Lecture 12- world health organization staging system (PHT 204/resp)

Question 1

How many stages are there for HIV infection?

Answer 1

4 clinical stages.

Question 2

Clinical stage 1:

Answer 2

1. Acute retroviral infection (occurs immediately after infection/ and when the immune system has not yet control the virus)
2. Asymptomatic (a person affected by a condition but showing no signs of symptoms.
3. lymphadenopathy (swelling of lymph nodes)
4. performance scale: asymptomatic , normal activity

Question 3

clinical stage 2:

Answer 3

1. <10% of body weight loss
2. skin infections, nail infections and inflammation of the corners of the mouth
3. shingles (herpes zoster)
4. recurrent upper respiratory tract infection
5. Performance scale: symptomatic , normal activity

Question 4

clinical stage 3:

Answer 4

1. weight loss, < 10% of body weight
2. chronic diarrhea > 1 month
3. Prolonged fever > 1 month
4. Oral candidacies
5. PTB within the past year
6. bacterial infections (pneumonia)
7. Performance scale: bedridden < 50% of the day during the last month

Question 5

Clinical stage 4:

Answer 5

AIDS- defining conditions
1. unwanted weight loos of >10% body weight
2. pneumocytis
3. toxoplasmosis (inflammation of the brain/ poor coordination, confsuion)
4. Cryptosporidiosis (disease causing diarrhea)
5. extrapulmonary TB (Tb in other organs besides the lungs)
6. lymphoma (cancers that start in the lymph system)
7. kaosis sarcoma (cancer cells are found in the skin and mucous membranes of the GI tract)
8. HIV encelphalpopathy, (infection that spreads throughout the brain)
9. performance scale: bedridden >50% of the during the last month

Question 6

AIDS signs and symptoms

Answer 6

-skin rashes
-coughing
-nausea, vomiting
-poor concentration, memory loss, confusion

Question 7

What is pneumonia?

Answer 7

is an acute inflammatory process involving the lung alveoli and surrounding airways.

Question 8

what are the two types of pneumonia?

Answer 8

lobar pneumonia and bronchopneumonia

Question 9

What are the predisposing factors?

Answer 9

viral infections (influenza, measles)
chronic airways disease (disease that causes airflow blockages
bronchial obstruction (getting carcinoma, is a form of cancer which lines lungs )
impaired resistance

Question 9

What is lobar pneumonia?

Answer 9

-is acute exudative inflammation of the entire lobe, is common in young or middle adult life and occurs predominantly during winter months.
- it is caused by streptococcus pneumonia

Question 10

What is the 4 pathology stages identified in lobar pneumonia?

Answer 10

1. Consolidation
2. Red hepatization
3. Grey hepatization
4. Resolution

Question 11

Explain the stages of lobar pneumonia?

Answer 11

1. During the consolidation stage, the lungs become very heavy and congested due to infectious fluid that has accumulated in the air sacs. The infection spreads rapidly leading to pleuritic pain.
2. During the Red hepatization stage red blood cells and immune cells that enter the fluid-filled lungs to combat the infection give the lungs a red appearance. Although the body is beginning to fight the infection during this stage, symptoms worsens.
3. Grey hepatization stage red blood cells will disintegrate during this stage, giving the lungs a grayish color. However, immune cells remain, and symptoms will likely persist.
4. During the resolution stage a large number of macrophages enters the air sacs , kills bacteria and removes dead cells. One will develop a production cough which will help in removing fluid from the lung.

Question 12

Clinical features of manifestations of lobar pneumonia is?

Answer 12

• high fever
  -poor appetitie
  -headaches (general aches and pains)
  -pleural pain
  -respiration is fast and shallow

Question 13

Findings on physical exam, medical treatment and physiotherapy:

Answer 13

Physical exam:
-Pain on inspiration
-Reduced chest expansion
-bronchial breath sounds during consolidation stage , crackles with resolution stage

Treatment:
-Antibiotic treatment
-Rest in warn environment
-Stay hydrated
-pain killers (amalgesics)

Physio: not always required
-Breathing exercises
-Gentle shaking and vibrating (pain decreases)
-coughing (resolution)
-postural drainage

Question 14

Define Bronchopneumonia?

Answer 14

-Is an acute inflammation of the bronchi and bronchioles with collapse and consolidation of associated groups of alveoli.
-affects the elderly and very young
-it is caused by mixed infection with streptococcus pneumonia and influenza

Question 15

What is the 5 of bronchopneumonia?

Answer 15

1. Acute inflammation of bronchi & bronchioles
2. Inflammatory exudates / pus is produced which fills alveoli
3. Consolidation or blocking of smaller airways
4. Atelectasis (a complete or partial collapse of the entire lung or lobe area.
5. Resolution follows, but in some areas fibrous tissue replaces damaged epithelium

Question 16

Clinical features of bronchopneumonia and physio treatment?

Answer 16

clinical features:
- acute bronchitis
-increase in temp, pulse, resp and dyspnoea
-Profuse cough
-no pleural pain
-confusion
-wheezing during early stages, later crackles

physio:
-shaking and vibrations
-coughing
-breathing exercises

Question 17

what are the 3 complications of pneumonia?

Answer 17

1. respiratory failure
2. right sided heart failure
3. incomplete resolution.