Pneumonias

Question 1

summarize the differences between lobar pneumonia and bronchopneumonia

Answer 1

Question 2

describe the phase seen in the image

Answer 2

Question 3

describe the phase seen in the image

Answer 3

Question 4

describe the phase seen in the image

Answer 4

Question 5

describe resolution (as seen in lobar pneumonia)

Answer 5

Question 6

____ is the most common organism involved in community-acquired acute pneumonia

Answer 6

S.pneumoniae is the most common organism involved in community-acquired acute pneumonia

Question 7

which patients are most susceptible to S. pneumoniae infection?

Answer 7

• underlying chronic disease: CHF, COPD, DM
• underlying congenital or acquired immunoglobulin deficiency
• decreased splenic fxn

Question 8

describe community-acquired atypical pneumonia

Answer 8

• atypical = moderate or no sputum, absence of signs of consolidation, moderate leukocytosis, lack of alveolar exudates
• acute febrile illness
• patchy or whole lungs
• largely confined to the alveolar septal walls (intersititum)

Question 9

___ is the most common organism involved in community-acquired atypical pneumonia

name other organisms

Answer 9

Mycoplasma pneumoniae (intracellular) is the most common organism involved in community-acquired atypical pneumonia

• Chlamydia pneumoniae (intracellular), Chlamydia psittaci (intracellular), Coxiella burnetti (intracellular), Francisella tularensis
• viral = influenza types A and B, RSV, human metapneumovirus, adenovirus, rhinovirus, rubeola, VCV

Question 10

describe clinical signs of Mycoplasma pneumoniae

Answer 10

• usually occurs in younger age groups
• fever, nonprodctive cough, dyspnea
• rashes (trunk, extremities)
• hematologic effects are common
  
  • anemia (hemolytic)
  • cold agglutinins
• reticular opacities on CXR

Question 11

describe patients that are susceptible to hospital-acquired pneumonia

Answer 11

• common in:
  
  • patients with underlying lung disease
  • the immunocompromised
  • patients with prolonged antibiotic regimens
  • catheters, ventilators

Question 12

which organisms commonly cause hospital-acquired pneumonia?

Answer 12

• G-ve organisms
  
  • Klebsiella, E. coli, Pseudomonas

Question 13

describe lung abscesses

Answer 13

• cavity in the lung secondary to suppurative destruction of lung parenchyma
• mechanism
  
  • aspiration
  • complication of necrotizing bacterial pneumonia
  • obstruction
  • secondary infection of TB cavity
  • septic emboli
  • hematogenous spread of bacteria
• more common on the right side
• rupture can lead to empyema

Question 14

describe clinical signs of a lung abscess

Answer 14

• clinical:
  
  • cough with copious, foul sputum
  • hemoptysis
  • spiking fever
  • malaise
  • clubbing of fingers
  • weight loss
  • anemia

Question 15

describe complications of a lung abscess

Answer 15

• complications:
  
  • bronchopleural fistula
  • empyema, septicemia → meningitis, brain abscess
  • amyloidosis

Question 16

describe chronic pneumonia in immunocompetent vs. immunocompromised

Answer 16

Question 17

name the dimorphic fungi

Answer 17

• histoplasmosis
• coccidiomycosis
• blastomycosis

Question 18

describe Histoplasma capsulatum

Answer 18

Question 19

describe Coccidiodes immitis

Answer 19

Question 20

describe Blastomyces dermatitidis

Answer 20

Question 21

name a virus that can cause pneumonia in immunocompromised patients

Answer 21

cytomegalovirus

Question 22

name a fungi that can cause pneumonia in immunocompromised patients

Answer 22