| Question | Answer |
| True or False: Antitussives fall under Opioid and Non-opioid categories. | True. |
| What is the action of antitussives? | Suppressing the cough reflex by direct action on the cough center in the medulla |
| What precipitates tuberculosis disease, and what percentage results in disease? | Tuberculosis infection. Only 10% of infections progress to disease. |
| The initial symptoms of anthrax resembles what? Excluding what? | The common cold or influenza, except infected persons will not develop nasal secretions |
| Rifampin and isoniazid are 1st or 2nd line drug? | 1st line |
| What are manifistations of Streptoccocal /pneumococcal pneumonia? | Rust colored sputum; possible friction rub |
| What happens when antiacids are taken with isoniazid? | Decreased absorption of isoniazid |
| What medications are used to treat TB? | Isoniazid (INH), Streptomycin, and rifampin |
| List three 2nd line anti-TB drugs | *amikacin *Capreomycin *Cycloserine *Ethionamide *Levofloxacin *Ofloxacin *Para-aminosalicylic acid (PAS) |
| Why is rifampin used in TB PTs? | prevention of meningococcal meningitis |
| What does tuberculosis result in? | inflammatory infiltrations |
| How should a PT with pleurisy lay in bed? | On the affected side |
| True or False: A single chest tube is placed at the base of the affected plural space to drain accumilated fluids. | False. A chest tube is place at the anterior and posterior of the affected pleural space and drains into 2 or 3 glass bottles or a 3 chamber drainage system. |
| What are manifistations of staphylococcal pneumonia? | *Rust colored sputum *possible friction rub *COPIOUS SALMON COLORED SPUTUM |
| Define pleural effusion: | Fluid accumulation in the pleural space |
| How is anthrax spread? | Through direct contact with bacteria and its spores. |
| PTs with bronchitis are at increased risk of what, and why? | Respiratory infections, Due to retained pulmonary secretions. |
| The rate of TB in foreign born americans increased how much since 1986? | 65% |
| How is tuberculosis aquired? | Inhalation |
| True or False: tuberculosis has rapid onset. | False. TB is usually latent in the early stages of infection and has potential for recurrence. |
| How do antitussives differ from expectorants? | *Antitussives work by suppressing cough *Expectorants work by breaking down and thinning secretions, relying on coughs to expel mucus |
| Why must foods with tyramine and histamine be avoided while on isoniazid? | may cause lightheadedness, flushing, hypotension, headache and other symptoms |
| What causes legionnaires disease? | Legionella Pneumophilia (Gram-negative) |
| Legionaires disease progresses on what two courses? | *Influenza *Legionella disease (results in life threatening pneumonia) |
| What is pneumonia? | An inflammatory process of the respiratory bronchioles and alveolar spaces that is caused by an infection |
| What are the symptoms of atelectasis? | *May cause few, if any, symptoms. *Fever, dyspnia, hypertension, TACHYPNEA if symptoms do occur. |
| What does death usually result from in a PT with Anthrax? | Blood loss and shock |
| How does tuberculosis spread to susceptable organs? | Via the blood and lymphatic system. |
| What happens when alchohol is taken with isoniazid? | Toxicity |
| isoniazid inhimibts the metabolism of what? | phenytoin |
| What is the most reliable screening for cutaneous and GI anthrax? | Culture |
| List 4 Tx in the medical management of pneumonia | *Antibiotic therapy *O2 therapy *Analgesics/antipyretics *Expectorants *Bronchodilators *Vaccine *Physiotherapy *Humidification |
| How does an x-ray of inhaled anthrax differ from an x-ray of pneumonia? | *Inhalation anthrax (widened mediastinum) *Pneumonia (infiltrates) |
| Which anti-TB drug requires an opthalmologic follow up? | Ethambutol |
| What can be taken to minimize the s/s when foods with tyramine/histamine are taken with isoniazid? | 50-200mg of vitamin B6 daily |
| How do the s/s of pneumonia differ in older adults? | s/s of pneumonia often atypical (fever, sputum, cough often absent) |
| What is done to confirm the Dx of active TB? | Sputum culture |
| What do anthrax bacterial toxins cause? | Hemorrhage, necrosis, and lymph edema |
| What are the precautions of antitussives? | *Asthmatics *Geriatrics *Debilitated patients |
| List 3 early signs of TB | *Fatigue *Anorexia/weight loss *Productive cough *Fever *Weakness |
| What is the treatment of anthrax for soldiers? | 30 days antibiotic and 3 doses of anthrax vaccine |
| What is the medical management of a pleural effusion/empyema? | *Thoracentesis *Chest tube placement *Antibiotics |
| What form of pneumonia commonly follows a URI? | Hemophilus |
| What form of pneumonia carries a poor prognosis? | Bacterial aspiration |
| What is the bacteria involved with tuberculosis? | Mycobacteria |
| List 3 clinical manifistations of legionaires disease | *Significantly elevated temperature 102f - 105f (38.8c - 40.5c) *Headache *Diarrhea *General malaise *NONPRODUCTIVE cough with tachypnea *crackles and wheezing *Signs of shock *HEMATURIA indicating renal failure |
| Define bronchitis: | Inflammation of the mucous membranes of the major bronchi and their branches |
| True or False: A person infected with anthrax is at high risk for infecting others. | False. It is not contagious by person-to-person |
| What are manifistations of Hemophilus pneumonia? | *Croupy cough *Arthralgias (joint pain) *Yellow or green sputum |
| How would you administer anti-TB drugs if GI upset/irritation occures | Administer with food |
| Bronchitis is usually secondary to what? | Upper respiratory infections |
| How should a PT with chest tubes be placed, and why? | On the unaffected side to prevent kinks. |
| List 3 causes of pneumonia | *Bacterial pneumonia *Aspiration pneumonia *Viral pneumonia *Fungal *Chemical |
| List 3 causes of pleurisy | *Bacterial *Tuberculosis *Pleural trauma *Pulmonary infarction *Lung cancer *Viral infections of intercostal muscles |
| True or False: Antitussives and Expectorants fall under different categories | False. They both fall under the 'antitussive' category. |
| What are manifistations of mycoplasmal pneumonia? | *Severe, non-productive cough *Crackles *Decreased breath sounds |
| True or False: Deep breathing exercises are discouraged for pneumonia PTs due to the inflammation to the lungs and pleural rub | False. Deep breathing/coughing exercises are encouraged to open the airways and clear the lungs of mucous. |
| What antibiotic is the treatment of choice for anthrax, and how long should it be taken? | Ciprofloxacin, 60 day course recommended. |
| When does the pain of UNTREATED pleurisy subside? | When pleural effusion developes |
| True of False: PTs with TB are easily identifiable by their symptoms. | False. Many PTs with TB disply no s/s. |
| What are the clinical manifistations of pleurisy? | *SHARP PAIN ON ISNPIRATION *Fever and dry cough *Dyspnea *Elevated temperature |
| List 2 antibiotics used to treat pneumonia | *penicilin *e-mycin *cephalosporin *tetracycline |
| Define Pleurisy: | An inflammation of visceral and parietal pleura |
| What times of the year are cases of pneumonia most common? | Winter and spring |
| Who are cases of pneumonia most common in? | Infants and elderly |
| What are the contraindications of antitussives? | *Hypothyroidism *Pregnancy *Lactation |
| Anthrax most commonly infects what? | wild and domestic hoofed animals |
| What are manifistations of klebsiella pneumonia? | Same as stRep + more of a gradual onset; more inflam of the terminal brochioles and alveoli (bronchopneumonia); if tx delayed beyond second day>>critically ill pt w/ increased risk of mortality rate |
| Approximately how many PTs fail to complete their tuberculosis Tx? | 50% |
| What are the most common adverse effects of antitussives? | *Dizziness *Drowsiness *Nausea *Vomiting |
| What is the use of antitussives? | To treat NON-PRODUCTIVE coughs occurring in pneumonia, bronchitis, TB, cystic fibrosis, and emphysema |
| What are the late signs of TB? | *Daily reoccurring fever with chills *Night sweats *Hemoptysis (blood stained sputum) |
| List 3 clinical manifistations of bronchitis | *Productive cough *Low grade fever *Diffuse rhonchi/wheezes, dyspnea *Chest pain *Generalized malaise, and headache |
| Is chest tube a closed or open system? | Closed |
| Approximately how many americans are infected with TB? | 15 million |
| What should you avoid while taking isoniazid for TB? | food with tyramine and histamine... eg. Tuna, aged cheeze, red wine, soy sauce, yeast extracts |
| rifampin significantly decreases levels of what drug? | saquinavir |
| Define pleural empyema: | INFECTED fluid accumilation in the pleural space. |
| What do you question a PT about during an assessment if bronchitis is suspected? | health, presence of headache, and/or aching chest pain |
| True or False: Pneumonia os the most common cause of death in North America | True |
| Pneumonia is a major cause of disease and death in who? | Critically ill PTs |
| list 3 clinical manifistations of pneumonia | *Sudden onset of pleurisy *Severe chills *Elevated temperature and night sweats *Painful productive cough *Increased heart rate *Tachypnea with difficult expiration |
| What is the most common form of anthrax? | Cutaneous |
| What is the least common form of anthrax? | GI |
| What is a chest tube inserted for (Tx, not disease) | Continuous drainage and medication instillation |
| How does anthrax appear at first? | It appears first like an insect bite (macule/papule), then black eschar formation and edema to site appears. |
| True or False: Infants and children with TB dont usually require isolation. | True. |
| What are the manifistations of viral pneumonia? | *generally mild s/s *Cold symtoms *Irrating cough that produces mucopurulent or bloody sputm |
| What is atelectasis? | The collapse of alveoli, preventing respiratory exchange of CO2 and O2 |
| How does a fever associate with pleural empyema differ? | Fever persists despite antibiotics. |
| What causes atelectasis? (mechanism, not diseases) | Air blockage to a portion of the lung |
| What is the most reliable screening for inhalation anthrax? | Trick question. No single reliable screening is available. |
| What is an expected adverse effect of rifampin? | discoloration of all body fluids (red) |
| List 3 potential causes of atelectasis | *Hypoventilation *Shallow breathing post-op *Mucus accumulation *Compression from tumors *Stasis pneumonia *Aspiration |
| What is the action of expectorants? | Expectorants act by liquefying and reducing the viscosity of thick, tenacious secretions. |
| What kind of room do TB PTs require, and what is needed upon exiting room? | Negative pressure room, must wear particulate matter mask when leaving room |
