Tumours, Pneumonia, Atelectasis

Question 1

2 main causes of lung cancer

Answer 1

Smoking

Environmental exposures

Question 2

2 types of lung cancer

Answer 2

Small cell

Non-small cell

Question 3

Where does small cell lung cancer develop? how does it spread? common?

Answer 3

• develops in bronchial cell mucosa
• Spread rapidly: metastasizes early

20-25%

Question 4

3 types of non-small cell lung cancer

Answer 4

Squamous cell
Adenocarcinoma
Large cell

Question 5

Where does squamous cell lung cancer develop? how does it spread?

Answer 5

In central portion near hilum

Spread slow, metastasizes late

Question 6

Where does adenocarcinoma lung spread? How common?

Answer 6

slow to mod spread, early mets t/o lungs, brain, organs

35-40%

Question 7

Where does large cell lung cancer spread? prognosis?

Answer 7

rapid spread, wide spread mets, kidney, liver, adrenals,

poor prognosis

Question 8

PT management of lung cancer?

Answer 8

Manage fatigue

Question 9

_____ is the #2 cause of death for brain conditions (stroke #1)

Answer 9

Brain tumours

Question 10

What is the survival rate of brain tumours

Answer 10

50% chance of survival, significant cause of death in kids (intra-tentorial)

Question 11

4 types of brain tumour

Answer 11

Intracerebral primary
Intracerebral metastatic
Medulloblastomas
Neuromas

Question 12

Key feature of intrecerebral primary brain tumours

Answer 12

Tumour neurons don’t proliferate - (other cells (glia) around proliferate)

Question 13

What do intracerebral metastatic tumours come from

Answer 13

lung
breast
prostate

Question 14

How does the body compensate for o Intracerebral Metastatic tumours

Answer 14

• compensate by decreased brain tissue volume, CSF volume + blood flow volume

Question 15

What is the key feature of medulloblastomas

Answer 15

Frequently metastasize to other areas in brain/spine

Question 16

Brain tumours S&S

Answer 16

• nerve root pain, worse at night, pain with cough, radicular pain
• headache and seizure, nausea, vomit, cognition and behavior

Question 17

Brain tumour Rx

Answer 17

Surgery or radiation

Question 18

What is pneumonia

Answer 18

inflammation of parenchyma of lungs (lung tissue) with development of intra-alveolar exudate

Question 19

Pneumonia Causes o

Answer 19

• bacterial, viral or fungal (NORMALLY – airborne pathogens)
• inhalation of toxic chemicals (smoke, dust, gas)
• aspiration (ie. of stomach contents, vomit contains bacteria)
  - impaired consciousness : intoxication, after surgery, neuro disease, drowning

Question 20

Pneumonia types

Answer 20

Typical

Atypical (walking pneumonia)

Question 21

What are the features of typical pneumonia

Answer 21

• Sudden onset of symptoms: usually bacterial cause

- Fever, sputum, physical consolidation signs

Question 22

What are the features of atypical pneumonia

Answer 22

No symptoms, little sputum, minimal chest signs

Question 23

Pneumonia S&S

Answer 23

• Most preceded by upper rep infection then Sudden + sharp chest pain
• productive cough - green sputum
• tachypnea (increased rate of breathing)
• SOB

Question 24

Pneumonia Rx

Answer 24

• antibacterials/antibiotics
• airway clearance techniques
• antifungals (if fungal infection)
• oxygen support

Question 25

Does hospital acquired (nosocomial) or community acquired pneumonia have a higher mortality rate

Answer 25

Hospital

Question 26

What is atelectasis

Answer 26

Collapse of normally expanded & aerated lung tissue, may involve all or part of the lung

Question 27

Atelectasis mechanisms

Answer 27

• blockage of bronchus/bronchiole
• lung is prevented from expanding due to: paralysis, diaphragmatic disorders, mucous or airway obstruction, hypoventilation
• compression external force or pressure that prevents alveoli from expanding - pneumothorax, pleural effusion, space-occupying lesion (tumor)
• post-anesthetic: effects of anesthesia and prolonged recumbency

Question 28

Atelectasis S&S

Answer 28

• CXR - shifting of lung structures toward collapse - if entire lob may show shadow on chest xray
• Quiet breath sounds
• Dyspnea
• Tachypnea
• Cyanosis - low O2 saturation - skin’s blue

Question 29

Atelectasis Rx

Answer 29

• identify underlying cause
• suctioning if due to secretions
• chest tube if due to pneumo/hemo thorax or extensive pleural effusion