Culture, chest films, physical examination

Class 6 - Respiratory 2 Flashcards by a w

Pneumonia

Inflammation of the lungs. Can be infection (bacterial/viral) that affects one or both lungs

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Pneumonia Incidence

Very common, worldwide leading cause of death. Viral m/c in children, Bacterial m/c in adults

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Pneumonia Risk Factors

Smoking, acute respiratory infections, chronic bronchitis, illness, age (young or old)

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Community acquired pneumonia

Streptococcus (m/c), haemophilus influenza

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Hospital-acquired pneumonia

Staphylococcus aureus

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Alveolar pneumonia

involves alveoli

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Interstitial pneumonia

involves septa

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Bronchopneumonia

limited to segmental bronchi

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Lobar pneumonia

widespread or diffuse

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Pneumonia upper respiratory flora

Streptococcus, Staphylococcus, Haemophilus

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Pneumonia Enteric Saphrophytes

*
* Candida albicans (rare)

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Pneumonia Extraneous pathogens

- Mycobacterium tuberculosis, viruses

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Pneumonia routes of infection Inhalation

pathogens in air droplets

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Pneumonia routes of infection Aspiration

Of infected secretion from URT, infected particles from GI

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Pneumonia routes of infection Hematogenous

Spread from sepsis

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Pneumonia Clinical Manifestations

chest pain, productive cough, brown/green sputum, dyspnea, headache, chills, fever

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Pneumonia Diagnosis

- Culture, chest films, physical examination

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Pneumonia Treatment

Antibiotics, rest, fluids, medications, vaccinations

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Pneumonia Complications Pleuritis

pus can fill pleural cavity (empyema). Lungs cannot expand during inspiration (fibrosis), leading to restrictive lung disease

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Pneumonia Complications Abscesses

Highly virulent bacteria, destroys lung parenchyma. Pus causes destruction of walls, leads to bronchial dilation.

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Pneumonia Complications Chronic Inflammation

Pneumonia unresponsive to treatment, destruction of lung parenchyma and fibrosis - looks like honeycomb lungs on x-ray

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Pneumocystis Jirovecii Pneumonia (PCP)

Idiopathic, often fatal fungal pneumonia

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Pneumocystis Jirovecii Pneumonia (PCP) Risk factors

immunosupression , chemo, transplantation, malnutrition

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Pneumocystis Jirovecii Pneumonia (PCP) Diagnosis/Treatment

culture lab tests, antifungal meds

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Legionnaires Disease

Rare pneumonia infectious disease, causes massive consolidation (fluid in lungs) and necrosis of lung tissue. Treatment - antibiotics

Pulmonary TB

Infectious, inflammatory disease of lungs that may involve lymph nodes and other organs

Primary Pulmonary TB

* * Infection usually aymptomatic

Secondary Pulmonary TB

When primary infection becomes active cause of lower resistance

Pulmonary TB Incidence

2 billion cases worldwide, highest in SE asia, africa, eastern europe

Pulmonary TB Etiology

* * Mycobacterium tuberculosis

Pulmonary TB Risk Factors

Immunocompromised, elderly, overcrowding, drugs, malnutrition, poor health

Pulmonary TB cause of increased risk of advanced disease

smoking

Pulmonary TB Pathogenesis

Granulomas with caseous necrosis (Type IV HS reaction)

Pulmonary TB Ghon Complex

* X ray of lymph node involvement, fibrosis

Pulmonary TB Clinical manifestations

**Hymoptysis (blood cough)** , Productive cough, weight loss, fever, **night sweats**, fatigue

Pulmonary TB diagnosis

History, PE, Tuberculin skin test, culture sputum

Pulmonary TB treatment

Medications

Lung Abscess

accumulation of purulent exudate within the lung. Usually complication of pneumonia

Lung Abscess Etiology

poor oral hygiene, alcohol, drugs, altered consciousness, older patients. M/c due to aspiration are anaerobic bacteria

Lung Abscess Pathogenesis

Inflammation, tissue necrosis, usually ruptures into bronchus. Erodes bronchial walls and patients get bad breath

Lung Abscess Clinical Manifestations

Productive cough, foul-smelling sputum, fever, chills,

Lung Abscess Diagnosis

* * X-ray, sputum analysis, imaging

Lung Abscess Treatment

Antibiotics, percussion, good nutrition, drainage

Chronic Obstructive Pulmonary Disease

Chronic airflow limitation that is not fully reversible

COPD Types

Chronic bronchitis, emphysema

Chronic bronchitis diagnosis

Productive cough lasting at least 3 months per year for 2 consecutive years

Emphysema

Destruction of lung parenchyma and pathological accumulation of air in lungs

COPD Etiology/risk factors

* * Smoking, age, genetics

Pathogenesis of Chronic Bronchitis

Inflammation and bronchoconstriction. Increased mucus production, leading to increased infection risk

COPD clinical manifestation

Productive cough, SOB, cor pulmonale, malaise, recurrent infection

Pathogenesis of Emphysema

Destruction of elastin protein causes narrowing or collapse of bronchioles which traps air in lungs

Emphysema Blebs and bullae

Blebs (small pockets of trapped air) Bullae (large pockets of trapped air)

Emphysema Clinical Manifestation

Exertional dyspnea, thin, barrel chest, tachypnea, anxiety, wheezing, cough

COPD Diagnosis

History, physical exam, pulmonary function tests, x-ray, CT, blood tests

COPD Treatment

Quit smoking, medications, airways clearance, exercise, avoiding irritants, diet, oxygen, surgery

COPD Prognosis

Poor, mortality rate 10 years after diagnosis >50%

Bronchiectasis

Obstructive lung disease characterized by irreversible destruction and dilation of airways – Generally with chronic bacterial infections and cystic fibrosis

Bronchiectasis Etiology/Risk factors

Cystic Fibrosis, any condition producing of narrowed lumen of bronchioles (tb, viral, pneumonia)

Bronchiectasis Pathogenesis

Frequent infections/inflammation causing mucus and fibrosis

Bronchiectasis Clinical Manifestations

persistent coughing, dyspnea, fatigue, weight loss

Bronchiectasis Treatment

Bronchodilators, Antibiotics, Corticosteroids, hydration, surgery

Bronchiectasis Diagnosis

Imaging, history, clinical manifestation, genetic testing

Class 6 - Respiratory 2 Flashcards

(62 cards)