Lung Infections Flashcards
etiologic agent?
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strep pneumonia (gram +, lancet shaped diplococcus)
etiolgic agent?
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h. influenza
pleomorphic gram - coccobacilli
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m. catarrhalis
gram - diplococcus
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staph aureus
gram - coccus
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klebsiella pneumonia
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pseudomonas aerguinosa
gram - rod
pseudomonas aerguinosa
- causes what kind of pneumonia?
- disproportionately effects what patients?
- casuses
- HAP - mostly
- CAP - in CF / immunocompromised patients
- effects neutropenic pts
- invades blood vessels –> fulminant infection
- etiologic agent
- causes what respiratory tarct illness and has what distinguishing clinical features?
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legionella pneumonia
- is one cause of walking (atypical) pneumonia (mycoplasma pneumonia/SARS-Cov2 are top causes of walking pneumonia) and has other distinguishing features.
- + CPK test
- diarrhea (& ther GI disturbances)
- bradycardia
- hyponatremia
- is one cause of walking (atypical) pneumonia (mycoplasma pneumonia/SARS-Cov2 are top causes of walking pneumonia) and has other distinguishing features.
what is the most common cause of community aquired pneumonia in adults?
streptococcus pneumonia
what is the most common bacterial acute exacerbation of COPD?
H. influenza
who is at high risk for pneumonia due to
s .aureus pneumonia?
peudomonas pneumonia?
klebsiella pneumonia?
- IV drug users
- neutropenic / immunocompromised / CF / ventilators
- alcoholics
what are the four stages of lobar pneumonia?
- congestion
- red hepatization
- gray hepatization
- resolution
“congestion” phase of lobar pneumonia
- gross morphology
- microscopic morphology
- gross: lung is heavy, boggy, red
- micro: vascuar engorgement
- intraalveolar fluid has lots of bacteria > few neutrophils
“red hepatization” phase of lobar pneumonia
- gross
- microscopic
- gross: lobes are very red, firm, AIRLESS - “liver like consistency”
- microscopic: alveolar spaces with MANY neutrophils + erythrocytes + fibrin
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“gray hepatization” phase of lobar pneumonia
- gross appearance
- microscopic appearance
- gross: lobe still airless, becomes grey/brown
- microscopic: persistently fibrinosuppratative (i.e, neutrophils + fibrin stay HIGH, with DISTINTIGRATION of erythrocytes
“resolution” phase of lobar pneumonia
- gross appearance
- microscopic appearance
- gross - n/a
- microscopic - granular, semifluid debris that are ingested by macrophages then organized by fibroblasts into fibroblast plugs
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lobar vs bronchopneumonia
- bronchopneumonia - patchy consolidation
- lobar pneumonia - consolidation to one lobe/large part of a lobe
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morphology of viral pneumonia
what about covid 19 specifically?
- viral = damage confined to the alveolar wall
- congestion (edmea)
- hyaline membranes
- covid 19: damage to hyaline membranes + Type I pnuemocytes
chronic pneumonia
- demographics
- etiologic agents
- demographics - immunocompromised host
- etiologic agents:
- mycoplasma pneumonia (m/c)
- fungi - histoplasosis, blastomycosis, coccidiomycosis
mycobacterium tuberculosis - gross morphology
(chronic pneumonia)
- two presentations:
-
primary TB (previously unsensitized person)
- gohn complexes (calficications)
- caseating necrosis of hilar lymph nodes
-
secondary TB:
- classically involves apex of upper lobes
- can have cavitations
- classically involves apex of upper lobes
-
primary TB (previously unsensitized person)
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mycobacterium tuberulosis
microsopic morphology
granuloma with central caseation surrounded by epitheloid histiocytes + multinuceated giant cells
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dx of tuberculosis?
ziehl- neelsen stain for AFG - m. tuberculosis rods will stain deep red (acid fast)
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histiopalsmosis pneumonia
- demographics
- presentation
- morphology - gross and microscopic
-
only effects immunocompromised
- clinical presentation = asymptomatic in immunocopmetent host
- morphology:
- gross: granulomas with conentric calcifications - “tree bark” appearance
- microscopic: necrotizing + non-necrotizing granulomas
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histoplasmosis pnuemonia dx
-
stain black wth GMS
- monomorphic / oval
- NOT encapsulated
- have narrow based buds
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blastomycosis
- demographics
- presentation
- morphology
- gross and microscopic
- effects BOTH immunocompromised and immunocompetent patients
- morphology
- microscopic:
- suppurative granulomas with many neutrophils
- microscopic:
blastomyocisis pnueumonia - dx
- yeasts are
- pleomorphic
- round
- hav thick, refractile cel swalls
- NOT encapsulated
- produce broud-based buds
- b = blastomyocis