Chapter 17 Patho

Question 1

1. Lung abscess (necrotizing pneumonia)
2. defined as a necrosis of lung tissue that in severe cases leads to a localized air-and fluid-filled cavity. Lung abscesses most commonly occur as a complication of aspiration pneumonia.
3. Is an infectious disease caused by mycobacterium tuberculosis. Predisposing factors or homelessness, drug abuse, and AIDS.
4. a pneumonia that develops more than 48 to 72 hours after endotracheal intubation.

Answer 1

1. defined as a necrosis of lung tissue that in severe cases leads to a localized air-and fluid-filled cavity. Lung abscesses most commonly occur as a complication of aspiration pneumonia.

Question 2

2. List the anatomic alterations of the lungs associated with lung abscess
3. Is an infectious disease caused by mycobacterium tuberculosis. Predisposing factors or homelessness, drug abuse, and AIDS.
4. Anatomic alterations of the lung: alveolar consolidation, alveolar-capillary and bronchial wall destruction, tissue necrosis, cavity formation, fibrosis and calcification of the lung parenchyma, bronchopleural fistulas and empyema, atelectasis and excessive airway secretions

Answer 2

2. Anatomic alterations of the lung: alveolar consolidation, alveolar-capillary and bronchial wall destruction, tissue necrosis, cavity formation, fibrosis and calcification of the lung parenchyma, bronchopleural fistulas and empyema, atelectasis and excessive airway secretions

Question 3

3. Describe the causes of lung abscess ( 1 of 2 )
4. Aspiration often occurs in the patient with a decreased level of consciousness. Predisposing factors: (1) alcohol (2) seizure disorders (3) general anesthesia (4) head trauma (5) cerebrovascular accidents (6) swallowing disorders. Flash burns: aspiration of acidic gastric fluids is associated with immediate injury to the tracheobronchial tree and lung parenchyma
5. a pneumonia that develops more than 48 to 72 hours after endotracheal intubation.

Answer 3

1. Aspiration often occurs in the patient with a decreased level of consciousness. Predisposing factors: (1) alcohol (2) seizure disorders (3) general anesthesia (4) head trauma (5) cerebrovascular accidents (6) swallowing disorders. Flash burns: aspiration of acidic gastric fluids is associated with immediate injury to the tracheobronchial tree and lung parenchyma

Question 4

Describe the causes of lung abscess (2 of 2)

1. a pneumonia that develops more than 48 to 72 hours after endotracheal intubation.
2. Organisms known to cause lung abscess
   A.) Common Organisms Associated with Aspiration: (Anaerobic gram-positive cocci): Peptostreoptococci, Peptococci ( Anaerobic gram-negative bacilli): Bacteroides fragillis, Prevotella melaninogenica and Fusobacterium species
   B.) Less Common Organisms: Klebisella, Staphylococci, Mycobacterium tuberculosis, Histoplasma capsulatum, Coccidioides immitis, Blastomyces and Aspergillus fumigatus
   C.) Parasites: Paragonimus westermani, Echinococcus and Entamoeba histolytica
   D.) Rare causes: Streptococcus pneumoniae, Pseudomonas aeruginosa and Legionella pneumophila

Answer 4

2. Organisms known to cause lung abscess
   A.) Common Organisms Associated with Aspiration: (Anaerobic gram-positive cocci): Peptostreoptococci, Peptococci ( Anaerobic gram-negative bacilli): Bacteroides fragillis, Prevotella melaninogenica and Fusobacterium species
   B.) Less Common Organisms: Klebisella, Staphylococci, Mycobacterium tuberculosis, Histoplasma capsulatum, Coccidioides immitis, Blastomyces and Aspergillus fumigatus
   C.) Parasites: Paragonimus westermani, Echinococcus and Entamoeba histolytica
   D.) Rare causes: Streptococcus pneumoniae, Pseudomonas aeruginosa and Legionella pneumophila

Question 5

5. Treatment of Lung Abscess

Answer 5

based on the severity of the pneumonia and the lung abscess. Treatment includes appropriate antimicrobial therapy coupled with prompt drainage and surgical debridement. Standard treatment for a lung abscess caused by an anaerobic pathogen is clindamycin. Other drugs that may be used are any combination of beta-lactam-beta-lactamase inhibitors, penicillin plus metronidazole or a carbapenem

Question 6

6. Lung Abscess Ethology

Answer 6

1. Lung abscess is often associated with aspiration caused by a variety of disorders: alcohol abuse, seizure disorder, general anesthesia, head trauma, cerebrovascular accidents, swallowing disorders
2. Infection resulted from an anaerobic bacteria the sputum is often foul smelling
3. Should the infection produce a bronchopleural fistula drainage into the plural space may result in a pleural effusion and empyema
4. producing sensations of dyspnea and pleurisy
5. During the early stage of a pulmonary infection polymorphonuclear leukocytes and macrophages move into the infected area to engulf and destroy any invading organisms

Question 7

7. Lung Abscess (Causative Organisms)

Answer 7

Lung abscess is often the result of an aspiration of the following organisms:

1. Anaerobic gram-positive cocci: Peptostreptococci and Peptococci
2. Anaerobic gram-negative bacilli: Bacteroides fragilis, Prevotella melaninogenica and Fusobacterium species

Question 8

8. Respiratory Care Treatment Protocols

Answer 8

1. Oxygen Therapy Protocol
2. Bronchopulmonary Hygiene Therapy Protocol
3. Lung Expansion Therapy Protocol

Question 9

Which of the following is or are anaerobic organisms?

1. Blastomyces
2. Peptococcus
3. Coccidioides immitis
4. Bacteriodes
   a. 1 and 2 only
   b. 2 and 4 only
   c. 3 and 4 only
   d. 2, 3, and 4 only

Answer 9

b

Question 10

Which of the following is or are predisposing factors to the aspiration of gastrointestinal fluids (and anaerobes)?

1. Seizure disorders
2. Head trauma
3. Alcoholic beverages
4. General anesthesia
   a. 1 and 4 only
   b. 2 and 3 only
   c. 2, 3, and 4 only
   d. 1, 2, 3, and 4 only

Answer 10

d

Question 11

Which of the following is or are associated with the formation of lung abscess?

1. Bullae or cysts that become infected
2. Interstitial lung disease with cavity formation
3. Bronchial obstruction with secondary cavitating infection
4. Penetrating chest wounds that lead to an infection
   a. 1 only
   b. 3 only
   c. 2 and 4 only
   d. 1, 2, 3, and 4 only

Answer 11

d

Question 12

Anatomically, a lung abscess most commonly forms in which part(s) of the lung?

1. Posterior segment of the upper lobe
2. Lateral basal segment of the lower lobe
3. Anterior segment of the upper lobe
4. Superior segment of the lower lobe
   a. 1 only
   b. 3 only
   c. 1 and 4 only
   d. 2 and 3 only

Answer 12

c

Question 13

Which of the following pulmonary function findings may be associated with a severe and extensive lung abscess?

1. Decreased FVC
2. Increased PEFR
3. Decreased RV
4. Increased FRC
   a. 3 only
   b. 2 and 4 only
   c. 3 and 4 only
   d. 1 and 3 only

Answer 13

d