Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pulm Path > Nichols handout > Flashcards

Nichols handout Flashcards

(85 cards)

Start Studying
1
Q

What are almost all acute bacterial pneumonias caused by?

A

aspiration of saliva containing the pathogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is an infiltrate?

A

radiologic manifestation of pneumonia or edema or hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is consolidation?

A

manifestations of alveoli filled with blood, pus, or water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the cell type during MOST acute bacterial pnuemonias?

A

neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is are neutrophils generally replaced by in acute bacterial pneumonia? When does this occur?

A

macrophages, usually beginning around day 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is characteristic of subacute bacterial pneumonia?

A

foamy macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What type of pneumonia is staph aureus? (alveolar necrotizing vs. non- necrotizing, interstitial, etc)

A

alveolar necrotizing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of pneumonia is legionella? (alveolar necrotizing vs. non- necrotizing, interstitial, etc)

A

alveolar non-necrotizing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of pneumonia is mycoplasma? (alveolar necrotizing vs. non- necrotizing, interstitial, etc)

A

alveolar non-necrotizing or interstitial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of pneumonia is influenza? (alveolar necrotizing vs. non- necrotizing, interstitial, etc)

A

interstitial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of pneumonia is Klebsiella? (alveolar necrotizing vs. non- necrotizing, interstitial, etc)

A

alveolar necrotizing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What type of pneumonia is strep pneumo? (alveolar necrotizing vs. non- necrotizing, interstitial, etc)

A

alveolar non-necrotizing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What type of pneumonia is pseudomonas aeruginosa? (alveolar necrotizing vs. non- necrotizing, interstitial, etc)

A

alveolar necrotizing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How common is strep pneumo and how is it acquired?

A

very common, community

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What patient population is strep pneumo most likely to effect?

A

older, men, preceding viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 4 phases of gross pathology of a pneumococcal pneumonia?

A

1: congestions with exudation
2: red hepatization
3: grey hepatization
4: slimy yellowish exudate: resolution without scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What days do the 4 phases of gross pathology of strep pnuemo occur?

A

1: day 1
2: days 2-3
3: days 4-7
4: day 8 and on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where does a pneumococcal pneumonia infection stop? Why?

A

lobar septum because its non-necrotizing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Microscopically, what are the phases of a pneumococcal pneumonia?

A

1: engorged septal capillaries, few RBCs
2: continuing congestion, extravastion of RBCs, numerous neutrophils, abundant fibrin in alveoli. Infection spreads through pores of Kohn
3: degenerating dead cells in alveoli, firbin nets through pores of Kohn: foamy macrophages replace neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the major symptoms of strep pneumo?

A

rusty-colored sputum, severe chills, sustained high fever

alcoholics: increased purulent sputum
old: confused, tired, cold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the signs of strep pneumo?

A

crackles, bronchial breath sounds, tachycardia (barely), tachypnea (mild), dullness to percussion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does the CXR for strep pneumo show?

A

lobar alveolar consolidation with segmental or subsegmental alveolar infiltrates without air bronchograms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What will a blood test of strep pneumo patient show?

A

elevated LDH, elevated bilirubin, bandemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What will the gram stain show for strep pneumo?

A

gram +, lacent shaped (if not already treated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is used to treat strep pneumo?
beta lactams
26
What is the prognosis for strep pneumo
excellent (usually) if treated
27
How common is staph aureus pneumo and how is it acquired?
common, community or hospital acquired
28
What are some risk factors for getting staph aureus pneumo?
S. aureus skin infection, nursing home, hospitalization, intubation, previous viral respiratory infection
29
How does staph infect? (virulence factors)
exotoxins: hemolysins protein A: binds TNFr1 and opens path for invasion between epithelial cells resistance to commonly used antibiotics
30
What does staph aureus pneumo look like on gross pathology?
heavy plum-colored lungs with numerous small abscesses | Commonly with pleuritis and empyema
31
What does staph aureus pneumo look like microscopically?
acute necrotizing bronchitis, bronchiolitis, and alveolitis with abundant neutrophils, fibrin, and edema fluid
32
What can the edema fluid in staph aureus pneumo become?
hyaline membranes
33
How common is hemorrhage in staph aureus pneumo?
Very common and usually prominent
34
What does staph aureus pneumo generally form on microscopic and gross pathology that may rapidly enlarge?
abscesses
35
What are the major symptoms of staph aureus pneumo?
cough (productive of purulent sputum-late), dyspnea, fever, chills, confusion
36
What are the signs of staph aureus pneumo?
fever, tachycardia, hypotension, tachypnea, crackles
37
What does a CXR of staph aureus pneumo look like?
bronchopneumonic infiltrates with abscesses and pleural effusions
38
What does a gram stain of staph aureus pneumo show?
gram + cocci in clusters (but not always in clusters)
39
What should staph aureus be treated with?
if sensitive: oxacillin | MRSA: vancomycin
40
What is the prognosis for staph aureus pneumo?
50% mortality when treated
41
How common is legionella? How is it acquired?
relatively common. community or hospital acquired, esp. from warm water sources
42
How does legionella infect?
attaches to respiratory epithelial cells and macrophages by flagellae and pili. Once intracellular, prevent fusion of phagosomes and lysosomes
43
What is significant about the transmission of legionella?
It cannot be transmitted person-to-person
44
What is the gross pathology of legionella?
bulging firm rubbery areas of consolidation
45
What is the microscopic pathology of legionella?
acute non-necrotizing alveolitis
46
What is significant about the type of cells present in acute infection of legionella?
macrophages infiltrate much earlier than mornal
47
What are the symptoms of legionella?
cough (dry or productive of mucoid sputum), diarrhea, high fever, headache, confusion, chills, rigor, dyspnea
48
What are some signs of legionella?
FEVER, bradycardia, crackles, confusion
49
What does a CXR of legionella show?
patchy unilobar bronchopneumonic infiltrate with pleural effusion (50%)
50
What organ, besides the lungs, is often affected by legionella?
liver
51
What change in electrolyte is suggestive of legionella?
hyponatremia
52
What does the gram stain of legionella usually show?
false negative, not helpful
53
What is the best (and rapid) way to test for legionella?
urine antigen test
54
How is legionella treated?
newer macrolides (azithromycin) or respiratory tract quinolones ( levofloxacin)
55
What is the typical prognosis of legionella?
good. <5% mortality in immunocompetent pts
56
How common is pseudomonas aeruginosa? How is it acquired?
common, hospital acquired
57
What are major risk factors for pseudomonas?
intubation and neutropenia
58
From where is pseudomonas transmitted?
water: inhaled or aspirated
59
What is significant about how pseudomonas lives within the body?
It will colonize before causing an infection.
60
What are pseudomonas virulence factors?
inherent resistance to many common antibiotics, form a biofilm, produce elastase and other enzymes and exotoxins
61
What is the gross pathology of pseudomonas?
firm red areas of hemmorhagic consolidation | yellow areas of consolidation with a rim of hemmorhage (target areas)
62
What is the microscopic pathology of pseudomonas?
acute necrotizing alveolitis with groups of long thin, almost filamentous bacilli invading blood vessels (pseudomonas vasculitis)
63
What are the symptoms of pseudomonas vasculitis?
cough productive of purulent sputum, dyspnea, fever, chills, confusion
64
What are the signs of pseudomonas?
fever, tachycardia, hypotension, tachypnea, pulmonary crackles
65
What does a CXR of pseudomonas show?
diffusely distributed bilateral bronchopneumonic infiltrates +/- nodular lesions, small abscesses, pleural effusions
66
What wil a gram stain of pseudomonas show?
long thin gram - bacilli with pointed ends
67
Why is culturing pseudomonas difficult?
positive sputum culture commonly only represents colonization
68
What is the treatment for pseudomonas?
combo of 2: antipsuedomal beta-lactam, antipseudomonal quinolone, aminoglycoside
69
What is the prognosis of pseudomonas if treated?
very bad. 87% mortality
70
How common is mycoplasma pneumonia and how and when is it acquired?
common, community acquired during fall and fall/winter
71
What is mycoplasma also called due to its presentation of symptoms?
walking pneumonia. Its an atypical pneumonia, so it isn't as severe
72
What is significant about the size of mycoplasma?
smallest of free-living organisms
73
What does mycoplasma look like on a gram stain?
invisible
74
How is mycoplasma transmitted? How does it infect?
person-to-person by respiratory droplets during close contact. It attached to respiratory epithelial cells by adherence proteins and cause illness that is largely immune-mediated
75
What does the gross pathology of mycoplasma show?
virtually nothing
76
What does the microscopic pathology of mycoplasma show?
lymphoplasmacytic bronchiolitis with mucosal ulceration and fibrinopurulent exudate in the lumen
77
What type of cells are affected by mycoplasma?
type II alveolar cells --> hyperplasia
78
What are the symptoms of mycoplasma?
insidious onset malaise, headache, anorexia, low fever, chills --> then: persistent incessant intractable dry cough
79
What are the signs of mycoplasma?
wheezing, crackles, sinus tenderness, pharyngeal mucosal erythema, tympanic membrane erythema, mild cervical lymphadenopathy, maculopapular skin rash
80
What does CXR of mycoplasma show?
patchy areas of airspace consolidation or reticulonodular infiltrate with pleural effusion, unilateral or bilateral usu lower lobes
81
What is WBC count usually in mycoplasma?
normal
82
What can cause cardiac arrhythmias and heart failure, along with meningitis or encephalitis?
mycoplasma
83
What bugs can cause pleural effusion?
mycoplasma pseudomonas (20%) staph aureus legionella (50%)
84
What is the treatment for mycoplasma?
azithromycin or levofloxacin
85
What is the prognosis of mycoplasma?
most recover with no sequelae

Pulm Path (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions