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Pulm disease final


Strepptococcal pneumonia? 80% of bacterial pneumonias, gram positive, cocci, rusty sputum
Stapphylococcal pneumonia? responsible for most staph infections, gram positive, cocci, bacterial, immunosuppressed adults, children, can follow after a virus
Pseudomonas aeruginosa? pulm infection that is the leading cause of hospital acquired pneumonia, sputum is green/yellow/sweet smelling, copious, is often associated with cystic fibrosis, gram negative rod shaped
Mycoplasma pneumonia ( atypical/ walking) sub acute, mild condition, pt ambulatory, young people
Pneumocystis carini? immunosuppressed (HIV), pulm infection that presents as pneumonia, treated with pentamindine/nebupent
VAP? pneumonia that develops after 48-72 after being intubated, hospital does not get reimbursed
Everything must be document upon admission? to determine what pt had before and what was caused by hospital
Common cause of lung abscess? aspiration pneumonia, anaerobic organisms from teeth, treated with antibiotics (primary tx), antimicrobials, drainage
Lung abscess changes? cavity formation, Broncho pleural fistulas, empyema
TB lung changes? Cavity formation, alveolar capillary destruction, fibrosis, scarring, consolidation, tubercles, granulomas, calcification, secretions
Main treatment for TB isoniazid INH
TB patient will present with? hemoptysis, thin, weak, night sweats, excess sputum, weight loss
Tb can be reactivated from a child or from previous years, this is called? post primary TB
Diagnosing TB positive PPD (does not mean active) positive sputum culture (does not mean active) acid fast bacillus GROWTH (means active)
Fungal disease lung changes? consolidation, A-C destruction, tubercles, granulomas, cavity formation, fibrosis, calcification, secretions
Fungal disease histoplasmosis? mimics TB, Ohio/Mississippi river valley (mid west)
Fungal disease treatment? amphotericin b (aerosolized antibiotic) fungal disease usually effects upper lobes
Do not put a patient on a medication until? disease is confirmed, or else that disease will follow them forevor
What is Emphysema? A permanent enlargement of the air spaces distal to the terminal bronchioles w/ destruction of bronchiole walls
Panlobular Emphysema Genetic defect, effects lower lungs, Apha1-antitrypsin deficiency
Emphysema is detected by: Spirometry can tip off but CT scan needed , also lung biopsy can diagnose
What is asthma? Reversible broncial smooth muscle constriction (bronchospasm), airway inflammation, increased airway responsiveness to an assortment of stimuli
What is Chronic Bronchitis? Cough > 3mths in 2 consecutive years
Pink Puffer: Type A COPD - emphysema, red complexion, pursed-lip breathing
Blue Bloater: Type B COPD- chronic bronchitis, bluish color (cyanosis)
Chronic Bronchitis features: Sputum, cyanosis, peripheral edema, neck vein distention, wheezes & crackles, typically normal DLCO, thick neck
Emphysema features: Barrel chest, pursed-lip breathing, accessory muscle use, decreased breath sounds, decreased DLCO, hyperinflation, radiolucent lungs, flattened diaphragms, long narrow heart
Intrinsic asthma? adults, non allergic
Extrinsic asthma? children, allergies
Asthma can cause pulses paradoxes? Systolic BP that is more than 10mmHg lower on inspiration than on expiration
Asthma xray findings: Barrel Chest - hyperinflation
Chronic bronchitis can cause cor pulmonale by? chronic hypoxemia and ischemia
cor pulmonale symptoms? JVD, hepatomegaly, pedal edema (no digital clubbing)
What is cough variant asthma? patient only presents with a cough
What is varicose (fusiform) bronchiectasis? Bronchi are dilated and constricted in an irregular fashion similar resulting in a distorted, bulbous shape
What is cylindrical (tubular) bronchiectasis? Bronchi are dilated and rigid and have regular outlines similar to a tube
What is cystic (saccular) bronchiectasis? Bronchi progressively increase in diameter until they end in large, cystlike sacs in the lung parenchyma
Bronchiectasis care: CPT, postural drainage, expectorants, antibiotics (7-10 days), immunizations, neb txs, no surgery
A bronchoscope must be cleaned with? soaked in gluteraldehyde for 45 mins
Biopsy and bronchoalveolar lavage can also be done? with bronchoscopy
Needle aspiration with bronchoscopy are done for? cytology, biopsy, culture
Diagnostic brushings are done with bronchoscopy? bacterial culture, cytology, using a double sheathed protected catheter brush
With bronchoscopy trans bronchial needle aspirations are performed with? needle catheters
What are some surgical complications of a tracheostomy? hemorrhage, air leaks (pneumo and sub q emphysema), cardiac arrest, airway trouble, fistula
Complications while tracheostomy is in place? injury, perforation, infection, displacement, air leak
Complications while tracheostomy is in place? injury, perforation, infection, displacement, air leak
Complication during and after decannulation? scar, granuloma, keloid, persistent open stoma, dysphagia, tracheal stenosis, tracheomalacia, web formation
A percutaneous tracheostomy is done at the bedside instead of the OR, benefits of this are? decrease operative time, decrease cost ( do not decrease amount of staff needed)
Transtracheal 02 catheters are used for? they conserve 02, reduce 02 flow requirements by 50-75%, minimize need for high flows, give pt more mobility
Complications of transtracheal 02 catheters? hemoptysis, subcutaneous emphysema, site infection
What are signs of a pleural effusion? decreased breath sounds, dull percussion, decreased tactile fremitus, diminished breath sounds, decreased unilateral expansion
A chest x ray must be done to determine pleural effusion, you will see? blunted costo phrenic angles, and fluid level on the affected side
Empyema is? infected pus in the pleural space, begins as bacterial pneumonia
Exudative effusions? infected, transudate-not infected
A large pleural effusion will appear? restrictive
The term interstitial lung disease refers to a? broad group of inflammatory lung disorders
What are some anatomic alterations of the lung associated with interstitial lung disease? destruction of alveoli and pulmonary capillaries, Fibrotic thickening, granulomas, honeycombing, cavity formation, pleural plaques, bronchospasm, excessive secretions
What is the most common medication given for interstitial lung disease? corticosteroids
Interstitial lung disease of a known cause can be caused by? occupational, environmental, and therapeutic exposures
Hypersensitivity pneumonitis caused by mouldy hay? farmers lung
What are other hypersensitivity pneumonitis causes? Byssinosis (cotton), Aspergillosis ( organism present everywhere, some people are allergic) Sick building syndrome...
Organic material exposure can cause hypersensitivity pneumonitis, this eventually? causes interstitial lung disease, it is a cell mediated response cause by inhalation of offending agents or antigens
Sarcoidosis has an? unknown origin
Idiopathic pulmonary fibrosis is diagnosed by? open lung biopsy (treated with corticosteroids)
Cancer is a term that? refers to abnormal new tissue growth, progressive uncontrolled multiplication of cells, the new growth is called a tumor
Most common cause of lung cancer? cigarettes and occupational exposure (asbestosis)
Small cell cancer (oat cell) ? most aggressive, metastasizes quickly, and responds best to chemotherapy and radiation therapy, NO SURGERY
Small cell cancer accounts for 14% of lung cancers, it is associated with? cigarette smoking , worst prognosis
Non small cell is more common and accounts for? 75-85% of all lung cancers, usually gets surgery then chemo or radiation
What are the non small cell cancers? squamous cell carcinoma, adenocarcinoma, large cell (undifferentiated)
Squamous cell accounts for? 30% of lung cancers , treated with surgery first
Adenocarcinoma has what features? glandular configuration, excess mucous production, moderate growth, common in women, surgery first
Pulmonary edema results from? excessive movement of fluid from the pulm vascular system to air spaces of the lungs , As a consequence of this fluid movement- the alveolar walls and interstitial spaces swell
Cardiac pulm edema occurs when? the left ventricle is unable to pump out enough blood during each contraction
A patient with left ventricular failure often has? activity intolerance, weight gain, anxiety, delirium, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, cough, fatigue, cardiac arrhythmias, and adventitious breath sounds, wheezing
Non cardiogenic pulmonary edema? PCWP <20, = ARDS= Commonly caused by sepsis! also caused by capillary leak, and decreased hydrostatic pressure
What x-ray findings will you see with cardiogenic pulm edema? fluffy opacities, kerly A and B lines, bats wings or butterfly pattern, pleural effusion( cardiogenic) , left cardiomegaly
On a non cardiogenic pulmonary edema xray? fluffy infiltrates, NO pleural effusion, and NO cardiomegaly
TB is a rod shaped mycobacterium with a? waxy capsule, needs 02, is aerobic
Coccidiomycosis is a fungal disease? caused by spore inhalation, spherical carried by dust particles in California and western deserts
Blastomycosis is a fungal disease? caused by bastomyces dermatidis found in Chicago, central and mid west
The TB acid fast bacillus is also called? ziehl neelson
Created by: juialynn92
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