Pneumonia - correct answer - -Inflammatory or infectious process which
results in accumulation of inflammatory exudate in the alveolar sacs
-Casues: Bacterial, viral, fungal, or aspiration
Common bacterial causes of pneumonia - correct answer - -Streptococcus
Pneumoniae: Most common cause of pneumonia. Elderly, debilitated,
malnourished, or cardiopulmonary patients.
-Staphylococcus Aureas: Often a complication of influenza or viral
pneumonia. Elderly, debilitated hospitalized patients or chronic lung
disease.
-Streptococcus Pyogenes: Complication of viral infection such as influenza
or measles
-Klebsiella Pneumoniae: Common in hospitalized, debilitated patients,
diabetics, and alcoholics. Elderly infected with this bacteria have a high
mortality!
-Haemophilus Influenza: Commonly seen in infants and children. Occurs in
adults with COPD.
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Healthcare-Associated Pneumonia - correct answer - -Occurs in any
individual who has had contact with healthcare system
-Patients who have received infusion therapy or dialysis or have resided in
a nursing home within 90 days of the diagnosis are said to have a
healthcare-associated pneumonia
-Common causes: Gram-negative (harder to treat) Klebsiella,
Pseudomonas aeruginosa, E-Coli
Hospital-Acquired Pneumonia - correct answer - -Diagnosed 48 hours after
admission to hospital
-Common causes: Gram-negative (harder to treat) Klebsiella,
Pseudomonas aeruginosa, E-Coli
Tuberculosis - correct answer - -Most commonly occurs in disadvantaged
populations
-Caused by mycobacterium tuberculosis
-Spread via droplets containing the organism
Tuberculosis Stages - correct answer - 1. Primary infection: Macrophages
engulf the mycobacterium and form a granuloma (mass) called a Ghon.
Inflammatory cascade is triggered. Center of lesion necroses and
eventually calcifies. This infection is usually asymptomatic and does not
cause active disease.
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2. Secondary infection: Ghon has activated and the infection has spread to
additional sites within the lung. SIGNS OF INFECTION OCCUR: fever,
hemoptysis, pleural effusion, wasting, weight loss. Lesions often occur in
the apices (highest point of lung). These individuals are infectious and can
spread disease! Mycobacterium can spread to other parts of the body via
blood or lymphatic systems.
During what stage of TB infection is the patient infectious and has
signs/symptoms? - correct answer - Secondary infection
Mitral Valve Stenosis - correct answer - - Characterized by NARROWING
of mitral valve
- Normal is 4-6 cm
-Narrowed is less than 2.5 cm
- Caused by RHEUMATIC FEVER
-More common in WOMEN
-Oxygenated blood comes back into heart into the left atrium and down
through the mitral valve to the left ventricle
- Complex: Stenosis leads to volume/pressure in left atrium, which results
in atrial hypertrophy/dilation, which increases pressure/volume in the
pulmonary circulation & causes PULMONARY EDEMA
- Simplified: Skinny mitral valve doesn't let blood pass through easily, so
blood backs up into the left atrium and causes it to swell, then backs up into
the lung and causes resp. symptoms
-S/sx: dyspnea, hemoptysis, a-fib, dysphagia, pulmonary hypertension
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Mitral Valve Regurgitation - correct answer - -Characterized by
INCOMPLETE CLOSURE of mitral valve
-Caused by MITRAL VALVE PROLAPSE (flaps don't close together
properly, leaving valve ajar); more common in WOMEN; STICKING CHEST
PAIN
-Blood in left ventricle backs up to left ventricle during systole (mitral valve
should be closed during systole/contraction of heart)
-Leads to atrial dilation/hypertrophy, increased pulmonary vascular
pressure/volume, PULMONARY EDEMA
-S/sx: Dyspnea, rales, pansystolic murmur, S3 & S4 heart sounds
Aortic Valve Stenosis - correct answer - -Most common valvular disease
-Most common causes are aortic valve CALCIFICATION (stiffening) in
people over 60; congenital aortic valve stenosis in people less than 30
-Normal valve 3 cm; symptoms seen when valve less than 1 cm; severe
when valve is less than 0.5 cm
-Narrowed valve prevents outflow from left ventricle to aorta. This backs up
blood to the left atrium and ultimately floods the lung causing
PULMONARY EDEMA
S/Sx: Pulmonary hypertension/edema, poor outflow of aorta to body (aorta
sends out oxygenated blood to body), causing fainting or chest pain
Simplified: Aorta is stiff and can't send out oxygenated blood properly to the
body, depriving tissues of oxygen. Blood gets backed up into lungs,
causing pulmonary edema.
Aortic Valve Regurgitation - correct answer - -Valve is TOO WIDE or TOO
NARROW, blood doesn't pass through effectively, causing back flow of
blood into the left ventricle