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Flashcards in Pneumonia Tutorial Deck (13)
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1
Q

What are different types of pneumonia?

A

community/hopsital/ventilator acquired

2
Q

What is the difference between bronchitis, bronchiolitis and pneumonia?

A
  1. Bronchitis: inflammation and swelling of the bronchi
  2. Bronchiolitis: Inflammation and swelling of the bronchioles
  3. Pneumonia: Inflammation and swelling of alveoli
3
Q

Why, physiologically, does pneumonia present a more challenging disease than bronchitis and bronchiolitis?

A
  1. Gas exchange occurs in the alveoli
  2. Impairment of this process through cellular infiltration or fluid leakage into the airspace over a substantial area of the respiratory tract
  3. will prevent uptake of O2 and removal of CO2.
4
Q

What is the first immune cell recruited to the site during acute bacterial pneumonia?

A

Neurophil

5
Q

Why is this the case?

A
  1. Rapid release of neutrophil chemokines such as IL-8 causes rapid recruitment in all inflammation
  2. However the alveoli do also have a specialised resident immune cell.
  3. The alveolar macrophage.
6
Q

What type of cell accumulates during prolonged pneumonia?

A
  • Prolonged inflammation will result in accumulation of
    1. lymphocytes (primarily T cells)
    2. macrophages
    3. monocytes at the site of inflammation
7
Q

Why do these cells accumulate in prolonged pneumonia?

A

If the innate immune system is not sufficient to rapidly clear an infection from the alveoli then adaptive immune responses will develop to clear the infection

8
Q

What is steptoccocus pneumoniae? How is it treated?

A
  • gram-positive bacterium susceptible to beta lactams that bind proteins in the bacterial cell wall to prevent transpeptidation and bacterial replication
  • admitted and given macrolife
9
Q

What is chlamydia. penuomiae? How is it treated?

A
  1. gram negative and due to the difference in the bacterial cell wall is therefore penicillin resistant
  2. Thus a macrolide, clarithromycin, which inhibits the 50S ribosomal subunit limiting protein synthesis was used
10
Q

How do you treat a typical bacteria like C.penuemoniae?

A

slower replication cycles thus longer treatment courses are recommended compared to typical bacteria

11
Q

What is walking pneumonia?

A

Some atypical bacteria cause milder, more prolonged symptoms due to their slower replication rate. E.g. mycoplasma pneumoniae and C. pneumoniae

12
Q

How can steroids be used to treat viral pneumonia?

A
  • Steroids most likely effective by suppressing the immune inflammation and thus further lung damage
  • In individuals with milder disease steroids are potentially counter productive as they may suppress the immune clearance of the virus
13
Q

Why are anti-virals only effective early?

A

Early damage is virus dependent, late damage is immune mediated