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57 Cards in this Set
- Front
- Back
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define pneumonia?
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inflammatory process of infectious etiology affecting lung parenchyma
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Etiologies of pneumonia?
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Bacterial
Fungal Viral |
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What fractions of deaths in US from pneumonia?
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1/6
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2 types of Bacterial Pneumonia?
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Lobar
Lobular |
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Lobar vs Lobular
involvement? |
Lobar = entire lobe
Lobular = patchy in one or more lobes |
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Location of exudate in lobar vs lobular?
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Lobar = intraalveolar
Lobular = bronchioles to alveoli |
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Most common causes of Lobar Pneumonia?
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Strep pneumoniae
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Most common causes of lobular?
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Staphylococcus
Haemophilus Klebsiella |
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How does acute bacterial pneumonia present?
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Abrupt onset
High Fever Chills Productive Cough |
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Cell count w/ diff findings in acute bacterial pneumonia?
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Markedly elevated WBC's
+ Neutrophils Left Shift (inc bands) |
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Possibly underlying contributors to acute bacterial pneumonia?
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CHF
COPD Dec or absent splenic fxn (sickle cell) |
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Which infection is more common w/ sickle cell's splenic dysfxn?
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strep pneumoniae
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Who else is Strep Pneumoniae common in?
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Elderly
CHF Malnourished |
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Who gets staph aureus pneumonia?
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Complication w/ viral pneumonia
IVDU COPD |
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Who gets Klebsiella pneumonia?
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Diabetics
Alcoholics |
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Who gets H. influenza pneumonia?
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Kids
COPD |
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How might one get Legionella pneumonia?
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aerosol of contaminated water (AC units)
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Stages of Acute Bacterial Lobar Pneumonia?
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Congestion
Red Hepatization Gray Hepatization Resolution |
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Kickers for each stage?
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Congestion: few polys, exudate
Red H: many poly's, RBC's Gray: fibrinopurulent exudate Resolution: healing/scarring |
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Complications of Acute Bacterial Pneumonia?
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Abscess
Empyema Pleuritis |
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Quick Definition of empyema?
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suppurative exudate in pleural cavity
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Quick Definition of Pleuritis?
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Suppurative Inflammation of Pleura
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Kickers for Lung Abscess?
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Local area of suppurative necrosis
Abundant PMN's Cavitation |
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Pathogenesis of Lung Abscesses?
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Aspiration
Obstruction Complication |
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Bugs causing lung abscesses?
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Staph
Klebsiella Pseudomonas Proteus Anaerobes are common |
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Location of abscess w/ Aspiration?
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Right Lung
Posterior Upper Lobe Apical Lower Lobe |
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location of abscess w/ obstruction?
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Distal to obstruction
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Location of abscess as a complication?
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Multiple
Scattered |
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Different presentation of Community acquired atypical pneumonia?
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modest sputum production
modestly elevated WBC's |
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Etiology of Community acquired atypical pneumonia
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Mycoplasma (most common)
Viral Chlamydiae |
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Local of Community acquired atypical pneumonia
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Interstitial
Septal |
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Exudate location in Community acquired atypical pneumonia?
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Not in alveoli
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Bug etiology of aspiration pneumonia?
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Aerobes (#1) and Anaerobes
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Morphology of Aspiration Pneumonia?
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Necrotizing
Abscess common |
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Bug etiology of Nosocomial Pneumonia?
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Gram Negative Rods (pseudo, kleb, h. flu)
S. aureus |
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Chronic diseases predisposing you to TB?
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Diabetes
Lymphoma Chronic Lung Disease Alcoholism |
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Difference between primary and secondary TB?
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primary is an unexposed, unsensitized person
secondary is a reactivation |
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Location of areas affected by Primary TB?
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Ghon Focus
Ghon Complex |
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what the crap is the Ghon Focus?
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Mid lung fields
Close to pleura |
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What is the Ghon Complex?
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Peribronchial Lymph Nodes
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Appearance of Histo of Primary TB?
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Caseous Necrosis
Granulomatous |
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Appearance of histo of secondary TB?
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Caseous, Granulomatous inflammation
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Location of Secondary TB?
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Apex of one or both upper lobes
CAVITATION |
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Who gets candidiasis pneumonia?
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Immunocompromised pts
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Histo appearance of Candidiasis pneumonia?
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pseudo and true hyphae
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Who gets cryptococcus neoformans pneumonia?
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immunocompromised
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Disease progression of cryptococcus?
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starts in the lungs
moves to the brain |
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Histo appearance of cryptococcus?
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Budding yeast
Thick capsule India ink stains the capsule makes it look like it has a halo |
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Opportunistic molds that can cause pneumonia?
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Mucormycosis
Aspergillosis |
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Mucor vs aspergillosis?
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Mucormycosis: nonseptate hyphae, branch at right angles
Aspergillosis: septate hyphae, branch at acute angles |
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Kicker w/ both opportunistic molds?
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Angioinvasive leading to Infarction or cavitation
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What type of virus is cytomegalovirus?
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Herpesvirus
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Who gets CMV infection?
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Young
HIV Neonates Bone Marrow Transplant |
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Kicker appearance of CMV?
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Intranuclear Inclusion (owl's eye)
Intracytoplasmic Inclusion Affected cells are enlarged |
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Who gets pneumocystis pneumonia?
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Immunocompromised
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Kickers for Pneumocystis Pneumonia?
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Intraalveolar Exudate (foamy)
Silver Stain are key for visualizing |
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How does viral pneumonia present?
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Interstitial pneumonia w/ lymphocyte response
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