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What is the most common cause of death in the world?
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Lower respiratory diseases
___________ is one of the most common conditions seen in primary care and is usually a sequelae to an upper respiratory infection.
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Acute bronchitis
A type of bronchitis that develops in patients with COPD is called ___________, and it represents an acute infection superimposed on chronic bronchitis. It can lead to respiratory failure.
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Acute Exacerbation of Chronic Bronchitis (AECB)
What are the organisms involved in most cases of bronchitis?
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It is usually viral: rhinovirus or influenza
What organisms are typically responsible for bacterial bronchitis in a smoker?
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Streptococcus pneumoniae or Haemophilus influenzae
What organisms are typically responsible for bacterial bronchitis in a non-smoker?
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Mycoplasm pneumoniae or chlamydia pneumoniae
How does an Xray of someone with bronchitis look different than an Xray of someone with pneumonia?
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Patients with bronchitis don't have inflitrates or consolidation like those with pneumonia
How is AECB in COPD patients typically treated?
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With broad spectrum antibiotics for 5-7 days, the earlier they start the antibiotics, the lower the chances of relapse & hospital admissions
_________ is an acute inflammation of the lung parenchyma caused by a microbial organism.
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Pneumonia
_______ is the leading cause of death from an infectious disease in the United States.
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Pneumonia
How does decreased levels of consciousness increase the risk of a lower respiratory disease?
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It depresses the cough and epiglottal reflexes, which may allow aspiration of oropharygeal contents into the lungs
How does tracheal intubation interfere with the normal defense mechanisms that protect the lower respiratory system?
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It bypasses the filtration and humidification provided by the upper airways and intereferes with the normal mucoculiary mechanism and cough reflex.
What factors can impair the mucociliary protective mechanism? (4)
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-air pollution -cigarette smoking -viral URIs -changes related to aging
_________ impairs the functions of leukocytes and polymorphnuclear leukocytes in combating lower respiratory infections.
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Malnutrition
Diseases like leukemia, diabetes mellitus and alcoholism allow for the normal flora of the oropharynx to be disrupted. The presence of ________, which is not normally present, increases the risk of a lower respiratory infection like pneumonia.
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Gram negative bacilli
There are several medical interventions that are considered a predisposing factor for pneumonia. They are: (6)
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-Altered consciousness from anesthesia -Altered oropharyngeal flora from antibiotics -bed rest -Immunosuppressive drugs -NG or nasointestinal feeding tubes -tracheal intubation
What are some environmental factors that can predispose someone to pneumonia?
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-air pollution -smoking
What are some diseases/medical conditions that predispose a patient to pneumonia?
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-Anything that causes altered consciousness including strokes, seizures, head injuries, etc. -Prolonged immobility -Chronic diseases like lung disease, diabetes, heart disease, cancer, etc. -Any debilitating illness -HIV -URI -Malnutrition
What is NOT a preventable predisposing factor to pneumonia?
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Aging
What are preventable predisposing factors for pneumonia?
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-Smoking -Alcholism -Malnutrition
T/F Many of the organisms that cause pneumonia are opportunistic pathogens that already reside in the pharynx of healthy adults.
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True
What are the three portals of entry into the lungs for pneumonia?
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-Aspiration of oropharyngeal or nasopharyngeal contents -Inhalation into the lungs -Hematogenous spread from a primary infection elsewhere in the body
The organisms responsible for pneumonia that are most likely to be inhaled from the air into the lungs are:
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Mycoplasma pneumoniae and fungal pneumoniae
An organism that can cause pneumonia from hemtagenous spreading is...
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Staphylococcus aureus
T/F Pneumonia can be caused by parasites.
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True
T/F Pneumonia can be caused by chemicals.
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True
What organisms is the most common cause of a Community Acquired pneumonia?
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Streptococcus pneumoniae
A case of pneumonia that is detected within ______ days of hospitalization is considered community acquired.
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2 days
What is a pneumonia PORT PSI?
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It is a risk assessment scale used to determine whether a patient shhould be treated at home or in a hospital. Pneumonia/Patient Outcomes Research Team (PORT) Pneumonia Severity Index (PSI)
What is the three step approach to determining where a patient is best treated (home vs. hospital) for a community acquired pneumonia?
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1-Assess the patient's ability to care for themselves at home 2-Calculate the PORT PSI 3-Use clinical judgment


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