Pulmonary Infections- Path Flashcards
This is the patchy consolidation of the lung with focal consolidated areas of acute suppurative inflammation.
Lobular bronchopneumonia
What is the main cause to lobular bronchopneumonia, bacterial or viral?
bacterial
The bacterial infection to cause bronchopneumonia causes what characteristic of the exudate?
supporative, neutrophil-rich that fills the bronchi, bronchioles, and adjacent alveolar spaces
This is fibrinosuppurative consolidation of a large portion of a lobe or of an entire lobe.
Lobar PNA
What are the 4 stages of the inflammatory response in lobar PNA?
- congestion
- red hepatization
- gray hepatization
- resolution
What happens during the congestion stage in the inflammatory response in lobar PNA?
edema with lots of bacteria
What happens during the red hepatization stage in the inflammatory response in lobar PNA?
lots of neutrophils, BLOOD, liver-like change in lung
What happens during the gray hepatization stage in the inflammatory response in lobar PNA?
progressive disintigration of red cells and fibrinosuppurative exudate
What happens during the resolution stage in the inflammatory response in lobar PNA?
consolidation of exudate, results in fibrous thickening or permanent adhesions
Which cells cause the regeneration of the lung tissue in the resolution stage of lubar PNA?
Type II pneumocytes
the stem cells of the lung
For community-aacquired PNA, what typically causes a bacterial infection?
A previous viral infection
What is the most common cause of community-acquired PNA?
Strep pneumo
What shows on sputum culture for strep pneumo infections?
lancet-shaped diplococci
These are gram-negative, pleomorphic bacteria with pili that causes community-acquired PNA.
H. influenza
H. influenza secretes a factor that disorganizes ciliary beating and a protease that degrades which Ab?
IgA
What is the life-threatening condition in kids that;s a manifestation of H. inflenzae?
meningitis
True or false: H. influenza is a common cause of otitis media.
True
True or false: H. influenza is a common cause of pink eye.
True
What is present on the H. influenza bacterium that secretes haemocin and allows survival in the bloodstream by preventing opsonization and phagocytosis?
Capsule
Which serotype of H. influenza is the most common cuase severe invasive disease?
type b
Moraxella catarrhalis causes bacterial PNA in which pts?
elderly
Moraxella catarrhalis causes which problem in kids?
Otitis media
What is the most common cause of secondary PNA?
S. aureus
What is a common complication of S. aureus infections?
lung abscesses and empyema
People who do what are at risk for S. aureus infections?
drugs
I feel like
I havent told a story in a while, so here’s my story about being vegan.
in postbac i decided to try to be vegan for a month to see what it’s like. so i dumped everything dairy and meaty and went cold-turkey vegan (no pun intended). so it was weird- went to wegmans, got all the fancy food, ate my salads and almond milk, drank my protein shakes, and went hard for 3 weeks. finally after the 3 weeks i was at coffee culture studying and had yellow diarrhea. I decided then to drop this diet and go regular again. it was glorious. didn’t make the month. still donno what causes yellow diarrhea.
CF patients are at risk for PNA from which bug?
P. aeruginosa
This is the bug that can cause PNA in immunocompromised pts and organ transplant recipients and is from inhaling the organisms from artificial water environments.
Legionella pneumophilia
What are the 2 bugs to cause lobar PNA?
Strep pneumo (95%) Klebsiella pneumo
Who is at risk for klebsiella infections?
aspiration risk people (elderly, alcoholics)
What are the 5 bugs to cause bronchopneumonia?
S. aureus H. influenza P. aeruginosa Moraxella catarrhalis Legionella pneumophilia
Atypical PNA is located where in the lung?
interstitum
What are the Sx to interstitial PNA (atypical)?
URT Sx, no sputum, cough, low fever
What is in the air sacs in interstitial PNA?
nothing
What is in the interstitum in interstitial PNA?
WBC
What is the most common cuase of atypical PNA?
Mycoplasma pneumoniae
Who is at risk for M. pneumoniae infections?
children and young adults (college kids)
How can Mycoplasma pneumo cause autoimmune hemolytic anemia?
IgM against I Ag on RBCs –> cold hemolytic anemia
What is the 2nd most common cause of atypical PNA in young adults?
Chlamydia poneymoniae
What is the most common cause of aypical PNA in infants?
RSV
What is the most common cause of atypical PNA in posttransplant pts?
CMV
What is the most common cause of atypical PNA in the elderly, immunocompromised, or those with pre-existing lung disease?
Influenza virus
This is the rikettsial-like organism that causes atypical PNA with a HIGH fever (Q fever).
Coxiella burnetii
Who is at risk for coxiella burnetii infections?
Farmers (it comes from cows)
What are the 3 bugs are the biggest causes of hospital-acquired PNA?
Gram negative rods (enterobacteriacae and Pseudomonas)
S. aureus
What are the 3 bugs that are the biggest contributors to aspiration PNA?
Bacteriodes, fusiform and peptococcus
What is a common complication to aspiration PNA?
Abscesses
What happens in a pulmonary abscess?
there is local suppurative destruction with necrosis, forming a central cavitation
Where in the lung is the most common place for aspiration-induced lung abscesses?
R lower lobe
What are signs of a lung abscess?
cough, fever, foul/blood sputum, clubbing
Septic emboli from lung abscesses may cause what 2 conditions?
- brain abscesses/meningitis
2. secondary amyloidosis
Who typically gets chronic PNA?
immunocompromised (IC) patients
The inflammatory rxn in chronic PNA causes what formation?
Granulomas
What are the 3 fungi to cause granulomatous diseases of the lung?
Histoplasmosis
Blastomycosis
Coccidiooidomycosis
What similiar characterisitic do all the granulomatous disease fungi share?
Thermally dimorphic
Where is histoplasma capsulatum found?
OH/MI river basins
What is the reservoir for histoplasma capsulatum?
soil with bird/bat poop that contians spores
Histoplasma capsulatum is an intracellular parasite of which WBC?
Macropahge
What is shown on CXR for self-limited and latent primary pulmonary involvement of H. capsulatum?
Coin lesions
Chronic, secondary lung disease from H. capsulatum causes what Sx?
cough, fever, night sweats
Who gets disseminated disease from H. capsulatum?
IC pts
Immunocompetent patients get epithelioid cell granulomas, which undergo what change in H. capsulatum infections?
Caseous necrosis –> consolidation –> fibrosis and calcification (tree-bark appearance)
True or False: epitheloid granulomas are formed in fulminant disseminated histoplasmosis in IC pts.
FALSE. instead, focal accumulation of mononucelar phagocytes filled with fungal yeasts appear throughout the body
Where is Blastocyces dermatitidis found?
central and southwestern US
What is the reservoir for B. dermatitidis?
soil
What are the Sx to pulmonary blastomycosis?
abrupt illness with infection-like Sx,
upper lobe involvement, consolidation, multilobar infiltrates, perihilar infiltrates, multiple nodules
What type of things are formed in the lungs from B. dermatitidis?
Suppurative granulomas
How does B. dermatitidis divide?
Broad based budding (BBB) yeast, thick wall, multiple nuclei
Where is coccidioides immitis found?
Southwest US and Mexico
How do u get coccidioides immitis?
Inhale the spores
What are the Sx to coccidioides immitis infections?
most are asymptomatic, some involve lung lesions, fever, cough, and pleuritic chest pains, with erythema nodosum or erythema multiforme
What is the morphology of coccidioides immitis in macrophages or giant cells in the lugns?
thick-walled
nonbudding
filled with small endospores
HIV+ individuals with CD4+ counts >200 cells/mm3 are at risk for what 2 types of infections?
Bacterial and tubercular
HIV+ individuals with CD4+ counts <200 cells/mm3 are at risk for which type of infection?
Pneumocystis PNA
HIV+ individuals with CD4+ counts < 50 cells/mm3 are at risk for what 2 types of infections?
CMV and Mycobacterium avium
