Pathology of Pulmonary Infection Flashcards by Sarah Anderson

What are micro-organisms three pathways of pathogenicity

Primary - infectious on their own
Facultative - Need additional help to infect
Opportunistic - Hit you when your immune system is low

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What does your capacity to resists infection depend on

state of the hosts defence mechanism

Age of the host (new born and elderly most at risk)

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Is the Upper respiratory tract Sterile or not?

Not sterile

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What are examples of URT infections

Crazy- common cold
Sore throat syndrome
Acute Laryngotracheobronchitis (Croup) - swelling of windpipe 
Laryngitis
Sinusitis
Acute Epiglottitis

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Is the lower respiratory tract sterile or non sterile

Sterile

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What are examples of LRT infections

Bronchitis
Bronchiectasis
Pneumonia

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What are upper respiratory tract defence mechanisms

The nose acts as a filter
URT is moist anf lined with cilla
Allows large particle deposition

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What is the lower respiratory tract defence mechanism

Macrophage-mucociliary escalator system

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What are the three mechanism of the Macrophage-mucociliary escalator system

and over all function

ALVEOLAR MACROPHAGES

MUCOCILIARY ESCALATOR

COUGH REFLEX

beat in a corrdianted fashion to move the alveolar macrophages and mucous up and out of the lungs

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What is the alternative pathway of the alveolar macrophages

Rather than moving up the throat they can leave the throat wall and enter the interstitial pathway via lymph tp the lymph nodes

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What is the effect of viral infection e.g. influenza on the

Macrophage-mucociliary escalator system

Can destroy epithelium so no longer has cilla

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What are you more likely in catching if virus infection destroys epithelium

Bacterial infection

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What are the 6 different aetiologies of pneumonia

Community Acquired Pneumonia
Hospital Acquired (Nosocomial) Pneumonia
Pneumonia in the Immunocompromised
Atypical Pneumonia
Aspiration Pneumonia
Recurrent Pneumonia

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How does atypical pneumonia occur

the infection is caused by different bacteria than the ones that cause typical pneumonia

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How does Aspiration Pneumonia occur

lung infection that develops after you aspirate (inhale) food, liquid, or vomit into your lungs

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Define recurrent Pneumonia

Pneumonia that reoccurs more than twice in a year

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What is the different patterns of pneumonia

Bronchopneumonia - bronchioles
Segmental - parts of the lungs
Lobar - whole lobe

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What is the complications with pneumonia?

Pleurisy - inflammation of pleura

Emphysema - a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness.

Lung abscess

Fibrous organisation resulting constrictive bronchiolitis or mass lesion

Bronchiectasis

cryptogenic organising pneumonia

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What is cryptogenic organising pneumonia

is a form of non-infectious pneumonia that is an inflammation of the bronchioles (bronchiolitis) and surrounding tissue in the lungs.

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What is Bronchiectasis

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abnormal widening of the bronchi or their branches, causing a risk of infection

As the damaged dilated airways have thickened airway wall and increased mucus production

What is the causes of lung abscess

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Obstructed Bronchus: tumour or foreign body
Pneumonia Aspiration
Particular Microorganism (Staph aureus, some pneumococci, Klebsiella)
Metastatic in Pyaemia - Pus in the blood
Necrotic Lung

What is the potential causes for Bronchiectasis

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Sever or repetitive infections
Lung tissue destruction
Bronchial obstruction

Symptoms of bronchiectasis

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Daily Cough
Daily copious purulent 
sputum production (> 2 tsps/day)
Occasional haemoptysis
Chest Infections frequent

What are the signs for bronchiectasis

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Finger clubbing, lung crackles on inspiration & expiration

What are the causes of pneumonia aspiration

``` Vomiting Oesophageal Lesion Obstetric Anaesthesia Neuromuscular Disorders Sedation ```

Where is aspiration pneumonia most likely to occur

Right bronchus (where objects are most likely to get lodged due to the angle)

What is the treatment options for bronchiectasis

Antibiotics Surgery - possible if localised Postural Drainage

How does empyema occur in pneumonia

In pneumonia, a collection of fluid may form between the two pleural layers occasionally, microorganisms will infect this fluid

Beyond bronchiole terminal how does air move

By diffusion

What is hypostatic pneumonia

patients has lots of accumulation of fluid in the lung

What is the cause of hypostatic pneumonia

chronic bronchitis | pulmonary odema

Is there any air in lobar pneumonia?

What is the normal alveolar partial pressure for pulmonary gas exchange

Normal PaO2 10.5 – 13.5 kPa | Normal PaCO2 4.8 – 6.0 kPa

What does airflow across the alveoli to the blood depend on

The blood air pressure difference

What are the four abnormal states associated with Hypoxiemia

Ventilation / Perfusion imbalance - V/Q Diffusion impairment Alveolar Hypoventilation Shunt

What do all vessels do if there is arterial hypoxemia and why do they do this

Constrict | Protective mechanism not to send blood to alveoli short of oxygen

What is the two respiratory failures

Type 1 Pa Oxygen decrease below 8Kpa | Type 2 Pa CO2 increases above 6KPa

What two abnormal states causes hypoxemia in broncho/lobarpneumonia + bronchitis

bronchopneumonia + bronchitis - Ventilation / Perfusion abnormality (mismatch) Severe bronchopneumonia and lobar pneumonia - Shunt

How do you decreases hypoxemia in pneumonia due to ventilation perfusion mismatch

Increase oxygen levels

What is not an issue in Ventilation / Perfusion abnormality (mismatch)

CO2 retention

In a shunt how does it respond to an increase in oxygen

poorly

Is ventilation occurring in Ventilation / Perfusion abnormality (mismatch) or shunts?

V/Q - Yes, some | Shunt - No

What causes the type 2 respiratory failure when Pa CO2 to high

alveolar hypoventilation

Why does a pulmonary shunt not respond to an increase in oxygen

as is doesn't contact ventilated alveoli

How does alveolar hypoventilation increase ventilation drive

cant move air out of the lungs, this increase PCO2 therefore decrease PO2, resulting in an increase in ventilation drive to increase inspired oxygen

What is Chronic (Hypoxic) Cor Pulmonale

Hypertrophy of the Right Ventricle resulting from disease affecting the function and/or the structure of the lung,

What is the effect of Cor Pulmonale

Pulmonary vasoconstriction Loss of capillary bed Secondary polycythaemia - increase in RBC

Why does pathological large shunts respond poorly to increased oxygen

as the blood leaving the lung is already 98% saturated | a shunt only affect 2-4% of the blood

Pathology of Pulmonary Infection Flashcards

(48 cards)