Respi (NP + Patho) Flashcards
list 2 investigation for COPD
- pulmonary function test
- AAT deficiency screening
what is the 2 characteristic of COPD
- chronic bronchitis (inflammation of the bronchial tube, resulting in hypersecretion of mucus in the airway)
- emphysema (alveoli destruction)
which bacteria cause lobar pneumonia + what is the 4 stages
streptococcus pneumonia
day 1-2 (congestion): blood vessels & alveoli start filling w excess fluid
day 3-4 (red hepatization): exudates (containing RBC, neutrophils & fibrins) start filling up the airspace & making them more solid
day 5-6 (grey hepatization): lobe is still solid, but RBC in exudates are broken down (hence grey)
day 8, last for 3 weeks (resolution): exudates are digested by enzymes, ingested by macrophages or cough out
explain how does ventilator pneumonia occur
occur when biofilm (containing protein, sugar & bacteria) form on the surface of endotracheal tube
as patient is already weak and unable to cough, biofilm will move into the lung & cause pneumonia
give 1 example of a virulent and resistant microbes in HAP
methicillin resistant staphylococcus aureus (MRSA)
list 6 risk factor of COPD
- asthma
- alpha1 antitrypsin deficiency
- chemical agents
- > 40 y/o
- smoking
- pollution eg. dust, silica
what is bronchopneumonia
infection of the bronchioles and alveoli
why does pt sit in tripod position + 1 consequence
to promote positive end expiratory pressure (PEEP), however this cause the use of accessory muscle, therefore making the patient more tired
how does chronic hypoxemia leads to cor pulmonale + what is 1 sign of corp pulmonale
it constrict the pulmonary blood vessel resulting in pulmonary HTN
this cause right side of heart to overwork, resulting in right sided HF (cor pulmonale)
1 symptoms: JVD
explain why nosocomial pneumonia are more serious
patient in hospital already have a weakened immune system, furthermore the microbes in hospital are virulent (great offense) and more resistant (great defence) to common atbx, where some of the bacteria are able to swap some of it atbx resistance gene w one another
what is the difference between hypoxemia & hypoxia
hypoxemia - low o2 in blood
hypoxia - low o2 in tissue
what is lobar pneumonia
infection of one/both lobar that results in complete consolidation
what is the most common bacterial cause of community acquired pneumonia
streptococcus pneumoniae
list 3 causes of aspiration pneumonia
- food
- drink
- gastric content (can cause chemical irritation on top of infection)
what is the range of PEFR
what is the quickest way to measure airway obstruction during emergency situation
peak expiratory flow rate (PEFR)
fastest & hardest the patient exhale after a full inhalation
what is an ideal urine output rate
0.5-1.0mls/kg/hr
eg. 60kg = 30-60mls/hr
how to perform PFT
- give pt bronchodilator
- FEV1/vital capacity (FVC) = <70% indicate airway limitation
list 5 mechanical technique that expel microbes
- cough/sneezing
- mucociliary escalator
- mucociliary blanket (trap dirt/micro organism, sweeping mechanism)
- alveolar macrophages
- alveolar fluids
list 4 long term management for COPD patient
- bronchodilator
- ICS
- supplemental o2
- diet adjustment (as pt use a lot of energy in breathing)
list 3 bacteria that cause atypical or walking pnuemonia
- mycoplasma pneumoniae
- chlamydophila pneumoniae
- legionella pneumophila
what is the pedal pulse range
what is 3 way to detect lobar pneumonia
- dullness on percussion (due to consolidation)
- tactile vocal fremitus (feel more vibration from pt chest/back when they repeat certain phrase, as sound travel better in fluid filled space > air filled space)
- crackles
what is the 2 catogeries of pneumonia
- hospital acquired pneumonia
- community acquired pneumonia
which fungal increase the risk of pneumonia in immunocompromised individuals (opportunistic infection)
pneumocystis jirovechi
what is 1 test to determine the criteria for admission in pneumonia
CURB-65
list 2 pneumococcal vaccine
- 23-valent pneumococcal polysacharride vaccine (PPSV23)
- 13-valent pneumococcal conjugated vaccine (PCV13)
what is the most common viral cause of pneumonia
influenza
list 3 bacteria causing pneumonia
- streptococcus pneumoniae
- haemophilus influenzae
- staphylococcus aureus
how is gas exchange in alveoli
- o2 leave the air in alveoli & cross into the bloodstream
- co2 leave the bloodstream & is then exhaled out of the body
what should the room setting be for patient with TB
negative pressure isolation room
what cause barrel chest in COPD patient
barrel chest occur when emphysema results in loss of elastic recoil, which collapse the airway during exhalation, trapping air & dilating the airspace
what is the definition of pneumonia
infection of the lung parenchyma, resulting in consolidation and buildup of exudates in alveolar
what should the spo2 be in COPD pt when on supplemental o2
88-92%
what is capnography use for
to monitor PaCO2 in blood
normal range: 35-45
what is atypical/interstitial pneumonia
infection of the interstitial space around the alveoli
what is hypoxemia & hypercapnia
hypoxemia - low o2 in blood
hypercapnia - high co2 in blood
which virus increase the risk of asthma in children
adenovirus
