyema with BPF** - Rads

Answer 49

Question 50

INVx of **Empyema with BPF** - Thoracentesis

Answer 50

Question 51

INVx of **Empyema with BPF** - Special tests

Answer 51

Question 52

TTT of **Empyema with BPF**

Answer 52

Question 53

TTT of **Empyema with BPF** - Antimicrobials

Answer 53

According to the type of organisms as described in ttt of lung abscess

Question 54

TTT of **Empyema with BPF** - Chest tube under water seal

Answer 54

To drain pus.

Question 55

TTT of **Empyema with BPF** - Fibrinolytics

Answer 55

Intrapleural instillation of fibrinolytic drugs to lyse adhesions.

Question 56

TTT of **Empyema with BPF** - Thoracoscopic Drain

Answer 56

In loculated empyema.

Question 57

TTT of **Empyema with BPF** - Surgery

Answer 57

- Pleural decortication. - Pleuro-pneumonectomy

Question 58

Incidenec of **Infected Cystic Lung**

Answer 58

Cystic lesions of the lung parenchyma: - Congenital cystic lesions are rare in comparison with acquired cysts.

Question 59

Types of **Infected Cystic Lung**

Answer 59