Pathology of Pulmonary Infection Flashcards

1
Q

Multifactorial aspects of lung infections

A

Microorganism pathogenicity
Capacity to resist infection
Population at risk (exposure)

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2
Q

Types of pathogens

A

Primary - most dangerous
Facultative - require help
Opportunistic - infect immunocompromised

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3
Q

Upper respiratory tract infections

A
Coryza (common cold)
Sore throat syndrome
Acute laryngotracheobronchitis
Laryngitis
Sinusitis
Acute epiglottitis
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4
Q

Acute epiglottitis agents

A

Haemophilus influenzae

Group A beta-haemolytic streptococci

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5
Q

Lower respiratory tract infections

A

Bronchitis
Bronchiolitis
Pneumonia

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6
Q

Bronchitis

A

Infection involving bronchi

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7
Q

Bronchiolitis

A

Infection involving bronchioles, inflammation - inflammatory exudate cause obstruction

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8
Q

Pneumonia

A

Infection involving alveolar spongy air space

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9
Q

Respiratory tract defence mechanisms

A

Macrophage-mucociliary escalator system
General immune system
Respiratory tract secretions
Upper respiratory tract as a ‘filter’

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10
Q

Macrophage-mucociliary escalator system involves

A

Alveolar macrophages
Mucociliary escalator
Cough reflex

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11
Q

Ways to classify pneumonia

A

Anatomical - radiology
Aetiology - circumstances
Microbiology - treatment

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12
Q

Aetiology classification of pneumonia

A

Community acquired
Hospital acquired
In immunocompromised
Atypical, aspiration, recurrent

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13
Q

Patterns of pneumonia

A
Bronchopneumonia 
Segmental
Lobar
Hypostatic
Aspiration
Obstructive, retention, endogenous lipid
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14
Q

Bronchopneumonia

A

Acute inflammation, localised in small airways and surrounding alveolar tissue (doesn’t spread)

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15
Q

Lobar pneumonia

A

Acute inflammation that spreads and fills an entire lobe or lung

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16
Q

Hypostatic pneumonia

A

Accumulation of lung secretes

17
Q

Aspiration pneumonia

A

Develops after you aspirate food, liquid or vomit into the lungs

18
Q

Outcome of pneumonia

A

Most resolve with or without pharmacological intervention, but still potentially fatal

19
Q

Complications of pneumonia

A

Pleurisy, pleural effusion and empyema
Organisation (scaring)
Lung abscess
Bronchiectasis

20
Q

Lung abscess

A

Death necrosis of tissue, formation of cavity where pus accumulates

21
Q

Causes of lung abscesses

A
Obstructed bronchus - tumour
Aspiration
Particular organism - staph aureus
Metastatic in pyaemia
Necrotic lung
22
Q

Bronchiectasis

A

Pathological dilation of bronchi

23
Q

Causes of bronchiectasis

A

Severe infective episodes
Recurrent infections
Proximal bronchial obstruction
Lung parenchymal destruction

24
Q

Symptoms of bronchiectasis

A
Cough
Abundant prudent foul sputum
Haemoptysis
Coarse crackles
Clubbing
Signs of chronic infection
25
Q

Treatment of bronchiectasis

A

Antibiotics
Surgery
Postural drainage

26
Q

Opportunistic infections

A

Infections by organisms not normally capable of producing disease in patients with intact lung defences - opportunistic pathogens. Increased chance of ordinary infections

27
Q

Examples of opportunistic pathogens

A

Cytomegalovirus (CMV)

Pneumocystis jirovecii

28
Q

Respiratory failure type I

A

PaO2<8kPa

PaCo2 normal or low

29
Q

Respiratory failure type II

A

PaCo2>6.5kPa

PaO2 low

30
Q

4 abnormal states associated with hypoxaemia

A

V/Q imbalance (commonest)
Diffusion impairment
Alveolar hypoventilation
Shunt

31
Q

V/Q in pneumonia

A

Mismatched as a result of bronchitis/bronchopneumonia - some ventilation in abnormal alveoli but not enough

32
Q

Shunt in pneumonia

A

Severe bronchopneumonia, lobar pattern with large areas of consolidation. No ventilation in abnormal alveolar.

33
Q

Normal V/Q

A

4/5 or 0.8

34
Q

Pathological shunt in

A

Arteriovenous (AV) malformation
Congenital heart disease
Pulmonary disease

35
Q

Why pneumonia causes hypoxaemia

A

V/Q mismatch and shunt