Infections of the Lower Respiratory Tract by malj


									               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
                    Hematogenous seeding
             2 major categories:
                    community acquired
             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
      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
     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
     Peritonsillar Abscesses

Viral Agents see box 57-1 pg 902

Oral cavity:
      Peridontal infections
      Salivary Gland infections


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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