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CPR Week 6 > Pathoma Pulmonary Infections > Flashcards

Pathoma Pulmonary Infections Flashcards

1
Q

Pneumonia

A

Infection of the lung parenchyma

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2
Q

Normal cause of Pneumonia

A

Occurs when normal defenses are impaired

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3
Q

Clinical features of PNA

A

Fever and chills, cough with yellow green or rusty sputum, tachypnea with pleuritic chest pain, decreased breath sounds with dullness to percussion

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4
Q

Labs for PNA

A

Elevated WBC count

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5
Q

3 chest x ray patterns involving Penumonia

A

Lobar PNA - Whole lobe consolidated

Bronchopneumonia - Consolidation in patchy pattern on airways

Interstitial pneumonia - N oconsolidation, just inflammation in the interstitium. Increased in lung markings

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6
Q

CXR for bacterial PNA

A

Lobar and broncho PNA

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7
Q

CXR for viral PNA

A

Interstitial PNA

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8
Q

Most common causes of lobar PNA

A

Strep Pneumonia in 95%

Klebsiella pneumonia in 5% or less

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9
Q

Which PNA is associated with community-acquired?

A

Streptococcus Pneumoniae

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10
Q

Which PNA is associated with malnourished or debilitated individuals like in nursing homes?

A

Klebsiella Pneumoniae?

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11
Q

Regarding Klebsiella PNA, we typically see this PNA etiology and complication:

A

Thick mucoid capsule results in gelatinous sputum (currant) jelly.

Often complicated by abscess

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12
Q

4 phases of lobar pneumonia

A
  1. Congestion - congested vessels and edema
  2. Red Hepatization - Develop exudate in the lung with blood and neutrophils, making a thick, tougher lung over spongy normal one
  3. Grey Hepatization - RBCs break down
  4. Resolution - Resolve exudate and heal
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13
Q

Discuss lung healing and the most important cell involved

A

Type II pneumocyte which a stem cell of the lung that regenerates the lung.

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14
Q

How does bronchiopneumonia look?

A

Scattered, often bilateral. Centered around bronchioles

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15
Q

There are 5 bacteria associated with bronchopneumonia:

A
  1. Staph Aureus
  2. H Influenza
  3. Pseudomonas aeruginosa
  4. Moraxella Catarrhalis
  5. Legionella Pneumophila
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16
Q

This bacteria is seen in cystic fibrosis patients who have bronchopneumonia

A

Pseudomonas Aeruginosa

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17
Q

This bacteria is seen in community acquired pneumonia patients who have bronchopneumonia

A

H. Influenza
M. Catarrhalis
L. Pneumophila

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18
Q

This bacteria is seen superimposed on COPD patients patients who have bronchopneumonia

A

H. Influenza
M. Catarrhalis
L. Pneumophila

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19
Q

This bacteria is seen in patients who have bronchopneumonia and is often associated with an abscess and empyema, which is pus

A

S. Aureus

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20
Q

This bacteria is seen in patients who have bronchopneumonia and are immune compromised

A

L. Pneumophila

21
Q

This bacteria is associated with bronchopneumonia and is superimposed on a viral upper respiratory infection

A

S. Aureus

22
Q

This bacteria is best visualized on a silver stainm and is associated with bronchopneumonia

A

L. Pneumophila

23
Q

This bacteria is associated with bronchopneumonia and is the most common cause of secondary pneumonia

A

S. Aureus

24
Q

Presentation of interstitial pneumonia, also called atypical PNA

A

Diffuse infiltrates

Presents with relatively mild upper respiratory symptoms like minimal sputum, cough, and low fever

25
Q

Most common cause of atypical PNA in infants

A

RSV - Respiratory Syncytial virus

26
Q

This atypical pneumonia is associated with post transplant immunosuppressive therapy

A

Cytomegalovirus (CMV)

27
Q

Most common cause of atypical PNA, usually in young adults

A

Mycoplasma pneumoniae

28
Q

Complications of atypical pneumoniae caused by Mycoplasma pneumoniae

A
  1. Autoimmune hemolytic anemia (IgM against I antigen on RBCs causes cold hemolytic anemia)
  2. Erythema multiforme
29
Q

Why can’t we visualize Mycoplasma pneumoniae on a gram stain?

A

No cell wall

30
Q

Second msot common cause of atypical pneumonia

A

Chlamydia pneumoniae

31
Q

This causes an atypical pneumonia of the elderly or immune compromised or those with preexisting lung disease

A

Influenza virus

32
Q

Typically atypical pneumonia does not present with a high fever, but with this organism, it does:

A

Coxiella Burnetti

33
Q

What is special about Coxiella Burnetti?

A

It is rickettsial, but it distinct because

  1. Causes pneumonia
  2. Does not require arthropod vector for transmission (survives as highly heat-resistant endospores)
  3. Does not produce a skin rash
34
Q

This organism increases the risk for superimposed S. Aureus or H. Influenza bacterial pneumonia

A

Influenza virus

35
Q

This organism puts farmers and vets at risk for developing atypical pneumonia

A

Coxiella burnetti

36
Q

Who gets Aspiration Pneumonia?

A

Those at risk for aspiration…idiot

Like alcoholics and comatose patients, and Nick

37
Q

What causes aspiration pneumonia? Give top 3 examples

A

Anaerobic bacteria in the oropharynx like:

  1. Bacteroides
  2. Fusobacterium
  3. Peptococcus
38
Q

spiration Pneumonia classically results in what?

A

Right lower lobe abscess

39
Q

What causes tuberculosis?

A

Inhalation of aerosolized Mycobacterium tuberculosis

40
Q

What is primary TB?

A

Results from initial exposure of M. Tuberculosis

41
Q

Symptoms of primary TB

A

Usually asymptomatic

42
Q

Describe what is happening biologically with primary TB

A

Results in focal caseating necrosis in the lower lobe of the lung and hilar lymph nodes. The foci undergo fibrosis and calcification, forming a Ghon complex.

43
Q

What is secondary TB and who gets it the most?

A

Its when you have a reactivation of your TB, usually seen in AIDS and sometimes with aging

44
Q

Where does Secondary TB hit and what does it lead to

A

Occurs at the apex of the lung

Forms a cavitary foci of caseous necrosis, may also lead to miliary pulmonary TB or tuberculosis bronchopneumonia

45
Q

Presentation of Secondary TB

A
  1. Fever and night sweats
  2. Cough with hemoptysis
  3. Weight loss
46
Q

Biopsy/staining of secondary TB shows what?

A

Biopsy reveals caseating granulomas

AFB stain reveals red acid-fast bacilli

47
Q

Secondary TB can spread to any tissue. What are the top three and what do they cause?

A
  1. Meninges leading to meningitis
  2. Kidney which can lead to sterile pyuria
  3. Lumbar vertebrae leading to Pott Disease

Can also go to cervical lymph nodes but everything does.

48
Q

What is the most common organ affected by secondary TB?

A

Kidney

49
Q

With Meningitis caused by Secondary TB, which ones are most affected and how do we know?

A

The base of the brain, you’ll see granulomas there

CPR Week 6 (29 decks)

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