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Respiratory Pathology and Immunology > Pathology of Pulmonary Infections > Flashcards

Pathology of Pulmonary Infections Flashcards

1
Q

What is pneumonia?

A

Infection involving the distal airspaces usually with inflammatory exudation where fluid filled spaces lead to consolidation

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2
Q

Which types of organisms can cause pneumonia? (3)

A

Viruses
Bacteria
Fungi

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3
Q

Which viruses can cause pneumonia?

A 
Influenza
Parainfluenza
measles
Varicella-zoster
Respiratory syncytial virus (RSV)
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4
Q

Which bacteria can cause pneumonia?

A

Chlamydia

Mycoplasma

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5
Q

Fungal pneumonia only really occur in _______ patients

A

Immunocompromised

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6
Q

What is lobar pneumonia?

A

Confluent consolidation involving a complete lung lobe

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7
Q

What causes lobar pneumonia (organisms)

A

Strep pneumoniae or other organisms(Klebsiella/Legionella)

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8
Q

What is the clinical setting of lobar pneumonia?

A

Usually community-acquired

Classically in otherwise healthy young adults

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9
Q

What distinguishes between lobar and bronchopneumonia?

A

Morphology

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10
Q

Pathology of lobar pneumonia involves a classical ______ __________ response

A

acute immune

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11
Q

What are the possible complications of lobar pneumonia?

A

Fibrous scarring
Abscess
Bronchiectasis
Empyema

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12
Q

What is bronchopneumonia?

A

Patches of pus/infection thought the lung

Mostly associated with airways

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13
Q

What are the causes of bronchopneumonia?

A

COPD
Cardiac failure
Complicate not viral infection
Aspiration

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14
Q

Which organisms are found in bronchopneumonia?

A 
Strep. pneumoniae
Haemophilus influenza 
Staphylococcus 
Anaerobes 
Coliforms
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15
Q

Aspiration-caused bronchopneumonia is associated with which organisms?

A

Staph
Anaerobes
Conforms

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16
Q

What are the possible complications of bronchopneumonia?

A

Organisation (scarring)
(lung) Abscess
Bronchiectasis
Empyema

17
Q

What is bronchiectasis?

A

Chronic infection of the bronchi and bronchioles leading to permanent dilation of these airways

18
Q

What are the main organisms associated with bronchiectasis?

A

Haemophilia influenza
Strep pneumonia
Staph aureus
Pseudomonas aeruginosa

19
Q

What are the congenital causes of Bronchiectasis?

A

Cystic fibrosis
Young’s syndrome
Primary ciliary dyskinesia
Kartagener’s syndrome

20
Q

What are the post-infection causes of bronchiectasis?

A 
Measles 
Pertussis 
Bronchiolitis
Pneumonia
HIV 
TB
21
Q

What are other other (non-congenital/non-post-infection) causes of bronchiectasis?

A 
Bronchial obstruction
Allergic broncho-pulmonary aspergillosis 
Hypo-gammaglobulinaemia 
Rheumatoid arthritis 
Ulcerative colitis 
Idiopathic
22
Q

Tuberculosis is …

A

a mycobacterial infection found in many body sites

23
Q

What characterises the pathology of TB?

A

Delayed (type IV) hypersensitivity leading to granulomas with necrosis

24
Q

Which organisms are the main pathogens in TB?

A

M. tuberculosis

M. bovis

25
Q

What gives TB-causing-organisms their pathogenicity?

A

Ability to avoid phagocytosis and simulate a host-T-cell response

26
Q

What constitutes immunity in TB?

A

T-cell response to organism enhances macrophage ability to kill mycobacteria

27
Q

What constitutes hypersensitivity in TB?

A

T-cell response causes granulomatous inflammation, tissue necrosis and scarring

28
Q

What is meant by primary tuberculosis?

A

1st exposure and up to 5 years after

29
Q

What occurs when first exposed to TB?

A

Inhaled organism > phagocytosed > carried to hilar lymph nodes > immune activation > granulomatous response in nodes + lungs

Usually causes killing of organism / sometimes overwhelming and spreads

30
Q

What is meant by secondary tuberculosis?

A

Reinfection or reactivation of disease in person with some immunity

31
Q

In secondary tuberculosis disease tends to be _______ (often in ___ of lungs) but can progress to spread by ______ or _______

A

localised
apices
airways
bloodstreams

32
Q

Which tissue changes occur in primary TB?

A

Small focus (Ghan focus) in periphery / mid zone of lung

33
Q

What tissue changes occur in secondary TB?

A

Fibrosing and caveating apical vision

34
Q

What causes reactivation of TB?

A

decreased T-cell function

35
Q

What causes decreased T-cell function?

A

Age
Coincident disease (HIV)
Immunosuppressants (steroids/chemotherapy)

36
Q

When does reinfection with TB occur?

A

At higher dose or with more virulent organism

37
Q

What are opportunistic pathogens?

A

Pathogens that aren’t normally disease causing but cause disease in immunocompromised patients

38
Q

What are examples of opportunistic pathogens that cause infection in the immunocompromised?

A

Viral (Cytomegalovirus - CMV)
Bacteria (Mycobacterium avid intracellulare)
Fungi (aspergillus / Candida / Pneumocystis)
Protozoa (Cryptosponridia / toxoplasma)

39
Q

How is TB diagnosed?

A

high index of suspicion
MDT
Bronchoalveolar lavage
Biopsy with stains

Respiratory Pathology and Immunology (7 decks)

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