Infection & Inflammatory Respiratory Diseases

Question 1

parenchyma

Answer 1

functional tissue of an organ

excludes connective tissue

Question 2

nosocomial infection

Answer 2

infection acquired in hospital

Question 3

granuloma

Answer 3

small area of inflammation

Question 4

ghon complex

Answer 4

lesion in lung formed from TB

Question 5

pneumonia

Answer 5

acute lung injury where an inflammatory process affects the parenchyma of the lungs

Question 6

causes of pneumonia

Answer 6

• bacterial
• viral
• fungal
• inhalation of toxic or caustic chemicals, smoke, dusts or gases via airborne transmission
• aspiration of food, fluids, vomitus

Question 7

risk factors of pneumonia

Answer 7

• age
• chronic bronchitis
• poorly controlled diabetes
• uremia
• dehydration
• malnutrition
• confinement to an extended stay facility/hospital
• intubation/surgery, etc.

Question 8

pathogenesis of pneumonia

Answer 8

• full scale inflammatory and immune responses with damaging side effects to the lung tissue
• damage type II cells that produce surfactant

Question 9

community acquired pneumonia

Answer 9

• people with limited or no contact with medical institutions or setting
• remains a common and serious clinical problem

Question 10

• hospital acquired pneumonia

Answer 10

• high mortality rate
• 40% hospital deaths, 90% older than 65
• common complication of the flu

Question 11

S&S of pneumonia

Answer 11

• sudden and sharp pleuritic chest pain aggravated by chest movement and accompanied by a hacking, productive cough
• innappropriate dyspnea
• tachypnea –> decreased chest excursion –> decreased tidal volume –> increased respiratory rate
• cyanosis
• headache
• fatigue
• fever and chills
• aches and myalgias
• altered mental status

Question 12

pneumonia medical management

Answer 12

antibiotic
vaccine
chest PT

Question 13

PT implications for pneumonia

Answer 13

• wash hands
• deep breathing, coughing, airway clearance
• hydration
• early ambulation
• proper positioning
• out of bed activities

Question 14

influenza

Answer 14

viral infection

Question 15

symptoms of influenza

Answer 15

fever
chills
muscle aches
cough
congestion
runny nose
HA 
fatigue

Question 16

treatment influenza

Answer 16

rest and fluids

OTC anti-inflammatory meds

Question 17

PT implications and influenza

Answer 17

• be conscious of fatigue
• ease back into therapy
• check resting HR
• skeletal muscle altered from the infection

Question 18

tuberculosis

Answer 18

• disease caused by bacteria mycobacterium TB
• primarily in the lungs
• can be in the vertebral column, CNS or heart

Question 19

what is multi drug resistant strains regarding TB

Answer 19

TB caused by bacteria that do not respond to isoniazid and refampicin

Question 20

transmission of TB

Answer 20

• airborne
• unpasteurized milk
• inhalation of infected airborne particles or droplets by an infected person

Question 21

what is active TB

Answer 21

bacteria is inside a granuloma and becomes active when that breaks up and is now circulating through the body

Question 22

progression of primary TB can lead to what

Answer 22

• pt’s not knowing they have TB because the granuloma is sealed off due to cell-mediated immunity from macrophages

Question 23

what is a secondary infection in TB

Answer 23

the ghon complex becomes reactivated, high infectious state, forms cavity that is not reachable from immune cells

Question 24

clinical manifestations of TB

Answer 24

• asymptomatic
• 2-12 wks
• highest risk for active infxn is in the first two years

Question 25

symptoms of Tb

Answer 25

- productive cough - weight loss - anorexia - fever - night sweats - fatigue - malaise - hemoptysis

Question 26

PT implications for TB

Answer 26

- protect yourself - clean equipment - notice S&S - thorough chest assessment - postural deviations - gait - strength - balance - functional mobility - exercise - observe med list - negative air pressure rooms - PT EDUCATION

Question 27

if someone has TB, will they always show a positive test for the rest of their lives?

Answer 27

yes

Question 28

HEPA filter mask

Answer 28

trap 99.97% airborne particles 0.3 microns or larger

Question 29

N95 Mask

Answer 29

filter particles 1 micron in size > 95%

Question 30

PAPR

Answer 30

power air purifying respirator

Question 31

for a chest expansion assessment where does the tape measure go around

Answer 31

at or about the level of 4th intercostal - nipple level or just below

Question 32

chest expansion assessment

Answer 32

measure a deep max inspiration and a max expiration - take the difference

Question 33

childrens amount of expansion

Answer 33

2 cm

Question 34

young males amount of expansion

Answer 34

5-8 cm

Question 35

emphysemia amount of expansion

Answer 35

< 1 cm

Question 36

equal chest expansion

Answer 36

- place fingertips of both hands on either side of lower ribs, thumbs meet at midline, ask pt to breathe deep - posteriorly at the level of and parallel to the 10th rib - if one thumb is closer to midline, diminished expansion on that side