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Questions and Answers
What is the primary mechanism by which endotracheal intubation contributes to the development of pneumonia?
Which of the following bacteria is most commonly associated with severe abscessing bronchopneumonia with destruction?
What is the primary location of the infiltrate in the pathology of pneumonia?
What is the purpose of the cold agglutinin test in the diagnosis of pneumonia?
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What is the primary factor that contributes to the spread of antibiotic-resistant virulent organisms in pneumonia?
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Which of the following is a common risk factor for the development of pneumonia?
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What is the primary type of cells that infiltrate the alveolar septa in pneumonia?
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Which of the following is a Gram-positive rod that can cause pneumonia?
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What is the primary location where pneumonia occurs in closed communities?
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What is the primary reason why poor infection control measures contribute to the development of pneumonia?
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Study Notes
Morphological Patterns of Pneumonia
- Lobar pneumonia: consolidation (solidification) of a part or all of a lobe, homogeneously filled with an exudate, hardening of lung parenchyma
- Bronchopneumonia: patchy distribution, involving one or several lobes, neutrophilic exudate in bronchi and bronchioles, frequently bilateral and basal
- Interstitial pneumonia: milary pattern, usually TB
Community-Acquired Pneumonias (CAP)
- Acute bacterial CAP: ABCDEF (Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Mycoplasma pneumoniae, Chlamydia, Coxiella burnetii)
- Atypical CAP: Mycoplasma pneumoniae, Chlamydia (trachomatis, psittaci, pneumonia), Coxiella burnetii (Q fever)
- Viral pneumonia: respiratory syncytial virus (RSV), human metapneumovirus (HMPV), adenovirus (military recruits), parainfluenza (children), influenza A & B (adults)
Risk Factors
- Age (>70), smoking, COPD, dementia, seizures, CHF
- Immunosuppression, alcoholism, asthma
- Dependent on organism
Common Etiologies
- Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Mycoplasma pneumoniae
- Chlamydia pneumoniae, influenza, adenoviruses, RSV
Microbe Notes
- Streptococcus pneumoniae: acute fever, cough, CHF, COPD, or DM, rusty sputum, chest pain (pleura), Ig production - AIDS (congen or acquired)
- Haemophilus influenzae: most common bacterial cause, acute exacerbations of COPD
- Staphylococcus aureus: ↑ incidence of complications, lung abscess & empyema, R-sided staphylococcal endocarditis (IV drug abuse)
Host Factors
- Impaired defense: phagocytic dysfunction, ciliary dysfunction, alcohol, smoking, gases
- Anatomical defects: bronchus obstruction, bronchiectasis
- Loss or suppression of cough reflex: coma, GA, NMD, drugs
- Existing pulmonary disease: atelectasis, edema, COPD
Intro
- Respiratory tract infections (RTIs) are more frequent than infections of any other organ
- Account for the largest number of workdays lost in the general population
- The vast majority of RTIs are upper respiratory tract infections (URTIs): viruses (common cold, pharyngitis)
- Lung infections (pneumonia): enormous amount of morbidity, responsible for one-sixth of all deaths in the US
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Description
This quiz covers the morphological patterns of community-acquired pneumonias (CAP) including lobar consolidation and atypical CAP. Learn about the characteristics of acute bacterial CAP and more.
