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Pathology > Pulmonary Sepsis > Flashcards

Pulmonary Sepsis Flashcards

1
Q

components of the upper respiratory tract

A
  • nose
  • sinus
  • larynx
  • trachea
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2
Q

components of the lower respiratory tract

A
  • bronchi
  • terminal bronchi
  • lung parenchyma
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3
Q

characteristics of lower pulmonary sepsis

A
  • serious
  • mortality/morbidity risk
  • secondary to irritants
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4
Q

name the defense mechanisms of the respiratory tract

A
  • nasal hair
  • saliva
  • filtering function of nasopharynx
  • cough reflex
  • mucociliary apparatus
  • secretion of IgA
  • phagocytic activity by alveolar macrophages
  • alveolar fluid
  • cell mediated immunity
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5
Q

causes of primary infection

A
  • viral
  • bacterial
  • atypical bacteria
  • fungi
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6
Q

causes of secondary infection

A
  • irritants
  • bacterial following a viral infection
  • long-standing cold
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7
Q

commonest viral organisms to cause upper respiratory tract sepsis

A
  • rhinovirus
  • adenovirus
  • influenza
  • RSV
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8
Q

characteristics of rhinovirus

A
  • no cross immunity between different serotypes
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9
Q

infections caused by adenovirus

A
  • pharyngitis (sore throat)

- conjunctivitis

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10
Q

infections caused by influenza virus

A
  • upper resp tract
  • fever
  • lassitude
  • depression
  • primary influenzal pneumonia
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11
Q

what infection does croup cause?

A
  • laryngotracheobronchitis

- bronchiolitis in children

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12
Q

what kind of virus causes croup?

A

RSV

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13
Q

characteristics of URT bacterial sepsis

A
  • uncommon in developed countries
  • secondary to viral infections
  • 2 main bacteria: strep pyogenes, haemophilus influenzae
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14
Q

characteristics of bacterial acute laryngitis

A
  • HIB or strep pyogenes
  • swellling
  • inability to breath (mechanically)
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15
Q

what kind of infection is trigged from irritative occupational hazards

A
  • acute laryngitis and tracheitis
  • irritation by smoke, corrosives, noxious gases
  • oedema with obstruction
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16
Q

what is pneumonia?

A

infection of the alveolar spaces, causing alveolar exudates, polymorph infiltration, fibrin, oedema fluid resulting in consolidation

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17
Q

morphological classification of pneumonia

A
  • bronchopneumonia

- lobar pneumonia

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18
Q

infective causes of bronchopneumonia

A
  • strep pneumoniae
  • haemophilus influenzae
  • moraxella catarrhalis
  • staph pneumonia
  • klebsiella
  • pseudomonas aeruginosa
  • coliform bacteria
  • chlamydia
  • legionella pneumophilia
  • tuberculosis
  • mycobacterium avium-intercellulare
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19
Q

how does bronchopneumonia develop?

A
  • inflammation centred onto the bronchi

- spreads out to cause inflammation in the alveoli

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20
Q

histological characteristics of bronchopneumonia

A
  • polymorphs and fibrin infiltration
  • spread to adjacent alveoli
  • patchy foci coalsce
  • frequently widespread and bilateral
  • rarely heals with fibrosis
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21
Q

how does lobar pneumonia develop?

A
  • starts in the alveoli

- spreads to the bronchioles luminally as the exudate flows out

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22
Q

histological characteristics of lobar pneumonia

A
  • polymorphs, fibrin, oedema fluid in alveoli
  • all or most of the lobe is affected here
  • consolidation present
23
Q

aetiology of pneumonia

A
  • bacterial
  • fungal
  • viral
  • aspiration
  • radiation (like radiotherapy)
  • allergic mechanisms
24
Q

which bacteria are associated with smokers and COPD?

A
  • strep pneumoniae
  • haemophilus influenzae
  • moraxella catarrhalis
25
Q

which organisms are associated with HAP?

A
  • klebsiella
  • pseudomonas aeruginosa
  • coliform bacteria
26
Q

which organisms are associated with immunosuppression?

A
  • mycobacterium avium-intercellulare
  • pneumocystis jirovecii
  • aspergillus fumigatus
27
Q

which bacteria causing pneumonia are gram positive?

A
  • strep pneumoniae (diplococci)

- staph aureus (cocci)

28
Q

which bacteria causing pneumonia are gram negative?

A
  • haemophilus influenzae (coccobacillus)
  • moraxella catarrhalis (diplococci)
  • klebsiella (rods)
  • pseudomonas aeruginosa (rods)
  • legionella
29
Q

infective causes of CAP

A
  • strep pneumoniae
  • haemophilus influenzae
  • moraxella catarrhalis
  • staph aureus
  • legionella
  • klebsiella
  • pseudomonas
  • mycoplasma
  • chlamydia
  • coxiella
  • viruses
30
Q

cause of aspiration pneumonia

A

anaerobes

31
Q

pathogenesis of pneumonia

A
  • suppression of the cough reflex
  • impaired ciliary function
  • impaired phagocytic activity
  • pulmonary oedema and congestion
  • secretions
  • low host resistance
  • virulent infections
32
Q

how can the cough reflex be suppressed?

A
  • coma
  • anaesthesia
  • drugs
  • aspiration
33
Q

how can the ciliary function be impaired?

A
  • cigarette smoke
  • hot gases
  • corrosives
  • viruses
34
Q

how can phagocytic activity be impaired?

A
  • alcohol
  • tobacco
  • smoke
  • excess oxygen
35
Q

how can host resistance be depleted?

A
  • chronic disease
  • immune deficiency
  • immunosuppression
  • leucopenia
  • chemotherapy
36
Q

which populations are more vulnerable to pneumococcal infections?

A
  • chronic disease
  • immunodeficiency syndromes
  • poor splenic function
37
Q

clinical/investigative characteristics of CAP

A
  • either morphological pattern
  • sputum: gram-positive diplococci, neutrophils
  • some are penicillin-sensitive
38
Q

stages of an acute pneumonia

A
  • congestion
  • red heparisation
  • gray heparisation
  • resolution
39
Q

characteristics of red heparisation

A
  • lung becomes like a liver

- alveoli packed with polymorphs, red cells, fibrin

40
Q

characteristics of gray heparisation

A
  • dry, gray firm lung
  • lysis of red cells
  • fibrinouus exudate persists
41
Q

characteristics of resolution

A
  • digestion of exudates
  • resolution of pleura
  • formation of adhesions
42
Q

what stages do pneumonia patients go through nowadays?

A

if the correct treatment is given, they go directly into the resolution phase

43
Q

complications of pneumonia

A
  • pleurisy/pleural adhesions (due to fibrin formation in the lung)
  • lung abscess
  • alveolar fibrosis
  • empyema
  • bacteraemia
44
Q

what is septicaemia?

A

when bacteria and their toxins circulate in the blood

45
Q

causes of lung abscesses

A
  • aspiration of infected material, gastric contents
  • necrotising or suppurative pneumonia
  • bronchiectasis
  • bronchial obstruction
  • septic emboli
  • haematogenous spread
46
Q

contents of lung abscesses

A
  • anaerobic bacteria from mouth commensals

- staph aureus and B-haemolytic streptococci, nocardia and gram negative organisms

47
Q

how do you treat lung abscesses?

A

drainage and antibiotics

48
Q

pathological characteristics of viral pneumonia

A
  • interstitial pneumonia
  • interstitial infiltrate
  • no alveolar exudate
49
Q

causes of viral pneumonia

A
  • influenza virus type A+B
  • RSV
  • adenovirus
  • rhinovirus
  • coronavirus (yep)
50
Q

what is bronchiectasis?

A
  • abnormal permanent dilatation
  • happens in the lower limbs, distal bronchi and bronchioles
  • associated chronic infection
51
Q

causes of bronchiectasis

A
  • localised obstruction (tumours, foreign bodies, mucus, chronic bronchitis)
  • congenital (CF, immunodeficiency, immotile cilia)
  • necrositing or suppurative pneumonia (virulent organisms - staph aureus, klebsiella, tuberculosis)
  • symptoms precipitated by URTI or new pathogens
52
Q

pathogenesis of bronchiectasis

A
  • obstruction - air resorbed from distal airways
  • atelectasis - loss of elastic tissue in interstitium - fibrosis attaches lung to pleura
  • dilatation of proximal airways due to pressure of inspired air
  • becomes irreversible if:
    • obstruction persists especially during growth
    • persistent infection - bronchial wall ulceration, inflammation and further dilatation
53
Q

complications of bronchiectasis

A
  • lung abscess
  • cor pulmonale
  • metastatic brain abscesses
54
Q

what is cor pulmonale?

A

abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels

Pathology (21 decks)

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