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Respiratory system SA > Pathology of Pulmonary Infection > Flashcards

Pathology of Pulmonary Infection Flashcards

1
Q

What are micro-organisms three pathways of pathogenicity

A

Primary - infectious on their own
Facultative - Need additional help to infect
Opportunistic - Hit you when your immune system is low

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2
Q

What does your capacity to resists infection depend on

A

state of the hosts defence mechanism

Age of the host (new born and elderly most at risk)

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3
Q

Is the Upper respiratory tract Sterile or not?

A

Not sterile

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4
Q

What are examples of URT infections

A 
Crazy- common cold
Sore throat syndrome
Acute Laryngotracheobronchitis (Croup) - swelling of windpipe 
Laryngitis
Sinusitis
Acute Epiglottitis
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5
Q

Is the lower respiratory tract sterile or non sterile

A

Sterile

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6
Q

What are examples of LRT infections

A

Bronchitis
Bronchiectasis
Pneumonia

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7
Q

What are upper respiratory tract defence mechanisms

A

The nose acts as a filter
URT is moist anf lined with cilla
Allows large particle deposition

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8
Q

What is the lower respiratory tract defence mechanism

A

Macrophage-mucociliary escalator system

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9
Q

What are the three mechanism of the Macrophage-mucociliary escalator system

and over all function

A

ALVEOLAR MACROPHAGES

MUCOCILIARY ESCALATOR

COUGH REFLEX

beat in a corrdianted fashion to move the alveolar macrophages and mucous up and out of the lungs

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10
Q

What is the alternative pathway of the alveolar macrophages

A

Rather than moving up the throat they can leave the throat wall and enter the interstitial pathway via lymph tp the lymph nodes

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11
Q

What is the effect of viral infection e.g. influenza on the

Macrophage-mucociliary escalator system

A

Can destroy epithelium so no longer has cilla

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12
Q

What are you more likely in catching if virus infection destroys epithelium

A

Bacterial infection

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13
Q

What are the 6 different aetiologies of pneumonia

A 
Community Acquired Pneumonia
Hospital Acquired (Nosocomial) Pneumonia
Pneumonia in the Immunocompromised
Atypical Pneumonia
Aspiration Pneumonia
Recurrent Pneumonia
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14
Q

How does atypical pneumonia occur

A

the infection is caused by different bacteria than the ones that cause typical pneumonia

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15
Q

How does Aspiration Pneumonia occur

A

lung infection that develops after you aspirate (inhale) food, liquid, or vomit into your lungs

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16
Q

Define recurrent Pneumonia

A

Pneumonia that reoccurs more than twice in a year

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17
Q

What is the different patterns of pneumonia

A

Bronchopneumonia - bronchioles
Segmental - parts of the lungs
Lobar - whole lobe

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18
Q

What is the complications with pneumonia?

A

Pleurisy - inflammation of pleura

Emphysema - a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness.

Lung abscess

Fibrous organisation resulting constrictive bronchiolitis or mass lesion

Bronchiectasis

cryptogenic organising pneumonia

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19
Q

What is cryptogenic organising pneumonia

A

is a form of non-infectious pneumonia that is an inflammation of the bronchioles (bronchiolitis) and surrounding tissue in the lungs.

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20
Q

What is Bronchiectasis

A

abnormal widening of the bronchi or their branches, causing a risk of infection

As the damaged dilated airways have thickened airway wall and increased mucus production

21
Q

What is the causes of lung abscess

A

Obstructed Bronchus: tumour or foreign body
Pneumonia Aspiration
Particular Microorganism (Staph aureus, some pneumococci, Klebsiella)
Metastatic in Pyaemia - Pus in the blood
Necrotic Lung

22
Q

What is the potential causes for Bronchiectasis

A

Sever or repetitive infections
Lung tissue destruction
Bronchial obstruction

23
Q

Symptoms of bronchiectasis

A 
Daily Cough
Daily copious purulent 
sputum production (> 2 tsps/day)
Occasional haemoptysis
Chest Infections frequent
24
Q

What are the signs for bronchiectasis

A

Finger clubbing, lung crackles on inspiration & expiration

25
Q

What are the causes of pneumonia aspiration

A 
Vomiting
Oesophageal Lesion
Obstetric Anaesthesia
Neuromuscular Disorders
Sedation
26
Q

Where is aspiration pneumonia most likely to occur

A

Right bronchus (where objects are most likely to get lodged due to the angle)

27
Q

What is the treatment options for bronchiectasis

A

Antibiotics
Surgery - possible if localised
Postural Drainage

28
Q

How does empyema occur in pneumonia

A

In pneumonia, acollection of fluid may form between the two pleural layers occasionally, microorganisms will infect this fluid

29
Q

Beyond bronchiole terminal how does air move

A

By diffusion

30
Q

What is hypostatic pneumonia

A

patients has lots of accumulation of fluid in the lung

31
Q

What is the cause of hypostatic pneumonia

A

chronic bronchitis

pulmonary odema

32
Q

Is there any air in lobar pneumonia?

A

No

33
Q

What is the normal alveolar partial pressure for pulmonary gas exchange

A

Normal PaO2 10.5 – 13.5 kPa

Normal PaCO2 4.8 – 6.0 kPa

34
Q

What does airflow across the alveoli to the blood depend on

A

The blood air pressure difference

35
Q

What are the four abnormal states associated with Hypoxiemia

A

Ventilation / Perfusion imbalance - V/Q
Diffusion impairment
Alveolar Hypoventilation
Shunt

36
Q

What do all vessels do if there is arterial hypoxemia and why do they do this

A

Constrict

Protective mechanism not to send blood to alveoli short of oxygen

37
Q

What is the two respiratory failures

A

Type 1 Pa Oxygen decrease below 8Kpa

Type 2 Pa CO2 increases above 6KPa

38
Q

What two abnormal states causes hypoxemia in broncho/lobarpneumonia + bronchitis

A

bronchopneumonia + bronchitis
- Ventilation / Perfusion abnormality (mismatch)
Severe bronchopneumonia and lobar pneumonia
- Shunt

39
Q

How do you decreases hypoxemia in pneumonia due to ventilation perfusion mismatch

A

Increase oxygen levels

40
Q

What is not an issue in Ventilation / Perfusion abnormality (mismatch)

A

CO2 retention

41
Q

In a shunt how does it respond to an increase in oxygen

A

poorly

42
Q

Is ventilation occurring in Ventilation / Perfusion abnormality (mismatch) or shunts?

A

V/Q - Yes, some

Shunt - No

43
Q

What causes the type 2 respiratory failure when Pa CO2 to high

A

alveolar hypoventilation

44
Q

Why does a pulmonary shunt not respond to an increase in oxygen

A

as is doesn’t contact ventilated alveoli

45
Q

How does alveolar hypoventilation increase ventilation drive

A

cant move air out of the lungs, this increase PCO2 therefore decrease PO2, resulting in an increase in ventilation drive to increase inspired oxygen

46
Q

What is Chronic (Hypoxic) Cor Pulmonale

A

Hypertrophy of the Right Ventricle resulting from disease affecting the function and/or the structure of the lung,

47
Q

What is the effect of Cor Pulmonale

A

Pulmonary vasoconstriction
Loss of capillary bed
Secondary polycythaemia - increase in RBC

48
Q

Why does pathological large shunts respond poorly to increased oxygen

A

as the blood leaving the lung is already 98% saturated

a shunt only affect 2-4% of the blood

Respiratory system SA (37 decks)

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