Acute Diseases

Question 1

Bacterial pneumonia:
An ___-___ bacterial infection. Gram_ bacteria usually acquired in the community. ____ PNA (streptococcal) is the most common type of gram_ PNA.
Gram_ bacteria develop in host with underlying, chronic, debilitating conditions, severe acute illness, and recent antibiotic therapy. Gram_ infections result in early tissue __ and abscess formation.

Answer 1

Intra-alveolar
\+
Pneumococcal
\+
-
-
Necrosis

Question 2

Klebsiella, Haemophilus influenzaes, pseudomonas aeruginosa,proteus, serratia

Examples of what?

Answer 2

Common infecting organisms for gram- bacteria

Question 3

1. Shaking chills
2. Fever
3. Chest pain if pleuritic involvement
4. Cough becoming PRODUCTIVE of PURULENT, BLOOD-STREAKED or RUSTY sputum
5. Decreased or bronchial breath sounds and/or CRACKLES
6. Tachypnea
7. INCREASED WBC count
8. Hypoxemia, HYPOcapnea initially; hypercapnea with increasing severity
9. CXR: confirmation of infiltrate

Answer 3

Bacterial pneumonia

Pertinent physical findings

Question 4

An interstitial or intra-alveolar inflammatory process caused by viral agents (influenza, adenovirus, cytomegalovirus, herpes, parainfluenza, respiratory synctial virus, measles)

Answer 4

Viral pneumonia

Question 5

1. Recent hx of upper respiratory infection
2. Fever
3. Chills
4. DRY cough
5. Headaches
6. Decreased breath sounds and/or CRACKLES
7. Hypoxemia and HYPERcapnea
8. NORMAL WBC count
9. CXR: confirmation of interstitial infiltrate

Answer 5

Viral pneumonia

Pertinent physical findings

Question 6

Aspirated material causes acute inflammatory rxn within lungs

Answer 6

Aspiration PNA

Question 7

Aspiration PNA usually found in patients with ____, fixed neck ____, ____, impaired ____, NM disease, recent ____

Answer 7

Dysphagia, extension, intoxication, consciousness, neuromuscular disease, recent anesthesia

Question 8

1. Symptoms begin shortly after causal event (hours)
2. Cough maybe DRY at onset, progresses to PRODUCTIVE PUTRID secretions
3. Dyspnea
4. Tachypnea
5. Cyanosis
6. Tachycardia
7. WHEEZES and CRACKLES with decreased breath sounds
8. HYPOxemia, HYPERcapnea in severe cases
9. Chest pain over involved area
10. Fever
11. WBC shows varying degrees of LEUKOCYTOSIS
12. CXR: initially shows pneumonitis, chronic event shows necrotizing PNA with cavitation

Answer 8

Aspiration PNA

Question 9

Mycobacterium tuberculosis: Infection spread by acrosolized droplets from untreated infected host.
Incubation period is?
How long does primary disease last?

Answer 9

TB
Incubation: 2-10 weeks
Lasts: 10 days-2 weeks

Question 10

TB: postprimary infection is deactivation of dormant tuberculous bacillus, which can occur ___ after primary infection

Answer 10

Years

Question 11

TB: How long on appropriate antituberculin drugs renders host non-infectious?

Answer 11

2 weeks

Question 12

TB: During infectious stage, pt must be ___ from others in ____ room. Anyone entering must _____ and follow ____. If pt leaves room, he or she must wear _____ to keep from infecting others.

Answer 12

Isolated
Negative-pressure
Protective TB mask
Universal pxns
specialized mask

Question 13

TB: Medication is taken for ______ _____: ______

Answer 13

Prolonged periods

3-12 months

Question 14

TB: increased incidence of TB in patients with ____

Answer 14

HIV

Question 15

TB: Pertinent physical findings of primary disease can go unnoticed, as it only causes mild symptoms including: (3)

Answer 15

1. Slight nonproductive cough
2. Low-grade fever
3. Possible CXR changes consistent with primary disease

Question 16

1. Fever
2. Weight loss
3. Cough
4. Hilar adenopathy (enlargement of lymph nodes surrounding hilum)
5. Night sweats
6. Crackles
7. Hemoptysis: BLOOD-streaked sputum
8. WBC shows INCREASED LYMPHOCYTES
9. CXR: UPPER LOBE involvement with air space densities, cavitation, pleural involvement, and parenchyma fibrosis

Answer 16

TB

Question 17

What condition has CXR that shows:
Upper lobe involvement
Air space densities
Cavitation
Pleural involvement
Parenchyma fibrosis

Answer 17

TB

Question 18

___ disease (tuberculosis ____) is a form of spinal TB that affects primarily the thoracic and upper lumbar vertebrae

Answer 18

POTT’S

Spondylitis

Question 19

Pott’s Disease: arthritic changes often result in ____

Answer 19

Kyphosis

Question 20

pulmonary infection caused by fungus

Answer 20

Pneumocystis pneumonia (PCP)

Question 21

pneumocystis PNA (PCP) often found in pts following ____, ____ or patients infected with ____

Answer 21

Transplantation
Neonates
HIV

Question 22

1. Insidious progressive SOB
2. Nonproductive cough
3. crackles
4. Weakness
5. Fever
6. CXR: interstitial infiltrates
7. CBC shows NO EVIDENCE of infection

Answer 22

Pneumocystis PNA

Question 23

Multisystem inflammatory disease consisting of granulomas in multiple organs

Answer 23

Sarcoidosis

Question 24

Where do granulomas primarily exist with sarcoidosis?

Answer 24

Lungs
Skin
Lymph nodes
Eyes
Liver

Question 25

Sarcoidosis affects people of ____ age and ___ race more than others

Answer 25

Middle | Persons of color

Question 26

Sarcoidosis most often diagnoses as incidental finding on chest films. Dx requires what 3 things?

Answer 26

1. Radiographic findings 2. Histology with granulomas 3. Exclusion of all other dx

Question 27

1. Fever 2. Cough 3. SOB 4. Chest pain 5. Fatigue

Answer 27

Sarcoidosis

Question 28

Sarcoidosis may have increased secretions if ____ involvement, which can mimic ____ and ___ ___ due to scarring from repeated infections. Patients may also exhibit ___oxemia and ___capnea.

Answer 28

``` Bronchial Bronchiectasis Pulmonary fibrosis Hypoxemia Hypocapnea ```

Question 29

What is used to manage sarcoidosis?

Answer 29

Long term glucocorticoids, multisystem monitoring required

Question 30

___ and ___ (objective measures) used to monitor progression of sarcoidosis

Answer 30

PFTs | 6MWT

Question 31

New symptoms of sarcoidosis may include? (7)

Answer 31

1. Skin lesions 2. Visual changes 3. Diaphoresis 4. Palpitations 5. Jt pain 6. Jt swelling 7. Muscle weakness