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DPPT Unit 3 > Lung infections 1 > Flashcards

Lung infections 1 Flashcards

1
Q

What does viral pneumonia cause?

What viruses are responsible?

A

(1) Acute interstitial pneumonitis

(2) Influenza, cytomegalovirus

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2
Q

What are characteristics of acute interstitial pneumonitis?

3

A

(1) Thickening of alveolar wall with (2) edema and (3) inflammatory cells

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3
Q

What bacteria are responsible for bacterial pneumonia?

Bronchopneumonia (3)
Lobar pneumonia (1)
A

Bronchopneumonia:

(1) Staph aureus
(2) H. influenzae
(3) Strep pneumoniae

Lobar pneumonia:
(4) Strep pneumoniae

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4
Q

Which patients tend to get lobar pneumonia?

A

(1) Debilitated patients
(2) Alcoholics

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5
Q

What are radiographic features of lobar pneumonia?

4

A

(1) Single lobe involved with bulging fissure
(2) Abscess with cavity formation
(3) Pleural effusion and empyema (pus in pleural cavity)
(4) Septicemia following acute episode

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6
Q

What are predisposing factors for lobar pneumonia?

5

A

(1) Cirrhosis
(2) Renal failure
(3) Malignancy
(4) Diabetes
(5) Sickle cell disease

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7
Q

What are features of bronchopneumonia?

3

A

(1) Acute patchy infection located around small airways
(2) Microscopically: intra-alveolar process
(3) Inflammation with destruction of alveoli

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8
Q

What is red hepatization of the lung?

A

Lung appears thick and red like the liver:

Acute phase of pulmonary consolidation occurring secondary to untreated bronchopneumonia

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9
Q

What is grey hepatization of the lung?

A

Lung appears like liver but grey from breakdown of red cells

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10
Q

How do patients with necrotizing pneumonia and abscess formation present?
(4)

A

(1) Fever
(2) Pleuritis
(3) Putrid sputum
(4) Late complication - empyema (infection of pleural space resulting in pus)

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11
Q

What happens in pulminary cavitation secondary to abscess?

2

A

(1) Inability to cough up sputum, (2) leading to necrosis and constant reinfection

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12
Q

What are some differences between viral and bacterial pneumonia?

A

Viral: infection of membranous pneumocytes resulting in alveolar injury leading interstitial pneumonitis

Bacterial: Intra-alveolar infection, alveolar injury not necessary, acute inflammatory response, leads to lobar/bronchopulmonary pneumonia

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13
Q

What are the two forms of tuberculosis?

A

(1) Primary infection - Ghon complex, occurring in children

(2) Secondary infection - reactivation TB, affecting adults

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14
Q

What are the characteristics of primary pulmonary tuberculosis?
(4)

A

(1) Children most often infected
(2) Peripheral lung infection with granuloma formation
(3) Ghon complex: (a) parenchymal subpleural nodule with active infection and (b) enlarged caseous lymph nodes draining parenchymal nodule
(4) Rarely progresses

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15
Q

What are the characteristics of reactivation pulmonary tuberculosis?
(4)

A

(1) Adults affected
(2) Upper lobe disease with necrotizing granulomas
(3) Cavitation of upper lobe
(4) Hematologic dissemination leads to extra-thoracic sites of disease

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16
Q

Which organisms are acid fast?

3

A

(1) Mycobacterium species
(2) Actinomyces
(3) Nocardia

17
Q

Which species of Mycobacterium does not cause granuloma formation?

A

M. avium intracellularae (atypical Mycobacterium)

18
Q

Which fungi are filamentous?

4

A

(1) Aspergillus
(2) Mucor
(3) Petrolidium
(4) Penicillium

19
Q

Which fungi are yeasts?

4

A

(1) Cryptococcus
(2) Blastomyces
(3) H. capsulatum
(4) Candida

20
Q

What are the characteristics of aspergillus?

A

(1) Ubiquitous in soil
(2) Isolation from sputum does not imply pathogenicity
(3) Form broad septate hyphae with acute-angle branching
(4) Form conidiophores in culture

21
Q

What are the three pulmonary manifestations of Aspergillus?

A

(1) Mycetoma (fungus ball)
(2) Invasive aspergillosis
(3) Hypersensitivity pneumonitis

22
Q

What can Aspergillus hypersensitivity pneumonitis lead to?

2

A

(1) Bronchiectasis or (2) pulmonary fibrosis

23
Q

What are the characteristics of Cryptococcus?

4

A

(1) Soil fungus found in pigeon feces
(2) Encapsulated budding yeast
(3) Visualized with India ink (halo from capsule)
(4) Presents radiographically as localized pulmonary lesion

24
Q

What are the clinical features of Cryptococcus infection?

3

A

(1) Often asymptomatic
(2) Headache and fever
(3) Involvement of skin, bones, heart, and other systems

25
Q

What are the characteristics of Blastomyces dermatitidis?

4

A

(1) Causes granuloma formation
(2) Primary infection usually subclinical
(3) Infection through inhalation
(4) Presents radiographically as solitary pulmonary mass

26
Q

What are the clinical features of Blastomyces infection?

2

A

(1) Mild fever, cough, malaise

(2) Macules on hand and face

27
Q

What are the characteristics of Coccidiodes immitis?

2

A

(1) Soil fungus that infects through inhalation (often after earthquakes)
(2) Illness usually asymptomatic

28
Q

What are the clinical features of Histoplasma infection?

7

A

(1) Primary histoplasmosis:
(a) 95% benign
(b) Multiple calcified nodules/nodes
(2) Chronic/reinfection histoplasmosis
(a) Early chronic disease - upper lobe consolidation, fever, chest pain
(b) Chronic cavitary disease, like Tb
(c) Disseminated histoplasmosis

29
Q

What is Pneumocystis jiroveci?

A

Opportunistic pathogen that only infects immunocompromised hosts, leading to interstitial lung disease

30
Q

How is Pneumocystis infection diagnosed?

3

A

(1) Bronchoalveolar lavage
(2) Lung biopsy
(3) Can’t be cultured because no sputum (dry cough)

31
Q

What is the treatment for Pneumocystis jiroveci?

2

A

(1) Trimethoprim-sulfamethoxazole (Bactrim)

(2) Aerosolized pentamidine

32
Q

What are causes of diffuse pulmonary infiltrate?

4

A

(1) Pneumocystis jiroveci
(2) Viral pneumonitis
(3) Drug reaction
(4) Interstitial lung disease

33
Q

What are causes of focal pulmonary infiltrate?

5

A

(1) Staph aureus
(2) Aspergillus
(3) Candida
(4) Tumors
(5) Cryptococcus

DPPT Unit 3 (15 decks)

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