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Respiratory System > Lecture 9.1: Pneumonia and Lower Respiratory Tract Infections > Flashcards

Lecture 9.1: Pneumonia and Lower Respiratory Tract Infections Flashcards

1
Q

What is Bronchitis?

A

An infection of the main airways of the lungs (bronchi), causing them to become irritated and inflamed

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2
Q

What is Bronchiolitis?

A

Bronchiolitis affects the smaller airways (bronchioles)

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3
Q

What is Pneumonia?

A

Inflammation in the alveoli/tissue in one or both lungs

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4
Q

What causes Acute Bronchitis? (2)

A
  • Viruses
  • Bacteria
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5
Q

What causes Chronic Bronchitis?

A
  • Not primarily infective
  • Consequence of repeated infections
  • Irritation from smoking
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6
Q

Types of Defences of the Respiratory Tract (3)

A
  • Muco-Ciliary Clearance Mechanisms
  • Cough and Sneezing Reflexes
  • Respiratory Mucosal Immune System
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7
Q

Defences of the Respiratory Tract: Muco-Ciliary Clearance Mechanisms

A
  • Nasal Hairs
  • Ciliated Epithelium
  • Goblet Cells
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8
Q

Defences of the Respiratory Tract: Respiratory Mucosal Immune System

A
  • Lymphoid Follicles of the Pharynx and Tonsils
  • Alveolar Macrophages
  • Secretory IgA and IgG
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9
Q

Predisposing Factors for Pneumonia: INSPIRATION Pneumonic

A

I: mmunosuppression
N: eurologically impaired cough reflex
S: ecretion retention
P: ulmonary oedema
I: mpaired mucociliary clearance
R: espiratory tract infection (viral)
A: ntibiotics and cytotoxins
T: racheal instrumentation
I: mpaired alveolar macrophages
O: ther
N: eoplasia

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10
Q

Symptoms of Pneumonia (11)

A
  • Cough
  • Fever/Chills/Sweats
  • Haemoptysis
  • Dyspnoea
  • Pleuritic Chest Pain
  • Malaise
  • Anorexia and Vomiting
  • Headache
  • Myalgia
  • Diarrhoea
  • Green/Yellow Sputum
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11
Q

Signs of Pneumonia (5)

A
  • Bronchial Breath Sounds
  • Crackles
  • Wheeze
  • Dullness to Percussion
  • Increased Vocal Resonance
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12
Q

Classifications of Pneumonia (4)

A
  • By Clinical Setting
  • By Presentation
  • By Organism
  • By Lung Pathology
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13
Q

Classifications of Pneumonia: Clinical Setting (4)

A

1) Community acquired
2) Hospital acquired (nosocomial)
3) Aspiration Pneumonia
4) Pneumonia in the immunocompromised
patient

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14
Q

Classifications of Pneumonia: Organism (3)

A

1) Bacterial
2) Viral
3) Fungal

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15
Q

Classifications of Pneumonia: Presentation (3)

A

1) Acute
2) Sub-Acute
3) Chronic

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16
Q

Classifications of Pneumonia: Lung Pathology (3)

A

1) Lobar Pneumonia
2) Bronchopneumonia
3) Interstitial Pneumonia

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17
Q

Common Organisms Causing Community-Acquired Pneumonia (5)

A
  • Streptococcus pneumoniae (30%)
  • Haemophilus influenzae (13%)
  • Klebsiella pneumoniae
  • Moraxella cattarhalis
  • Currently SARS-CoV-2
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18
Q

Atypical (10% of cases) Organisms Causing Community-Acquired Pneumonia (3)

A
  • Legionella
  • Mycoplasma
  • Chlamydia spp
19
Q

What is the Definition of Hospital Acquired Pneumonia? Who does it occur in?

A
  • Occurs within 48hr after admission
  • ITU patients, ventilated patients, post surgery
20
Q

Organisms Causing Hospital-Acquired Pneumonia (9)

A
  • Influenza/parainfluenza
  • Respiratory Syncytial Virus
  • Adenovirus
  • SARS-CoV-2
  • Mixed infections (10%)
  • Staphylococcus Aureus
  • Pseudomonas
  • MRSA
  • Gram-negative enteric bacteria
21
Q

What is Aspiration Pneumonia?

A

Occurs upon aspiration of exogenous material or secretions into lung

22
Q

What type of organism commonly affects immunocompromised patients?

A
  • Opportunistic pathogens
  • High risk of virulent infection with common
    organism
23
Q

What type of patients is Mycoplasma found in?

A
  • Young
    prior antibiotics, extra-pulmonary involvement
24
Q

When are patients at risk of infection with Staphylococcus aureus?

A

Post-Viral Infection

25
Q

When are patients at risk of infection with Chlamydia?

A

Contact with birds

26
Q

When are patients at risk of infection with Coxiella?

A

Contact with animals

27
Q

What conditions put patients at risk of infection with Klebsiella? (2)

A
  • Thrombocytopenia
  • Leucopenia
28
Q

What are some Viral Pneumonia Causing Pathogens? (3)

A
  • Influenza
  • Parainfluenza
  • Respiratory syncytial virus (RSV)
29
Q

What are some effects of SEVERE Pneumonia?

A
  • Lung Necrosis
  • Haemorrhage in to Lung Parenchyma
  • ARDS
  • High Mortality
30
Q

What is SARS-CoV-2? What are the effects of infection?

A
  • RNA Virus
  • Most sufferers have mild/moderate disease
  • Asymptomatic transmission important
  • Some patients develop severe pneumonia and
    multi-organ failure
31
Q

What is Lobar Pneumonia? What pathogen most commonly causes this?

A
  • Consolidation involving a whole lobe
  • Streptococcus pneumoniae
32
Q

What happens in the typical acute inflammatory response in lobar pneumonia? (3)

A

1) Fibrin Rich Exudate
2) Neutrophil Infiltration
3) Macrophage Infiltration

33
Q

What parts of the lungs does Bronchopneumonia affect?

A
  • Infection starting in airways
  • Spreads to alveoli
  • Consolidation is patchy
34
Q

Pathogens that can cause Bronchopneumonia (4)

A
  • Streptococcus pneumoniae
  • Staphylococcus aureus
  • Anaerobes
  • Coliforms
35
Q

Complications of Bronchopneumonia (4)

A
  • May leave fibrous scarring
  • Lung abscess
  • Bronchiectasis (recurrent pneumonia)
  • Empyema (pus in pleural cavity)
36
Q

What Investigations are done for the diagnosis of Pneumonia? (6)

A
  • Chest X-Ray
  • Oxygen saturation
  • ABGs
  • Full Blood Count
  • Urea, liver function tests and CRP
  • Cultures (blood and sputum)
37
Q

How are samples for cultures collected?

A
  • Drawing blood
  • Cough-up sputum
  • Endotracheal aspirates
  • Nose and throat swabs
  • Bronchoalveolar lavage (BAL)
  • Urine for antigens of legionella and
    pneumococcus
38
Q

What does CURB-65 stand for?

A
  • Confusion
  • Urea (>7mmol/L)
  • Respiratory Rate (>30)
  • Blood Pressure (Systolic<90, Diastolic<60)
  • Age (more than 65)
39
Q

What is the 1st-line Antibiotic used to treat Pneumonia?

A

Penicillin class first choice (amoxicillin)

40
Q

What Antibiotics are used to treat severe Pneumonia? (2)

A

Penicillin plus clavulanic acid (co-amoxiclav)

41
Q

What Antibiotics are used to treat Legionella?

A

Levofloxacin

42
Q

What classes of Antibiotics are used to treat “Atypical” Pneumonia? (2)

A
  • Tetracyclines
  • Macrolides
43
Q

What pathogen is Whooping Cough caused by?

A

Bordetella pertussis

44
Q

What is Whooping Cough?

A

A highly contagious bacterial infection of the lungs and airways that causes repeated coughing bouts that can last for two to three months

Respiratory System (19 decks)

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