Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HHD 2 > Pneumonia, Tuberculosis and Lung cancer > Flashcards

Pneumonia, Tuberculosis and Lung cancer Flashcards

1
Q

What is pneumonia ?

A

the inflammation of the lungs with consolidation or interstitial lung infiltrates most often categorises according to the causative organism

consolidation- refers to air sacs that should be filled with air now being filled with fluid

fluid fills the lungs in pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List some causes of pneumonia

A

atypical bacteria
legionella
severe acute respiratory syndrome
acute aspiration (dental elements)- aspiration pneumonia
aspergillosis
community acquired
hospital acquired
pneumocystis jirovecii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is community acquired pneumonia?

A

this is pneumonia that is acquired outside of healthcare facilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who is most at risk of community acquired pneumonia?

A

those that are >65 years
more men at risk than women
residential home
COPD
cigarette smoke- smoking damages cilia; mucous left stagnant on respiratory membrane; increased risk of infection
alcohol abuse
poor oral hygiene
contact with children
diabetes
chronic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does fluid appear on a chest x-ray ?

A

radiopaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does air appear on a chest x-ray?

A

radiolucent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the most common causative pathogen of community acquired pneumonia?

A

streptococcus pneumoniae (30-35%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name some atypical bacteria that can cause community acquired pneumonia (CAP)

A

mycoplasma pneumoniae (37%)
chlamydophila pneumoniae (5-15%)
legionella pneumophila (2-6% immunocompromised pts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Viruses are responsible for around 10-30% of community acquired pneumonia. List some viral pathogens that can cause pneumonia

A

influenza virus A/B
respiratory syncytial virus
adenovirus
rhinobvirus
parainfluenza virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

5-13% of community are acquired pneumonia are polymicrobial. True or false

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the mechanisms by which pathogens can reach the lower respiratory tract in CAP ?

A

inhalation
aspiration (foreign object enters via aspiration)
haematogenous (less common)
direct (penetrating wound from outside)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Outline the pathophysiology of pneumonia

A

invasion and overgrowth of lung parenchyma
overwhelms host defences
intraalveolar exudates
reduces ventilatory capacity (V/Q) mismatch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the components of the fluid that fill the alveoli in pneumonia?

A

pus (dead cells)
mucous
blood
-contains everything that is trying to kill off the infective agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Briefly compare and contrast lobar vs bronchial pneumonia

A

lobar pneumonia tends to affect one or more lobes of the lungs

whilst

bronchial pneumonia affects patches throughout the lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What measures can we take to prevent CAP?

A

smoking cessation
hygiene
vaccination
- pneumococcal polysaccharide vaccine for >65 years
- pneumococcal conjugate vaccine for infants
- annual flu vaccine for at risk groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is V/Q (ventilation/perfusion) mismatch? Describe the V/Q observed in pneumonia

A

this is when part of the lung receives oxygen without blood flow or receives blood flow but no oxygen

in pneumonia, ventilation is affected as the alveoli is filled with fluid and thus not being aerated whilst perfusion remains okay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the presentation of CAP?

A

productive cough- can be different colours
pyrexia (fever)
dyspnoea
pleuritic pain (lung presses against the visceral pleura)
abnormal auscultation (abnormal breath sounds, presence of cackling sounds)
confusion- based on lack of oxygen
dull percussion- this is due to consolidation (fluid)
arthralgia (joint pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can exercise help relieve symptoms of COPD/pneumonia ?

A

exercise can get the mucous in the bronchi moving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the clinical investigations for diagnosing CAP?

A

history and examination
bloods (urea&electrolytes, c-reactive protein, FBC)
arterial blood gas
chest Xray
blood cultures
sputum cultures- can take a long while to grow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

CRP is a marker of ____________.

A

inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the CURB-65 score ?

A

it is a severity score for CAP

Confusion (new onset) - oxygen lack
Urea- >7mmol/l
Respiratory rate >30
Blood pressures <90mmHg (s), <60mmHg (d)
age> 65 years

1 point is assigned to each of the components of the CRUB-65 scores (5 possible points)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A higher CURB-65 score increases the ______________.

A

mortality

23
Q

How would you manage a patient with a CURB-65 score of 0-1?

A

treat as an outpatient

24
Q

How would you manage a patient with a CURB-65 score of 2?

A

either admit or monitor closely as an outpatient

25
Q

How would you manage a patient with a CURB-65 score of 3-5?

A

requires hospitalisation with consideration of ITU

26
Q

What is the management of CAP?

A

ABCD resuscitation

antibiotics (IV/ oral) according to local guidelines
outpatient vs inpatient treatment
+/- oxygen
+/- fluids

27
Q

What is tuberculosis?

A

This is an infectious disease that is caused by mycobacterium tuberculosis

28
Q

In many cases of tuberculosis, it remains ___________ before it progresses to ___________.

A

dormant
active tuberculosis

29
Q

Many cases of tuberculosis involves the lungs (communicable), list some other organs that can be affected by the tuberculosis causing bacteria

A

lymph nodes
cns
Liver
bone
genitourinary tract
gastrointestinal tract- TB affects the terminal ileum (crohns disease which can occur anywhere in the GI tract, particularly affects the terminal ileum)

30
Q

What situations can aid the progression of dormant to active TB?

A

immunocompromised
steroids

31
Q

Briefly describe the pathogenesis for tuberculosis

A

inhalation of infected droplets- deposition in the alveoli
M tuberculosis is engulfed by macrophages
They then multiply within macrophages
Proliferating pathogen kills the macrophages then triggering the immune response
(Type IV hypersensitivity reaction- cell mediated reaction)

granuloma formation
there are no effective attempts to get rid of the bug hence it ends up consuming the lung

32
Q

What are the potential outcomes of tuberculosis infection?

A

clearance

persistent latent infection (granuloma) - an incomplete attempt to clear the infection

progression to primary disease

33
Q

What is the most common type of granuloma present in tuberculosis?

A

caseous granuloma
caseous granuloma is a collection of macrophages due to inflammation

34
Q

What is the presentation of tuberculosis?

A

cough
haemoptysis - coughing up blood
night sweats
risk factors
pyrexia
anorexia
weight loss
malaise
chest pain

35
Q

Night sweats are most common in the following conditions…

A

malaria
tuberculosis
lymphoma

36
Q

What are the risk factors of tuberculosis?

A

exposure to infection
birth in endemic country
HIV
Immunosuppressive meds (trigger active TB)
malignancy (which may cause immunosuppression?)
IV drug use
malnutrition
alcoholism
diabetes
age
smoking
low socio economic status

37
Q

Extrapulmonary presentations of tuberculosis are most common in what type of patients ?

A

immunocompromised patients (e.g. >50% HIV cases)
children

38
Q

What organs are affected by extrapulmonary tuberculosis?

A

pleura
CNS
lymphatics
Scrofula (cervical tuberculous lymphadenitis)- in the neck
genitourinary system- lymph nodes are affected in this area
bones/joints- joints of the spine collapse
Potts disease

39
Q

Why does tuberculosis usually affect the upper apices (lobes) of the lungs?

A

Mycobacterium tuberculosis is a strict aerobe!
air tends to rise- relatively higher oxygen tension in upper lobes

There is also delayed lymphatic drainage in upper lobes of the lungs

40
Q

What clinical investigations can be carried out to aid diagnosis of tuberculosis?

A

chest Xray
sputum culture (acid fast bacilli)
tuberculin skin test (mantoux test)- to see if latent TB is present
FBC
lymph node biopsy
pleural fluid ta
long bone xray
CSF
urinalysis

41
Q

What is the management for latent TB?

A

evaluate close relatives
isoniazid for 6-9 months, rifampicin for 4 months
pyroxidine for immunocompromised patients

RIP- rimfampicin, isoniazid, pyroxidine

42
Q

What is an important drug interaction of rimfapicin?

A

increases clearance of warfarin and thus reduces the anti-coagulant effect

43
Q

What is the management of active TB?

A

initial phase therapy
continuation therapy
many treatment regimens
HIV treatments
+/- Surgery

44
Q

What are the dental considerations for latent TB?

A

normal infection control precautions

45
Q

What are the dental considerations for active TB?

A

defer non-urgent treatment until non-infectious
if not already refer for medical care
urgent dental care should be provided in a facility that has the capacity for airborne infection isolation

46
Q

What are the two main types of lung cancer?

A

Metastatic lung cancer- lots of cancers metastasise to the lungs

Primary lung cancer

47
Q

What are the types of primary lung cancer?

A

small cell (12%)
non small cell (87%)- adenocarcinoma, squamous cell carcinoma, large cell carcinoma

48
Q

What is the presentation of lung cancer?

A

cough
dyspnoea
haemoptysis (shared presentation with tuberculosis)
chest/shoulder pain
weight loss
hoarseness of voice
confusion
dysphagia
bone pain/fractures

Haemoptysis
weight loss
hoarseness of voice

clubbing is a sign of lung cancer in the absence of thyroid disease or other conditions

49
Q

What are the risk factors for lung cancer?

A

smoking
environmental exposure
COPD
family history
age
asbestos exposure

50
Q

What are the investigations for lung cancer diagnosis?

A

chest XR
CT of neck, thorax, abdominal, pelvis (to look for other primary sites)
endoscopy and biopsy
FBC, urea and electrolytes

51
Q

Outline the management for lung cancer

A

Discussion in multi-disciplinary team

Management is dependent on type, TNM staging and fitness for surgery
-operable Vs non operable
-resection
-chemotherapy
-radiotherapy
-palliative care

52
Q

Give possible options for an operable type of lung cancer

A

Wedge resection (small section of a lobe)
Segmentectomy- segment of one lobe removed
Lobectomy- an entire lobe removed
Pneumonectomy (removal of an entire lung or a large portion of a lung)

53
Q

What are some dental considerations for lung cancer patients

A

chemotherapy- affects bone marrow (fast replicating) cells- bleeding risk

avoid non essential dental work

non invasive dental treatment can be provided in primary care

immunocompromised (white cells in bone marrow due to chemotherapy)- risk of infection

blood test in the last 48 hours if urgent treatment is required; RBC (white cells, platelets etc can be monitored)

HHD 2 (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions