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Respiratory > Pathology of Respiratory Tract Infections > Flashcards

Pathology of Respiratory Tract Infections Flashcards

1
Q

What are different kinds of microorganisms in terms of pathogenecity?

A

Primary

Facultative

Opportunistic

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2
Q

What are primary microorganisms?

A

Can establish an infection in almost anyone

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3
Q

What are facultative microorganisms?

A

Requires defences to be reduced a little bit to cause disease

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4
Q

What are opportunistic microorganisms?

A

Not very infectious, do not have pathogenic properties to invade human tissue, but if defences are dropped then they can cause a clinically evident infection

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5
Q

What does the ability to resist infection depend on?

A

State of the host defence mechanism

Age of patient

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6
Q

What are some upper respiratory tract infections?

A

Coryza (common cold)

Sore throat syndrome

Acute laryngotracheobronchitis (coup)

Laryngitis

Sinusitis

Acute epiglottitis

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7
Q

What is the common cold also known as?

A

Coryza

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8
Q

What is coup also known as?

A

Laryngotracheobronchitis

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9
Q

What is acute epiglottis commonly caused by?

A

Group A beta haemolytic streptococci

Haemophilus influenza

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10
Q

Who seems to be most prone to acute epiglottitis?

A

Young children

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11
Q

What are some examples of lower respiratory tract infections?

A

Bronchitis

Bronchiolotis

Pneumonia (acute inflammatory process in the alveoli)

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12
Q

What is pneumonia?

A

Acute inflammatory process in the alveoli

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13
Q

What are some respiratory tract defence mechanisms?

A

Macrophage-mucociliary escalator system

General immune system

Respiratory secretions

Upper respiratory tract as a filter

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14
Q

What is the macrophage-mucociliary escalator system composed of?

A

Alveolar macrophages

Mucociliary escalator

Cough reflex

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15
Q

How does the upper respiratory tract help to prevent the lower respiratory tract from becoming infected?

A

Warms and humidifies air, supplying a large surface area where material in the air may be deposited so it does not reach the lower respiratory tract

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16
Q

How are particles cleared from the lungs?

A

Macrophage-mucociliary escalator:

1) Macrophages clear particles by phagocytosis
2) Leave via the muco-ciliary escalator or through lymph

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17
Q

What is pneumonia classified by?

A

Anatomical (understand radiology)

Aetiological (how acquired, such as from a hospital or community)

Microbiology (tells us how to treat the patient)

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18
Q

What are some different aetiological classifications of pneumonia?

A

Community acquired

Hospital acquired (nosocomial)

Pneumonia in the immunocompromised

Atypical pneumonia (caused by unusual organism)

Aspiration pneumonia

Recurrent pneumonia

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19
Q

What is a hospital acquired infection also known as?

A

Nosocomial infection

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20
Q

What are infections from hospital more likely to be?

A

Resistant to antibiotics

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21
Q

What are some different patterns of pneumonia?

A

Bronchopneumonia

Segmental

Lobar

Hypostatic

Aspiration

Obstructive, retention, endogenous lipid

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22
Q

What is hypostatic pneumonia?

A

Patient has some other pathological process that lead to the accumulation of fluid in the lung, such as cardiac failure with chronic edema

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23
Q

What occurs in bronchopneumonia?

A

Acute inflammation

Pus from polymorphs replaces air

Accumulation of neutrophils in alveolar space

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24
Q

What is the infected site in segmental and lobar pneumonia normally like?

A

Unilateral in a single site or area of the lung which is infected

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25
How does segmental and lobar pneumonia differ from bronchopneuonia?
Segmental and lobar are at a single site whereas broncho is multilocal
26
What is bronchopneumonia characerised by?
Spots of infection stay around alveoli Rare for infection to reach the pleura Basal parts of the lungs infected
27
What is lobar pneumonia characterised by?
Large amount of lung infected by the same inflammatory process Could be an entire lobe Meaning the whole part is airless due to being filled with pus
28
What kind of pneumonia could lead to a pleural infection?
Lobar, pleural infections are rare with bronchopneumonia
29
What are possible outcomes of pneumonia?
Most resolve Pleurisy, pleural effusion and emphysema Organisation Lung abscess Bronchiectasis
30
What are examples of pneumonia leading to organisation?
Mass lesion Cryptogenic organising pneumonia (COP) Constructive bronchiolotis
31
What could pneumonia lead to instead of resolution?
Fibrosis Abscess (infected area dies which creates a hole in the lung)
32
What can the outcome of pneumonia mimic?
Can result in a lump which mimics cancer, only to realise it is not cancer once it has been removed
33
What is a lung abscess?
Necrosis of the lung and formation of a cavity
34
What causes a lung abscess?
Necrotic lung (2nd degree infection) Particular organisms Obstructed bronchus (tumour)
35
What can a lung abscess lead to?
Blood poisoning (pyaemia)
36
What is pyaemia?
A type of septicaemia that leads to widespread abscesses (blood poisoning)
37
What is bronchiectasis?
Pathological dilation of bronchi
38
What can bronchiectasis be due to?
Severe infective episode Recurrent infections Proximal bronchial obstruction Lung parenchymal destruction
39
What is parenchyma?
The functional tissue of an organ
40
What is the functional tissue of an organ called?
Parenchyma
41
In basic terms, what is bronchiectasis?
Increase in the diameter of the airways relative to its position
42
When does bronchiectasis usually start?
75% of the time in childhood
43
What are symptoms of bronchiectasis?
Cough Abundant purulent foul sputum Haemoptysis Signs of chronic infection Coarse crackle, clubbing
44
What is haemoptysis?
Coughing up blood
45
What is coughing up blood called?
Haemoptysis
46
What is bronchiectasis diagnosed by?
Thin section CT
47
What is the treatment of bronchiectasis?
Postural drainage Antibiotics Surgery
48
Is bronchiectasis usually localised or widespread?
Widespread
49
When can bronchiectasis be removed?
When it is localised
50
What do we need to consider in recurrent lung disease?
Why the defences are failing
51
What can we ask when considering why the defences are failing?
Local bronchial obstruction (tumour, foreign body)? Local pulmonary damage (bronchiectasis)? Generalised lung disease (cystic fibrosis, COPD)? Non-respiratory disease (immunocompromised, aspiration)?
52
What may aspiration pneumonia be due to?
Vomiting Oesophageal lesion Obstetic anaesthesia Neuromuscular disorders Sedation
53
What are opportunistic infections?
Infections by organisms not normally capable of producing disease in patients with intact lung defences
54
What are some examples of opportunistic pathogens?
Low grade bacterial pathogens Cytomegalovirus (CMV) Pneumocystis jirovecii Other fungi and yeasts
55
What are the 2 things flow of air can be?
Laminar or turbulent
56
What is laminar flow?
Ordered
57
What is ordered flow known as?
Laminar
58
What is turbulent flow?
Random or chaotic
59
What is random or chaotic flow known as?
Turbulent flow
60
What does bulk flow depend on?
Pressure difference
61
What occurs beyond the terminal bronchiole?
Diffusion
62
What barrier is present in the alveoli?
Blood air barrier
63
What is the normal PaO2 value?
10.5-13.5kPa
64
What is the normal PaCO2 value?
4.8-6kPa
65
What are the 2 kinds of respiratory failure?
Type 1 Type 2
66
What is type 1 respiratory failure?
PaO2 \< 8kPa, PaCO2 normal or low)
67
What is type 2 respiratory failure?
PaCO2 \> 6.5kPa, PaO2 usually low
68
What are 4 abnormal states associated with hypoaemia?
Ventilation/perfusion imbalance (V/Q) Diffusion impairment Alveolar hypoventilation Shunt
69
What is hypoxaemia?
Low levels of oxygen in the blood
70
What is low levels of oxygen in the blood known as?
Hypoxaemia
71
What happens when alveolar oxygen tension falls?
Pulmonary arteriolar vasoconstriction occurs so blood is not sent to alveoli short of oxygen
72
What happens if there is arterial hypoxaemia?
All vessels constrict
73
What is the size of a normal breath?
4L
74
What is the normal cardiac output?
5L
75
What is the normal ventilation/perfusion (V/Q) value?
0.8
76
What is the commonest cause of hypoxaemia?
Low V/Q
77
What does a low V/Q in some alveoli arise due to?
Local alveolar hypoventilation due to some disease
78
What is shunt?
Blood passes from right to left side of the heart without contacting ventilated alveoli
79
What is it called when blood travels from the right to the left side of the heart without contacting ventilated alveoli?
Shunt
80
How do large shunts respond to increases in FIO2?
Poorly because the blood leaving the lung is already 98% saturated (no level of oxygen can oxygenate the blood because it cannot be passed onto the blood)
81
What is FIO2?
The fraction of inspired air which is oxygen
82
What is the normal value of FIO2?
0.21

Respiratory (37 decks)

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