Pulmonary Patho - Pneumonia and Cystic Fibrosis

Question 1

1. what is pneumonia?

Answer 1

infection that causes inflammation of the tiny air sacs in the lower respiratory tract

Question 2

how can pneumonia be categorized?

Answer 2

CAP, HAP, VAP

Question 3

what is the most common route for lower respiratory tract infection?

Answer 3

• oropharyngeal secretion

Question 4

what is another common route of infection for pneumonia?

Answer 4

• inhalation of microorganisms

Question 5

how does VAP infection occur?

Answer 5

• occurs when biofilms form in ventilation tubes and patients inhale the microorganisms

Question 6

what is a less common way pneumonia is spread?

Answer 6

• bacteremia
• IV drug abuse

Question 7

what is the most important guardian cell of the lower respiratory tract? how does it recognize pathogens?

Answer 7

• alveolar macrophage
• recognizes pathogens through PRRd

Question 8

what is the most common cause of CAP? how do they most commonly infect the lungs? what do these bacteria have that affect phagocytosis? what do they release?

Answer 8

• pneumococcal pneumonia
• through oropharyngeal secretions
• they have capsules
• they release pneumolysins which kill alveolar macrophages

Question 9

how does CAP cause alveolar edema?

Answer 9

by filling the alveoli with pus or fluid

Question 10

what is the most common form of viral CAP? what does it do to epithelial cells?

Answer 10

• influenza
• damage epithelial cells

Question 11

how do viruses affect the respiratory system? what happens to the bronchial walls as a result?

Answer 11

• damage epithelial cells and evade goblet cells
• bronchial wall becomes edematous and infiltrated with neutrophils

Question 12

13. what are most cases of pneumonia preceded by? what do individuals then develop? what can the physical examination show signs of? what else may individuals demonstrate symptoms and signs of?

Answer 12

• upper resp tract infection
• cough, malaise, chills, dyspnea, hemoptysis
• pulmonary consolidation
• underlying systemic disease

Question 13

what is cystic fibrosis (CF)?

Answer 13

• recessive inherited disease that causes malfunction of epithelial ion transport channels

Question 14

what is the CF gene named and where is it located? how many variants are there? how many classes is it divided into? what does mortality correlate with?

Answer 14

• CFTCR
• chromosome 7
• 2000
• five
• mortality correlate with severity of the classes

Question 15

what organs does CF affect?

Answer 15

• lungs
• reproductive
• GI

Question 16

what are the typical features of CF lung disease?

Answer 16

-mucous plugging, chronic inflammation and chronic infection

Question 17

what does the mucous plugging result from?

Answer 17

• larger goblet cells
• altered physiology of the mucus itself
• impaired ability to clear the mucus

Question 18

what causes the mucous to adhere to the airway epithelium in CF?

Answer 18

depleted fluid and impaired ciliary activity

Question 19

in CF lung disease what damages lung structural proteins?

Answer 19

neutrophils releasing oxidants and proteases

Question 20

how does the excess neutrophils in CF lung disease affect immunity? what does this contribute to?

Answer 20

• excess neutrophils release mediators that destroy IgG results in chronic infection

Question 21

what does the CF airway environment favor? what does this cause? what does the biofilm resist?

Answer 21

-favors bacterial colonization
- chronic endobronchial infection

Question 22

what are the diagnostic criteria for CF? what are the two standard methods of testing for CF?

Answer 22

• one or more clinical signs
• sibling with CF
• positive screening on newborn

methods: sweat test immunoreactive tripsinogen blood test