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Respiratory System > Pathology of Pulmonary Infections > Flashcards

Pathology of Pulmonary Infections Flashcards

1
Q

Healthy people are mainly infected by what kind of microorganisms?

A

Viruses/aggressive organisms

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2
Q

What are the different categories of pathogens?

A
  • primary
  • facultative
  • opportunistic
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3
Q

The capacity of a host to resist infection depends on what factors?

A
  • State of host defence mechanisms

- Age of patient

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4
Q

What effect will being immunocompromised have on a patient’s likelihood to have an infection?

A

It increases the patient’s susceptibility (particularly from opportunistic pathogens)

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5
Q

What are the most common upper respiratory tract infections?

A
  • Coryza (common cold)
  • Sore throat syndrome
  • Acute Laryngotracheobronchitis (croup)
  • Laryngitis
  • Sinusitis
  • Acute Epiglottitis
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6
Q

As a result of vaccination, what pathogen is increasing responsible for epiglottitis?

A

Group A beta-haemolytic streptococci

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7
Q

What are the most common lower respiratory tract infections?

A
  • Bronchitis
  • Bronchiolitis
  • Pneumonia
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8
Q

Aside from the general immune system and respiratory tract infections, what is the main respiratory tract defence mechanism?

A

The macrophage-mucociliary escalator system

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9
Q

In normal conditions, is the lower respiratory tract sterile or non-sterile?

A

Sterile

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10
Q

What cells are responsible for trapping dirt allowing it to be removed from the lower respiratory tract?

A

Alveolar Macrophages

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11
Q

What is the function of ciliated cells in the respiratory tract?

A

To carry a layer of mucous upwards on the mucociliary escalator from the lower respiratory tract to the larynx

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12
Q

What happens to the mucous layer containing any dirt or foreign particles once it is swept by the mucociliary escalatory into the larynx?

A

It is swallowed or spat out

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13
Q

What kind of infection is often fatal to people in a flu epidemic due to disruption of the mucociliary escalator?

A

Secondary bacterial infection

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14
Q

What is the danger of cellular bronchitis, especially in small children?

A

Inflammatory exudate produced during infection can close off the airway very rapidly

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15
Q

Pneumonia can be classed in what three categories?

A
  • Anatomical
  • Aetiological
  • Microbiological
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16
Q

Microbiological classification can be used to do what?

A

Confirm what organism is causing infection and allow a suitable treatment to be given

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17
Q

Under what headings can pneumonia be classed, aetiologically?

A
  • Community acquired
  • Hospital Acquired
  • Pneumonia in the Immunocompromised
  • Atypical
  • Aspiration
  • Recurrent
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18
Q

What is the most common aetiological classification of pneumonia?

A

Community acquire pneumonia

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19
Q

What two aetiological classes of pneumonia are generally caused by aggressive organisms?

A

Community acquired

Hospital acquired

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20
Q

What aetiological class of pneumonia is caused by abnormal organisms?

A

Atypical

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21
Q

A pneumonia infection in a patient with another condition e.g. cardiac failure can lead to what in the lungs making it difficult to clear the infection?

A

Accumulation of secretions

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22
Q

What anatomical distributions of pneumonia are there?

A
  • Bronchopneumonia
  • Segmental Pneumonia
  • Lobar Pneumonia
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23
Q

What form of pneumonia shows acute inflammation at a pathological level and spots of infection and formation of pus in the lungs?

A

Bronchopneumonia

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24
Q

What is often seen on a chest x-ray of a patient with bronchopneumonia relating to the focal nature of consolidation?

A

Bilateral basal patchy opacification

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25
Q

What is consolidation?

A

The replacement of air in the lungs by another substance

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26
Q

What is seen in lobar pneumonia?

A

Consolidation/infection of an entire lobe

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27
Q

The extensiveness of lobar and broncho-pneumonia is dependent on what feature of the causative organism?

A

The aggressiveness

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28
Q

Give a complication of pneumonia

A
  • Pleurisy
  • Pleural effusion
  • Empyema
  • Lung abscess
  • Bronchiectasis
  • Organising pneumonia (mass lesion/cryptogenic organising pneumonia/constrictive bronchiolitis)
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29
Q

What is the cause of Organising Pneumonia?

A

Bronchopneumonia turning into fibrosis

30
Q

10% of patients presenting with a lung abscess will have what?

A

An underlying tumour

31
Q

Lung abscess can result from the obstruction of what structure?

A

Bronchus

32
Q

What 3 pathogens most commonly cause lung abscesses?

A
  • Staphylococcus Aureus
  • Klebsiella
  • some Pneumococci
33
Q

What is Bronchiectasis?

A

The severe dilatation of bronchi

34
Q

What are the causes of Bronchiectasis?

A
  • Severe infective episode
  • recurrent infections
  • proximal bronchial obstruction
  • lung parenchymal destruction
35
Q

Is Bronchiectasis most common in adult life or childhood?

A

Childhood

36
Q

What are the symptoms of chronic bronchiectasis infection?

A
  • cough
  • abundant purulent sputum
  • haemoptysis
37
Q

What are the main treatments for bronchiectasis?

A
  • postural drainage
  • antibiotics
  • surgery
38
Q

What might cause local bronchial obstruction and lead to recurrent lung infection?

A
  • tumour

- foreign body

39
Q

What local pulmonary damage is a common cause of recurrent lung infections?

A

Bronchiectasis

40
Q

What generalised lung disease is a common cause of recurrent lung infection?

A
  • Cystic Fibrosis

- COPD

41
Q

In what kind of patients might non-respiratory disease cause recurrent lung infection?

A
  • Immunocompromised
42
Q

What is the cause of Aspiration Pneumonia?

A

Vomit travelling down the oesophagus into the lung

43
Q

What section of the lung is most common affected by aspiration pneumonia?

A

Apical segment of the right lower lobe

44
Q

What type of pneumonia might affect someone after excessive alcohol consumption?

A

Aspiration pneumonia

45
Q

What is an opportunistic lung infection?

A

An infection caused by organisms not normally capable of producing disease in patients with functioning lung defences

46
Q

Opportunistic infections are most common in what patients?

A

Immunocompromised

47
Q

Bulk flow in airways can be _ or _

A

Laminar

Turbulent

48
Q

What does turbulent flow in the upper respiratory tract do to inhaled air?

A

Humidifies/warms it

49
Q

Pulmonary gas exchange occurs at what barrier?

A

Blood-air barrier

50
Q

Gas moves by diffusion beyond

A

terminal bronchioles

51
Q

What is Type I respiratory failure?

A

Failure to maintain arterial oxygen concentration above 8 kPa

52
Q

What is Type II respiratory failure?

A

Inability to get rid of carbon dioxide

53
Q

What four abnormal states are associated with Hypoxaemia?

A
  • Ventilation/Perfusion imbalance
  • Diffusion impairment
  • Alveolar Hypoventilation
  • Shunt
54
Q

What pulmonary vascular change occurs in hypoxia?

A

Pulmonary arteriolar vasoconstriction

55
Q

Pulmonary arteriolar vasoconstriction occurs when

A

Oxygen tension falls in pulmonary tissue

56
Q

In Hypoxia, what changes will occur in the amount of blood going to the abnormal lung?

A

Amount of blood going to abnormal lung will be greatly reduced compared to normal

57
Q

Other than in lung disease, when might hypoxia occur?

A

At high altitudes

58
Q

Severe bronchopneumonia can cause what abnormal state associated with Hypoxaemia?

A

Shunt

59
Q

Bronchitis and Bronchopneumonia can cause what abnormal state associated with Hypoxaemia?

A

Ventilation/Perfusion mismatch

60
Q

To what abnormal state would treating with 100% oxygen make no difference due to no ventilation?

A

Shunt

61
Q

What is the most common cause of hypoxaemia encountered clinically?

A

Low V/Q mismatch

62
Q

Hypoxaemia due to low V/Q responds well to small increases in what?

A

FIO2

63
Q

What is Shunt?

A

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

64
Q

What are the common causes of Hypoxaemia in COPD?

A
  • Ventilation/Perfusion abnormality
  • alveolar hypoventilation
  • diffusion impairment
  • shunt
65
Q

What would the cause of hypoxaemia likely be in a patient with chronic COPD?

A

Alveolar hypoventilation (as breaths per minute are decreased and CO2 retained)

66
Q

What is Alveolar Hypoventilation?

A

An insufficient amount of air moved in and out of the lungs

67
Q

What effect does hypoventilation have on PACO2, PaCO2, PAO2 and PaO2?

A

PACO2 - increases
PaCO2 - increases
PAO2 - decreases
PaO2 - decreases

68
Q

Fall in PaO2 due to hypoventilation can be corrected by raising what?

A

FIO2

69
Q

Why can chronic hypoxia lead to pulmonary hypertension?

A

Causes bone marrow to produce more red blood cells which makes blood more viscous and difficult to move through blood vessels and lungs

70
Q

What is Chronic Cor Pulmonale?

A

Hypertrophy of the right ventricle resulting from disease affecting the function and/or structure of the lung

Respiratory System (17 decks)

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