Pneumonia

Question 1

pneumonia (aka “pneumonitis”)

Answer 1

• inflm within the lung

Question 2

infectious or non-infectious

Answer 2

both

Question 3

infectious classification subtypes

Answer 3

• pneumococcal pneumonia (most common aka “typical pneumonia”)
• community acquired
• nosocomial (hospital-acquired)

Question 4

typical pneumonia

Answer 4

caused by bacterial infection

Question 5

atypical pneumonia

Answer 5

caused by something other than bacteria (viral)

Question 6

etiology

Answer 6

• several microbes (bacteria, viral, fungi)
• noxious fumes
• aspiration pneumonia

Question 7

aspiration pneumonia

Answer 7

anything other than air enters the lungs (ex. gastric content)

Question 8

example of noxious fumes

Answer 8

house fire smoke

Question 9

what microbe usually causes pneumonia

Answer 9

bacteria

Question 10

patho

Answer 10

• mucociliary blanket compromised (ex. smoking)
• immunocompromised pts have impaired resp defences
• agent enters lungs –> infect within lung –> inflm of lungs –> tissue damage & edema –> impaired gas exchange

Question 11

4 stages of pneumococcal pneumonia

Answer 11

1. edema stage
2. red hepatization stage
3. grey hepatization stage
4. resolution

Question 12

edema stage (1)

Answer 12

• microbes enter alveoli

- abundance of proteins present in purulent exudate, microbes, defence cells, and edema

Question 13

red hepatization stage (2)

Answer 13

RBC and polymorphonuclear leukocytes (PMN) containing bacteria in alveoli, capillary congestion (d/t hyperemia, vasodilation)

Question 14

grey hepatization stage (3)

Answer 14

• clearance of alveolus
• phagocytosis: macrophages engulf microbes, debris, RBCs, & PMNs
• less capillary congestion
• occurs 2-3 days after red hepatization stage

Question 15

resolution stage (4)

Answer 15

• immunocompromised may not recover

- non-immunocompromised recover gradually

Question 16

mnfts

Answer 16

• acute, wide variation
• systemic mnfts: fever, lethargy, malaise, headache
• dyspnea
• productive cough w/ sputum
• chest pain
• inc fever
• consolidation

Question 17

why does productive cough w/ sputum occur

Answer 17

secretion of mucus for protection in the resp tract + purulent exudate from bacterial infect

Question 18

is coughing beneficial mnft

Answer 18

no, a persistent cough can worsen the mucociliary blanket b/c the cough is fast and the pt is immunocompromised

Question 19

consolidation

Answer 19

• accum of inflammatory cellular exudate in the alveoli that causes lung tissue to harden/solidify (liquid cannot be expectorated)
• consolidation must be present to Dx pneumonia

Question 20

what is the liquid components in consolidation

Answer 20

• pulmonary edema
• inflammatory exudate
• pus
• inhaled water
• blood

Question 21

dx

Answer 21

• Hx, Px
• CXR
• sputum C&S analysis (to look for bacteria)

Question 22

tx

Answer 22

• remove offending agent if not infectious and give supportive care (ex. O2)
• anti-inflm
• pain meds
• Abx if bacterial