Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Pneumonia.
Chest medicine- test 2
| Question | Answer |
|---|---|
| What is pneumonia? | pneumonitis with consolidation |
| What is surface phagocytosis? | when polumorphonuclear leukocytes move into the infected area to engulf and kill invading bacteria onthe alveolar walls |
| What is consolidation? | when the alveoli become filled with fluid, RBC's, polymorphonuclear leukocytes and macrophages |
| What are the 3 major pathologic or structural changes associated with pneumonia? | Inflammation of alveoli, Alveolar consolidation, and Atelectasis |
| What type of percussion sound is heard in a patient with pneumonia? | Dull, flat |
| What type of breath sounds are heard in a patient with pneumonia? | bronchial breath sounds |
| Why do you only auscultate bronchial breath sounds in a pneumonia patient? | bronchial breath sounds are prevented from being converted to vesicular bc of consolidation |
| What is Whispered Pectoiliquy? | Whispered sounds are more clearly heard during auscultation when consolidation present |
| Atelectasis is often associated with what type of pneumonia? | aspiration pneumonia |
| How many people are estimated to die from pneumonia each year? | more than 60,000 |
| What is the pathogenesis of pneumonia? | causative factor, inflammatory response, Capillary effusion, cellular and bacterial debris, and consolidation |
| What happens during the inflammatory response of pneumonia? | accumulate fluid, narrows airways, stimulate irritant receptors, diminishes lung volume |
| Capillary effusion involves what 4 things? | Serum, RBC, Leukocytes, macrophages |
| Causes of pneumonia | bacteria, viruses, fungi, TB, anaerobic organisms, aspiration, and inhaling irritating chemicals such as chlorine |
| Wha is Lobar pneumonia? | pneumonia involving an entire lobe of the lung |
| What is double pneumonia? | When both lungs are involved |
| What is the organism most often associated with "walking pneumonia"? | Mycoplasma pneumoniae |
| Why is pneumonia an insidious disease? | bc its symptoms vary greatly depending on the patient's specific underlying condition and type of organism causing the pneumonia |
| There are over ___ causes for pneumonia | 30 |
| When does bacterial pneumonia often occur? | after an individual has had an upper respiratory infection such as cold or flu |
| What are early signs and symptoms of bacterial pneumonia? | shaking chill, shaking, high fever, sweating, chest pain, increased RR, and cough with yellow and green sputum. |
| Is bacterial pneumonia most often lobar or double? | lobar, its usually confined to just one lobe of the lung |
| What are the 4 classes of baterial causes | Gram +, Gram -, Atypical, and Anaerobic |
| What are the 2 Gram + organisms that cause bacterial pneumonia? | Streptococcus and Staphylococcus |
| What is Streptococcus pneumoniae? | a Gram+, nonmotile coccus that is found singly, in pairs, and in short chains and is the most common pneumonia |
| Which bacteria accounts for 80% of bacterial pneumonias? | Streptococcus pneumoniae |
| There are more than __ different types of S.pneumoniae | 80 |
| What causes the increased virulence of S. pneumoniae? | it is enclosed in a polysaccharide capsule |
| What S.pneumoniae is the most virulent? | Serotype 3 |
| How are streptococci usually transferred? | by aerosol from a cough or sneeze of an infected individual |
| Most strains of Streptococcus Pneumoniae are sensistive to what medication? | penicillin and its derivatives |
| S.Pneumoniae is commonly cultured from the sputum of patients having what? | an acute exacerbation of chronic bronchitis |
| What are the 2 major groups of Stapylococcus? | Coagulase positive and Coagulase negative |
| What is Staphylococcus aureus? | coagulase positive staphylococcos found in anterior nasal carriage in 20-40% of humans |
| Which Staphylococcus is responsible for most "staph" infections in humans? | S. aureus |
| Coagulase negative staphylococcus, normal inhabitant of the skin, forms biofilms on plastic medical devices and damaged heart valves(endocarditis) | Staphylococcus epidermidis? |
| Coagulase negative Satphylococcus, found widely in the environment and causes up to 20% of UTI in sexually active women ages 15-35 | Staphylococcus saprophyticus |
| How are staphylococci arranged? | in clusters |
| When does Staphyloccal pneumonia usually occur and in whom? | usually follows a predisposing virus infection and is seen most often in children and immunosuppressed adults |
| How is S. aureus transmitted? | by aerosol from a cough or sneeze of an infected individual and indirectly via contact ith contaminated floors, bedding, clothes etc |
| What are staphylococci a common cause of? | hospital acquired pneumonia |
| What is MDRSA? | multiple drug resistant S. aureus |
| 7 Gram (-) Pneumonia causing bacteria | haemophilus influenzae, klebsiella, Pseudomona aeruginosa, Moraxella catarrhalis, Escherichia coli, Serratia species, and Enterobacter species |
| the major Gram (-) organisms responsible for pneumonia are what shape? | rod shaped known as bacilli |
| What is Haemophilus influenzae? | a common inhabitant of the human pharyngeal flora, smallest 1.5u-0.3u, gram(-) bacilli that appears as a coccobacilli on gram stain |
| There are six types of H. influenzae but only type ___ is commonly pathogenic | B |
| Who is pneumonia caused by H. influenzae type B most often seen in? | children 1 month- 6yrs old |
| H. influenza type B is almost always the cause of what? | acute epiglottitis |
| H. influenza can also cause | otitis media, meningitis, pneumonia and bacteremia |
| What is the vaccine for H. influenza? | HIB (polysaccharide-protein conjugate vaccine) |
| How is H. influenzae transmitted? | via aerosol or contact with contaminated objects (nasopharyngeal carriage rate 2-5%) |
| What are some additional risk factors for H. influenzae infection? | COPD, defects in B-cell function, functional and anatomic asplenia, and HIV infection |
| Klebsiella pneumoniae is AKA | Friedlander's bacillus |
| K.pneumoniae have long been associated with what type of pneumonia and who? | lobar pneumonia particularly in men over 40 and in chronic alcoholics of both genders |
| What is Klebsiella? | gram(-) bacillus found in chains and a normal inhabitant of the GI tract. |
| How is K.pneumoniae transmitted? | aerosol and contaminated items |
| K.pneumoniae is a common nosocomial infection with a high mortality rate bc | septicemia is a frequent complication |
| Pseudomona aeruginosa is AKA | Bacillus Pyocyaneus |
| What is P. aeruginosa? | highly motile, gram(-) bacillus that colonizes in the GI tract, burns and catheterizes urinary tract and is a contaminant is many aqueous solutions |
| Risk factor for P. aeruginosa infection | neutropenia, HIV, preexisting lung disease, ET tube and prior Antibiotic use |
| P. aeruginosa is a leading cause of hospital acquired infection and is usually cultured from the respiratory tract of | chronicall ill, tracheostomized patients |
| Why is P. aeruginosa a particular problem from respiratory therapists? | bc it thrives in dampness and is usually cultured from contaminated respiratory equipment |
| How is P.aeruginoa transmitted? | aerosol or contact with contaminated items |
| The sputum from patients with Pseudomonas infection is frequently | purulent, green, viscous and sweet smelling |
| This Gram(-) bacillus is naturally found in the human pharynx and is the 3rd most common cause of acute exacerbation of chronic bronchitis(COPD exacerbation) | Moraxella catarrhalis |
| This Gram(-) bacillus is normall found in the intestinal tract and is sometimes the cause of nosocomial penumonia | Escherichia coli |
| This Gram(-) bacillus causes about 7% of nosocomial pneumonia | Serratia species |
| 4 Atypical bacterial causes of pneumonia | Mycoplasma pneumoniae, Legionella pneumophila, Chlamydia psittaci, and Chlamydia pneumoniae |
| People infected with this Atypical bacterial cause of pneumonia are often said to have "walking pneumonia" bc symptoms are mild | Mycoplasma pneumoniae |
| M. pneumoniae lacks a cell wall therefore it is resistant to ______ but sensitive to _________ | penicillin resistant, tetracycline sensitive |
| Why is mycoplasma pneumoniae considered the primaery atypical pneumonia(PAP)? | organism escapes ID by standard bacterial tests |
| What is a common symptom of M. pneumoniae infection? | cough that comes in violent attacks producing only a small amount of white mucus |
| Mycoplasma are smaller than _____ but bigger than ______ | bacteria, viruses |
| M. pneumoniae is often seen in who and when? | people younger than 40, during late summer and early fall months., schools, crouds, homeless shelters |
| What is Legionella pneumophila? | an unusual and fastidious gram(-) bacillus with atypical concentrations of certain branched-chain lipids that muliplies in standing water. |
| How is L.pneumophila transmitted? | when it becomes airborne it enters throught the patient's lungs as an aerosol |
| L.pneumophila can be detected in | pleural fluid, sputum, or lung tissue by direct fluorescent antibody microscopy. |
| Who is L.pneumophila most seen in? | middle-aged men who smoke |
| What is Chlamydia psittaci? | a small gram(-) bacteria in the respiratory tract and feces of a variety of birds |
| How is C. psittaci transmitted? | from bird to human through aerosol or direct contact |
| The clinical manifestations on C. psittaci closely resemble those caused by what other Atypical bacteria? | M. pneumoniae |
| What is Chlamydia pneumoniae? | recently identified as a cause of pneumonia in adults |
| What is C. pneumoniae associated with? | meningoencephalitis, myocarditis, endocarditis, CAD, and Guillain-Barre syndrome |
| The major anaerobic organisms associated with pneumonia are | Peptostreptococcus |
| 5 organisms in the Peptostreptococcus class | Bacteroides melaninogenicus, Fusobacterium necrophorum, Bacteroides asaccharolyticus, Porphyromonas endodontalis, and Porphyromonas gingivalis |
| What is the major cause of anaerobic lung infections? | aspiration of oropharyngeal secretions and gastric juices |
| What are some predisposing risk factors of aspiration? | decreased LOC, impaired swallowing, poor dental hygeine, and GI abnormalities |
| Aspiration pneumonia is often _______ | multimicrobial |
| What are viruses? | parasites, cant live without host, DNA or RNA, cant culure in a lab, most common cause of pneumonia in children. |
| URI = __%viral | 90 |
| LRI = __% viral | 50 |
| 5 viral causes of pneumonia | Influenza virus, Respiratory Syncytial Virus, Parainfluenza virus, Adenovirus, and Coronavirus |
| Which 2 types of influenza virus are the most common causes of Respiratory tract infections? | type A and type B |
| What is the incubation period of the influenza virus? | 1-3 days |
| What is often the first sign of an influenza epidemic? | school absenteeism |
| What is the Respiratory syncytial virus(RSV)? | a member of the paramyxovirus group and is most often seen in children less than 12 months of age and in older adults with underlying heart or pulmonary disease in winter and spring |
| RSV often goes unrecognized but may play an important role as a forerunner to | bacterial infections |
| What 4 viruses belong to the paramyxovirus group? | RSV, parainfluenza virus, mumps and rubella virus |
| There are 5 types of parainfluenza virus but which 3 types are the major causes of infections of humans? | Type 1, 2, and 3 |
| Which parainfluenza virus type is considered a croup type virus | 1 |
| parainfluenza Type 2 and 3 are associated with ______ infections | severe |
| Which parainfluenza virus type is most seen in infacnts younger than 2 months and in the late spring and summer? | type 3 |
| Which parainfluenza virus type(s) are seen most often in children between the ages of 6 month and 5 years and occurs in the fall? | Typers 1 and 2 |
| Parainfluenza viruses are known for what? | their ability to spread rapidly among members of the same family |
| There are more than __ adenovirus subgroups | 30 |
| Which adenovirus serotypes cause viral infections and pneumonia in all age groups? | Serotypes 4, 7, 14, and 21 |
| This adenovirus serotype has been related to fatal cases of pneumonia in children? | serotype 7 |
| This is a newly recognized virus strain that causes SARS | coronavirus |
| What is SARS? | severe acute respiratory syndrome, highly contagious but rare mortality |
| What is the incubation period for SARS? | 2-7 days |
| Where was the first case of SARS? | China 2002 |
| According to the CDC, __-___% of SARS patients require mechanical ventilation | 10-20% |
| Rickettsiae, Varivella, and Rubella are causes of what type of Pneumonia? | Viral |
| Name 3 illnesses the Rickettsiae virus causes? | Rocky mountain spotted fever, Q fever, and Typhus. |
| What is the mode of transmission for Typhus? | vectors and raw milk |
| What is aspiration pneumonitis? | serious and fatal pneumonia, inflammation seen 12-26 hours after aspiration, leads to ARDS in 24-48 hours. |
| What is gastric pH? | <2.5 |
| What are some clinical mainfestations of aspiration pneumonitis? | Mendelson’s syndrome 1946, Tachycardia, dyspnea, cyanosis |
| What is Mendelson’s syndrome? | The aspiration of stomach contents into the lungs during obstetric anesthesia |
| What disease is 3x’s more prevalent in asthma and may be a cause of asthma? | GERD |
| Tests for GERD? | modified barium swallow test, and Evan’s blue dye test |
| What is the percentage of trach patients that have silent aspiration? | 55-70% |
| What is the cause of silent aspiration in trach patients? | inflated cuff impairs swallowing |
| What was originally defined as “Disease predictive of defect in cell-mediated immunity, occuring in persons with no known resistance to that disease”? | AIDS |
| What is AIDS no viewed as? | end stage manifestations of prolonged chronic erosion of immune system, late stage HIV infection |
| When was the lowest incidence of TB? | 1980’s |
| What caused is the Tb organism? | Mycobacterium tuberculosis |
| What is Mycobacterium tuberculosis and where in the lung is it found? | slender, rod shaped aerobic organism found in apices of lung |
| Predisposing factors for TB infection | homeless, drug abuse, AIDS |
| According to the WHO b/w 2000-2020 there will be __ new cases and ____ million will die | 1 billion; 35 million |
| __%of people test positive on a PPD test but are not really infected | 20% |
| Most fungal infections are from ______organisms and occur in the _____ of the lungs | aerobic; apices |
| Who is most at risk for fungal pneumonia? | Aids and steroid therapy |
| 5 fungal infections/ organisms | Histoplasma capsulatum, Coccidiodes immitis, Blastomyces dermatidis, Candida albicans, Aspergillus fumigatus |
| Where can you get Aspergillus fumigatus from? | barns, silos, granaries |
| What are the 4 locations or methods of exposure to acquired pneumonia? | Community acquired, Hospital acquired, Ventilator acquired, and Nursing home acquired |
| What are the primary pathophysiologic mechanisms caused by consolidation from pneumonia? | immune response(inflammatory), decreased V/Q ratio, pulmonary shunting, venous admisture, hypoxemia; decreased lung capacity, increased lung density |
| What are the secondary pathophysiologic mechanisms caused by consolidation from pneumonia? | Stimulation of O2 receptors; deflation reflex, irritant reflex |
| What trreatment is used for sonsolidation? | no specific treatment modality |
| What are the primary pathophysiologic mechanisms caused by atelectasis? | decreased V/Q ratio, pulmonary shunting, venous admisture, hypoxemia; reversible decreased lung compliance, increased lung density |
| What are the secondary pathophysiologic mechanisms caused by atelectasis from pneumonia? | Stimulation of O2 receptors; deflation reflex, irritant reflex |
| Atelectasis Tx? | hyperinflation protocol therapy |
Created by:
Dabi