pneumonia Flashcards
(12 cards)
Pneumonia is “an — , — of the — (tissue)”.
Pneumonia can be further subdivided and categorised depending on the way in which the infection is —.
1-Community – acquired: infection with an organism occurs outside of the — or in the — .
2-Hospital – acquired: infection with an organism occurs from within the — setting and includes — associated pneumonia.
3-Aspiration pneumonia:infection is acquired after — contents are inhaled into the — after—- or due to —- abnormalities.
acute infection
lung parenchyma
acquired
hospital or in community
hospital
ventilator
bowel content
pulmonary tracts
vomiting
swallowing abnormalities
microorganisms involved in pathogenesis of pneumonia:
1- bacteria:
- — species (commonest causes of community acquired pneumonia)
- Haemophilus influenza
- Moraxella catarrhalis
- Staphylococcus aureus
-Gram —- :(common cause of — pneumonia)
-Pseudomonas Aeruginosa (most common cause of —acquired pneumonia)
2- viruses :
Influenza A and B
RSV
COVID-19 and other coronaviruses
Adenoviruses
Rhinoviruses
Parainfluenza viruses
3- fungi ( in — patients ) :
-Aspergillus species
-PCP
-Candida species
-Histoplasmosis
-Blastomycosis
-Coccidioidomycosis
streptococcus
-ve anaerobes
aspiration
hospital acquired
immuocompromsied
pathology of pneumonia:
Pneumonia constitutes an — of the — tissue caused by various microorganisms (bacteria, viruses, fungi).
(Step 1) — :
Microorganisms are usually transmitted and therefore acquired in a—- fashion via — spread.
However, microorganisms can also be transmitted from — sources, — involved in air-conditioning, and hospital — .
(Step 2) — and — :
-Following inhalation, the pathogen — the —- and then reaches the —- via —
-When the inoculum size is sufficient and/or host immune defences are impaired, — results.
- — of the pathogen, the production of — factors, and the host — response leads to — and damage of the lung—- , resulting in — .
infection
lung tissue
transmission
person to person
droplet spread
water m devices , hospital ventilators
inhalation and infection
colonises
nasopharynx
lung alveoli
micro aspiration
infection
replication , virulence , immune
inflammation
lung parenchyma
pneumonia
cardinal symptoms of pneumonia:
Most common symptoms:
- — with or without phlegm/sputum production.
- —-
- Pleuritic —
Other common symptoms:
Fevers/Chills.
—.
Fatigue.
—-.
—/— (particularly in older patients)
cough
shortness of breath
pleuritic chest pain
malaise
anorexia
confusion / delirium
cardinal signs of pneumonia:
Vitals:
— , — , — , —-
Chest examination findings:
—- to percussion at site of infection (may also indicate a parapneumonic —- , see next slide for chest X-ray image of same).
—- tactile fremitus and vocal resonance.
Inspiratory — .
— air entry at site of infection.
tachypnoea , hypoxia , tachycardia , fevers
dullness
pleural effusion
increased
crackles
reduced
A Parapneumonic pleural effusion: Forms in the — space — to a — . When microorganisms infect the pleural space, a complicated parapneumonic — or — may result from pleural — and — accumulation.
pleural space
adjacent
pneumonia
effusion or empyema
pleural inflammation and serous fluid
After the lung tissue is colonised by microorganisms; alveolar — recognise the organism, and the immune response is triggered to contain the — .
All of the clinical features of pneumonia result from a combination of:
The — response.
The accumulation of — (organisms, white blood cells, fluid, and proteins) in the — space.
macrophages
infection
systemic immune
inflammatory excavate
alveolar
Symptom and sign severity is directly related to the — of the — and — response in each patient.
- Cough, phlegm, dyspnoea, tachypnoea and hypoxaemia result from —-material occupying the alveolar space.
–> Clogging of the alveolar space results in subsequent impairment of alveolar —- of —-
–> The — produced while coughing is the clearing away of the alveolar inflammatory exudate
intensity
local and systemic immune
inflammatory exudative
gas exchange
c02 and 02
sputum
- Fevers/Rigors/Chills/Tachycardia are features of — : result from the —- response to the infection.
—> Pathogens — and releases — components such as endotoxins, exotoxins, and DNA that bind to — immune cells.
–> proinflammatory cytokines and mediators like — and — are released by immune cells in response.
–> Sepsis occurs when the release of — in response to an infection exceeds the boundaries of the local environment, triggering, — and — activation; along with — , — and — release.
sepsis
systemic immune
replicate
microbial components
host immune
interleukins and tnf
pro inflammatory mediators
RAAS , baroreceptor , nitrous oxide , glucocortocode and catecholamine
The differential diagnosis should be based on the patient’s — and — findings.
Since common symptoms include cough, dyspnoea, chest pain, and systemic features like fevers and chills, we need to provide —- based on some or all these features.
The list is broad and varied, and includes a variety of other common respiratory, and non-respiratory causes
presentation
clinical
differential diagnosis
differential diagnosis :
1- respiratory
PE
Atelectasis
Bronchitis
Asthma exacerbation
COPD exacerbation
Sarcoidosis
Cryptogenic organising pneumonia
Lung cancer
2- cardiac:
ACS
Pericarditis
Myocarditis
Congestive heart failure with pulmonary oedema
3- gastrointestinal:
Gastritis
GORD
Aspiration
Oesophagitis
key points:
Pneumonia is an — infection of the lung tissue and is a very common cause of — and — admission.
A variety of bacteria, viruses and fungi may be responsible for infection.
There are different ways to categorise pneumonia depending on how the infection is originally — .
The clinical features of pneumonia arise because of the local complications of — and — cell activation, and the — effects of the immune response.
Differential diagnoses of pneumonia are multiple, varied, and common illnesses that require exclusion.
acute infection
infection and hospital
acquired
infection
inflammatory
systemic
