Pulmonary Infections Lecture Notes

Flashcards to help review a lecture on pulmonary infections and related respiratory topics.

Basic Anatomy and Physiology of The Respiratory System

Air distributor, gas exchanger, filters/warms/humidifies air, influences speech, allows for sense of smell.

General Functions of the Respiratory System

Exchange of gases, regulation of pH, vocalization, synthesis.

Three sections of the Pharynx

Nasopharynx, oropharynx, laryngopharynx

Respiration

The series of exchanges that leads to the uptake of oxygen by the cells and the release of carbon dioxide to the lungs.

Steps of Respiration

Ventilation, exchange between alveoli and pulmonary capillaries (External Respiration), transport of gases in blood, exchange between blood and cells.

Function and components of the Nose

Warms and moistens air, contains the palantine bone, septum, and sinuses.

Upper Respiratory Tract Structures

Nose, nasal cavity, sinuses, pharynx, larynx

Lower Respiratory Tract Structures

Larynx, trachea, bronchial tree, lungs

Bronchi

Tubes that branch off the trachea and enter into lungs; branch into Primary, Secondary, Tertiary Bronchi, and Bronchioles.

Brain's Role in Respiration

Senses when oxygen levels are low or CO2 levels are high; when CO2 is low, breathing slows down.

Volumes of Air Exchange

Tidal volume, expiratory reserve volume, inspiratory reserve volume, residual volume.

Eupnea

Normal quiet breathing, 12-17 breaths per minute.

Hyperpnea

Increase in breathing to meet an increased demand by body for oxygen.

Hyperventilation

Increase in pulmonary ventilation in excess of the need for oxygen.

Hypoventilation

Decrease in pulmonary ventilation.

Apnea

Temporary cessation of breathing at the end of normal expiration.

Spirometer Function

Tests how much air the lungs can hold and how much and how quickly air can be exhaled; identifies abnormal ventilation patterns.

Pleural Effusions

Fluids in the pleural space; can be transudates or exudates.

Principal Causes of Pleural Exudate Formation

Microbial invasion, cancer, pulmonary infarction, viral pleuritis.

Causes of Transudate Pleural Effusion

Heart failure, hypoalbuminaemia, nephrotic syndrome, pulmonary emboli.

Causes of Exudate Pleural Effusion

Pneumonia, tuberculosis, tumors.

Pneumonia Definition

Any infection in the lung.

Classifications of Pneumonia

Community-acquired, hospital-acquired, or occurring in immunocompromised hosts.

Pathogens of Community-Acquired Bacterial Pneumonia

Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, etc.

Pathogens of Community-Acquired Viral Pneumonia

Respiratory syncytial virus, influenza A and B, adenovirus, etc.

Pathogens of Nosocomial Pneumonia

Gram-negative rods, Pseudomonas spp., S. aureus.

Pathogens of Aspiration Pneumonia

Anaerobic oral flora, admixed with aerobic bacteria.

Pathogens of Chronic Pneumonia

Nocardia, Actinomyces, Mycobacterium tuberculosis, Histoplasma capsulatum, etc.

Pathogens of Necrotizing Pneumonia and Lung Abscess

Anaerobic bacteria, S. aureus, K. pneumoniae, Streptococcus pyogenes.

Indications for Referral to ICU for Pneumonia

Failing to respond rapidly to initial management, persisting hypoxia, progressive hypercapnia, severe acidosis, circulatory shock, reduced conscious level.

Antibiotic Treatment for Community-Acquired Pneumonia

Amoxicillin, Clarithromycin, Erythromycin (Uncomplicated); Clarithromycin/Erythromycin + Co-amoxiclav/Ceftriaxone/Cefuroxime/Amoxicillin+Flucloxacillin (Severe)

Hospital Acquired Pneumonia (HAP) Definition

New episode of pneumonia occurring at least 2 days after admission to hospital.

Factors Predisposing to Hospital-Acquired Pneumonia

Reduced host defences, endotracheal intubation, infected ventilators.

Key aspects of pneumonia management

Oxygenation, fluid balance, and antibiotic therapy.

Burden of Respiratory Disease

Morbidity and death, allergy, asthma, COPD, tobacco-related respiratory conditions.

Pathologies covered by Respiratory Disease

Infectious, inflammatory, neoplastic, and degenerative processes.

Cough

Most pathognomonic of all respiratory symptoms; can be dry or productive.

Sputum examination

Naked eye examination looking for mucoid, pus, muco-purulent, haemorrhagic, pus-like, fibrinous, or watery appearance.

Haemoptysis

Expectoration of blood, may vary from streaks to liters.

Characteristics of Haemoptysis

Blood is frothy, bright red, and sputum may be stained for days.

Characteristics of Haematemesis

Blood is often altered in color, usually dark red or brown.

Dyspnoea Definition

Undue awareness of respiratory effort or of the need to increase this effort.

Predisposing Factors for CAP

Smoking, upper respiratory tract infections, alcohol, glucocorticoid therapy, old age, recent influenza, pre-existing lung disease, HIV, indoor air pollution

Clinical Features of Pneumonia

Fever, rigors, shivering, malaise, delirium, loss of appetite, headache, cough, expectoration, chest pain.

Differential Diagnosis for Pneumonia

Pulmonary infarction, tuberculosis, pulmonary oedema, eosinophilia, malignancy.