Infectious and Inflammatory Respiratory Diseases Flashcards
List 3 infectious diseases of the lungs
- Pneumonia
- Influenza
- TB
what is pneumonia?
an acute lung injury where an inflammation process damages the parenchyma of the lungs
leading cause of death in the very young and very old
nosocomial infections have 2x mortality and morbity compared to non-hospital aquired infections
list some causes of pneomonia
- bacterial
- viral
- fungal
- inhalation of toxic or caustic chemicals, smoke, dusts, or gases via airborne transmission
- aspiration of food, fluids, or vomit
List some risk factors for pneumonia
- age
- Comorbidities:
- Chronic bronchitis, poorly managed DM, uremia, dehydration, malnutrition, and prior exisiting critical illness
- confinement to an extended hosptial, ICU visit
- intubation, surgery, being on immunosuppresive drugs, chemotherapy
Pneumonia primarily affects what part of the lungs?
alveoli
inflammation occurs there sparking a full scale immune response which can damage lung tissue
inflammation and edema cause the terminal alveoli to fill w/cellular debris and exudate
T/F: pneumonia has systemic effects?
TRUE
pro-inflammatory state brings on systemic effects of fever, chills, malaise, and myalgias
what factors can lead to a poor prognosis for a patient with pneumonia?
- advanced age
- aggressive organisms
- comorbidity present
- respiratory failure
- neutropenia
- sepsis
what are the main differences between community and hosptial aquired pneumonia?
where they are contracted
hosptial has higher mortality rate (accounts for 40% of hospital deaths)
Pneumonia is a common complication of ______
the flu
list the s/s of pneumonia
- sudden and sharp pleuritic chest pain aggravated by chest movement and accompanied by a hacking, productive cough w/rust colored or green purulent sputum
- inappropriate dyspnea
- tachypnea accompanied by decreased chest excursion on afected side
- cyanosis
- HA
- fatigue
- fever, chills, generalized aches (myalgia)
T/F: pneumonia can impact mental status?
TRUE
it is associated with changes in gas exhange (hypoxemia and hypercapnia) which can impact mental status and lead to balance issues and increase fall risk
complete resolution of pneumonia depends on what?
extent of damage
if there are enough Type I and Type II cells, normal tissue can be restored
if damage is more extensive, fibroblasts may dominate repair process resulting in fibrosis
describe the medical management of pneumonia
- antibiotic therapy along with rest and fluids
- pneumonia vaccine
- chest physical therapy
List some PT implications for pneumonia
- teach deep breathing techniques, coughing techniques, airway clearance techniques
- adequate hydration
- early ambulation, proper positioning, sitting out of bed activities, upright posture!
what is influenza?
a common viral infection that can be deadly especially in high risk populations
what are the s/s of influenza?
- fever
- chills
- muscle aches
- cough
- congestion
- runny nose
- HA
- fatigue
how is influenza generally treated?
rest and fluids
some OTC pain relievers may help with symptoms
overall we have no effective antibody meds against it (Tamaflu has been shown to help some)
list some PT implications for influenza
- don’t treat active case
- in patient PT → hydration, out of bed
- with return to exercise later on:
- be conscious of fatigue
- ease back into TherEx
- check resting HR and base progression off that
- if they feel tired they prob are!
what is TB?
a bacterial infection that can impact:
- primarily the lungs
- vertebral column (Potts disease)
- CNS
- Heart
what types of people are at risk for TB?
- homeless, malnourished, debilitated
- immunocompromised (HIV, transplant recipients)
what are multi drug resistant TB strains?
TB caused by bacteria that do not respond to isoniazid and rifampicin (1st line antibiotics for TB)
2nd line trx are available but limited and require 2 yrs of trx
how is TB transmitted?
- Airborne
- unpasteurized milk
- inhalation of infected airborne particles or droplets generated by an infected person
- causal contact usually insufficient to lead to infection
- household exposure over many months requried to develop an infection
how does primary TB affect the lungs?
infection in the alveoli results in immune response and epithelial cells surrounding and encapsulating the bacterium (called a tubercle)
over time tubercle becomes a granuloma (macrophges accumulate)
how does primary TB progress to secondary TB?
over time the granulomas can become necrotic in the center and eventually produce fibrosis and calcification of the tissues
they can also rupture leading to increased spread of the bacteria (secondary TB)
T/F: TB can re-emerge decades after an individual originally contracts it?
TRUE
when is the risk for developing an active case of TB most likely?
the first 2 years after infection and development of a + TB skin test
what are the s/s of TB?
- productive cough
- weight loss
- anorexia
- fever
- night sweats
- fatigue
- malaise
- hemoptysis (bloody sputum)
what is miliary TB?
a type of TB characterized by a wide dissemination throughout the human body and by the tiny size of lesions
may infect many organs
what type of precautions are required when working w/TB patients?
Airborne precautions
HEPA filters, N95 masks, PAPR
List some PT implications for TB
- 2-step tuberculin skin testing
- wear appropriate PPE
- when treating pulmonary patients pay attention to their history
- when in doubt protect yourself
- thorough chest assessment
- postural deviations/overall posture
- gait
- muscle strengthening
- balance
- functional mobility
