Infectious Lung Diseases Flashcards
Pneumonia
Definition
An acute inflammation of the lungs associated with alveolar filling by exudate (consolidation)
- Lots of secretions & retention
Common complications & cause of morbidity / mortality in hospitalized patients
- Longer the stay = INC chances of aquiring pneumonia
Pneumonia: Pathophysiology
(2)
- Infectious agent (typically a virus or bacteria) or irritant reaches the lungs triggering an inflammatory reaction.
- May also be a result of an auto-immune disease
** Leading cause of death in Canada - infectious diseases/agent
Pneumonia: Etiology
(5)
- Aspiration
- Contact (ie trauma or chest tube)
Laceration (open-wound injury) OR lung contusion causing an inflammatory response - Inhalation - droplet
- Hematogenous - circulation
- INC risk: infants, the elderly, those with chronic cardiac or respiratory disease & immunosuppressed patients (HIV, rheumatological disease, post-transplant, meds)
Pneumonia: Clinical Presentation
(depends on etiology)
(6)
Inspection:
- Dyspnea
- Cyanosis - hypoxeamia
- INC RR + shallow breathing (tachypneic breathing)
- Cough (productive = bacterial, non-productive = viral)
- Fever (high fever = bacterial, moderate fever = viral)
Palpation:
- Tactile Fremitus: INC (b/c of consolidation)
Percussion:
- Dull
Auscultation:
- Wet inspiratory crackles (anytime there is a lot of secretions)
- Broncial or bronchovesicular (normal EXCEPT when they are heard somewhere they shouldnt be)
ABGs:
- DEC PaO2 - poor ventilation - blood is passing by w/o picking up O2 (shunt)
- May have DEC PaCO2 (if hyperventilation - INC RR)
CXR:
- Air bronchograms
- Opacities in surround alveoli
Tuberculosis
Definition & Pathophysiology & Etiology
An infectious, systemic, inflammatory disease that primarily affects the lungs & other organs
- Presentations are related to the lungs
Patho:
- Mycobacterium tuberculosis (airborne precautions) - extra precautions when treating pt
- Most infectious do not have symptoms (latent TB). May lay dormant then reactivate when immune system weakens (post-primary tuberculosis)
Common: 3rd world countries & low-economic status
Tuberculosis: Clinical Presentation
(2) - 1 + 5
Respiratory:
- Cough > 2 weeks
Dry cough (early)
Productive cough (mucus / blood) < physical examination - common character of TB
Systemic:
- Fever
- Fatigue
- Night sweats
- Weight loss (poor appetite)
- May have swollen lymph nodes - fighting off infection
Tuberculosis: Diagnosis
(2)
TB Infection
- TB Skin Test
- TB Blood Test
TB disease (ACTIVE)
- CXR
1. Infiltrates (white spots) & cavitation in the upper lobes (apical segments)
Cavitation = gas fillled area in the lung in the center of a nodule or area w/ consolidation
2. May have pleural involvement &/or parenchymal fibrosis - not neccessarily
- Sputum sample
- Medical history - immunocompromised (INC hypo), recently travelled to a country w/ TB
- Physical examination
Tuberculosis: Intervention
(5)
- Medication (cocktail of meds for 6-8 months)
-
Prevent exposure to others
Negative pressure room
Anyone entering the room must follow universal precautions & an N-95 respirator mask (airborne diseases) - Secretion clearance techniques - manual
- Deep breathing
- Coughing - proper cough to expel secretions