Practical task that should be performed during practical training

1. Revealing and assessment of symptoms and signs of focal and lobar pneumonias

2. Revealing and assessment of symptoms and signs of pleurisies

3. Revealing and assessment of symptoms and signs of lung cancer

4. Revealing and assessment of symptoms and signs of pneumosclerosis

5. Assessment of the pleural fluid analysis

Topic content

Pneumoniais aninfection of lung parenchyma, which leads to inflammation and exudates filling air spaces with fluid (consolidation). This leads to reduced lung compliance and ventilation-perfusion mismatch or shunt, which results in decreased oxygenation.

Classification:

Community-acquired pneumonia (CAP) acquired outside the hospital; common in nonimmuno-compromised individuals, may be primary or secondary to underlying disease.

Hospital-acquired pneumonia develops after 48-72 hours after hospital admission and is not apparent at admission.

Aspiration pneumonia follows the aspiration of exogenous material or endogenous secretions into the lower respiratory tract. Can be in patients with stroke, myasthenia, bulbar palsies, diminished consciousness (post-ictal, drunk), oesophageal disease (achalasia, reflux), or with poor dental hygiene, risk aspirating oropharyngeal anaerobes.

Pneumonia at immunocompromised patients (AIDS, prolonged systemic corticosteroids and other immunosuppressive therapy)

Causes of CAP:

S. pneumoniae, M. pneumoniae, C. pneumoniae, H. influenzae, S. aureus, Legionella spp., M. catarrhalis, Gram-negative bacilli and Viruses.

Clinical features of lobar CAP

Breathlessness occurs due to large injury of lung that results to diminution of it function and changing of gas content of blood.
Chest pain happens due to involving of pleura in inflammatory process.
Cough can be dry or with purulent bloody sputum. It is depended from stage or form of disease.
Fever, rigors, malaise, anorexia

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