Lower Respiratory Tract Infections

Question 1

1)definition of bronchitis
2)pathophysiology of bronchitis
3)clinical manifestation
4)pathogen
5)diagnosis
6)treatment

Answer 1

1)inflammation of bronchitis
2)smoking damage cilia plus virus cause inflammation and both this cause cough reflex with low motion of cilia
3)upper respiratory tract symptoms plus cough more than 5 days , wheezing, cough may be persist several more weeks due to airway hyper reactivity
4)Respiratory viruses are most common
5)Cough more than 5 day , fever , sputum but most clinically significant is distinguishing pneumonia from bronchitis by chest x-ray
6)It is self-limited but symptomatic treatment include NSAID + bronchodilator and if patient with CPD present with influenza viruses give him/her Oseltamivir(neuraminidase inhibition)

Question 2

1)Definition of bronchiolitis and most common age for infection cause
2)Pathophysiology
3)clinical manifestations
4)pathogens
5)Diagnosis
6)Treatments
7)prevention

Answer 2

1)bronchiolitis is inflammation of bronchioles, it is caused by infection in infants and children
2)virus damage respiratory cells in terminal bronchioles and cause inflammation which cause obstruction of bronchioles
3)initially upper respiratory tract symptoms than tachypnea , wheezing, chest retraction in severe cases respiratory failure
4)RSV most common and other are Respiratory viruses in children under 2 years. But chemicals and toxins are etiology factor in adult
5)diagnosis clinically with symptoms in children at winter. plus ELISA and PCR of RSV
6)self-limiting but general supportive treatments are oxygen , bronchodilators
and ribavirin
7)vaccine against influenza or Palivizumab against RSV fusion protein in Cardiopulmonary disease infants

Question 3

1)Definition of lung abscess
2)pathophysiology
3)clinical manifestations and complication
4)pathogens
5)Diagnosis
6)treatment
7)Prevention

Answer 3

1)Necrotising inflammation of lung (leads from pneumonia) and can cause cavity formation in parenchyma
2)aspiration, poor dental hygiene , pneumonia , IVDA with s.aureus endocarditis(right side) leads to septic embolism and cancer(obstruction), first of all there are inflammation of lung which than cause necrosis
3)Them most distinguish is foul smelling due to anaerobes , empyema, pneumothorax, hemorrhaging and pyemia.
4)s.aureus and other anaerobes
5)CXR infiltration with cavity and in rare cases blood and pleural culuture
6)ampicillin-sulbactam(B-lactam with B-lactamase inhibitor) + Clindamycin (Ihibit protein synthesis by effect on 50s subunit, side effect c. Difficile caused pseudomembranous colitis) or surgical drainage
7) good dental hygiene and avoidance of unconsciousness by drug overdose and alcohol abuse

Question 4

1)Definition of empyema
2)Predisposing factor
3)pathogen
4)Clinical findings
5)Diagnostic
6)treatment

Answer 4

1)Pus in pleural fluid
2)pneumonia, thoracotomy, trauma and diabetes
3)s. Pneumonia, s. Aureus , k. Pneumoniae and anaerobes
4)such in pneumonia
5)CT and ultrasound, pleural culture
6)drainage of pus plus appropriate antibiotics

Question 5

1)Definition of pneumonia
2)2 Types of pneumonia
3)pathophysiology
4)Clinical manifestations
5)complication
6)nosocomial pneumonia symptoms
7)pathogen
8)diagnosis

Answer 5

1)inflammation of lung affecting alveoli
2)community acquired and nosocomial(48 hours after admission to hospital)
3)bacterial exposed (virulent) or defect in host immunity leads to inflammation of alveoli(no necrosis) there are predisposing factors -1)aspiration(sedation and alcohol), 2)inhalation, 3)COPD, smoke , eldery, cystic fibrosis, bronchiectasis 4)IVDA 5) immunosuppressed 6)VAP
4)atypical pneumonia-URT symptoms,
Typical - fever high, weight lost, night sweat(IL-1, IL-6 and TNF-a) , tachicardia and tachipnea(Due to hypoxia), productive cough , pleural pain( both due to receptors in lungs and pleura)
5)pleural effusion, empyema, bronchopneumonia, ARDS, and sepsis
6)because they are paralyzed there wont be reflex action and only will be fever, high mucus secretion with hypxoia
7)see photo
8)see photo

Question 6

1)Definition of pneumonia and 2 different types of it
2)pathophysiology
3)Clinical manifestations and compication
4)pathogen
5)Diagnosis
6)Treatment

Answer 6

1)Inflammation of lung affecting the alveoli, community acquired and nosocomial(2 day after admission in hospital)
2)microbes exposure to alveoli and leading inflammation, there will be disease if there is high virulence or defect in host immunity. Predisposing factors are: 1)Aspiration(alcohol, drug and neuronal disease) 2)Inhalation 3) high mucous secretion or cilia damage(Cystic fibrosis, Bronchiectasis, COPD, Smoke and old age), 4)IVDA ,5)immunosuppressed 6)VAP
3)Atypical pneumonia (URT symptoms),
High fever, night sweat and weight lose(IL-1,6, TNF-a), tachypnea and tachycardia due to hypoxia, cough and pleural pain, Complication may be pleural effusion, empyema , bronchopneumonia or sepsis. If patient is intubated there are no reflex (no hypoxia , cough and pain) , and present with fever , high mucous secretion and hypoxia
4)see photo
5)see photo
6)