NURS 3303 - Pathophysiology for Nursing - Module 4 Exam Questions and Answers Already
Passed
Characterize community-acquired pneumonia, hospital-acquired pneumonia, and pneumonia in
immunocompromised people in terms of pathogens, manifestations and prognosis (Ch 30). (pg.
785-788) - Answers - community-acquired pneumonia: an infection that begins outside of the
hospital or is diagnosed within 48 hours after admission to the hospital in a person who has not
resided in a long-term care facility for 14 days or more before admission; dx usually based on hx
and physical and examination, chest x-ray; and knowledge of common local infections; sputum
specimen may be obtained and blood cultures may be drawn; abx for tx
- pathogens: viral or bacterial; most common cause is all S. pneumoniae; common viral causes
are influenza, RSV, adenovirus, and parainfluenza virus
- hospital-acquired pneumonia: lower respiratory tract infection that was not present or
incubating on admission to the hospital; usually occurring 48hours or more after admission;
30%-50% mortality rate; immunocompromised and chronic lung disease patients are at
increased risk
- pathogens: most are bacterial; include P. aeruginosa, S. aureus, Enterobacter species,
Klebsiella species, E. coli, and Serratia species. They are different from community-acquired
because most are abx resistant
- pneumonia in immunocompromised people: remains a major source of morbidity and mortality;
"Immunocompromised host" usually applies to people with a variety of underlying defects in
host defenses. It includes people with primary and acquired deficiencies, those who have
undergone bone marrow or organ transplants, people with solid organ or hematologic cancers,
and those on corticosteroid and other immunosuppressant drugs
- certain types of immunologic defects tend to favor certain types of infections; defects in
humoral immunity predispose to bacterial infections whereas defects in cellular immunity
predispose to infections caused by viruses, fungi, mycobacteria, and protozoa. Neutropenia and
impaired granulocyte function predispose to infections caused by S. aureus
Describe the immunologic properties of the tubercle bacillus, and the clinical manifestations,
diagnosis, and treatment of primary tuberculosis (Ch 30). (pg. 788-791) - Answers -
immunologic properties: cell-mediated response that confers resistance to the organism and
development of tissue hypersensitivity to the tubercular antigens; the destructive features of the
disease, such as caseating necrosis and cavitation, result from the hypersensitivity immune
response rather than the destructive capabilities of the tubercle bacillus; inhaled droplet nuclei
pass down the bronchial tree w/o settling on the epithelium and are deposited into the alveoli.
Soon after entering the lung, the bacilli are phagocytosed by alveolar macrophages but resist
killing, apparently because cell wall lipids of M. Tuberculosis block fusion of phagosomes and
lysosomes; Ghon complex develops
, - clinical manifestations: form of the disease that develops in previously unexposed and
therefore unsensitized people; typically initiated as a result of inhaling droplet nuclei that
contain the tubercle bacillus; most develop latent infection in which T lymphocytes and
macrophages surround the organism in granulomas that limit their spread; people with latent
TB do not have active disease and cannot transmit the organism to others
- immunocompromised individuals might develop progressive disease with insidious and
nonspecific symptoms including fever, weight loss, fatigue, and night sweats. Sometimes the
onset of symptoms is abrupt with high fever, pleuritis, and lymphadenitis. As the disease
spreads, the organism gains access to the sputum, allowing the person to infect others.
- diagnosis: has many challenges and is often missed; screening methods are tuberculin skin
tests and chest x-ray; A positive reaction to the skin test does not mean that the person has
active TB but rather there has been exposure to the bacillus and that cell mediated immunity to
the organism has developed. False-positives (can result from cross-reactio
Compare and contrast the clinical manifestations, diagnosis, and treatment of the primary types
of fungal lung infections - Histoplasmosis, Coccidioidomycosis, and Blastomycosis (Ch 30). (pg.
791-793) - Answers - these fungi form infectious spores, which enter the body through the
respiratory system. Most people who become infected with these fungi develop only minor
symptoms or none at all. Only a small minority develops serious disease. Although most fungal
infections are asymptomatic, they can be severe or even fatal in people who have experienced a
heavy exposure, have underlying immune deficiencies, or develop progressive disease that is
not recognized or treated.
- Histoplasmosis: caused by H. capsulatum. Most US cases occur near river valleys of the
Midwest (Ohio & Mississippi); grows in soil and other areas that have been enriched with bird
and bat feces
- acquired by inhaling the fungal spores that are released when the dirt or dust from the
infected areas is disturbed. The spores covert to the parasitic yeast phase when exposed to
body temperature in the alveoli. Dissemination in the blood stream occurs during the first
several weeks of infection before specific immunity has developed. After 2-3 weeks, cellular
immunity develops as long as the host is immunocompetent, establishing the body's ability to
control the infection
- usually causes no symptoms and resolves spontaneously. Average incubation period for the
infection to cause symptoms is 4 weeks after exposure. Latent asymptomatic histoplasmosis is
characterized by evidence of healed lesions in the lungs or hilar lymph nodes. Mild, self-limited,
febrile respiratory infection with symptoms of muscle and joint pains and a non-productive, dry
cough. Erythema (subcutaneous nodules) or erythema multiforme (hive-like lesions) sometimes
appears. Chest x-ray might show single or multiple infiltrates.
Passed
Characterize community-acquired pneumonia, hospital-acquired pneumonia, and pneumonia in
immunocompromised people in terms of pathogens, manifestations and prognosis (Ch 30). (pg.
785-788) - Answers - community-acquired pneumonia: an infection that begins outside of the
hospital or is diagnosed within 48 hours after admission to the hospital in a person who has not
resided in a long-term care facility for 14 days or more before admission; dx usually based on hx
and physical and examination, chest x-ray; and knowledge of common local infections; sputum
specimen may be obtained and blood cultures may be drawn; abx for tx
- pathogens: viral or bacterial; most common cause is all S. pneumoniae; common viral causes
are influenza, RSV, adenovirus, and parainfluenza virus
- hospital-acquired pneumonia: lower respiratory tract infection that was not present or
incubating on admission to the hospital; usually occurring 48hours or more after admission;
30%-50% mortality rate; immunocompromised and chronic lung disease patients are at
increased risk
- pathogens: most are bacterial; include P. aeruginosa, S. aureus, Enterobacter species,
Klebsiella species, E. coli, and Serratia species. They are different from community-acquired
because most are abx resistant
- pneumonia in immunocompromised people: remains a major source of morbidity and mortality;
"Immunocompromised host" usually applies to people with a variety of underlying defects in
host defenses. It includes people with primary and acquired deficiencies, those who have
undergone bone marrow or organ transplants, people with solid organ or hematologic cancers,
and those on corticosteroid and other immunosuppressant drugs
- certain types of immunologic defects tend to favor certain types of infections; defects in
humoral immunity predispose to bacterial infections whereas defects in cellular immunity
predispose to infections caused by viruses, fungi, mycobacteria, and protozoa. Neutropenia and
impaired granulocyte function predispose to infections caused by S. aureus
Describe the immunologic properties of the tubercle bacillus, and the clinical manifestations,
diagnosis, and treatment of primary tuberculosis (Ch 30). (pg. 788-791) - Answers -
immunologic properties: cell-mediated response that confers resistance to the organism and
development of tissue hypersensitivity to the tubercular antigens; the destructive features of the
disease, such as caseating necrosis and cavitation, result from the hypersensitivity immune
response rather than the destructive capabilities of the tubercle bacillus; inhaled droplet nuclei
pass down the bronchial tree w/o settling on the epithelium and are deposited into the alveoli.
Soon after entering the lung, the bacilli are phagocytosed by alveolar macrophages but resist
killing, apparently because cell wall lipids of M. Tuberculosis block fusion of phagosomes and
lysosomes; Ghon complex develops
, - clinical manifestations: form of the disease that develops in previously unexposed and
therefore unsensitized people; typically initiated as a result of inhaling droplet nuclei that
contain the tubercle bacillus; most develop latent infection in which T lymphocytes and
macrophages surround the organism in granulomas that limit their spread; people with latent
TB do not have active disease and cannot transmit the organism to others
- immunocompromised individuals might develop progressive disease with insidious and
nonspecific symptoms including fever, weight loss, fatigue, and night sweats. Sometimes the
onset of symptoms is abrupt with high fever, pleuritis, and lymphadenitis. As the disease
spreads, the organism gains access to the sputum, allowing the person to infect others.
- diagnosis: has many challenges and is often missed; screening methods are tuberculin skin
tests and chest x-ray; A positive reaction to the skin test does not mean that the person has
active TB but rather there has been exposure to the bacillus and that cell mediated immunity to
the organism has developed. False-positives (can result from cross-reactio
Compare and contrast the clinical manifestations, diagnosis, and treatment of the primary types
of fungal lung infections - Histoplasmosis, Coccidioidomycosis, and Blastomycosis (Ch 30). (pg.
791-793) - Answers - these fungi form infectious spores, which enter the body through the
respiratory system. Most people who become infected with these fungi develop only minor
symptoms or none at all. Only a small minority develops serious disease. Although most fungal
infections are asymptomatic, they can be severe or even fatal in people who have experienced a
heavy exposure, have underlying immune deficiencies, or develop progressive disease that is
not recognized or treated.
- Histoplasmosis: caused by H. capsulatum. Most US cases occur near river valleys of the
Midwest (Ohio & Mississippi); grows in soil and other areas that have been enriched with bird
and bat feces
- acquired by inhaling the fungal spores that are released when the dirt or dust from the
infected areas is disturbed. The spores covert to the parasitic yeast phase when exposed to
body temperature in the alveoli. Dissemination in the blood stream occurs during the first
several weeks of infection before specific immunity has developed. After 2-3 weeks, cellular
immunity develops as long as the host is immunocompetent, establishing the body's ability to
control the infection
- usually causes no symptoms and resolves spontaneously. Average incubation period for the
infection to cause symptoms is 4 weeks after exposure. Latent asymptomatic histoplasmosis is
characterized by evidence of healed lesions in the lungs or hilar lymph nodes. Mild, self-limited,
febrile respiratory infection with symptoms of muscle and joint pains and a non-productive, dry
cough. Erythema (subcutaneous nodules) or erythema multiforme (hive-like lesions) sometimes
appears. Chest x-ray might show single or multiple infiltrates.
