Critical Thinking questions: 1. A traveler, in excellent physical condition, is

Question

Critical Thinking questions:

1.   A traveler, in excellent physical condition, is takin a trip to Andes Mountain in South America. Once climbing up to the high, she fined herself breathing rapidly. What happen to her and why? Explain.

2.   Upon placement of endotracheal tube (ET) into anaesthetized patient, the resident noticed that the air sounds were coming from epigastric region rather than from the lungs. What went wrong?

3.   What is the difference between pneumonia and pneumonitis?

4.   What is bronchogenic carcinoma? Provide detailed explanation.

Explanation / Answer

1)This situation is called as Altitude sickness.

Altitude sickness (sometimes termed mountain sickness) is an illness due to the decreasing the amount of oxygen at above sea level altitudes ranging usually about 4800 ft or 1500 m that may range from a mild headache and weariness to a life-threatening build-up of fluid in the lungs or brain, and even fatality at moderate to high altitudes.

Symptoms of altitude sickness that are not life threatening are called acute mountain sickness. Mountain climbers on any high mountain and skiers in high-altitude locations such as South America are at risk of developing acute mountain sickness. Symptoms from acute mountain sickness improve if you descend to lower altitude quickly. For very mild symptoms, a delay before further climbing may be enough to allow symptoms to go away.

2)The worst possible outcome of attempted endotracheal intubation is unrecognized esophageal intubation. The tube placement is confirmed by listening for air entry over both lung fields and over the epigastrium. If air entry or a "gurgling" sound is heard over the epigastrium, or there is an absence of air entry over the lung fields, the rescuer should immediately remove the ET tube and resume bag-valve-ventilation.

3)Pneumonitis (noo-moe-NIE-tis) is a general term that refers to inflammation of lung tissue. Technically, pneumonia is a type of pneumonitis because the infection causes inflammation.Pneumonitis, however, is usually used by doctors to refer to noninfectious causes of lung inflammation.

Difference between pneumonia and pneumonitis

Pneumonia   

Pneumonitis

Causes

Bacteria, fungus, viruses

·        Aspiration of gastric acid or vomit

·        Inhalation of toxic gases, dust, or molds

·        Adverse reaction to drugs

·        Complication of autoimmune diseases such as systemic lupus erythematosus (SLE)

Affected lung part

Alveoli or interstitium

Alveoli or interstitium

Is it contagious?

Yes

No

Who can get it?

Anyone, but especially infants, elderly, and those with weak immune system

Persons who vomit during alcohol intoxication, farmers sensitive to dust and molds, workers in chemical or textile industry, individuals with low immunity or autoimmune diseases

Symptoms

Coughing up sputum, shortness of breath, fever (or no sputum or fever)

Shortness of breath, dry cough (occasionally, low-grade fever)

Symptom duration

A week to few months

Few hours to few days (months or even lifelong if it becomes chronic)

Diagnosis

X-ray, blood and sputum culture

CT, lung biopsy

Treatment

Antibiotics, antivirals, antifungals, oxygen

Steroids, oxygen

Prevention

Avoid contact with infected persons

Avoid dust and mold, or wear a protective mask

4)Bronchogenic carcinoma is a malignant neoplasm of the lung arising from the epithelium of the bronchus or bronchiole. Pathology.Bronchogenic carcinomas begin as a small focus of atypical epithelial cells within the bronchial mucosa.

Definition
Bronchogenic carcinoma is a malignant neoplasm of the lung arising from the epithelium of the bronchus or bronchiole.

Pathology
Bronchogenic carcinomas begin as a small focus of atypical epithelial cells within the bronchial mucosa. As the lesion progresses, the atypia becomes frankly malignant and the neoplasm grows in size. The neoplasm may grow into the bronchial lumen, along the mucosa or into the?bronchial wall and adjacent lung parenchyma. Eventually the neoplasm spreads to regional lymph nodes and distant organs such as the liver, brain and bone. Most bronchogenic carcinomas form a mass in or near the?hilus. Some neoplasms, especially the adenocarcinomas, form a mass in the periphery of the lung. The following classification scheme represents the major histologic types of bronchogenic carcinoma.

Pathophysiology

Pneumonia   

Pneumonitis

Causes

Bacteria, fungus, viruses

·        Aspiration of gastric acid or vomit

·        Inhalation of toxic gases, dust, or molds

·        Adverse reaction to drugs

·        Complication of autoimmune diseases such as systemic lupus erythematosus (SLE)

Affected lung part

Alveoli or interstitium

Alveoli or interstitium

Is it contagious?

Yes

No

Who can get it?

Anyone, but especially infants, elderly, and those with weak immune system

Persons who vomit during alcohol intoxication, farmers sensitive to dust and molds, workers in chemical or textile industry, individuals with low immunity or autoimmune diseases

Symptoms

Coughing up sputum, shortness of breath, fever (or no sputum or fever)

Shortness of breath, dry cough (occasionally, low-grade fever)

Symptom duration

A week to few months

Few hours to few days (months or even lifelong if it becomes chronic)

Diagnosis

X-ray, blood and sputum culture

CT, lung biopsy

Treatment

Antibiotics, antivirals, antifungals, oxygen

Steroids, oxygen

Prevention

Avoid contact with infected persons

Avoid dust and mold, or wear a protective mask

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