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Respiratory block > Pathology of respiratory tract infections > Flashcards

Pathology of respiratory tract infections Flashcards

1
Q

What types of Microorganism Pathogenicity exist How invasive it is, infectivity etc ?

A

Primary - very invasive and infectious to healthy people

Facultative (most common)- A bit of illness needed for invasion to occur

Opportunistic -cause infections in immunocompromised host

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2
Q

What are common upper respiratory tract infections ?

A 
Coryza- common cold
Sore throat syndrome
Acute laryngotracheobronchitis (croup)
Laryngitis
Sinusitis
Acute epiglottitis
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3
Q

What does the capacity to resist infection depend on ?

A

State of Host Defence Mechanisms Age of Patient

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4
Q

What are some examples of upper respiratory tract infections ?

A 
Coryza- common cold
Sore throat syndrome
Acute laryngotracheobronchitis (croup)
Laryngitis
Sinusitis
Acute epiglottitis
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5
Q

What causes acute epiglottis ?

A 
Group A beta-haemolytic Streptococci 
Haemophilus influenzae (type b - Hib) 
Rarely caused by Parainfluenza virus type 4 but other viruses may also be responsible
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6
Q

What are the effects of acute epiglottitis ?

A

Potentially life threatening
Affects children
Swells up and obstructs airway
Causes extreme respiratory difficulty

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7
Q

What are some examples of lower respiratory tract infections ?

A

Bronchitis
Bronchiolitis
Pneumonia

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8
Q

How do lower respiratory tract infections compare to upper ?

A

More morbidity and mortality rate with lower respiratory tract infections

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9
Q

What are the respiratory tract defence mechanisms ?

A

Macrophage-mucocilary escalator system

- alveolar macrophages
- mucocilary escalator
- cough reflex

General immune system
- humoral and cellular immunity

Respiratory tract secretions
Upper respiratory tract as a filter

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10
Q

Which part of the respiratory tract is sterile ?

A

Lower

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11
Q

Which part of the upper respiratory tract acts as a filter ?

A

Nose

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12
Q

What components of the the upper respiratory tract as a filter ?

A

Hair, moist, mucous and cilia in epithelium

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13
Q

What is the effect of alveolar macrophages ?

A

Phagocytose, (if they cannot digest) travel towards the ciliary escalator for digestion

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14
Q

Why might the macrophage pass through the alveolar membrane ?

A

To reach Interstitial pathway via lymph to the lymph nodes

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15
Q

Where does particle deposition occur ?

A

Deposition on the conducting airways

Deposition on the terminal bronchioles/ proximal alveoli

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16
Q

How can the ciliary escalator fail ?

A 
Viral infections (influenza) – damage to normal respiratory epithelium – no longer functional or cilia, severe when there is no mucocilary membrane
Common cause of bacterial chest infections
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17
Q

What are the 3 classifications of pneumonia ?

A

Anatomical
Aetiological
Microbiological

18
Q

What are the aetiological classifications of pneumonia ?

A

Community Acquired Pneumonia (usually treated by GP’s)

Hospital Acquired (Nosocomial) Pneumonia (more likely to be severe, bacteria more likely to be resistant)

Pneumonia in the Immunocompromised (AIDS patients)

Atypical Pneumonia (unusual infectious agents)

Aspiration Pneumonia (result in the inhalation of gastric content)

Recurrent Pneumonia – signal that there is something particularly odd going on)

19
Q

What are the different patterns of pneumonia ?

A

Bronchopneumonia

Segmental

Lobar

Hypostatic

Aspiration

Obstructive, Retention, Endogenous Lipid

20
Q

What does bronchopneumonia affect ?

A

Both lungs and the bronchi

21
Q

What does lobar pneumonia affect ?

A

One or more sections/ lobes of the lung

22
Q

What causes most cases of bacterial pneumonia ?

A

Streptococcus pneumonia- main one

Staphylococcus aureus

Haemophilus influenzae

Klebsiella pneumoniae

23
Q

What is the classic type of pneumonia that is community acquired ?

A

Shows lung consolidation of one lung segmental lobe

24
Q

What is hypostatic pneumonia ?

A

Infection in the dependent portions of the lungs due to decreased ventilation of those areas

Failure to drain bronchial secretions

Occurs primarily in old people or those debilitated by disease who remain recumbent in the same position for long periods

25
Q

What is aspiration pneumonia ?

A

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

26
Q

What causes aspiration pneumonia ?

A

Vomiting

Oesophageal Lesion

Obstetric Anaesthesia (any anaesthetic used in childbirth)

Neuromuscular Disorders Sedation

27
Q

Where is the most common location for aspiration pneumonia ?

A

Apical segment of right lower lobe

28
Q

What is the effect of acute inflammation in bronchopneumonia ?

A

Lung filled with pus, neutrophils and inflammatory exudate

It is the most common hypostatic pneumonia story

29
Q

How does the action of bacteria differ in lobar pneumonia ?

A

Organisms are more aggressive, greater tissue reaction, greater spread of organism. Infection stops at the pleura

30
Q

What are the outcomes/ complications of pneumonia ?

A

Most Resolve

Pleurisy, Pleural Effusion and Empyema

Organisation – formation of fibrous tissue, inflammatory area becomes scar tissue
–mass lesion
–COP(cryptogenic organising pneumonia (BOOP))
–Constrictive bronchiolitis

Lung Abscess - necrosis, hole in lung

Bronchiectasis

Pneumonia is still a potentially fatal disease

31
Q

What happens during the organisation in pneumonia ?

A

Formation of fibrous tissue, inflammatory area becomes scar tissue

32
Q

What is a lung abscess ?

A

Pus forms in the space where there was tissue destruction

33
Q

What organisms are more likely to cause abscess ?

A

Staph aureus
Some pneumococci
Klebsiella

34
Q

When is lung abscess metastatic ?

A

Pyaemia

35
Q

What can happen if there is secondary infection in a lung abscess ?

A

Necrotic lung

36
Q

What is the mechanism of bronchiectasis ?

A 
The mechanism of disease is breakdown of the airways due to an excessive inflammatory response
Involved airways (bronchi) become enlarged and thus less able to clear secretions
These secretions increase the amount of bacteria in the lungs, result in airway blockage and further breakdown of the airways
37
Q

What is bronchiectasis ?

A

Abnormal dilation of the bronchi in the periphery of the lung

38
Q

what is bronchiectasis due to ?

A

Severe infective episode
Recurrent infections- many causes
Proximal bronchial destruction
Lung parenchyma destruction

39
Q

What are the symptoms of bronchiectasis ?

A

Cough
SOB
Abundant purulent foul sputum
Coughing up blood (haemoptysis)

40
Q

What are the signs of bronchiectasis ?

A

Coarse crackles

Clubbing

41
Q

How might you get a recurrent lung infection ?

A

Local Bronchial Obstruction - Tumour, Foreign body?

Local Pulmonary Damage - Bronchiectasis?

Generalised Lung Disease - Cystic Fibrosis?, COPD?

Non-Respiratory Disease - Immunocompromised (HIV, other)?, Aspiration?

42
Q

What are Oppurtunistic pathogens and can you give an example of one ?

A

Infection by organisms not normally capable of producing disease in patients with intact lung defences
–Pneumocystis jirovecii

Respiratory block (38 decks)

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