Pulmonary Infections Flashcards
A patient presents with fever and chills, and a productive cough with yellow-green sputum. He also has tachypnea and pleuritic chest pain. Breath sounds are decreased, chest is dull to percussion. His blood work shows elevated WBCs. What does he have? When does this disease occur? How is it diagnosed? What are the three types of this disease?
Pneumonia which is infection of the lung parenchyma. Occurs when normal body defenses are impaired due to impaired cough reflex, damage to mucociliary escalator or mucus plugging. Diagnosis is made by chest X-Ray, sputum gram stain and culture and blood cultures. Lobar pneumona, Bronchpneumonia and Interstitial pneumonia
A patient presents with fever and chills, and a productive cough with yellow-green sputum. He also has tachypnea and pleuritic chest pain. Breath sounds are decreased, chest is dull to percussion. His blood work shows elevated WBCs. What does he have? When does this disease occur? How is it diagnosed? What are the three types of this disease?
Pneumonia which is infection of the lung parenchyma. Occurs when normal body defenses are impaired due to impaired cough reflex, damage to mucociliary escalator or mucus plugging. Diagnosis is made by chest X-Ray, sputum gram stain and culture and blood cultures.
What are the four phases of lobar pneumonia?
- Congestion 2. Red hepatization 3. Gray hepatization 4. Resolution
What causes red hepatization in lobar pneumonia?
Due to exudate, neutrophils and hemorrhage filling the alveolar air spaces, giving the normally spongy lung a solid consistency
What causes gray hepatization in lobar pneumonia?
Due to degradation of red cells within the exudate
What microrganisms is lobar pneumonia usually caused by ?
Streptococcus Pneumonia (95%) and Klebsiella pneumoniae.
What is bronchopneumonia and what 5 organisms cause it?
Characterized by scattered patchy consolidation centered around bronchioles. Ofter multifoca and bilateral. Caused by Staphylococcus aureus, Hameophilus influenzae, Pseudomonas aeruginosa, Moraxella catarrhalis, Legionella pneumophila
How does interstitial (atypical) pneumonia present? What 6 organisms causes it?
Presents with relatively mild upper respiratory symptoms (minimal sputum and low fever). Caused by Mycoplasma pneumoniae, Chlamydia pneumoniae, RSV, CMV, Influenza virus and Coxiella burnetii
Which patients usually show aspiration pneumonia? Which part of the lung is affected and why? What organism cause it?
Alcoholics and comatose patients. Classically results in a right lower lobe abscess because the right main stem bronchus branches at a less acute angle than the left. Most often due to anaerobic bacteria in the oropharynx (e.g Bacteroides, Fusobacterium, and Peptococcus.
What causes Tuberculosis?
Due to inhalation of aerosolized Mycobacterium tuberculosis.
How does primary TB arise? What does it cause? Which part of the lung does primary TB occupy? What structure does it form? Symptoms?
Primary TB arises with initial exposure. Results in focal, caesating necrosis in the lower lobe of the lung and hilar lymph nodes that undergoes fibrosis and calcification, forming a Ghon complex.Generally asymptomatic but leads to a positive PPD.
What causes Tuberculosis?
Due to inhalation of aerosolized Mycobacterium tuberculosis.
How does primary TB arise? What does it cause? Which part of the lung does primary TB occupy? What structure does it form? Symptoms?
Primary TB arises with initial exposure. Results in focal, caesating necrosis in the lower lobe of the lung and hilar lymph nodes that undergoes fibrosis and calcification, forming a Ghon complex.Generally asymptomatic but leads to a positive PPD.
What causes secondary TB? Which patients are vulnerable? Which part of the lung does secondary TB occupy? What structure does it form?
Reactivation of Mycobacterium tuberculosis sually in AIDS patients and aging patients. Occurs at the apex oflung relatively poor lymphatic drainage and high oxygen tension). Forms cavitary foci of caseous necrosis, may also lead to miliary pulmonary TB of tuberculous bronchopneumonia.
A 69 year old patient presents with fevers and night sweats. He is also coughing with hemoptysis and has experienced significant weight loss. Biopsy reveals caseating granulomas. What would you see on AFB staining? What is causing this presentation? What are the common sites this disease can spread to?
In Secondary Tuberculosis, AFB stain reveals acid-fast bacilli. Common sites include meninges (meningitis), cervical lymph nodes, kidney (sterile pyuria) and lumbar vertebrae (Pott disease).
