Pulm Infectious Diseases (Handorf) Flashcards Preview

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Flashcards in Pulm Infectious Diseases (Handorf) Deck (28):
1

Bacterial pneumonia and associated inflammation cause lung tissue to:

consolidate (firm to the touch)

2

How does bronchopneumonia affect lung tissue? What does this suggest?

patchy consolidation

suggests distribution from terminal bronchioles

3

Most common pathogen causing bronchopneumonia:

Streptococcus pneumoniae

4

How does lobar pneumonia affect lung tissue? What are the stages of its progression?

consolidation of a whole lobe or a large part of a lobe

congestion, red hepatization, grey hepatization, resolution

5

Under what conditions would you see lobar pneumonia?

virulent organism and/or compromised host

6

Describe the histopathology of acute pneumonia.

congested septal capillaries
extensive neutrophil exudation into alveoli

7

In early organizing pneumonia, what is seen microscopically?

intra-alveolar exudate streaming through pores of Kohn

8

In advanced organizing pneumonia, what is seen microscopically?

exudate transformed to fibromyxoid masses
macrophages and fibroblasts present

9

What stage does acute/early pneumonia correspond to? Advanced?

1. red hepatization
2. grey hepatization

10

What is a classic sign of Klebsiella pneumonia in a patient?

Currant jelly sputum
(blood and mucous)

11

How does Klebsiella pneumonia appear microscopically?

Large encapsulated “boxcar” Gram-negative rods

12

Lung scarring after infection relates to:

severity
organism (viral more likely to scar than bac)

13

In acute bacterial pneumonia, what causes hypoxia?

polys in alveoli

14

Describe primary atypical pneumonia.
What organism is usually responsible?

acute febrile respiratory illness with patchy lung inflammation, primarily septal/interstitial

Mycoplasma pneumoniae

15

When death occurs in viral pneumonia, it usually does so due to:

superimposed (bacterial) infection

16

Pulmonary fungal infections are primarily caused by what 2 organisms?
How do these appear microscopically?

histoplasmosis (crowded into histiocytes)

blastomycosis (broad based budding yeast; "snowman")

17

Who is more at risk of TB infection?

males
economically disadvantaged
inner city residents
alcoholics
drug abusers
recent immigrants

18

Describe:
primary phase TB infections
secondary phase TB infections
progressive phase TB infections

Ghon complex; usually clinically inapparent

reactivation; apical consolidation and granuloma

associated with cavitary fibrocaseous TB, miliary TB or TB bronchopneumonia

19

Where are TB infections typically localized?

apices (more O)

20

How do TB infections spread within the lungs?

from periphery to hilum

21

Miliary TB is associated with:

massive hematogenous dissemination (spleen, lung, brain, etc) and MOF

22

TB is associated with what type of lesion?

caseating

23

Describe a pulmonary abscess

A local suppurative process within the lung characterized by necrosis of lung tissue

24

How do pulmonary abscesses present clinically?

Clinical “chronic pneumonia” with cough, fever, weight loss, copious foul smelling sputum

25

Causes of pulmonary abscess?

Aspiration—alcoholism, anesthesia
Antecedent acute pneumonia
Septic embolism
Neoplasm—”postobstructive pneumonitis”
Miscellaneous—direct spread from adjacent organ

26

Common immune suppression related pulmonary infections include:

pneumocystis, histoplasmosis, Aspergillus and tuberculosis

27

Histopath associated with Pneumocystis:

fluffy looking intraalveolar exudate

organisms look like "deflated soccer balls"

28

How does Aspergillus affect lung tissue?

angioinvasive: propensity to infarct surrounding tissues by growing into and occluding vessel lumens

may form "fungus ball"