Resp - Path (Pneumonia, Lung abscess, Pleural effusions, & Pneumothroax)

Question 1

What organism most frequently causes lobar pneumonia? What are 2 other typical organisms that also cause it?

Answer 1

S. pneumoniae most frequently, also Legionella, Klebsiella

Question 2

What are characteristics of lobar pneumonia in terms of its appearance and location?

Answer 2

Intra-alveolar exudate –> consolidation; may involve entire lung

Question 3

What are 4 typical organisms that cause bronchopneumonia?

Answer 3

(1) S. pneumoniae (2) S. aureus (3) H. influenzae (4) Klebsiella

Question 4

What are characteristics of bronchopneumonia in terms of its appearance and location?

Answer 4

Acute inflammatory infiltrates from bronchioles into adjacent alveoli; patchy distribution involving >= 1 lobe

Question 5

What are 4 pathogens causing interstitial (atypical) pneumonia?

Answer 5

(1) Viruses (influenza, RSV, adenoviruses) (2) Mycoplasma (3) Legionella (4) Chlamydia

Question 6

What are the 3 types of viruses that typically cause interstitial (atypical) pneumonia?

Answer 6

Viruses (influenza, RSV, adenoviruses)

Question 7

What are characteristics of interstitial (atypical) pneumonia in terms of its appearance and location?

Answer 7

Diffuse patchy inflammation localized to interstitial areas at alveolar walls; distribution involving >= 1 lobe.

Question 8

What kind of course does interstitial (atypical) pneumonia generally follow?

Answer 8

Generally follows a more indolent course.

Question 9

What is another name for interstitial pneumonia?

Answer 9

Interstitial (atypical) pneumonia

Question 10

What kind of opacities can be seen in interstitial pneumonia?

Answer 10

Coarse bilateral reticular opacities

Question 11

What is a lung abscess?

Answer 11

Localized collection of pus within parenchyma.

Question 12

What are 2 causes of lung abscess?

Answer 12

Caused by: (1) bronchial obstruction (e.g., cancer) or (2) aspiration of oropharyngeal contents (especially in patients predisposed to loss of consciousness [e.g., alcoholics or epileptics]

Question 13

Give an example of a condition that can cause lung abscess due to bronchial obstruction.

Answer 13

Bronchial obstruction (e.g., cancer)

Question 14

Give 2 examples of conditions that can cause lung abscess due to aspiration of oropharyngeal contents.

Answer 14

Aspiration of oropharyngeal contents (especially in patients predisposed to loss of consciousness [e.g., alcoholics or epileptics])

Question 15

What is a characteristic finding of CXR on lung abscess?

Answer 15

Air fluid levels often seen on CXR.

Question 16

What are 2 type of bacteria that often cause lung abscess?

Answer 16

Often due to S. aureus or anaerobes (Bacteroides, Fusobacterium, Peptostreptococcus)

Question 17

Give 3 examples of anaerobes that often cause lung abscess.

Answer 17

Anaerobes (Bacteroides, Fusobacterium, Peptostreptococcus)

Question 18

What are pleural effusions, and what effect do they have?

Answer 18

Excess accumulation of fluid between the 2 pleural layers => restricted lung expansion during inspiration

Question 19

What is the protein content like in transudate?

Answer 19

Low protein content

Question 20

What are 3 conditions that cause pleural effusion as transudate?

Answer 20

Due to CHF, Nephrotic syndrome, or Hepatic cirrhosis.

Question 21

What is the protein content like in exudate? How does exudate appear?

Answer 21

High protein content, cloudy

Question 22

What are 4 conditions that cause pleural effusion as exudate? In general, in what context does exudate occur?

Answer 22

Due to malignancy, pneumonia, collagen vascular disease, trauma (occurs in states of increased vascular permeability).

Question 23

What must be done to exudate, and why?

Answer 23

Must be drained in light of risk of infection

Question 24

What are 3 types of pleural effusions?

Answer 24

(1) Transudate (2) Exudate (3) Lymphatic

Question 25

What is another name for lymphatic pleural effusion?

Answer 25

Also known as chylothorax

Question 26

What injury causes lymphatic pleural effusion (or chylothorax)? What are 2 conditions in which this may happen?

Answer 26

Due to thoracic duct injury from (1) trauma, (2) malignancy.

Question 27

How does the fluid of lymphatic pleural effusion appear? What substance is high in content within the fluid?

Answer 27

Milky-appearing fluid; High triglycerides

Question 28

How may pleural effusion appear on x-ray, and why?

Answer 28

Blunting of costophrenic angle due to fluid in pleural space

Question 29

What is Pneumothorax?

Answer 29

Accumulation of air in the pleural space

Question 30

What are 6 signs/symptoms of Pneumothorax?

Answer 30

Unilateral (1) chest pain and (2) dyspnea, (3) Unilateral chest expansion, (4) Decreased tactile fremitus, (5) Hyperresonance, (6) Diminished breath sounds, all on the affected side.

Question 31

In what patient population does Spontaneous pneumothorax usually occur, and why?

Answer 31

Occurs most frequently in tall, thin, young males because of rupture of apical blebs

Question 32

In what setting(s) does Tension pneumothorax usually occur?

Answer 32

Usually occurs in setting of trauma or lung infection

Question 33

Describe the air in Tension pneumothorax.

Answer 33

Air capable of entering pleural space but not exiting

Question 34

Describe the appearance of the Trachea in Tension pneumothorax.

Answer 34

Trachea deviates away form affected lung

Question 35

What would a CT of Pneumothorax show?

Answer 35

CT shows collapsed lung