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Pulm disease final
spc
| Question | Answer |
|---|---|
| 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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