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lower respiratory disease
lwoer respe
55
Medical
Graduate
12/19/2011

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Term
pathogenesis
Definition
inhalation- aerosolized, aspiration-orpharyngeal flora (anythign that alters alertness so usual mechanisms to protect aspiratio ndont work), hematogenous spread- blodostream bringing it to lungs. , spread from a contigious focus-via trauma .
Term
normal host defenses
Definition
cough- to clear bacteria from oropharynx. Mucocilliary clearance. Alveolar macrophages.
Term
impaired cough reflex,
Definition
drugs, alcohol, neuromuscular diseases
Term
Impairment of mucocillayr trnasport
Definition
COPD, INfluenza interfering with respiratory epithelium.
Term
younger healthy adults more liekly pahtogens
Definition
pnuemococcus, mycolplsam, chlamydia, and viruses
Term
elderly
Definition
pnuemoccous, influenza, myocbacteirum tuberculosis (reactivation disease , as immuen system wanes).
Term
debilitated
Definition
gram negative bacilli mostly.
Term
hospitalized
Definition
MRSA, G- bacilli, legionella
Term
duratiosn of sy mtposm : hours to few days
Definition
bacterial pathogens
Term
days to weeks duration of symtpoms
Definition
fungal, anaerobic, mycobacterial .
Term
extrapulm symtposm: rhinitis and pharyrngiits
Definition
viruses, mycoplasma, chalmidyia
Term
extrapulm symptoms pneumonia : diarrhea
Definition
legionella
Term
expulm symtpoms: severe malaise and myalgias:
Definition
influenza
Term
physical exam findings inspection
Definition
tachypnea, use ofa cecsory msucles, cyanosis
Term
lung findings of pneumonia
Definition
dullness to percussion (consolidtaion). rales. egophony- e-a changes. bronchial breath sounds- sounds liek trachea. Increased fremitus. whispered petroquikley.
Term
lobar consodolitation
Definition
bacterial ifnection (exudate in alveoli)
Term
interstitial pneymonia
Definition
pnuemocysits of hiv, viral, bronchoalveolar carcinoma. early staphylocacal pnuemonia. mostly not bacteirtal
Term
Hilar adenopathy
Definition
enlarge dlymph nodes ofh ilum- tb,viral, fungal.
Term
pleural effusion pnuemonia
Definition
pneumoccosu, TB.
Term
pnuemonia with cavities
Definition
necrotizing organisms
Term
lab findings with pneumonia
Definition
luekocytosis with elft shift. sputum- polys: alveolar macrohpages and bronchial epithealial cells, blood culture positive
Term
cytomegalovirus epimediology
Definition
mostly in immuncoompromised
Term
viral pneumonia frequent causes in adults
Definition
influenza most common in adults, CMV in immunocomporomised, varicella, and measles in unvaccinated people
Term
clincial sytmpsom of viral penumonia
Definition
dry cough, dyspnea, constit symtpoms- tired and drop in appetite. Interstitial infilrtates on chest ex ray, mostly normal lung findings
Term
strep pneumonia colonization
Definition
nasopharynx
Term
clnical sytmpoms strep pneumonia
Definition
cough, fever, rusty sputum produciton , pleurtiic chest pain, dyspnea. UR symtposm usually preceed . physical exam: rales or decreased breath sounds
Term
lab findings strep pneumonia
Definition
lue,ocytosis. sputum gramstain grapmositic dipolocci (lancet shaped).

pleural effusions can be seen, and empyema (pus in pleural cavity). outline of bronchi in x-ray- blod oculturep ositi9ve
Term
treatment of strep pneum
Definition
penicillin, cehpalosporins,quionolones (donte ver use cipro in URI unless know it is G-). Vancomycin for resistant pathogens.
Term
strep complciaitons of pneumonia
Definition
meningitis ,endocarditis ,perciarditis, arhiritis
Term
increased risk for s pneumoniae infeciton
Definition
POST INFLUENZA/VIRAL IFNECTION .

asplenci patients- spleen eneded to fight encapsulated organisms. AIDS, multiple myeloma cant fight encapsulated orgnaisms.
Term
who receives pneumocola vaccine
Definition
Asplenic patinets, funcitona l asplenims (anemia), comorbid illenss- kdiney, l ung heart, diabetes cirhorris,

HIv, mutliple myleoma- cssf leak- risk for menigitis.
Term
Hemophilus influenzae pneumonia senei nwhich patients
Definition
seen in patients with chronic bornhciitsi and infants , coccobacilli
Term
Hemophilus influenzae pneumonia senei nwhich patients
Definition
seen in patients with chronic bornhciitsi and infants
Term
H influenzae treatment
Definition
ampicillin b lactamasei nhib, cephalosporin
Term
gram negative bacilli pneumonia seen in
Definition
impairedi mmune system: chronic alcoholism, cycstic fiboris, neturopenia ,diabetes, comorbid illness, hospitalized pagients, malignancy
Term
kelbsiella pnuemonia comonly senei n
Definition
chronic alcoholics
Term
E coli pneumonia sene in
Definition
hematogenous spread from urinarty tract
Term
psueodmoans pnuemonai seen in paitnets with
Definition
cystic fibroisis , and nosomoaial
Term
treatment of g- baciclli
Definition
penicillin , ecphalosporin, flouroquionlone
Term
staph aureus clincially
Definition
simliar ot s pneumonia - but cna cause ncerosis ,asbeess, cacvitaiton ,epmyema
Term
staph aures transmission
Definition
hematogenous spread
Term
staph aureus culture
Definition
gram positive cocic in clusters
Term
septic emboli seen with which organism
Definition
staph aureus. , also see wedge shaped infiltrate. , nodular infiltrate
Term
treatmnet staph aureus
Definition
penicillinae reissitant penicillin. or cephalosporin
Term
atypical pnuemonias
Definition
mycoplasma pneumonaie, legionelal pneumophila,chlaymdiae pneumoniae
Term
mycoplasma pneuomaniae
Definition
young adults, usually upper respiratory tract ifnection
Term
mycoplasm apneumonaie clincial symtpoms
Definition
dry hacing cough, lots of extra pulm symtpoms-myalgias, arthralgias, skin lesion: stevens johnson.
Term
mycoplasma pneumonia lab findigns
Definition
cold aggluttiins, complement fixaiton ntibody.
Term
myocplasma pneumoaniet reatmet
Definition
macroldies, quinolones, tetracyclines.
Term
legionella pneumonia
Definition
g- bacilli, reservoir fresh water, increased risk in patients with iimpaired cel mediated immunity
Term
legionella pnuemonia- lab findings
Definition
sputum with neturophils but no organisms.
Term
legionella diagnosis
Definition
indirect flourect antibody and direct flourescent antibody.
Term
chlaydia pneumonaie
Definition
half population is already seropostitive. infection only leads ot partial immunity. Coinfections
Term
chlamydiae pnuemonaie preseenatations
Definition
symtpos gradual. headaceh prominent with clhalymydia
Term
chlaymydia complciations
Definition
reactive arhtiritis. Erythema nodosum(painful rash over ankels). Coronary artery disease
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