S8 L2 Pneumonia and LRTI Flashcards
Are lungs sterile?
Lung Microbiota
What can cause dysregulation? (in an infection)
Pathogen
Host factors
Drugs
Host factors affecting infection…
Drugs affecting infection…
Defences of the Respiratory System
How can these defences become compromised?
The respiratory tract has many in-built defences to infection. These include:
- Muco-ciliary clearance mechanisms – nasal hairs and ciliated columnar epithelium that line the respiratory tract.
- Expulsion mechanisms – coughing and sneezing.
- Respiratory mucosal immune system.
- Alveolar microbiota
However, there are also many ways these defences can become compromised, including having a poor swallow (usually due to muscle weakness), abnormal ciliary function (seen in people who smoke, and patients with cystic fibrosis), airway dilation (seen in bronchiectasis), and defects in host immunity (patient with immunocompromising conditions or who are on immunosuppressants). All of these things help to weaken the defence mechanisms of the respiratory system and predispose to infection.
List of Upper Respiratory Tract Infections
List of Lower Respiratory Tract Infections
Bronchitis
- What is this?
- What does it affect?
- Who?
- Symptoms?
- 2 types of bronchitis (and cause for each)
- CXR result?
- Treatment
- Don’t look at pic until seen answer side
Bronchiolitis
- What is this?
- Which part of the lungs?
- Which group of people?
- Symptoms
- Cause?
- Treatment?
Bronchiectasis
- What is this?
- What does it affect?
Bronchiectasis can be defined as chronic dilation of one or more bronchi.
Lung Abscesses
- What is this?
- Type of necrosis?
- Where?
- How can they be classified?
- Symptoms?
- Investigation (how to diagnose?)
- Treatment?
Pneumonitis
- What is this?
- Cause?
Pneumonitis refers only to the inflammation of the lung parenchyma. The term is usually only used to describe inflammation due to non-infective causes, such as physical or chemical damage, such as occurs when noxious fumes are breathed in.
Pneumonia:
- What is this?
- Caused by?
- 2 types (anatomically)
- Types (through where got the infection…)
Pneumonia can be defined as inflammation of the alveoli due to infection. This acute inflammatory response causes exudation of fibrin-rich fluid into the alveolar spaces, and neutrophil and macrophage infiltration. The presence of exudate in the alveolar spaces may be localised (lobar pneumonia) or diffuse (bronchopneumonia).
- Hospital Aquired Pneumonia
- Community Acquired Pneumonia
- Aspiration Pneumonia
- Atypical Pneumonia
- Ventilation Acquired Pneumonia
Hospital and Community Acquited Pneumonias
- Causative organisms of each type
- Definition of HAP
Aspiration Pneumonia:
- Cause
- Which patients?
- When commonly seen?
- Organisms?
Aspiration pneumonia is caused by the aspiration of contents such as food, liquids, saliva or vomit, into the respiratory tract, which collects and leads to infection. It is most commonly seen in patients with a defective swallowing mechanism, for example people with neurological conditions like Parkinson’s disease, or patients with an altered level of consciousness, which may be seen in anaesthetic induction, after excessive alcohol intake, or due to drug abuse.
Aspiration pneumonia can be caused either by aerobic bacteria such as Streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella species (usually seen in aspiration pneumonia in alcoholics), or by anaerobic bacteria such as fusobacterium.
Investigations for Pneumonia
Accessing Severity of the Pneumonia
- When to admit a patient?
Treatment of Pneumonia
- Community-Acquired
- Hospital Acquired
u
Pathology of Pneumonia
- Acute inflammatory response
- Exudation of fibrin
- Neutrophil infiltration
- Macrophage infiltration
Differential Diagnosis to Pneumonia
