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MDRS > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

what is pneumonia

A

acute infection of the lower respiratory tract due to infectious agents, therefore causing consolidation of the affected tissue

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2
Q

what are 3 anatomic alterations of the lung in pneumonia

A
  • Inflammation of the alveoli
  • Alveolar consolidation
  • Atelectasis (e.g., aspiration pneumonia)
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3
Q

What is CAP?

A

community acquired pneumonia

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4
Q

what is the characteristic of CAP?

A

infection occurs in a previous healthy individual or somebody with COPD

  • a syndrome in which acute infection of the lungs develops in persons who have not : 1) been hospitalized recently and have not 2) had regular exposure to the health care system
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5
Q

what is HAP?

A

hospital acquired pneumonia

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6
Q

what is the characteristic of HAP?

A
  • develops 2 or more days after admission to hospital for some other reason
  • occurs 24 hours or more after admission, which was not incubating at the time of admission
  • pneumonia is a 2nd infection in patient with other disease
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7
Q

what is CAP caused by

A

streptococcus pneumonia

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8
Q

what is VAP

A

ventilator associated pneumonia that arises more than 48-72 hours after ETT intubation

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9
Q

what is HCAP?

A
  • health care associated pneumonia
  • patient that was hospitalized within 90 days of infection
  • -> reside in nursing home LTC facility; received IV antibiotics, chemotherapy or wound care within 30 days of the current infection
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10
Q

what is the etiology of pneumonia

A
  1. host upper and lower respiratory tracts are overwhelmed by micro-organisms
  2. lead to a production an inflammatory response that affects gas exchange
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11
Q

what is the mechanism that lead to pneumonia

A
  1. Aspiration of “upper airway” secretions
  2. Inhalation of droplets
  3. Dissemination of pathogens by blood
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12
Q

what are the risk factors of pneumonia

A
  • ineffective cough
  • elderly
  • immunocompromised
  • intubation
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13
Q

what are the 2 bacteria causes of pneumonia

A
  1. Gram-positive organisms(round)
    - Streptococcus
    - Staphylococcus
  2. Gram-negative organisms(rod)
    - Hemophilus influenzae
    - Klebsiella pneumonia
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14
Q

what are some atypical cause of pneumonia

A

Chlamydia
Legionella
Mycoplasma

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15
Q

What is Pneumocystis carinii pneumonia (PCP)?

A

a lung infection that can affect people with weakened immune systems, such as those infected with HIV

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16
Q

What is PCP caused by

A

fungus

17
Q

what is the treatment of PCP

A

Trimethoprim-Sulfamethoxazole orally

Pentamidine

18
Q

What is the pathophysiology of pneumococcus pneumonia

A
  1. aspiration of stretptococcus
  2. adherence of alveolar macrophage
  3. inflammation response
    - ->attraction of neutrophil
    - ->release of inflammatory mediators
    - ->accumulation of RBC and bacteria
  4. red heparization
    - red blood cells, neutrophils, and fibrin in the pulmonary alveolus/ alveol
    - lead to consolidation of lung parenchyma
  5. grey heparization
    - deposition of fibrin on pleural surfaces
    - phagocytosis in alveoli
  6. resolution of infection
    - ->macrophages in alveoli
    - ->removed by lymphatics
19
Q

what cause aspiration pneumonitis or lead to it

A
  • gastic aspiration due to GERD (Gastroesophageal reflux disease)
  • food
  • asthma/osa (huge effor to breath–>aspirate acid)
  • may lead to ARDS within 24hrs
20
Q

what is the treatment of aspiration pneumonitis

A

bronchio-alveolar lavage (BAL)

21
Q

What are the type of pneumonia based on lung location

A
  1. Broncho-pneumonia
    - ->Patchy pattern limited to segmental bronchi
  2. Lobar Pneumonia
    - ->Widespread or diffuse alveolar inflammation & consolidation
  3. Interstitial Pneumonia
    - ->Usually diffuse & typically associated with viruses or infections with mycoplasma
22
Q

characteristic of Bronchopneumonia

A
  • a patchy pattern of infection that is limited to the segmental bronchi and surrounding lung parenchyma.
  • involves both lungs (bilateral) and non-homogenous patchy infiltrates surrounding one or more bronchi
23
Q

what is the characteristic of lobar pneuomna

A
  • not limited to – segmental boundaries, but can spread throughout entire lobe
  • a widespread or diffuse alveolar inflammation and consolidation.
  • the end result of a severe or long-term bronchopneumonia in which the infection has spread from one lung segment
24
Q

what is the characteristic of Interstitial Pneumonia

A

inflammatory process within interstitial walls (connective tissue) rather than alveolar spaces

patchy densities often bilateral and diffuse in distribution

associated with infections with Mycoplasma pneumonia or viruses

25
Q

What is the change in vitals signs in patient with pneumonia

A

SNS effect

  • increase RR, HR, CO, BP
  • decrease Spo2
  • increase temperature
26
Q

What are the findings in physical assessment

A
  • Chest pain (pleuritis or i.c. muscle)/decreased chest expansion
  • Cyanosis
  • Cough (dry early), sputum production, and hemoptysis

Chest assessment findings

  • Increased tactile and vocal fremitus
  • Dull percussion note
  • Bronchial breath sounds
  • Crackles and rhonchi
  • Pleural friction rub
  • increase Whispered pectoriloquy
27
Q

What is a typical ABG of mild to moderate pneumonia

A

Acute alveolar hyperventilation with hypoxemia

  • increase ph
  • decrease Paco2
  • decrease Hco3 (slightly)
  • decrease Pao2
28
Q

What is a typical ABG of severe pneumonia

A

Acute ventilatory failure with hypoxemia

ph:decrease
Paco2: increase
Hco3: decrease slightly
Pao2: decrease

29
Q

what are some chest radiological findings in pneumonia

A
  • Increased density
  • Air bronchograms
  • Pleural effusions
30
Q

how about CT scan

A

Consolidation and bronchograms

31
Q

what are the symptoms of pneumonia

A
  • Cough
  • Fever
  • Sputum production
  • Pleuritic chest pain
32
Q

what are the signs of pnuemonia

A
  • Chest x-ray infiltrates
  • Physical exam:
  • Crackles
  • Pulse oximetry
  • Tachypnea
  • Tachycardia
  • Diminished breath sounds
33
Q

how to prevent VAP?

A

via VCB

34
Q

What are the 4 components of VCB

A
  • Elevation of the head of the bed
  • Daily sedation hold
  • Gastric ulcer prophylaxis
  • DVT prophylaxis
35
Q

What is the management of pneumonia

A

bronchscopy–> to obtain the secretion

Use higher peep for mechanically ventilated patient

36
Q

what is the complication of pneumonia

A
  • VAP
  • reduce lung volume
  • sepsis
  • organ failure
37
Q

What are RT roles in pnuemonia

A
  • Collection of sputum samples
  • Assist with bronchoscopy, monitoring, auscultation, medication delivery
  • Oxygen, ventilation & ABG’s
  • Counsel patients in sputum clearance techniques such as PEP & autogenic drainage
  • Model optimal infection control practices and prevent nosocomial by handwashing

MDRS (23 decks)

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