Pneumonia Flashcards
what is the definition of pneumonia?
infection of the pulmonary parenchyma - alveoli and interstitium
acute infection of the lung parenchyma
what are the associated symptoms ?
cough
dyspnea
chest pain
abnormal opacities on images
with/without fever
what are the causes of pneumonia ?
responses to the infection at alveolar level by
bacteria
virus
fungi
how do bacteria enter the lungs ?
microaspiration
inhalation
hematogenic
direct extension
what are the dominant bactereia in healthy lungs ?
Prevotella
Veillonella
strptococcus
which is the most common cuase of Pneumonia pathway ?
microaspiration
when does microaspiration happen ?
during sleep when protective reflexes are reduced
explain the defense mechanisms against penumonai ?
hair and turbine
mucociliary clearance
local antibacteraial facotrs
gag reflex
cough mechanism
resident alvelolar macrophages
what conditions impair resistance ?
chronic diseases
immunologic deficienceies
leukopenia
how can local pulmonary defenses be compromised ?
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
what is the host inflammatory response
increased bllod flow to infected area
fluid leaks into lungs - congestion
white blood cells - pus formation
what are the clinical symptoms ?
cough
fever
difficulty breathing
chest pain
what are the classifications of pneumonia
community acquired pneumonia -CAP
hospital acquired pneumonia -HAP
ventilator associated pneumonia -VAP
give the explanation of CAP
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
explain the pathological evolution of bacterial CAP involveing an entire lobe
edeme (exudate) -> red hepatisation -> gray hepatisation -> resolution
what are the risk factors of CAP
alcoholism
smoking
asthma/COPD
immunosuppresssion
initialization
age > 70
Dementia
HF
cerebrovascular diseases
What is the clinical picture of CAP?
indolent to fulminant
cough dry -> productive -> bloody
fever
myalgia
pleurtitic chest pain
abdominal pain
older
newborn
alcoholic
immunosuppressed
what can we expect to find in physical examination ?
sweating/dehydration
hypotension
tachycardia
dyspnea, tachypnea (25), superficial respiration
cyanosis
compensated respiration
what can we find on auscultation ?
focal crackles over the affected area
pleural friction rub
what can we expect to find on percussion ?
dullness due to consolidation or effusion
how is the tacticle fremitus ?
it is increased
how is pneumonia diagnosed ?
clinical manifestations combined with opacities deteced on imaging
where can we find the site of inflammation in the lungs ?
lobar
multilobar
segmental
bronchopneumonia
explain what the CURB-65 is
it is a scoring system to assess pneumonia severity
