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Respiratory > Respiratory Exam 3 > Flashcards

Respiratory Exam 3 Flashcards

1
Q

What are the three types of pneumonia?

A

Acute Pneumonia - usually pyogenic bacteria, neutrophils
Pneumoitis - “atypical pneumonia” non pyogenic (viral or mycoplasmal)
Chronic Pneumonia - Often TB, fungi, parasites, odd bacteria

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2
Q

What are the two top Community Acquired Pneumonia bacteria?

A

S. Pneumonia

Hemophilus Influenza

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3
Q

What are predisposing factors to CAP?

A

Age extremes, chronic disease, immuno deficiencies, decreased splenic function

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4
Q

When is a common time to get a bacterial pneumonia?

A

AFTER a viral infection. immune down

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5
Q

Where does pneumonia originate?

A

Lower lobes of right middle lobe

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6
Q

What are the two overlapping morphologic patterns of bacterial pneumonia?

A

Lobar and Bronchopneumonia

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7
Q

What are common manifestations of bacterial pneumonia?

A

Fever, chills, productive cough, Pleuritic chest pain, tachycardia, tachypnea

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8
Q

Describe Bronchopneumonia

A

Patchy, exudative consolidation of lung, specifically in airspaces and airways around bronchioles and bronchi

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9
Q

Describe Lobar Pneumonia

A

Large portion or entire lobe consolidated. 90-95% S. Pneumo

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10
Q

Describe progression of Lobar Pneumonia

A

Congestion: Heavy and congested lungs, vasc. engorged
Red Hepatization: Exudation of RBCs/fibrin
Gray Hepatization: RBCs break down, exudate remains
Resolution: Consolidation eaten up

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11
Q

What are indications for hospitalization for CAP?

A

Severe dyspnea, hypoxemia, empyema, extrapulmonary foci, signif. underlying disease, Mental problems

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12
Q

Describe Community Acquired Atypical Pneumonia

A

Lack of alveolar exudate, dry cough, cold like symptoms, interstitial pneumonitis, patchy inflammatory disease

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13
Q

What is the pathogenic mechanism of atypical pneumonia

A

Binds to epithelium, necrosis of cells, inflammatory response, predisposes to secondary bacterial infection, severe cases can progress to ARDS

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14
Q

What are two granulomatous diseases?

A

Sarcoidosis and Hypersensitivity Pneumonitis

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15
Q

Describe Sarcoidosis disease process

A

Increased CD4+ TH1 cells, increased IL-2 and IFN g, Increased macrophages, Increased IL-8 and TNF, which causes non caseating granulomas, leading to interstitial fibrosis and honeycomb lung. Black ladies
NON SMOKERS
Genetic component - HLA

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16
Q

What are some unique cells seen in sarcoidosis?

A

Asteroid bodies, and schauman bodies

17
Q

What are some treatments for sarcoidosis?

A

Corticosteroids

Prognosis is favorable

18
Q

Describe Hypersensitivity Pneumonitis

A 
#1 Occupational pneumonia-allergic, Restrictive, attacks the alveoli/interstitim. 2/3 have RBC leak.
Caused by thermophilic bacteria, fungi, bacterial stuff
19
Q

Describe the two types of Hypersenstivity Pneumonitis

A

Acute- large antigen exposure, neutrophils, resolves on its own
Chronic - Prolonged exposure, gradual symptoms, mononuclear infiltration, fibrosis

20
Q

What types of hypersensitivity is hypersensitivity pneumonitis?

A

Type III early - antibodies

Type 4 later- Form non caseating granulomas and fibrosis

21
Q

How Diagnose Sarcoidosis?

A

Biopsy-Non-caseating granulomas, Special stain, Culture
BAL - CD4+ cells, macrophages
CXR - bilateral hilar lymphadenopathy

22
Q

How Diagnose Hypersensitivity Pneumonitis?

A

BAL - CD4+ and CD8+ cells

Farmers lung, pidgeon breeders lung, humidifier

23
Q

How do you treat Hypersensitiity Pneumonitis?

A

Remove from allergens

24
Q

Describe Silo Fillers disease

A

NO NO2 exposure from silos, causes pulmonary edema and Bronchiolitis obliterans

25
Q

Describe Desquamative Interstitial Pneumonia

A

SMOKERS
Gradual dyspnea/dry cough
INcreased intraalveolar macrophages + Type 2 pneumocytes
Minimal fibrosis

26
Q

What is the treatment for DIP?

A

Steroids

27
Q

Describe Pulmonary Alveolar Proteinosis

A

CXR - patchy opacification
accumulation of surfactant
Minimal inflammatory response
Have a white “jello” sputum

28
Q

What is the treatment for PAP?

A

Whole lung lavage therapy

Respiratory (4 decks)

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