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Z MD1 Respiratory block > URTI and LRTI and lung infections (pneumonia and TB) > Flashcards

URTI and LRTI and lung infections (pneumonia and TB) Flashcards

1
Q

microbial aetiology of infective pneumonia

A
  • URT flora - strep pneumonia, hameophilis influenzae, staph aureus - enteric saprophytes - E coli, pseudomonas - extraveous pathogens - legionella pneumophilia, TB
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2
Q

stain used to look for TB

A

Ziehl-Neelsen

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2
Q

what are the two examples of single organ TB

A

potts disease (spine) urogenital tract

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3
Q

bacterial causes of atypical pneumonia

A

mycoplasma pneumoniae coxiella burnetti legionella spp chlamydia pneumoniae

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4
Q

what organisms are the main causative agent in hospital acquired pneumonia

A

gram negatives

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5
Q

rhinovirus causes

A

mainly URTI and no LRTI

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6
Q

frequent aetiological agents that cause lung abscess

A

Strep pnemonia mixed anaerobes Klebsiella

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7
Q

frequent aetiological agents that cause atypical pneumonia

A

mycoplasma - doesnt have a cell wall! chlamydia M catarrhalis influenza RSV adenovirus Coxiella Legionella

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7
Q

pathology of interstitial pneumonia

A

alveolar septa are widened and are infiltrated by lymphocytes, plasma cells and macrophages - no inflammatory cells in alveoli (may be filled with fluid)

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8
Q

frequent aetiological agents that cause the common cold

A

rhinovirus, parainfluenza virus, RSV, enterovirus, coronavirus, HMPV

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9
Q

frequent aetiological agents that cause of sinusitis

A

primary: viral secondary: H influenzae and Strep pnaumoniae

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10
Q

Gram stain of strep pneumonia

A

Gram positive dipplococci

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11
Q

4 routes of entry of micro-organisms to cause pneumonia

A
  • inhalation of pathogens in air droplets - aspiration of infected secretions from the URT - aspiration of infected particles - gastric contents, food, drink, foreign bodies - haematogenous spread
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11
Q

what is secondary TB

A

reactivation of dormant infection or reinfection where a cell mediated immune response leads to extensive caseation and cavitation if the caseous material discharges into a bronchus - usually involves the upper lobe

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12
Q

what is the characteristic of alveolar pneumonias

A

consolidation! When lung tissue becomes firm and solid neutrophils within the alveolar saces

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13
Q

frequent aetiological agents that cause of epiglottis

A

H influenzae type b

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13
Q

serological diagnosis of pneumonia is important for which organisms

A

mycoplasma pneumoniae legionella pneumonophila chlamydophila and Chlaydia species coxiella burnetti

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13
Q

treatment of pneumonia

A

best guess therapy - Penicillin G/amoxycillin + doxycycline/macrolide Bacteriostatic + bacteriocidal

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14
Q

characteristic of miliary TB in organs

A

numerous granulomas

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15
Q

chest x-ray signs of atypical pneumonia

A

reticulonodular infiltrate (dots and dashes) throughout both long fields

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16
Q

frequent aetiological agents that cause empyema

A

staph aureus, secondary to pneumonia

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17
Q

what is bronchopneumonia

A

alveolar pneumonia when consolidation is patchy around bronchioles - there are some areas that are affected separated by areas that are spared. Often multiple foci, involving more than one lobe or both lungs

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18
Q

frequent aetiological agents that cause otitis media

A

pnuemococci H infleunzae, M catarrhalis

19
Q

frequent aetiological agents that cause pharyngitis/tonsillitis with nasal involvement

A

adenovirus, enterovirus, parainfluenza, influenza

19
Q

definition of tuberculosis

A

a chronic granulomatous pneumonia due to infection with the bacterium mycobacterium tuberculosis

20
Q

hallmark of abscesses

A

cavitating lesion containing purulent exudate

21
Q

What two organisms live in the lungs in a latent state in some people

A

P. jirovecii M. Tuberculosis

22
Q

what does exposure to birds (wild) in a cage predispose you to get

A

Psittacosis

23
Q

what kind of calcification occurs in secondary TB

A

dystrophic

25
Q

frequent aetiological agents that cause of acute bacterial pneumonia

A

pneumococci - mainly H influenzae Staph Klebs Legionella TB chlamydophila

26
Q

common microbiota in the URT

A

viridans streptococci Neisseria spp. Corynebacterium spp., gram-negative anaerobes H influenzae A, C, D C albicans strep pneumoniae CCGHNSV

27
Q

2 patterns of infective pneumonia

A

alveolar inflammation interstitial inflammation

28
Q

which organs does miliary TB involve

A

liver, spleen, BM, brain

29
Q

clinical features of TB

A

variable weight loss, malaise, fevers, night sweats, haemoptysis, dyspnoea and chronic cough

31
Q

frequent aetiological agents that cause of acute exacerbation of chronic bronchitis

A

usually pneumoccoci and/or H. Influenzae

33
Q

frequent aetiological agents that cause pharyngitis/tonsillitis (with no nasal involvement)

A

adenovirus, influenza, enterovirus, reovirus, Strep pyogenes, Strep group C and G

33
Q

what organism is the main causative agent in community acquired pneumonia

A

strep pneumoniae

34
Q

pathology of primary TB

A

Gohn complex - gohn focus - area of inflammation in the periphery of the midzone of the lung - enlarged mediastinal and hilar lymph nodes

35
Q

occasional microbiata pathogens in URT

A

strep pyrogenes meningococci

36
Q

when does acute bronchpneumonia usually occur

A
  • at the extremes of life - secondary to pre-existing chronic condition (COPD, CHF, malignancy, CF) - post-operative complication related to impaired clearance of respiratory secretions - hospital acquired - secondary infections after viral URTI
37
Q

frequent aetiological agents that cause of croup

A

parainfluenza virus influenza A RSV

39
Q

frequent aetiological agents that cause of bronchiolitis

A

RSV

40
Q

how do the lungs macroscopically look with interstitial pneumonia

A

wet, dark and heavy

41
Q

how can TB spread through the body (routes)

A
  • lymphatics - coughed up –> laryngeal - coughed up and swallowed –> gut and intestine - haematogenous - via blood stream
43
Q

characteristics of atypical pneumonia

A

not as sick cough for a long time slower onset overall milder course

45
Q

4 stages of lobar pneumonia

A
  1. congestion- proteinasous exudate into alveoli 2. red hepatization - alveoli filled with neutrophils (consolidation), RBCs squeezed out - haemorrhage 3. grey hepatization - no longer have RBCs in alveolar space - have fibrin and macrophages 4. resolution
46
Q

presentation of a patient with atypical pneumonia

A
  • systemic symptoms predominate over respiratory - flu like illness - malaise, aches and pains, headache, diarrhoea - dry, non-productive cough
47
Q

complications of secondary pulmonary TB

A
  • progressive spread of caseation into surround lung - erosion of BVs - haemoptysis - erosion into bronchial tree leading to cavitation and spread of infection via airways - pleural inflammation and fibrosis - lung scarring
49
Q

what is lobar pneumonia

A

when it involves entirety of single lobe - often causes adjacent inflammation of the pleura

50
Q

how does legionella grow in air conditioning towers

A

grows inside amobae inside the tower

51
Q

characteristics of typical pneumonia

A

Productive cough Fever Dyspnoea Malaise

52
Q

complications of pneumonia

A
  • pleurisy - empyema - abscess - bronchiectasis - death
53
Q

why is it important that you know where a patient has acquired pneumonia from?

A

so you have an idea on how to treat them

54
Q

characteristics in the patient with lobar pneumonia

A
  • abrupt onset - fever -raised WBC count - cough - pleuritic chest pain - blood stained sputum - gram positive diplococci in sputum - bacteriemia
55
Q

2 kinds of alveolar pneumonia

A

bronchopneumonia lobar pneumonia

56
Q

which organism is notorious for producing abscesses

A

staph pneumonia

57
Q

frequent aetiological agents that cause acute bronchitis

A

usually as a complication of a viral URTI

Z MD1 Respiratory block (11 decks)

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