Pulmonary Sepsis Flashcards
1
Q
components of the upper respiratory tract
A
- nose
- sinus
- larynx
- trachea
2
Q
components of the lower respiratory tract
A
- bronchi
- terminal bronchi
- lung parenchyma
3
Q
characteristics of lower pulmonary sepsis
A
- serious
- mortality/morbidity risk
- secondary to irritants
4
Q
name the defense mechanisms of the respiratory tract
A
- nasal hair
- saliva
- filtering function of nasopharynx
- cough reflex
- mucociliary apparatus
- secretion of IgA
- phagocytic activity by alveolar macrophages
- alveolar fluid
- cell mediated immunity
5
Q
causes of primary infection
A
- viral
- bacterial
- atypical bacteria
- fungi
6
Q
causes of secondary infection
A
- irritants
- bacterial following a viral infection
- long-standing cold
7
Q
commonest viral organisms to cause upper respiratory tract sepsis
A
- rhinovirus
- adenovirus
- influenza
- RSV
8
Q
characteristics of rhinovirus
A
- no cross immunity between different serotypes
9
Q
infections caused by adenovirus
A
- pharyngitis (sore throat)
- conjunctivitis
10
Q
infections caused by influenza virus
A
- upper resp tract
- fever
- lassitude
- depression
- primary influenzal pneumonia
11
Q
what infection does croup cause?
A
- laryngotracheobronchitis
- bronchiolitis in children
12
Q
what kind of virus causes croup?
A
RSV
13
Q
characteristics of URT bacterial sepsis
A
- uncommon in developed countries
- secondary to viral infections
- 2 main bacteria: strep pyogenes, haemophilus influenzae
14
Q
characteristics of bacterial acute laryngitis
A
- HIB or strep pyogenes
- swellling
- inability to breath (mechanically)
15
Q
what kind of infection is trigged from irritative occupational hazards
A
- acute laryngitis and tracheitis
- irritation by smoke, corrosives, noxious gases
- oedema with obstruction
16
Q
what is pneumonia?
A
infection of the alveolar spaces, causing alveolar exudates, polymorph infiltration, fibrin, oedema fluid resulting in consolidation
17
Q
morphological classification of pneumonia
A
- bronchopneumonia
- lobar pneumonia
18
Q
infective causes of bronchopneumonia
A
- strep pneumoniae
- haemophilus influenzae
- moraxella catarrhalis
- staph pneumonia
- klebsiella
- pseudomonas aeruginosa
- coliform bacteria
- chlamydia
- legionella pneumophilia
- tuberculosis
- mycobacterium avium-intercellulare
19
Q
how does bronchopneumonia develop?
A
- inflammation centred onto the bronchi
- spreads out to cause inflammation in the alveoli
20
Q
histological characteristics of bronchopneumonia
A
- polymorphs and fibrin infiltration
- spread to adjacent alveoli
- patchy foci coalsce
- frequently widespread and bilateral
- rarely heals with fibrosis
21
Q
how does lobar pneumonia develop?
A
- starts in the alveoli
- spreads to the bronchioles luminally as the exudate flows out
22
Q
histological characteristics of lobar pneumonia
A
- polymorphs, fibrin, oedema fluid in alveoli
- all or most of the lobe is affected here
- consolidation present
23
Q
aetiology of pneumonia
A
- bacterial
- fungal
- viral
- aspiration
- radiation (like radiotherapy)
- allergic mechanisms
24
Q
which bacteria are associated with smokers and COPD?
A
- strep pneumoniae
- haemophilus influenzae
- moraxella catarrhalis
25
which organisms are associated with HAP?
- klebsiella
- pseudomonas aeruginosa
- coliform bacteria
26
which organisms are associated with immunosuppression?
- mycobacterium avium-intercellulare
- pneumocystis jirovecii
- aspergillus fumigatus
27
which bacteria causing pneumonia are gram positive?
- strep pneumoniae (diplococci)
| - staph aureus (cocci)
28
which bacteria causing pneumonia are gram negative?
- haemophilus influenzae (coccobacillus)
- moraxella catarrhalis (diplococci)
- klebsiella (rods)
- pseudomonas aeruginosa (rods)
- legionella
29
infective causes of CAP
- strep pneumoniae
- haemophilus influenzae
- moraxella catarrhalis
- staph aureus
- legionella
- klebsiella
- pseudomonas
- mycoplasma
- chlamydia
- coxiella
- viruses
30
cause of aspiration pneumonia
anaerobes
31
pathogenesis of pneumonia
- suppression of the cough reflex
- impaired ciliary function
- impaired phagocytic activity
- pulmonary oedema and congestion
- secretions
- low host resistance
- virulent infections
32
how can the cough reflex be suppressed?
- coma
- anaesthesia
- drugs
- aspiration
33
how can the ciliary function be impaired?
- cigarette smoke
- hot gases
- corrosives
- viruses
34
how can phagocytic activity be impaired?
- alcohol
- tobacco
- smoke
- excess oxygen
35
how can host resistance be depleted?
- chronic disease
- immune deficiency
- immunosuppression
- leucopenia
- chemotherapy
36
which populations are more vulnerable to pneumococcal infections?
- chronic disease
- immunodeficiency syndromes
- poor splenic function
37
clinical/investigative characteristics of CAP
- either morphological pattern
- sputum: gram-positive diplococci, neutrophils
- some are penicillin-sensitive
38
stages of an acute pneumonia
- congestion
- red heparisation
- gray heparisation
- resolution
39
characteristics of red heparisation
- lung becomes like a liver
| - alveoli packed with polymorphs, red cells, fibrin
40
characteristics of gray heparisation
- dry, gray firm lung
- lysis of red cells
- fibrinouus exudate persists
41
characteristics of resolution
- digestion of exudates
- resolution of pleura
- formation of adhesions
42
what stages do pneumonia patients go through nowadays?
if the correct treatment is given, they go directly into the resolution phase
43
complications of pneumonia
- pleurisy/pleural adhesions (due to fibrin formation in the lung)
- lung abscess
- alveolar fibrosis
- empyema
- bacteraemia
44
what is septicaemia?
when bacteria and their toxins circulate in the blood
45
causes of lung abscesses
- aspiration of infected material, gastric contents
- necrotising or suppurative pneumonia
- bronchiectasis
- bronchial obstruction
- septic emboli
- haematogenous spread
46
contents of lung abscesses
- anaerobic bacteria from mouth commensals
| - staph aureus and B-haemolytic streptococci, nocardia and gram negative organisms
47
how do you treat lung abscesses?
drainage and antibiotics
48
pathological characteristics of viral pneumonia
- interstitial pneumonia
- interstitial infiltrate
- no alveolar exudate
49
causes of viral pneumonia
- influenza virus type A+B
- RSV
- adenovirus
- rhinovirus
- coronavirus (yep)
50
what is bronchiectasis?
- abnormal permanent dilatation
- happens in the lower limbs, distal bronchi and bronchioles
- associated chronic infection
51
causes of bronchiectasis
- localised obstruction (tumours, foreign bodies, mucus, chronic bronchitis)
- congenital (CF, immunodeficiency, immotile cilia)
- necrositing or suppurative pneumonia (virulent organisms - staph aureus, klebsiella, tuberculosis)
- symptoms precipitated by URTI or new pathogens
52
pathogenesis of bronchiectasis
- obstruction - air resorbed from distal airways
- atelectasis - loss of elastic tissue in interstitium - fibrosis attaches lung to pleura
- dilatation of proximal airways due to pressure of inspired air
- becomes irreversible if:
- - obstruction persists especially during growth
- - persistent infection - bronchial wall ulceration, inflammation and further dilatation
53
complications of bronchiectasis
- lung abscess
- cor pulmonale
- metastatic brain abscesses
54
what is cor pulmonale?
abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels
