Pneumonia

Question 1

what is pneumonia?

Answer 1

Inflammation and consolidation of lung tissue due to an infectious agent

– Consolidation is an inflammatory induration of a normally aerated lung due to cellular exudative in alveoli

Question 2

key points in epidemiology

incidence, gender, seasonal, mortality rate

Answer 2

Incidence rate: is higher in kids between 0-4 yo and people older than 65 years.

By gender: it is more common in males.

Seasonal average: there is a raise in the cases during january, mainly because the characteristics of the air is difference and the habit of not ventilating spaces (air is no humidified enough, so our body produce more mocus, and we tend to be more comfortable in closed not ventilated spaces).

Mortality rate: it is really high

Question 3

factors favoring colonization

4

Answer 3

1. disruption of mucociliary clearance (not able to push microbes away)
   - airway obstruction
   - ciliary dysfunction
2. disruption of epithelial barrier
   - injury (smoking or inhalted things)
3. incresing inoculation
   - altered consciousness
   - intubation (foreign object prone infection)
4. decreasing immune function
   - inmune supression (diabetes)

Question 4

steps of the physiopathology

Answer 4

1. arrival of the patogens to the alveolar space
2. uncontrolled multiplications of it
3. local production of cytokines primarily by alveolar macrophages
4. recruitment of neutrophils into the alveolar space and introduction of cytokines into systemic circulation.
5. generation of alveolar exudate

Question 5

which cytokines elevate temp

Answer 5

tl-1 and tl-6

Question 6

main risk factors

Answer 6

1. smoking
2. upper respiratory tract infections
3. alcohol (broncoaspiration risk)
4. corticosteroid therapy
5. old age
6. influenza infection
7. pre-existing lung disease (like COPD)

Question 7

anatomical classification of pneumonia

Answer 7

• bronchopneumonia: affects the lungs in patches around bronchi.
• lobar pneumonia: only involves a single lobe or section of a lung.
• interstitial pneumonia: involves areas in between the alveoli.

Question 8

clinical classification of pneumonia

Answer 8

• Community acquired pneumonia (CAP)
• Nosocomial (hospital-acquired infection) it is different because bacteria tends to be stronger
• Ventilator associated (intubated patients)

Question 9

types of CAP

community acquired pneumonia

Answer 9

typical and atypical

Question 10

main microorganisms that cause the four diferent types of pneumonia

Answer 10

a) typical
*1. streptococcus pneumoniae
*2. haemophilus influenzae
3. moraxella catarrhalis

b) atypical
1. mycoplasma
2. chlamydophila psittaci or pneumoniae
*3. legionella pneumophila *

c) nosocomial
1. streptococcus pneumoniae
2. pseudomona aeruginosa
3. haemophilus influenzae

d) ICU
1. streptococcus pneumoniae
2. pseudomona aeruginosa
3. staphylococcus aureus
4. acinetobacter baumanii

Question 11

what are the main microorganisms that cause pneumonia in 1-3 months babies and 5 years old kids

Answer 11

1-3 months: viruses
5 years and older kids: bacterial

Question 12

when you see patches at an x-ray you suspect there is a

Answer 12

viral infection

Question 13

period of time to be considered nosocomial

Answer 13

within 48 hours of being admitted in the hospital and 72 hours after being released

Question 14

signs and symptoms of typical pneumonia

4 & 3

Answer 14

signs:
1. fever
2. taquicardia (infection)
3. taquipnea (dysnea)
4. rough crackles

symptoms
1. general malaise
2. productive cough (w/ yellowish sputum)
3. pleuritic chest pain (stabbed when inhaling)

sometimes they also use accessory respiratory muscles

Question 15

signs and symptoms of atypical pneumonia

Answer 15

1. symptoms
   - walking pneumonia (no general malaise)
   - minimal sputum
   - sore throat
   - intractable cough
2. signs
   - diffuse wheezes
   - fine crackles

usually confused with upper respiratory infections