Medical lecture

1. 1
SIR ALI MUSHTAQ
BS EMERGENCY & ICU (GULAB DEVI)
LECTURER
AVICENNA MEDICAL COLLEGE LAHORE

2. ⦿ Pneumonia is an inflammation of the
lungparenchyma(i.e.alveoliratherthanthebronchi)
ofinfectiveorigin.

3. ⦿Itisusuallycharacterizedbyconsolidation.
⦿Consolidationisapathologicalprocessinwhichthealveol
i are filled with a mixture of
inflammatoryexudate,bacteria&WBC
Pneumonia 12/12/2011 3
⦿Itisthemostcommoninfectiouscauseofdeath.

4. ◾ Occursthroughouttheyear
◾ Resultsfromdifferentetiologicala
gentsvaryingwith theseasons
◾ Occursinpersonsofallages
◾ Clinicalmanifestationssevereinveryy
oung, elderly & in chronically
illpatients
Pneumonia 12/12/2011 4

5.  Bacteria:Streptococcuspneumoniae,Legionellapneum
ophila,Chlamydophilapneumoniae,Staphylococcusaur
eus,Moraxellacatarrhalis,Streptococcuspyogenes,Neis
seriameningitidis,Klebsiella pneumoniae, and
Haemophilus influenzae ,Pneumocystisjiroveci.
 Viruses:Influenzavirus,Adenoviruses,Rhinovirus
 Otherinfectiousagents,such asfungi :Pneumocystis
carini

6. RISK
FACTORS

7. Classifiedbasedontwotypes
2. Type2
⦿ Community-acquiredpneumonia(CAP)
⦿ Hospital-acquiredpneumonia(HAP)
1.
⦿
⦿
Pneumonia 12/12/2011 7
Type1
Lobar
pneumoniaBroncho
pneumonia

8. ⦿Lobarpneumoniaisacutebacterialinfectionofapar
t of lobe the entire lobe, or even two lobes
ofoneorboththelungs.
Pneumonia 12/12/2011 8

9. ⦿
Bronchopneumoniaisinfectionoftheterminalbron
chioles that extends into the surroundingalveoli
resulting in patchy consolidation of thelung.
Pneumonia 12/12/2011 9

11. (BronchitisandPneumoniaoccurtogether)

12. ⦿Itincludes4stages
1. congestion
2. redhepatization
3. grayhepatization
4. resolution

13. ⦿ After the pneumococcus organism
reachesthe alveoli, there is an outpouring
of fluidsintoalveoli.
⦿Theorganismmultipliesintheserousfluidandi
nfectionspreads

14. ⦿Themassivedialationofthecapillariesandalveo
li that are filled with this
organism,neutrophils,RBC,andfibrin.
⦿Thelungappearsredandgranular,similartothat
of liver which is why the process
iscalledhepatization.

15. ⦿Bloodflowdecreasesandleukocytesandfibr
in consolidate in the affected part
oflung.

16. ⦿Completeresolutionandhealingoccursifthereisn
ocomplications.
⦿Theexudatesbecomelysedandisprocessedbym
acrophages.
⦿Thenormallungtissueisrestoredandthepersons
gas exchange ability returns tonormal.

17.  Highfever,ShakingChills
 Shortnessofbreath(Dyspnoea)
 Increasedbreathing rate
 Chestpainwhen youbreathedeeplyorcough
 Dusky or purplish skin colour (cyanosis) from
poorlyoxygenatedblood
 Fatigueandmuscleaches
 Nausea, vomitingordiarrhoea
 Cough,particularlycoughproductiveofsputum

18. Consolidation
confined
tooneormor
elobes(orse
gments
oflobes)oflu
ngs.
Lobarpneumonia
12/12/2011
Pneumonia 18

19. •Patchyconso
lidationusuall
y in thebases
of bothlungs.
Bronchopneumonia
Pneumonia 12/12/2011 19

20. Pneumoniawhichdevelopsinanotherwisehealthy
personoutsideofhospitalorhavebeeninhospitalfor
lessthan48hrs
Pneumonia 12/12/2011 20

21. Pneumoniathatwasnotincubatinguponadmission
developinginapatienthospitalizedforgreaterthan4
8hrs.
Pneumonia 12/12/2011 21

22.  Bacteriainthebloodstream(bacteremia)
 Lungabscess.
 Build up of fluid in the space between the lung
andchest wall (pleuraleffusion).
 Difficultybreathing.
 Shockandrespiratoryfailure
 Septicarthritis
 Endocarditis

23.  Don'tsmoke.
 Practicegoodhygiene.
 Stayrestedandfit.
 Wearingsurgicalmasksbythesickmayalsopreventillness.
 Appropriately treating underlying illnesses (such as
HIV/AIDS,diabetes mellitus, and malnutrition) can decrease
the risk ofpneumonia.
 GetaPneumoniaVaccination.

24.  Pneumococcalconjugatevaccine(Prevnar):
Forchildrenlessthan2yearsofageorbetweentwoandfo
uryearswith certainmedicalconditions.
 Pneumococcal polysaccharide
vaccine(Pneumovax):
Adultswhoareatincreasedriskofdevelopingpneumoco
ccalpneumonia,suchastheelderly,diabetics, those
with chronic heart, lung, or
kidneydisease,alcoholics,smokers,andthosewithoutas
pleen.

25. Anemia
R/tdisease
progression
AnxietyR
/tDiseas
econditio
n
Impaired
gasexchange
R/tDiseaseproc
ess
Ineffectiveair
wayclearance
&chancesofE.
TTubeBlockag
e
SelfcaredeficitR
/t
Diseaseconditio
n andBed-
riddenStatus
ImpairedN
utritionals
tatus
R/tdisease
condition
RiskofinfectionR/tdi
sease
process,Invasive
lines
andLowTC,Hblevel