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Questions and Answers
Which type of pneumonia is caused by organisms that are often multiple drug resistant?
Which type of pneumonia is caused by organisms that are often multiple drug resistant?
What is the most common causative agent of community-acquired pneumonia in adults younger than 60 without comorbidities?
What is the most common causative agent of community-acquired pneumonia in adults younger than 60 without comorbidities?
S.pneumoniae
____ is a type of pneumonia that develops 48 hours or more after patient admission.
____ is a type of pneumonia that develops 48 hours or more after patient admission.
Hospital-acquired pneumonia (HAP)
What are the main classifications of pneumonia?
What are the main classifications of pneumonia?
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Viruses are the most common cause of pneumonia in adults.
Viruses are the most common cause of pneumonia in adults.
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Which organism is a common cause of pneumonia that often affects older adults with comorbidities?
Which organism is a common cause of pneumonia that often affects older adults with comorbidities?
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What is a characteristic symptom of pneumonia caused by inflammatory response?
What is a characteristic symptom of pneumonia caused by inflammatory response?
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Which of the following is a key component of supportive treatment for viral pneumonia?
Which of the following is a key component of supportive treatment for viral pneumonia?
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What pharmacologic therapy may be included in the treatment of pneumonia with known multidrug resistance?
What pharmacologic therapy may be included in the treatment of pneumonia with known multidrug resistance?
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Which position is recommended to promote rest and ease breathing in pneumonia patients?
Which position is recommended to promote rest and ease breathing in pneumonia patients?
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What is the primary transmission method for pulmonary tuberculosis?
What is the primary transmission method for pulmonary tuberculosis?
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Which of the following statements about sputum in pneumonia is true?
Which of the following statements about sputum in pneumonia is true?
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What is a common consequence of impaired host defenses in patients that may lead to hospital-acquired pneumonia?
What is a common consequence of impaired host defenses in patients that may lead to hospital-acquired pneumonia?
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Which organism is specifically associated with causing pneumonia in patients with chronic obstructive pulmonary disease (COPD)?
Which organism is specifically associated with causing pneumonia in patients with chronic obstructive pulmonary disease (COPD)?
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Why is initial antibiotic treatment for healthcare-associated pneumonia often different from that for community-acquired pneumonia?
Why is initial antibiotic treatment for healthcare-associated pneumonia often different from that for community-acquired pneumonia?
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Which characteristic distinguishes ventilator-associated pneumonia from other types?
Which characteristic distinguishes ventilator-associated pneumonia from other types?
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What type of pneumonia predominantly results in interstitial infiltrate rather than alveolar infiltrate?
What type of pneumonia predominantly results in interstitial infiltrate rather than alveolar infiltrate?
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Study Notes
Pneumonia
- Pneumonia is an inflammation of the lung parenchyma.
- Caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses.
- Classified into four types:
- Community-acquired pneumonia (CAP),
- Health care–associated pneumonia (HCAP),
- Hospital acquired pneumonia (HAP), and
- Ventilator Assisted Pneumonia (VAP)
- Resident macrophages play a key role in protecting the lung from foreign pathogens.
- Macrophages engulf pathogens and trigger inflammatory cells like neutrophils, causing inflammation of the lung parenchyma and making the capillaries “leaky” resulting in exudative congestion.
Community Acquired Pneumonia (CAP)
- Occurs in the community setting or within the first 48 hours after hospitalization or institutionalization.
- Streptococcus pneumoniae (pneumococcus) is the most common cause in people younger than 60 without comorbidity and in those 60 years and older with comorbidity.
- Haemophilus influenzae is a common cause in older adults and those with chronic illnesses like COPD, alcoholism, and diabetes.
- Mycoplasma pneumonia caused by M. pneumoniae is spread through person-to-person contact.
- Viruses are the most common cause of pneumonia in infants and children.
Health Care Associated Pneumonia (HCAP)
- Causative pathogens are often MDR (Multiple drug resistant).
- Often difficult to treat.
- Initial antibiotic treatment is different from CAP due to the possibility of MDR bacteria.
Hospital Acquired Pneumonia (HAP)
- Develops 48 hours or more after admission.
- Predisposing factors include impaired host defenses, comorbid conditions, supine positioning, aspiration, coma, malnutrition, prolonged hospitalization, hypotension, and metabolic disorders.
- Common organisms responsible for HAP include Enterobacter species, Escherichia coli, H. influenzae, Klebsiella species, Proteus, Serratia marcescens, Pseudomonas aeruginosa, methicillin-sensitive or methicillin-resistant Staphylococcus aureus (MRSA), and S. pneumoniae.
Ventilator Associated Pneumonia (VAP)
- Occurs in patients who have been endotracheally intubated and on mechanical ventilation for at least 48 hours.
- Can be a complication in up to 28% of patients on mechanical ventilation.
Community Acquired Pneumonia
- S. pneumoniae is the most common cause in people younger than 60 without comorbidity and those 60 and older with comorbidity.
- H. influenzae is a common cause in older adults and people with chronic illnesses.
- Mycoplasma pneumoniae is spread through respiratory droplets and causes mainly interstitial inflammation.
- Viruses are the most common cause among infants and children.
Hospital-Acquired Pneumonia (HAP)
- HAP develops 48 hours after admission.
- Patients with impaired host defenses, multiple chronic conditions, being supine, coma, etc. are predisposed to HAP.
- Common HAP organisms include Enterobacter species, Escherichia coli, H. influenzae, Klebsiella species, Proteus, Serratia marcescens, Pseudomonas aeruginosa, methicillin-sensitive or methicillin-resistant Staphylococcus aureus (MRSA), and S. pneumoniae.
Health Care Associated Pneumonia (HCAP)
- Causative pathogens are often multidrug resistant (MDR).
- Initial antibiotic treatment for HCAP is often different than CAP because of the possibility of MDR bacteria.
Ventilator-Associated Pneumonia (VAP)
- The patient must have been intubated and on mechanical ventilation for at least 48 hours.
- Sputum is often purulent.
Pneumonia Assessment and Diagnostic Findings
- History is important
- Sputum analysis is critical
- A physical exam, chest x-ray, and blood culture are all utilized.
Pneumonia Preventive Measures
- Vaccination is important, especially for high-risk individuals.
- Handwashing frequently
- Avoid close contact with sick people.
- Keep vaccinations up-to-date.
Pneumonia Medical Management
- Goal is to improve oxygenation, reduce inflammation, and combat infection.
Pneumonia Pharmacologic Treatment
- Antibiotics are the mainstay of treatment, chosen based on culture and sensitivity results.
- A three-drug regimen may be used for known MDR cases.
- Viral pneumonia is primarily managed supportively with hydration, antipyretics, and cough suppressants.
Pulmonary Tuberculosis
- M. tuberculosis is the causative organism.
- It mainly affects the lung parenchyma, but can also spread to meninges, kidneys, bones, and lymph nodes.
- Airborne transmission occurs through droplet nuclei released by coughing, sneezing, etc.
- Risk factors include close contact with someone with active TB, overcrowded housing, and HIV infection.
Pulmonary Tuberculosis Assessment and Diagnostic Findings
- A sputum culture, chest x-ray, and tuberculin skin test are used for diagnosis.
Tuberculosis Classification
- Pulmonary tuberculosis refers to TB of the lungs
- Extrapulmonary tuberculosis refers to the TB affecting other parts of the body, including the lymph nodes, meninges, kidneys, bones, and joints
Pulmonary Tuberculosis Medical Management
- Directly observed therapy (DOT) is typically used for TB.
- Multidrug therapy is essential for treatment.
- Treatment regimens vary based on the category of TB.
Pulmonary Tuberculosis Nursing Management
- Encourage hydration through increased fluid intake.
- Adherence to medication regimen is critical.
- Promote rest and activity schedule to manage activity tolerance.
- Emphasize proper hygiene to prevent transmission.
Ebola
- Fruit bats are the natural reservoir host.
- Humans are infected through contact with infected bodily fluids or animals.
- The first outbreak was in 1976 near the Ebola River.
- The 2014 outbreak in West Africa was particularly severe.
- Transmission is primarily via direct contact with blood, bodily fluids of infected individuals, and potentially semen of a recovered individual.
H1N1 (Swine Flu)
- Swine influenza is a respiratory disease in pigs caused by Type A influenza viruses.
- H1N1 influenza A virus was first detected in humans in the United States in 2009.
- Symptoms include fever, lethargy, cough, runny nose, sore throat, eye irritation, nausea, and vomiting.
H1N1 (Swine Flu) Management
- Antiviral medications (oseltamivir, peramivir, zanamivir, baloxavir) are recommended for treatment.
- Vaccination is advised for those in contact with pigs, as well as those at increased risk for complications.
- Safe handling and preparation of pork are essential to prevent the spread.
- Avoid exposure to pigs for those at increased risk of complications.
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Description
This quiz covers the key aspects of pneumonia, including its definition, causes, and types. Focus is given to Community Acquired Pneumonia (CAP), its common causative agents, and the role of resident macrophages in lung defenses. Test your understanding of these crucial topics related to lung health.
