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2 - CPR (pulmonary) > Respiratory Pathology - 4 (Acute Pneumonia) > Flashcards

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
Q

Atypical (walking) Pneumonia usually affects who and what symptoms predominate?

A

Teenagers and young adults

= Systemic symptoms predominate

26
Q

What will be seen on CXR with Atypical (walking) Pneumonia?

A

Patchy infiltrates

27
Q

What 2 bacteria can cause Atypical Community Acquired Bacterial Pneumonia?

A

Mycoplasma Pneumoniae

Legionella Pneumophila

28
Q

What 2 bacteria can cause Atypical Community Acquired Bacterial Pneumonia?

A

Mycoplasma Pneumoniae

Legionella Pneumophila

29
Q

What is unique about Mycoplasma Pneumoniae?

A

NO cell wall and smallest free living and self replicating microorganism

30
Q

How is Legionella Pneumophila spread and what type of bacteria is it?

A

Airborne disease

- Gram (-) bacilli

31
Q

Where does Legionella Pneumophila grow?

A

Warm freshwater - AC units, hot tubs, misters

32
Q

Slower onset, systemic symptoms and patchy infiltrates

A

Atypical (walking) Community Acquired Bacterial Pneumonia

– Mycoplasma or legionella

33
Q

Community Acquired Viral Pneumonia will show cells where histologically?

A

IN INTERSTITIUM

34
Q

Community Acquired Viral Pneumonia is more likely to show what distribution on CXR?

A

Multi-lobar – diffuse

35
Q

What are the 4 most common causes of Community Acquired Viral Pneumonia?

A

Influenza virus
SARS
COVID-19
Respiratory Syncytial Virus

36
Q

What 2 proteins classify Influenza virus?

A

Hemagluttinin

Neuraminidase

37
Q

Action of Hemagluttinin protein with the Influenza Virus?

A

Attaches to the host cells

38
Q

Action of Neuraminidase protein with the Influenza Virus?

A

Cleaves Hemagluttinin tether and allows release of replicated virus to go infect other cells

39
Q

What drug (-) Neuraminidase?

A

Oseltamivir (tamiflu)

40
Q

Describe how Influenza Virus replicates

A
  • 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
Q

Symptoms of Community Acquired Viral Pneumonia caused by Influenza virus?

A

Abrupt onset and fever for a few days

Aches, chills, fatigue, headache

42
Q

Influenza virus shows Antigenic Drift and Shift. What is Antigenic Drift?

A

Minor changes to proteins on the virus
= Increases spread
– still similar enough to original virus to allow for some immunity in people

43
Q

Influenza virus shows Antigenic Drift and Shift. What is Antigenic Shift?

A

Genomic alterations with major changes in hemagluttinin and neuraminidase
– naive immunity for almost all people

44
Q

Which type of Antigenic movement causes epidemics and which causes pandemics with the Influenza virus?

A

Epidemics - Antigenic Drift

Pandemics - Antigenic Shift

45
Q

What virus is responsible for SARS?

A

(severe acute respiratory syndrome)

- coronavirus

46
Q

What type of virus is COVID-19?

A

(+) ss-RNA = most direct route to viral proteins

47
Q

What receptors does COVID-19 affect?

A

ACE in the lung and gut

48
Q

Once COVID-19 binds the ACE receptors, what will occur?

A
  • Cytokine storm –> ARDS

- Coagulation and inflammation

49
Q

What cells will enter circulation and cause more coagulation and thrombi formation with COVID-19?

A

Megakaryocytes

50
Q

What will be seen on autopsy of COVID-19?

A

Congested lungs, hyperemia, pleurisy

and Thrombi Formation!

51
Q

What do COVID-19 patients usually expire from, therefore what will be seen histologically with the cells?

A

Superimposed bacterial pneumonia

= Cells in the alveolar spaces and in interstitium

52
Q

What is a common cause of Community Acquired Viral Pneumonia in children older than 1 month old?

A

Respiratory Syncytial Virus

53
Q

What type of virus is and what does replication of that virus result in with Respiratory Syncytial Virus?

A

Paramyxovirus

= Epithelial cell sloughing, inflammation, mucus secretion and impaired ciliary action

54
Q

What are the symptoms in children of Community Acquired Viral Pneumonia caused by RSV?

A
  • Rhinorrhea
  • Cough and wheeze
  • Dyspnea/Tachypnea
  • Cyanosis
55
Q

Bacterial and Viral pneumonia - onset type and which has epidemics commonly?

A 
Bacterial = abrupt onset
Viral = slower onset with epidemics common
56
Q

Bacterial and Viral pneumonia - is bacteremia/viremia common and what type of fevers?

A

Bacterial - high fevers with associated bacteremia

Viral - no/low fevers with NO viremia

57
Q

Bacterial and Viral pneumonia - lung sounds

A

Bacterial - crackles

Viral - wheezes

58
Q

Bacterial and Viral Pneumonia - CXR findings

A

Bacterial - Lobar/consolidation

Viral - diffuse infiltrates

59
Q

Which type of pneumonia (bacterial or viral) often involves the pleura?

A

Bacterial

60
Q

Outlook for bacterial and viral pneumonia?

A

Bacterial - responds to antibiotics

Viral - self limiting

2 - CPR (pulmonary) (26 decks)

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