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Pulmonary Infections Flashcards

1
Q

Inflammatory process of infectious origin affecting the pulmonary parenchyma

A

Pneumonia

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2
Q

Clinical Features of pneumonia

A

Chills and fever
Productive cough
Blood-tinged or rusty sputum
Pleuritic pain
Hypoxia with shortness of breath
Cyanosis (sometimes)
Neutrophilic leukocytosis (if bacterial cause)

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3
Q

What are the types of pneumonia?

A

Lobar pneumonia
Bronchopneumonia
Interstitial pneumonia
Viral pneumonia
Rickettsial pneumonia
Ornithosis pneumonia

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4
Q

Cause of Lobar pneumonia

A

Streptococcus pneumonia

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5
Q

Macro/Microscopic picture of Lobar pneumonia

A
  • Intra-alveolar exudate (involving an entire lobe of lung) → Consolidation Stages:
  • Congestion
  • Red Hepatisation
  • Gray Hepatisation
  • Yellow Hepatisation
  • Resolution
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6
Q

Causes of Bronchopneumonia

A

Staphylococcus aureus, Haemophilus influenzae, Klebsiella pneumoniae, Streptococcus pyogenes

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7
Q

Macro/microscopic features of bronchopneumonia

A

Extension of acute inflammatory exudate from the
bronchioles into the adjacent alveoli Patchy distribution, involving one or more lobes

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8
Q

Causes of interstitial pneumonia

A

Viruses, mycoplasma pneumoniae

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9
Q

Macro\Microscopi features of of interstitial pneumonia

A

Involvement of more than one lobes
Diffuse, patchy inflammation localised to interstitial areas of the alveolar walls

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10
Q

Most common form of interstitial pneumonia

A

mycoplasma pneumonia

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11
Q

Clinical features of mycoplasma pneumonia

A

Insidious onset
Mild, self-limited course

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12
Q

Lab test of mycoplasma pneumonia

A

ass w nonspecific cold agglutinins reactive to erythrocytes

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13
Q

Macro-/Microscopic findings of mycoplasma pneumonia

A
  • Inflammatory reaction limited to the interstitium
  • NO exudate in the alveolar spaces
  • Intra-alveolar hyaline membranes
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14
Q

What is the most common type of pneumonia in childhood?

A

Viral pneumonias

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15
Q

Causes of viral pneumonias

A

Influenza viruses, Adenoviruses, Rhinovirus, Expiratory Syncytial Virus, Varicella Zoster Virus (Chickenpox & Shingles) or Rubeola (Measles)

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16
Q

How is ornithosis transmitted

A

Chlamydia species
Transmission by inhalation of dried excreta of infected birds.

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17
Q

What is the most common rickettsial pneumonia?

A

Q-fever

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18
Q

What causes Q-fever?

A

Coxiella burnetii

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19
Q

How is Q-fever transmitted?

A

Inhalation of dust particles containing the organism.
Contamination through infected cattle or sheep.

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20
Q

Localised area of suppuration within the parenchyma

A

Lung abscess

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21
Q

Causes of lung abscess

A

Staphylococcus
Pseudomonas
Klebsiella
Proteus, combined with anaerobes

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22
Q

Pathogenesis of lung abscess

A
  • Bronchial obstruction
  • Aspiration of gastric contents (due to loss of consciousness; from alcohol or drug overdose, neurologic disorders, general anaesthesia)
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23
Q

Complications of lung abscess

A

Bacterial pneumonia

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24
Q

Clinical Features of lung abscess

A

Fever Foul smelling purulent sputum Fluid-filled cavity (X-ray)

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25
Causative agent of nocardiosis
Nocardia
26
What type of infection is nocardiosis?
Opportunistic infection
27
Where can nocardiosis disseminate to?
Brain and meninges
28
Describe nocardia?
Gram-positive, aerobic, filamentous, weakly acid-fast bacteria
29
Causative agent of aspergillosis
Aspergillus fumigatus
30
How is aspergillus fumigatus transmitted?
Airborne conidia
31
What is the major portal of entry of aspergillosis?
Lung
32
Pathogenesis of aspergillosis
Aspergillus spores (2-3 μm) reach alveoli → Engulfment & killing of Aspergillus conidia by alveolar macrophages → Secretion of cytokines & chemokines (by macrophages), thus stimulating adaptive immune responses T lymphocytes confer protective immunity
33
Causative agent of candidiasis
Candida albicans
34
What is the most frequent cause of human fungal infections?
Candida albicans
35
How can fungal infections manifest
Superficial lesions in healthy persons Disseminated infections in immuno-compromised patients (severe disseminated candidiasis associated with neutropenia, secondary to leukaemia or anticancer therapy, immunosuppression after transplantation, etc.) Pulmonary, renal and hepatic abscesses and vegetative endocarditis Invasive form (Invasive Candidiasis) → Blood-borne dissemination (Candida can be directly introduced into the blood by i.v. lines, catheters, i.v. drug abuse, etc.)
36
Causative agent of Actinomycosis
Actinomyces israelii
37
Macro/Microscopic features of Actinomycosis
Formation of abscess & sinus tract Exudate, with sulphur granules (yellow clusters of the organism)
38
Describe actinomyces israelii
Gram-positive, anaerobic, filamentous bacteria
39
Causative agent of coccidioidomycosis
Coccidioides immitis
40
10% of people have symptoms like coccidioidomycosis
Lung lesions, fever, cough and pleuritic pain, erythema nodosum or erythema multiforme
41
Morphology of coccidioidomycosis
Primary & secondary lesions similar to granulomatous lesions of Histoplasma Presence of thick-walled non-budding spherules, often filled with small endospores Pyogenic reaction, when rupture of spherules & release of endospores
42
Causative agents of cryptococcosis
Cryptococcus neoformans
43
Primary manifestation of cryptococcosis
Lungs
44
If a patient of cryptococcus with AIDS what do u see in them
Fungal meningitis and encephalitis
45
Visualisation of the capsule in cerebral spinal fluid
INDIA INK
46
Staining of polysaccharide cell wall in tissue
Mucicarmine stain
47
What causes Histoplasmosis?
Histoplasma capsulatum
48
How is Histoplasmosis transmitted?
Inhalation of dust particles from soil contaminated with bird or bat droppings containing microconidia (small spores)
49
What are the clinical forms of Histoplasmosis?
Self-limited, often latent primary pulmonary involvement (coin lesions on chest radiography). Chronic progressive secondary lung disease: Localised to lung apices. Symptoms: Cough, fever, night sweats. Localised extra-pulmonary lesions: Mediastinum, adrenals, liver, meninges. Widely disseminated disease: Occurs in immunocompromised patients.
50
What is the typical morphology in healthy adults with Histoplasmosis?
Formation of epithelioid cell granulomas. Caseation necrosis. Coalescence into large consolidation areas or liquefaction forming cavities (in COPD patients). Fibrosis and concentric calcification ("tree-bark appearance").
51
What is observed in fulminant disseminated Histoplasmosis?
Focal accumulations of mononuclear phagocytes filled with fungal yeasts (in immunosuppressed individuals).
52
What is the causative agent of Tuberculosis?
Mycobacterium tuberculosis
53
How is Tuberculosis transmitted in its pulmonary and non-pulmonary forms?
Pulmonary form: Inhalation of droplets containing the organism. Non-pulmonary form: Ingestion of infected milk.
54
Summarize the pathogenesis of Tuberculosis.
Ingestion of M. tuberculosis by macrophages. Presentation of antigens to CD4+ T-helper cells. CD4+ T-cells proliferate & secrete cytokines. Attraction of lymphocytes & macrophages. Formation of epithelioid cells & Langhans multinucleated giant cells.
55
What is a Ghon complex?
A combination of: Peripheral sub-pleural parenchymal lesion. Hilar lymph node involvement.
56
What are the clinical features of primary Tbc?
Typically asymptomatic. No clinically evident disease.
57
What is the histopathology of the Tbc tubercle?
Central caseous necrosis. Langhans giant cells.
58
What causes secondary Tuberculosis?
Reactivation of a prior Ghon complex, with spread to new pulmonary or extra-pulmonary sites.
59
What are the clinical features of secondary Tbc?
Progressive disability. Fever. Haemoptysis. Bloody pleural effusion. Generalised wasting.
60
What macroscopic findings are seen in secondary Tbc?
Localised lesions in apical or posterior segments of the upper lobes. Involvement of hilar lymph nodes.
61
What are the key microscopic findings in secondary Tbc?
Liquefaction and cavitary lesion formation (unique to secondary Tbc). Caseation (seen in both primary and secondary Tbc). Scarring and calcification.
62
What is Miliary Tbc?
Secondary Tbc complicated by lymphatic and haematogenous spread, leading to small, seed-like lesions in distal organs.
63
Name common forms of extra-pulmonary Tbc.
Tuberculous meningitis. Pott disease of the spine. Para-vertebral or psoas abscess.

Pathology (26 decks)

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