URTI and LRTI and lung infections (pneumonia and TB) Flashcards Preview

Z MD1 Respiratory block > URTI and LRTI and lung infections (pneumonia and TB) > Flashcards

Flashcards in URTI and LRTI and lung infections (pneumonia and TB) Deck (57):
1

microbial aetiology of infective pneumonia

- URT flora - strep pneumonia, hameophilis influenzae, staph aureus - enteric saprophytes - E coli, pseudomonas - extraveous pathogens - legionella pneumophilia, TB

2

stain used to look for TB

Ziehl-Neelsen

2

what are the two examples of single organ TB

potts disease (spine) urogenital tract

3

bacterial causes of atypical pneumonia

mycoplasma pneumoniae coxiella burnetti legionella spp chlamydia pneumoniae

4

what organisms are the main causative agent in hospital acquired pneumonia

gram negatives

5

rhinovirus causes

mainly URTI and no LRTI

6

frequent aetiological agents that cause lung abscess

Strep pnemonia mixed anaerobes Klebsiella

7

frequent aetiological agents that cause atypical pneumonia

mycoplasma - doesnt have a cell wall! chlamydia M catarrhalis influenza RSV adenovirus Coxiella Legionella

7

pathology of interstitial pneumonia

alveolar septa are widened and are infiltrated by lymphocytes, plasma cells and macrophages - no inflammatory cells in alveoli (may be filled with fluid)

8

frequent aetiological agents that cause the common cold

rhinovirus, parainfluenza virus, RSV, enterovirus, coronavirus, HMPV

9

frequent aetiological agents that cause of sinusitis

primary: viral secondary: H influenzae and Strep pnaumoniae

10

Gram stain of strep pneumonia

Gram positive dipplococci

11

4 routes of entry of micro-organisms to cause pneumonia

- inhalation of pathogens in air droplets - aspiration of infected secretions from the URT - aspiration of infected particles - gastric contents, food, drink, foreign bodies - haematogenous spread

11

what is secondary TB

reactivation of dormant infection or reinfection where a cell mediated immune response leads to extensive caseation and cavitation if the caseous material discharges into a bronchus - usually involves the upper lobe

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what is the characteristic of alveolar pneumonias

consolidation! When lung tissue becomes firm and solid neutrophils within the alveolar saces

13

frequent aetiological agents that cause of epiglottis

H influenzae type b

13

serological diagnosis of pneumonia is important for which organisms

mycoplasma pneumoniae legionella pneumonophila chlamydophila and Chlaydia species coxiella burnetti

13

treatment of pneumonia

best guess therapy - Penicillin G/amoxycillin + doxycycline/macrolide Bacteriostatic + bacteriocidal

14

characteristic of miliary TB in organs

numerous granulomas

15

chest x-ray signs of atypical pneumonia

reticulonodular infiltrate (dots and dashes) throughout both long fields

16

frequent aetiological agents that cause empyema

staph aureus, secondary to pneumonia

17

what is bronchopneumonia

alveolar pneumonia when consolidation is patchy around bronchioles - there are some areas that are affected separated by areas that are spared. Often multiple foci, involving more than one lobe or both lungs

18

frequent aetiological agents that cause otitis media

pnuemococci H infleunzae, M catarrhalis

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frequent aetiological agents that cause pharyngitis/tonsillitis with nasal involvement

adenovirus, enterovirus, parainfluenza, influenza

19

definition of tuberculosis

a chronic granulomatous pneumonia due to infection with the bacterium mycobacterium tuberculosis

20

hallmark of abscesses

cavitating lesion containing purulent exudate

21

What two organisms live in the lungs in a latent state in some people

P. jirovecii M. Tuberculosis

22

what does exposure to birds (wild) in a cage predispose you to get

Psittacosis

23

what kind of calcification occurs in secondary TB

dystrophic

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frequent aetiological agents that cause of acute bacterial pneumonia

pneumococci - mainly H influenzae Staph Klebs Legionella TB chlamydophila

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common microbiota in the URT

viridans streptococci Neisseria spp. Corynebacterium spp., gram-negative anaerobes H influenzae A, C, D C albicans strep pneumoniae CCGHNSV

27

2 patterns of infective pneumonia

alveolar inflammation interstitial inflammation

28

which organs does miliary TB involve

liver, spleen, BM, brain

29

clinical features of TB

variable weight loss, malaise, fevers, night sweats, haemoptysis, dyspnoea and chronic cough

31

frequent aetiological agents that cause of acute exacerbation of chronic bronchitis

usually pneumoccoci and/or H. Influenzae

33

frequent aetiological agents that cause pharyngitis/tonsillitis (with no nasal involvement)

adenovirus, influenza, enterovirus, reovirus, Strep pyogenes, Strep group C and G

33

what organism is the main causative agent in community acquired pneumonia

strep pneumoniae

34

pathology of primary TB

Gohn complex - gohn focus - area of inflammation in the periphery of the midzone of the lung - enlarged mediastinal and hilar lymph nodes

35

occasional microbiata pathogens in URT

strep pyrogenes meningococci

36

when does acute bronchpneumonia usually occur

- at the extremes of life - secondary to pre-existing chronic condition (COPD, CHF, malignancy, CF) - post-operative complication related to impaired clearance of respiratory secretions - hospital acquired - secondary infections after viral URTI

37

frequent aetiological agents that cause of croup

parainfluenza virus influenza A RSV

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frequent aetiological agents that cause of bronchiolitis

RSV

40

how do the lungs macroscopically look with interstitial pneumonia

wet, dark and heavy

41

how can TB spread through the body (routes)

- lymphatics - coughed up --> laryngeal - coughed up and swallowed --> gut and intestine - haematogenous - via blood stream

43

characteristics of atypical pneumonia

not as sick cough for a long time slower onset overall milder course

45

4 stages of lobar pneumonia

1. congestion- proteinasous exudate into alveoli 2. red hepatization - alveoli filled with neutrophils (consolidation), RBCs squeezed out - haemorrhage 3. grey hepatization - no longer have RBCs in alveolar space - have fibrin and macrophages 4. resolution

46

presentation of a patient with atypical pneumonia

- systemic symptoms predominate over respiratory - flu like illness - malaise, aches and pains, headache, diarrhoea - dry, non-productive cough

47

complications of secondary pulmonary TB

- progressive spread of caseation into surround lung - erosion of BVs - haemoptysis - erosion into bronchial tree leading to cavitation and spread of infection via airways - pleural inflammation and fibrosis - lung scarring

49

what is lobar pneumonia

when it involves entirety of single lobe - often causes adjacent inflammation of the pleura

50

how does legionella grow in air conditioning towers

grows inside amobae inside the tower

51

characteristics of typical pneumonia

Productive cough Fever Dyspnoea Malaise

52

complications of pneumonia

- pleurisy - empyema - abscess - bronchiectasis - death

53

why is it important that you know where a patient has acquired pneumonia from?

so you have an idea on how to treat them

54

characteristics in the patient with lobar pneumonia

- abrupt onset - fever -raised WBC count - cough - pleuritic chest pain - blood stained sputum - gram positive diplococci in sputum - bacteriemia

55

2 kinds of alveolar pneumonia

bronchopneumonia lobar pneumonia

56

which organism is notorious for producing abscesses

staph pneumonia

57

frequent aetiological agents that cause acute bronchitis

usually as a complication of a viral URTI