NGR6200 Pneumonia- Exam Questions with Verified Solutions Latest Version (Already Passed)

NGR6200 Pneumonia- Exam Questions with Verified Solutions Latest Version (Already Passed) Epidemiology of Community Aquired Pneumonia (CAP) - Answers • Pneumonia is the most common cause of death for infectious disease • 8th leading cause of overall mortality in US • Most cases occur in immunocompetent community dwelling individuals • 20% of children develop pneumonia by age 5 Epidemiology • Epidemiology-four million adults per year contract community-acquired pneumonia - Incidence is 12 per 1000 - Increases to 30 per 1000 in those > age 75 • Considered to be one of the most "overtreated" diagnoses Risks for Community Aquired Pneumonia (CAP) - Answers • Risk factors include smokers, alcoholics, asthma, immune suppression and age > 70 - Infants and the elderly are the most severely affected • Most common effecting organisms of CAP are: - Answers - Streptococcus pneumoniae- (typical) • Gram positive - Haemophilus influenzae • Gram negative - Mycoplasma pneumoniae (walking pneumonia) • Atypical-(does not show up on a gram stain because it lacks a cell wall ) - Chlamydophila pneumoniae • Atypical - Legionella species • Atypical • From inhaling contaminated water - Atypical organisms account for 15%-20% of CAP CAP due to Mycoplasma pneumoniae is more common in the ____________________ and is highly contagious - Answers summer M. pneumonia is rare in children <5 years , T/F? - Answers True Source: CAP ppt Macrolide resistance is common with M. pneumonia, T/F? - Answers True Source: CAP ppt Clinical Features of CAP - Answers • Cough, fever, chills, shortness of breath, pleuritic chest pain, guarding, and sputum (60% report putrid sputum) production • S. pneumoniae can cause rust-colored sputum • Signs include increased respiratory rate, hypoxemia, dullness to percussion, bronchial breathing, egophony, crackles, wheezing, pleural friction rub, increased tactile fremitus Source: CAP ppt Differentials for CAP: - Answers • Asthma • Bronchitis • Sinusitis • Pulmonary edema • TB • Lung cancer • Pneumonitis Source: CAP ppt Tactile Fremitus - Answers • use hands or ulnar surface, this helps you to feel for vibrations of the chest as the patient repeats "99". • Compare and contrast the sensation of the fremitus when the numbers are spoken. • If you note a decreased sensation, have the patient repeat the number and see if it is still decreased. Source: CAP ppt If the tactile fremitus is (increased/decreased) , the cause may be pleural effusion, fibrosis, pneumothorax, COPD, an obstructed bronchus or pleural thickening. - Answers • decreased Source: CAP ppt If the tactile fremitus is (increased/decreased) , the cause may be in the presence of lobe consolidation or pneumonia. - Answers • increased Source: CAP ppt Review Abnormal Voice Sounds - Answers • Egophony • Bronchophony • Whispered pectoriloquy Source: CAP ppt • If you hear bronchial sounds in areas that you should not hear them, then have the patient do one of three maneuvers 1. Bronchophony - - Answers - have the patient say "99" and listen to the chest with your stethoscope. - Usually the sound is muffled but if it is clear and distinct, then it is considered bronchophony - say (+) result Source: CAP ppt • If you hear bronchial sounds in areas that you should not hear them, then have the patient do one of three maneuvers: 2. Egophony - - Answers - ask the patient to say "E" and listen with the stethoscope. - If you hear "e" this is NORMAL, if you hear "Ay", then it is termed egophony. Source: CAP ppt • If you hear bronchial sounds in areas that you should not hear them, then have the patient do one of three maneuvers: 3. Whispered pectoriloquy - - Answers - listen with your stethoscope while the patient wh