Transcript Pneumonia

RESPIRATORY SYSTEM
DISEASES
According prof Ya. Bodnar
+ (Frank H. Netter’s illustrations)
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Pneumonia
Pneumonia is a disease, which unites the
large group of various inflammations
different etiology, pathogeny and
morphological description of
respirator department of lung.
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BACTERIAL
PNEUMONIAS
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VIRAL
PNEUMONIAS
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OPPORTUNISTIC
PNEUMONIAS
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Pneumonia
 Pneumonia is the acute
infectious disease, mainly
bacterial etiology, which is
characterized by the nidus
defeat of respirators
departments of lungs and
presence of intraalveolar
exudation.

( Order of health service
ministry of Ukraine # 499 from
28.10.03.)
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INFECTIOUS AGENTS CAUSING PNEUMONIA
Class
Etiologic Agent
Type of Pneumonia
Bacteria
Streptococcus pneumoniae Streptococcus
pyogenes Staphylococcus aureus
Klebsiella pneumoniae Pseudomonas
aeruginosa Escherichia coli Yersinia pestis
Legionella pneumophila
Peptostreptococcus, Peptococcus
Bacteroides Fusobacterium Veillonella
Legionnaires disease
Aspiration (anaerobic) pneumonia
Bacterial pneumonias
Actinomycetes Actinomyces israelii Nocardia asteroides
Pulmonary nocardiosis Pulmonary
actinomycosis
Fungi
Coccidioides immitis Histoplasma
capsulatum Blastomyces dermatitidis
Aspergillus Phycomycetes
Coccidioidomycosis
Histoplasmosis
Blastomycosis
Aspergillosis
Mucormycosis
Rickettsia
Coxiella burnetii
Q fever
Chlamydia
Chlamydia psittaci
Psittacosis Ornithosis
Mycoplasma
Mycoplasma pneumoniae
Mycoplasmal pneumonia
Viruses
Influenza virus, adenovirus, respiratory
syncytial virus, etc
Viral pneumonia
Protozoa
Pneumocystis carinii
Pneumocystis pneumonia (plasma
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cell pneumonia)
Classification of pneumonias
after M.S. Molchanov
 according to etiology:
 bacterial, viral, оrnitosic, ricketsic,
mycoplasmic, mycotic, mixed, allergic,
unstated etiology
 according to pathogeny:
 primary, second (hypostatic, pin
(contactic), aspiration, traumatic,
afteroperative, toxic, thermal, at the
infectious diseases)
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Continuation of classification after
M.S. Molchanov
 according to clinic-morphologic
signs:
 parenchimatic (croupous
(lobar) and
bronchopneumonia (lobular),
interstitial.
 according to localization and
stretch(протяжність):
 one-sided (left- or right-side),
among them: total, lobar,
segmental, lobular, bilateral
 according to severity of
process:
 heavy, middle severity, easy
and abortive forms
 according to motion:
 acute, protracted (more than
4 weeks).
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Classification of pneumonias
(Ministry of Health of Ukraine Order # 499
28/10/03)
 Nohospital (pneumococcuss, respirators viruses,
micoplasms)
 Hospital (nosokomial) - in 2-3 days after
entering permanent establishment (стационар)
(klebsiella, hemophilic stick, anaerobic microflora,
staphylococcuss)
 Aspiration
 Pneumonia in persons which have the heavy
dysimmunity ( congenital immunodeficit, AIDSinfection, paratherapeutic immunosuppression)
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Pathogeny of pneumonias
 Аdhesing (adhesion of
microorganisms into the surface of
ephithelial cells of bronchial tree
with subsequent microorganism
colonization.
 Disfunction of blinking
mucociliary.
 Violation of mucocell hovergap.
 Secreting of biologically-active
matters - cytokines.
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Pathogeny of pneumonias
 Chemotaxis of macrophages,
neutrophills and other cells which take
part in the local inflammatory reaction;
 Invasion and intracellular persistence
of microorganisms with making of
endo- and exotoines;
 Development of clinical displays of
disease.
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Risk factors
 age
 smoking, alcohol
 chronic diseases of lungs, heart,
kidneys
 professional harmfulness
 immunodeficient states
 contact with birds, rodents
 trips (подорож)
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Acute pneumonia
croupous P.
broncho-P.
interstitial P.
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Etiology of croupous
pneumonia
 in 95 % cases caused by pneucoccus,
rarer – diplobatsil, streptococcus,
staphilcoccus A cold which reduces
immunobiological reactivity comes forward
a procatarxis. Illness arises up often in
persons with alcoholism, avitaminosises,
cardiac insufficiency, chronic overstrain.
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Croupous pneumonia
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Morphogeny of croupous
pneumonia
 The morphological changes at croupous
pneumonia test a certain evolution, which
enables to select a few stages of process
(R. Rokytanskyy) - stage of congesting
(from 12 hours to 3 days), stage of red
hepatisation (1-3 days), stage of grey
hepatisation
(2-6
days),
stage
of
resolution.
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Carnification of lungs.
Abscesses in lungs
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Bronchopneumonia
 A term “bronchopneumonia
pneumonia (lobular pneumonia)”
unite the lungs fevers different
originally, and the general line of
which there is localization of
primary process in bronchial
tubes. From here inflammation
passes to pulmonary tissue and
can be limited in the acinus,
lobulus, segment or lobe.
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 In
most
cases
reason
of
bronchopneumonia
is
a
bronchogenic
(aerogene) infection, however can be the
haematogenic and lymphogenic ways of
infecting. A process begins from bronchiolus
and passes to alveolar ducts. A peribronchitis
can join to the bronchitis. The process
passes from peribronchial tissue to the
neighbouring
alveoluses
(peribronchial
pneumonia).
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Interstitial pneumonia
 Interstitial
pneumonia
spreads
mainly on interstitial tissue. At this
case the insignificant accumulation of
exsudate appears in the road clearance
of alveoluses. Interstitial pneumonia
belongs to the atypical forms. Meets at
viral infections, croupous pneumonia. A
process begins from a bronchitis with
next
distribution
of
process
by
lymphatic ways (lymphangitis) or
vasculitis (system red lupus).
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Interstitial pneumonia
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Chronic
Obstructive
Pulmonary
Disease
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Bronchitis
 Distinguish a acute and chronic bronchitis
(bronchitis acuta, bronchitis chronica).
 Among the etiologic factors of acute inflammation
of bronchial tubes of primary value give to the
viruses and bacteria which cause the respirators
diseases. From physical factors select the pathogenic
action of dry or cold air, dust, from chemical is
breathing in tobacco smoke, chlorine steam, nitrogen
oxides. The inherited insolvency of barrier
mechanisms of mucus, insufficiency of cellular
(phagocytosis) and humural (IgA) protective factors
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of local value, assists to development of bronchitis.
Bronchitis
acute
chronic
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Acute bronchitis
 It can be independent nosology unit or
secondary display of row of other illnesses
(croupous pneumonia, uremia). Almost all
forms of catarrhal inflammation develop in
mucus bronchial tubes: serosal, festering,
fibrin,
fibrin-hemorragic,
mucous.
Destruction of mucus membrane with ulcers
development is possible sometimes.
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Acute bronchitis
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acute bronchitis
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Chronic inflammation of bronchial tubes
Shows up in such forms:
 a) a chronic mucous or festering catarrh with
atrophy of mucus plate, cystophorous
regeneration of glands and metaplasia of
prismatic epithelium into multi-layered flat;
 b) chronic productive inflammation with
polypuses formation by granulation tissue
(polypal chronic bronchitis);
 c) deformation of bronchial tube at ripening of
granulation tissue, excrescence of connecting
tissue in a muscular layer, sclerosis and atrophy
of mucus membrane (deforming chronic
bronchitis).
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Chronic
Bronchitis
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chronic bronchitis
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Cystic
Fibrosis
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Emphysema of lungs
 Emphysema of lungs (emphysema
pulmonum) is the pathosis of pulmonary
tissue,
which
is
characterized
by
enhanceable (↑) maintenance in her air.
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Emphysema
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Bubble (bullous) emphysema of
lungs
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Asthma
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Adult
Respiratory
Distress
Syndrome
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Pulmonary Embolism
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Cancer of lung
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Lung Cancer
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Small-Cell Lung Cancer
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NonSmall
-Cell
Lung
Cancer
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Lung Cancer:
Extrapulmonary
Manifestations
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Metastatic
Malignancy
to the Lung
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Thank you for attention!
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