Respiratory Disorders 2 Flashcards
Pneumonia
What are 3 characteristic features of pneumonia?
- Results from an infection (mostly bacterial)
- Elicits an innate and adaptive immune response
- Lung consolidation occurs (alveoli are filled with fluid)
What are the 3 types of pneumonia? What pattern of spread does each have?
- LOBAR - diffuse + confluent
- BRONCHO - patchy
- ATOPIC
What 3 factors determine whether a person will develop lobar or broncho pneumonia?
- Organism (that infects the person to cause the pneumonia)
- Immune response
- Treatment
What size is Nasal clearance? Tracheobronchial? Alveolar?
N: >10um
T: 5-10um
A: 1-5um
<1um and it will be exhaled cos it is too small to get stuck anywhere
We get pneumonia when our immune defence is either COMPROMISED (4 reasons) or INADEQUATE (2 reasons)? What are the reasons?
Compromised:
- Decreased cough reflex (CNS depression - slumped - alcohol), mucociliary apparatus (smoking), phagocytic activity (genetic)
- Increased congestion/oedema/secretions
Inadequate:
- Have a virus
- Have a nosocomial infection (from hospital)
What are the 5 most common organisms to cause pneumonia? What % of lobar pneumonia is caused by streptococci?
- Streptococci
- Haemophillus influenzae
- Staphylococci
- Pseudomonas aeruginosa
- Coliforms
* ** All of these can cause either broncho or lobar pneumonia
95% of lobar pneumonia
What are the 4 stages of pneumonia disease progression?
- Congestion
- Red hepatisation
- Grey hepatisation
- Resolution
What are 3 features of the CONGESTION stage of pneumonia?
- Bacterial multiplication
- Engorgement of vessels
- Neutrophils start to come in
What are 4 features of the RED HEPATISATION stage of pneumonia?
- Exudate ++++
- RBC extravasation
- Neutrophils +++
- Fibrin
What are 5 features of the GREY HEPATISATION stage of pneumonia?
- Exudate +++
- RBC decreasing
- Neutrophils +
- Fibrin
- Macrophages
*** Bacteria has been cleared now and the lung is regenerating itself
What are 5 features of the RESOLUTION stage of pneumonia?
- Digestion of exudate
- RBC decreasing
- Resorption & expectoration of liquid exudate
- Digestion of fibrin
- Macrophages +++ to remove debris
Is there a difference in the 4 stages of progression between broncho and lobar pneumonia?
Not really - same 4 stages. Lobar can have more blanket hepatisation whereas broncho can be more focal (can distinguish different structures still)
What 3 factors dictate the outcome of the pneumonia?
- Virulence
- Dose (how much of the organism there is)
- Immune status
- Decreased IS = more spread = lobar
- Better IS = not so much spread = broncho
*** However the immunopathology of streptococci means that healthy people will develop lobar
What are 4 complications that can arise as a result of pneumonia?
- Abscess formation - cavitation
- Empyema - pus in the pleural cavity, lethal
- Fibrosis
- Haematogenous dissemination e.g. to pericardium, heart valves, brain, spleen, joints, kidney or to the remainder of healthy lung
What are the 2 types of ATYPICAL PNEUMONIA? What makes atypical pneumonia different from lobar and broncho? 3 features?
- Viral (influenza A + B, varicella)
- Mycoplasma (chlamydia)
It is an INTERSTITIAL disease, not an interalveolar one
+/- oedema, lots of lymphyctes (and their infiltration results in a thick AF interstitiam) and hardly any neutrophils, predisposition for a secondary bacterial infection to occur
