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Respiratory Pathology - 4 (Acute Pneumonia) Flashcards

1
Q

In what 2 ways can Pneumonia be classified?

A
  • Clinical Setting

- Anatomic Distribution

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2
Q

What are 2 types of Anatomic Distribution classified Pneumonia?

A
  • Bronchopneumonia

- Lobar Pneumonia

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3
Q

What are the 4 stages of Lobar Pneumonia?

A
  1. Congestion - vascular engorgement
  2. Red Hepatization - red cells and inflammation
  3. Grey Hepatization - inflammation and debris
  4. Resolution - fibrosis and macrophage clean up
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4
Q

What are 3 possible complications of Lobar Pneumonia?

A

Abscess
Empyema
Bacteremia

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5
Q

Lobar Pneumonia affects ____ and shows up how on CXR?

A

Affects an entire LOBE

- White lobe on CXR

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6
Q

Community Acquired Bacterial Pneumonia will show cells where histologically in the lungs?

A

Alveolar spaces

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7
Q

Typical Pneumonia affects what populations and what symptoms predominate?

A
  • Children and Older adults

= Respiratory symptoms predominate

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8
Q

Typical Pneumonia shows what on CXR?

A

Consolidation

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9
Q

What are the 5 most common causes of Typical Community Acquired Bacterial Pneumonia?

A 
Streptococcus Pneumoniae
Haemophilus Influenzae
Staphylococcus Aureus
Klebsiella Pneumoniae
Pseudomonas Aeruginosa
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10
Q

What is the most common cause of Typical Community Acquired Bacterial Pneumonia?

A

Streptococcus Pneumoniae

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11
Q

What describes the appearance of Streptococcus Pneumoniae?

A

Lancet shaped gram (+) diplococci

– pairs and chains

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12
Q

Lancet shaped gram (+) diplococci

– pairs and chains

A

Streptococcus Pneumoniae

- Most common cause of Community Acquired Bacterial Pneumonia

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13
Q

When are vaccinations recommended for S. Pneumoniae?

A

Infants, elderly and smoking/respiratory disease

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14
Q

What population does Haemophilus Influenzae primarily affect with Typical Community Acquired Bacterial Pneumonia?

A

Children

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15
Q

When are vaccinations recommended and what type for Haemophilus Influenzae?

A

Vaccinations for Type B in children < 5 years old

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16
Q

Staphylococcus Aureus can cause Typical Community Acquired Bacterial Pneumonia. What patients are at an elevated risk and what will likely form?

A

IV drug users

= Abscess formation

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17
Q

In what patients will Klebsiella Pneumoniae likely present?

A

Alcoholics

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18
Q

What characterizes the Klebsiella Pneumoniae infection causing Typical Community Acquired Pneumonia?

A

Currant Jelly Sputum

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19
Q

Current Jelly Sputum

A

Klebsiella Pneumonia

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20
Q

In what patients is Pseudomonas Aeruginosa common?

A

Cystic Fibrosis patients

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21
Q

What color is Pseudomonas Aeruginosa?

A

Green

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22
Q

Pseudomonas Aeruginosa can cause what in CF patients?

A

Typical Community Acquired Bacterial Pneumonia

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23
Q

Klebsiella Pneumoniae can cause what in alcoholics?

A

Typical Community Acquired Bacterial Pneumonia

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24
Q

Staph. Aureus can cause what in IV drug users?

A

Typical Community Acquired Bacterial Pneumonia

– With Abscess formation

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25
Atypical (walking) Pneumonia usually affects who and what symptoms predominate?
Teenagers and young adults | = Systemic symptoms predominate
26
What will be seen on CXR with Atypical (walking) Pneumonia?
Patchy infiltrates
27
What 2 bacteria can cause Atypical Community Acquired Bacterial Pneumonia?
Mycoplasma Pneumoniae | Legionella Pneumophila
28
What 2 bacteria can cause Atypical Community Acquired Bacterial Pneumonia?
Mycoplasma Pneumoniae | Legionella Pneumophila
29
What is unique about Mycoplasma Pneumoniae?
NO cell wall and smallest free living and self replicating microorganism
30
How is Legionella Pneumophila spread and what type of bacteria is it?
Airborne disease | - Gram (-) bacilli
31
Where does Legionella Pneumophila grow?
Warm freshwater - AC units, hot tubs, misters
32
Slower onset, systemic symptoms and patchy infiltrates
Atypical (walking) Community Acquired Bacterial Pneumonia | -- Mycoplasma or legionella
33
Community Acquired Viral Pneumonia will show cells where histologically?
IN INTERSTITIUM
34
Community Acquired Viral Pneumonia is more likely to show what distribution on CXR?
Multi-lobar -- diffuse
35
What are the 4 most common causes of Community Acquired Viral Pneumonia?
Influenza virus SARS COVID-19 Respiratory Syncytial Virus
36
What 2 proteins classify Influenza virus?
Hemagluttinin | Neuraminidase
37
Action of Hemagluttinin protein with the Influenza Virus?
Attaches to the host cells
38
Action of Neuraminidase protein with the Influenza Virus?
Cleaves Hemagluttinin tether and allows release of replicated virus to go infect other cells
39
What drug (-) Neuraminidase?
Oseltamivir (tamiflu)
40
Describe how Influenza Virus replicates
- Attaches to cell via Hemagluttinin - Enters cell via endocytosis - Viral RNA is replicated in the nucleus - mRNA is used to make viral proteins - Neuraminidase cleaves and allows release of virus
41
Symptoms of Community Acquired Viral Pneumonia caused by Influenza virus?
Abrupt onset and fever for a few days | Aches, chills, fatigue, headache
42
Influenza virus shows Antigenic Drift and Shift. What is Antigenic Drift?
Minor changes to proteins on the virus = Increases spread -- still similar enough to original virus to allow for some immunity in people
43
Influenza virus shows Antigenic Drift and Shift. What is Antigenic Shift?
Genomic alterations with major changes in hemagluttinin and neuraminidase -- naive immunity for almost all people
44
Which type of Antigenic movement causes epidemics and which causes pandemics with the Influenza virus?
Epidemics - Antigenic Drift | Pandemics - Antigenic Shift
45
What virus is responsible for SARS?
(severe acute respiratory syndrome) | - coronavirus
46
What type of virus is COVID-19?
(+) ss-RNA = most direct route to viral proteins
47
What receptors does COVID-19 affect?
ACE in the lung and gut
48
Once COVID-19 binds the ACE receptors, what will occur?
- Cytokine storm --> ARDS | - Coagulation and inflammation
49
What cells will enter circulation and cause more coagulation and thrombi formation with COVID-19?
Megakaryocytes
50
What will be seen on autopsy of COVID-19?
Congested lungs, hyperemia, pleurisy | and Thrombi Formation!
51
What do COVID-19 patients usually expire from, therefore what will be seen histologically with the cells?
Superimposed bacterial pneumonia | = Cells in the alveolar spaces and in interstitium
52
What is a common cause of Community Acquired Viral Pneumonia in children older than 1 month old?
Respiratory Syncytial Virus
53
What type of virus is and what does replication of that virus result in with Respiratory Syncytial Virus?
Paramyxovirus | = Epithelial cell sloughing, inflammation, mucus secretion and impaired ciliary action
54
What are the symptoms in children of Community Acquired Viral Pneumonia caused by RSV?
- Rhinorrhea - Cough and wheeze - Dyspnea/Tachypnea - Cyanosis
55
Bacterial and Viral pneumonia - onset type and which has epidemics commonly?
``` Bacterial = abrupt onset Viral = slower onset with epidemics common ```
56
Bacterial and Viral pneumonia - is bacteremia/viremia common and what type of fevers?
Bacterial - high fevers with associated bacteremia | Viral - no/low fevers with NO viremia
57
Bacterial and Viral pneumonia - lung sounds
Bacterial - crackles | Viral - wheezes
58
Bacterial and Viral Pneumonia - CXR findings
Bacterial - Lobar/consolidation | Viral - diffuse infiltrates
59
Which type of pneumonia (bacterial or viral) often involves the pleura?
Bacterial
60
Outlook for bacterial and viral pneumonia?
Bacterial - responds to antibiotics | Viral - self limiting

2 - CPR (pulmonary) (26 decks)

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