Pathology of pulmonary infection

Question 1

Name the 3 components making lung infection a multifactorial situation

Answer 1

Microorganism pathogenicity
Capacity to resist infection
Population at risk

Question 2

Name the 3 types of microorganism pathogenicity

Answer 2

Primary
Faculative
Opportunistic

Question 3

State the 2 components which determine the capacity of the host to resist infection

Answer 3

State of host defence mechanism

Age

Question 4

Name the 6 upper respiratory tract infections

Answer 4

coryza, sore throat syndrome, acute laryngotracheobronchitis, laryngitis, sinusitis and acute epiglottitis

Question 5

What is coryza better known as?

Answer 5

Common cold

Question 6

What is acute laryngotracheobronchitis better known as?

Answer 6

Croup

Question 7

Name the 3 lower respiratory tract infections

Answer 7

Bronchitis, bronchiolitis, pneumonia

Question 8

Name the 3 constituents of the macrophage mucociliary escalator system

Answer 8

General immune system
Respiratory tract secretions
URT as a filter

Question 9

Is the lower respiratory tract sterile or non sterile?

Answer 9

Sterile

Question 10

What do alveolar macrophages do?

Answer 10

Phagocytose and digest particles then move to the lymph

Question 11

What happens to the macrophage mucociliary escalator during a viral infection?

Answer 11

Escalator fails and foreign material stays in the lung

Question 12

What are the 3 ways to classify pneumonia?

Answer 12

Anatomical - radiology
Aetiological
Microbiological

Question 13

What are the 6 aetiological classifications of pneumonia?

Answer 13

Community acquired 
Hospital acquired 
Immunocompromised eg HIV/AIDs, TB 
Atypical - caused by different bacteria 
Aspiration 
Recurrent - underlying problem

Question 14

Name the 3 patterns of pneumonia

Answer 14

Bronchopneumonia
segmental
lobar

Question 15

Hypostatic - what is it and who is most commonly affected?

Answer 15

Accumulation of fluid eg pulmonary oedema

Bed bound and elderly - gravity

Question 16

Aspiration

Answer 16

After inhaling food, liquid or vomit

Question 17

Bronchopneumonia

Answer 17

Often bilateral basal

More patchy and widespread

Question 18

Pleurisy

Answer 18

Inflammation of pleura

Question 19

Pleural effusion

Answer 19

Gathering of liquid in pleural space

Question 20

Empyema

Answer 20

Pockets of pus

Question 21

Organisation of pneumonia

Answer 21

Mass lesion

Fibrous tissue

Question 22

Lung abscess

Answer 22

Hole in the lung - aspiration
Obstructed bronchus - tumour
Metastatic in pyaemia
Necrotic lung

Question 23

What is bronchiectasis?

Answer 23

Pathological dilation of bronchi

Question 24

What 4 things can cause bronchiectasis?

Answer 24

Severe infective episodes
Recurrent infections
Proximal bronchial obstruction
Lung parenchymal destruction

Question 25

What percentage of bronchiectasis start in childhood?

Answer 25

75%

Question 26

What are the symptoms of bronchiectasis?

Answer 26

Cough | abundant foul sputum

Question 27

What are the signs of bronchiectasis?

Answer 27

Coarse crackles | Clubbing

Question 28

What is used to diagnose and thereafter treat bronchiectasis?

Answer 28

Thin section CT | Postural drainage, antibiotics and surgery

Question 29

Name 4 ways in which the mechanisms in the respiratory tract are failing to give recurrent lung infection

Answer 29

Local bronchial constriction Local pulmonary damage Generalised lung disease Non respiratory disease

Question 30

Local bronchial obstruction

Answer 30

Tumour, foreign body?

Question 31

Local pulmonary damage

Answer 31

Bronchiectasis

Question 32

Generalised lung disease

Answer 32

CF, COPD

Question 33

Non respiratory disease

Answer 33

HIV Immunocompromised Aspiration

Question 34

Name 5 things which cause aspiration pneumonia

Answer 34

``` Vomiting Oesophageal lesion obstetric anaesthesia neuromuscular disorders sedation ```

Question 35

Name the 2 types of bulk flow in airways

Answer 35

Laminar or turbulent

Question 36

Name the 4 abnormal states associated with hypoxaemia

Answer 36

V/Q Diffusion impairment alveolar hypoventilation shunt

Question 37

Do pulmonary vessels constrict or dilate if there is arterial hypoxaemia?

Answer 37

Constrict

Question 38

What is shunt?

Answer 38

Blood passing from right to left side of heart without contacting ventilated alveoli

Question 39

What % or perfusion is usually shunt?

Answer 39

2-4%

Question 40

Name 3 conditions with pathological shunt?

Answer 40

AV malformations heart disease pulmonary disease

Question 41

Why do large shunts respond poorly to increases in FI02?

Answer 41

Blood leaving the normal lungs is already 98% saturated