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PTH560 Pathology > Exam 2 - respiratory infections > Flashcards

Exam 2 - respiratory infections Flashcards

(57 cards)

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1
Q

What are the two classifications of Pneumonia

A

-community acquired (CAP)
(typical and atypical)

-nosocomial (aka hospital acquired)

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2
Q

typical CAP: most commonly caused by

A

bacterial: strep pneumoniae

- in top 10 causes of death in US

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3
Q

Typical CAP: bronchopneumonia

A
  • bronchitis -> pna
  • locations = lower lobes, RML
  • patchy consolidations (microabscesses)
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4
Q

Typical CAP: lobar pneumonia

A

consolidation of lobe (complete or incomplete)

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5
Q

typical CAP: pathogenesis

A

most common: microaspiration of oropharyngeal contents during sleep

second most common: aerosol inhalation

uncommon: blood stream infection

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6
Q

typical CAP: clinical findings

A
  • sudden high fever
  • productive cough
  • CP
  • tachycardia

Consolidation signs =

  • dullness to percussion
  • inspiratory crackles
  • bronchial breath sounds
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7
Q

typical CAP: chest X-ray (CXR), labs

A
  • screen
  • patchy infiltrates (bronchopneumonia)
  • lobar consolidation

labs: gram + stain, leukocytosis, blood cultures

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8
Q

Nosocomial pneumonia: risk factors

A
  • **respirators = most common
  • underlying disease
  • antibiotics
  • immunosuppression
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9
Q

Nosocomial pna bugs

A

Gram (-) = pseudomonas, E.coli

Gram (+) = staph. aureus

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10
Q

Rhinovirus

A

most common cause of common cold

transmission: hand-to-eye/nose

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11
Q

Coxsackievirus

A

-acute chest syndrome

fever, pleuritis

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12
Q

Parainfluenza

A

-most common cause of CROUP!!

CXR: steeple sign (mucosal edema in trachea)

treatment: cold water humidifiers, aerosolized racemic epinephrine

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13
Q

Cytomegalovirus (commonly cause, pathology, treatment)

A
  • common cause of pna in immunocompromised
  • pathology: enlarged macrophages and pneumocytes
  • Treatment: anti-virals
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14
Q

What are the 2 classifications of influenza?

A
  • Type A (most common, worldwide epidemics)

- Type B (major outbreaks)

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15
Q

Hemagglutinins vs neuraminidase

A
  • hemagglutinins: protein on virus. how it binds to cells in nasal passages
  • neuraminidase: disolves mucus. facilitates release of virus
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16
Q

Influenze: clinical findings and associations

A

clinical finding: fever, headache, cough, muscle/chest pain

associations:
- guillain-barre syndrome
- Reye syndrome

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17
Q

Influenza treatment

A
  • prevention = vaccinate
  • neuraminidase inhibitors
    (i. e., tamiflu - within 48 hrs of sx)
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18
Q

Rubeola: Measles (pathology and clinical findings)

A
  • patho: Warthin-Finkeldey multinucleated giant cells

- clinical findings: Koplik spots in mouth before rash, rash, fever, cough, conjunctivitis, nasal mucus)

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19
Q

Respiratory syncytial virus

A
  • **Most common cause of pna and bronchiolitis in infants
  • winter illness
  • pathology = fusion protein
  • you want to vaccinate high risk kids
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20
Q

Mycoplasma pneumoniae

A
  • most common cause of atypical pna (***“walking pna”)
  • patient pop = teens, military recruits
  • symptoms: insidious onset, low-grade fever
  • other pathology = cold agglutinins in blood
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21
Q

Chlamydia trachomatis

A

***NEWBORN PNA (infected during birth)

-symptoms: afebrile, choppy cough, conjunctivitis, wheezing

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22
Q

Coxiella burnetii

A
  • associated with: birthing process of infected animals, milking, handling of animal waste (vets, dairy farmers)
  • clinical findings: atypical PNA, myocarditis, hepatitis
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23
Q

Streptococcus pneumoniae

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A
  • most common cause of typical CAP
  • Gram (+) diplococcus
  • rapid onset of sx = productive cough, consolidation signs
24
Q

Staphylococcus aureus

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A
  • Common pts: influenza, measles, CF, IVDA
  • yellow sputum

pathology: Gram (+), ABSCESSES!!!, pneumatoceles, hemorrhagic pulmonary edema

25
Bacillus anthracis: classifications
Cutaneous anthrax - direct contact with contaminated animal products - eschar formation with central necrosis Pulmonary anthrax - "first sign is death" - inhalation of spores - findings = necrotizing PNA, meningitis, splenomegaly
26
Bacilus anthracis (pathology)
- Gram (+) rod | - EXOTOXINS!!: edema factor, lethal factor, protective antigen
27
Bordetella pertussis
WHOOPING COUGH!!! patho: - Gram (-) rod - droplet transmission - bacteria pili attach to cilia in resp tract - toxin (blahhhh)
28
Haemophilus influenzae
***most common bacterial cause of COPD exacerbations - Gram (-) rod causes: epiglottitis, sinusitis, otitis media, conjunctivitis
29
Moraxella catarrhalis
- common cause of typical PNA (especially elderly!) - major cause of COPD exacerbations - also causes (chronic bronchitis, sinusitis, otitis media -Gram (-) diplococcus
30
Pseudomonas aeruginosa
"respirator PNA" ******* - most common cause of nosocomial PNA in CF - green sputum - vessel invasion (pulmonary infarctions)
31
Klebsiella pneumoniae
- typical PNA - patho (gram (-) rod - elderly nursing home pts - ALCOHOLICS**** - blood-tinged sputum
32
Legionella pneumophilia (main info)
-atypical PNA -****sources (moist places) -patho: ****"Water loving bacteria"*** Gram (-) risk factors: EtOH, smokers, immunosuppression
33
Legionella pneumophilia: clinical findings and screens
- clinical findings: high fever, dry cough, flu like sx | - screen: *****antigens in urine!
34
Yersinia pestis (the plague): transmission and reservoir
Transmission - rat flea bite!!**** - person to person via droplet reservoir -***ground squirrels
35
Yersinia pestis: the plague (pathology)
- V and W antigens: provide protection and macrophages cannot kill it - Gram (-) rod
36
Yersinia pestis: the plague (classifications)
- bubonic (most common, rat flea bite, infected lymph nodes, drain to surface) - pneumonic (aerosol transmission) - septicemic
37
Mycobacterium tuberculosis
- TB - strict aerobe - **ACID-FAST - resides in phagosomes of macrophages - produces CORD FACTOR (protein that prevents lysosome fusion, provides virulence)
38
TB screening
- purified protein derivative - intradermal skin test - CANNOT differentiate active vs inactive -(+) test detected bacterium cell wall protein
39
Primary TB
location: *** upper lower lobes and lower upper lobes!!!***
40
Secondary TB
- reactivation of primary TB - location: **** apices of lungs!** (greatest O2 saturation) - cavitary lesion (release of cytokines by memory T cells)
41
TB: clinical findings
- fever - night sweats - weight loss - hemoptysis - bronchiectasis - scar carcinoma
42
Extrapulmonary TB
- kidneys = most common - adrenals = addison disease - vertebrae = Pott disease
43
TB diagnosis and treatment
Diagnosis: screen treatment: triple therapy * ***Treat 9-12 months!!!*****
44
Cryptococcus neoformans: what and where you find
- fungus (budding yeast) - environmental locations: * ***Pigeon waste, windows, bridges, near buildings***
45
Cryptococcus neoformans: clinical findings
- lung disease (granulomatous inflammation, caseation) | - infects (immunocompetent and immunocompromised)
46
Aspergillus fumigatus: structure
-fungus (fruiting body) Asperilloma: ***fungus ball!*
47
Aspergillus fumigatus: pathology
- invades vessels*** | - necrotizing PNA***
48
Mucor species
- fungus (wide angled, no septa) - pulmonary vessel invasion - in people with DIABETES!!!***
49
Coccidioides immitis
- fungus (***SPHERULES**) - found in: ***deserts (valley fever) and earthquakes *** - pulmonary granulomatous inflammation - flu-like symptoms and erythema nodosum
50
Histoplasma capsulatum
* **most common systemic fungal infection** - yeast found in macrophages * ***-locations***: mississippi river valley!!!!!*
51
Blastomyces dermatitidis
- ***yeast with broad-based buds*** - found in ****great lakes*** - associated with ***outdoor activities*** - skin lesions similar to SCC
52
Pneumocystis jiroveci
- similar to fungi in structure * ***most common pathogen causing PNA in AIDS - patho: produces cysts, produces tropozoites
53
P. jiroveci clinical findings
- fever - dyspnea - hypoxemia - intra-alveolar exudates
54
Causes of lung abscesses (4)
- oropharyngeal material aspiration - bacterial PNA - septic emboli - obstructive lung tumor
55
Aspiration
- **most common cause of lung abscess - risk factors (alcohol, LOC, dental work) Pathogens: mixed aerobic and anaerobic (anaerobes 60%)
56
Lung abscess: gross pathology
-size and location vary | aspiration abscesses generally on Right side
57
Lung abscess **
- ***productive cough (foul sputum)**** - CXR: ***cavitation*** with air fluid level - treatment: abx and bronchoscopy

PTH560 Pathology (15 decks)

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