CSIM1.70 Respiratory D/z 1

Question 1

Describe bronchopneumonia

Answer 1

Most common pneumonia

Infection of airways, bilateral, bronchi/bronchioles

Question 2

What organisms cause bronchopneumonia?

Answer 2

Strep pneumoniae, h influenzae, staphylococcus and pseudomonas in immunocompromised

Question 3

What pathological features can be seen in bronchpneumonia?

Answer 3

Lung consolidation = alveoli filled with fibrin, blood, fluid, inflammatory cells, macrophages and fibroblasts

Multifocal exudates

Question 4

Difference between bronchopneumonia and lobar pneumonia

Answer 4

Lobar pneumonia is more widespread, infection goes deeper into the lungs, covers a larger area.

Question 5

Common cause of lobar pneumonia?

Answer 5

Pneumococcus, staphylococcus, klebsiella in diabetics and alcoholics

Question 6

Progress of lobar pneumonia

Answer 6

1st stage - red hepatisation: alveoli fill with blood in response to toxins and pathogens, consolidates and haemorrhages

2nd stage - grey hepatisation - consolidations solidify due to inflammation and fibrosis.

Question 7

Possible sequlae of lobar pneumonia?

Answer 7

Resolution if treated
If not
Abscess, empyema, septicaema, fibrosis/scarring

Question 8

Difference between atypical pneumonia and typical pneumonia?

Answer 8

More varied clinical features

No consolidations/suppurations, no acute inflammatory response

Question 9

Where does atypical pneumonia pathology occur?

Answer 9

In the lung interstitium, among the pneumocytes and capillaries.

Question 10

What pathological features does atypical pneumonia cause?

Answer 10

Edema and monocytic infiltrate

Question 11

What is hyaline membrane formation?

Answer 11

Occurs at the edges of alveolar membrane, inflammation causes it become fibrotic and damaged.

Question 12

What are common causes of atypical pneumonia in immunocompetent and immunosuppresed patients?

Answer 12

Competent - mycoplasma, chlamydia, legionella, VZV

Suppressed - PCP, aspergillus, candida, CMV, HSZ, VZV

Question 13

What is a lung abscess?

Answer 13

Complication of pneumonia, localised suppurations caused by necrotic infections. More common in right lung

Question 14

How can infections be introducd into the lung?

Answer 14

Aspirations, obstructive tumors, direct trauma, infections from other organs

Question 15

What causes TB, what stain is used?

Answer 15

Mycoplasma tuberculosis, ziehl-nielsen stain.

Question 16

Transmission of TB?

Answer 16

Inhalation

Question 17

Describe primary infection of TB

Answer 17

TB goes to lungs, causesd granulamatous response forming a Ghon focus.

Can spread to lymph nodes which is called a Ghon complex.

Usually heals by itself with some calcification and scarring.

Question 18

What causes disease with TB infection?

Answer 18

The secondary reactivation or reinfection.

Due to sensitisation from primary infection.

Causes type 4 hypersensitivity reaction.

Bacteria causes granulomas + T cell response = necrotising granulomas = casseous necrosis

Question 19

Symptoms of TB

Answer 19

Fever, night sweats, weight loss, productive cough and haemoptysis.

Question 20

Where in the lung are TB lesions usually found?

Answer 20

Apices, more oxygen there.

Question 21

What complications can arise from TB?

Answer 21

Spread to entire lung - tuberculosis bronchopneumonia

Spread to blood - miliary TB

Spread to other organs, adrenal glands, kidney, female genital tract.