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Pathoma > Respiratory: Pulomanry infection > Flashcards

Respiratory: Pulomanry infection Flashcards

1
Q

what is pneumonia

A

infection of lung parenchyma

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2
Q

when does pneumonia occur? examples?

A

when normal defenses are impaired

  1. impaired cough reflex
  2. damage to mucociliary escalator
  3. mucus plug
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3
Q

what are clinical features of pneumonia

A
  • fever and chills
  • productive cough with yellow-green (pus) or rusty (bloody sputum
  • tachypnea
  • pleuritic chest pain
  • decreased breath sounds
  • dullness to percussion
  • elevated WBC count
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4
Q

how is the diagnosis for pneumonia made

A
  • chest X-ray
  • sputum gram stain and culture
  • blood cultures
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5
Q

what are the 3 classical patterns seen on chest x-ray for pneumonia

A
  1. lobar pneumonia
  2. bronchopneumonia
  3. interstitial pneumonia
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6
Q

what characterizes lobar pneumonia

A

consolidation of an entire lobe of the lung

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7
Q

what is the most common cause of lobar pneumonia

A

usually bacteria

  • Streptococcus pneumoniae
  • Klebsiella pneumoniae
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8
Q

What are 4 phases of loar pneumonia

A
  1. congestion
  2. red hepatization
  3. gray hepatization
  4. resolution
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9
Q

why is there congestion in lobar pneumonia

A

due to congested vessels and edema

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10
Q

what causes red hepatization

A

due to exudate, neutrophils, and hemorrhage filling the alveolar air spaces, giving the normal spongy lung a solid consistency

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11
Q

what causes gray hepatization

A

due to degradation of red cells within the exudate

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12
Q

what is the most common cause of community-acquired pneumonia and secondary pneumonia and who usually gets it

A

Streptococcus Pneumonia

- middled-aged adults and elderly

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13
Q

what is secondary pneumonia

A

bacterial pneumonia superimposed on a viral upper respiratory tract infection

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14
Q

klebsiella pneumoniae impacts who

A
  • malnourished and debilitated individuals

- elderly in nursing homes, alcoholics, and diabetics

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15
Q

what is clinical presentation for klebsiella pneumoniae

A
  • enteric flora that is aspirated

- thick mucoid capsule results in gelatinous sputum ( currant jelly)

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16
Q

what complicates Klebsiella pneumoniae

A

abscess

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17
Q

what characterizes bronchopneumonia

A

scattered patchy consolidation centered around bronchioles

- multifocal and bilateral

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18
Q

what causes bronchopneumonia

A 
Staphylococcus aureus
Haemophilus influenzae
Pseudomonas aeruginosa
Moraxella catarrhalis 
Legionella Pneumophila
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19
Q

what is the 2nd most common cause of secondary pneumonia

A

Staphylococcus aureus

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20
Q

Staphylococcus aureus bronchopneumonia is complicated with what

A

abscess and empyema

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21
Q

empyema

A

pus in pleural space

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22
Q

what is a common cause of secondary pneumonia and pneumonia superimposed of COPD, leading to exacerbation of COPD

A

haemophilus influenzae

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23
Q

Pneumonia in cystic fibrosis patients

A

Pseudomonas aeruginosa

24
Q

causes community-acquired pneumonia and pneumonia superimposed on COPD, leads to exacerbation of COPD

A

Moraxella Catarrhalis

25
Q

what type of pneumonia does Legionella cause

A
  1. community acquired pneumonia
  2. pneumonia superimposed on COPD
  3. pneumonia in immunocompromised states
26
Q

how is legionella pneumophila transmitted

A

from water source

27
Q

how is Legionella best visualized

A

intracellular organism best visualized by silver stain

28
Q

what characterizes interstitial atypical pneumonia

A

diffuse interstitial infiltrates

29
Q

what symptoms presents with interstitial atypical pneumonia

A

mild upper respiratory symptoms
- minimal sputum
- low fever
‘atypical’ presentation

30
Q

what causes interstitial (atypical pneumonia)

A 
Mycoplasma pneumoniae
chlamydia pneumoniae
respiratory syncytial virus (RSV)
Cytomegalovirus (CMV)
Influenza virus
Coxiella burnetii
31
Q

what is the most common cause of atypical pneumonia

A

mycoplasma pneumoniae

32
Q

who does mycoplasma pneumoniae impact

A
  • young adults
  • military recruits
  • college students living in dormitory
33
Q

what are complications with mycoplasma pneumoniae

A
  • autoimmune hemolytic anemia (IgM against I antigen on RBCs causes cold hemolytic anemia)
  • erythema multiforme
34
Q

why is mycoplasma pneumoniae not visible on gram stain

A

lack of cell wall

35
Q

What is the second most common cause of atypical pneumonia in young adults

A

Chlamydia pneumoniae

36
Q

what is the most common cause of atypical pneumonia in infants

A

Respiratory syncytial virus (RSV)

37
Q

what causes atypical pneumonia with post-transplant immunosuppressive therapy

A

Cytomegalovirus (CMV)

38
Q

who is influenza virus usually seen in for atypical pneumonia

A

elderly
immunocompromised
preexisting lung disease

39
Q

influenza virus atypical pneumonia increases the risk of what

A

superimposed S aureus or H. influenzae bacterial pneumonia

40
Q

how does Coxiella Burnettii present atypical pneumonia?

A
  • high fever ( Q fever)
41
Q

who usually gets Coxiella Burnetti? how do they get it?

A

farmers and veterinarians

- coxiella spores are deposited on cattle by ticks or are present in cattle placentas

42
Q

Coxiella is what type of oragnism

A

Rickettsial organism

43
Q

how distinguishes Coxiella from the other Rickettsial species

A
  1. causes pneumonia
  2. does not require arthropod vector for transmission (survives as highly heat-resistant endospores)
  3. does not produce a skin rash
44
Q

aspiration pneumonia is seen in patients at risk for what

A

aspiration

eg, alcoholics, and comatose patients

45
Q

what causes aspiration pneumonia

A

anaerobic bacteria in oropharynx

eg. bacteroides, Fusobacterium, Paptococcus

46
Q

how does aspiration pneumonia present in lungs? why?

A

right lower lobe abscess

- right main stem bronchus branches at a less acute angle than the left

47
Q

what causes Tuberculosis

A

inhalation of aerosolized mycobacterium tuberculosis

48
Q

what results in primary TB

A
  • focal, caseating necrosis in lower lobe of lung

- hilar lymph nodes that undergo fibrosis and calcification, forming Ghon complex

49
Q

what are the symptoms of primary TB? what about tests?

A
  • usually asymptomatic

- positive PPD test

50
Q

when does secondary TB occur

A

reactivation of mycobacterium tuberculosis

  • commonly due to AIDS
  • can be seen with aging
51
Q

where in the lung does secondary TB usually occur?

A

apex of lung ( relatively poor lymphatic drainage and high O2 tension)

52
Q

clinical features of secondary TB

A

fevers
night sweats
cough with hemoptysis
weight loss

53
Q

what does biopsy reveal about secondary TB

A

caseating granulomas

54
Q

how does TB stain

A

AFB stain reveals acid-fast bacilli

55
Q

how and what does secondary TB lead to

A

forms cavitary foci of caseous necrosis

- may lead to miliary pulmonary TB or Tuberculous bronchopneumonia

56
Q

Systemic spread often occurs in secondary TB and involve what common tissues

A
  1. meninges ( meningitis)
  2. cervical lymph nodes
  3. kidneys ( produces sterile pyuria)
  4. lumbar vertebrae ( Potts disease)

Pathoma (38 decks)

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