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Respiratory > Pathology of respiratory tract infection > Flashcards

Pathology of respiratory tract infection Flashcards

1
Q

What are the different types of microorganism pathogenicity?

A

Primary, these are highly infectious and dangerous
Facultative- need the immune system to be slightly reduced/weakened to infect
Opportunistic- require the hosts immune system to be greatly reduced so that the can infect the host (the host must have a compromised immune system)

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2
Q

What groups of patients have a compromised immune system?

A

Elderly
Patients on immunosuppressants (such as after transplant surgery)
Infants

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3
Q

What does a patients ability to resist infection depend upon?

A

State of the host’s defence mechanisms (their immune system)

The age of the patient

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4
Q

What are the two categories of respiratory tract infection?

A

Upper (from larynx up) and Lower

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5
Q

Give examples of upper respiratory tract infections

A 
Common cold (Coryza)
Sore throat syndrome
Acute Laryngotracheobronchitis (Croup)
Laryngitis
Sinusitis
Acute Epiglottitis
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6
Q

What microorganisms can cause Acute Epiglottitis?

A

Haemophilus influenzae type B
Group A beta haemolytic streptococci
(others can cause it)

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7
Q

Name some viruses that commonly cause upper respiratory tract infection

A 
Rhinovirus
Influenza
Adenovirus
EB Virus 
Parainfluenza
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8
Q

Give a few examples of lower respiratory tract infections.

A

Bronchitis
Bronchiolitis
Pneumonia

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9
Q

What is the main respiratory tract defence mechanism?

A

Macrophage-mucociliary escalator

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10
Q

How does the macrophage-mucociliary escalator work?

A

Macrophages engulf and digest foreign bodies that make it to the alveoli and respiratory bronchioles. These macrophages them stick in the mucus and get transported with the dust and bacteria, up the respiratory tract by the cilia which move the mucus along.
The cilia move the bacteria and pathogens out of the lower respiratory tract and they get swallowed in a cough reflex (or expelled out of your nose or mouth)

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11
Q

What are the other mechanisms that are in place as defence mechanisms?

A

General immune system- humoral and cellular immunity
Respiratory tract secretions
Upper respiratory tract acts as a filter

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12
Q

What happens when ciliated epithelium is lost?

A

The air breathed in will not be humidified and warmed.
The mucociliary escalator will also be lost in that area, this means that bacteria and pathogens won’t be removed from that area or anywhere below it. Therefore secondary infections are likely.

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13
Q

Name one instance in which the ciliated epithelium can be lost

A

Influenza

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14
Q

What microorganisms cause a common cold?

A

Rhinovirus

Human parainfluenza virus

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15
Q

What microorganisms cause Croup?

A

Respiratory Syncytial virus
Parainfluenza virus
Rhinovirus

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16
Q

What are the three methods for classifying pneumonia?

A

Anatomically
Aetiologically (how the infection occurred)
Microbiologically

17
Q

Name the classes on pneumonia in aetiological classification of Pneumonia

A 
Community Acquired Pneumonia
Hospital Acquired (Nosocomial) Pneumonia
Pneumonia in the immunocompromised
Atypical pneumonia
Aspiration pneumonia
Recurrent pneumonia
18
Q

What are the patterns of pneumonia?

A

Bronchopneumonia- affects the bronchioles and surrounding alveolar tissue
Segmental
Lobar- affects one or more lobes
This tells you how much of the lung is infected.

19
Q

Give some types of pneumonia

A

Hypostatic- associated with elderly and bed ridden people who remain in the same position for long periods of time, which causes areas of decreased ventilation in the lungs.
Obstructive
Retention
Endogenous lipid/ lipoid

20
Q

What is bronchopneumonia?

A

It is pneumonia that affects the bronchioles and the surrounding alveolar tissue. This tends not to spread to large areas of the lungs and doesn’t usually reach the pleura, so there are no pleural complications.

21
Q

What does bronchopneumonia usually look like on the x-ray?

A

Often bilateral
Causes patchy basal opacification (white areas) where consolidation has occurred.
Doesn’t usually occur in young people.
Generally occurs in people with other health issues and is caused by facultative pathogens.

22
Q

What are the possible outcomes or complications of pneumonia?

A

Resolve
Pleurisy (inflammation of the pleura)
Pleural effusion- collection of fluid in the pleural space
Empyema (chronic empyema sometimes never goes away)
Organisation: mass lesion,cryptogenic organising pneumonia (COP), Constrictive bronchiolitis
Lung abscess
Bronchiectasis

23
Q

What is organisation?

A

It is when a healing process is occurring and the exudate heals/forms scar tissue rather then undergoing reabsorption and resolution.

24
Q

What can cause lung abscesses to form?

A

Obstructed bronchus (possibly obstructed by a tumour)
Aspiration
Microorganisms
Necrotic lung tissue (the abscess would then be a secondary infection)

25
Q

Name some microorganisms that can cause lung abscesses

A

Staph aureus
Some pneumococci
Klebsiella

26
Q

What is pyaemia?

A

It is the presence of infective agents or their toxins in the bloodstream (septicaemia) due to pyogenic organisms causing multiple abscesses.

27
Q

What can the formation of multiple abscesses cause?

A

Pyaemia (septicaemia)

28
Q

What are the clinical signs of bronchiectasis?

A 
Cough
Production of abundant purulent (containing pus) foul sputum.
Coarse crackles
Clubbing
(75% start in childhood)
29
Q

What are some of the causes of bronchiectasis?

A

Severe infective episode
Recurrent infections
Proximal bronchial obstruction
Lung parenchymal destruction

30
Q

What are the complications of bronchiectasis?

A

Suppuration

Haemorrhage

31
Q

What are the causes of recurrent lung infections

A

Local bronchial obstruction- could be caused by tumour or foreign body
Local pulmonary damage -e.g. caused by bronchiectasis
Generalised lung disease- e.g cystic fibrosis, COPD or Asthma
Non- respiratory disease- immunocompromised ect

32
Q

Describe what Type 1 respiratory failure is

A

Failure of gas exchange in all or part of the lungs

33
Q

What would gas pressure look like in Type 1 respiratory failure?

A

PaO2 <8kPa (normal range is 10.5-13.5 kPa)

PaCO2 would be normal or low

34
Q

Describe what Type 2 respiratory failure is.

A

A failure of ventilation (you aren’t breathing well enough)

35
Q

What would gas pressure look like in Type 2 respiratory failure?

A

PaCO2 > 6.5 kPa (Normal range is 4.8-6.0 kPa)

PaO2 is usually low.

36
Q

What are four reasons for abnormal gas exchange (specifically hypoxaemia)?

A

Ventilation/perfusion imbalance- V/Q (usually the ventilation that goes wrong)
Diffusion impairment- this is usually something wrong with the alveolar tissue
Alveolar hypoventilation (not breathing enough)
Shunt

37
Q

What conditions cause ventilation/ perfusion abnormalities (mismatch)?

A

Bronchitis

Bronchopneumonia

38
Q

What conditions cause shunt to occur?

A

Severe bronchopneumonia

Large areas of consolidation.

39
Q

What is the normal V/Q ratio?

A

0.8

Respiratory (12 decks)

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