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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

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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)

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A
  • Legionella
  • Mycoplasma
  • Chlamydia spp
19
Q

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

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

Organisms Causing Hospital-Acquired Pneumonia (9)

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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?

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A

Occurs upon aspiration of exogenous material or secretions into lung

22
Q

What type of organism commonly affects immunocompromised patients?

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

What type of patients is Mycoplasma found in?

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

When are patients at risk of infection with Staphylococcus aureus?

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A

Post-Viral Infection

25
When are patients at risk of infection with Chlamydia?
Contact with birds
26
When are patients at risk of infection with Coxiella?
Contact with animals
27
What conditions put patients at risk of infection with Klebsiella? (2)
* Thrombocytopenia * Leucopenia
28
What are some Viral Pneumonia Causing Pathogens? (3)
* Influenza * Parainfluenza * Respiratory syncytial virus (RSV)
29
What are some effects of SEVERE Pneumonia?
* Lung Necrosis * Haemorrhage in to Lung Parenchyma * ARDS * High Mortality
30
What is SARS-CoV-2? What are the effects of infection?
* RNA Virus * Most sufferers have mild/moderate disease * Asymptomatic transmission important * Some patients develop severe pneumonia and multi-organ failure
31
What is Lobar Pneumonia? What pathogen most commonly causes this?
* Consolidation involving a whole lobe * Streptococcus pneumoniae
32
What happens in the typical acute inflammatory response in lobar pneumonia? (3)
1) Fibrin Rich Exudate 2) Neutrophil Infiltration 3) Macrophage Infiltration
33
What parts of the lungs does Bronchopneumonia affect?
* Infection starting in airways * Spreads to alveoli * Consolidation is patchy
34
Pathogens that can cause Bronchopneumonia (4)
* Streptococcus pneumoniae * Staphylococcus aureus * Anaerobes * Coliforms
35
Complications of Bronchopneumonia (4)
* May leave fibrous scarring * Lung abscess * Bronchiectasis (recurrent pneumonia) * Empyema (pus in pleural cavity)
36
What Investigations are done for the diagnosis of Pneumonia? (6)
* Chest X-Ray * Oxygen saturation * ABGs * Full Blood Count * Urea, liver function tests and CRP * Cultures (blood and sputum)
37
How are samples for cultures collected?
* Drawing blood * Cough-up sputum * Endotracheal aspirates * Nose and throat swabs * Bronchoalveolar lavage (BAL) * Urine for antigens of legionella and pneumococcus
38
What does CURB-65 stand for?
* Confusion * Urea (>7mmol/L) * Respiratory Rate (>30) * Blood Pressure (Systolic<90, Diastolic<60) * Age (more than 65)
39
What is the 1st-line Antibiotic used to treat Pneumonia?
Penicillin class first choice (amoxicillin)
40
What Antibiotics are used to treat severe Pneumonia? (2)
Penicillin plus clavulanic acid (co-amoxiclav)
41
What Antibiotics are used to treat Legionella?
Levofloxacin
42
What classes of Antibiotics are used to treat "Atypical" Pneumonia? (2)
* Tetracyclines * Macrolides
43
What pathogen is Whooping Cough caused by?
Bordetella pertussis
44
What is Whooping Cough?
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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