Term
|
Definition
| any infection of the lungs, acute or chronic |
|
|
Term
| 4 general ways microbes get into the lungs |
|
Definition
nasopharyngeal flora aspirated in sleep
lung disease makes vulnerable to virulent organisms
defects in immunity
exogenous interferences |
|
|
Term
| 3 ways lung disease makes lung vulnerable to virulent organisms |
|
Definition
secondary bacterial infection follow viral infection
microbes damage mucocilliary elevator
mucous plugging |
|
|
Term
| 3 defects in immunity that lead to pneumonia and which organisms |
|
Definition
innate (neutrophil and complement defect): pyogenic bacteria
humoral: pyogenic bacteria
cell mediated: microbes, viruses, low virulence organisms |
|
|
Term
| 2 exogenous interferences of lung defenses and how they do it |
|
Definition
cigarettes: compormise mucocilliary elevator and macrophage activity
alcohol: impairs cough and epiglottic reflexes increasing aspiration, interferes with neutrophil chemotaxis |
|
|
Term
| host defenses in the nasopharynx 4 |
|
Definition
nasal hairs
turbinates
mucocilliary apparatus
IgA |
|
|
Term
| 4 host defenses in the oropharynx |
|
Definition
saliva
sloughing of epithelium
local complement production
interference from resident flora |
|
|
Term
| 6 host defenses in the trachea and bronchi |
|
Definition
cough
epiglottic reflexes
sharp angled branching
mucocilliary apparatus
IgG
IgM
IgA |
|
|
Term
| 9 host defenses in the terminal airway and alveoli |
|
Definition
alveolar lining fluid: surfactant, ig, complement, fibronectin
cytokines: IL-1, TNF
alveolar macrophages
polymorphonuclear leukocytes
cell mediated immunity |
|
|
Term
| general symptoms of pneumonia 12 |
|
Definition
acute or chronic disease
organism leaks into blood: fever, chills
cough: yellow green or rusty sputum
tachypenia and pleuritic CP due to stretch of pleura on breathing
decreased breath sounds
rales
dullness to percussion
elevated WBC |
|
|
Term
| how can you tell apart viral and bacterial pneumonia morphologicaly |
|
Definition
bacterial: fibrinopurulent exudate
viral and atypical: mononuclear interstitial infiltrate |
|
|
Term
| how can you tell morphologically a pneumonia is chronic |
|
Definition
|
|
Term
| 3 ways to diagnose the orgsnism in pneumonia |
|
Definition
culture and stain of sputum
CBC: increased WBC, left shift, culture
CXR: lobar, segmental, bronchopulmonary, pleural effusions |
|
|
Term
| bronchopneumonia: location |
|
Definition
| patchy exudate involving more than one lobe, bilateral |
|
|
Term
| bronchopneumonia: morphology 4 |
|
Definition
gray yellow lesions
confluence of foci may look lobar
hyperemic and edematous around foci
exudate fills bronchi and alveoli |
|
|
Term
| causes of bronchopneumonia 5 |
|
Definition
stapn aureus
H. influenza
pseudomonas
moraxella
legionella |
|
|
Term
| complications of bronchopneumonia 5 |
|
Definition
fibrous scaring
pleural adhesions
lung abscess
emphyema
necrosis |
|
|
Term
| lobar pneumonia: location |
|
Definition
| contiguous homogenous exudate in one lobe |
|
|
Term
|
Definition
bacterial commonly following viral infection
strep pneumo 90%
klebsiella pneumonia |
|
|
Term
| sighs of lobar pneumonia 6 |
|
Definition
| sbrupt shaking, chills, high fever, pleuritic pain, mucopurulent cough |
|
|
Term
| causes of community acquired typical pneumonia 7 |
|
Definition
strep pneumo
h. influenzae
moraxella
staph aureus
legionella
klebsiella
pseudomonas |
|
|
Term
| causes of community acquired atypical pneumonia 7 |
|
Definition
mycoplasma
infleunza
chelmydia pneumpnia
coxiella burnetti
RSV
PIV
adenovirus |
|
|
Term
| causes of nosocomal pneumonia 4 |
|
Definition
klebsiella
E. coli
pseudomonas
S. aureus - usually MRSA |
|
|
Term
| causes of aspiration pneumonia 8 |
|
Definition
oral flora: bacteroides, prevotella, fusobacterium, peptostreptococcus
S. pneumoniae
S. aureus
H. infleunzae
pseudomonas |
|
|
Term
| causes of chronic pneumonia 9 |
|
Definition
nocardia
actinomyces
TB
MAC
M. kanasaii
M. avscessus
histoplasma
coccidioides
blastomyces |
|
|
Term
| causes of opportunistic pneumonia 7 |
|
Definition
CMV
pneumocystis pneumonia
candidia
cryptococcus
mycosis: mucor, rhizopus (zygomycophyta)
aspergillus |
|
|
Term
| causes of pneumonia with HIV 4 |
|
Definition
S. pneumonia
S. aureus
H. influenza
GNR |
|
|
Term
| what are the symptoms of a CA typical 6 pneumpnia vs CA atypical 4 |
|
Definition
CA: fever, shaking, chills, pleuritic CP, mucopurulent cough, hemoptysis
atypical: fever, headache, malaise, cough (no suptum) |
|
|
Term
| most common cause CA pneumonia |
|
Definition
|
|
Term
| most common cause bacterial pneumpnia in COPD pt |
|
Definition
|
|
Term
| second most common cause bacterial pneumonia in COPD pt |
|
Definition
|
|
Term
| most common cause of pneumpnia secondary to viral infection |
|
Definition
|
|
Term
| most common gram negative cause of pneumpnia |
|
Definition
|
|
Term
| most common cause of pneumpnia in CF, neutropenic pt, burn patient, pt on ventilator |
|
Definition
|
|
Term
| most common atypical pneumonia |
|
Definition
|
|
Term
| most common cause of pneumonia in pt with splenectomy |
|
Definition
|
|
Term
| most common cause of pneumonia in pt with DM or CHF |
|
Definition
|
|
Term
| most common cause of pneumonia in alcoholic |
|
Definition
|
|
Term
| most important cause of chronic pneumonia |
|
Definition
|
|
Term
| most common fungal pneumonia in neutropenic and leukemia patients |
|
Definition
|
|
Term
| most common fungal pneumonia in AIDS and hematolymphoid malignancies (hodgkins) |
|
Definition
|
|
Term
| streptococcal pneumonia: who goes it infect most 6 |
|
Definition
| CHF, COPD, DM, Ig defects, AIDS, splenectomy |
|
|
Term
| streptococcal pneumonia: location in lung |
|
Definition
lobar or bronchopneumonia
mostly low/middle lobes |
|
|
Term
| streptococcal pneumonia (and other gram positive pneumonias): 4 stages of infection and changes at each stage |
|
Definition
1. congestion (24h): dilation of vessels causes blood and edema with protein, lobe is red, heavy, boffy, protein fluid, neutropphils, bacteria
2. red hepatization (days): exudate in alveoli with fibrin, RBC, neutrophils, live like consistancy
3. gray hepatization: dry, gray, firm due to RBC lysis, fibrinosuppurative exudate, persists in alveoli
4. resolution: exudate digested by macriphages making semi fluid which is resorbed or coughed up. type II pneumocytes regenerate leaving thickening and adhesions made with fibroblasts |
|
|
Term
| streptococcal pneumonia: capsule?, stain type, lab tests |
|
Definition
encapsulated
GP diplococci
exudates
optochin sensitive
a hemolytic
bile soluble |
|
|
Term
| streptococcal pneumonia: complications 4 |
|
Definition
abscessl: due to tissue necrosis
empyema: suppurlitive material accumulates in pleural cavity
fibrous change: intra alveolar exudate converts adjacent areas
dissemination: meningitis, arthritis, infective endocarditis |
|
|
Term
| streptococcal pneumonia: diseases it causes 5 |
|
Definition
pneumonia
meningitis
otitis media
arthritis
infective endocarditis |
|
|
Term
| hemophilus influenza: capsile?, growth medium, types and who they infect |
|
Definition
polyribitol capsule
chocolate with factor V (NAD) and X (hematinin)
A: adults with pulmonary disease (COPD, CF, bronchiectasis, bronchitis)
B: kids causing epiglottis, suppurative meningitis |
|
|
Term
| hemophilus infleunza: diseases it causes 5 |
|
Definition
suppurative meningitis
otitis media
sinusitis
epiglottis
pneumonia |
|
|
Term
| moraxella catarrhalis: who it infects |
|
Definition
elderly
second most common bacterial pneumonia in COPD |
|
|
Term
| moraxella catarrhalis: diseases it causes and in who |
|
Definition
pneumonia in adults
otitis media in kids |
|
|
Term
| staphlococcis aureus: who it infects 2 |
|
Definition
pt who just had viral infection (often measles or influenza)
IV drug users |
|
|
Term
| staphlococcis aureus: complications 3 |
|
Definition
| lung abscess empyema (puss), right side endocarditis (IV drug users) |
|
|
Term
| which microbes cause nectrotizing pneumonia 5 |
|
Definition
anaerobes
S. aureus
Klebsiella
strep pyogenes
pseudomonas |
|
|
Term
| klebsiella pneumonia: who it infects 2 |
|
Definition
malnourished
chronic alcoholics
elderly |
|
|
Term
| klebsiella pneumonia: stain type |
|
Definition
|
|
Term
| klebsiella pneumonia: signs 2 |
|
Definition
emphyema (puss)/ absvess
thick gelatenous current jelly sputum |
|
|
Term
| pseudomonas aeruginosa: who it infects 6 |
|
Definition
| CF, nosocimal, neutropenic (secondary to chemo, buruns, ventilation) |
|
|
Term
| how does pseudomonas aeruginosa cause damage |
|
Definition
| exotoxin A: alongation factor 2 inhibitor decreasses protein synthesis |
|
|
Term
| pseudomonas aeruginosa; stain type, diagnostic tests 4 |
|
Definition
GNR
non lactose fermenting
oxidase positive
blue green (pricyanin pigment)
exotoxin (causes shock) |
|
|
Term
| pseudomonas aeruginosa: morphology changes 2 |
|
Definition
coagulative necrosis of lung parenchyma
pseudomonas vasculitis: organisms invade vessel |
|
|
Term
| legionella pneumonophilia: who it infects |
|
Definition
| pt who went into aqueous environment and aspirated water (esp with cardiac, renal, immunologic,c hematologic disease or transplant) |
|
|
Term
| 2 conditions caused by legionella and they symptoms |
|
Definition
legionaires: epidemic, sportic, pneumonia, high fever, diarrhea, hyponatremia
often in smoker
pontiac ffever: self limited URI |
|
|
Term
| legionella pneumophilia: stain tyoe, growth medium |
|
Definition
GNR, silver stain (intracellular)
charcoil yeatt + FA + cystine |
|
|
Term
| diagnosis of legionella 2 |
|
Definition
| antigens in urine, florescent antibody in sputum |
|
|
Term
| explain the look of atypical pneumonia on CXR |
|
Definition
patchy inflammation of the lungs confined to alveolar septa and interstitium
no alveolar exudates, consolidation, sputum
respiratory distress may be out of proportion with CXR findings |
|
|
Term
| mycoplasma pneumonia: who does it infect 3 |
|
Definition
young kids and young adults
closed communities (epidemics)
serous in compormised |
|
|
Term
| mycoplasma pneumonia: changes in respiratory morphology 2 |
|
Definition
attacks epithelium and alveoli: necrosis, inflammation
inhibits mucocilliary clearance (this is weird, normal viral) |
|
|
Term
| mycoplasma pneumonia: stain type, capsule?, cell components, growth medium |
|
Definition
not visible on gram stain
lacks cell wall (pen/ceph resistant)
membrane has cholesterol
grows on eatons agar |
|
|
Term
| mycoplasma pneumonia: CXR |
|
Definition
| lobar, bronchopneumonia, interstitial consolidations (watch out this is unlike other atypicals) |
|
|
Term
| mycoplasma pneumonia: symptoms 7 |
|
Definition
non-specific: fever, headache, malaise, cough, minimal sputum
autoimmune hemolytic anemia (IgG cold agglutinin)
erythema multiform |
|
|
Term
| mycoplasma pneumonia: why is respiratory distress out of proportion with alveolar findings |
|
Definition
| edema and inflammation are specific to alveolar septa |
|
|
Term
| which pneumonia microbe is most likley to cause sepsis, why, 7 signs |
|
Definition
pseudomonas aeruginosa
invades vessels at site and becomes extrapulmonaly in days
echyma gangrenosum (black skin lesions), UTI, external otitis, malignant otitis external (DM), osteomyelitis, hot tub follicles |
|
|
Term
| infleunza: genoma type, 3 cell components, 3 types and what they infect |
|
Definition
ssRNA
hemoagglutinin, neuraminidase, ameliroate
A: pigs, horses, birds, humans
H5N1: bird flu
H1N1 (A): swine flu |
|
|
Term
| which microbe displays antigenic drift and shift, define each |
|
Definition
influenza virus
drift: epidemics, mutation in hemagglutinin/neuraminidase allowing virus to escape host antibodies
shift: pandemic, both hemagglutinin/neuraminidase replaced by recombination of RNA with animal viruses makign new influenza virus |
|
|
Term
| H5N1: what it infects, why its a concern |
|
Definition
| bird flu: outbreals in domesticated poultry in SE Asia and has potential to jump to humans making pandemic |
|
|
Term
| H1N1: signs, prognosis, who it infects and why |
|
Definition
pandemic of mostly self limiting illness with viral replication limited to pharynx and tracheobronchial tree, some progressed to pneumonia
cormorbid conditions allowed for fatality
immunity may have been achieved with previous exposure because it killed few >60yo |
|
|
Term
| H1N1: morphological changes 3 |
|
Definition
alveolar damage
pulmonary thrombosis
alveolar hemorrhage |
|
|
Term
| chalmydia pneumonia: life cycle |
|
Definition
elementary body (small, endocytose into cell)
reticulate body (visible, replicates in cell) |
|
|
Term
| chalmydia pneumonia: gram stain type, |
|
Definition
obligate intracellular
no muramic acid in cell wall
use gemisa stain |
|
|
Term
| C. trachomatis: 4 diseases it causes |
|
Definition
| urethritis, reactive arthritis, conjunctivits, PID |
|
|
Term
| coxiella birnetti: who it infects and how transmitted |
|
Definition
seen in farmers and vets
deposited on cattle by tick
respiratory transmission via endospores |
|
|
Term
| coxiella burnetti: microbe family |
|
Definition
| rickettsia (but is weird cause it causes pneumonia, no arthropod transmission, no rash) |
|
|
Term
| coxiella burnetti: signs of infection |
|
Definition
|
|
Term
| method of HA-pneumonia infection |
|
Definition
immune supression
prolonged antibiotics
mechanical ventilation |
|
|
Term
| method of aspiration pneumonia infection |
|
Definition
aspiration of gastric contents when unconscious, vomiting, GERD
gastric acid damage allows bacterial invasion |
|
|
Term
| morphology of aspiration pneumonia |
|
Definition
| necrotizing, fulminant, abscess formation (RIGHT LOWER LOBE) |
|
|
Term
| what type of pneumonia would give the lung a liver like consistancy |
|
Definition
| strep pneumonia typical CA |
|
|
Term
| what type of pneumonia causes fibrous changes in the lung (thickening and adhesions) |
|
Definition
| strep pneumonia typical CA |
|
|
Term
| what type of pneumonia can also cause epiglottitis |
|
Definition
|
|
Term
| what type of pneumonia can cause suppurlative meningitis |
|
Definition
|
|
Term
| what type of pneumonia can cause right side endocarditis |
|
Definition
| S. aureus typical CA in IV drug user |
|
|
Term
| what type of pneumonia can cause current jelly sputum |
|
Definition
| klevsiella pneumonia typical CA |
|
|
Term
| what type of pneumonia can cause echyma gangrenosum |
|
Definition
| pseudomonas aeruginosa typical CA |
|
|
Term
| what type of pneumonia can cause malignant otitis media in DM |
|
Definition
| pseudomonas aeruginosa typical CA |
|
|
Term
| what type of pneumonia can cause osteomyelitis |
|
Definition
| pseudomonas aeruginosa typical CA |
|
|
Term
| what type of pneumonia can cause diarrhea and hyponatremia |
|
Definition
| legionella pneumonia typical CA |
|
|
Term
| what type of pneumonia can cause autoimmune hemolytic anemia (IgM cold agglutinin) |
|
Definition
| mycoplasma pneumonia atypical CA |
|
|
Term
| what type of pneumonia can cause erythema multiform |
|
Definition
| mycoplasma pneumonia atypical CA |
|
|
Term
| what type of pneumonia can cause pulmoney thrombosis and alveolar hemorrhage |
|
Definition
|
|
Term
| what type of pneumonia can cause very high fever |
|
Definition
| coxiella burnetti atypical CA |
|
|
Term
|
Definition
aspiration of infective material
aspiration of gastric contents
necrotizing pneumonia
bronchial obstruction
septic emboli
hemotegnous spread
anaerobic bacteria |
|
|
Term
| gives examples of aspirated material that could cause lung abscess |
|
Definition
| teeth, sinus materia, tonsils, oral surgery, anesthesia delivered, coma, intoxication, depressed cough reflex |
|
|
Term
| examples of things that can cause bronchial obstruction 4 |
|
Definition
bronchogenic carcinoma
impaired drainage
distal atlectasia
aspiration of blood or tumor fragment |
|
|
Term
| where could a septic emboli come from that causes lung abscess |
|
Definition
| thrombophlebitis from endocarditis of right heart |
|
|
Term
| how can you identify lung abscess came from hemotgenous spread |
|
Definition
| causes multiple abscesses |
|
|
Term
| what microbes are in lung abscess |
|
Definition
always have oral mucrobes (fusobacterium, bacteriudes, peptostreptococcus, microaerophilic streptococci)
plus the offending microbe |
|
|
Term
| most common location of lung abscess, why |
|
Definition
right because usually caused by aspiration
usually posterior upper lobe and apical lower lobe |
|
|
Term
| what causes diffuse lung abscesses 3 |
|
Definition
| caused by pneumonia, bronchiectasis, hemotenous spread |
|
|
Term
| what causes multiple lung abscesses in one region |
|
Definition
|
|
Term
| symptoms of lung abscess 7 |
|
Definition
foul smelling purulent or sanquineous sputum, sometimes shemoptysis
spiking fever
malaise
clubbing fingers
weight loss
anemia |
|
|
Term
| what tumor can lead to lung abscess |
|
Definition
| bronchiogenic carcinoma: infective abscess in 10-15% |
|
|
Term
| morphology of a lung abscess 5 |
|
Definition
suppurative
necrotizing
large cavitation
mononuclear infiltrate
fibrous scars |
|
|
Term
| complications of lung abscess 6 |
|
Definition
bronchopleural fistula: ABSCESS RUPTURE INTO PLEURAL CAVITY CAUSING PNEUMOTHORAX OR AMPYEMA
hematogenous spread: meningitis, brain abscess
septic emboli: endocarditis, thrombi to other part of body
bronchial obstruction; esp from tumor
seconday amyloidosis: when chronic
necrotozing pneumonia: when necrotizing microbe |
|
|
Term
|
Definition
antibiotics
surgical draining |
|
|
Term
| what lung condition causes foul smelling purulent or sanquineous sputum and clubbing of fingers |
|
Definition
|
|
Term
| what lung condition causes pneumothorax and empyema |
|
Definition
| bronchopleural fistual: lung abscess ruptures into pleural cavity |
|
|
Term
| chronic pneumonia general shared characteristic |
|
Definition
| granulomatous inflammation in localized lesion |
|
|
Term
| who does TB infect (too many) |
|
Definition
| crowds, elderly, compormised, chronic illnesses, AIDS, poor, minotiries, DM, hodgkins lymphoma, chronic lung diseases (silicosis), chronic renal failure, malnutrition, alcoholism ummune supression, HIV |
|
|
Term
| what is the single most important risk factor for the development of TB |
|
Definition
|
|
Term
|
Definition
direct inhilation
contaminated secretions
milk (M. bovis) |
|
|
Term
|
Definition
| infection of TB in a previously unsensitized patient |
|
|
Term
|
Definition
| asymptomatic, may have pleural effusions |
|
|
Term
|
Definition
acid fast rods, complex lipids
ziehl neelson (carbol fuschin) staining |
|
|
Term
| 6 steps of primary TB infection |
|
Definition
1. bacilli inhaled into LOWER LOBE or UPPER LOBE CLOSE TO PLEURS
2. phagocytosed and PREVENT FUSION of phagolysosome stopping degredation
3. ghon complex: TB bacilli replicate in macrophages and travel to regional nodes seeding sites, flu like signs
4. ghon focus: gray-white inflammatory consolidation and ceseating necrosis forms due to initial sensitization
5. 3wk: Th1 made, secretes INFy which upregulates TNF, which recruits monocytes, NO antibacteria, and ROS antibacterial
6. ranke complex: ghon complex undergoes fibrosis and calcification as INFy, IL-12, TNF, NO cause granulomas walling off infected macrophages and progression stops |
|
|
Term
| complications of primary TB infection 3 |
|
Definition
hypersensitivity and increased resistance
could activate and transmit if defenses lowered
progressive primary TB |
|
|
Term
| progressive primary TB: cause |
|
Definition
| compormised pt (esp HIV) or of inuir descent has inability of CD4 reaction due to hypersensitivity and resistance leads to absence of caseating granulomas (non-reactive TB) |
|
|
Term
| what is NRAMP1, how does it effect the body |
|
Definition
natural resistance associated macrophage protein 1
if B has this gene it may not elict immune response and then the gene kills itself |
|
|
Term
|
Definition
reaction in sensitized host due to immune compormised state
exogenous re-infection with large amounts of TB |
|
|
Term
| location of secondary TB 2 |
|
Definition
simon focus: at apex of one or both upper lobes due to like of O2
regional nodes: less prominant than primary TB because bacilli cause tissue response that walls off ghon focus |
|
|
Term
|
Definition
infection causes delayed hypersensitivity
2-4wk later PPD is positive in 48h
CXR: consolidation or cavitation at apices
culture: acid fast, florezcent auramine rhodamine, PCR amplification |
|
|
Term
| 6 things that cause false positive PPD |
|
Definition
viral infection
sarcoidosis
malnutrition
hodgkin lymphoma
immune supression
atypical mycobacteria |
|
|
Term
| what do the lesions in secondary TB look like, location, color, texture (10) |
|
Definition
small circumscribed focus on consolidation
in apical pleura
firm
white-gray
central caseation
peripheral fibrosis
coalescent tubercles
cavitation leading to erosion and dissemination in airway so pt is infectious |
|
|
Term
| clinical signs of secondary TB and what causes them 12 |
|
Definition
asymptomatic
TNF/IL-1: malaise, anorexia, weight loss, fever (low grade, remittent, afternoon), night sweats
mucoid followed by purulent sputum (after cavitation of lesion)
pleuritic pain: extension of infection into pleura
extrapulmonary: salpingitis causes infertility, meningitis, potts causes back pain |
|
|
Term
| TX and prognosis of secondary TB |
|
Definition
multidrug resistance
favorable prognosis if localized to lung
worse prognosis if disseminated, old, immune supressed, miliary TB, multi drug resistance |
|
|
Term
| complications of secondary TB |
|
Definition
amyloidosis in persistant cases
progressive pulmonary TB |
|
|
Term
| progressive pulmonary TB: lesion appearance and location, signs 3, treatment and prognosis |
|
Definition
paical lesion: more caseation, erosion into bronchi, fibrous tissue walls, erosion of vessels, hemoptysis
signs: pleura effusions, TB empyema, obliterative fibrous pleuritis
tx stops process but cannot fix pulmonary tissue (irregular cavities, free of caseation necrosis or fibrosis) |
|
|
Term
| what happens in progressive pulmonary TB without tx |
|
Definition
| direct expansion via airway dissemination, hematologenous, lymph |
|
|
Term
| what are 7 special types or manifestations of TB |
|
Definition
miliary
endobronchial/trachial/laryngeal
systemic miliary
isolated organ
lymphadenitis
intestinal
HIV TB |
|
|
Term
| miliary TB: MOA, lesion type |
|
Definition
bacili drain into lymph, right heart, and pulmonary arteries
many small yellow-white lesions in parenchyma |
|
|
Term
| endobronchial/tracheal/laryngeal TB: MOA, appearance |
|
Definition
| spread via lymph or expectorated sputum causing studded mucous lining |
|
|
Term
| systemic miliary TB: MOA, organs infected 7 |
|
Definition
disseminated through systemic arteries to organs making granulomas
marrow, spleen, adrenal, maninges, kidney, fallopian, epididymis |
|
|
Term
| isolated organ TB: MOA, 5 organs affected, 2 specific conditions |
|
Definition
hematogenous spreading
meninges, kidney, adrenal, bone, fallopian tube (salpingitis)
pott disease: infection of vertebrae
cold abscess: paraspinal tracking, pelvic and abdominal mass |
|
|
Term
| what is the most frequent extrapulmonary form of TB |
|
Definition
|
|
Term
| TB lymphadenitis: locations, why gets it |
|
Definition
scrofula: cervial region
unifocal, almost always in HIV patients |
|
|
Term
| intestinal TB: causes 2, spread |
|
Definition
caused by drinking contaminated milk (old days) or secondary TB secondary to swallowing coughed up TB
TB in lymph of Si, inflammation, ulceration of mucosa (Esp ileum) |
|
|
Term
| HIV and TB presentation when CD4<200 |
|
Definition
| like progressive primary TB: lower middle consolidation, hilar lymphadenopathy, noncavitation, 50% extrapulmonary involvement |
|
|
Term
| HIV and TB presentation when CD4>300 |
|
Definition
| present with secondary TB: apical disease, cavitation, 15% extrapulmonary involvement |
|
|
Term
|
Definition
| fever, night sweats, weight loss, HSM, lymphadenopathy, diarrhea, pulmonary involvement that looks like TB |
|
|
Term
|
Definition
| only disseminates in AIDS when CD4<100 as foamy histocytes stuffied with it |
|
|
Term
| what type of pneumonia has lesion in apical pleura, circumscribed, gray white, peripheral fibrosis |
|
Definition
|
|
Term
| what type of pneumonia causes low grade, remittent, and afternoon fevers |
|
Definition
|
|
Term
| what type of pneumonia causes salpingitis and infertility |
|
Definition
|
|
Term
| what type of pneumonia causes back pain |
|
Definition
| secondary TB potts disease |
|
|
Term
| what type of pneumonia causes erosion into bronchi, bessels, and hemoptysis |
|
Definition
|
|
Term
| what type of pneumonia causes cold abscess (paraspinal tracking, pelvic and abdominal masses) |
|
Definition
|
|
Term
| what type of pneumonia causes scrofula, what is it |
|
Definition
| cervical lymphadenitis caused by secondary TB (often in HIV patient) |
|
|
Term
|
Definition
| fungi is mold at 20C (68F) (hyphe, multicellular colony, joined end to end) and yeast at 37C (unicellular growth form) |
|
|
Term
| how is fungal pneumonia transmitted |
|
Definition
| environmental source, not by people |
|
|
Term
| what is a primary nodule in fungal pneumonia made of |
|
Definition
| macrophages stuffed with organisms evolve into granuloma with giant cells, central necrosis, fibrosis, calcification (very simillar to primary TB) |
|
|
Term
| histoplasmosis capsulatum: location 5 |
|
Definition
| mississippi and ohio river valley, appalachia, SE US, warm moist soil, in bat poo |
|
|
Term
| histoplasmosis capsulatum: lesion morphology 8 |
|
Definition
macrophages filled with histoplasma bodies
hyphae
microconidia
tuberculate microconidia
no capsule
round or oval
small yeast |
|
|
Term
| histoplasmosis capsulatum: signs 2 |
|
Definition
pneumonia (HSM, flu like)
fungemia (esp in AIDS) |
|
|
Term
| coccidioidomycosis immitis: location 3 |
|
Definition
| SW US, california, San joaquin valley "valley fever" |
|
|
Term
| coccidioidomycosis immitis: morphology of microbe 4 |
|
Definition
thick wall
non budding spherules
filled with endosopores
NOT dimorphic |
|
|
Term
| coccidioidomycosis immitis: signs of infection 5 |
|
Definition
calcification of pulmonary lesion
dissemination to bone and skin
erythema nodosum (Desert bumps)
pneumonia
dissemination more in 3rd trimester |
|
|
Term
| blastomycosis dermatitis: location |
|
Definition
| same as histoplasmosis but US only |
|
|
Term
| blastomycosis dermatitis: morphology of microbe |
|
Definition
round, oval, larger
broad based budding
hyphae with conidia as yeast |
|
|
Term
| blastomycosis dermatitis: signs of infection 2 |
|
Definition
pneumonia
disseminate to skin and bone in compormised causing epipthelial hyperplasia (like SCC) |
|
|
Term
| clinical signs of fungal pneumonia 6 |
|
Definition
acute primary pulmonary infection
PREDOMINANCE IN UPPER LOBE
chronic GRANULOMATOUS pulmonary disease
disseminated MILIARY disease
flu like, often self limited
PREHILAR lesion: bronchogenic carcinoma like (Causes cough, hemoptysis, dyspnea, CP) |
|
|
Term
| signs of fungal pneumonia in compormised (HIV) and infant |
|
Definition
disseminated disease (miliary)
focal collections of phagocytes stuffed with yeast within cells of liver, spleen, nodes, lymph of GI marrow, adrenals, meninges, dry mouth and ulcers, HSM, anemia, leukopenia, thrombocytopenia |
|
|
Term
| what type of pneumonia causes erythema nodosa with bumps |
|
Definition
| coccidioidomycosis immitis |
|
|
Term
| what type of pneumonia causes increased dissemination in third trimester of pregnancy |
|
Definition
| coccidioidomycosis immitis |
|
|
Term
| what type of pneumonia causes bronchogenic carcinoma like signs (prehilar lesion, induces cough, hemoptysis, dyspnea, CP) |
|
Definition
|
|
Term
| what type of pneumonia causes epithelial hyperplasia like squamous cell carcinoma |
|
Definition
| blastomycosis dermatitidis |
|
|
Term
|
Definition
congenital: transplacenital
perinatal: birth canal, breast milk
saliva, fecal oral, marrow, transplant, organ transplant, AIDS |
|
|
Term
| CMV: when is a person infectious |
|
Definition
| can excrete virus for months to years (seropositive for life, virus is latent) |
|
|
Term
| CMV: 6 cells it infects and what it does to them |
|
Definition
giant cells with pleomorphism
glandular or parenchymal epithelium, neurons, alveolar macrophages, tubular epithelium, glomerulus |
|
|
Term
|
Definition
owl eye: enlarged inclusion in nuclei with halo
mononuclear infiltrate with foci of necrosis and inclusions (can cause ARDS)
pseudomembranes: intestinal necrosis and ulceration |
|
|
Term
| CMV: whi is symptomatic 3 |
|
Definition
asymptomatic in healthy adults
symptomatic: in organ transplant, AIDS, allogenic marrow transplant, neonates |
|
|
Term
|
Definition
cytomegalic inclusion disease (neonate)
CMV pneumonitis
pseudomembrane colitis
retinitis
CMV mononucleosis: fever, atypical lymphocytes, lymphadenopathy, HSM, abnormal liver enzymes, mild hepatitis |
|
|
Term
|
Definition
viral owl eye inclusions in secretions and culture
PCR
antiviral titer |
|
|
Term
| pneumocystic pneumonia aka |
|
Definition
| P. juroveci or P. carinii |
|
|
Term
| pneumocystic pneumonia: who gets symptoms 5 |
|
Definition
asymptomatic in healthy adults
symptomatic in AIDS CD4<200, malnourished infants, transplant pt, chemo, steroids |
|
|
Term
| pneumocystic pneumonia: symptoms 4 |
|
Definition
| interstitial pneumonitis: cough, dyspnea, fever, hypoxia |
|
|
Term
| interstitial pneumonia: causes 7, definition, CXR look |
|
Definition
inflammation of interstitium of lung increases lung markings on CXR
causes: atypical or virus (mycoplasma, chalmydia, legionella, RSV, CMV, influenza virus, coxiella) |
|
|
Term
| pneumocystic pneumonia CXR |
|
Definition
| bilateral prehilar and basilar infiltrates |
|
|
Term
| pneumocystic pneumonia morphology |
|
Definition
cotton candy exudate: intraalveolar fomy pink staining exudate
round to cup shaped cysts: septa thickened with edema and monocytes
honeycomb
patchy infiltrate ground glass |
|
|
Term
| candidia albicans transmission |
|
Definition
| normal flora of oral cavity, GI, vagina |
|
|
Term
| candidia albicans pneumonia: who gets it |
|
Definition
| often in neutropenic and leukemia patients |
|
|
Term
| candidia albicans: stages 4, properities 3 |
|
Definition
pseyxohyphae > budding yeast > germ tubule 37C > true hyphe
KOH shoes pseudohyphe, true hyphe, budding yeast |
|
|
Term
| signs of candidia infection |
|
Definition
thrush: white pseudomembrane one oral mucosa
vaginitis: esp when pregnant or on BC
esophagitis
hematolymphoid malignancies: in AIDS
dysphagia
retrosternal pain |
|
|
Term
| who usually gets thrush 4 |
|
Definition
immune compormised
newborns
kids on steroids and antibioics
HIV |
|
|
Term
| what types of cutaneous infections can candidia cause 6 |
|
Definition
onchomycosis: nail
paronychia: nail folds
folliculitis: follicle
intertrigo: pits, webs
blantitis: penis
diaper rash |
|
|
Term
| who is more susceptible to chronic mucocutaneous candidia infections, why |
|
Definition
| T cell defects and autoantibodies (endocrinopathies: hypothyroid, addisons) (job syndrome TH17 defect) |
|
|
Term
| invasive candidiasis usually goes where 8 |
|
Definition
renal abscess
myocardial abscess
endopathalmitis: eye
hepatic abscess
meningitis
braiin abscess
endocarditis (esp IV drug users and prosthatic valves)
candidia pneumonia |
|
|
Term
| who is at high risk for invasive candidiasis |
|
Definition
| pt with leukemia who are neutropenic after chemo |
|
|
Term
| CXR sign of candidia pneumonia |
|
Definition
| bl nodular infiltrate looks like pneumocystis |
|
|
Term
| cryptococcus neoformans: transmission |
|
Definition
|
|
Term
| cryptococcus neoformans: who it infects |
|
Definition
| compormised, esp AIDS and hematolymphoid malignancies (hodgkins) |
|
|
Term
| cryptococcus neoformans: structure, staining |
|
Definition
thick gelatenous capsule (halo on stain with india ink)
budding seen
no pseudohyphae or true hyphae, urease positive |
|
|
Term
| cryptococcus neoformans: lung morphology |
|
Definition
localizes in lung then disseminates (often to meninges)
minimal inflammation to granuloma depending on degree of immune deficiency |
|
|
Term
| cryptococcus neoformans: diagnosis |
|
Definition
| cryptococcal latex agglutination assay |
|
|
Term
|
Definition
| mucor and rhizopus (zygomycophyta) |
|
|
Term
| mucor and rhizopus (zygomycophyta): structure |
|
Definition
wide angle branching
non-septate
filamentous |
|
|
Term
| mucor and rhizopus (zygomycophyta): dissemination sites |
|
Definition
sinuses and brain
vascular invasion, necrosis and infarct!
hematolymphoid malignancies! (need marrow transplant) |
|
|
Term
| mucor and rhizopus (zygomycophyta): who does it infect |
|
Definition
| immune compormised (eso hematolymphoid malignancies, neutropenia, steroid pt, allogenic stem cell transplant) |
|
|
Term
| mucor and rhizopus (zygomycophyta): signs of infection 4 |
|
Definition
rhinocerebral mucormycosis: fulminant invasive form in patient with ketoacitosis
pulmonary disease: cavitary or miliary
necrotic tissues esp on face
hemorrhage in nose and eyes |
|
|
Term
| aspergillus: where is it found |
|
Definition
|
|
Term
|
Definition
| dicotomously branching, acute angles, septate |
|
|
Term
| aspergillosis: who does it infectic, what does it cause, 3 complications |
|
Definition
infects immune compormised causing necrotic pneumonia
vascular invasion, necrosis, infarct
hematolymphoid malignancies
systemic dissemination to brain |
|
|
Term
| allergic bronchopulmonary aspergillosis: who does it infect, what does it cause, 2 cellular signs |
|
Definition
infects pt with asthma causing type I hypersensitivity in bronchi
IgE Ab to aspergillus, increased eosinophils |
|
|
Term
| aspergilloma: appearance, location, effects, 2 complications |
|
Definition
fungus ball colonizing pulmonary cavity causes mass that acts as ball valve causing occlusion
increases risk for infection and hemoptysis |
|
|
Term
| 3 non infectious pulmonary infiltrates common in HIV |
|
Definition
kaposki sarcoma
pulmonary non-hodgkin lymphoma
primary lung cancer |
|
|
Term
| most common infection in HIV CD4>200 |
|
Definition
|
|
Term
| most common infection in HIV CD4<200 |
|
Definition
|
|
Term
| most common infection in HIV CD4<50 2 |
|
Definition
|
|
Term
| what type of pneumonia causes cells with owl eyes |
|
Definition
|
|
Term
| what type of pneumonia causes ARDS as a complication |
|
Definition
|
|
Term
| what type of pneumonia causes pseudomembrane colitis |
|
Definition
|
|
Term
| what type of pneumonia causes retinitis |
|
Definition
|
|
Term
| what type of pneumonia causes mild hepatitis |
|
Definition
|
|
Term
| what type of pneumonia causes cotton candy exudate (intraalveolar, foamy, pink staining) |
|
Definition
|
|
Term
| what type of pneumonia causes round to cup shaped cysts (thick septa with edema and monocytes) |
|
Definition
|
|
Term
| what type of pneumonia causes honeycomb and ground glass lung |
|
Definition
|
|
Term
| what type of microbe has thicke gelatenus halo on stain |
|
Definition
|
|
Term
| what type of pneumonia causes vascular invasion, necrosis, infarct, hematolymphoid malignancies |
|
Definition
molds: mucor, rhizopus
aspergillosis |
|
|
Term
| what type of pneumonia causes necrosis on the face, hemorhage in nose and eyes |
|
Definition
| molds: mucor and rhizopus |
|
|
Term
| what type of pneumonia becomes fulimant invasive in ketoacidosis |
|
Definition
|
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