pulmonary
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| The 6th leading cause of death in the USA | Pneumonia
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| Most lethal infection | Pneumonia
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| Acute infection of the lower reps tract caused by bacteria and viruses (also fungi, protozoa, parasites) leading to consolidation of involved lung | pneumonia
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| pneumonia effecting a lobe | lobar pneumonia
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| pneumonia effecting a more diffuse aea | bronchopneumoni
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| what usually causes community acquired pneumonia | pneumococcus
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| why usually causes nosocomial pneumonia | P. aeruginosa
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| what are the normal defensive mechanisms for getting rid of microorg in the lungs | cough, mucociliary clearance, phagocytosis.
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| Once a microorg that is not expelled reaches the lungs, it initiates ________response with an ______ which causes alveolar_____ | inflammatory response
exudate
edema
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| Infiltration with _______ and ________ usually lead to resolution of the inflammation process in PNA | neutrophils and phagocytocis
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| ________ PNA is usually mild but can set the stage for secondary bacterial infection | viral
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| clinical manifestations of PNA | fever, chills, cough, asthenia, anorexia, pleural pain, dyspnea, hemoptysis, leukocytosis, neutrophilia. CXR-infiltrates involving single lobe or diffuse area
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| Frequently PNA is preceded by an _______ | URTI
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| pathogen of PNA is identified via | sputum characteristics, staining and cultures
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| to avoid contamination the sputum is collected via _______ ______ | transtracheal aspiration or bronchoscopy or lung biopsy
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| treatment of bacterial PNA is ________ treatment of viral PNA is _________ Proper __________ is important and may need mech vent and O2 | Abx
supportive therapy
hydration
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| highly contagious infection caused by mycobacterium tuberculosis | TB
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| An acid-fast bacillus which usually affects the lungs but may invade other body systems and organs. | mycobacterium tuberculosis
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| worldwide it is the leading cause of death from a curable infectious disease! | TB
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| this disease is transmitted from person to person in airborne droplets, lodges in the lungs, multiplies and causes non-specific pneumonitis | TB
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| which lobe does TB usually first effect? | upper
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| TB can migrate through the _____________ and lodge in the _______ __________ triggering the immune response with ___________ and _________ | lymphatics
lymph nodes
inflammation
phagocytosis
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| in TB exposure inflammation and phagocytosis isolate the bacilli, preventing their spread and sealing off their colonies creating a _______ ___________ with caseation necrosis inside | granulomatose lesion (tubercle)
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| what type of scar tissue grows around the tubercle to isolate the microorg with no further multiplication | collagenous scar tissue
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| TB may remain dormant for life, but if the ______ ________ is impaired active decease occurs and may spread to other organs | immune system
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| example of impaired immune systems | aids, poor nutritional state, long-term steroi therapy, chronic debilitating disease
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| Live _______ can escape in the bronchi and cause TB to become active | bacilli
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| many infected individuals are ________ and others develop s/s so gradually that they notice them when the disease is __________ | asymptomatic
advanced
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| common manifestations of TB (9) | fatigue, weight loss, anorexia, lethargy, low grade fever (usually in afternoons), cough c purulent sputum, dyspnea, CP, hemoptysis
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| how is TB diagnosed? | Positive TB skin test, sputum cultcher and CXR
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| the positive skin test proves that the individual has been ________ to the _________ and developed antibodies against it. | exposed
bacillus
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| what type of stain can TB be seen with under the microscope? | acid-fast stain
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| what will the CXR show in TB | nodules, calcifications, cavities and enlarged mediastinal lymph nodes.
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| if a pt has no exposure, no TB and no infection--what type of TB grade are they? | 0
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| if a pt has EXPOSURE TO TB, NO INFECTION what type of TB grade are they | 1
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| if a pt has TB infection and no disease what grade are they | 2
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| if a pt has TB and clinically active disease, what grade are they? | 3
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| if a pt has TB and not clinically active disease, what grade are they | 4
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| if TB is suspected what grade are they? | 5
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| what is Cor Pulmonale | pulmonary heart disease-cardiac disorder 2/2 pulmonary pathologic condition
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| Acute Cor pulmonale results from | PE where emboli usually originated from thrombi in the leg--occlude plum artery supply
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| clinical s/s of acute Cor pulmonale | profound shock, hypotension, tachypnea, tachy, severe pulm HTN, CP, fever, leukocytosis and hempotysis-----IMMINENT DEATH
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| chronic clinical s/s of Cor pulmonale | RV dilation, hypertrophy 2/2 long-term pulmonary HTN
caused by disorders of the lung (bronchitis or emphysema) or thoracic wall
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| does plum HTN have increased or decreased pulmonary resistsance | increased
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| does pulmonary HTN increase or decrease RV afterload | increase
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| does plum HTN increases or decrease RV workload, and what dose this lead to | increases RV workload leading to dilation and hypertrophy of the myocardial wall until if fails
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| clinical manifestations of pulmonary HTN | CP, peripheral eema, hepatic congestion, altered tricuspid and pumonic valve sounds, hepatomegaly, jugular distention
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| what is diagnosis of plum HTN based on? | physical and radiological exams, keg, echo
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| what is treatment of pulmonary HTN aimed towards | decreasing RV workload and reversal of the underlying lung disease
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