suppurative lung disease

Question 1

Metastatic abscess

Answer 1

A secondary abscess formed at a distance from the primary abscess, as
a result of the transport of pyogenic bacteria through the lymph or blood.

Question 2

Suppurative

Answer 2

Producing pus

Question 3

similarities of the 3 suppurative lung disease, Bronchiectasis, Lung abscesses and Empyema:

Answer 3

All suppurative ie pus forming
* All essentially complications of lung infections
* All due to bacteria including some unusual ones
* All chronic problems
* All require antibiotics often for prolonged periods
* Therefore, important to try to get representative samples for culture and susceptibility testing
before starting treatment
* Often require physiotherapy to encourage drainage of excess or thick sputum (bronchiectasis
and lung abscess)
* May require surgery to drain pus (lung abscess and empyema)

Question 4

Bronchiectasis

Answer 4

Abnormal bronchi and bronchioles - permanently dilate.

irreversible dilation and destruction

Question 5

what is the cause of bronchiectasis.

Answer 5

is due to previous inflammation of the surrounding lung tissue.

resultant scarring or fibrosis
causes dilatation of bronchi. Then ongoing inflammatory changes lead to further damage to airways

Question 6

Symptoms of Bronchiectasis

Answer 6

• Chronic cough with copious amounts of sputum production

Question 7

complication of bronchiectasis

Answer 7

pneumonia
lung abscess
pulmonary fibrosis
spread via blood stream.
amyloidosis

Question 8

Due to a variety of lung insults:

Answer 8

• Severe infections: TB, measles, pertussis, adenovirus
• Underlying genetic abnormalities that predispose to severe infections: cystic fibrosis with abnormally thick
  secretions that can’t be cleared, immotile cilia, hypogammaglobulinaemia, others

Question 9

Pseudomonas aeruginosa often
associated with bronchiectasis

Answer 9

is a gram negative bacilli.
can cause pneumonia to patient with bronchiectasis.

It usually causes severe infection, often recurrent and
persistent and difficult to treat.

Question 10

lung abscess

Answer 10

is also called necrotizing pneumonia.

focal breakdown of the lung tissue

Question 11

lung abscess symptoms:

Answer 11

coughing lots of sputum
smelling bad due to anearobes

Question 12

how to disgnose lung abscess

Answer 12

• CXR: air fluid level classic finding

Question 13

Lung abscesses can develop via a number of ways:

Answer 13

• As a result of severe lung infection
• Staphylococcus aureus notorious for causing breakdown of lung tissue
• as a consequence of a blockage of local area of lung leading to unresolving infection
• e.g due to a foreign body or a tumour.
• Occasionally from hematogenous /blood borne spread

Question 14

Probably most commonly as a complication of ‘aspiration pneumonia??

Answer 14

Aspiration of fluid or food into lung causing inflammation (sometimes termed ‘macroaspiration’)
* Patients at risk : sedated or with reduced level of consciousness or swallowing problems
* Pattern of distribution of affected areas in the lung depends on position of patient,
whether lying on back or sid

Question 15

Organisms that cause a lung abscess

Answer 15

Anaerobes
are commonly associated with aspiration pneumonia- come from the mouth
* Staphylococcus aureus
* can be acquired via respiratory tract, especially after preceding viral
infection
* can also be result of haematogenous spread when there can be multiple
lung abscesses
* Typical respiratory bacteria can also be involved

Question 16

pleural effusin

Answer 16

fluid in the pleural space

Question 17

Disorder Collection Causes
Hemothorax

Answer 17

Blood in
Chest injury; ruptured aortic aneurysm

Question 18

Hydrothorax

Answer 18

Low protein fluid (transudate) Liver failure; cardiac failure; renal
failure

High protein fluid (exudate):Tumours; infection; inflammation

Question 19

Chylothorax

Answer 19

Lymph
Neoplastic obstruction of thoracic
lymphatics

Question 20

Pneumothorax

Answer 20

Air
Spontaneous, following rupture of
alveolus or bulla in emphysema or
tuberculosis
Traumatic, e.g. following penetrating
injuries of the chest

Spontaneous idiopathic (in young
healthy people without pulmonary
disease); cause unknown

Question 21

Pleural empyema

Answer 21

pus in the pleural space.
Occurs if pleural effusion becomes more purulent, e.g. S. aureus infection can cause pus