Respiratory Infections and Tumours Flashcards
Term inflammation of the different parts of the trachea and its divisions i.e trachea, bronchi, bronchioles and alveoli
Trachea - Tracheitis
Bronchi - Bronchitis
Bronchioles - Bronchiolitis
Alveoli - Pneumonia
What is pneumonia?
Inflammation and consolidation of lung tissue due to an infectious agent
Describe the histology of an alveolus in pneumonia
Contains large amount of infectious material and cells so very little gaseous exchange occurs
What are the 2 most common bacterial pathogens involved in pneumonia?
- S. pneumoniae
2. M. pneumoniae
Name 4 possible bacterial pathogens involved in pneumonia apart from S. pneumoniae and M. pneumoniae
- H. influenzae
- Leginella
- C. psittaci
- S. aureus
Name 2 types of bacterial pathogen most associated with aspiration pneumonia
- Gram negative bacilli
2. Anaerobes
Why is legionella of particular interest with regards to pneumonia?
It causes Legionnaires disease with the source usually being warm water
Name 4 common viral pathogens which may cause pneumonia
- Influenza A
- Influenza B
- Adenovirus
- Coronavirus
What is the % spilt of pneumonias caused by bacterial, viral and fungal pathogens?
Bacterial - Around 90%
Viral - Around 10%
Fungal - Very uncommon
Name 4 fungal pathogens which can cause pneumonia
- Pneumocystis jiroveci
- Nocardia species
- Cryptococcus
- Mucormycosis
Describe the basic microscopic appearance of sputum taken from a patient with pneumococcal pneumonia
Gram positive bacteria seen occuring in pairs of short chains usually with the presence of inflammatory cells
Why are there often radiolucent areas on radiographs of patients suffering from pneumonia?
Necrosis in the area of pneumonia will lead to air fluid imbalances
What is a typical radiographic appearance of staphylococcal pneumonia?
Air filled cysts termed pneumatoceles
Describe 6 main symptoms of pneumonia
- Fever
- Chills
- Pleuritic chest pain
- Cough
- Purulent sputum
- Dyspnoea
Describe 6 relatively non specific symptoms of pneumonia
- Confusion
- Headache
- Nausea
- Abdominal pain
- Diarrhoea
- Arthralgia
Describe antibiotic treatment for uncomplicated pneumonia
Aminopenicillin or benzylpenicillin or macrolide
Describe antibiotic treatment for complicated pneumonia
Extended spectrum antibiotic and macrolide
What is aminopenicillin?
Combination of amoxicillin and apicillin
What is a common grading system of pneumonia?
CURB-65
Describe the 5 components of the CURB-65 grading system
- Confusion
- Urea > 7mM
- Respiratory rate > 30 min(-1)
- Blood pressure - Diastolic <60 or systolic <90mmHg
- Older than 65
Name 3 common pathogens causing COPD exacerbations and the pharmacological treatment for each
- S. pneumoniae - Penicillin
- H. influenzae - Penicillin +/- beta-lactamase inhibitor
- M. catarrhalis - Penicillin +/- beta-lactamase inhibitor
Name 5 common pathogenic causes of bronchiectasis in descending order of how common they are
- S. aureus
- S. pneumoniae
- H. influenzae
- E. Coli, enterococci
- P. aeruginosa
Name 3 treatments for bronchiectasis
- Postural drainage
- Early antibiotic therapy at high dose
- Long term azithromycin
Name 3 locations where secondary lung tumours commonly arise
- GIT
- Breast
- Kidney
What is lung cancer?
Malignancy originating in airways or lung parenchyma
What is the major risk factor for lung carcinoma?
Tobacco smoke
Name 4 risk factors for lung carcinoma which are not related to smoking
- Environmental smoke
- Asbestos, radon, arsenic
- Ionizing radiation
- Haloethers
Describe the 2 divisions of lung cancers
- Non small cell lung cancer
2. Small cell lung cancer
Name 3 types of non small cell lung cancers
- Squamous cell
- Adenocarcinoma
- Bronchoalveolar carcinoma
Describe the symptoms of lung cancer
- Cough and chest pain
- Weight loss
- Dyspnoea
- Superior vena cava obstruction
- Bone pain
- Haemoptysis
Name 4 most common lung cancer metastases
- Liver
- Bone
- Adrenal
- Brain
What is paraneoplastic phenomena?
Syndromes which arise from a production of various of factors from tumours e.g hormones, cytokines or immune responses
Name 5 examples of paraneoplastic phenomena
- Hypercalcaemia
- Hypertrophic osteoarthropathy
- Dermatomyositis
- Cushing’s Syndrome
- Hyponatraemia
What is PET scanning?
Positron emission tomography used to highlight cancers and metastases
Describe the staging of NSCLC
Stage I - Small tumour
Stage II - Moderate sized tumour and / or local nodes
Stage III - Big tumour and / or non-local nodes
Stage IV - Non-nodal metastases
Describe 3 possible treatments for NSCLC
- Surgery - Depends on stage and fitness for surgery
- Radiotherapy - Radical or palliative
- Chemotherapy
Describe the prognosis of SCLC
Poor prognosis as usually not picked up until the latter stages of the cancers
