Respiratory Disorders: Pneumonia

Question 1

What is pneumonia? What’s another name for it?

Answer 1

Inflm of the lung

Pneumonitis

Question 2

Pneumonia occur in the ______ resp tract. What structures?

Answer 2

lower resp tract

alveoli and bronchioles = finer a/w

Question 3

T or F: Pneumonia is always infectious.

Answer 3

F: infectious or non-infectious

Question 4

Pneumonia is the most common ________ _______

Answer 4

nosocomial infection

Question 5

Etiology of Pneumonia (4)

Answer 5

1. several microbe
2. usually bacteria
3. noxious fumes
4. aspiration

Question 6

What microbes cause pneumonia? What bacteria commonly cause pneumonia?

Answer 6

bacterias, viruses, or fungi

streptococcus pneumoniae

Question 7

Example of noxious fumes.

Answer 7

toxic fumes from a fire causing damage when inhaled

Question 8

What is aspiration? Example?

Answer 8

anything besides air getting into the lungs

Ex: inhaling water into the lungs causing damaging effects or gastric content

Question 9

What are the two classifications of Pneumonia?

Answer 9

1. infectious

2. non-infectious

Question 10

What are the types of infectious pneumonia? (3) Explain. Which one is most common?

Answer 10

1. pneumococcal (most common): refers to bacterial colony
2. community acquired: acquired from people in the community
3. nosocomial: acquired in the hospital setting esp immunocompromised elders

Question 11

What is an example of non-infectious pneumonia?

Answer 11

Aspiration Pneumonia–> caused by anything but air such as inhaling toxic fumes

Question 12

Patho: Mucociliary blanket compromised. What is it? How does it work?

Answer 12

The mucociliary blanket is a thin film lining the surface of epithelial cells in the a/w that contains cilia and goblet cells producing mucus providing a defense mechanism.

Cilia beats synchronously in the opposite direction to airflow in order to expectorate mucus containing foreign debris.

If compromised, bacteria and foreign debris enter the lungs

Question 13

What can compromises mucociliary blanket or what group of individuals have compromised mucociliary blanket? (3)

Answer 13

immunocompromised individuals, trauma, and smoking

Question 14

What makes the lung an ideal place for bacteria?

Injurious agents _______ and _______ when it get into the lungs of individuals with compromised mucociliary blanket.

Answer 14

Environment is warm and moist

establishes

proliferate

Question 15

What is impaired after bacteria establish and proliferate in the LRT?

Answer 15

infection establishes in LRT–> inflm–> edema–>impaired gas exchange

Question 16

How is gaseous exchange (GE) impaired?

Answer 16

1. edema –> increase prod. of exudate–> obstructs a/w–> impede GE between alveoli and capillaries

Question 17

What is GE?

Answer 17

GE = inhaled oxygen moves from the alveoli to the blood in capillaries, and carbon dioxide moves from the blood in the capillaries to the air in the alveoli.

OR

O2 moves from lung to bloodstream and CO2 moves from bloodstream to lungs

Question 18

How does edema affect alveoli? Explain Alveoli.

Answer 18

Alveoli have thin layer of fluid lining the surface in which gas diffused into or out of the blood or alveoli

W/ edema, the layer increases and become thicker –> increase diffusion distance

Question 19

What are the four stage of pneumococcal pneumonia? Explain the main actions in each.

Answer 19

1. edema–> increase proteins + microbes
2. red hepatization –> RBC, PMN, and capillary congestion
3. grey hepatization–> phagocytosis
4. resolution

Question 20

Explain the first stage of Pneumococcal Pneumonia. What kind of exudate is occuring.

Answer 20

Purulent exudate containing lots of proteins (eg antibodies), fluids and cells, and microbes, and pneumococci.

In this stage, alveoli become filled with protein-rich edema fluid containing numerous organisms.

Question 21

Explain the second stage of Pneumococcal Pneumonia.

Answer 21

Marked capillary congestion, leading to massive outpouring of polymorphonuclear (PMN) leukocytes and RBC.

Defense cells activate when microbes proliferate.

PMN ingest bacteria and cause damage to capillaries

Question 22

Why is the 2nd stage called red hepatization?

Answer 22

Red is d/t the presence of erythrocytes in alveoli from inflm, hyperemia, and exudate.

Hepatization is d/t the affected part of lung resembling the consistency of liver –> soft and flaccid

Question 23

What is PMN leukocytes?

Answer 23

polymorphonuclear leukocytes is a group of leukocytes that have polymorphous nuclei –> nucleus have different shapes (eg trilobular)

Question 24

What is typical pneumonia? Example? Explain the effects on alveoli.

Answer 24

Typical Pneumonia is caused by bacterial infection eg Pneumococcal Pneumonia.

When bacteria proliferate, it takes up space in alveoli (where there are least resistance) causing inflm and exudation and fluid into air-filled spaces

Question 25

What is Atypical Pneumonia? Explain effect on alveoli. Where is it confined?

Answer 25

Atypical Pneumonia is caused by viral and mycoplasma infections but there is a lack of alveolar infiltration = empty alveoli. largely confined to the alveolar septum and pulmonary interstitium Viruses must get into host cells to replicate but bacteria replicate anywhere.

Question 26

What is lobar pneumonia?

Answer 26

refers to the consolidation of part or all of a lung lobe

Question 27

What is a bronchopneumonia?

Answer 27

refers to a patchy consolidation involving more than one lobe granules are inflamed

Question 28

What is consolidation in the lungs?

Answer 28

Air-filled sac is replaced with fluids that has been solidified

Question 29

Manifestations of Pneumonia (4)

Answer 29

1. dyspnea 2. productive cough 3. pleuritic pain 4. elevated fevers

Question 30

Manifestations are _____ and have ______ variation

Answer 30

1. acute | 2. wide

Question 31

What is benefits of productive coughs?

Answer 31

body is able to remove exudate by coughing and bring up expectorate eg sputum and clear the a/w

Question 32

What is the speed of air when coughin?

Answer 32

One cough ranges from 100-160 km/hr on average

Question 33

Why is the coughing reflex important?

Answer 33

protect against aspiration into tracheobronchial tree by bringing up whatever is lodged in the a/w

Question 34

What is pleuritic pain? What does it refer to?

Answer 34

sudden and intense sharp, burning, and stabbing pain when inhaling and exhaling refers to the pleura membrane

Question 35

What is elevated fever?

Answer 35

Fever with a temperature higher than expected in general

Question 36

Diagnosis of Pneumonia (3)

Answer 36

1. hx and px 2. chest x-ray 3. sputum analysis

Question 37

What is found in chest x-ray? very ________ and most _____ approach

Answer 37

consolidation is present = solidification of fluids, microbes, inflm debris, exudate, or cells revealing direct

Question 38

What is sputum analysis?

Answer 38

collect sputum sample to be analyzed to identify microbes

Question 39

Treatment of Pneumonia (2)

Answer 39

1. antibiotic if bacterial to eradicate bacteria | 2. supportive

Question 40

What is the 3rd stage of pneumococcal pneumonia? How long after stage 2 does this stage begin? Why is it grey?

Answer 40

arrival of macrophages that phagocytose PMN, RBC, inflm debris, and microbes. 2-3+ days after stage two (depending on tx) Grey b/c there is less capillary congestion but still takes on the consistency of the liver (hence hepatization)

Question 41

What is the 4th stage of pneumococcal pneumonia? There ______ and _______ _______ is intact and are no longer ___________

Answer 41

individuals gradually makes a full recovery defense and IR compromised