Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
32 Cards in this Set
- Front
- Back
|
Rhinoviruses |
picornaviruses (polio, HBA, Coxsackie) |
|
|
Rhinovirus human receptor |
ICAM-1 on epithelial cells |
|
|
Influenza viruses |
RNA virus, hemagglutinin binds to sialic acid, proteins, or host cells; neuraminidase removes sialic acid (allows release of viruses from host cells) |
|
|
most common cause of acute community acquired pneumonia |
Strep pneumoniae |
|
|
other causes acute CAP |
H. influenzae, Moraxella catarrhalis, Staph aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, legionella |
|
|
Lobar pneumonia |
one lobe involved; 4 stages = congestion -> red hepatization -> gray hepatization -> resolution |
|
|
mortality rate of classic lobar pneumonia |
~20%, incr. with age, other co-morbidity |
|
|
Bronchopneumonia |
multiple foci of inflammation in dependent areas (post. lungs if laying down, basal lungs if sitting up), alveoli around bronchi, patchy, multiple lobes |
|
|
complications of bronchopneumonia |
abscesses, empyema, organization w/ fibrosis, bacteremic dissemination |
|
|
bronchopneumonia is usually... |
hospital-acquired; co-morbidity present |
|
|
Atypical pneumonias |
Mycoplasma pneumoniae, Chlamydia, Viral (IC, neonates, elderly), Q fever (Coxiella burnetti), most diffuse, interstitial lymphocytic inflammation |
|
|
Pseudomonas aeruginosa |
more common in immunocompromised patients; presents w/ vasculitis (incr. dissemination); found in lettuce, taps |
|
|
Severe acute respiratory syndrome (SARS) |
Coronavirus; 2-10 d incubation, severe diffuse alveolar damage |
|
|
aspiration pneumonia |
lose gag reflex, damage from gastric acid & bile (kill ciliated cells), bacteria from mouth, lung abscess patients are debilitated/traumatized (swallowing/coughing impaired) |
|
|
lung abscess |
cause: S. aureus, gram neg. bacteria, anaerobic oral bacteria -aspiration, septicemia, neoplasia, trauma |
|
|
chronic pneumonia |
TB, histoplasmosis, blastomycosis, coccidioidomycosis presents w/ caseating granulomata & calcification |
|
|
Tuberculosis characteristics |
curved rod, 4 um long, acid fast, high lipid center strict aerobes, inhibited by ph 6.5, escapes killing by macrophages |
|
|
Primary tuberculosis |
inhale bacillus -> reaches alveolus -> phagocytosed by alveolar macrophages -> transported by hilar lymph nodes -> kills macs & rephagocytosed -> develop T-cell immunity, helper T cells produce IFNg (induce mac killing) -> suppressor T cells kill infected macs which cause granuloma to form |
|
|
Ghon lesion |
in primary TB; subjacent to pleura, lower part of upper lobes, or upper part of lower lobes; 1.0-1.5 cm, nonspecific infl. rxn caseous rxn by 2nd week, drains into peribronchial lymphatic channels, calcification |
|
|
secondary TB |
reinfection; apices of lung, 1-3 cm focal area of caseous consolidation |
|
|
secondary disseminated TB |
reactivate dormant disease or reinfection; most at apex of lung; inflammation destroys lung, disseminates via bv |
|
|
miliary TB |
widespread involvement |
|
|
complications of TB |
pleural effusions, tuberculous empyema, endotracheobronchial TB, laryngeal TB, intestinal TB, miliary TB, isolated organ TB |
|
|
TB in HIV |
higher incidence; spectrum from well-formed granulomatous infl. to poorly formed granulomata -only 1/3 have positive PPD!! |
|
|
granulomatous conditions |
TB, sarcoidosis, brucellosis, tularemia, syphilis, leprosy, glanders, lymphogranuloma inguinale, cat-scratch fever, beryliosis, mycoses |
|
|
Histoplasmosis |
-from bird droppings -intracellular parasites -mimics TB -disseminated disease in immunocompromised pts |
|
|
Blastomycosis |
-dimorphic fungus -southcentral & SE US |
|
|
Coccidioidomycosis |
-southwestern US -only 10% of people w/ positive skin test have lung granuloma, fever & skin lesion (Valley fever) -<1% develop disseminated dz |
|
|
HIV-associated lung dz |
-diffuse infiltrate = CMV, herpesvirus, Pneumocystis jiroveci, drug rxn -patchy infiltrate = bacterial, fungal (candida, aspergillus) |
|
|
characteristics of Pneumocystis |
-interstitial inflammation -Type II cell hyperplasia -"bubbly infiltrate" -see w/ silver stain! |
|
|
lung transplant |
given to endstage emyphysema & IPF, CF patients |
|
|
post-transplant infections/problems |
CMV, Pneumocystic carinii pneumonia & fungal; acute rejection, chronic rejection (bronchiolitis obliterans) |
