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Infections of the Lower Respiratory Tract Chp 53 pg 798 Updated 6/19/07 Anatomy: fig. 53-1 pg 799 Pathogenesis: read over Host factors: review nonspecific factors See normal flora pg 800 box 53-1 Microorganism Factors: Know the virulence factors and know the bold terms pg 798-799 Recognize the processes of the organisms some of which we’ve studied Respiratory Tract Pathogens pg 800 box 53-2 Recognize some of the “rare” pathogens in the same box Diseases of the lower respiratory tract Bronchitis: acute vs chronic Know the organisms usually causing both Table 53-1 and Box 53-3 pg 802 Pneumonia: inflammation of the lower respiratory tract Infection by 4 possible routes Colonization/infection of the upper airway Aspiration Inhalation Hematogenous seeding 2 major categories: community acquired nosocomial Children: 2months-5 yrs: Usually Viruses: RSV, parainfluenza, influenza, adenoviruses Bacterial: H. influenzae,S.pneumoniae,S.aureus Neonates: C.trachomatis or P.carinii Young adults: (<30yrs) M.pneumoniae, influenzae, Chlamydia pneumoniae Adults: read through predisposing conditions Community acquired: bacterial usually S. pneumoniae Note the variety of organisms for aspiration pneumonia: where do they come from? See tables pg 805 Hospital-acquired pneumonia: nosocomial Read thru pg 890-891 Chronic lower respiratory tract infections: Mycobacterium tuberculosis Cystic fibrosis patients: read over pg 891 Immunocompromised patients Neoplasms Transplant: S. pneumoniae, Haemophilus influenzae, Pneumoncystis carinii, cytomegalovirus, and fungus HIV: Pneumoncystis carinii, M.tuberculosis and M. avium complex Laboratory Diagnosis: Specimen collection & transport Read over chp 1 table 1-1 for collection, transport & processing Types of sputum Read over, understand the difference, esp the amount of normal Flora Bronchoscopy and other invasive procedures What’s a transtracheal? Specimen processing: Evaluating specimens w/ the gram stain What stain for acid fast bacilli? What other procedures for other etiological agents? Routine culture: what plates, and why BCYE for what organism, what does each letter stand for? Upper Respiratory tract infection (including oral cavity & Neck) Chpt 57 pg 899 Anatomy: know See fig 57-1 pg 900 Know what & where, and what the usual etiological agent is Laryngitis Laryngotracheobronchitis Epiglottitis Pharyngitis Tonsillitis Peritonsillar Abscesses Rhinitis Viral Agents see box 57-1 pg 902 Oral cavity: Stomatitis Thrush Peridontal infections Salivary Gland infections Neck Direct visual examination or detection Thrush: ________ Vincent’s angina: Direct detection of S.pyogenes: pg 905 Viral agents Culture: S.pyogenes Review direct detection methods Corynebacterium diphtheriae: media? Bordetella pertusses: media? Epiglottitis: etiological agent? Media?
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