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Respiratory Physiology > Pathology of Respiratory Tract/Pulmonary Infection > Flashcards

Pathology of Respiratory Tract/Pulmonary Infection Flashcards

1
Q

Healthy people are mainly infected by…

A

Viruses or aggressive organisms

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2
Q

What are the types of mico-organism pathogenicity/ different types of pathogens?

A

Primary
Faculative
Opportunistic

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3
Q

What does a patients capacity to resist infection rely on?

A

State of the hosts 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 URTIs?

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

As a result of vaccination, what pathogen is increasingly responsible for acute 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

What is the main respiratory tract defence mechanism?

A

The macrophage-mucociliary escalator system

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9
Q

What are some other defences the respiratory tract uses against infection?

A

General immune system - Humoral and cellular immunity

Respiratory tract secretions
Upper respiratory tract as a filter

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10
Q

What can failure in any of these systems lead to?

A

An increased risk of a respiratory tract infection

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11
Q

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

A

Sterile

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12
Q

What cells trap dirt allowing it to be removed from the lower respiratory tract?

A

Alveolar macrophages

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13
Q

What is the function of the cillated 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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14
Q

What happens to the mucous layer with dirt or foreign particles once it is swept up via mucociliary escalatory into the larynx?

A

It’s swallowed or spat out

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15
Q

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

A

Secondary bacterial infection

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16
Q

What is a big 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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17
Q

What 3 categories can you class pneumonia into?

A

Anatomical
Aetiological
Microbiological

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18
Q

Microbiological classification is useful because…

A

Allows you to confirm what organism is causing infection and can plan appropriate treatment

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19
Q

Under what headings can pneumonia be classed, aetiologically?

A

Community Acquired Pneumonia

Hospital Acquired (Nosocomial) Pneumonia

Pneumonia in the Immunocompromised

Atypical Pneumonia
Aspiration Pneumonia
Recurrent Pneumonia

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20
Q

What is the most common aetiological classification of pneumonia?

A

Community acquired pneumonia

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21
Q

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

A

Community and Hospital acquired

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22
Q

What aetiological class of pneumonia is caused by abnormal organisms?

A

Atypical Pneumonia

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23
Q

If a patient has a pneumonia infection alongside another condition (e.g. cardiac failure), what can it lead to?

A

Accumulation of secretions making it difficult to clear the infection

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24
Q

What anatomical distributions/patterns of pneumonia are there?

A 
Bronchopneumonia Segmental Pneumonia  Lobar Pneumonia
Hypostatic P
Aspiration P
Obstructive P
Retention P
Endogenous lipid P
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25
Q

What does bronchopneumonia display as?

A

Displays acute inflammation at a pathological level

Has spots of infection and formation of pus in the lungs

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26
Q

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

A

Bilateral basal patchy opacification

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27
Q

What is consolidation

A

The replacement of air in the lungs by another substance

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28
Q

What is seen in lobar pneumonia?

A

Consolidation/infection of an entire lobe

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29
Q

ilateral basal patchy opacification

A

The aggresiveness

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30
Q

What are some complications of pneumonia?

A 
Pleurisy, Pleural Effusion and Empyema
Organisation 
Constrictive bronchiolitis
Lung Abscess
Bronchiectasis

Pneumonia is still a potentially fatal disease

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31
Q

What can organisation lead to?

A

Mass lesions
Cryptogenic organizing pneumonia/ COP (BOOP)
Constrictive bronchiolitis

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32
Q

Cause of organising pneumonia?

A

Bronchopneumonia turning into fibrosis

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33
Q

What does BOOP stand for?

A

Bronchioloitis Obliterans Organising Pneumonia

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34
Q

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

A

An underlying tumour

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35
Q

Lung abscess can result from the obstruction of what structure?

A

The bronchus

36
Q

What 3 pathogens cause lung abscesses?

A

Staph aureus

Some pneumococci Klebsiella

37
Q

What is Bronchiectasis?

A

A severe dilation of bronchi

38
Q

What causes Bronchiectasis?

A

Severe Infective Episode
Recurrent Infections
Proximal Bronchial Obstruction
Lung Parenchymal Destruction

39
Q

When is bronchiectasis most common?

A

Childhood

40
Q

What are the symptoms of a chronic bronchiectasis infection?

A

Cough
Haemoptysis
Abundant, purulent, foul sputum

41
Q

What are the main treatments for bronchiectasis?

A

Postural drainage Antibiotics

Surgery

42
Q

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

A

Tumours

Foreign Bodies

43
Q

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

A

Bronchiectasis

44
Q

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

A

COPD

Cystic Fibrosis

45
Q

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

A

Immunocompromised

46
Q

What causes aspiration Pneumonia?

A

Vomit traveling down the trachea and into the lung

47
Q

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

A

Apical segment of the right lower lobe

48
Q

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

A

Aspiration pneumonia

49
Q

What can oesophageal diseases/leasions lead to?

A

Aspiration pneumonia

50
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

51
Q

Opportunistic infections are most common in what patients?

A

Immuno-compromised

52
Q

What two things can bulk flow in airways be?

A

Laminar or turbulent

53
Q

What does the air flow in airways depend on?

A

The pressure difference

54
Q

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

A

Humidifies/warms it

55
Q

Pulmonary gas exchange occurs at what barrier?

A

Blood-air barrier

56
Q

Gas moves by diffusion beyond…

A

Terminal bronchiole

57
Q

What is Type I respiratory failure?

A

Failure to maintain arterial partial pressure of oxygen above 8 kPa

PaCO2 is usally normal or low

58
Q

What is Type II respiratory failure?

A

Failure to remove CO2, so PaCO2 is above 6.5kPa

PaO2 is usually low

59
Q

Four abnormal states are associated with Hypoxaemia are….

A

Ventilation / Perfusion imbalance - V/Q
Diffusion impairment
Alveolar Hypoventilation
Shunt

60
Q

What pulmonary vascular change occurs in hypoxia?

A

Pulmonary arteriolar vasoconstriction

61
Q

Pulmonary arteriolar vasoconstriction occurs when…

A

When alveolar oxygen tension falls

62
Q

Alveolar oxygen tension falling can be a…

A

Localised effect

63
Q

Do all vessels constrict if there is arterial hypoxaemia?

A

Yes

64
Q

Why do vessels constrict?

A

As a protective mechanism - so blood is not sent to alveoli short of oxygen

65
Q

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

A

Blood going to abnormal lung will be reduced when compared to normal

66
Q

Outside lung disease - when might hypoxia occur?

A

At high altitudes with minimal O2

67
Q

Severe bronchopneumonia can cause what abnormal state associated with Hypoxaemia?

A

Shunt

68
Q

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

A

Ventilation/Perfusion abnormality (mismatch)

69
Q

What is hypoxaemia?

A

An abnormally low concentration of oxygen in the blood.

70
Q

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

A

Shunt

71
Q

What is the most common cause of hypoxaemia encountered clinically?

A

Low Ventilation/Perfusion (V/Q) mismatch

72
Q

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

A

FlO2

73
Q

Shunt is…

A

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

74
Q

What are the common causes of Hypoxaemia in COPD?

A

Ventilation/Perfusion abnormality
Alveolar hypoventilation Diffusion impairment
Shunt

75
Q

When would a ventilation/perfusion mismatch occur?

A

Airway obstruction

76
Q

When could alveolar hypo-ventilation occur?

A

With a reduced respiratory drive

77
Q

When would diffusion impairment occur?

A

Loss of alveolar surface area

78
Q

When does a shunt occur?

A

Only during acute exacerbation

79
Q

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

A

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

80
Q

What is alveolar hypo-ventilation?

A

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

81
Q

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

A

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

82
Q

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

A

FIO2

83
Q

What is FIO2

A

The fraction of inspired air which is O2

84
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

85
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 Physiology (13 decks)

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