Pneumonia and Respiratory Tract Infections

Question 1

What are the 3 ways pneumonia can be acquired?

Answer 1

Community
Hospital
Ventilator

Question 2

Define bronchitis

Answer 2

Inflammation and swelling of the bronchi

Question 3

Define bronchiolitis

Answer 3

Inflammation and swelling of the bronchioles

Question 4

Define pneumonia

Answer 4

Inflammation and swelling of the alveoli

Question 5

In pneumonia how is gas exchange impaired?

Answer 5

Via infiltration of cells or fluid leakage

Question 6

Why is pneumonia more concerning than bronchitis or bronchiolitis?

Answer 6

It impairs gas exchange (so o2 uptake and co2 removal are impaired)

Question 7

What is the first immune cell thats recruited in pneumonia?

Answer 7

Neutrophils

Question 8

What do neutrophils release when they are recruited to the lungs in pneumonia?

Answer 8

Chemokines like IL-8

Question 9

What does neutrophils releasing chemokines do?

Answer 9

Causes recruitment of other inflammatory cells

Question 10

What is the name of the specialised resident immune cell that alveoli have?

Answer 10

Alveolar macrophage

Question 11

What are alveolar macrophages?

Answer 11

Specialised immune cells that reside in the alveoli

Question 12

How is prolonged pneumonia different to acute pneumonia?

Answer 12

There is a switch from innate to adaptive immune system

Accumulation is now of lymphocytes (mainly t cells) at site of inflammation

Question 13

What is the main infectious bacteria that causes pneumonia?

Answer 13

Streptococcus pneumoniae

Question 14

Describe steptococcus pneumoniae

Answer 14

It is gram positive
It is extracellular
It is opportunistic

Question 15

What antibiotics is strep pneumoniae susceptible to?

Answer 15

Beta lactams

Question 16

How do beta lactams work?

Answer 16

They bind proteins in the bacterial cell wall and prevent transpeptidation so the bacteria cannot replicate

Question 17

What is chlamydia pneumoniae resistant to?

Answer 17

Penicliin

Question 18

How is chlamydia pneumoniae treated?

Answer 18

By using a macrolide that inhibits the 50s ribosomal subunit stopping protein synthesis

Question 19

What is walking pneumonia?

Answer 19

Atypical bacteria causing a milder pneumonia that is more prolonged in terms of symptoms due to slower replication rates

Question 20

What are some risk factors for pneumonia development?

Answer 20

Under 2 yrs or over 65 yrs
Smoking
Alcoholism
Poverty
Inhaled corticosteroids
Immunosuppressants
Proton pump inhibitors
Medical conditions eg asthma, COPD, heart disease, liver disease, diabetes, HIV, malignancy

Question 21

What scoring system is used to assess the severity of pneumonia and decide course of treatment?

Answer 21

CRB severity score

Question 22

What supportive treatment is used for pneumonia if other things aren’t working?

Answer 22

Mechanical ventilation

Question 23

When are steroids given in viral pneumonia?

Answer 23

When progression is severe, if they are given before when disease is mild immune clearance of the virus will be suppressed

Question 24

When are anti virals effective in viral pneumonia? Why?

Answer 24

Early as early damage is virus mediated, late damage is immune mediated