Resp Path 4 - Pulmonary Infection and Neoplasia - Galbraith Flashcards Preview

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Flashcards in Resp Path 4 - Pulmonary Infection and Neoplasia - Galbraith Deck (99)
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1

Five things that if compromised, can allow pulmonary infections to occur.

1. Cough reflex - decreased = aspiration
2. Ciliary function - impaired = 3. mucus-stasis
4. Decreased phagocytic function of pulmonary macrophages
5. Pulmonary edema/congestion

2

Definition of pneumonia.

Any infection of the lung parenchyma.

3

What 2 lab testing characteristics help differentiate between bacterial pneumonia and viral pneumonia?

In bacterial pneumo:
Higher CRP
Higher procalcitonin levels

4

Absent splenic function predisposes toward what type of infection?

Encapsulated bacterial infection

5

Seven bacterial causes of Community-Acquired Acute Pneumonias

**Strep pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Staph aureus
Klebsiella pneumoniae
Pseudomonas aeruginosa
Legionella pneumophilia

6

- G+, lancet shape diplo
- Elongated DIPLOCOCCI in SPUTUM
- **Most common cause of CA-pneumonia**

Strep pneumoniae characteristics

7

- Gram (-)
- ENCAPSULATED type B most virulent
- Kids and COPD

Haemophilus influenzae characteristics

Pediatrics - bacterial pneumonia (meningitis and LRIs)
- Adults - Most common cause of bacterial acute EXACERBATION OF COPD.
- Virulence factors like adhesive pili and IgA degredation by protease.

8

- G- cocci
- Elderly - exacerbation of COPD
- Pediatric - OTITIS MEDIA

Moraxella catarrhalis characteristics

9

- G+ cocci
- Imp cause of SECONDARY BACTERIAL PNEUMONIA, after a viral infection
- High risk of complications (abscess, empyema)
- Think: IV drug abusers and endocarditis

Staph aureus characteristics

10

- Most common G- bacterial pneumonia (rod)
- **CHRONIC ALCOHOLICS, MALNOURISHED, DM**

Klebsiella pneumoniae

11

- Imp cause of pneumo in CF and neutropenic pts
- Hematogenous spread!
- **Nosocomial infection

Pseudomonas aeruginosa characteristics

12

- Water tanks >> aerolization
- Pontiac fever and Leginnaires' disease
- Immunosuppressed, chronic disease
- URINE LEGIONELLA ANTIGEN for diagnosis

Legionella pneumophila characteristics

13

- in children and YA
- a dry cough that won't go away

Mycoplasma pneumonia characteristics

14

What is the main morphologic change in lung tissue due to bacterial invasion?

CONSOLIDATION, as alveoli fill with inflammatory cells and exudate.

15

Two main patterns of consolidation in the lungs.

1. Bronchopneumonia
2. Lobar pneumonia

16

What type of consolidation pattern is this?
- PATCHY exudative consolidation of lung parenchyma.

What else is characteristic of this?

Bronchopneumonia

- Focal, consolidated areas that may coalesce

- BASAL, MULTIlobar and frequently BILATERAL.

17

What type of consolidation pattern is this?
- Consolidation occupies an ENTIRE LOBE

Lobar pneumonia

18

List the four stages of lobar pneumonia

1. Congestion
2. Red hepatization
3. Gray hepatization
4. Resolution

19

1/4 Stage of Lobar Pneumonia and characteristics

1. CONGESTION due to vascular engorgement and with fluid and bacteria

20

2/4 Stage of Lobar Pneumonia and characteristics

2. RED HEPATIZATION - full of neutrophils, RBCs, fibrin

21

3/4 Stage of Lobar Pneumonia and characteristics

3. GREY HEPATIZATION - fibrinosuppurative material, RBC breakdown, early org.

22

4/4 Stage of Lobar Pneumonia and characteristics

4. Resolution - organizing fibrosis admixed with macrophages resorption of debri and enzymatic digestion of exudates.

23

What does resolution normally result in ?

Restoration of normal lung structure and function. But organization with fibrous scarring can occur.

24

What is empyema?

Fibrinopurulent material.
Expansion of infection into pleural space

25

s/s of CA-acute pneumonia

- Abrupt fever
- Shaking chills
- Productive cough
- Rust-colored sputum

26

Look for what in PE to suggest pleural involvement in CA-acute pneumonia.

Friction rub and pleuritic chest pain

27

Potential complications of CA-acute pneumonia.

Systemic dissemination causing: endocarditis, meningitis, suppurative arthritis, metastatic abscesses.
Galbr: abscess, empyema (pleural involvement), bacteremia

28

Difference in CXR between lobar and bronchpneumonia.

Lobar - obque lobe
Bronch - focal opacities

29

What is the common pathogenic mechanism between CA-Atypical (Viral and Mycoplasmal) Pneumonias?

Attachment of organisms to epithelial cells, followed by necrosis and inflammation.
- In alveoli, causes fluid transudation.
- In upper airways - **loss of mucociliary clearance of resp epithelium=secondary bacterial (super) infection predisposition.**

30

Morphology of CA-Atypical pneumonias (differing characteristics from bacterial)

- Patchy or lobar congestion WITHOUT CONSOLIDATION
- Widened, EDEMATOUS alveolar walls with LYMPHOCYTES AND MACROPHAGES
- HYALINE MEMBRANES reflex DAD