Pulmonary II - Pneumonias
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show | Inflammatory consolidative process involving the lung parenchyma
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show | Steptococcus pneumoniae 60-80% of all bacterial pneumonias
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Organism most commonly involved in pneumonias occurring after viral infection | show 🗑
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show | (1) Aerogenous (2) Hematogenous (3) Direct Traumatic introduction(1) Aerogenous (2) Hematogenous (3) Direct Traumatic introduction
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What are the effect of alcohol on the immune system | show 🗑
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show | Alveolar hypoxia and mucus stasis
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Why is CHF a risk factor for bacterial pneumonia infections? | show 🗑
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show | Strepococcus pneumoniae pneumonias. Asplenia secondary to autoinfarction is a complication of sickle cell anemia. Aspelnic patients are susceptible to infections caused by encapsulated bacterial organisms such as Steptococcus penumoniae, Haemophilus infl
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Why are cystic fibrosis patients susceptible to recurrent bouts of pneumonia? | show 🗑
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show | Azotemia
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What conditions result in the loss of cough reflex? | show 🗑
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Symptoms of Bacterial Pneumonia | show 🗑
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Chest x-ray findings of Bacterial Pneumonia | show 🗑
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Stages of Bacterial Pneumonia | show 🗑
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Morphologic change in Pneumonia: Congestion and Edema | show 🗑
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Morphologic change in Pneumonia: Red hepatization | show 🗑
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Morphologic change in Pneumonia: Gray hepatization | show 🗑
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show | Occurs Day 8 to 21. Microscopically characterized by the clearing of exudates and the reestablishment of normal structure/function.
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show | Brochiectasis
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What is a complication found in 20-30% of patients with lobar pneumonia? | show 🗑
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A lung pathology characterized as a collection of pus in the pleural space. Found in 1% of all treated pneumonia infections. Characterized by persistent fever following apparent recovery from the infection | show 🗑
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Complications of bacterial pneumonia | show 🗑
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show | Lung Abscess
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show | Typically polymicrobial. Specific organisms include anaerobes, Klebsiella, Pseudomonas, Legionella, Staphylococcus type III, Streptococcus, and anaerobic necrotizing pneumonias.
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show | (1) Accidental inhalation or aspiration of necrotic/caustic material from stomach, oral cavity, or nasopharynx(2) Necrotizing pneumonias (3) Septic embolus from distant infection (4) Pulmonary trauma (5) Secondary infection of bullae in emphysema patients
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A lung pathology characterized as persistent dilatation of bronchi, associated with loss of distal and surrounding lung parenchyma typically caused by chronic inflammation and necrosis. | show 🗑
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What area of the lung most commonly involved in bronchiectasis? | show 🗑
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What is the primary cellular response to viral pneumonia | show 🗑
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show | Respiratory syncytial virus
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show | Herpes zoster virus
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show | CMV. Has 80% mortality.
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show | CMV
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Symptoms of viral pneumonia | show 🗑
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What percentage of chicken pox patients develop Varicella zoster pneumonia? | show 🗑
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show | Inflammation is more interstitial and less exudative. Immune response is characterized by lymphocytes and monocytes/macrophages. Most severe forms histologically and clinically resemble Diffuse Alveolar Damage (DAD) or Acute Interstitial Pneumonia (AIP)
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show | (1) Mycoplasma (2) Chlamydia (3) Rickettsia
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An immune reaction mediated by T cells interacting with monocyte/macrophages. Accumulation of macrophages (epithelioid cells) surrounded by a rim of lymphocytes often with an outer rim of fibrous tissue. Epithelioid cells may fuse to become giant cells. | show 🗑
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show | (1) Gold standard – culture (2) Microscopy with acid-fast stain (3) Molecular diagnostics
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show | True
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show | False
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(T or F) Wegener’s Granulmoatosis is associated with necrotic granulomatous inflammation | show 🗑
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Occurs in individuals who have not primarily been exposed to tuberculosis bacteria; often children. Often asymptomatic. | show 🗑
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show | False
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Ghon complex | show 🗑
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What does a positive PPD result indicate? | show 🗑
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show | (1) fever (mid-afternoon) (2) night sweats (3) weakness/fatigability (4) loss of appetite (5) blood-streaked sputum (6) cough (7) dyspnea
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show | The apical or posterior segments of the upper lobe where secondary pulmonary tuberculosis infection typically begins. The higher PO2 of the upper lobe favor Mycobacterium tuberculosis.
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Descirbe a pulmonary tuberculosis Lesion | show 🗑
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A complication of secondary tuberculosis infection. Seeding of distant organs by lymphatic or hematogenous spread. Infected organs are covered with small millet seed-like lesions. | show 🗑
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(T or F) Cavitation is seen in both primary and secondary tuberculosis infections. | show 🗑
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show | Mycobacterium avium-intracellulare
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show | Mycobacterium kansasii
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show | False. Histologically, it is characterized by non-coalescing granulomas randomly scattered in the parenchyma. Granulomas have a lymphocytic cuff and are non-caseating.
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Endemic area for Histoplasmosis | show 🗑
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Endemic area for Blastomycosis | show 🗑
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Endemic area for Coccidiomycosis | show 🗑
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show | Worldwide
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show | Ubiquitous and nosocomial
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Endemic area for Candidiasis | show 🗑
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show | Soils contaminated by bird droppings
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Microscopy of Histoplasmosis | show 🗑
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show | Yeasts with broad-based buds (5-25 um)
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show | Similar to tuberculosis with latent, primary, disseminated and chronic states
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show | Primary infection is pulmonary. Dissemination is common and usually to skin. Lung disease can be solitary or progressive.
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show | Thick-walled, non-budding spherule 20-60um in diameter filled with endospores
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Describe the clinical disease of Coccidioidomycosis | show 🗑
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Source of Coccidioidomycosis | show 🗑
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show | Soil contaminated with pigeon droppings
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Morphology of Cryptococcosis | show 🗑
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Describe the clinical disease of Cryptococcosis | show 🗑
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Morphology of Aspergillosis | show 🗑
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show | Aspergillosis
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show | Secondary colonization of tumors by aspergillosis
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What is allergic Bronchopulmonary Aspergillosis? | show 🗑
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Morphology of Mucormycosis | show 🗑
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show | Capable of being angioinvasive, necrotizing, or form fungal balls
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show | Budding yeast and pseudohyphae
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show | (1) Immunocompromised states (2) Deep infections (3) Patients with indwelling venous catheters (4) Prolonged antibiotic use (5) Severe burns (6) Major abdominal surgery
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Predisposing conditions for Fungus Ball Formation | show 🗑
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show | True
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Opportunistic pneumonia that commonly occurs in AIDS patients. | show 🗑
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Histopathologic features of PCP | show 🗑
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Morphology of Pneumocystis carinii | show 🗑
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show | Lipid pneumonia
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Pathogenesis of aspiration of large particle | show 🗑
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Pathogenesis of aspiration of gastric contents | show 🗑
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