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79 Cards in this Set
- Front
- Back
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major risk factors for pulmonary infection
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-dec cough reflex
-mucociliary dysfunction -dec phago/bactericidal activity of macs -pulm congestion/edema -accum of airway secretions |
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location of suppurative
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intralveolar
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cells of interstitial
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mononuclear
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cells of suppurative
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polymorphonuclear
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lobar pneumonia evolution
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-congestion
-red hepatization -gray hepatization -resolution |
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presentation of pneumonia
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-malaise
-fever -productive cough - +/- pleurisy - +/- pleural friction rub |
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complications of pneumonia
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-abscess
-empyema -organization -> fibrous tissue -dissemination -death |
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dissemination of pneumoia is seen where?
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meninges
arthritis endocarditis sepsis |
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gram + cocci seen in pairs
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s. pneumoniae
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most common cuase of lobar pneumonia
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s. pneumoniae
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risk factors for s. pneumoniae
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CHF
COPD DM alcoholism old age |
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gram + cocci in clusters
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s. aureus
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what type of pneumo does s. pneum cause
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lobar
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what type of pneumo does s. aureus cause
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bronchopneumo (>lobar)
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risk factors of s. aureus
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measles
flu IVDA |
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gram - coccobacili
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h. influenza
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what type of pneumo does h. influenza cause
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bronchopneumonia
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risk factors of h influenza
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-recent viral infection
-CF -chronic bronchitis -bronchiectasis |
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complications of h. influenza
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empyema
extrapulmonary infection |
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gram - coccobacilli seen in elderly
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moraxella catarrhalis
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risk factors for m. cararrhalis
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old age
COPD |
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what type of pneumo does m. catarrhalis cause
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bronchopneumonia
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most common gram - bacilli in pneumonia
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klebsiella pneumoniae
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what type of pneumo does klebsiella cause
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lobar or broncho
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complications of klebsiella
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fibrosis
bronchiectasis death -abscess -gelatinous sputum (currant jelly) |
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what is pseudomonas aeruginosa
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gram - bacilli
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what type of pneumo does p. aeruginosa cause
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bronchopneumonia
-abscess, empyema |
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risk factors of p. aeruginosa
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-neutropenia
-burns -CF -mechanical vent |
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which bug frequently causes nosocomial pneum
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p. aeruginosa
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what is legionella
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gram - bacilli
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what type of pneumo does legionella cause
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bronchopenumonia (legionnaire's dz)
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risk factors for legionella
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-warm water
-old age -cardiac dz -renal dz -immunologic dz -hematologic dz -transplantation |
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what is nocardia asteriodes
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gram + filamentous bacteria
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what type of pneumo does nocardia asteroides cause
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necrotizing bronchopneumonia
-abscess |
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risk factor for nocardia asteroides
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immunocompromised
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what is actinomyces israeli
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gram + filamentous bacteria
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what type of pneumo does actinomyces israeli cause
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necrotizing bronchopneumonia
-abscess -sulfer granules |
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risk factor for actinomyces isreali
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COPD
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what is aspiration pneumonia
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chemical + bacterial pneum
chem: gastic acid bac: mixed flora -necrosis -abscess |
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microorganisms causing abscesses
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-streptococci
-s. aureus -gram - organisms: klebsiella, p. aeruginosa -oral anaerobes |
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risk factors for aspiration pneum
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-drunk
-coma -anesthics -sinusitis -gingivodental sepsis -dec cough reflex |
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risk factors for lung asbcess
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-pyogenic pneumonia
-fungal infection -bronchiectasis -immunosuppression |
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causes of lung abscess
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-aspiration
-complication of bac pneum -septic emboli -neoplasm -> obstruction -lung trauma -infection from adjacent tissue -hematogenous seeding |
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clincal setting:
aspiration number and distribution |
single
right side |
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clincal setting:
penumonia bronchiectasis number and distribution |
multiple
basal |
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lung abscess = ___ + ____
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air + pus
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symtpoms of lung abscess
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-cough
-fever -copious, malodorous sputum -weight loss -clubbing |
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complications of lung abscess
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-empyema
-hemorrhage -spetic emboli -amyloidosis |
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what are the suppurative fungi
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-candida
-aspergillus -zygomycetes |
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effect of candida
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granulomatous inflammation
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what is the effect of aspergillus
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angioinvasion -> thrombosis -> infarct
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effect of zygomycetes
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angioinvasion -> thrombosis -> infarct
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aspergillus vs. zygomyces
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a:
-septate -rigid -consistent width -45 degree branching z: -aseptate -ribbon-like -variable width -90 degree branching |
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characteristics of atypcial pneumonia
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-less sputum
-less leukocytosis -no real consolidation |
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pathogenesis of interstitial pneumonia
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-organisms enter alveolus
-infection of type I pneumos -interstitial inflammtion -resolution or intersitial fibrosis |
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most common cuase of interstitial pneumonia
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mycoplasma pneumoniae
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risk factor of mycoplasma pneumoniae
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childhood
adulthood young adulthood **life in a closed community (college, military, prison) |
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another bacteria that causes interstitial pneumonia
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chlamydia pneumoniae
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morphology of infectious intersitital pneum
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-DAD
-necrosis -> neutros -viral cytopathic effect |
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clincial clues of interstitial pneumonia
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-respiratory distress > physical exam
-respiratory distress > xray |
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CMV in children
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multisystem dz
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CMV in adults
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asymp
mononucleosis-like |
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CMV in immunosuppressed adults
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penumonitis
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clinical features of atypical pneumonia
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chest cold
fever headache malaise cough with minimal sputum |
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hallmark sign of TB
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caseating granuloma (tubercle)
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TB risk factors
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-HIV
-poverty -crowding -chronic debilitating dz -old age |
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TB pathogenesis
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-aerosol inhalation
-type IV hypersensitivity reaction -granulomatous inflammation -tissue destruction |
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primary TB gross
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ghon focus
gohn complex (gohn focus + LN) -often calficies -if progression can cavitate dissemination |
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secondary TB
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-reactivation of dormat primary lesion usually in lung apex
-consolidation with caseation -lymph node involvement less common -variant morphology - cavitary fibrocaseaous TB, miliary TB |
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clincial features of secondary TB
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-malaise
-anorexia -weight loss -low-grade fever -night sweats -sputum -hemoptysis -pleuritic pain |
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phases of histo
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mould: enviro 35 degrees
yeast: human tissue 37 degrees |
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histo vs TB
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looks like TB
-no AFB -fungal stain distinguishes histo |
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morpho of blasto
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-gran inflammation
-suppurattive with neutros -neutros admixed with histiocytes -budding organism -thick wall |
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pomogranate looking cell
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coccidoides immitis
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which yeast results in CNS dz
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cyrptococcus neoformans
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SARS morphology
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diffuse alveolar damage
-hyaline membranes |
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clinical features of SARS
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-2-10 day incubation
-atypical penumonia presentation with less URI sx -1/3 improve -2/3 -> severe respiratory distress -dyspnea, tachypnea, pleurisy |
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pneumocystis jiroveci morphology
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cup cells
-interstitial pneumonia -foamy, interalveolar exudate |
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PCP clinical features
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-fever
-dry cough -dypsnea -hypoxia -restrictive PFT -effective Rx |
