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45 Cards in this Set
- Front
- Back
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What are 2 major pathogens in pneumonia caused by microaspiration?
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S. pneumoniae, H. influenzae
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What are the pathogens that cause massive aspirational pneumonia?
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normal flora -anaerobes
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What are the 6 pathogens that cause pneumonia due to inhalation?
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Mycobacteria
Mycoplasma Chlyamydophila RSV Influenza Legionella |
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What are 2 pathogens that cause pneumonia due to hematogenous spread?
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S. aureus, S. typhi
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What are 3 innate defenses to pneumonia?
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Cough reflex
Mucociliary action neutrophil function |
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What is the #1 cause of community acquired pneumonia?
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Streptococcus
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Pneumococcal pneumonia
a. history b. exam c. CXR d. Labs e. Sputum gram stain |
a. Rapidly developed fever, chills, pleurisy, rust-colored sputum
b. acutely ill, fever, tachycardia, signs of consolidation, pleural friction rub c. lobar consolidation, air bronchogram d. leukocytosis, hypoxemia e. PMN, many bact. of a single type |
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How is pneumococcal pneumonia acquired?
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Small respiratory droplet --> nasopharygeal colonization (days, months) --> microaspiration in sleep --> multiplication in alveoli
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How does pneumococci induce pneumonia?
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Infects alveoli --> local inflammation
Influx of PMNs --> alveolar edema Bronchi remain patent --> air bronchogram |
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What are 4 defects that increase one's susceptibility to pulmonary invasion?
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1. Impaired mucociliary clearance (smoking, drinking, Kartagener's)
2. Defective phagocytosis (alcohol, smoking) 3. Endogenous immunosuppression (stress, illness) 4. Defective acquired immunity (hypogammaglobulinemia) |
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What are 2 defects that increase susceptibility to bacteremia after pneumonia?
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Defective opsonophagocytosis (Fc receptor)
Defective intravascular clearance (asplenia) |
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What should the CXR show in pneumococcal pneumonia? (3)
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lobar/segmental alveolar infiltrate
air bronchograms pleural effusion (maybe, need to drain) |
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What should lab findings be in pneumococcal pneumonia? (3)
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leukocytosis
high bacteria of one kind elevated c-reactive protein |
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In community acquired MRSA...
a. colonization? b. types of infections? c. virulence factor d. resistence to...? |
a. nasal vestibule, axillae, groin
b. skin/soft tissue infections Sever pneumonia (esp. diabetics, post influenza) c. Panton-valentine leukocidin (toxin) d. Resistent to b-lactams |
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what is macroaspirational pneumonia?
What causes it? |
Large volume aspiration of mixed oral flora during drugs overdose, anesthesia, neuromuscular disease
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What is one type of bacteria that cause aspirational pneumonia in hospital setting?
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gram negative bacilli
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What are 2 pathological features of aspirational pneumonia?
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necortizing abscess in lung
empyema = abscess in pleural space due to bacteria |
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What are 4 clinical features that differentiate macro from microaspirational pneumonia?
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Macroaspirational pneumonia has:
Foul smelling sputum Weight loss Chest pain |
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Aspiration pneumonia:
a. history b. exam c. CXR d. lab e. sputum gram stain |
a. reason for impaired consciousness, insidious onset of symptoms: low grade fever, purulent, foul-smelling sputum, wieght loss
b. poor dental hygeine, cachexia, maybe pulm. consolidation c. focal infiltrates in upper lobes w/cavities d. anemic, mild leukocytosis e. mixed oral flora with PMNs |
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How do you treat aspiration pneumonia?
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clindamycin or penicillin for several weeks
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What can aspiration pneumonia look like?
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TB (upper lobe infiltrate with cavitation), tumor
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Why is droplet size important when being infected by infected droplets?
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too big (>10 microns) --> land in upper respiratory tract
too small (<1micron) --> remains airborn |
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What 2 problems accompnay pneumonia from inhalation of infected droplets?
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bronchitis
Upper respiratory symptoms |
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Where does the pneumonia from inhalation of droplets develop in the lung?
Course of disease? |
Multiple non-contiguous sites
Course is slow |
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Atypical pneumonia
a. history b. physical c. cxr d. sputum e. labs |
a. gradual cough, malaise, low fever
b. NAd, normal c. patchy infiltrates, bilateral d. WBCs, no bact e. WBC normal |
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What characterizes a mycoplasma pneumonia?
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fever, nonproductive cough, myalgia, headache, rhinorrhea, sore throat
But still able to do stuff--"walking pneumonia" |
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Which pathogen causing atypical pneumonia affects young patients (<40)?
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mycoplasma pneumoniae
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Which pathogen causing atypical pneumonia is seen with diarrhea?
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legionella
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Which pathogen causing atypical pneumonia is seen from infected sheep?
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coxiella
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Which 3 causes of atypical pneumonia also cause mulitsystem illness?
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legionella, chlamydophila, coxiella
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What is the pathogen most commonly seen in pneumonia from hematogenous spread?
What does the disease look like? |
s. aureus from endocarditis
focal nodules, cavities in lung multiple lesions |
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What is Lemierre's syndrome?
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Septic thrombophlebitis of jugular vein from fusobacterium necrophorum on IV needles --> can spread to lungs to cause pneumonia
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What bacteria causes primary extravascular infections that spread to the lungs?
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y. pestis
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a. What bacteria cause CAP in patients with AIDS when CD4>200
b. CD4<200/microL c. CD4<50? cd4<200? |
a. m. tuberculosis, s. pneumoniae, s. aureus, h. influenzae
b. pneumocystis jeroveci c. p. aeruginosa, m. tuberculosis (systemic), nontuberculous mycobacteria, cryptococcus neoformans, CMV |
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What 2 factors determine if a sample of sputum is good?
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>25 neutrophils and <10 epithelial cells/field
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Which 6 etiologic agents don't gram stain?
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legionella, mycoplasma, mycobacteria, chlamydophilam virus, pneumocystis
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What stain do you do if you suspect TB?
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acid fast stains
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What test to detect legionella?
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legionella urine antigen - serotype 1
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most common cause of pneumonia?
Effect? |
streptococcus
acute |
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type of pneumonia seen in smokers/COPD?
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H. influenzae, moraxella
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type of pneumonia seen in post viral, endocarditis in IVDU?
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staph aureus
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type of pneumonia seen in epidemic or sporadic exposure to warm water?
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legionella
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causes of seasonal asthma?
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RSV, invluenza
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causes of pneumonia in young adults?
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mycoplasma of c. pneumoniae
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What are two empiric treatment regimens?
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1. Fluroroquiniolone
2. macrolide + beta-lactam |
