Elderly

Map Branches

• Classified by Etiology Agent
  • Agent determines treatment
    • Community Acquired pneumonia = Bacterial or Viral
      • Bacterial
        • Causes Alveoli to be filled with inflammatory exudate
          • Consolidation or solidification of pulmonary tissue
            • Predisposing conditions
              • Age
              • Chronic disease = DISH
              • Congenital or Acquired immune Deficiency
              • Decreased Splenic Function
        • Morphology
          • Pattern = Lobar & Lobular Pneumonia
          • Most Important = Classification of Causative Agent and Extent of disease
          • Lobar = Acute Infection w/Fibrinosuppurative Consolidation of entire lobe
          • Stages
            • Congestion
              • Lung is Heavy, boggy and Red
              • Vascular Engorgement
              • Intraaveolar fluid with few Neutrophils
              • Presence of numerous Bacteria
            • Red Hepatization
              • Massive amounts of Exudate with Red Cells, Fibrin, & Neutrophil Fill Alveolar Space
              • Red, firm & Airless w/liver like consistency
            • Gray Hepatization
              • Red Cells Disintegrate
              • Fibrinosuppurative exudate gives gray brown dry appearance
            • Resolution
              • Consolidated exudate digested by enzymes
              • Produces granular, semifluid debris
              • Resorbed, ingested by macrophages, coughed up or organized by fibroblasts
          • Complications
            • Abscess formation = Tissue destruction and necrosis
            • Empyema = Spread of infection causing Fibrosuppurative exudate in pleura cavity
            • Organization of exudate
            • Bacteremic dissemination = to heart valves, pericardium, brain, kidneys, spleen and joints
• Major Symptoms
  • Abrupt onset of High Fever
  • Shaking Chills
  • Cough production of mucopurulent sputum
• Agent Type
  • Staphylococcus Aureus
    • Cause of 2o Bacterial Pneumonia
      • Children & Healthy Adults
    • High Incidence of Complications
      • Lung Empyema
    • IV Drug Use (High Risk)
    • Important cause of Nosocomial Pneumonia
  • Streptococcus Pneumoniae (Aka Pneumococcus) Common
    • Diagnose from Sputum
      • Endogenous flora in 20% adults (false positive)
    • Blood Culture (more specific)
    • Penicillin Treatment
  • Haemophilus Influenzae (G-)
    • Pleomorphic
      • Life Threatening acute lower respiratory tract infection & Meningitis
        • Children
    • Colonized in Pharynx
      • Encapsulated = 5%
      • Unecapsulated = 95%
    • Pili on Surface
      • Secretes factor that disorganizes ciliary beating
        • Secretes protease degrades IgA
          • High Mortality Rate
            • Cause acute purulent Conjuctivitis
              • Most common Bacterial cause of acute COPD
  • Moraxella Catarrhalis
    • Elderly
    • 2nd most common Bacterial cause of acute COPD
  • Pseudomonas Aeruginosa
    • Most common cause of Nosocomial Infection
    • Occurs in cystic Fibrosis
    • Occurs in Neutropenic Patients
    • Incases Vessels w/Consequent extrapulmonary spread
  • Legionella Pneumophila
    • Agent of Legionnaires disease
    • Flourishes in artificial aquatic environment
      • Water cooling tower
      • Tubing system of domestic water supplies
    • Transmitted by inhalation or aspiration
    • Affects ppl with predisposing conditions
      • Cardiac Disease
      • Renal Disease
      • Immunologic Diseas
      • Hematologic Disease
      • Organ Transplant
    • Diagnosis by Legionella antigens in urine
    • Diagnosis by positive fluorescent antibody test of Sputum
  • Klebsiella Pneumoniae
    • Frequent cause of (G-) Bacterial Pneumonia
    • Affects debilitated and malnourished people
      • Chronic Alcholoic
• Viral & Mycoplasmal (G- & need Sterols ie..Chol)
  • Most Common
    • Mycoplasma Pneumoniae
      • Children and Young Adults
  • Atypical
    • Moderate Amt of Sputum
    • No Physical finding of Consolidation
    • Moderate Elevation of WBC Count
    • Lack of Aveolar Exudate
  • Other Viruses
    • Influenza A & B
    • Adenovirus
    • RhinoVirus
    • Rubeola Virus
    • Varicella Virus
    • Chlamydia Pneumoniae
    • Coxiella Burnetti = Q Fever
  • Causes (MAD)
    • Malnutrition
    • Alcholism
    • Debilitating Illness
  • DMG to respiratory Epithelium
    • Predisposes to 2o Infection
  • Morphology
    • Patchy Pattern
    • Involves Whole Uni-Bilateral Lobes
    • Pleuritis
    • Interstitial Nature of Inflammatory RxN
    • Localized w/in Walls of Alveoli = Alveolar DMG
  • Clinical Course
    • Masquerade as Chest Cold
    • Few Localizing Symptoms
    • Cough Absent
    • Low Mortality Rate
    • Can Reach Epidemic Levels
    • Major Manifestations
      • Fever
      • Muscle Ache
      • Pain in Legs
• 1 type of Pneumonia predisposes to another
  • Hematogenous spread from one organ to another
    • Chronic Patients acquire terminal pneumonia while hospitalized
• (untitled branch)
  • Infection of lung parenchyma (many Causes)
    • When defense mechanism impared
      • Loss or suppression of cough reflex
      • Injury to mucociliary apparatus
      • Interference with phagocytic or bactericidal action of alveolar macrophages
      • Pulmonary congestion and edema
      • Accumulation of secretions
    • Results when host resistance is low
      • Chronic disease
      • Immunological Deficiency
      • Immunosuppressive agent treatment
      • Luekopenia
      • Virulent Infection

Comments

► Comments for document "CNS Infections"

	Kathleen Sundmark about 4 years ago	Great info. Lots of work. Thank you for these maps. They represent a lot of information and a great deal of work.

	Edward Shekhter about 4 years ago	Re: Great info. Lots of work. Thank you. Just got NovaMind about 3 weeks ago. This is my first go at it. There is so much information, but I am not sure if the way I presented/did this is the best way. Also I am looking for more insight and better way to do these mind maps, from experienced people.

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