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48 Cards in this Set

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4 causes of pneumonia:
1. aspiration oropharyngeal secretions
2. inhalation of contaminants (virus)
3. contamination of systemic circulation
4. bacterial
bacterial cause of pneumonia:
-seems more acute than virus
-gram (+) or (-)
Exs of gram + :
staph, strep, pneumo
Exs of gram - :
hemophilus, klebsiella, pseudomonas, E Coli, proteus
-worse than gram + and more difficult to treat
clinical manifestations of pneumomia:
-rales (or crackles) make a popping sound
-bronchi sounds louder and it gurgles
-fever, chills, sputum
Diagnosis of pneumonia:
-gram stain and sputum culture
-chest xray
-usually a gram + organism or virus (unless hospitalization &/or other diseases)
Tx of pneumonia:
-antibiotics according to the cause
-time if viral
pneumonia:
-respiratory disorders involving inflammation of the lung structures, such as in the alveoli and bronchioles
tuberculosis:
-an infectious disease caused by Mycobacterium which is a rod-shaped, aerobic bacteria that is resistant to destruction
-any organ system can be involved
diagnosis of tuberculosis:
-sputum cultures
-gastric and bronchial washings
-chest xray (check for infiltrates in upper lobes)
-tuberculin test
Tx for tuberculosis:
-isoniazid and rifampin for months
-drug prophylaxis
Causes of neoplasms:
-smoking
-relation to asbestos
common symptoms of tuberculosis:
-history of contact
-cough, night sweats, weight loss
4 types of lung cancer:
1. large cell
2. small (Oat) cell
3. squamous cell
4. adenocarcinoma
Large cell lung cancer:
-aggressive and causes lung periphery
small cell lung cancer:
-aka "Oat" from size
-most aggressive
-usually located in central bronchi
-widespread, metastases
neoplasms of the lung:
-new growth or tumor
-varies with type and location of tumor
-can cause SVC compression, hoarseness (recurrent laryngeal nerve), phrenic nerve involvement, pleural effusion
squamous cell lung cancer:
-most common
-located in central bronchi
-metastases to hilar nodes
adenocarcinoma:
-located in the periphery of the lungs
-slowest growing
-peripheral location delays diagnosis usually
diagnosis of lung cancer:
1. chest xray
2. sputum cytology (bronchoscopy)
3. biopsy
4. pleural fluid
5. CT scan
Tx of lung cancer:
1. surgery (non-small cell)
2. radiation (non-operable)
3. chemotherapy
pulmonary hypertension:
PAP > 30 mmHg systolic
or > 18 mean
normal pulmonary artery pressure:
25/10 mmHg systolic
15 mean
2 types of pulmonary HTN:
primary and secondary
primary pulmonary HTN:
-common in young women 20-30 YO
-cause is unknown
-rapidly progressive
secondary pulmonary HTN:
-secondary response to anther condition or process
-increased resistance to pulmonary blood flow, increased flow, or increased left atrial pressure
2 main effects of pulmonary HTN:
1. thickening of vessel walls
2. pulmonary atherosclerosis
clinical manifestations of pulmonary HTN:
-exercise intolerance early in life
-eventually suffer from Cor Pulmonale (RHF)
Dx of pulmonary HTN:
1. chest xray to r/o enlargement of pulmonary arteries or RVH
2. EKG (r/o RVH)
3. Echocardiogram
Tx for pulmonary HTN:
-surgical repair for R to L shunt
-vasodilators and diuretics
-transplantation (sometimes the only solution to this condition)
2 types of occupational lung diseases:
1. pneumoconioses
2. hypersensitivity diseases
pneumoconioses:
-caused by inhalation of inorganic dusts and particlate matter
-duration, concentration and particle size is important
hypersensitivity disease:
-result from the inhalation of organic dusts and related occupational antigens
3 most common pneumoconioses:
anthracosis (coal)
silicosis
asbestosis
How does occupational lung disease affect the mucociliary system?
-atmospheric pollutants interfere with ciliary action
-inorganic particles have little effect
clinical manifestations of occupational lung disease:
-has long term effects
-progressive disease
diagnosis of occupational lung disease:
-chest xray (usually a late finding)
-pulmonary function delays abnormalities(?)
Tx of occupational lung disease:
-essential to take preventative measures
-use respirators at work
-removal from job
How successful are disease pathologies reversed with tx?
rarely successful
respirators:
-personal protective equipment designed to protect the wearer from respiratory hazards
What can cause a pulmonary embolism? (list predisposing factors)
1. stasis (stagnant) vein
2. hypercoagulability
3. damage to the intima of the vein
pulmonary embolism:
-obstruction of pulmonary arteries, usually by detached fragments of a clot from a leg or pelvic vein
-can be fat, air, amniotic fluid, blood clot
Where are most pulmonary embolisms formed?
-95% formed in lower extremities as a sequela (2ndary consequence) of other pathologies
How is a thrombi released during a pulmonary embolism?
trauma, effect of exercise and muscle action and changes in blood flow
What side of the heart can a pulmonary embolism damage mostly?
RIGHT sided heart failure
What percentage of infarctions are pulmonary?
15%
Dx of pulmonary embolism:
lung scan, ABGs and pulmonary arteriography
TX of pulmonary embolism:
prevention
O2 therapy
anticoagulation
thrombolytic therapy (sever cases)
vena caval filter
embolectomy