Pneumonia and TB Quiz for Health Students

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Questions and Answers

Which pathogen is responsible for approximately 50% of pneumonia cases?

Staphylococcus aureus

Klebsiella pneumoniae

Mycoplasma pneumoniae

Streptococcus pneumoniae (correct)

What is one of the first actions that occurs in the body when pneumonia develops?

Bronchoconstriction

Organisms colonize alveoli (correct)

Decreased blood flow to lungs

Airway dilation

What is a common consequence of fluid accumulation in the alveoli during pneumonia?

Increased lung elasticity

Decreased airway resistance

Improved gas exchange

Consolidation of lung tissue (correct)

Which of the following may NOT affect the ability to ventilate in patients with pneumonia?

Improved lung compliance (C) Signup and view all the answers

What is one way organisms can enter the lungs to cause pneumonia?

Through the bloodstream from other infections (B) Signup and view all the answers

Which organism is most commonly associated with atypical pneumonia?

Mycoplasma pneumoniae (D) Signup and view all the answers

How is pneumonia classified for a patient residing in a long-term care facility?

Healthcare associated (B) Signup and view all the answers

Which risk factor is NOT associated with an increased likelihood of developing pneumonia?

Regular physical exercise (C) Signup and view all the answers

Which patient demographic is particularly at risk for pneumonia due to age?

Seniors aged 65 and older (A), Infants and young children (C) Signup and view all the answers

What impact does smoking have on the risk of pneumonia?

It injures lung tissues (B) Signup and view all the answers

What is a common adverse effect associated with isoniazid that can be alleviated with Vitamin B-6?

Peripheral neuropathy (C) Signup and view all the answers

What is the recommended duration of isoniazid treatment for latent TB?

6-9 months (C) Signup and view all the answers

When is a patient with TB considered non-infectious?

When they have three consecutive negative AFB smears (D) Signup and view all the answers

What adjunct therapy may be used to increase compliance in patients with active TB?

Rifatar combination drug (A), Directly Observed Therapy (DOT) (C) Signup and view all the answers

What is a common side effect of rifampin treatment?

Red discoloration of body fluids (A) Signup and view all the answers

For patients with underlying HIV, what is the typical duration of TB treatment?

9 months (C) Signup and view all the answers

What role does Directly Observed Therapy (DOT) serve in TB treatment?

To assist with adherence (B) Signup and view all the answers

What initial regimen is typically followed in the first 2 months of treating active TB?

Rifampin, isoniazid, ethambutol, and pyrazinamide (A) Signup and view all the answers

What does an induration of 16 mm in a healthy adult indicate regarding tuberculosis?

A positive test result (A) Signup and view all the answers

Which of the following can be an indication for obtaining a sputum specimen?

Diagnosis of active tuberculosis (D) Signup and view all the answers

How long does it typically take to detect the presence of Mycobacterium tuberculosis using a sputum culture?

4-8 weeks (A) Signup and view all the answers

What should be documented for a client with a 6-mm area that is slightly red and soft at the PPD test site?

Negative response (B) Signup and view all the answers

Which of the following accurately describes the use of personal protective equipment (PPE) during sputum specimen collection?

PPE is mandated for all interactions with suspected TB patients (A) Signup and view all the answers

How many sputum specimens are typically needed to confirm the diagnosis of active tuberculosis?

Three specimens collected 8-24 hours apart (D) Signup and view all the answers

Which of the following indicates that a TB test has been administered correctly?

Subcutaneous injection in the forearm (B) Signup and view all the answers

What is the significance of a positive TB test result?

It indicates prior exposure to the tuberculosis bacterium (B) Signup and view all the answers

What is the etiologic agent responsible for tuberculosis?

Mycobacterium tuberculosis (B) Signup and view all the answers

Which organ is primarily affected by tuberculosis?

Lungs (D) Signup and view all the answers

What form of disease transmission involves aerosolization?

Airborne transmission (D) Signup and view all the answers

How long does it typically take for a cellular immune response to develop after initial infection with tuberculosis?

2-12 weeks (C) Signup and view all the answers

What term describes the isolated lesions formed in the lungs due to tuberculosis?

Tubercle (C) Signup and view all the answers

Which of the following is NOT a mode of transportation for tuberculosis?

Contaminated water (B) Signup and view all the answers

What public health status does tuberculosis hold?

Reportable disease (D) Signup and view all the answers

Which immune cells are primarily responsible for engulfing Mycobacterium tuberculosis?

Neutrophils and macrophages (B) Signup and view all the answers

Which statement correctly identifies a risk factor for pneumonia?

I am at higher risk for pneumonia because of my age and chronic lung disease. (B) Signup and view all the answers

What clinical manifestation would most likely indicate pneumonia in a patient?

Sudden onset of high fever, chills, and productive cough with purulent sputum (C) Signup and view all the answers

Which diagnostic test is primarily used to determine the extent and pattern of lung infection in pneumonia?

Chest x-ray (B) Signup and view all the answers

What is the role of sputum cultures in pneumonia diagnosis?

To identify specific pathogens causing pneumonia (D) Signup and view all the answers

What typical finding would you expect in a patient's blood test if they have pneumonia?

Elevated white blood cell count with neutrophilia (D) Signup and view all the answers

How does flu vaccination influence the risk for pneumonia?

It decreases the risk for pneumonia by preventing flu-related complications. (D) Signup and view all the answers

What might demonstrate a 'left shift' in a complete blood count for a pneumonia patient?

Increased number of immature white blood cells (B) Signup and view all the answers

What finding would least likely suggest pneumonia in a patient?

Clear lung sounds (A) Signup and view all the answers

Study Notes

Learning Outcomes

Provide safe, patient-centered, evidence-based nursing care, guided by the Caritas philosophy
Demonstrate intermediate levels of critical thinking and clinical reasoning to provide quality patient care
Relate the impact of quality improvement measures to improved patient care
Explain management of care concepts for adult patients

Concept of Infection: Pneumonia

Pneumonia is an inflammation of the lung parenchyma (bronchioles and alveoli) due to infection
Pathogens causing pneumonia include bacteria, viruses, fungi, and protozoa
Streptococcus pneumoniae is a common causative pathogen, accounting for roughly 50% of cases

Pathophysiology and Etiology

Organisms enter the lungs via inhalation, bloodstream from elsewhere, or aspiration
Pathogens colonize the alveoli
Initiates an inflammatory and immune response
Infectious debris and exudate fill alveoli
Inflammation, vascular congestion, and edema occur
Fluid accumulation and leakage
Infiltrates (dense substance like fluid or pus)
Consolidation (solidification of lung tissue)
Inflammatory response and immune response
Alveolar capillaries dilate
Fluid accumulation in alveoli
Fluid leaks into interstitial tissues
Infiltrates and lung tissue consolidation

Infectious vs. Noninfectious Etiology

Infectious etiologies include bacteria, viruses, fungi, protozoa
Noninfectious etiologies include aspiration of gastric contents, inhalation of toxic/irritating gases, and chemical injury to the GI tract

Bacterial Etiology

Bacterial pathogens circulate in the bloodstream, damaging cells in the lungs
Cellular debris and mucus block airways
Commonly results in unilateral lobar pneumonia (one lobe of lung affected)

Viral Etiology

Viruses commonly enter through the upper respiratory tract
Invade and replicate in alveoli near bronchi
Viruses burst out, killing cells and releasing debris
Rapid spread to adjacent areas, resulting in patchy distribution termed bronchopneumonia

Aspiration Etiology

Aspiration (food, emesis, gastric reflux, etc.) produces chemical injury and inflammation
Low pH of aspirated material further exacerbates inflammation
Aspiration creates an environment for bacterial invasion

Pneumonia Classifications

Community-acquired pneumonia (CAP): Infection acquired outside of healthcare facilities
Healthcare-associated pneumonia (HCAP): Acquired in the community but in individuals with underlying risk factors like long-term care facilities
Hospital-acquired pneumonia (HAP): Infection acquired after 48 hours of hospitalization
Ventilator-associated pneumonia (VAP): Infection acquired while on a ventilator

Etiology- Community-Acquired Pneumonia

Streptococcus pneumoniae: Causes about 50% of CAP cases
Individual-to-individual transmission via droplets
Aspiration of resident bacteria

Etiology- Primary Atypical Pneumonia

Mycoplasma pneumoniae: Differs in presentation from other bacterial pneumonias
Patchy inflammatory changes in alveolar septa, interstitial lung tissue; exudate and consolidation usually not found
Typically mild disease course

Etiology- Viral Pneumonia

Common organisms: Influenza and adenovirus
Usually limited to the alveolar septum and interstitial spaces
Often presents with flu-like symptoms and dry coughs
Typically mild with community-based outbreaks

Etiology- Opportunistic Pneumonia

Primarily in immunocompromised patients, like those with AIDS
Pneumocystis jiroveci is a common parasite/fungi
Causes alveoli to thicken, fill with foamy fluid, and impair gas exchange

Etiology- Aspiration Pneumonia

Aspiration of gastric contents, chemicals (like hydrocarbons)
Low pH of aspirated contents leads to severe inflammatory response, pulmonary edema
Common complications: abscesses, bronchiectasis (chronic dilation), and gangrene of lung tissue

Risk Factors for Pneumonia

Age (infants, young children, older adults)
Altered immunity (HIV/AIDS, cancer, organ transplants)
Frequent exposure to cigarette smoke
Alcohol or drug use
Impaired swallowing/cough/gag reflexes
Emergency surgeries/obstetrical procedures
Low pH of gastric contents

Diagnostic Tests

Chest X-ray
Computed tomography (CT scan)
Sputum culture
Complete blood count (CBC) with WBC differential
Pulse oximetry
Arterial blood gases (ABGs)
Bronchoscopy
Procalcitonin levels
Sepsis criteria tests to detect presence of and degree of infection

Clinical Manifestations of Pneumonia

Fever and chills
Dyspnea (shortness of breath) with crackles in lungs
Productive cough with purulent sputum
Chest pain (pleuritic - sharp and localized)
Confusion
Headache, fatigue, muscle pains, and diminished appetite
Bacteremia can spread to other tissues (meningitis, endocarditis, peritonitis)
Risks: increased mortality and septic shock/septicemia

Prevention

Identify vulnerable populations (e.g., immunocompromised, elderly, residents with long-term care facilities)
Early identification of infecting organisms
Vaccination (pneumococcal and influenza)
Preventative strategies (e.g., respiratory hygiene, smoking cessation)

Pharmacologic Therapy for Pneumonia

Antibiotics (eradicate infection based on culture findings)
Bronchodilators (reduce bronchospasm, improve ventilation)
Mucolytics (break up mucus, increase fluid intake)
Oxygen therapy (depending on hypoxia, may involve intubation or mechanical ventilation)
Antipyretics (fever reduction - acetaminophen)
Analgesics (pain relief)

Nonpharmacologic Therapy for Pneumonia

Supportive care o Airway management o Fluids (2500-3000 mL/day) o IV fluids as needed o Rest
Chest physiotherapy o Percussion o Vibration o Postural drainage

Incentive Spirometry

Used to prevent healthcare-acquired pneumonia (HAP)

Tuberculosis (TB): Overview

Chronic infectious, recurrent disease
Caused by Mycobacterium tuberculosis
Slow-growing bacilli; waxy outer capsule resists destruction
AFB (acid-fast bacilli)
Primary site of infection: lungs
Public health concern- reportable disease

Tuberculosis (TB): Classifications

Active TB: Infectious and shows clinical manifestations
Latent TB: Exposed, noninfectious, no clinical manifestations
Reactivation TB: Latent TB becoming active later in life for reasons such as age/immunosuppressive diseases/drugs

Tuberculosis (TB): Risk Factors

Immunocompromised individuals
Immigrants/foreign-born (in the U.S.)
HIV/AIDS
Homeless/overcrowded living conditions
Prison/detention facilities
Poverty (no access to healthcare, poor sanitation)

Tuberculosis (TB): Clinical Manifestations

Asymptomatic in early stages; initial infection
Fever (typically low grade)
Night sweats
Dry cough, progressing to hemoptysis (blood-tinged sputum)
Weight loss
Fatigue
Cough, pleuritic chest pain
Dyspnea (shortness of breath)

Tuberculosis (TB): Diagnostic Tests and Prevention

PPD skin tests (TST, Mantoux tests), intradermal, read 48–72 hours, measure INDURATION
Chest X-rays
Interferon-gamma release assays (IGRAs), “QuantiFERON-TB test" or "T-Spot test"
Sputum cultures (time-consuming, required multiple specimens 8–24 hours apart)

Collaboration and Prevention Precautions

TB Transmission reduction through measures like sunlight/ultraviolet light, family education, masks, patient isolation and N95 masks
Medications for TB (isoniazid, rifampin, ethambutol, pyrazinamide) for both latent and active TB
Active TB: first 2 months with combination of four medications, additional 4-6 months with two medications
Latent TB: 6-9 months with isoniazid

Collaboration: Infectious No Longer Considered Infectious

Clinical improvement demonstrated
On medications for at least two weeks
Three (3) consecutive AFB smears that are negative

Additional Resources

CDC website: https://www.cdc.gov/tb/ (comprehensive disease overview and treatment protocols)
Ohio Department of Health website

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Description

Test your knowledge on pneumonia with this quiz designed for health students. Explore key concepts about pathogens, symptoms, complications, and treatments related to pneumonia. Ideal for nursing students and healthcare professionals.