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CASE STUDY FINAL > Pneumonia and COPD > Flashcards

Pneumonia and COPD Flashcards

1
Q

Which portion of the lungs can pneumonia infect?

A

One lung or both

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2
Q

A prevalent cause of pneumonia during a certain season is?

A

During flu season, many individuals suffer pneumonia since influenza is a prevalent cause.

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3
Q

What are the 5 mentioned symptoms of pneumonia?

A

1.Fever
2.Coughing
3.Tiredness
4.Tachypnea
5.SOB

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4
Q

What are the causes of pneumonia?

A

1.Aspiration of “usual respiratory flora” oral bacteria into the lungs
2.Flu
3.Non-sterile instruments
4.Sepsis
5.Foreign objects
6.Staphylococcus pneumoniae

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5
Q

What is an additional issue patient with pneumonia might have had based on the symptoms?

A

Diabetic neuropathy which is typical for diabetics to develop this.

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6
Q

What are results manifested due to diabetic nephropathy?

A

High blood pressure
Renal damage

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7
Q

Why did this patient have numerous pneumonia aspirations and comorbidities?

A

DM II caused swallowing degeneration which sparked numerous aspiration induced pneumonia.

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8
Q

What are major treatments and permentant fixes for recurrent aspiration pneumonia?

A

Tracheostomy and PEG

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9
Q

What is toxic metabolic encephalopathy?

A

A kind of encephalopathy not caused by a stroke or intracranial pressure.

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10
Q

What does ABG measure vs. VBG?

A

ABG measures PaO2 and PaCO2, whereas VBG measures pH and CO2.

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11
Q

What is the CO2 difference between ABG & VBG? And which one has more? Is there any difference in sodium bicarbonate? What about O2?

A

2-3, VBG has more than ABG
There is no difference or change in sodium bicarbonate.
The O2 is greater in VBG then ABG (therefore we must be cautious)

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12
Q

What does CXR indicate for pneumonia when advanced?

A

If it’s advanced it usually is manifested as an infection-induced fluid buildup that creates a white hazy spot in normally black regions.

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13
Q

Which kind of debris is found from pneumonia and what is it achieving and causing?

A

Phagocytic debris from pneumonia combating produces this fluid.

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14
Q

What are cytokines causing during the presence of pneumonia?

A

Lung fluid build-up due to cytokines which also combat the infection and promote inflammation.

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15
Q

What does fluid build due to pneumonia cause?

A

Due to fluid buildup producing a VQ mismatch, gases cannot diffuse over the AC membrane into the alveoli as quickly, causing oxygen difficulties.

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16
Q

What can happen to a patient who is unable to swallow their own saliva? What is a better solution for these kinds of patients?

A

It could enter the airway and drown them. Best protected by intubation or tracheostomy.

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17
Q

What is Staphylococcus epidermidis presence in the blood usually caused by?

A

Improper blood draw hygiene. (Contamination)

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18
Q

What is the likelihood fo identifying bacterium causing pneumonia even with an open lung biopsy?

A

50% chance

19
Q

How much saliva do we produce a day?

A

1L of saliva

20
Q

What happens once we determine whether the infection is bacterial or viral?

A

we may treat it with specifically targeted medications instead of broad-based ones that might develop to resistance.

21
Q

What are COPD-like symptoms caused from?

A

Weight and lifestyle

22
Q

What can potentially cause inflammation? And what happens if they circulate for a long period of time?

A

Fat-derived cytokines; if these cytokines circulate for a lengthy period of time in the body, they could stimulate COPD-related processes in the lungs.

23
Q

Can doctors misdiagnose COPD?

A

Yes, easily.

24
Q

What can develop as a result of difficult exhalation and easy air intake?

A

Hyperventilation
exhalation is harder

25
Q

Although COPD was suspected what other syndrome could’ve been possible?

A

Pickwickian syndrome

26
Q

What is the cause of free-floating CO2? And what will cause it to disappear?

A

These patients’ co2 is free-floating where it doesn’t bother them. COPD and obesity will keep it around. It will disappear if caused by an opiate overdose.

27
Q

What does COPD typically breathe like and what do we need to be careful of doing?

A

Breathe hypoxically whereas healthy persons breathe hypercapnically. Therefore, we must not over oxygenate these individuals since we may kill their breathing drive.

28
Q

Which ABG values would be increased in COPD and why? What does the clinician use to diagnose COPD?

A

pH and PaCO2, due to retaining CO2.
The clinician utilizes the persistent hypercapnia as a means to diagnose COPD.

29
Q

What is the typical CXR presentation for COPD? and What was it like on the patient’s CXR?

A

Hyperinflation-induced big lungs.
although this case study patient had a very flat diaphragm on cxr.

30
Q

What do CPAP and BiPAP require in order to function?

A

They demand respiratory drive-dependent patient effort.

31
Q

What are typical PaCO2 and PaO2 findings for COPD?

A

High PaCO2 and low PaO2 since their bodies are acclimated to amounts of CO2 and the usual PaO2 range is 60–80.

32
Q

Which portions of the brain manage minute-by-minute breathing? And what is the issue for COPD?

A

Medulla oblongata and pons
but chronic COPD patients have problems getting airflow out of their lungs, which produces hyperinflation.

33
Q

Which kills patients is it hypercapnia or hypoxemia? and which does the other affect?

A

Hypoxemia kills patients while hypercapnia does not kill patients owing to the impact of right heart failure

34
Q

Where does the loss of respiratory drive occur for COPD?

A

They have a loss of respiratory drive while reaching below <30 and above >150.

35
Q

Where does the term “Pickwickian Syndrome” stem from and what does it portray?

A

Stems from Charles Dickens’ first book “The Pickwick Papers,” in which he portrays a character named Joe “Fat kid” who eats incessantly (fat) and falls asleep at any moment (daytime sluggishness, Narcolepsy). In 1886, Charles described obesity-hypoventilation syndrome (OHS).

36
Q

What is the Obesity hypoventilation syndrome(OHS) criteria?

A

BMI > 30 kg/m2, chronic arterial PCO2 > 45 mmHg, and no other cause for hypoventilation.
(i.e. no kyphoscoliosis no hypothyroidism, no neuromuscular impairment, no narcotic use, no interstitial lung disease)

37
Q

*What is the simple one sentence for diabetes explanation?

A

A simple disease with far-reaching complications.

38
Q

*What is type I diabetes “juvenile onset diabetes”?
Which is also a cause of what?

A

-In this type of diabetes, the body produces very little or no insulin, this means that you need daily insulin injections to maintain blood glucose levels in your blood
-Viral in nature
It is a cause of diabetic neuropathy.

39
Q

*What is type II diabetes “adult-onset” diabetes?
Which is also a cause of what? What is the cornerstone treatment? And what is the percentage of diabetic cases?

A
  • In this type of diabetes body doesn’t make good use of the insulin it produces and is associated with family hx & obesity. Also a cause of diabetic neuropathy.
  • Cornerstone treatment is a healthy lifestyle including increased physical activity & a healthy diet.
    -More common in adults and accounts for about 90% of all diabetes cases.
40
Q

*Where does diabetes affect? And what can it lead to?

A

It affects eyes, heart, nerves, feet, & kidneys.
Which can lead to: heart disease, chronic kidney disease, nerve damage, and other problems with your feet, oral health, vision, hearing, and mental health.

41
Q

*What is the respiratory failure type 1?

A

1) “I can no longer breath no matter how hard I try.”
This is exhibited in patients with increased WOB as seen:
in severe asthmatic attacks,
in patients with exacerbation of COPD or
in patients with respiratory failure secondary to cardiac failure or other disease processes

42
Q

*What is the respiratory failure type 2?

A

2) “I do not care whether I breathe or not.”
This is exhibited in patients w/ no respiratory drive as seen:
in patients with opioid overdose.

43
Q

*What is the respiratory center and what is it responsible for? What is particular about but doesn’t care too much about?

A

It is responsible for generating and maintaining the rhythm of respiration and adjusting homeostatic responses to physiological changes.
does not care too much about PO2 if there is enough of it in the blood but is very particular about PCO2 and wants it at about 40 mmHg.

44
Q

What drives the respiratory center PCO2 or PO2?

A

CASE STUDY FINAL (6 decks)

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