Pathoma Pulmonary Infections Flashcards Preview

CPR Week 6 > Pathoma Pulmonary Infections > Flashcards

Flashcards in Pathoma Pulmonary Infections Deck (49)
Loading flashcards...
1

Pneumonia

Infection of the lung parenchyma

2

Normal cause of Pneumonia

Occurs when normal defenses are impaired

3

Clinical features of PNA

Fever and chills, cough with yellow green or rusty sputum, tachypnea with pleuritic chest pain, decreased breath sounds with dullness to percussion

4

Labs for PNA

Elevated WBC count

5

3 chest x ray patterns involving Penumonia

Lobar PNA - Whole lobe consolidated

Bronchopneumonia - Consolidation in patchy pattern on airways

Interstitial pneumonia - N oconsolidation, just inflammation in the interstitium. Increased in lung markings

6

CXR for bacterial PNA

Lobar and broncho PNA

7

CXR for viral PNA

Interstitial PNA

8

Most common causes of lobar PNA

Strep Pneumonia in 95%
Klebsiella pneumonia in 5% or less

9

Which PNA is associated with community-acquired?

Streptococcus Pneumoniae

10

Which PNA is associated with malnourished or debilitated individuals like in nursing homes?

Klebsiella Pneumoniae?

11

Regarding Klebsiella PNA, we typically see this PNA etiology and complication:

Thick mucoid capsule results in gelatinous sputum (currant) jelly.

Often complicated by abscess

12

4 phases of lobar pneumonia

1. Congestion - congested vessels and edema

2. Red Hepatization - Develop exudate in the lung with blood and neutrophils, making a thick, tougher lung over spongy normal one

3. Grey Hepatization - RBCs break down

4. Resolution - Resolve exudate and heal

13

Discuss lung healing and the most important cell involved

Type II pneumocyte which a stem cell of the lung that regenerates the lung.

14

How does bronchiopneumonia look?

Scattered, often bilateral. Centered around bronchioles

15

There are 5 bacteria associated with bronchopneumonia:

1. Staph Aureus

2. H Influenza

3. Pseudomonas aeruginosa

4. Moraxella Catarrhalis

5. Legionella Pneumophila

16

This bacteria is seen in cystic fibrosis patients who have bronchopneumonia

Pseudomonas Aeruginosa

17

This bacteria is seen in community acquired pneumonia patients who have bronchopneumonia

H. Influenza
M. Catarrhalis
L. Pneumophila

18

This bacteria is seen superimposed on COPD patients patients who have bronchopneumonia

H. Influenza
M. Catarrhalis
L. Pneumophila

19

This bacteria is seen in patients who have bronchopneumonia and is often associated with an abscess and empyema, which is pus

S. Aureus

20

This bacteria is seen in patients who have bronchopneumonia and are immune compromised

L. Pneumophila

21

This bacteria is associated with bronchopneumonia and is superimposed on a viral upper respiratory infection

S. Aureus

22

This bacteria is best visualized on a silver stainm and is associated with bronchopneumonia

L. Pneumophila

23

This bacteria is associated with bronchopneumonia and is the most common cause of secondary pneumonia

S. Aureus

24

Presentation of interstitial pneumonia, also called atypical PNA

Diffuse infiltrates

Presents with relatively mild upper respiratory symptoms like minimal sputum, cough, and low fever

25

Most common cause of atypical PNA in infants

RSV - Respiratory Syncytial virus

26

This atypical pneumonia is associated with post transplant immunosuppressive therapy

Cytomegalovirus (CMV)

27

Most common cause of atypical PNA, usually in young adults

Mycoplasma pneumoniae

28

Complications of atypical pneumoniae caused by Mycoplasma pneumoniae

1. Autoimmune hemolytic anemia (IgM against I antigen on RBCs causes cold hemolytic anemia)

2. Erythema multiforme

29

Why can't we visualize Mycoplasma pneumoniae on a gram stain?

No cell wall

30

Second msot common cause of atypical pneumonia

Chlamydia pneumoniae

31

This causes an atypical pneumonia of the elderly or immune compromised or those with preexisting lung disease

Influenza virus

32

Typically atypical pneumonia does not present with a high fever, but with this organism, it does:

Coxiella Burnetti

33

What is special about Coxiella Burnetti?

It is rickettsial, but it distinct because

1. Causes pneumonia

2. Does not require arthropod vector for transmission (survives as highly heat-resistant endospores)

3. Does not produce a skin rash

34

This organism increases the risk for superimposed S. Aureus or H. Influenza bacterial pneumonia

Influenza virus

35

This organism puts farmers and vets at risk for developing atypical pneumonia

Coxiella burnetti

36

Who gets Aspiration Pneumonia?

Those at risk for aspiration...idiot

Like alcoholics and comatose patients, and Nick

37

What causes aspiration pneumonia? Give top 3 examples

Anaerobic bacteria in the oropharynx like:

1. Bacteroides
2. Fusobacterium
3. Peptococcus

38

spiration Pneumonia classically results in what?

Right lower lobe abscess

39

What causes tuberculosis?

Inhalation of aerosolized Mycobacterium tuberculosis

40

What is primary TB?

Results from initial exposure of M. Tuberculosis

41

Symptoms of primary TB

Usually asymptomatic

42

Describe what is happening biologically with primary TB

Results in focal caseating necrosis in the lower lobe of the lung and hilar lymph nodes. The foci undergo fibrosis and calcification, forming a Ghon complex.

43

What is secondary TB and who gets it the most?

Its when you have a reactivation of your TB, usually seen in AIDS and sometimes with aging

44

Where does Secondary TB hit and what does it lead to

Occurs at the apex of the lung

Forms a cavitary foci of caseous necrosis, may also lead to miliary pulmonary TB or tuberculosis bronchopneumonia

45

Presentation of Secondary TB

1. Fever and night sweats
2. Cough with hemoptysis
3. Weight loss

46

Biopsy/staining of secondary TB shows what?

Biopsy reveals caseating granulomas

AFB stain reveals red acid-fast bacilli

47

Secondary TB can spread to any tissue. What are the top three and what do they cause?

1. Meninges leading to meningitis
2. Kidney which can lead to sterile pyuria
3. Lumbar vertebrae leading to Pott Disease

Can also go to cervical lymph nodes but everything does.

48

What is the most common organ affected by secondary TB?

Kidney

49

With Meningitis caused by Secondary TB, which ones are most affected and how do we know?

The base of the brain, you'll see granulomas there