Pneumonia

Question 1

What is pneumonia?

Answer 1

An inflammatory condition of the lung leading to abnormal alveolar filling with consolidation and exudation

Question 2

What is the epidemiology of pneumonia?

Answer 2

It’s the single largest infectious cause of death in children worldwide

Question 3

Who is most affected by pneumonia?

Answer 3

Children, elderly and those who are immuno-suppressed

Question 4

What is the pathology of pneumonia?

Answer 4

During pulmonary infection, acute inflammation results in the migration of neutrophils out of the capillaries and into the alveoli. These cells phagocytose and release anti microbial enzymes and inhibitors
Leading to more inflammation and oedema

Question 5

What 3 things can pneumonia be? (Pathology)

Answer 5

Infection
Chemical
Aspiration irritant

Question 6

How many stages of pneumonia are there?

Answer 6

4

Question 7

What are the 4 stages of pneumonia?

Answer 7

1) Consolidation
2) Red Hepatization
3) Gray Hepiatization
4) Resolution

Question 8

What is the time frame of congestion?

Answer 8

First 24 hours

Question 9

What happens during consolidation phase?

Answer 9

Vascular engorgement, intra-alveolar fluid and numerous bacteria

Question 10

What does the lung look like during the consolidation phase?

Answer 10

Heavy, boggy and red

Question 11

What is the time frame of the red hepatization phase?

Answer 11

2-3 days

Question 12

What happens in the red hepatization phase?

Answer 12

Massive exudation develops with red blood cells, leukocytes and fibrin filling the alveolar spaces

Question 13

What does the lung look like during the red hepatization phase?

Answer 13

Red, firm and airless, with a liver like consistency

Question 14

What is the time frame of the gray hepatization phase?

Answer 14

4-6 days

Question 15

What happens during the gray hepatization phase?

Answer 15

Progressive disintegration of red blood cells and the persistent of fibrin exudate

Question 16

What is the time frame of the resolution phase?

Answer 16

6+ days

Question 17

What happens during the resolution phase?

Answer 17

Consolidated exudate within the alveoli undergoes progressive digestion to produce debris (speutum) that is later reabsorbed, ingested by macrophages or coughed up

Question 18

What are the 7 causes of pneumonia?

Answer 18

• bacteria
• fungi
• virus
• parasites
• chemical (chorine gas)
• aspiration
• inhalation (smoke and burns)

Question 19

What are the 2 anatomical classifications of pneumonia?

Answer 19

• lobar pneumonia
• bronchopneumonia

Question 20

What are the 4 setting classifications of pneumonia?

Answer 20

• CAP = community acquired pneumonia
• HCAP = health care associated pneumonia
• HAP = hospital acquired pneumonia
• VAP = ventilator acquired pneumonia

Question 21

When is HCAP contracted?

Answer 21

When being nursed in hospital

Question 22

When is HAP contracted?

Answer 22

Within 48 hours of being admitted into the hospital

Question 23

When is VAP contracted?

Answer 23

48-72 hours after being put onto ventilation

Question 24

Which are the 2 most common setting classification of pneumonia?

Answer 24

CAP and HAP

Question 25

What is the most common cause of CAP and VAP?

Answer 25

An unknown cause

Question 26

What are the common signs and symptoms of pneumonia?

Answer 26

- fever - malaise - muscle ache and fatigue - productive and non productive coughing - tactile fremitus on palpation - SOB - chest pain - rapid heartbeat - loss of appetite

Question 27

What is dyspnoea?

Answer 27

Shortness of breath

Question 28

What is tactile femitus?

Answer 28

Feeling vibrations from speutum when somebody has a productive cough

Question 29

What are less common symptoms of pneumonia?

Answer 29

- coughing up blood - nausea and vomiting - diarrhoea - wheezing - confusion

Question 30

What can be complications of pneumonia?

Answer 30

Lung abscess Pleural effusions Emphysema Septic shock (SEPSIS)

Question 31

How are lung abscesses formed?

Answer 31

A cavity in the lung is filled with puss, needing to be drained

Question 32

How do pleural effusions occur?

Answer 32

The pleural fluid increases, causing an inflammatory response

Question 33

What are the medical diagnosis stats for pneumonia?

Answer 33

- temperature above 37.8 degrees - HR above 100bpm - crackles - decreased breath sounds or bronchial breathing - absence of asthma

Question 34

What is the clinical prediction rule?

Answer 34

The higher the amount of findings and stats ticked, the higher the probability that somebody has pneumonia

Question 35

What are other diagnostic tests for pneumonia?

Answer 35

- chest X-ray - CT scan - blood test - sputum culture - pleural fluid culture - bronchoscopy

Question 36

What are the general management methods for pneumonia?

Answer 36

- antibiotics - oxygen support - IV fluids for hydration - rest - analgesics - cough suppressant meds - fever reducing meds -prevention via vaccinations

Question 37

What is a physios main ai m when treating somebody with pneumonia?

Answer 37

treating the symptoms

Question 38

What would physios do for pneumonia patients that are non productive?

Answer 38

- positioning - mobilising - perhaps even no intervention - supplementary oxygen

Question 39

What would physios do for pneumonia patients that are productive?

Answer 39

- sputum clearance - positioning - breathing exercises - adjuncts

Question 40

What is a pneumonia patients cough generally like in stages 1-3?

Answer 40

Dry cough, may require supplementary oxygen

Question 41

What is a pneumonia patients cough generally like during stage 4?

Answer 41

Wet (allows for productive physiotherapy treatment)