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Pathopharm Exam 3 > Module 9: part 4 (67-86) > Flashcards

Module 9: part 4 (67-86) Flashcards

1
Q

T/F
Viral pneumonia is two to three times more likely in adults than children

A

FALSE
Two to three times more likely in children than in adults

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2
Q

What is the most common cause of viral pneumonia?

A

RSV

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3
Q

How is Viral pneumonia aquired?

A

Acquired by direct contact, droplet transmission, or aerosol

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4
Q

What does viral pneumonia produce?

A

Destruction of ciliated epithelium of the distal airway, with sloughing of cellular material

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5
Q

_____ and ______ microorganisms are the two most common causes of infection producing bacterial pneumonia

A

Streptococcal and staphylococcal

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6
Q

What 3 factors are consistently higher in bacteril pneumonia compared to viral?

A
  • degree of elevated temperature
  • absolute neutrophil counts
  • percent of bands

are consistently higher than viral causes

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7
Q

Vaccine has helped decrease the incidence of bacterial pneumonia T/F

A

TRUE

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8
Q

How does bacterial pneumonia typically begin?

A

Usually begins with the aspiration of one’s own nasopharyngeal bacteria into the trachea.

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9
Q

What are the clincial manifestations of bacterial pneumonia?

A

Preceding viral illness followed by
* fever with chills and rigors
* shortness of breath
* increasingly productive cough

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10
Q

What is the treatment for bacterial pneumonia?

A

Oral or IV administration of antibiotics

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11
Q

Most common cause of CAP for school-age children (ages 5 and older) and young adults

A

atypical pneumonia

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12
Q

What are some of the causitive agents for atypical pneumonia?

A

Mycoplasma pneumoniae, Chlamydophila pneumoniae

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13
Q

What is the pathophysiology of atypical pneumonia?

A
  • Local sloughing of cells
  • Peribronchial lymphocytic infiltration
  • neutrophil recruitment to the airway lumen
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14
Q

What are the clinical manifestations and treatment for atypical pneumonia?

A
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15
Q

What is aspiration pneumonitis caused by?

A

foreign substance enters lung and causes inflammation of lung tissue

  • food
  • meconium
  • secretions (saliva or gastric)
  • environmental compounds
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16
Q

How do you treat aspiration pneuminitis?

A

Dependent on the material aspirated
Broad-spectrum antibiotic therapy

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17
Q

Bronchiolitis Obliterans is fairly common T/F

A

FALSE
fairly rare

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18
Q

Bronchiolitis Obliterans is mainly due to what?

A

Mainly due to local lung reactions or body allergic response

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19
Q

What is Bronchiolitis obliterans?

A

Fibrotic obstruction of the respiratory bronchioles and alveolar ducts, secondary to intense inflammation

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20
Q

What are the clinical manifestations of Bronchiolitis obliterans?

A
  • Initially, cough, respiratory distress, and cyanosis
  • brief period of improvement
  • progressing to tachypnea, sputum production, increased anteroposterior diameter, crackles, wheezing, and hypoxemia
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21
Q

What is the treatment for bronchiolitis obliterans?

A

No specific treatment
Inhaled corticosteroids, bronchodilators, antibiotics, and oxygen supplementation

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21
Q

What is asthma? What causes it?

A

Chronic inflammatory disease with:
* sensitivity to allergens
* bronchial hyperreactivity
* reversible airway obstruction

Causes:
* Environmental & genetic factors
* Hygiene hypothesis
* Type I hypersensitivity (primarily IgE) Inflammatory cell infiltration, mucosal edema, mucus plugging of airways, epithelial damage = airflow obstruction, long-term remodeling

22
Q

What are the clinical manifestations of Asthma?

A

Cough, expiratory wheeze, shortness of breath

23
Q

What test should be conducted when evaluating asthma?

A

pulmonary function test

24
Q

What is the treatment for asthma?

A

Algorithms
Medication administration techniques
Environmental controls, co-morbidities
Educational needs
Medications: Same as those administered to adults; initiated in a stepwise sequence

25
Q

Acute lung injury (ALI) precedes the development of ________ from either a direct or an indirect injury; is life threatening.

A

ARDS

26
Q

What clinical manifestations would you see with ARDS?

A
  • Progressive respiratory distress
  • severe hypoxemia refractory to supplemental O2
  • decreased pulmonary compliance
27
Q

How do you treat ARDS?

A
  • O2 with mechanical ventilation
  • relatively high PEEP
  • Lung protective strategies: low tidal volumes, PEEP ventilation, prone position
28
Q

Cystic fibrosis is an autosomal dominant multisystem disease T/F

A

FALSE
Is an autosomal recessive multisystem disease

29
Q

What are the typical features of cystic fibrosis?

A
  • Mucus plugging
  • chronic inflammation
  • infection of the small airways
  • Abnormal secretions obstruct respiratory, digestive, & reproductive tracts
30
Q

_______transport is a fundamental abnormality a/w cystic fibrosis

A

Chloride

31
Q

______ is almost always the cause of death with cystic fibrosis

A

Respiratory failure

32
Q

What happens with cystic fibrosis? How does it develop?

A
  • defective epithelial ion transport = abnormally thick mucus from exocrine or mucus-producing glands
  • Lungs: thick secretions obstruct bronchioles → chronic infections.
  • Chronic inflammation → goblet cell hyperplasia, bronchiectasis, pneumonia, hypoxia, and fibrosis, among other conditions.
33
Q

mucus plugging a/w cystic fibrosis is a combination of:

A
  • increased mucus production
  • altered physicochemical properties of mucus
  • reduced mucociliary clearance
34
Q

What makes mucus even more viscous in cystic fibrosis?

A

deoxyribonucleic acid (DNA) & filamentous (F) actin
released from the high number of degraded neutrophils in the airways

35
Q

What promotes inflammation in cystic fibrosis?

A

abnormal cytokines

36
Q

What is the pathophysiology of cystic fibrosis?

A
37
Q

What are the clinical manifestations of cystic fibrosis?

A
  • Persistent cough or wheeze
  • sputum production
  • recurrent or severe pneumonia
  • clubbing
38
Q

What are the different tests and screening tool you should use when evaluating for cystic fibrosis?

A

Immunoreactive trypsinogen (IRT) blood test
Sweat test
Universal newborn screening in the United States

39
Q

How should you treat cystic fibrosis?

A
  • Chest physical therapy
  • high-frequency chest wall oscillation vest
  • handheld positive-expiratory pressure (PEP) devices
  • Aerosols: Antibiotics, bronchodilators, nebulized deoxyribonuclease
  • Inhaled hypertonic saline
  • Azithromycin, ibuprofen, and corticosteroids
  • IV antibiotics
40
Q

What should be included in the nutritional support treatment of cystic fibrosis?

A

Meticulous monitoring of growth parameters
Controlling fat malabsorption
Ensuring adequate caloric intake
Keeping overall health stable
Including exogenous pancreatic enzymes with meals and snacks
Providing supplemental fat-soluble vitamins

41
Q

SIDS is a disease of unknown cause T/F

A

TRUE

42
Q

Is the most common cause of unexplained infant death in Western countries.

A

SIDS

43
Q

How is a SIDS diagnosis made?

A

Diagnosis of exclusion is made after a thorough investigation and after an autopsy of an infant younger than 6 months of age who suddenly dies.

44
Q

SIDS usually occurs during the daytime T/F

A

FALSE
Usually occurs during nighttime sleep.

45
Q

Incidence of SIDS is highest during the first month of life T/F

A

FALSE
Incidence is low during the first month of life, increases in the second month, and peaks at 2 to 4 months.

46
Q

Is SIDS more common in make or female infants?

A

males

47
Q

Is SIDS more common in summer or winter?

A

Seasonal variation: More in winter
Has a possible relationship to respiratory infections.

48
Q

What are the risk factors for SIDS?

A
  • Preterm or low birth weight
  • multiple births
  • siblings died of SIDS
  • maternal issues
  • Environmental stressors
  • Altered cardiorespiratory, circulatory, and arousal characteristics
49
Q

What are the methods for preventing SIDS?

A
  • Supine
  • firm sleep surface; no soft bedding
  • room-sharing without bed-sharing
  • Routine immunization
  • pacifier
  • Avoid overheating, tobacco smoke, alcohol, and illicit drugs
  • Breast-feeding: Specific risk reduction measure
  • Know CPR

** Home monitoring: Not proven to decrease the incidence

50
Q

It is common for bacterial pneumonia to precede viral pneumonia T/F

A

FALSE
It is common for viral to precede a bacterial pneumonia

51
Q

What is the hygeine hypothesis? What is it a/w?

A
  • if you are not exposed to enough allergens in your environment you will not be able to build up your immune system function enough
  • it is a/w asthma
52
Q

The chloride transport abnormality with cystic fibrosis is a/w thicker mucus production T/F

A

TRUE
less ion movement in means less water movement in and that creates thicker mucus

Pathopharm Exam 3 (18 decks)

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