Pulmonary Infections

Question 1

Pulmonary infections are usually ___ or ___, however fungal and mycoplasmal infections also occur

Answer 1

bacteria or viral

Question 2

Pulmonary infections generally occur when host defense mechanisms are ____ due to __

Answer 2

impaired; impaired cough reflex, injury to muccociliary apparatus, immunodeficiency, congestion and edema, or accumulation of secretions

Question 3

Bacterial pneumonia occurs when bacteria enter ____ and ___ and proliferate.

Answer 3

bronchioles and alveoli

Question 4

Bacterial pneumonia results in ______ in alveoli or in bronchioles and surrounding soft tissue. May follow respiratory infection due to mucous accumulation, and ciliary dysfunction

Answer 4

purulent exudate collecting

Question 5

bacterial pneumonia is considered immune____-

Answer 5

immunosuppression

Question 6

Lobar bacterial Pneumonia :

Answer 6

purulent fluid fillips alveoli, results in consolidation (“solidification”) of a large portion or all of a lobe
- usually unilateral

Question 7

Bronchopneumonia

Answer 7

infection within the walls of the bronchioles, may be association with infection into alveoli
- patchy consolidation (multiple small areas of acute suppurative inflammation), unilateral or bilateral

Question 8

Acute bacterial Pneumonia: complications of lobar and bronchopneumonia include ______

Answer 8

abscess formation , empyema (spread to pleural cavity) Organization of the exude (becomes solid) and bacteremia / sepsis

Question 9

Symptoms of acute bacterial pneumonia

Answer 9

typically develop quickly

• high fever and chills
• productive cough with sputum
• pleuritic chest pain
• shortness of breath
• altered mental status
• loss of appetite
• easy fatigue

Question 10

Viral pneumonia proliferation within respiratory epithelial cells results in _____-

Answer 10

inflammation of tissues, transudate/exudate formation

- generally no evidence of consolidation

Question 11

Viral pneumonia is typically uni or bi lateral?

Answer 11

bilateral

Question 12

Viral pneumonia can be caused by many organisms: ________

• consider immunosuppression
• symptoms are similar to bacterial pneumonia

Answer 12

• influenza A and B
• respiratory syncytial viruses
• adenovirus
• parainfluenza

Question 13

Abscess is a _____ infection within a tissue, generally filled with _____

Answer 13

focal, purulent fluid

Question 14

Four stages of Abscess formation

1. Infection

Answer 14

1. Infection
   - microbes enter tissue and become established
   - sourced include direct implantation, hematogenous spread, lymphatic spread

Question 15

Four stages of Abscess formation:

2. Localization/ acute inflammation

Answer 15

• microbial growth initiates inflammation, attracts neutrophils into area (pus is primarily neutrophils and necrotic debris), focuses area of infection
• tissue remodeling results in formation of a collagen -rich capsule around the area of inflammation

Question 16

Four stages of Abscess formation:

3. enlargement

Answer 16

As more neutrophils accumulate (macrophages enter after a few days) the abscess enlarges
- tissue remodeling and capsule formation continues

Question 17

Four stages of Abscess formation:

4. Rupture

Answer 17

The purpose of abscess formation is to eventually cause the purulent fluid tone extruded from the body by rupturing out of the tissue (onto skin, into bronchi, into cerebral ventricles)

Question 18

Microbes contained In the abscess may be released into blood (resulting in ____) or interstitial fluid and lymph (resulting in ____) to cause infection at another site.

Answer 18

sepsis; cellulitis;

Question 19

Causes of pulmonary abscesses include:

Answer 19

• aspiration: most common
• primary bacterial infection (pneumonia)
• septic embolism
• neoplasia

Question 20

Signs and symptoms of Pulmonary Abscess

Answer 20

• shortness of breath
• hemoptysis (coughing blood)
• pleuritic chest pain
• cough with sputum production, nigh sweats, anorexia, and weigh loss

Question 21

Empyema:

Answer 21

an infection within the pleural space and fluid resulting in accumulation of purulent pleural fluid; often caused by an extension of a pulmonary infection

Question 22

Stages of Empyema

Answer 22

1. Exudative stage
2. Fibrinopurulent stage
3. Organizational stage

Question 23

Empyema: exudative stage

Answer 23

pleural fluid accumulation int he pleural space secondary to inflammation (transudate)
(protein poor)

Question 24

Empyema: fibrinopurulent stage

Answer 24

bacterial invasion and growth with deposition of fibrin on visceral and parietal pleural membranes, formation of fibrinous locations (walled-off sections), adhesions
(protein rich)

Question 25

Empyema: Organizational Stage

Answer 25

if the infection progresses, the empyema fluid solidifies into a thick non-elastic pleural “peel” that inhibit lung expansion, causing known as trapped lung

Question 26

signs and symptoms of Empyema

Answer 26

• shortness of breath (secondary to large pleural effusion or pneumonia)
• fever
• pleuritic chest pain
• other associated symptoms of pneumonia