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28 Cards in this Set
- Front
- Back
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What are the risk factors for pulmonary infections?
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Decreased cough reflex
Mucociliary injury Alveolar macrophage inhibition Pulmonary congestion and edema Secretion accumulation |
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80% of respiratory infections are bacterial.
True or False? |
False
80% are viral |
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90% of community-acquired pneumonias are gram negative.
True or False? |
False
They are gram positive |
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What is the pathological sequence of changes in lobar pneumonia?
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Alveolar infiltrates cause congestion
Red hepatization (alveolar influx of serum & RBCs) Gray hepatization (alveolar influx of WBCs) Resolution |
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What is gray hepatization?
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This is when WBCs migrate into the alveolar spaces in lobar pneumonia
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What are the characteristics of the alveoli in lobar pneumonia caused by Streptococcus pneumoniae?
What is the onset? |
Alveolar involvement is confluent with neutrophils filling the spaces.
The onset is very rapid. |
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What clinical symptoms differentiates interstitial pneumonitis from lobar and bronchial pneumonia?
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Interstitial pneumonitis usually presents with a dry, non-productive cough
Causes are viral/mycoplasma |
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How can one differentiate between bronchial and lobar pneumonia based on the onset of symptoms?
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Lobar pneumonia has an abrupt onset
Bronchial pneumonia has an insidious onset |
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What are the outcomes of pneumonia?
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Resolution, abscess formation, empyema, organization, bacteremia, death
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Name some of the pathogenic bacterial infections.
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Streptococcus pneumoniae
Staphylococcus aureus Bordetella pertussis Corynebacterium diphtheriae Haemophilus influenzae Mycoplasma |
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Name two opportunistic bacterial respiratory infections.
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Legionella
Pseudomonas |
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Legionnaire's Disease
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Legionella pneumophila is causative
Gram negative rods Transmitted via air-conditioning units and contaminated water Fibrinopurulent pneumonia predominated by mononuclear phagocytes Intracellular replication in macrophages, prevents acidification of phagosome, thus phagosome-lysosome fusion |
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What pattern of lung injury is caused by Legionella pneumophila?
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Lobar pneumonia
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What patient population has the highest risk for Legionnaire's disease?
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Middle-aged and older persons
Smokers COPD patients Immunocompromised |
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Pontiac Fever
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Legionella pneumophila is causative
Does not cause pneumonia and is mild Usually affects young healthy people No treatment necessary |
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What is the pathophysiology of a Legionella pneumophila infection?
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Legionella pneumophila enter macrophages, block phagosome /lysosome fusion and lyse cells
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Cystic fibrosis, neutropenic, and burn patients are susceptible to which opportunistic infection?
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Pseudomonas aeruginosa
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Pseudomonas aeruginosa
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Gram negative rod
Leading caused of hospital acquired pneumonia Exotoxin A blocks protein synthesis and PLC (lyses RBCs and degrades surfactant) Vaculitis leads to sepsis |
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Bordetella pertussis
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Whooping cough
Gram negative rods Lymphocytosis |
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Corynebacterium diphtheriae
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Diphtheria
Gram positive rods |
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What does the diphtheria toxin cause?
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Myocardial fiber necrosis
Peripheral nerve damage |
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What is the pathophysiologic mechanism of Corynebacterium diphtheriae infection?
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Exotoxin destroys epithelial cells at infection site
Dead epithelial and inflammatory cells plus fibrin-rich exudate coalese to form pseudomembrane |
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Hemophilus influenzae
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Gram negative rods
Encapsulated (type b) Pharyngolaryngitis and epiglottitis |
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Interstitial pneumonitis
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Mononuclear cells largely confined to the interstitium
Alveolar walls widened and edematous Mycoplasma pneumoniae most common Teens, fever, NP cough, cold agglutinins (IgM) |
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What are the characteristics of interstitial pneumonitis?
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Chronic inflammation confined to septum
Monocytes and lymphocytes Mycoplasma and viruses Diffuse alveolar damage (ARDS) if severe DAD - capillary damage leads to fibrin rich hyaline membranes |
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What are the acute viral infections that are associated with interstitial pneumonitis?
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Influenza
RSV Adenovirus Hantavirus SARS Measles CMV |
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What lung pattern is most common in community-acquired pneumonias?
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Lobar
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What is the severity of RSV infection related to?
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The degree of TH2 response & levels of related cytokines (IL-4, IL-5, IL-6, IL-10)
TH1 responses are better at killing virus-infected cells |
