Term
| Pulmonary host defense mechanisms in the nasopharynx |
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Definition
| nasal hair ,turbinates ,mucociliary apparatus, IgA secretion |
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Term
| pulmonary host defense mechanisms in the oropharnyx |
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Definition
| saliva ,sloughing of epithelial cells ,local complement production ,interference from resident flora |
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Term
| pulmonary host defense mechanisms in the conducting airways(trachea+bronchi) |
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Definition
| cough +epiglottic reflexes , sharp angled branching of airways , mucocilliary apparatus ,immunoglobulin production (IgG,IgM,IgA) |
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Term
| pulomonary host defence mechamisms of the lower respiratory tract (terminal airways+alveoli) |
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Definition
aveolar lining (surfactant,Ig, complement,fibronectin ) Cytokines (IL1 ,TNF)
Alveolar Macrophages, polymorphonuclear leukocytes , cell mediated immunity . |
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Term
| Compromise in pul host defense mechanisms occurs thru |
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Definition
loss/suppression of cough reflexes (coma ,drugs ,chest pain )
Injury to mucocilliary apparatus .(impairment of cilliary function +destruction of ciliated epithelium )
Interference with phagocytic action of alveolar macrophages
Pulmonary congestion +oedema
Accumulation of secretions (cystic fibrosis+bronchial obstruction) |
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Term
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Definition
| inflammatory process involving the distal airways +alveoli resulting in formation of an inflammatory exudate . |
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Term
Community Acquired Acute Pneumonia
aetoilogical agents |
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Definition
| Streptococcus pneumonia , haemophilus influenza, moraxella catarrhalis, staph aureus, legionella pneumophila , kleb +pseudomnas |
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Term
Community acquired ATYPICAL pneumonia
aetoilogical agents |
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Definition
Bacteria-Mycoplasma pneumonia, chlamydia spp.
Virus-Resp Syncytial virus ,SARS |
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Term
| Hospital Acquired Pneumonia Aetiological agents |
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Definition
| gram -ve enterobacteriaceae (kleb, E Coli) Pseudomonas , Staph Aureus usually methicillin resistant |
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Term
| Health Care associated pneumonia aetiological agents |
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Definition
| Staph aureus ,Pseudomonas aeruginosa ,Strep pneumonia |
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Term
| Aspiration Pneumonia aetilogical agents |
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Definition
| Aerobic oral flora(bacteriodes) + Aerobic bacteria(strep pneumoniae,staph aureus , hemophilus influenzae ,pseudomonas aeruginosa) |
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Term
| Chronic Pneumonia aetiological agents |
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Definition
| Granulomatous : myobacterium TB + aytipical myobacteria |
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Term
| necrotizing pneumonia and lung abcess aetiological agents |
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Definition
| anaerobuc bacteria . ( staph aureus, klb , strep pyogenes |
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Term
| pneumonia in immunocompromised host aetiological agents |
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Definition
| pneumocystis jiroveci , invasive aspergillosis, invasive candidiasis. |
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Term
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Definition
| occurs in otherwise healthy person |
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Term
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Definition
| occurs with local or systemic defects in defense |
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Term
| Bacterial pneumonia aetiological agents |
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Definition
Streptococcus pneumoniae
Staphylococcus aureus
Myobacterium Tb |
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Term
| Viral aetiological agents of pneumonia |
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Definition
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Term
| Fungul aetiological agents of pneumonia |
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Definition
Cryptococcus Neoformans
Candidia sp
Aspergillus
Pneumocystis jiroverci |
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Term
| Other aetiological agents of pneumonia |
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Definition
mycoplasma pneumonia (Mollicutes)
Aspiration
Lipid
Eosinophilic |
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Term
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Definition
| According to dominant component of exudate |
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Term
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Definition
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Term
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Definition
| patchy consolidation involving lung |
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Term
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Definition
| whole lobe of lung affected, inflammatroy cells in alveoli and airways |
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Term
| Predisposing conditions of bronchopneumonia |
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Definition
| extremes of age ,debilitating diseases(Cardiac failure,chronic renal failure,CVA) pre-existing lung conditions, failure to clear respiratory secretion (post operative) manifestation of viral infection |
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Term
| aetiological agents of bronchopneumonia |
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Definition
| pneumococcus,klebsiella,staph aureus,strep pyogenes, haemophilus influenzae ,pseudomonas aeruginosa +legionella |
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Term
| Clinical features of bronchopneumonia |
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Definition
| fever,reduced consciousness, crackles on auscultation ,septicemia |
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Term
| Pathogenesis of bronchopneumonia |
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Definition
1. inhalation of organism
2. organism colonize bronchioles causing brochiolitis
3.inflammation spreads thru wall of bronchiole -transmural spread to surrounding aleveoli
4.significant damage to bronchiolar walls |
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Term
| Gross morphology of bronchopneumonia |
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Definition
| basal + bilateral lesions , initially focal ,involving one or more lobes . |
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Term
| Post mortem findings of bronchopneumonia |
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Definition
Grey/red lung
little resistance when gently pressing on affected area |
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Term
| Microscopic features of bronchopneumonia |
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Definition
neutrophil rich exudate (fills bronchi,bronchioles,adjacent alveolar spaces)
damaged ciliated epithelium of brochioles
Congested capillaries
intervening lung tissue not affected until it becomes confluent
Compensatory emphysema (distension without destruction) |
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Term
| Complications of brochopneumonia |
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Definition
organization which leads to fibrosis +brochectasis
abscess formation (staphylococcus +strep pyogenes)
Spread if infection ,Pleuresy in confluent bronchopneumonia ,extentensive blockage will lead to severe hypoxia+resp failure . |
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Term
| Predisposing conditions of lobar pneumonia |
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Definition
| age 20-50, males , elderly, diabetics +alcoholics |
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Term
| Aetiological agents of lobar pneumonia |
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Definition
Strep. pneumoniae (most common)
Klebsiella pneumonia |
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Term
| Clinical features of lobar pneumonia |
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Definition
| Acute onset ,fever, rigors, dry cough , rusty sputum ,pleuretic chest pain |
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Term
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Definition
| state when alveoli are filled with exudate |
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Term
| Pathogenesis of lobar pneumonia |
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Definition
1. Organism inhaled into bronchial tree right down into alveoli
2. bacteria cause inflammatory exudate in the alveoli
3. exudate is initially watery but later fibrin plus neutrophils
4.exudate flows directly into next alveolus via small airways carrying bacteria along
5.infection spread is thru the lumen rather than thru walls (less damage to bronchioles)
*klebsiella pneumonia usually causes one lobe involvement |
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Term
| Pathogenesis of strep pneumoniae |
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Definition
| 4 naturally progressing stages but patient may die before resolution occurs .stages are affected by antibiotics . |
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Term
| Lobar pneumonia stage 1 . |
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Definition
Congestion (1-2 days)
capillary congestion,alveolar oedema numerous bacteria , few neutrophils |
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Term
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Definition
| Red Hepatisation /Early consolidation (2-4 days) |
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Term
| Macroscopic characteristics of lobar pneumonia stage 2 |
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Definition
increased lung mass, fibrinous pleurisy on lung surface,sharp demarcation btw normal +abnormal lung. (lung has liver like consistency)
lung is friable |
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Term
| Microscopic characteristics of lobar pneumonia stage 2 |
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Definition
| congestion ,neutrophils,fibrin, bacteria +red cells present in alveoli +inflammatory oedema |
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Term
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Definition
| Grey Hepatization /late consolidation.(4-8 days) lung is grey due to decreased vasculature ,neutrophils are still present but much denser fibrin with hard to find bacteria |
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Term
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Definition
| Resolution (starts at 8 days -takes 1-3 weeks ) lung goes back to normal . |
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Term
| lobar pneumonia stage 4 macroscopic characteristics |
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Definition
| lung becomes patchy grey and red, pleurisy starts to resolve, fibrinous thickening/fibrous adhesions |
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Term
| lobar pneumonia stage 4 microscopic characteristics |
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Definition
| macrophages present which remove degenerate cells plus exudate, neutrophil enzymes liquefy exudate,fluid in alveolar spaces drained away by lymphatics +capillaries, lung undergoes re-aeration and returns to normal |
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Term
| complications of lobar pneumonia |
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Definition
incomplete resolution (organisation of exudate which leads to fibrosis + bronchiectasis)
lung abscess,fibrinous pleurisy can lead to empyema spread of infection . |
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Term
| Spread of lobar pneumonia infection locally |
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Definition
| pericarditis (contiguous spread) |
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Term
| Spread of lobar pneumonia infection thru blood |
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Definition
septicaemia , spread to other sites (meninges,joints,peritoneum)
heart _left sided infective endocarditis |
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Term
| Community Acquired Pneumonias |
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Definition
| term applied to an acute febrile resp disease characterized by patchy inflammatory changes in the lungs, largely confined to alveolar septa+pulmonary interstitium . |
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Term
| the term atypical denotes : |
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Definition
| moderate amounts of sputum +absence of physical findings of consolidation , only moderate elevation of white cell count , lack of alveolar exudates |
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Term
| Common cause of CAP atypical |
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Definition
| Mycoplasma infections .common among children +young adults . occur sporadically or as local epidemics |
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Term
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Definition
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Term
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Definition
Severe acute resp syndrome . -coronavirus
infects lower resp tract and causes viremia
Symptoms(fever,myalgias ,headache ,chills,dry cough ,dyspnoea) |
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Term
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Definition
| aka Hospital acquired pneumonias .commmon in patients with severe underlying immune supression or prolonged antibiotic therapy. plus patients on mechanical resp . |
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Term
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Definition
| localized area of supperative necrosis within lung parenchyma which results in the formation of one or more large cavities |
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Term
| Lung abscess causative organism intro method 1. aspiration |
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Definition
| aspiration of infective material (most frequent cause )aspiration first causes pnuemonia which progresses to tissue necrosis and formation of lung abscess |
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Term
| Lung abscess causative organism intro method 2.antecedent primary lung infection |
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Definition
| Antecedent primary lung infection .S aureus . k pneumonia . post transplant+immunocompromised patients |
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Term
| Lung abscess causative organism intro method septic |
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Definition
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Term
| Lung abscess causative organism intro method neoplasia |
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Definition
| secondary infection due to obstruction of bronchopulmonary segment by a primary or secondary malignancy |
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Term
| Lung abscess causative organism intro method miscellaneous |
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Definition
direct traumatic penetrations of the lungs ,spread of infections from neighboring organ
hematogenous seeding of the lung by pyogenic organisms |
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Term
| Cardinal histologic change in all abscesses |
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Definition
| suppurative destruction of the lung parenchyma within central area of cavitation |
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Term
| Chronic pneumonia aetiological agents |
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Definition
| Fungi (Histoplasmosis capsulatum, Coccidiodomycosisimmitis, blastomyosis dermatitidis ) |
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Term
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Definition
| Primary(patient not previously exposed to TB) +Secondary (recurrence of TB ,reactivation or reinfection) |
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Term
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Definition
Infection by inhalation ,ghon focus at the lung periphery is the site of infection . spread thru hilar lymph nodes.
Large caseous masses may form due to cellular immunity . |
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Term
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Definition
| Ghon focus +hilar node spread |
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Term
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Definition
| lesions undergo fibrosis or calcification and can heal . -fibrocalcific nodule |
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Term
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Definition
| patients have immunity to TB , Type 4 hypersensitivity resultant cellular response . which leads to caseation |
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Term
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Definition
1.Direct spread (pleura+pericardium )
2.by bronchi (bronchopneumonia +consolidation theu large areas of parenchyma)
3.lymphatics (miliary spread occurs thru lungs alone )
4.Pulmonary veins (may lead to isolated infection-Tb meningitis,renela Tb, potts disease of the spine 0
Miliary spread thru out body |
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