Respiratory I

1.

1 point

Infections occurring 48-72 hours or more after admission are considered hospital-acquired.

5-10% Hospital Admissions (most common death among ICU/CC patients)

Most commonly due to enteric gram-negative bacteria (E coli; P. aeruginsoa)

Second most common nosocomial infection (UTI is the common cause)

Mortality near 70% in patients with HAP (elderly & immune compromised patients)

Hospital-Acquired Pneumonias (HAP)

Typical Pneumonia

Community-Acquired Pneumonias (CAP)

Atypical Pneumonia

2.

1 point

Ventilation & Perfusion: Shunt

Perfusion without ventilation

Normal matching of ventilation & perfusion

Ventilation without perfusion

3.

1 point

Acute inflammation and consolidation (solidification) of the lung.

Sudden onset of HIGH-GRADE fever and chills.

Productive cough, purulent sputum

Signs of consolidation in the lungs on physical examination (dull percussion, increased tactile fremitus, crackles) and x-ray.

Community -Acquired Pneumonias

Hospital-Acquired Pneumonia

Typical Pneumonia

Atypical Pneumonia

4.

1 point

Elastic Recoil is:

Stretch in a change in volume relative to an applied change in pressure (ability to stretch and expand).

Increase in compliance, ease in lung inflation.

Elastic force of the lung tissue (elastin & collagen), elastic force caused by surface tension (surfactants).

5.

1 point

Residual Volume (RV) (1200ML)

Max of air that can be forcefully inhaled during inspiration.

Volume of air remaining in the lungs after maximum expiration.

Amount of air that moves into and out of the lungs with each breath.

6.

1 point

Pseudomonas Aeruginosa

Commonly associated with alcoholism & elderly; Most common Pneumonia in Nursing Homes

Most common bacterial cause of Pneumonia

Water-loving bugs, spread via water cooler

Water-loving gram-negative rods transmitted by respirators or water coolers; Most common in nosocomial pneumonia and pneumonia in cystic Fibrosis and ICU/CCU patients.

7.

1 point

Klebsiella Pneumoniae (gram-negative rod)

Commonly associated with alcoholism & elderly; Most common Pneumonia in Nursing Homes

Water-loving gram-negative rods transmitted by respirators or water coolers; Most common in nosocomial pneumonia and pneumonia in cystic Fibrosis and ICU/CCU patients.

Water-loving bugs, spread via water cooler

Most common bacterial cause of Pneumonia

8.

1 point

Ventilation & Perfusion: Dead Air Space

Ventilation without perfusion

Normal matching of ventilation & perfusion

Perfusion without ventilation

9.

1 point

Oxygen-Hemoglobin Dissociated Curve Right-Shift

The oxyhemoglobin dissociation curve is an important tool for understanding how our blood carries and releases oxygen.

Increased unloading O2; Easier for tissues to extract O2.

Decreased unloading O2; More difficult for tissues to extract O2.

10.

1 point

Most common cause of Atypical pneumonia in adolescents & young adults

Positive cold agglutinin Test (antibodies against RBC)

Influenza Virus

Cytomegalovirus (CMV)

Respiratory Syncytial Virus (RSV)

Myocoplasma Pneumoniae

Pneumocyctic Carinii Pneumonia

11.

1 point

A disease in which individuals who have not recently been hospitalized develop an infection of the lungs (pneumonia).

Most common due to Streptococcus Pneumoniae in adults

Most common in newborns, Streptococcus Agalactiae (Group B Streptococcus)

Mycoplasma Pneumoniae (walking PNA) is common in children & teenagers

Typical Pneumonia

Atypical Pneumonia

Community-Acquired Pneumonias (CAP)

Hospital-Acquired Pneumonias (HAP)

12.

1 point

Legionella Pneumophilia

Water-loving gram-negative rods transmitted by respirators or water coolers; Most common in nosocomial pneumonia and pneumonia in cystic Fibrosis and ICU/CCU patients.

Most common bacterial cause of Pneumonia

Water-loving bugs, spread via water cooler

Commonly associated with alcoholism & elderly; Most common Pneumonia in Nursing Homes

13.

1 point

Pulmonary Compliance is increased in:

COPD/Emphysema

Pulmonary Fibrosis

Asthma

14.

1 point

Is the most common opportunist infection in AIDS patients

CMV

Myocoplasma Pneumoniae

Pneumocyctic Carinii Pneumonia

15.

1 point

Pulmonary compliance is decreased in:

Pulmonary Fibrosis (scarring of lungs)

Asthma

COPD/Emphysema

ARDS

16.

1 point

Forced Expiratory Volume (FEV1) (8o%)

The total amount of air inhaled

The total amount of air exhaled

FEV1 is the maximal amount of air you can forcefully exhale in one second. measures how much air a person can exhale (forced breath)

17.

1 point

The most common cause of PNA & bronchiolitis in INFANTS & CHILDREN in winter months.

Respiratory Syncytial Virus (RSV)

Pneumocyctic Carinii Pneumonia

Cytomegalovirus (CMV)

Myocoplasma Pneumoniae

Influenza Virus

18.

1 point

Most common in immunosuppressed patients (cancer)

Cytomegalovirus (CMV)

Myocoplasma Pneumoniae

Pneumocyctic Carinii Pneumonia

Mycoplasma Pneumoniae

19.

1 point

Oxygen-Hemoglobin Dissociation Curve (Left-Shift)

The oxyhemoglobin dissociation curve is an important tool for understanding how our blood carries and releases oxygen.

Decreased unloading O2; More difficult for tissues to extract O2.

Increased unloading O2; Easier for tissues to extract O2.

20.

1 point

Total Lung Capacity (TLC) (6000ML):

Amount of air that moves into and out of the lungs with each breath.

Volume of air remaining in the lungs after maximum expiration.

Total amount of air that the lungs can hold.

21.

1 point

Forced Vital Capacity:

The total amount of air inhaled

The max amount of air that can be rapidly & forcefully exhaled from lungs after full inspiration.

FEV1 is the maximal amount of air you can forcefully exhale in one second. measures how much air a person can exhale (forced breath)

The total amount of air exhaled

22.

1 point

FEV1/FVC ratio, also called Tiffeneau-Pinelli:

The maximum amount of air that can be breathed in a given time

It represents the proportion of a person's vital capacity that they are able to expire in the first second of expiration.

Maximum amount of air that can be rapidly and forcefully be exhaled from lungs after full inspiration.

23.

1 point

Interstitial Pneumonia without consolidation, caused by certain bacteria, viruses, fungi.

Insidious onset, LOW GRADE fever

Non-productive cough; flu-like symptoms

No signs of consolidation

CXR with interstitial, patchy infiltrates.

Mycoplasma Pneumoniae (walking PNA) is the most common

Hospital-Acquired Pneumonia

Atypical Pneumonia

Community-Acquired Pneumonia

Typical Pneumonia

24.

1 point

Often complicated by secondary bacterial infection (S Aureas most commonly)

Reyes Syndrome: Viral Illness (influenza/varicella) + Aspirin with children

Encephalopathy and fatal liver damage.

Cytomegalovirus (CMV)

Influenza Virus

Pneumocyctic Carinii Pneumonia

Myocoplasma Pneumoniae

25.

1 point

Pulmonary Compliance is:
(It's determined by elastic recoil of the lungs)

Air drawn into the lungs

stretch in a change in volume relative to an applied change in pressure (ability to stretch and expand).

Elastic force of the lung tissue (elastin & collagen), elastic force caused by surface tension (surfactants).

Increase in compliance, ease in lung inflation.

26.

1 point

Steptococcus Pneumoniae (gram-positive diplococcus)

Most commonly associated with alcoholism and elderly; Most common Pneumonia in nursing homes.

Most common bacterial cause of Pneumonia

Water-loving gram-negative rods transmitted by respirators or water coolers; Most common in nosocomial pneumonia and pneumonia in cystic Fibrosis and ICU/CCU patients.

Water-loving bugs, spread via water cooler