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Respiratory System > Pathology of pulmonary infection 1 > Flashcards

Pathology of pulmonary infection 1 Flashcards

1
Q

Types of microorganism pathogenicity

A

-Primary(most dangerous)

-Facultative ( needs little
help to establish infection)

-Opportunistic ( doesn’t normally cause infection, but it does in the immunocompromised)

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2
Q

What determines the capacity of an individual to resist infection?

A
  • State of the host defence mechanisms

- Age of patient

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3
Q

State types of Upper respiratory tract infections (URTI)

A

SALSAC

  • Coryza (common cold)
  • Sore throat syNdrome
  • Acute Laryngotracheobronchitis ( Croup)
  • Laryngitis
  • Sinusitis
  • Acute epiglottiitis
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4
Q

What bacterias can be responsible for acute epiglottitis?

A
  • Haemophilus infuenzae ( type b - Hib)
  • Group A beta-haemolytic streptococci
  • Parainfluenza virus type 4 (rarely)
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5
Q

State examples of lower respiratory tract infections

A
  • Bronchitis (infection of bronchi)
  • Bronchiolitis ( ‘’ ‘’ of bronchioles)
  • Pneumonia( infection involving alveolar air space/air sacs + fluid)
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6
Q

State the respiratory tract defence mechanisms

A
  • Macrophage-mucociliary escalator system: main mechanism that sterilises LRT
  • General immune system ( humoral and cellular immunity)
  • RT secretions(mucous) + upper RT acting as a ‘filter’
  • failure of these will increase risk of RTI
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7
Q

Describe the macrophage-mucociliary escalator system

A
  • Alveolar macrophages ( englufs particles that reaches alveolar space>interstitial pathway via lymph to lymph nodes)
  • Mucociliary escalator (system of moving mucous from lower RT>throat)
  • cough reflex ( aspirtate/swallow)
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8
Q

State the aetiological classifications of pneumonia

A

CHAAIR
-Community Acquired Pneumonia

-Hospital Acquired (Nosocomial) Pneumonia (may have antibiotic resistance)

-Pneumonia in the
Immunocompromised (opportunistic pathogens can establish lung infection)

  • Atypical Pneumonia (unusual organisms)
  • Aspiration Pneumonia(vomit or other aspirated particles)
  • Recurrent Pneumonia(patient keeps getting it in same region)
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9
Q

Patterns of pneumonia

A
  • Bronchopneumonia
  • Segmental
  • Lobar
  • Hypostatic ( lung secretions accumulating)
  • Aspiration
  • Obstructive, retention, endogenous lipid
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10
Q

Features of bronchopneumonia

A
  • acute inflammation of bronchioles/bronchi
  • bilateral basal
  • patchy opacification relating to the nature of consolidation
  • high neutrophil count, ocalised in small airways and alveolated tissue, Does not reach pleura so no pleural complications unlike other types of pneumonia
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11
Q

State the outcomes/complications of pneumonia

A
  • pleurisy(inflammation of pleura), pleural effuision (fluid builds up between pleural membranes) effusion and empyema ( pus accumulates in pleural cavity)

-organisation(production of scar/fibrous tissue)
: mass lesion, COP (cryptogenic organising pneumonia BOOP), constricive bronchitis
-lung abscess
-bronchiectasis

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12
Q

Lung abscess

A

-obstructed bronchus: tumour(can be mistaken by this)

Caused by

  • aspiration
  • particular organism ( S.aureus, pneumococci, klebsiella)
  • metastatic in pyaemia
  • nectrotic lung ( secondary infection)
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13
Q

What is Bronchiectasis?

A
  • pathological dilation of bronchi due to :
  • severe infective episode
  • reduccrent infections
  • proximal bronchial obstruction
  • lung parenchymal destruction
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14
Q

Symptoms of Bronchiectasis

A
  • 75% starts in childhood
  • cough, abundant sputum, haemopytis, signs of chronic infection
  • course crackles, clubbing
  • thing sectrion CT ( previously bronchography)
  • postural drainage, antibiotics, surgery
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15
Q

Complications of Bronchiectasis

A

-Haemorrage

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16
Q

Causes of aspiration pneumonia

A
  • vomiting
  • oesophageal lesion
  • obstretic anaesthesia
  • neuromuscular disorders
  • sedation
17
Q

What is Opportunistic infections ?

A
  • increased chance of ‘ordinary ‘ infections

- infection by organisms not normally capaeble of producing disease in patients with intact lung defences

18
Q

Types of opportunistic lung infections

A
  • Low grade bacterial pathogens
  • CMV
  • pneumocystis jirovecii
  • other fungi + yeasts
19
Q

State the four abnormal states associated with hypoxaemia(Low O2 in blood)

A
  • ventilation/perfusion imbalance - V/Q ratio
  • diffusion impairment
  • alveolar hypoventilation
  • shunt ( ventilation
20
Q

Pulmonary vascular changes in hypoxia

A

-physiological pulmonary arteriolar vasoconstriction: when alveolar oxygen tension falls, can be localised effect. All vessels constrict if there is arterial hypoxaemia

21
Q

Why does pneumonia cause hypoxaemia

A
  • ventilation/perfusion abnormality ( bronchitis/bronchopneumonia) < Most common! : some ventilation of abnormal alveoli but just not enough
  • shunt ( in severe bronchopneumonia) : no ventilation of abnormal alveoli
22
Q

Signs of shunt/severe bronchopneumonia on lobes

A

lobar pattern with large areas of consolidation

23
Q

Shunt

A

Blood passing from Right to Left side of Heart WITHOUT contacting ventilated alveoli
Normally 2-4% shunt
Pathological shunt in AV malformations, congenital heart disease and PULMONARY DISEASE
Large shunts respond poorly to increases in FI O2
Blood leaving normal lung is already 98% saturated

24
Q

Why does COPD cause hypoxaemia?

A
  • Airway Obstruction
  • Reduced Respiratory Drive
  • Loss of Alveolar Surface Area
  • Only during acute exacerbation
25
Q

Alveolar hypoventilation

A
  • insufficient air moved in + out lungs

- increases PACO2 + decreases PAO2

26
Q

How is fall in PaO2 due to hypoventilation corrected?

A

-by raising FIO2 ( fraction of inspired air which is O2RR

27
Q

Why is there pulmonary hypertension in hypoxic cor pulmonale

A
  • pulmonary vasoconstriction
  • pulmonary arterioles ; muscle hypertrophy + intima fibrosis
  • loss of capillary bed
  • secondary polycythaemia
  • bronchopulmonary arterial anastomoses
28
Q

What is Chronic (hypoxic) cor pulmonale

A

-hypertrophy of right ventricle resulting from disease affecting the function and/or structure of the lung, except where diseases primarily affect the left side of the heart/congenital HD

Respiratory System (11 decks)

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