MedComplex-Exam 2 Part 1 (COPD, Pneumo)

Question 1

What is the OFFICIAL definition for CHRONIC BRONCHITIS? Defined as a __________ and production of ______ for a minimum of _____ months a year for at least ____ consecutive years.

Answer 1

chronic cough… sputum…3months…2 years

Question 2

Which condition is “BULLAE” formation associated with?

Answer 2

Emphysema from Alpha-1-AntiTrypsin Deficiency

Question 3

What is the term for deterioration of the elastic and reticular fibers of the lungs with the resultant loss of elastic recoil causing ENLARGED ALVEOLAR SPACES?

Answer 3

BULLAE

Question 4

What is the #1 reason/cause for a pneumothorax?

Answer 4

Emphysema

Question 5

______: are subpleural air-filled spaces formed by rupture alveoli which can rupture into the pleural cavity, causing a PNEUMOTHORAX.

Answer 5

BLEBS

Question 6

______ are parenchymal air-filled spaces greater than 1 cm in diameter.

Answer 6

BULLAE

Question 7

Which condition is associated with CURSCHMANN SPIRALS?

Answer 7

Bronchial Asthma

Question 8

In Bronchial Asthma: The mucosal infiltrates consists of non-specific inflammatory cells, along with several _______. The mucus sometimes contains whorls of shed epithelial cells called __________

Answer 8

EIOSINOPHILS…Curschmann Spirals

Question 9

What tissue/bodily fluid do you find Churchmann Spirals in a Bronchial Asthma patient?

Answer 9

mucus

Question 10

The role of Alpha-1-AntiTrypsin in the body? Alpha-1-Antitrypsin is a ________, also known as an ________, which is essential in protection against naturally occurring ________.

Answer 10

serum protein… antiprotease… proteases

Question 11

The role of Alpha-1-AntiTrypsin in the body? It is produced by the _____ and circulates in the serum, permeating tissues where it’s primary function is to NEUTRALIZE naturally occurring _______ in normal people who have the protein.

Answer 11

liver…. proteases

Question 12

The role of Alpha-1-AntiTrypsin in the body? The proteases (that A-1-A neutralize) are produced by bacteria, PMN’s, monocytes, and macrophages during the phagocytic process, and are capable of destroying ______ and reticular fibers in the lung….WITHOUT A-1-A THIS LEADS TO ________ FORMATION IN THE LUNGS!!

Answer 12

elastin…BULLAE

Question 13

Wait, what are the 4 types of cells that produce elastin eating proteases again?

Answer 13

1.bacteria 2.PMNs 3.Monocytes 4.Macrophages

Question 14

Bullae are parenchymal air-filled spaces greater than ____ in diameter.

Answer 14

1 cm

Question 15

What is the underlying association between COPD and poor oral health?

Answer 15

New research have linked PERIODONTAL DISEASE as a possible RISK FACTOR for the development of COPD.

Question 16

What is the association between poor oral health and COPD??? The onset and progression of COPD is dependent on _______ in almost all cases and repeated _______ infections can worsen the lung disease.

Answer 16

smoking… bacterial

Question 17

What is the association between poor oral health and COPD??? It is possible that the inflammation caused by ________may contribute to inflammation of the lining of the ________, leading to chronic bronchitis.

Answer 17

periodontal disease….bronchial tubes

Question 18

What is the association between poor oral health and COPD??? Bacteria such as ________ and ________, seen in dental plaque (along with periodontal disease-associated enzymes in the saliva) may modify oropharyngeal mucosal surfaces to PROMOTE GROWTH of respiratory pathogens, like ________ and _______…SONS OF BITCHES!

Answer 18

Streptococcus and Actinomyces….Pneumococcus and H. influenza!!

Question 19

What are the 4 diseases that comprise COPD?

Answer 19

1.Chronic Bronchitis 2.Emphysema 3.Bronchial Asthma 4.Bronchiectasis

Question 20

What is the main cause of chronic bronchitis (90% of cases)?

Answer 20

smoking

Question 21

What type of cell increases in chronic bronchitis?

Answer 21

goblet cells and there is an increase in mucus

Question 22

What is the metaplasia in chronic bronchitis? (from what cell type to what cell type?

Answer 22

from columnar epi to stratified squamous epi

Question 23

Which condition has blue bloaters? Which condition has pink puffers? Which condition has barrel chest?

Answer 23

Blue-Bloaters: chronic bronchitis…pink puffers: Emphysema…barrel= chest: emphaseyma

Question 24

Bronchitis vs Emphysema: Cyanosis

Answer 24

Bronchitis

Question 25

Bronchitis vs Emphysema: Pulmonary HTN

Answer 25

Bronchitis

Question 26

Bronchitis vs Emphysema: Peripheral Edema

Answer 26

Bronchitis

Question 27

What is a disease characterized by increased responsiveness of the bronchial tree to a variety of stimuli. These attacks are marked by wheezing during expiration, cough, and dyspnea?

Answer 27

Bronchial Asthma

Question 28

Which WHITE BLOOD CELL goes hand in hand with Asthma?

Answer 28

EOSINOPHILS

Question 29

What is a permanent dilatation of the bronchi which is the most common complication of chronic bronchitis?

Answer 29

BronCHIectasis

Question 30

What is a VERY COMMON CLINICAL manifestation of Bronchiectasis?

Answer 30

Halitosis!

Question 31

What is the species name for Legionella? What is its gram stain? Is it aerobic or anaerobic?

Answer 31

Legion-ella Pneumo-PHILA...gram negative...aerobic (WATER ENVIRONMENTS)

Question 32

In Legionaires' disease, No ______ to ______ transmission has been identified

Answer 32

person to person

Question 33

Legionnaires’ Disease should be suspected in patients who have pneumonia who are over 50 y.o.a., are smokers, or if the sputum gram stains reveals _________ and very few organisms.

Answer 33

neutrophils

Question 34

What organism is more associated with lung absecsses leading to pneumonia?

Answer 34

Staphlococcus (Aureus)

Question 35

HOLY CRAPOLA: Staphylococcus aureus pneumonia tends to produce multiple ________....A _______ form of pneumonia....Common in debilitated hospitalized patients....The mortality rate is over ____%.

Answer 35

abscesses... virulent...50%

Question 36

Which pneumonia causing organism is associated with RUST COLORED SPUTUM?

Answer 36

Streptococcus Pneumonia

Question 37

Streptococcus Pneumonia: accounts for >___% of all bacterial pneumonias and usually reach the alveoli in droplets of mucus or saliva.....Usually affects the _____ lobes due to GRAVITY.

Answer 37

50%...LOWER

Question 38

What type of pneumonia causes a "White out"?

Answer 38

pneumococcal lobar pneumonia

Question 39

Klebsiella pneumoniae infection occurs in middle-aged, alcoholic males. A thick current-red _____ sputum is characteristic.

Answer 39

JELLY

Question 40

____________ infection occurs in middle-aged, alcoholic males. A thick current-red jelly sputum is characteristic.

Answer 40

Klebsiella pneumoniae

Question 41

Which pneumonia causing organism is associated with red-jelly sputum?

Answer 41

Kelb-Siella Pneumoniae

Question 42

_________ is the most common HOSPITAL- acquired pneumonia characterized by vascular lesions that cause infarcts and necrosis of the lung parenchyma, and are the most common causes of lung infections in Cystic Fibrosis pt’s. A common source is contaminated ventilatory equiptment, and the mortality rate is over ___%.

Answer 42

Pseudomonas...70%

Question 43

Pseudomonas is the most common hospital- acquired pneumonia characterized by vascular lesions that cause infarcts and necrosis of the lung parenchyma, and are the most common causes of lung infections in _________ pt’s.

Answer 43

Cystic Fibrosis

Question 44

What is the world's smallest bacteria (same size of virus) and causes walking pneumonia?

Answer 44

Mycoplasma Pneumoniae.

Question 45

ROUTES: There are lots of bugs in the upper respiratory tract, but If ________ into the lower respiratory tract, they can cause pneumonia.

Answer 45

aspirated

Question 46

ROUTES: Even some GRAM NEGATIVES from the gut can cause pneumonia by contamination of the ______ to the lungs!!!.

Answer 46

blood

Question 47

ROUTES: Bacteria, such as Legionella or T.B., as well as various fungi and viruses that are not normally present in the nasopharyngeal flora may cause pneumonia if ______ accidently.

Answer 47

inhaled

Question 48

ROUTES: Aspiration of infected particles in ______ contents: Such aspiration pneumonia is often caused by AEROBIC OR ANAEROBIC???? bacteria and is common in people who are unconscious, who have neurologic deficits, or are alcoholics who have vomited and have lost control of their ________.

Answer 48

gastric...ANAEROBIC...gag reflex

Question 49

Hematogenous Spread: Bacteria may be transported to the lungs by the blood. Pneumonia is common in ______ and may develop secondary to UTI’s or GI tract infections.

Answer 49

sepsis

Question 50

What are the main two points Dr. F mentioned about Alveolar Pneumonia? (what type of organism? What type of immune cell response)

Answer 50

Alveolar pneumonia is bacterial and it has a neutrophil driven

Question 51

What are the main two points Dr. F mentioned about Interstitial Pneumonia? (what type of organism? What type of immune cell response)

Answer 51

Interstitial Pneumonia viral and mononuclear cell (lymphocytes, monocytes, macrophages, plasma cells)

Question 52

What are two examples of Alveolar Pneumonia?

Answer 52

1.Broncho Pneumonia 2.Lobar Pneumonia

Question 53

Interstitial pneumonia which primarily involves the alveolar | _______, which includes VIRAL pneumonia

Answer 53

septae

Question 54

Are alveolar pneumonias focal or diffuse?

Answer 54

HA TRICKED YA! Focal (Bronchial) OR diffuse (lobar)

Question 55

Which type of pneumonia (alveolar or interstitial) is most prevalent in debilitated elderly patients who are confined to bed?

Answer 55

alveolar

Question 56

Pneumonia limited to the segmental bronchi and surrounding parenchyma is called ___________.

Answer 56

Bronchopneumonia

Question 57

Widespread or diffuse alveolar pneumonia is called _________

Answer 57

Lobar Pneumonia.

Question 58

Are interstitial pneumonias focal or diffuse?

Answer 58

usually diffuse and often BILATERAL

Question 59

Periodontal Disease and Pneumonia: What type of pneumonia is associated with hospital patients having perio disease?

Answer 59

Nosocomial pneumonia (hospital acquired)

Question 60

Periodontal Disease and Pneumonia: What are the three bugs that are causing nosocomial pneumonia in patients with Perio disease/poor oral hygiene?

Answer 60

1. Staph Aureus 2.Pseudomonas 3.Klebsiella

Question 61

Periodontal Disease and Pneumonia: What is the main factor that allows Staph, Pseudomonas, and Kelbsiella to live in the mouth in hospital patients-even thought these bugs aren't normally there?

Answer 61

ANTIBIOTICS suppressing the normal flora

Question 62

Periodontal Disease and Pneumonia: Which part of the respiratory tract are the bugs involved in this situation aspirated to?

Answer 62

the LOWER respiratory tract