Ou Tulsa Pa Pulmonology

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Occupational disease usually from certain types of dust, fungus or mold

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Hypersensitivity pneumonitis

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MC respiratory disease in preterm infant (26-28)

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Hyaline Membrane disease

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Deficiency of surfactant production as well as surfactant inactivation by protein leak in air spaces of premature infants

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Hyaline Membrane disease

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MC in: N. American Blacks and N. European Whites
MC in Women
MC 3rd-4th decade

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Sarcoidosis

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MC from deep venous system of the lower extremity
(Illofemoral vein is MC)

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Pulmonary Embolism

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10% of all hospital deaths (or 3rd leading cause)
Very common

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Pulmonary Embolism

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Annual epidemics in fall and winter
Respiratory route; airborne; direct contact

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Influenza Virus (A&B)

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3 types of virus:
____ : infects mammals
____ : almost exclusively human
____ : Not as significant clinically

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Influenza Virus
A
B
C

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Most deadly infectious disease in the US and the eighth leading cause of death.

MC pathogen = S. pneumoniae

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Community Acquired Pneumonia

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People who are hospitalized
Ventilated more than 48 hours

MC organisms: S. aureus, P. aeruginosa, K. pneumo, E. coli

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Hospital Acquired Pneumonia (Nosocomial)

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PT w/ decreased consciousness b/c of drugs/alcohol
Seizures
Tracheal or nasogastric tubes
Periodontal disease/poor dental hygiene

MC organisms: P. melaninogenica, Peptostreptococcus, F. nucleatum, Bacteroides

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Anaerobic/Aspiration pneumonia

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Can be extrinsic, intrinsic, drug included, occupational or exercise induced

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Asthma

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Only non-communicable dz w/increasing mortality
4th leading cause of death in US
Death rate increasing in elderly men
>120,000 deaths annually

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COPD

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-mostly in young children
-globally, the MC cause of acute lower respiratory infection
-common cause of morbidity and mortality at the extremes of age

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RSV (respiratory syncytial virus)

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most commonly found in central and eastern US, east Canada, mexico, central america, south america, Africa and southeast asia.
inhalation of histoplasma capsulatum from contaminated bat droppings

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Histoplasmosis

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MC in caucasians
MC fatal autosomal recessive disease among Caucasian populations

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Cystic fibrosis

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-bacterial pneumonia and cancer are the MC causes
-reduced lymphatic drainage

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Exudative pleural effusion

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-imbalance between hydrostatic/oncotic forces
-increase in hydrostatic pressure w/CHF
-decreased oncotic pressure w/hypoalbuminemia

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Transudative pleural effusion

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-CHF accounts for most......... cases

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Transudative pleural effusion

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the most common cause of pleural effusion

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congestive heart failure

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Most common in thin, tall young men

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Pneumothorax

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Caused by barotrauma to the lungs, a penetrating chest wound or can occur spontaneously

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Pneumothorax

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Occurs after working in a shipyard, in construction, as a pipe-fitter or an insulator for at least 10-20 years

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Asbestosis

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Extensive or prolonged inhalation of free silica particles

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Silicosis

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what age are most children immune to RSV ?

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2 years

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What is the "peak" age that children are infected with RSV?

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2 months

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Infection of the small airways that is usually caused by a virus. It involves bronchiole epithelial cell death, sloughing of these cells, and increased mucus production.

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RSV

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If a patient is over 2 years old and exhibiting sx of bronchiolitis what are the most likely pathogens?

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-humanmetapneumovirus
-parainfluenza virus

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ingestion of ihaled coal dust by alveolar macrophages that leads to the formation of coal macules

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Coal Worker's Pneumoconiosis

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chronic fibrotic lung disease caused by the inhalation of inorganic dust.

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Pneumoconiosis

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The most common diagnosis among patients with interstitial lung disease

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Idiopathic interstitial pneumonia

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What is idiopathic interstitial pneumonia?

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A group of diseases with several similar histologic patterns

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disease that is caused by a mutation on chromosome 7 that encodes for CFTR protein, a complex chloride channel found in all exocrine tissues

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Cystic Fibrosis

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What is the primary reason for hospitalization in cystic fibrosis?

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pulmonary manifestations and exacerbations

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What pathogens are primarily responsible for colonizing the airways and creating problems for patients with cystic fibrosis?

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-staph aureus and Haemophilus during childhood
-pseudomonas

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Occurs when loss of normal pharyngeal muscle tone allows the pharynx to collapse during inspiration, and upper airway obstruction

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Obstructive Sleep Apnea

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Risk factors include:
- anatomically narrowed upper airways
- ingestion of alcohol or sedatives before sleeping
- nasal obstruction
- hyperthyroidism
- cigarette smoking
- obese, middle aged man

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Obstructive Sleep Apnea

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What causes pulmonary HTN?
Who is pulmonary HTN most commonly seen in?

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It is idiopathic
May be genetic from BMPR2 gene mutation
MC in young women

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What is bronchiectasis?

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Structural abnormality characterized by abnormal dilation and distortion of the bronchial trees

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What two factors are required for the induction of bronchiectasis?

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1. An infectious insult
2. Impaired drainage, airway obstruction or a defect in host defense

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What can disorders can lead to bronchiectasis?

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CF
Defective airway obstruction
Young's syndrome
Rheumatic and systemic diseases
Pulmonary infections
Smoking

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Bronchial walls are weakened and easily collapsible, chronically inflamed and plugged w/ mucus secretions

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Bronchiectasis

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Causes of Anaerobic/Aspiration pneumonia?

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P. melaninogenica
Peptostreptococcus
F. nucleatum
Bacteriodes

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Causes of CAP?

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S. pneumoniae (MC)
H. influenza
S. aureus
N. menigitidis
M. catarrhalis
M, C & K pneumoniae
Legionella

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What are the causes of HAP?

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S. aureus
P. aeruginosa
K. pneumoniae
E. coli

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What viral family causes influenza?

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Orthomyxoviridae
Types A, B and C