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Diseases Exam 2

What is pneumonia? The result of an inflammatory process that primary affect the gas exchange area of the lungs. In response to inflammation; fluid and RBCs from the pulmonary capillaries leaks into the alveoli.
What would be found in the alveolar effusion fluid of a pneumonia patient? RBCs, fluid, leukocytes (WBCs), macrophages
What types of microorganism(s) cause pneumonia? Bacteria (Gram + or Gram -), Fungal Viruses, TB, Anaerobic organisms
What are the classifications of pneumonia? Community Acquired Pneumonia (CAP), Hospital Acquired Pneumonia (HAP), and Ventilator Acquired Pneumonia (VAP)
How lost does it take to develop hospital acquired pneumonia (HAP)? Develops 48 hours or long after admission
How long does it take to develop ventilator acquired pneumonia (VAP)? Develops 48-72 hours after intubation
What type of pneumonia is most common in AIDS patients? Pneumocystis carinii pneumonia
What drug is used to treat pneumocystis carinii pneumonia? Aerosolized pentamidine (Nebupent) - via Respigard Nebulizer
What are the chest assessment findings for a patient with pneumonia? Increased tactile and vocal fremitus, dull percussion note, bronchial breath sounds, crackles and rhonchi, pleural friction rub (if process extended to the pleural space), whispered pectoriloquy
What is pulmonary edema? Results from excessive movement of fluid from the pulmonary vascuary system to the extravascular and air spaces of the lungs
What are the anatomical alterations found in Pulmonary Edema? Atelectasis, pink or frothy white sputum
What are the signs and symptoms associated with pulmonary edema? Increased HR, RR, and BP (BP can be low if cardiac output i low), Cyanosis, Peripheral Edema, Cheyne Stokes Respirations (in patients with severe left sided heart failure), Sudden Paroxysmal Nocturnal Dyspnea, Orthopnea, Cough with frothy pink sputum
What is the most common cause of Cardiogenic Pulmonary Edema? Congestive Heart Failure
What is the fluid movement associated with Pulmonary Edema? Fluid moves from the perivascular and peribronchial interstitial spaces, alveolar walls and interstitial spaces swell, progressively fluid moves into alveoli, bronchioles, and bronchi
What is the normal hydrostatic pressure in the pulmonary capillaries? 10-15 mmHg
What is the normal oncotic (Osmotic) pressure in the pulmonary capillaries? 25-30 mmHg
What is Paroxysmal Nocturnal Dyspnea? Sudden difficulty breathing at night
What are the ABG results for early stage pulmonary edema? Acute Alveolar Hyperventilation with Hypoxemia (Acute Respiratory Alkalosis)
What are the ABG results for late stage pulmonary edema? Acute Ventilatory Failure with Hypoxemia (Acute Respiratory Acidosis)
What treatments are used to treat pulmonary edema? O2 therapy, bronchopulmonary hygiene, hyperinflation with CPAP (first line of treatment), diuretics, inotropic agents, mechanical ventilation
What drugs are used to treat pulmonary edema? Diuretics (Lasix/ Furosemide) and Inotropic Agents (Digitalis/ Digoxin: increase myocardial contractility)
What is a pleural effusion? Excessive accumulation of fluid in the pleural space that separates the visceral and parietal pleura and compresses the lungs
What is a thoracentesis? A procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest
How would you treat a Pleura Effusion? Treat underlying cause, possible thoracentesis or chest tube depending on severity, pleurodesis, oxygen therapy, lung expansion therapy, mechanical ventilation
What PFT results would be found in patient with a pleural effusion? Restrictive
What is the most common cause of transudative fluid? Congestive heart failure
What is a pulmonary embolism? A blockage to the main artery of the lung or one of its branches by a substance that has traveled from elsewhere in the body through the bloodstream (embolism)
How will the deadspace ratio be affected by a pulmonary embolism? The deadspace ration will increase due to ventilation without perfusion at the embolus site
How will ventilation and perfusion be affected by a pulmonary embolism? Areas of deadspace will be found in the lungs where blood flow is blocked stopping perfusion; ventilation will not be affected
What are the primary symptoms of a pulmonary embolism? Increased HR and RR, pulmonary hypertension, sudden onset dyspnea (classic sign), severe chest pain (angina), anxiety, diaphoresis, cyanosis, cough/ hemoptysis, crackles at emboli site
What is a pulmonary infarction? Embolus significantly disrupts blood flow causing the lung tissue to die
What is the treatment for a pulmonary embolism? O2 therapy at 100%, anti-coagulants (Heparin, Warfarin, Coumadin), thrombocytes, preventative measures, pulmonary embolectomy (last resort)
What causes fungal diseases? Inhalation of spores
What is the main anti-fungal drug? Amphotericin B (Fungizone)
What is Coccidioidmycosis? Where are the spores found and in what part of the country? Endemic in hot, dry regions (CA, AZ, NV, NM, UT, TX); after inhalation of coccidioides immitis spores, spores settle into the lung, begin to germinate, and form round, thin walled calls called spherules
What is Blastomycosis? Spores are found in areas of high organic matter; forest soil, decaying wood, animal manure, and abandoned buildings
What part of the country is Blastmycosis found? Occurs in people living in the south central and midwestern United States and Canada
What is Histoplasmosis? Spores found in soils rich in bird excrement, most common fungal disease in the US
What part of the country is Histoplasmosis found? Prevalence is especially high along the major river valleys of the Midwest
What is another name for Coccidioidmycosis? Valley fever
What is another name for Blastomycosis? Chicago disease
What is an alternate name for Histoplasmosis? Ohio Valley Fever
Which fungal disease produces purulent sputum? Blastomycosis
What is disseminated TB? aka Extrapulmonary TB; bacilli escape from the lungs and travel to other parts of the body
What are the major pathological changes found in TB? Alveolar consolidation, A/C membrane destruction, caseous tubercule or granulomas, cavity formation, fibrosis and secondary calcification of lung parenchyma, distortion of bronchi, increased bronchial secretions
What is the most effective drug used to treat TB? Isoniazid (INH)
What is a closed pneumothorax? Gas in the pleural space is not in direct contact with the atmosphere
What is an open pneumothorax? Pleural space is in direct contact with the atmosphere; gas can move in and out
What is a tension pneumothorax? One-way valve-like action of ruptured parietal pleaur; gas enters during inspiration, but cannot leave during expiration (most serious)
What is the visceral pleura? Inner layer of the pleura
What is the parietal pleura? Outer layer of the pleura?
How are PFT volumes effected by a pneumothorax? Decreased
What are the symptoms of a tension pneumothorax? Increased HR, RR, and BP, hypoxemia, pain, anxiety, and cyanosis
What is a secondary spontaneous pneumothorax? Occurs suddenly without an underlying cause; can be secondary to pneumonia, TB, and COPD (bleb and bullae on surface of lung pop); also often occurs in tall, thin persons ages 15-35
What are the causes of an iatrogenic pneumothorax? Occurs during diagnostic or therapeutic procedures such as; pleural or liver biopsy, thoracentesis, intercostal nerve block, cannulation of a subclavian vein, tracheostomy
What is the treatment of a pneumothorax with a lung collapse of <15% to 20%? Bed rest or limited physical activity; reabsorption of intrapleural gas occurs usually within 30 days
What is the treatment of a pneumothorax with >20% lung collapse? Chest tube insertion to evacuate air
What is flail chest? Double fractures of three or more adjacent ribs produce instability of the chest wall and paradoxical motion of the thorax
What is the most common cause of Flail Chest? Trauma
What anatomic alterations are found in the lungs of a patient with Flail Chest? Double fracture of numerous adjacent ribs, rib instability, lung restriction, atelectasis, lung collapse (pneumthorax), lung contusion, and secondary pneumonia
What is Kyphoscoliosis? A combination of two thoracic deformities that commonly appear together
What anatomic alterations are found in the lungs of a patient with Kyphoscoliosis? Lung restriction and compression as a result of the thoracic deformity, mediastinal shift, mucous accumulation, and atelectasis
Created by: ashconrad417