Pneumonia

Question 1

what is the definition of pneumonia?

Answer 1

infection of the pulmonary parenchyma - alveoli and interstitium
acute infection of the lung parenchyma

Question 2

what are the associated symptoms ?

Answer 2

cough
dyspnea
chest pain
abnormal opacities on images
with/without fever

Question 3

what are the causes of pneumonia ?

Answer 3

responses to the infection at alveolar level by
bacteria
virus
fungi

Question 4

how do bacteria enter the lungs ?

Answer 4

microaspiration
inhalation
hematogenic
direct extension

Question 5

what are the dominant bactereia in healthy lungs ?

Answer 5

Prevotella
Veillonella
strptococcus

Question 6

which is the most common cuase of Pneumonia pathway ?

Answer 6

microaspiration

Question 7

when does microaspiration happen ?

Answer 7

during sleep when protective reflexes are reduced

Question 8

explain the defense mechanisms against penumonai ?

Answer 8

hair and turbine
mucociliary clearance
local antibacteraial facotrs
gag reflex
cough mechanism
resident alvelolar macrophages

Question 9

what conditions impair resistance ?

Answer 9

chronic diseases
immunologic deficienceies
leukopenia

Question 10

how can local pulmonary defenses be compromised ?

Answer 10

loss of suppresion of the cough reflex

dysfunction of the mucociliary apparatus

accumulation of secretions

interference with the phagocytic and bactericidal activites of alveolar macrophages

pulmonary congestion and edema

Question 11

what is the host inflammatory response

Answer 11

increased bllod flow to infected area
fluid leaks into lungs - congestion
white blood cells - pus formation

Question 12

what are the clinical symptoms ?

Answer 12

cough
fever
difficulty breathing
chest pain

Question 13

what are the classifications of pneumonia

Answer 13

community acquired pneumonia -CAP
hospital acquired pneumonia -HAP
ventilator associated pneumonia -VAP

Question 14

give the explanation of CAP

Answer 14

lung infection that is acquired from normal environment
may be bacterial or viral
often bacterial follow an upper respiratory tract viral infection
clinical feature can be insensitive to diff between bac and virus

Question 15

explain the pathological evolution of bacterial CAP involveing an entire lobe

Answer 15

edeme (exudate) -> red hepatisation -> gray hepatisation -> resolution

Question 16

what are the risk factors of CAP

Answer 16

alcoholism
smoking
asthma/COPD
immunosuppresssion
initialization
age > 70
Dementia
HF
cerebrovascular diseases

Question 17

What is the clinical picture of CAP?

Answer 17

indolent to fulminant
cough dry -> productive -> bloody
fever
myalgia
pleurtitic chest pain
abdominal pain
older
newborn
alcoholic
immunosuppressed

Question 18

what can we expect to find in physical examination ?

Answer 18

sweating/dehydration
hypotension
tachycardia
dyspnea, tachypnea (25), superficial respiration
cyanosis
compensated respiration

Question 19

what can we find on auscultation ?

Answer 19

focal crackles over the affected area
pleural friction rub

Question 20

what can we expect to find on percussion ?

Answer 20

dullness due to consolidation or effusion

Question 21

how is the tacticle fremitus ?

Answer 21

it is increased

Question 22

how is pneumonia diagnosed ?

Answer 22

clinical manifestations combined with opacities deteced on imaging

Question 23

where can we find the site of inflammation in the lungs ?

Answer 23

lobar
multilobar
segmental
bronchopneumonia

Question 24

explain what the CURB-65 is

Answer 24

it is a scoring system to assess pneumonia severity