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CPR 2 Exam 2 > Singh Pathology of Respiratory System #4 > Flashcards

Singh Pathology of Respiratory System #4 Flashcards

1
Q

What is the most common cause of sepsis and septic shock?

A

Pneumonia

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2
Q

What are the stages of lobar pneumonia?

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

Complications of lobar pneumonia?

A

Abscess

Empyema

Bacteremia

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4
Q

What is the most common cause of community acquired pneumonia?

A
  • Streptococcus pneumoniae
    • pairs and chains of lancet shaped gram positive diplococci
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5
Q

What are 3 other bacterial causes of CAP besides S.pneumonia? What are their characteristics?

A
  • Haemophilus influenzae
    • virulent pneumonia in kids
  • S. aureus
    • abscess forms
    • IV drug user
  • K. pneumoniae
    • alcoholics
    • currant jelly sputum
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6
Q

What characterizes typical pneumonia?

A
  • abrupt onset
  • respiratory sx predominate
  • Consolidation on CXR
  • Older adults or young kids
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7
Q

What characterizes Atypical (walking) pneumonia?

A
  • Slow onset
  • Systemic symptoms predominate
  • Patchy infiltrates on CXR
  • Young adults teens
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8
Q

What bacteria are responsible for atypical pneumonia?

A
  • Mycoplasma pneumoniae
  • Legionella pneumophila
  • Chlamydia pneumonia
  • Chlamydia psittaci
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9
Q

Describe Legionella pneumophila?

A
  • Gram negative bacillus
  • Gros in warm freshwater
    • air conditioning units
    • misters
    • hot tubs
  • Airborne
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10
Q

What is the most common viral CAP?

A
  • Influenza
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11
Q

What two proteins make up influenza virus?

A
  • Hemagglutinin
    • attaches to cells
  • Neuraminidase
    • allows release of replicated virus from cell
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12
Q

What is antigenic drift?

A
  • minor changes to proteins that are just enough to allow increased spread (epidemic)
  • Similar enough to original virus to allow for some immunity
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13
Q

What is antigenic shift?

A
  • Genomic alterations with major resulting change to protein structures
  • Naïve immunity for almost all people
  • Pandemics
  • Picked up from animal gene products
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14
Q

What kind of virus is COVID-19?

A

Positive sense ssRNA

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15
Q

How does COVID 19 lead to ARDS?

A

Induces a cytokine storm

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16
Q

How does COVID 19 induce coagulopathy? How do you test for it?

A
  • Venous and arterial thrombi
  • Megakaryocyte activation
  • D dimer predictive value
17
Q

What causes neonatal bacterial pneumonia?

A
  • Group B strep
  • Gram - bacilli
  • Listeria
18
Q

What are the viral and bacterial causes of pneumonia in kids less than 1 month old?

A
  • RSV
  • Parainfluenza virus
  • Influenza A and B
  • Adenovirus
  • Rhinovirus
  • S. pneumoniae
  • H. influenzae
  • M. catarrhalis
  • S. aureus
19
Q

Signs and sx of influenza?

A
  • Abrupt onset
  • Fever 3-4 days
  • Severe aches
  • Chills
  • Fatigue and weakness
  • Headache common
20
Q

Which type of viral class has the most direct route to viral proteins?

A
  • ssRNA + sense virus
  • they go straight to ribosome and begin translation
21
Q

RSV Pneumonia symptoms?

A
  • paramyxovirus
  • Rhinorrhea and cough
  • Wheezing dyspnea
  • Tachypnea
  • Cyanosis
22
Q

Presentation of bacterial pneumonia?

A
  • Abrupt onset
  • Not associated with epidemics
  • may have bacteremia
  • High grade fever
  • Crackles
  • Lobar or consolidated appearance
  • May involve pleura
23
Q

Viral presentation of pneumonia?

A
  • gradual onset
  • epidemics are common
  • Not associated with viremia
  • No fever or low grade
  • Wheezes
  • Diffuse infiltrates on CXR
  • Doesn’t involve pleura
  • Self limiting
24
Q

Complication of pneumonia?

A
  • Lung abscess
  • Aspiration
25
Q

Why would the right middle and lower lobes be preferentially afcted?

A
  • The right main bronchi has a steeper slope making it more favorable for anything to fall that way
26
Q

What is a ghon complex?

A

Caseating granulomata is found in the hilar lymph nodes and at the parenchyma

27
Q

What diseases cause pulmonary granulomatas?

A
  • TB
  • Sarcoidosis
  • Hypersensitivity pneumonia
  • Vasculitis (GPA)
28
Q

What is chronic pneumonia? What is the biggest cause?

A
  • Pneumonia lasting for months in a immunocompetent patient
  • Fungal infections are the most common cause
    • Histoplasma
    • Blastomycosis
    • Coccidiomycosis
29
Q

Histoplasma Capsulatum, where is it endemic and what is the characteristic?

A
  • Endemic in Midwest and Caribbean (ohio and mississippi river valleys)
  • Characteristic yeast shows pumpkin seed morphology
  • Subclinical infection with granulomatous response
    • calcification or coil lesion on CXR
30
Q

Blastomyces dermatitides endemic and characteristics?

A
  • Endemic in ohio and mississippi river valley
  • Infections gives granulomatous response
  • Characteristic yeast shows broad based buds
31
Q

Coccidiodes immitis?

A
  • Endemic in SW US and Mexico
  • Granulomatous response with eosinophils
  • Subclinical and self limited
  • Can produce disseminated infection especially with immunocompromised
32
Q

Pneumocystis jiroveci (carinii) pneumonia characteristics?

A
  • Opportuinistic fungal infection
  • AIDS defining illness
  • Characteristic cup shaped yeast forms
  • can be diffuse or focal
33
Q

CMV Pneumonia?

A
  • Opportunistic viral infection
  • AIDS defining illness
  • Characteristic inclusions in image “Cowdry”
34
Q

Mycobacterium avium complex?

A
  • Immunocompromised or elderly
  • Thin mycobacteria seen as slender red forms on acid fast staining

CPR 2 Exam 2 (17 decks)

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