Term
| Name some chronic diffuse (restrictive) interstitial lung diseases that are granulomatous. |
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Definition
| sarcoidosis and hypersensitivity pneumonitis |
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Term
| Typical community acquired pneumonia is caused by... |
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Definition
***streptococcus pneumoniae***
haemophilus influenzae, staphylococcus aureus, Klebsiella pneumoniae, pseudomonas aeruginosa, legionella pneumophilia |
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Term
| What are the symptoms of typical pneumonia? |
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Definition
| high fever, productive cough, CP, tachycardia |
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Term
| What are the physical findings of typical pneumonia? |
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Definition
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Term
| What are the possible complications of pneumonia? |
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Definition
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Term
| What is a bronchpenumonia? |
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Definition
| begins as acute bronchitis and spread locally into the lungs. usually involves the lower lobes or right middle lobe. Lung has patchy areas of consolidation |
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Term
| What is a lobar pneumonia? |
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Definition
| complete or almost complete consolidation of a lobe of lung |
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Term
| What are the four stages of lobar pneumonia? |
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Definition
| congestion, red hepatization, gray hepatization, resolution |
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Term
| What happens in the congestion stage of lobar pnumonia? |
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Definition
| alveolar fluid (edema) with few neutrophils |
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Term
| What characterizes the red hepatization phase of lobar pneumonia? |
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Definition
| exudate, many neutrophils, RBCs and fibrin |
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Term
| What characterizes the gray hepatization phase of lobar pneumonia? |
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Definition
| fibrinosuppurative exudate and RBCs disintegrated |
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Term
| What characterizes the resolution phase of lobar pneumonia? |
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Definition
| exudate undergoes resorption or becomes organized with fibroblasts |
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Term
| What are the physical exam signs of consolidation/alveolar exudate? |
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Definition
| dullness to percussion, increased vocal tactile fremitus- sound is transmitted better thru consolidation. Late inspiratory crackles |
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Term
| What is the most common cause of community acquried atypical pneumonia? other causes? |
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Definition
***mycoplasma pneumoniae***
chlamydia pneumoniae and viruses such as RSV, influenza, and adenovirus |
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Term
| How are atypical pneumonias contracted? |
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Definition
| inhalation (droplet infection) |
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Term
| What does an atypical pneumonia look like on CXR? |
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Definition
| patchy interstitial pneumonia; no signs of consolidation |
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Term
| What does atypical pneumonia look like histologically? |
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Definition
| mononuclear infiltrate in alveolar walls; alveolar spaces usually free of exudate |
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Term
| What are the symptoms of atypical pneumonia? |
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Definition
| insidious onset, low grade fever, nonproductive cough, chest pain, flu-like symptoms (pharyngitis, laryngitis, myalgias, h/a) |
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Term
| T/F Atypical pneumonias NEVER show signs of consolidation. |
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Definition
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Term
| What are the risk factors for hospital acquired (nosocomial) pneumonia? |
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Definition
| severe underlying disease, antibiotic therapy, immunosuppression, respirators |
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Term
| What are the pathogens that cause hospital-aquired pneumonia? |
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Definition
gram negative bacteria such as psudomonas aeruginosa (respirators), and Eschereichia coli
Gram positive bacteria such as Staphylococcus aureus |
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Term
| WWhat are the risk factors for lung abscess? |
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Definition
| alcoholism and loss of consciousness (aspiration of oropharyngeal material) |
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Term
| What organisms cause lung abscesses? |
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Definition
| aerobic and anaerobic streptococci; fusobacterium; bacteriodes |
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Term
| Lung abscess is a complication of pnumonia caused by what organisms? |
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Definition
| staph aureus and klebsiella pneumoniae |
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Term
| What other diseases can cause lung abscesses? |
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Definition
| bacterial pneumonia, septic embolism (from infective endocarditis, say), and obstructive lung neoplasia |
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Term
| Lung abscesses due to aspiration are primarily located where? |
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Definition
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Term
| What are the symptoms of a lung abscess? |
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Definition
| spiking fever with productive cough with foul-smelling sputum |
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Term
| What does CXR of lung abscess show? |
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Definition
| cavitation with air-fluid level |
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Term
| What four things can cause a chronic pnumonia? |
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Definition
| TB, histoplasmosis, blastomycosis, and coccidiodomycosis |
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Term
| Where is TB located in the lung? |
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Definition
| subpleural (upper lower lobe or lower upper lobe) |
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Term
|
Definition
| caseous necrosis in lung parenchyma under pleura due to primary TB |
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Term
| What is the Ghon complex? |
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Definition
| Ghon focus + hilar lymph nodal involvement |
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Term
| What happens in primary TB? |
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Definition
| usually resolves producing a calcified granuloma or area of scar tissue which may be a nidus for secondary TB |
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Term
| What is secondary (reactivation) TB caused by? |
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Definition
| reactivation of previous primary TB site |
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Term
| Where does secondary TB occur in the lung? |
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Definition
| one or both apices of upper lobes (ventilation is greatest there) |
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Term
| Cavitary lesions of secondary TB are due to... |
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Definition
| release of cytokines from memory T cells |
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Term
| What are the complications of chronic pneumonia due to tuberculosis? |
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Definition
| miliary spread in lungs via invasion to bronchus or lymphatics, miliary spread to extrapulmonary sites due to invasion of pulmonary vein tributaries, massive hemoptysis, bronchiectasis, granulomatous hepatitis, spread to verbetra (Pott's disease) |
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Term
|
Definition
| when TB spreads to vertebra |
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Term
| What are the symptoms of chronic TB? |
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Definition
| fever, drenching night sweats, weight loss |
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Term
| Where in the US is hisoplasmosis endemic? |
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Definition
| ohio and central mississippi river valleys |
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Term
| What environmental things can give you histoplasmosis? |
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Definition
| inhalation of microconidia in dust contaminated with excreta from bats, starlings, pigeons or chickens ("bird dz") |
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Term
| What does histoplasmosis do ot the lung? |
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Definition
| granulomatous inflammation with caseous necrosis and marked dystrophic calcification of granulomas |
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Term
| Which organisms has yeasts forms present in macrophages? |
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Definition
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Term
| Where in the US is blastomyces dermatitidis endemic? |
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Definition
| geat lakes region, central, and southeastern US |
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Term
| T/f Blastomycosis causes granulomatous inflammation with cseous necrosis in the lungs. |
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Definition
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Term
| What species of round budding yeasts has characteristic thick wall and nuclei? |
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Definition
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Term
| Where in the US do you get coccidiodes immitis? |
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Definition
| arthrospores in dust while living or passing through arid desert areas in the southwest |
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Term
| What are the symptoms of coccidiodomycosis? |
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Definition
|
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Term
| What are the morphological characteristics of coccidiodomycosis? |
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Definition
| spherules with endospores |
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Term
| What opportunistic infections commonly cause pneumonia? |
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Definition
| CMV, pneumocystisis, mycobacterium avium intracellulare complex, aspergillus fumigatus |
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Term
| What is the most common pathogen causing pneumonia in AIDS patients? |
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Definition
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Term
| Which disease has "cotton Candy' exudate and whose organisms has RBC-like morphology? |
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Definition
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Term
| What is the most common form of TB in AIDS pts? |
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Definition
MAC (mycobacterium avium-intracellulare complex)
occurs when CD4 T H coutn falls below 50 cells/mm3 |
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