PNEUMONIA AND CF Flashcards
1
Q
cystic fibrosis
A
FATAL DISORDER CHARACTERIZED BY EXCESSIVE PRODUCTION AND ACCUMULATION OF THE THICK MUCUS IN THE TRACHEOBROCHIAL TREE
2
Q
CFTR
A
CYSTIC FIBROSIS TRANSMEMEBRANE CONDUCTANCE REGULATOR
A GENE THAT, WHEN MUTATED, LEADS TO CF
3
Q
BROCNHIAL OBSTRUCTION
A
A CONDITION WHERE BRONCHIAL AIRWAYS ARE BLOCKED WHICH CAN BE CAUSED BY MUCUS PLUGGING
4
Q
ATELECTASIS
A
PARTIAL OR COMPLETE COLLAPSE OF THE LUNG OFTEN DUE TO BLOCKAGE OF THE AIR PASSAGES
5
Q
MUCUS PLUGGING
A
ACCUMULATION OF THICK MUCUS IN THE AIRWAYS THAT OBSTRUCT AIRFLOW
6
Q
SWEAT TEST
A
A DIAGNOSTIC TEST FOR CF THAT MEAUSRES THE AMOUNT OF SODIUM AND CHLORIDE IN SWEAT
7
Q
ELEVATED SWEAT CHLORIDE
A
SWEAT CHLORIDE LEVELS GREATER THAN 60 MEQ/L ON TWO OCCSAIONS INIDCATE A DX OF CF
8
Q
GENETIC COUNSELING
A
A PROCESS TO INFORM AND SUPPORT INDIVIDUALS REGARDING GENETIC ASPECTS OF CF INCLUDING RISKS AND INHERITANCE PATTERNS
9
Q
PFT
A
TESTS THAT MEASURE LUNG FUNCTION AND CAPACITY OFTEN INDICATING THE SEVERITY OF CF
10
Q
SYMPTOMS OF CF
A
Chronic cough, wheezing, sputum production, frequent respiratory infections, and failure to thrive.
11
Q
Hematologic outcomes in CF
A
Increased hematocrit and hemoglobin levels, often in response to chronic hypoxia.
12
Q
Nasal potential difference (NPD)
A
A measurement that assesses the transport of sodium and chloride across epithelial cell linings, indicative of CFTR function.
13
Q
Pre-natal testing for CF
A
Screening for CF mutations in pregnant women to assess the risk of having a child with CF.
14
Q
anatomic alterations of the lungs -cf
A
EXCESSIVE RODUCTION AND ACCULULATIONOF THICK TENACIOUS MUCUS IN THE TTRACHEA-BRONCHIAL TREE
PARTIAL BRONCHIAL OBSTRUCTION (MUCUS PLUGGING)
HYPERINFLATION OF ALVEOLI
TOTAL BRONCHIAL OBSTRUCTION (MUCUS PLUGGING)
ATELECTASIS
15
Q
ETIOLOGY AND EPIDEMIOLOGY OF CF
A
AL GENE DISORDER CAUSED BY MUTATIONS IN APAIR OF GENES LOCATED ON CHROMOSOME 7
OVER 1700 DIFF MUTATIONS IN THE GENE THAT ENCODES FOR THE CF TRANSMEMBRANE CONDUCTANCE REGULATOR, CFTR.
16
Q
THE ABNORMAL EXPRESSIONOF THE CFTR RESULTS IN
A
RESULTS IN THICK VICIOUS ACCULUMALTION IN THE LUNGS
MUCUS BLOCKS THE PASSAGEWAYS OF THE PANCREAS WHICH PREVENTS ENZYMEABNORMLA TRANSPORT OF SODIUM AND CHLORIDE IONS ACROSS MANY TYPES OF EPIHERLIAL SURFACES
S FROM THE PANCREAS FROM REACHING THE INTESTINE
17
Q
6 CLASSES OF CFTR MUTATIONS
A
DIVIDED INTO 3 BROAD CATEGORIES:
AFFECING THE QUALITY OF THE CFTR PROTIEN
AFFECTING FUNCTION PF THE CFTR PROTEIN
AS A GATING DEFECT (CLASSII) WHERE THE CHANNEL DOES NOT OPEN
A CONDUCTANCE DEFECT (CLASS IV) WHERE THE ION FLOW IS IMPAIRED
18
Q
HOW CF GENE IS INHERITED
A
A RECESSIVE GENE DISORDR
THE CHILD MUST INHERIT 2 COPIES OF THE DEFECTIVE CG GENE TO HAVE DISESE
IF BOTH PARENTS CARRY THE GENE, THE POSSIBILITY OF HEIR CHILDREN HAVING FOLLOW THE MENDELIAN inherited pattern of 1 in 4.
19
Q
SCREENING AND DX OF CF
A
BASED ON THE CLINCAL MAIFESTATIONS ASSOCIATED WITH CF
FAMILY HX OF CF
LAB FINDINGS
20
Q
2 CRITERIA MUST BE MET TO DX FOR CF
A
1) Clinical presentation consistent with CF symptoms
. 2) Laboratory evidence of CFTR dysfunction or the presence of two CFTR mutations.
21
Q
clinical eveidence of CF CFTR DYSFUNCTION
A
ELEVATED SWEAT CHLORIDE GREATER THAN 60 MEQ/L (ON 2 OCCASIONS)
MOLECULAR DX - GENETIC TESTING
ABNRMAL NASAL POTENTIAL DIFFERENCE
22
Q
NEBORN SCREENING OF CF
A
A test performed on newborns to detect cystic fibrosis early, typically through the measurement of immunoreactive trypsinogen (IRT) levels.
23
Q
HOW LONG HAS CF SCREENING IN NEWBORNS BEEN PRRACTICED IN ALL 50 STATES
A
2011
24
Q
MOST INFANTS WITH CF HAVE AN ELEVATED
A
BLOOD LEVEL OF IMMUNOREACTIVE TRYPSINOGEN (IRT)
25
THE IMMUNOREACTIVE TRYPSIN IS MEASURED FROM
A blood sample taken from the newborn's heel. ON THE GUTHRIE CARDS
26
WHAT IS TEH SWEAT TEST
A diagnostic test used to measure the amount of chloride in sweat, helping to confirm a diagnosis of cystic fibrosis.
27
WHAT US THE GOLD STANADRD FOR DX TEST FOR CF
The sweat test is considered the gold standard diagnostic test for cystic fibrosis, measuring chloride levels in sweat to confirm the condition.
28
WHAT DOES THE SWEAT TEST MEASURE
The sweat test measures the concentration of chloride and sodium in sweat, which can indicate cystic fibrosis when elevated.
29
WHAT IS PILOCARPINA
a medication used to stimulate sweat production during the sweat test for cystic fibrosis.
USUALLY DONE 2X
30
INFANTS WITH A + CF NEWBORN SCREENING RESULT SHOULD HAVE WHAT DONE
A diagnostic sweat test performed to confirm cystic fibrosis. AFTER 2 WEEKS OF AGE AND GREATER THAN 2 KG IF ASYMPOTAMTIC
31
SWEAT TESTS INTERPRETATIONS INFANTS LESS THAN 6 MONTHS OF AGE
LESS THAN OR EQUAL TO 29 MMOL/L - NORMAL
30-59 MMOL/L -INTERMEDIATE - POSSIBLE CF
GREATER THAN OR EQUAL TO 60 MMOL/L - ABNRMAL - DX OF CF
32
SWEAT TESTS INTERPRETATIONS INFANTSOLDER 6 MONTHS OF AGE, CHILDREN AND ADULTS
LESS THAN OR EQUAL TO 39 MMOL/L - NORMAL
40-59 MMOL/L - INTERMEDIATE - POSSIBLE CF
GREATER THAN OR EQUAL TO 60 MMOL/L - ABNORMAL - DX OF CF
GREATER THAN 60MMOL/L ABNRONAL - DX OF CF
33
CLINICAL INDICATIONS JUSTIFYING THE INTIAL EVELAUTAION FOR CF
WHEEZE DISTAL INTEST. OBSTRUCTION SYNDROME
CHRINIC COUGH
PANCREAS INSUFFICIENT
SPUTUM PRODUCTION
PANCREATITIS
PARASINUSITIS
CHOLELITHIASIS
GI ISSUES
FAT SOLUBLE DEF (A, D, E, K)
FREQ RESP INFECTIONS
FAILURE TO THRIVE
HYPOPROTEINEMIA
HEPTOMEGALY
LABNORMAL CT SCAN
HEPTOBILARY
PROLAPSE INFERTILITY
MECONIUM ILEUS
OBSTRUCTIVE AZOOSPERMIA
MECONIUM PERITONITIS
NASAL POLYPS
FOCAL BILIARY
CIRRHOSIS
PARASINUSITIS
CHOLELITHIASIS
34
MOLECULAR DX FOR CF
Molecular diagnosis for cystic fibrosis involves genetic testing to identify mutations in the CFTR gene, which is responsible for CF.
35
NASAL POTENTIAL DIFFERENCES OF CF
THE IMPAIRED TRANSPORT NA+ AND CL- ACROSS THE EPITHELIAL CELL LINING THE AIRWAY OF THE CF PT CAN BE MEASURED
by nasal potential difference measurements. This reflects abnormal ion transport, characteristic of cystic fibrosis.
36
WHEN NA+ AND CL- MOVE ACROSS THE EPITHELIAL CELL MEMBRANE THEY GENERATE
an electrical potential difference, which can be measured to assess ion transport abnormalities in cystic fibrosis.
37
THE NASAL PASSAGES THE ELECTRICAL POTENTIAL DIFFERENCE IS CALLED
the nasal potential difference.
38
PRE NATAL TESTING FOR CF
PREG FEMALES OFFERED SCREENING FOR CF MUTATIONS
IF BOTH PARENTS TEST + TEST FOR CF MUTATIONS THEN THE FETUS HAS A 1:4 CHANCE OF HAVING CF
39
STOOL FECAL FAT TEST FOR CF
a diagnostic test that measures the amount of fat in a stool sample, used to assess pancreatic function in cystic fibrosis patients.
MEAUSRES THE AMOUNT OF FATE IN THE IN INFANTS STOOL AND THE % OF DIETARY FAT THAT IS NOT ABSORBED BY THE BODY
40
WHAT IS THE PURPOSE OF THE STOOL FECAL FAT TEST
USED TO EVEALUATE HOW THE LIVER, GALL BLADDER, PANCREASE, AND INTESTINES ARE FUNCTIONING
41
INFANTS WITH CF AND PANCREATIC INSUFF WILL HAVE A FECAL ELASTANCE OF LESS THAN
50 UG/G OF STOOL
42
WHAT IS THE NORMAL VALUES FOR INFANTS FOR THE STOOL FECAL FAT TEST
NORMAL IS GREATER THAN 300 UG/G OF STOOL
43
OVERVIEW OF TEH CARDIOPULMONARY CLINICAL MANIFESTATIONS OF CF
ATELECTASIS
BRONCHOSPASM
EXCESSIVE BRONCHIAL SECRETIONS
44
VITALS SIGNS FOR CF PT
INCREASED
BP
RR (TACHYPNEA)
HR
45
HOW ARE ACCESSORY MUSCLES AND BREATHING IN CF
used during respiration to assist with breathing due to increased work of breathing and airway obstruction.
ACCESSORY MUSCLES FOR INSPIRATION AND EXPIRATION AND PURSED LIP BREATHING
BARREL CHEST
COUGH AND SPUTUM PRODUCTIO AND HEMPPYTSIS
CYANOSIS
46
CHEST ASSESMENT FOR CF
DECREASED TACTILE AND VOCAL FREMITUS
HYPER-RESONANT
DIM BS
DIM HEART SOUNDS
BRONCHIAL BREATH SOUNDS (OVER ATELECTSASIS)
CRACKLES
WHEEZE
SPONTANEOUS PNEUMOTHORAX
47
PULM FUNCTION TEST FOR SEVERE CF
FEV1/FVC RATIO - D
PEFR - D
FEF 25-75 -
VT - N OR I
IC - N OR D
IRV - N OR D
FRC - I
ERV - N OR D
TLC - N OR I
RV - I
VC -D
RV/TLC RATIO - N OR I
FVC -D
FEVt -D
FEF 50% - D
FEF200-1200 -D
48
ABG FOR NORMAL CF PT
PH - ELEVATED
PACO2 - DECREASED
HC03- - DECREASED
PAO2 - DECREASED
SAO2/SPO2 - DECREASED
49
ABG OF SEVERE STAGE CF
PH = NORMAL
PACO2 - ELEVATED
HC03- - ELEVATED
PAO2 - DECREASED
SAO2/SPO2 - DECREASED
50
HEMODYNAMICS INDICES FOR MODERATE TO SEVRE STAGES CF
CVP - I
RAP - I
PA - I
CO - N
SV - N
PCWP - N
CL - N
RVSWI - I
LVSWI N
PVR -I
SVR - N
51
ABNORmal testiung for cf- hematology
increased hct/hgb
INCREASED WBC COUNT
52
ABNORMAL TESTING FOR ELECTROLYTES FOR CF
HYPOCHLOREMIA- (CHRONIC VENT FAILURE)
INCREASED SERUM BICARBONATE
53
ABNORMAL TESTING SPUTUM FOR CF
GRAM +
STAPH AUREAUS
HAEMOPHILUS INFLUENZAE
GRAM -
PSEUDOMONAS AERUGINOSA
STENTROPHOMONAS MALTOPHILIA
BURkholderia cepacia
54
ABNORMAL CHEST RADIOGRAPH FOR CF
TRANSLUCENT (DARK) LUNG FIELDS
DEPRESSED OR FLATTENED DIAPHRAGM
RIGHT VENTRICULAR ENLARGEMENT
MAY SHOW TRAM TRACKS
PNEUMOTHORAX (SPONATEOUS)
ABCESS FORMATION
may show hyperinflation, atelectasis, and bronchiectasis.
55
COMMON NON-RESPIRATORY CLINCAL MANIFESTATIONS FOR CF
DIOS (Distal Intestinal Obstruction Syndrome)
MALNUTRITION AND POOR BODY DEVELOPMENT
DEF OF VIT A, D, E, AND K
NASAL POLYPS AND SINUSITIS
INFERTILITY (MALES)
56
GENETIC MANAGEMENT OF CF
THE PRIMARY GOALS ARE TO PREVENT PULM INFECTIOONS AND REDUCE THE AMOUNT OF THICK BRINCHIAL SECRETIONS
IMPROVE THE AIR FLOW AND PROVIDE ADEQUEATE NUTRITION
57
RESP CARE TX PROTOCOLS FOR CF
O2 THERAPY
AIRWAY CLEARANCE THERAPY
LUNG EXPANSION THERAPY
AERSOLOZISED MEDS
MECH VENT PROTOCOL
OTHER MEDICATIONS AND SPECIAL PROCESURES
CFTR modulators and supplemental therapies.
PATHOGENS AND ABX
EXERCISE AND PULM REHAB
ANTI INFLAMM THERAPY
PREVENTION
LUNG TRANSPLANT
58
THERAPY RECOMMENADATIONS FOR CF
BRONCHOPULM HYGIENE (VEST)
NIV (IF APPROPRIATE)
MECH VENT (IF APPROPRIATE)
IS 10X/HR
DB&C
SURGERY (LUNG TRANSPLANT)
59
PHARM RECOMMENDATIONS FOR CF ACUTE
ACUTE - BROAD SPECTRUM ABX
SABA PRN
60
PHARM RECOMMENDATIONS FOR CF MANAGEMENT
SABA PRN
61
PHARM RECOMMENDATIONS FOR CF ASSESS FOR
LABA
LAMA
ICS
INHALED ABX
DNA-ASE
HYPERTONIC SALINE
CFTR CORRECTOR/POTENTIATOR
CFTR POTENTIATOR
O2 THERAPY
PANCREATIC LIPASE
IBUPROFREN
62
TEST RECOMMENDATIONS FOR CF
PFT
ABG (ACUTE AND BASELINE)
CXR (ACUTE AND BASELINE)
CBC WITH DIFF
ELECTROLYET PANEL
63
WHAT ARE DIAGNOSTIC TEST RECOMMENDATIONS FOR CF
SWEAT CHLORIDE X2 (GREATER THAN 60MEQ/L
MOLECULAR GENETIC TESTING (CFTR 2 MUTATIONS)
NASAL POTENTIAL DIFFERENCE
IMMUNOREACTIVE TRYPSIN
STOOL FECAL FAT TEST
64
Pneumonia
An inflammatory process primarily affecting the gas exchange area of the lung, often resulting in alveolar consolidation and atelectasis.
65
Etiology (PNEUMONIA)
The study of the cause of a disease, in this case, pneumonia.
66
Community Acquired Pneumonia (CAP)
Pneumonia acquired from normal social contact, often caused by pathogens like Streptococcus pneumoniae.
67
Atypical Pneumonia
Pneumonia that does not present with classic symptoms and is typically caused by pathogens like Mycoplasma pneumoniae.
68
Hospital Acquired Pneumonia (HAP)
Pneumonia that occurs 48 hours or more after hospital admission and was not present at the time of admission.
69
Aspiration Pneumonia
A type of pneumonia caused by the inhalation of foreign materials, such as gastric fluids, into the lungs.
70
Mendelson's Syndrome
A condition associated with aspiration of acidic stomach contents, causing tachycardia, dyspnea, and cyanosis.
71
Fungal infections in pneumonia
Infections caused by fungi, such as Histoplasmosis and Coccidioidomycosis, that can lead to pneumonia.
72
Pneumocystis jirovecii (formerly Pneumocystis carinii)
A common opportunistic pathogen causing pneumonia in immunocompromised individuals, especially those with AIDS.
73
Nebulization Therapy
A treatment for pneumonia involving the use of nebulizers to deliver medication directly into the lungs.
74
Ventilator Associated Pneumonia (VAP)
Pneumonia that occurs more than 48 hours after endotracheal intubation.
75
Alveolar consolidation
The filling of air spaces in the lungs with fluid, pus, blood, or other material, disrupting normal gas exchange.
76
Diagnosis of pneumonia
Can include chest X-rays, sputum cultures, and blood tests to identify the causative organisms.
77
Streptococcus pneumoniae
A common bacterial pathogen that accounts for more than 80% of all bacterial pneumonias.
78
COPD
Chronic Obstructive Pulmonary Disease, a condition that can increase the risk of severe pneumonia.
79
Lobar pneumonia
A type of pneumonia that affects a large and continuous area of the lobe of a lung.
80
Pulmonary Function Tests
Tests that measure lung function and capacity, often with decreased values in pneumonia patients.
81
Chest radiograph findings
X-ray findings in pneumonia patients, which can show consolidation, atelectasis, and pleural effusion.
82
what happens in pneumonia
Structural changes in lung tissues due to pneumonia, including inflammation, consolidation, and impaired gas exchange.
the result of an inflammation process that primarily affects the gas exchange
83
ANATOMIC ALTERATIONS OF LUNGS - PNEUMONIA
INFLAMMATION OF THE ALVEOLI
ALVEOLI CONSOLIDATION
ATELECTSASIS (ASPIRATION PNEUMONIA)
84
PNEUMONIA -ETIOLOGY AND EPIDEMIOLOGY
PNEUMONIA AND INFLUENZA COMBINED ARE THE 8TH LEADING CAUSE OF DEATH AMONG AMERICANS
85
IN WHOM IS PNEUMONIA BAD
WHOSE LUNGS ARE ALREADY DAMAGED BY COPD
OR ASTHMA OR SMOKING
86
THE RISK OF DEATH FROM PNEUMONIA OR INFLUENZA IS HIGHER AMONG
PEOPLE WITH HEART DISEASE
DIABETES
OR WEAKENED IMMUNE SYSTEM
87
PNEUMONIA IS LEADING CAUSE OF MORTALITY AND MORBIDITY IN
CHILDREN
88
WHAT ARE CAUSES OF PNEUMONIA
BACTERIA
FUNGI
VIRUS
PROTOZOA
PARASITES
TB
ANAEROBIC ORGANISMS
ASPIRATION
INHALATION OF IRRITATING CHEMICALS (FOR EX. CHLORINE)
89
COMMON WAYS PNEUMONIA CAUSING AGENTS SPREAD
LAND DIRECTLY ON:
MOUTH
EYES
NOSE
LAND DIRECTLY ON NEARBY SRFACES
90
general pneumonia terminology
double pneumonia
walking pneumonia
91
pneumonia is named for location such as the
bronchopneumonia
lobarpneumonia
interstitial pneumonia
92
what is community acquired pneumonia
pneumonia acquired from normal social contact
93
common causes of community acquired pneumonia
streptococcus pneumonaiae
staphyloccocal pneumonia
haemophilus influenza
leginonella pneumophiia
mycoplasma pneumoniae
94
STREPTOCCOUS PNEUMONAIE ACCOUNTS FOR
80% OF ALL BACTERIAL PNEUMONIA
95
STAPHYLOCCOSUS PNEUMONIA IS FROM WHAT BACTERIA
STAPHYOCCOUS AUREUES
STEPHYLCOCUS ALBANS
STAPHYLOCOCCUS EPIDERMIDIS
96
COMMON CAUSES OF COMMUNITY ACQUIRED PNEUMONIA ASSOCIATED WITH LOBAR PNEUMONIA
THE COMMON CAUSE IS MOXAXELLA CATARRHALIS
97
CLINICAL PRESENTATION IS OFTEN SUB ACUTE
PT PRESENTS WITH A VARIETY OF BOTH PULM AND EXTRAPULM FINDINGS
MYCOPLASMA ORGANISMS IS THE MOST COMMON CAUSE
CAUSES SIMILAR TO BOTH BACTERIAL AND VIRAL PNEUMONIA
A COUGH THAT TENDS TO COME IN VIOLENT ATTACKS PRODUCING ONLY A SMALL AMOUNT OF WHITE MUCUS
98
ATYPICAL REFERS TO WHAT (PNEUMONIA)
THE ORGANISM ESCAPES IDENTIFICATION BY STANARD BACTERIOLOGIC TESTS
GENERALLY ONLY A MODERATE AMOUNT OF EXPECTORANT SPUTUM
THERE IS AN ABSENCE OF ALVEOLAR CONSOLIDATION
THERE IS ONLY A MODERATE ELEVATION OF WBC COUNT
THERE IS A LACK OF ALEVEOLAR EXUDATE
99
EXAMPLES OF ATYPICAL PNEUMONIA CAUSES
COXIella burnetii, Chlamydophila pneumoniae, Legionella pneumoniae
100
FACTS ABOUT COXIELLA BURNETTI
GRAM NEG BACTERIA
CAUSES Q FEVER IN HUMANS
101
VIRUS ACCOUNT FOR
50% OF ALL PNEUMONIAS
SEVERAL ARE ASSOCIATED WITH A COMMUNITY ACQUIRED ATYPICAL PNEUMONIA
102
VIRUS ASSOCIATED WITH ATYPICAL PNUEMONIA
RSV
PARAINFLUENZA (CHILDREN) - RELATED TO MUMPS, RUBELLA, AND RSV
INFLUENZA A AND B - MOST COMMON CAUSES OF VIRAL RESP TRACT INFECTIONS
ADENOVIRUS
HUMAN METAPNEUMOVIRUS - 2ND MOST COMMON CAUSE OF LOWER RESP INFECTIONS IN YOUNG CHILDREN
103
HOSPITAL ACQUIRED PNEUMONIA IS
A TYPE OF PNEUMONIA THAT OCCURS 48 HOURS OR MORE AFTER HOSPITAL ADMISSION AND THAT WAS NOT PRERSENT AT THE TIME OF ADMISSIONA TYPE OF PNEUMONIA THAT OCCURS 48 HOURS OR MORE AFTER HOSPITAL ADMISSION AND THAT WAS NOT PRESENT AT THE TIME OF ADMISSION.
104
MOST IMPORTANT PATHOGENS ASSOCIATED WITH HOSPITAL ACQUIRED PNEUMONIA
include Staphylococcus aureus,
Pseudomonas aeruginosa, and
Klebsiella pneumoniae. .
MRSA
105
HEALTHCARE ASSOCIATED PNEUMONIA REFERS TO
A PT WHO HAVE RECENTLY BEEN HOSPITALIZED IN AN ACUTE CARE HOSPITAL WITH IN 90 DAYS OF THE INFECTION
HAVE BEENRESIDING IN NURSING HOME OR LONG TERM CARE FACILITY
AND HAVE RECIEVED PARENTERAL ANTIMICROBIAL THERAPY, CHEMOTHERAPY OR WOUND CARE WITH IN 30 DAYS OF PNEUMONIA
106
vent associated pneumonia is a pneumonia that
a pneumonia of infectious diseases origin that develops more than 48-72 hours after endotracheal intubation
107
common infections associated with vent associated pneumonia
include Staphylococcus aureus
, Pseudomonas aeruginosa,
Acinetobacter species.
ENTERBACTER SPECIES
S.MALTOPHILIA
108
CAUSES OF ASPIRATION PNEUMONIA
result from the inhalation of or aspiration of foreign material, such as food, liquid, or vomit, into the lungs, leading to infection.
ASPIRATION OF GASTRIC FLUID OF 2.5 PH OR LESS can also cause significant lung injury and infection.
109
THE MAJOR CAUSE OF ASPIRATION PNEUMONIA - ASPIRATING ON GASTRIC JUICES IS THE MAJOR CAUSE OF
ANAEROBIC LUNG INFECTIONS
110
3 DISTINCTIVE FORMS OF ASPIRATION PNEUMONIA
TOXIC INJURY TO THE LUNG
OBSTRUCTION BY FORGEIN BODY OR FLUID
INFECTIONS
111
WHAT IS THE ISSUE WITH ASPIRATION PNEUMONIA
COMMONLY MISSED BECAUSE ACUTE INFLAMMATION REACTIONS MAY NOT BEGIN UNTIL SEVERAL HOURS OBSERVED ASPIRATION OF THE GASTRIC FLUID
112
THE INFLAMMATORY REACTION IN ASPIRATION PNEUMONIA GENERALLY
INCREASES IN SEVERITY 12-26 HOURS AND MAY PROGRESS TO ARDS
113
WHAT IS ARDS
Acute Respiratory Distress Syndrome, a serious condition characterized by widespread inflammation in the lungs, leading to respiratory failure.
114
MENDELSONS SYNDROME
a form of aspiration pneumonia resulting from the inhalation of gastric contents, leading to chemical pneumonitis.
115
SYMPTOMS OF MENDELSONS SYNDROME
TACHYCARDIA
DYSPNEA
CYANOSIS ASSOCIATED WITH ASPIRATION OF ACID STOMACH CONTENTS
USUALLY CONFINED TO ASPIRATIONS PNEUMONITIS IN PREG WOMEN
116
WHAT IS GERD
THE REGULATION OF STOMACH CONTENTS INTO THE ESOPHAGUS
117
GERD IS SEEN 3X MORE IN WHAT PTS
ASTHMA
118
CHRONIC PNEUMONIA IS
TYPICALLY is a localized lesion in pts with a normal immune system with or without regional node involvement
commonly seen in pt with tb and fungal diseases of the lungs
pts usually have granulomatous inflammation
119
fungal infections - anatomic alterations of the lungs
alveolar consolidation
alveolar capill;ary memebrane thickening/destruction
caseous tubercles or granulomas
cavity formation
fibrosis and secondary calcification of the lung parencychema
120
primary pathogens of fungal diseases
histoplasmosis
coccidiodmycosis
blastomycosis
paracoccidioidomycosis
121
facts about hisoplasmosis
most common fungal disease in the us - along river valleys of the midwest
found in soil enriched with bird excreta
122
screening and diagnosis for histoplasmosis
fungal culture
fungal stain - 100% accurate
serology - relatively fast and accfurate test
122
how is histoplasmosis contracted
by inhaling the spores found in contaminated soil or dust.
123
what is coccididmycosis
caused by the inhalation ofCoccidioides immitis spores, often found in dry, arid regions.
124
screning and diagnosis for coccidiodomycosis
made by visaulization of distinctive spherules in microscopy of the pt:
sputum
tissue exudate
biopsies
spinal fluid
125
screening and diagnosis for blastomycosis
direct visaulaization of yeast in sputum smears
culture of fungal infection
126
cryptococcus neoformans
caused from the high nitrogen content of pigeon droppings
127
aspergillus is found
in decaying vegetation and soil, and its spores are commonly inhaled.
128
Pneumonia in the immunocompromised host
Cytomegalovirus -members of herpes family
Pneumocystis jirovecii - seen in pt who are profoundly immunosuppressed
Mycobacterium avium complex - a series opportunistic infections that is caused by similar bacteria
129
Cytomegalovirus is common viral pulmonary complications of
aids
130
Pneumocystis jirovecii is an
Fatal form of pneumonia
Seen in pt who are profoundly immunocompromised
Major pulmonary infection seen in pts with HIV and AIDS
131
Mycobacterium avium complex is caused by what 2 bacteria
Mycobacterium avium
Mycobacterium intercellulare
Found in soil and dust particles
132
Other types of pneumonia impacting immunocompromised pt
Invasive aspergillosis
Invasive candiasis
Ricketsia
Varicella
Rubella
Severe acute respiratory syndrome
Lipoid pneumatic
Avian influenza A
133
Lipoid pneumonitis is from
Aspiration of mineral oil
134
What is the mortality rate of varicella pneumonia is
About 20%
135
Where is mycobacterium avium complex found
Found in soil and dust particles
136
What is necrotizing pneumonia
The pneumonia that causes the death of lung tissue cells within the infected pulmonary parenchyma
137
What is the result of necrotizing pneumonia
In lung abscess
138
Major pathological or structural changes in necrotizing pneumonia
Alveolar consolidation
Alveolar capillary and bronchial wall destruction
Tissue necrosis
Alveolar consolidation
Alveolar capillary and bronchial wall destruction
Tissue necrosis
Cavity formation
Fibrosis and calcification of the lung parenchychema
Bronchial pleural fistula and emphysema
Atelectasis
Excessive airway secretions
139
What is a common complication of aspiration pneumonia
Lung abscess
140
What are pre disposing factors forming abscess for necrotizing pneumonia include
Alcohol abuse
Seizure disorder
General anesthesia
Head trauma
CVA
Swallowing disorders
141
142
What are some of the reasons besides lung abscess associated with necrotizing pneumonia
Bronchial obstruction with secondary infection
Vascular obstruction with tissue infraction
Interstitial lung disorder with cavity formation
Bullae or cyst that become infected
Penetrating chest wounds lead to an infection
143
vital signs for pneumonia
chest pain
cynanosis
decreased lung expansionn
cough and sputum production
emopytsis
144
pulmonary function test for pneumonia
FVC -D
FEV1T -N OR D
FEV/FVC RATIO = N OR I
FEF25-75 - N OR D
FEF 50% N OR D
FEF 200-1200 - N OR D
FVC -D
FEV1T -N OR D
FEV/FVC RATIO = N OR I
FEF25-75 - N OR D
FEF 50% N OR D
FEF 200-1200 - N OR D
FRC - D
TLC - D
RV/TLC RATIO - N
145
WHAT TYPE OD DISEASE IS PNEUMONIA RESTRICTIVE OR OBSTRUCTIVE
RESTRICTIVE
146
ABG FOR SEVERE STAGES - PNEUMONA
PH - DECREASED
PACO2 - ELEVATED
HCO3- - ELEVATED
PAO2-DECREASED
SPO2/SAO2 -DECREASED
147
ABNORMAL TESTS FOR PNEUMONIA
ABNORMAL SPUTUM
CHEST RADIOGRAPH (INCREASED DENSITY FROM CONSOLIDATION AND ATEECSTASIS AND INFILTRATES)
ABNORMAL BRONCHOGRAM (MAY HAVE AIR OR FLUID FILLED CAVITIES)
LUNG ABSCESS
PLEURAL EFFUSIONS OR EMPHYSEMA
148
GENRAL MANAGEMENT OF PNEUMONIA
TH TX OF PNEUMONIA IS BASED ON THE SPECIFIC ETIOLOG OF THE PNEUMONIA
THE SEVERITY OF THE SYMPTOMS BY THE PT
O2 THERAPY
LUNG EXPANISION LUNG EXPANISON THERAPY PROTOCL
AIRWAY CLEARANCE THERANCE
THORACENTIS
149
DIAGNOSTIC THORACENTIS
COLOR
OROR
RBC COUNT
PROTIEN
GLUCOSE
LDH
AMYLASE
PH
WRIGHTS, GRAM OR ACID FAST BACILLUS
AFB STAIN
AEROBOC, ANAAERBOIC, TB, AND FUNGAL CULTURES
CYTOLOGY
150
RECOMMENDED THERAPY FOR PNEUMONIA
BRINCHIAL HYGIENE
DB & C
IS 10/HR
151
RECOMMENDED PHARM FOR PNEUMONIA
BROAD SPECTRUM ABX
SABA PRN IF INDICATED
ICS IF INDICATED
O2 THERAPY IF INDICATED
152
RECOMMENDED TESTS FOR PNEUMONA
ABG
CXR
CBC WITH DIF
SPUTUM WITH CULTURE AND SENSISTIBTY
153
pneumonia is said to be
PROCESS THAT PRIMARILY AFFECTS THE GAS EXCHANGE AREA OF THE LUNG
154
THE DEVELOPMENT OF PNEUMONIA OCCURS IN 4 STAGES
1. STAGE - OCCURS WITH IN 24 HOURS OF AN INFECTION. IN RESPONSE TO INFLAMM BLOOD FLOW TO ALEVOLI INCREASES
2. STAGE 2 - DAYS 2 -3 - CHARACTERIZED BY THE PRESENCE OF RBC, POLY MORPH ONUCLEAR LEUKOCYTES INCREASE TO ENGULF INDAING PATHOGENS
3. STAGE 3 - DAYS 4-6 - INCREASED NUMBER OF MACROPHAGES THAT MOVE INTO THE INFECTED AREA TO REMOVE CELLULAR DEBRIS
4. STAGE 4 - DAYS 7-100- CALLED THE RESOLIUTION STAGE. CHARACTERIZED BY THE REABSORPTION OF INFLAMM FLUIDS AND CELLULAR DEBRIS AND RE-ESTABLISHMENT OF NORMAL AIRWAYS AND ALVEOLI
155
WHEN IS ATELECTSASIS A NORMAL SIDE EFFECT
ASPIRATION PNEUMONIA
156
THE MAJOR PATHOLOGIC OR STRUCTUAL CHANGE ASSOCIATED WITH PNEUMONIA ARE AS FOLLOWS
1. INFLAMM OF THE ALVEOLI
2. ALVEOLI CONSOLIDATION
3. ATEECTASIS
157
WHAT DOES PNEUMONIA OFTEN MIMIC
A COMMON COLD
158
SOME BACTERIAL PNEUMONIAS ARE CALLED ATYPICAL BECUASE
THE PNEUMONIA CAUSED BY THESE (MYCOPLASMA PNEUMONIA, CHLAYMDIOPHILIA PNUEMONIA, AND LEGIONELLA ONEUMONIA)
HAVE SLIGHTLY DIFFERENT SYMPTOMS, APPEAR DIIFERENT ON CXR OR RESPOND TO DIFFERENT ABX THAN TYPICAL PNUEMONIA
159
RISK FACTORS FOR ONUEMONIA
OVER 65 Y/O AGE
ASPIRATION OFOROPHARYNGEAL SECRETIONS
VIRAL RESP INFECTIONS
CHRONIC ILLNESS
CHRONIC RESP DISEASE (COPD, ASTHMA, CF)
CANCER ESPECIALLY LUNG CA
PROLONGED BED REST
TRACHEOSTOMY OR ET TUBE
ABDOMINAL OR THORACIC SURGERY
RIB FRACTURE
IMMUNOSUPPRESSIVE THERAPY
AIDS
160
HOW IS PNUEMONIA TYPICALLY TRANSMITTED
PERSON TO PERSON THROUGH SMALL AEROLSIZED DROPLETS THAT ARE PRODUCED WHENAN INFECTED PERSON COUGH, SNEEZES, OR TALKS STRONGLY NEAR INFECTED PEOPLE
161
IF INFECTED DROPLETS LAND ON TEXTILES OR FABRICS HOW LONG CAN THEY LIVE
APPROX 26 DAYS ON COTTON
APPROX 28 DAYS ON SILK
APPROX 30 DAYS ON WOOL
162
HOW IS PNUEMONIA CLASSIFIED
1. THE PATHOGEN RESPONSIBLE
2. THE CLINCAL SETTING THE PNUEMONIA OCCURED
163
WHAT IS DOUBLE ONUEMONIA
BOTH LUNGS INVOLVED
164
WHAT IS WALKING PNEUMONIA
USED TO DESCRIBE A MILD CASE OF PNUEMONIA
165
BRONCHOPNEUMONIA REFERES TO
BY A PATCHY PATTERN PATTERN OF INFECTION THAT IS LIMITED TO TEH SEGEMNETAL BRONCHI AND SURROUNDING LUNG PARENCHYEMA
USUALLY INVOLVES BOTH LOBES AND OFTEN SEEN IN LOWER LOBES
166
LOBAR PNEUMONIA REFERS TO
WIDESPREAD OR DIFFUSE ALVEOLAR INFLAMM AND CONSOLIDATION CONTINUED TO ONE OR MORE LOBES OF THE LUNG
THE END RESULT OF SEVERE OR LONG TERM BRONCHOPNEUMONIA IN WHICH THE INFECTION SPREAD FROM ONE SEGEMNT TO ANOTHER UNTIL THE ENTIRE LOBE IS INVOLVED
167
INTERSTITIAL PNUEMONIA REFERS TO
USUALLY A DIFFUSE AND BILATERAL INFLAMM
THAT PRIMARILY INVOLVES THE ALVEOLAR SEPTA AND INTERSTITIAL
168
COMMUNITY ACQUIRED PNA REFERS TO
PNEUMONIA FROM NORMAL SOCIAL CONTACT
169
STREPTOCOCCUS PNEUMONIAE IS
ACCOUNTS FOR 80% OF ALL TEH BACTERIAL PNUEMONIA
IS GRAM +
IS FOUND IN PARIS (DIPLOCOCCI)
USUALLY TRANSMITTED FROM AEROSOL
MOST ARE SENISTIVE TO PENICILLIN AND ITS DERIATIVES
COMMONLY CULTURED FROM THE SPUTUM OF PATEINTS HAVING AN ACUTE EXACERBATIION OF CHRONIC BRINCHITIS
170
WHAT IS THE APPEARANCE OF STREPTOCOCCUS PNEUMONIAE
THE COCCI ARE ENCLOSED IN A SMOOTH, POLY SACCHARIDE CAPSULE THAT IS ESSENTIAL FOR VIRULENCE
171
STAPHLOCCOSUS HAS 2 MAJORS
1. STAPH AUREUS - RESPONSIBLE FOR MOST STAPH INFECTION
2. STAPH ALBUS/STAPH EPIDERMIDIS - PART OF NORMAL SKIN FLORA
172
STAPHYLOCCOCUS PNEUMONIA ARE
GRAM + BACTERIA
FOUND SINGLY, AND IN IRREGULAR CLUSTERS
OFTEN FOUND AFTER A PREDISPOSING VIRUS INFECTION AND OFTEN SEEN IN CHILDREN AND IMMUNOSUPPRESSED ADULTS
173
S. AUREUS IS OFTEN TRANSMITTED
BY CONTACT
COMMON CAUSE OF HOSIPTAL ACQUIRED PNEUMONIA AND MRSA
174
HAEMOPHILUS INFLUENZAE IS
SOMMON HUMAN PHARYNGEAL FLORA
ONE OF THE SMALLEST GRAM NEG. BACILLI
APPEARS AS COCCOBACILLI
THERE ARE 6 TYPES, LABELED A TO F
MOST COMMON TYPE IS B -PATHOGENIC
OFTEN SEEN IN CHILDREN 1 MONTH TO 6 YEARS OLD
ALMOST ALWAYS THE CAUSE OF EPIGLOTITIS
TRANSMITTED VIA AEROSOL OR CONTACT
175
WHICH PATEINTS IS H.INFLUENZAE COMMONLY CULTURED
SPUTUM OF PATIENTS HAVING ACUTE EXERABTION OF CHRONIC BRINCHITIS
176
RISK FACTORS FOR H. INFLUENZAE
COPD
DEFECTS IN B CELL FUNCTION
FUNCTIONAL AND ANATOMIC ASPLENIA
HIV
177
LEGIONELLA PNUEMONIA IS
GRAM NEG BACILLUS AND ATYPICALL CONCENTRATION OF CERTAIN BRANCHED CHAIN LIPIDS
178
WHEN WAS THE FIRST CASE OF LEGIONELLA PNEUMONIA AND WHAT IS LEGIONAIRES DISEASE
IN JULY 1976 AT AMERICAN LEGION CONF. A SEVERE PNUEMONIA OUTBREAK OCCURED
THE CAUSE EXCLUDED IDENTIFICATION FOR MANY MONTHS
LEGIONAAIRES DIS - THE PNUEMONIA ASSOC WITH LEGIONIONLA HAVE NOW BEEN TERMED LEGIONAIRES
179
LEGIONELLA PNEUMONIA IS CLASSIFIED BY BOTH
1. BACTERIAL CAUSATIVE AGENT
2. AN ATYPICAL PNEUMONIA
180
WHERE DO MOST LEGIONALA PNUEMONIA RESISE
FREE LIVING ON SOIL AND WATER TEHY ACT AS A DECOMPOSER ORGANISMS
MULTIPLES IN STANDING WATER SUCH AS CONTAMINATED MUD PUDDLES, ALRGE AIR CONDITIONING SYSTEMS AND WATER TANKS
TRANSMITTED WHENIT BECOMES AIRBORNE AND ENTERES THE PT VOA AEROSOL
181
WHO DOES LEGIONELLA PNUEMONIA MOSTLY IMPACT
MIDDLE AGE MEN WHO SMOKE
182
KLEBISELLA PNUEMONIA IS PART OF WHAT BACTERIAL FAMILY
ENTERBACTERIACAE
HE BACILUUS IS NAMED - FRIEDLANDER
183
WHAT IMPACT DOES KLEBISELLA PNEUMONIA NORMALLY HAVE
ASSOC WITH LOCAR PNUEMONIA
184
WHO IS AT RISK FOR KLEBSIELLA PNYEMONIA
MEN OLDER THAN 40
IN CHRONIC ALCOHOLICS OF BOTH GENDERS
185
WHAT KIND OF BACTERIA IS KLEBISELLA
GRAM NEG BACILLUS
FOUND SINGLY, IN PAIRS, OR CHAINS
NORMAL INHABITATES IN GI TRACT
COOMON HOSPITAL ACQUIRED DISEASE
NORMALLY TRANSMITTED VIA ROUTES SUCH AS:
CLOTHING, IV ROUTES, AND HEALTH WORKER HANDS
186
HOW IS KLEBISELLA TRANSMITTED
DIRECTLY BY AEROSL OR INDIRECTLY BY CONTACT
187
WHAT IS THE MORTALITY RATE OF KLEBISELLA
VERY HIGH AS SEPTICEMIA IS A FREQUENT COMPLICATION
188
MORAXELLA CATARRHALIS IS WHAT TYPE OF BACTERIA
GRAM NEG
DIPLOCOCCUS
COLONIZES TO THE UPPER RESP TRACT COMMONLY IN CHILDREN
IF IT OFTEN CUASED CASE OF OTOTIS MEDIA IN CHILDREN AND ASSOCIATED WITH EXACERBATIONS IN ADULTS WITH COPD
189
PSEUDOMONAS AERUGINOSA IS
HIGHLY MOBILE GRAM NEG BACILLUS
OFTEN FOUND IN GI TRACT, BURNS, AND CATHERIZED URINARY TRACT
OFTEN CULTURED FROM CHRINICALLY ILL PT AND PT WHO HAVE TRACH
LEADING CAUSE OF HOSPITAL ACQUIRED PNEUMONIA
THRIVES IN DAMPNESS
190
WHAT ARE RISK FACTORS FOR P. AERUGINOSA
NEUTROPENIA
HIV
INFECTION
PRE-EXITING LUNG DISEASE
ET TUBE
PREVIOUS ABX USE
191
HOW IS P. AERUGINOSA TRANSMITTED
AEROSOL OR BY DIRECT CONTACT WITH FRESHLY CONTAMINATED ARTICLES
192
WHAT IS THE APPEARANCE OF P. AERUGINOSA
VERY MUCOID COLONIAL FORM
193
WHAT DOES THE SPUTUM LOOK LIKE IN PT WITH P. AERUGINOSA
GREEN AND SWEET SMELLINH
194
COMMON CAUSES OF COMMUNITY ACQUIRES ATYPICAL PNEUMONIA ARE
1. MYCOPLASM BACTERIA
2.COXIELLA BURNETTI
3. CHALMYDOPHILA SPP.
4. RSV
5. PARAINFLEUENZA
6. INFLUENZA A AND B
7. ADENOVIRUS
8. HUMAN METAPNEUMOVIRUS
195
WHAT DOES THE MYCOPLASMA BACTERIA LOOK LIKE
TINY CELL WALL
CELL WALL DEFICIENT
SMALLER THAN BACTERIA BUT LARGER THAN VIRUSES
196
THE PNUEMONIA CAUSED BY MYCOPLASMA ORGANISM IS OFTEN DESCRIBED AS
PRIMARY ATYPICAL PNEUMONIA
THE AYTPICAL REFERS TO:
1. THE ORGANISM ESCAPES IDENTIFICATION
2. GENERALLY ONLY A MODERATE AMOUNT
3. THERE IS AN ABSENCE OF ALVEOLAR CONSOLIDATION
4. ONLY A MODERATE ELEVATION OF WBC COUNT
5. A LACK OF ALVEOLAR EXUDATE
197
HOW ARE THE SYMPTOMS OF MYCOPLASMA ORG
SIMILAR TO BACTERIAL AND VIRAL PNEUMONIA BUT MORE GRADUAL AND OFTEN MILDER
COUGH THAT COMES IN VIOLENT ATTACKS IS COMMON SIGN PRODUCING ONLY A SMALL AMOUNT OF WHITE MCUCUS
OFTEN SEEN IN PEOPLE WHO CONGREGATE
OFTEN SAID IN PT THAT HAVE BEEN DX - AS WALKING PNEUMONIA
198
COXIELLA BURNETTI IS WHAT TYPE OF BACTERIA
GRAM NEG THAT CAUSES Q FEVER IN HUMANS
MORE RESISTANT THAN OTHER RICKETSISAE
PASSED VIA AEROSOL TO PERSON TO PERSON
ACUTE PNUEMONIA AND CHRONIC ENDOCARDITIS ARE ALSO ASSCO WITH THIS SPECIES
199
CHLAMYDOPHILIA SPP IS FOUND WHERE NORMALLY
IN CERVIX, URETHRA
RECTUM
THROAT
AND RESP TRACT
FOUND IN THE FECES OF BIRDS
200
VIRUSES ACCOUNT FOR WHAT % OF ALL ONEUMONIAS
50% AND ARE ASSOC WITH A COMMUNITY ACQUIRED AATYPICAL PNEUMONIA
201
WHAT ARE THE SYMPTOMS OF VIRAL PNEUMONIA
FLU-LIKE SYMPTOMS
UNPRODUCTIVE COUGH
HEADACHE
FEVER
MUSCLE PAIN
FATIGUE
AS DISEASE PROGRESSES, PT MAY BECOME
SHORT OF BREATH
COUGH
AND PRODUCE A SMALL AMOUNT OF CLEAR OR WHITE SPUTUM
202
WHAT POTENTIAL RISK DOES VIRAL PNEUMONIA CARRY
FOR THE DEVELOPMENT OF A SECONDARY BACTERIAL PNEUMONIA
203
HOW DO VIRUSES EXIST
THEY ARE PARASITIC AND DEPEND ON NUTRIENTS INSIDE THE CELL FOR THEIR METABOLIC AND REPRODUCTIVE NEEDS
204
WHAT % OF ACUTE RESP TRACT INFECTIONS ARE CAUSED BY VIRUSES
90%
205
WHAT OTHER DISEASE BELONG TO THE RSV GROUP
PARAINFLUENZA
MUMPS
RUBELLA
206
WHO DOES RSV MOSTLY IMPACT
CHILDREN YOUNGER THAN 12 MONTHS
AND OLDER ADULTS WITH UNDERLYING HEART OR PULM DISEASE
207
HOW IS RSV TRANSMITTED
AEROSOL ROUTE AND BY DIRECT CONTACT
208
THERE ARE 5 TYPES OF PARAMYXOINFLUENZA GROUP (AND RELATED TO MUMPS, RUBELLA AND RSV)
TYPES 1, 2, 3, 4a and 4b
TYPES 1,2, AND 3 - ARE MAJOR CAUSES OF INFECTION IN HUMANS
TYPE 1 IS CROUP
TYPE 2-3 ARE ASSOCIATED WITH SEV INFECTION
TYPES 1 -2 SEEN IN FALL AND LATE SPRING
TRANSMITTED BY AEROSOL DROPLET AND DIRECT CONTACT
209
PARAINFLUENZA VIRUSES ARE KNOWN FOR THEIR ABILITY TO
SPREAD RAPIDLY
210
INFLUENZA A AND B
MOST COMMON CAUSES OF RESP TRACT INFECTIONS
AND OCCUR IN EPIDEMIC IN WINTER
MOST AT RISK CHILDREN AND OLDER ADULTS
HABVE INCUBATION PERIOD OF 1-3 DAYS
211
HOW DO INFLUENZA A AND B SUSVIVE
IN CONDITIONS OF LOW TEMP AND LOW HUMIDITY
212
ADENOVIRUS SEROTYPE 7
HAS BEEN RELATED TO FATAL CASES OF PNEUMONIA IN CHILDREN
213
HOW IS ADENOVIRUS TRANSMITTED
AEROSOL
214
WHEN IS THE ADENOVIRUS MOST PREVALENT
FALL
WINTER
SPRING
215
HUMAN METPNEUMOVIRUS
NEG SINGLE STRAND RNA VRIUS ASSOC WITH A FAMILY OF VIRUSES THAT ASLO CAUS RSV AND PARAINFLEUNZA VIRUS
TYPICALLY OCCURS IN YOUNG CHILDREN
IS THE SECOND COMMON CAUSE OF LOWER RESP TRACT INFECTIONS IN YOUNG CHILDREM
216
HOSPITAL ACQUIRED PNUEMONIA IS DEFINED AS
PNEUMONIA THAT OCCURS 48 HOURS OR MORE AFTER HOSPITAK ADMISSION AND THAT WAS NOT PRESENT AT TIME OF ADMISSION
217
WHAT ARE THE MOST IMPORTANT PATHOGENTS ASSOC WITH HOSPITAL ASSOC PNEUMONIA
P.AERGUNIOSA
MRSA
METHICILLIN SENSISTIVE S.AUREUS
ENTERBACTER SPP.
KLEBESILLA PNEUMONIA
ESCHERIA COLI
SERRATIA MARCESCENS
PROTEUS SPP.
ACINBACTER SPP
218
THE PATIENT THAT DEVELOPS PNEUMONIA BETWEEN 4-7 DAYS AFTER OF HOSPITALIZATION, THE MOST COMMON PATHOGENS ARE
MRSA
S. PNEUMONIOIAE
H. INFLEUNZAE
219
IN PT HOSPITALIZED LONGER THAN 7 DAYS, WHICH PATHOGENS ARE RESPONSIBLE FOR PNEUMONIA
P. AERUGINOSA
MRSA
ENTERIC GRAM NEG ORGANISMS
220
WHAT IS HOSPITAP CARE ASSOCIATED PNUEMONIA
REFERES TO PT WHO HAVE BEEN HOSPITALIZED IN AN ACUTE CARE HOSPITAL WITHIN 90 DAYS OF AN INFECTION
WHO RESIDE IN A NUSRING HOME OR LTCF
WHO HAVE RECIEVED PARENTERAL ANTIMICROBIAL THERAPY
CHEMO THERPY OR WOUND CARE WITHIN 30 DAYS OF PNEUMONIA
221
WHAT ARE COMMON PATHGOGENS OF HEALTH CARE ASSOC PNEUMONIA
COMMON PATHOEGNS INCLUDE MIXED AEROBIC AND ANAEROBIC MOUTH FLORA
S.AUREUS
ENTERIC GRAM NEG BACILLUS
INFLUENZA M. TUBERCULOSIS
222
WHAT IS VENTILATO ASSOC PENUMONIA
CAN BE CATERGORIZE DAS A NOSCOSMIAL INFECTION
DEFINED AS A PNEUMONIA THAT DEVELOPS MORE THAN 48 TO 72 HOURS AFTER ENDOTRACHEAL INTUBATION
223
WHAT PATHOGENS ARE ASSOC WITH VAP
P.AERUGINOSA
ENTERBACTER
KLEBISELLA
ACINTEROBACTER SPP.
STENOTROPHOMONAS MALTOPHILIA
S. AUREUS
224
COMMON PATHOGENS ASSOC WITH ASPIRATION PENUMONIA ARE
INCLUDE ANAAEROBIC ORAL FLORA
PEPTOSTREPTOCOCUS
PEPTOCOCCI
BACTERIODES FRAGILIS
PREVOTELLA MELANINGENICA
FUSOBACTERIUM SPP
AEROIB BACTERIA
KLEBISELLA
STAPHYLOCOCCUS
MYCOBACTERIUM TUBERCULOSIS
225
ASPIRATION PNUEMONI OCCURS BECUASE
ASPIRATION OF GASTRIC FLUID, IT HAS A PH OF 2.5 OR LESS
CNA CAUSE A SERIOUS AND FATAL FORM OF PNUEMONIA
226
ASPIRATING GASTRIC FLUIDS IS MAJOR CAUSE OF
ANAEROBIC LUNG INFECTIONS
227
WHY IS ASPIRATION PNEUMONIA COMMONLY MISSED
BECAUSE ACUTE INFLAMM REACTION MAY NOT BEGIN UNTIL SEVERAL HOURS AFTER OBSERVED ASPIRATION OF THE GASTRIC FLUID
228
WHAT IS THE COMPLICATION WHICH CAN ARISE FROM ASPIRATION PNEUMONIA
ARDS
THE INFLAMMATORY REACTION GENERALLY INCREASES SEVERITY FOR 12-26 HOURS AND MAY PROGRESS TO ARDS
WHICH MAY INCLUDE INTRAALVEOLAR EDEMA
INTRALVEOLAR HYALINE MEMBRANE FORMATION
ATELECTATSIS
229
WHAT IS MENDELSON SYNDORME
DESCRIBED AS THE TACHYCARDIA, DYSPNEA, AND CYANOSIS ASSOCI WITH ASPIRATION
USUALLY CONFINED TO ASPIRATION PNEUMONIA IN PREG WOMEN
230
HOW IS APRIRATION PNEUMONIA DEFINED
PULMONARY RESULT OF THE ENTRY OF MATERIAL FROM THE STOMACH OR UPPER RESP TRACT INTO THE LOWER AIRWAYS
231
3 DIDTSINCTIVE FORMS
1. TOXIC INJURY TO THE LUNG (CUASED BY GASTRIC JUICES)
2. OBSTRUCTION (FORGEIN BODY OR FLUID)
3. INFECTION
232
THERE IS A DIFFERENCE BETWEEN ASPIRATION OF GASTRIC CONTENTS AND THE ASPIRATION OF FOOD
ASPIRIARTION OF GASTRIC CONTENTS CAUSES INTIAL HYPOXEMIA REGARDLESS OF THE PH LEVEL OF THE ASPIRATE
IF THE PH OF APSIRATE IS HIGH THE INTIAL INJURY IS REVERSIBLE
OF THE PH OF THE ASPIRATE IS LOW THEN PARENCHYEMA DAMAGE MAY OCCUR WITH INFLAMM, EDMEA AND HEMORRHAGE
233
SIX CRANIAL NERVES WHICH CARRY MOTOR SIGNALS GENERATED BY CERBERAL AND BRAIN STEM ARE
V -TRIGEMINAL
VII - FACIAL
IX - GLOSSOPHARYNGEAL
X -VAGUS
XI - SPINAL ACCESORY
XII HYPOGLOSSAL
234
DYSPHAGIA
THE RESULT OF AN ABNORMAL SWALLOW THAT CAN INVOLVE THE ORAL, PHARYNHEAL AND ESOPHAGEAL PHASES
235
WHAT TEST IS DONE TO TEST FOR DYSPHAGIA
EVANS BLUE DYE TEST
236
WHAT ARE THE NIRMAL SWALLOWING MECHANICS
1. ORAL PREP
2. ORAL
3. PHARYNGEAL
4. ESOPHEGEAL
237
TX OF DYSPHAGIA
IS SPECIFIC TO THE NATURE OF THE DISORDER
VARIED METHODS OF PRESENTATION OF FOODS AND LIQUIDS, BLOUS VOLUMES AND CONSISTENCY, PSOTURAL MOVEMENTS AND FOOD TEMP CAN AFFECT THE DYNAMICS OF THE RELATION BETWEEN RESP AND SWALLOING
238
WHAT IS SILENT ASPIRATION
DEFINED AS THE ASPIRATION THAT DOES NOT EVOKE CLINICALLY OBSERVABLE ADVERSE SYMPTOMS SUCH AS:
COUGHING ABD IMMEDIATE RESP DISTRESS
239
PT WITH TRACH ARE AT HIGH RISK FOR
SILENT ASPIRATION
55% TO 70% OF INTUBATED OF TRACH PT ASPIRATE
240
GRANULOMONAS ARE ASSOC
CHRONIC PENUMONIA AND FUNGAL DISEASE OF THE LUNG
241
BECAUSE FUNGI ARE _________ THE LUNGS ARE A PRIME LOCATION FOR FUNGAL INFECTIONS
AEROBES
242
HOW DOES FUNGI MAKE US SICK
WHEN SPORES INHALED THEY REACH THE LUNGS AND GERMINATE
THEN THIS HAPPENS THE SPORES PROCUDE A FROTHY YEASTLIKE SUBSTANCE THAT LEADS TO AN INFLAMM RESPONSE
243
FUNGAL DISEASES OF THE LUNG CAUSE A CHRONIC __________ PULM DISORER
restrictive
244
when h.capsilulatum reaches the alveoli what happens
AT BODY TEMP, IT CONVERTS FROM ITS MYCELIAL FORM (MOLD) TO A PARASITIC YEAST FORM
245
WHAT ARE THE CLINICAL MANIFESTATIONS OF HISTOPLASMOSIS
ARE SIMILAR TO TB
THE INCUBATION PERIOD IS ONLY 17 DAYS
246
WHAT ARE THE FORMS OF HSITOPLASMOSIS
1. ASYMPOTMATIC
2. ACUTE SYMPOTOMATIC PULM HISTOPLASMOSIS
3. CHRONIC SYMPTOMPMATIC PULM HISTOPLASMOSIS
4. DISSEMINATED HISTOPLASMOSIS
247
WHAT IS COCCIDIOMYCOSIS CAUSED FROM
INHALATION OF SPORES OF COCCIDIES INMITITIS
WHICH IS SPHERICAL FUNGI CARRIED BY WINDBLOWN DUST PARTICLES
ENDEMIC IN HOT REGIONS
248
BLASTOMYCOSIS
OCCURS IN 1 (OR 2) OUT OF EVERY 100,000 PEOPLE
CAUSED BY B. DERMATIDIIS
MOST COMMON IN PREG WOMEN AND MIDDLE AGED AFRICAN MEN
PRIMARY PORTAL OF ENTRY OS THE LUNGS
249
OPPORTUNISTIC PATHOGENS
CANDIDIS ALBICANS
CRYPTOCOCCUS NEOFORMATUS
ASPERGILLUS
250
ALLERGIC BRONCHOPULMONARY ASPERGILLUS IS A FORM OF
ASTHMA
251
WHO IS CRYPTOCOCCUS NEOFORMANOUS USSUALLY SEEN
PTS WITH HIV
252
ONEUMOCYITIS ORGANISM IS WHAT TYPE OF ORGANISM
PROTOZOAN AND MORE RELATED TO FUNGI
253
LIPOID PNEUMOCYITIS
CAN DEVELOP IN THE LUNGS WHEN LIPIDS ENTER THE TRACHEAL BRONCHIAL TREE
COMMON CAUSES INCLUDE
EXOGENOUS SOURCES SUCH AS:
INHLAED NOSE DROPS WITH AN OIL BASE
OR THE ACCIDENTAL INHALATION OF COSMETIC OIL
THE SEVERITY OF THE ONEUMONIA DEPENDS ON THE TYPE OF OIL ASPIRATED
254
WHEN MINERAL OIL IS ASPIRATED IN AEROSOL FORM
AN INTENSE PULM TISSUE REACTION OCCURS
255
WHAT IS THE RESOSONANCE
DULL OR LOUD (HYPER)
DULL
256
