Download Document

Essentials of Human Diseases
and Conditions
4th edition
Seminar 5
Dr. Lena Watson, RN, MBA/HCM
Learning Objectives



Trace the process of normal digestion and
absorption.
Discuss the importance of normal teeth and a
normal bite.
Discuss conditions of esophagus, stomach
and intestines , and mouth.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
1
Learning Objectives (cont’d.)



Explain the diagnostic criteria for celiac
disease.
List some ways one can lower the risk of food
poisoning.
Distinguish between the clinical picture of the
patient with anorexia and that of the patient
with bulimia.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
2
Learning Objectives



Discuss the causes and medical treatment for
(a) the common cold, (b) sinusitis, and (c)
pharyngitis, pulmonary abcess, and nasal
polyps
Discuss the prognosis of cancer of the larynx.
Discuss the prognosis and treatment of lung
and digestive tract cancers.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
3
The Oral Cavity and Jaw (cont’d.)
Diseases and Conditions


Malocclusion: specific angles of malposition and
contact of the maxillary and mandibular teeth
Temporomandibular joint (TMJ) syndrome:
a symptom complex related to inflammation,
disease, or dysfunction of the temporomandibular
joint
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
4
The Oral Cavity and Jaw (cont’d.)
Diseases and Conditions


Herpes simplex (cold sores): a recurrent viral
infection that affects the skin and mucous
membranes.
Thrush: candidiasis of the oral mucosa, involving
the mouth, tongue, palate, and gums.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
5
Clicker Question





Gingivitis that is not treated may lead to:
a. plaque.
b. periodontitis.
c. discoloration of the teeth.
d. impacted molars.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
6
Oral Cancer






Appears as white patchy lesion or oral ulcer that
won’t heal
Pain occurs late in disease
Lip is most common site
Alcohol and smoking is multiplicative
Treatment depends on stage
Because of late diagnosis overall survival rate is
about 51%
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
7
Clicker Question





Oral thrush, a fungal infection that produces
sore patches in the mouth and throat, may be
the result of:
a.leukoplakia.
b. plaque.
c. prolonged antibiotic therapy.
d. all of the above.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
8
Digestive Distress Signals





Hiccup
Indigestion
Heartburn
Nausea
Vomiting





Colic
Flatulence
Diarrhea
Constipation
Fecal incontinence
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
9
Diseases of the
Gastrointestinal Tract
Esophageal varices: are dilated submucosal
veins that develop in patients with underlying
portal hypertension and may result in serious
upper gastrointestinal bleeding.
Esophagitis: inflammation and tissue injury of the
esophagus
Esophageal cancer: cancer of the esophagus
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
10
Diseases of the
Gastrointestinal Tract (cont’d.)
Gastroesophageal reflux disease (GERD):
the clinical manifestations of regurgitation of
stomach and duodenal contents into the
esophagus
Barrett’s esophagus: severe consequence of
GERD that replaces normal striated
squamous epithelium of the distal esophagus
with abnormal columnar epithelium
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
11
Diseases of the
Gastrointestinal Tract (cont’d.)
Peptic ulcers: sores or lesions in the mucous
membrane of the stomach or upper intestinal
tract
Duodenal ulcers: ulcers of the first part of the
small intestine
Gastric ulcers: ulceration of the gastric
mucosa of the stomach that follows chronic
gastritis
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
12
Acute Appendicitis



Inflammation of the appendix
Symptoms: begins with vague abdominal
discomfort that localizes as pain in right lower
quadrant of abdomen; nausea; vomiting;
fever; diarrhea or constipation
Treatment: surgical removal
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
13
Diseases of the
Gastrointestinal Tract (cont’d.)
Hiatal hernia: a defect in the diaphragm that
permits segment of stomach to slide into
thoracic cavity
 Symptoms: heartburn, chest pain, swallowing
difficulty; some cases asymptomatic
Abdominal hernia: a condition in which an
organ protrudes through an abnormal
opening in the abdominal wall
 Symptoms: lump or bulge; groin pain
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
14
Clicker Question





Abdominal discomfort with maximum
tenderness of the abdomen at McBurney’s
point, nausea, vomiting, fever, diarrhea, or
constipation, are clinical signs of:
a. hiatal hernia.
b. gastric cancer.
c. gastritis.
d. appendicitis.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
15
Diseases of the
Gastrointestinal Tract (cont’d.)
Crohn disease (ileitis): chronic inflammatory
disorder of the gastrointestinal tract
Ulcerative colitis: chronic inflammatory bowel
disease affecting the mucosa and submucosa
of the rectum and colon
Gastroenteritis: acute inflammation of the
stomach and intestines
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
16
Diverticular Conditions


Diverticulosis: outpouches (diverticula) of mucosa
penetrate weak points in muscular layer of large
intestine
Symptoms: mild discomfort, irregular bowels; may be
asymptomatic
Diverticulitis: trapped fecal matter causes
inflammation of diverticula
Symptoms: fever, nausea, pain, changes in bowel
function
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
17
Diseases of the
Gastrointestinal Tract (cont’d.)
Colorectal cancer: a cancer that arises in any
part of the colon or rectum
 Symptoms: abdominal pain, change in bowel
habits, bloody stools, weight loss, weakness,
rectal bleeding, iron deficiency anemia
 Serum level of tumor marker CEA is used to
plan treatment and assess prognosis
 Treatment options: surgical resection;
colostomy; chemotherapy; radiation
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
18
Diseases of the
Gastrointestinal Tract (cont’d.)
Peritonitis: inflammation of the peritoneum that
can be acute or chronic, local or generalized
 Symptoms: abdominal pain, nausea,
vomiting, weakness, sweating, fever,
distended abdomen, paralytic ileus
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
19
Diseases of the Liver, Biliary Tract, and
Pancreas
Cirrhosis of the liver: an irreversible chronic
degenerative disease that results in the
replacement of normal liver cells with hard,
fibrous scar tissue
 Symptoms: loss of appetite and weight,
nausea, vomiting, indigestion, abdominal
distention, edema, easier bleeding and
bruising, jaundice, pruritis, spider nevi
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
20
Diseases of the Liver, Biliary Tract, and
Pancreas (cont’d.)
Viral hepatitis



Hepatitis A: highly contagious condition caused
by the hepatitis A virus (HAV) causing mild, acute
liver infection.
Hepatitis B: inflammation of the liver caused by
the hepatitis B virus (HBV).
Hepatitis C: chronic condition caused by the
hepatitis C virus (HCV) resulting in gradual,
insidious liver disease.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
21
Cancer of the Liver
Hepatocellular carcinoma: primary tumor of
the liver; usually arises in chronic liver
disease setting
 Symptoms: same as liver disease–upper
abdominal pain, weight loss, early satiety,
palpable abdominal mass, ascites,
hepatomegaly splenomegaly, jaundice
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
22
Clicker Question

Health care workers exposed to body fluids
are a risk for hepatitis B.

A) True

B) False
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
23
Diseases of the Liver, Biliary Tract, and
Pancreas (cont’d.)
Cholelithiasis (gallstones): condition in which
there is abnormal presence of calculi that
form in the bile.
Pancreatitis: acute or chronic inflammation of
the pancreas with variable involvement of
adjacent or remote organs.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
24
Pancreatitis



Symptoms: sudden onset of severe
abdominal pain radiating to the back, nausea,
and vomiting
Causes: alcoholism, biliary disease,
gallstones
Treatment: Acute pancreatitis may require
emergency treatment of intravenous fluid and
electrolyte replacement
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
25
Diseases of the Liver, Biliary Tract, and
Pancreas (cont’d.)

Pancreatic cancer: A neoplasm, usually an
adenocarcinoma, that occurs more often in the
head of the pancreas.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
26
Pancreatic Cancer



Symptoms: abdominal pain, weight loss, or
jaundice
Causes: cigarette smoking, obesity, family
history of pancreatitis or diabetes
Treatment: surgical resection
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
27
Diseases of Nutrient
Intake and Absorption
Malnutrition: a disorder of nutrition caused by
primary deprivation of protein energy or
secondary to deficiency diseases
Malabsorption syndrome: a group of
disorders in which intestinal absorption of
dietary nutrients is impaired
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
28
Malnutrition



Symptoms: decreased or increased appetite;
emaciation or obesity; loss of energy;
diarrhea
Causes: deprivation of protein energy from
eating disorders, chronic illnesses, etc.
Treatment: nutritional supplements, oral and
intravenous feeding
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
29
Clicker Question
Cancer of the liver is typically:
 a. usually a primary cancer.
 b. usually a secondary cancer.
 c. likely to have a good prognosis.
 d. likely to be discovered early.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
30
Malabsorption Syndrome



Symptoms: impaired digestion, inability to
absorb fat or other components of diet
Causes: defective mucosal cells in the
small intestine
Treatment: high-protein, high-calorie diet
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
31
Diseases of Nutrient
Intake and Absorption (cont’d.)
Celiac disease (gluten enteropathy): a
disease of the small intestine characterized
by malabsorption, gluten intolerance, and
damage to the lining of the intestine
The disease has multisystem effects
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
32
Clicker Question





Signs and symptoms of malnutrition can
result from
a. eating too much or too little.
b. a malabsorption syndrome.
c. a case involving severe burns or other
severe trauma.
d. all of the above.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
33
Celiac Disease



Symptoms: weight loss, anorexia, diarrhea,
flatulence, abdominal distention
Causes: toxic or immunologic reaction to
component of gluten (found in wheat, barley,
and oats)
Treatment: gluten-free diet; if no
improvement, corticosteroid drugs
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
34
Diseases of Nutrient
Intake and Absorption (cont’d.)

Food poisoning: an illness resulting from the
ingestion of foods that contain bacterial or toxic
substances
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
35
Food Poisoning



Symptoms: sudden nausea, vomiting, and
diarrhea
Causes: poisoning from mushrooms,
shellfish, contaminated foods
Treatment: nutritional support and fluid
replacements
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
36
Eating Disorders
Anorexia nervosa: psychological disturbance
in which self-imposed starvation and
compulsion to be thin leads to denial of
hunger
Bulimia: behavioral disorder characterized by
recurring episodes of binge eating followed
by self-induced vomiting or purging
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
37
Clicker Question



The symptoms of food poisoning are due to
the pathogens themselves or to the toxins
they produce.
A) True
B) False
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
38
Chapter 9
RESPIRATORY SYSTEM
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
39
Diseases of the Respiratory System
Causes:
 Infection
 Circulatory disorders
 Tumors
 Trauma
 Immune diseases
 Inflammatory
disturbances



Congenital defects
Central nervous system
damage or diseases
Environmental
conditions
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
40
Upper Respiratory Tract Infections

Common cold: acute inflammatory process
that affects the mucous membrane that lines
the upper respiratory tract

Sinusitis: acute or chronic inflammation of
the mucous membranes of the paranasal
sinuses
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
41
Clicker Question





The common cold is a group of minor
illnesses caused by
a. fungi.
b. bacteria.
c. almost 200 viruses or from mycoplasma.
d. all of the above.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
42
Upper Respiratory Tract Infections (cont'd.)


Pharyngitis: acute or chronic infection of the
pharynx
Laryngitis: inflammation of the larynx,
including the vocal cords
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
43
Epistaxis (nosebleed)
First aid:



Mild hemorrhage - controlled by applying direct,
constant pressure on either side of nose for 5 to
10 minutes
Persistent bleeding - treated with local application
of epinephrine followed by cauterization or nasal
packing
Severe - surgical ligation of bleeding artery
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
44
Nasal Disorders


Deviated septum: crooked nasal septum
(cartilage partition between the nostrils)
Nasal polyps: benign growths that form as
consequence of distended mucous
membranes protruding into the nasal cavity
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
45
Nasal Polyps
Nasal Polyps - benign growths that form as a
consequence of distended mucous
membranes protruding into nasal cavity
Causes:


overproduction of fluid in the cells of the mucous
membrane,
often the result of allergic rhinitis
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
46
Clicker Question





Causes of epistaxis are:
a. direct trauma or foreign body.
b. hypertension or other systemic disorders.
c. hemophilia and leukemia.
d. all of the above.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
47
Disorders of the Larynx



Tumors of the larynx: benign or malignant
growths on the larynx
Laryngeal cancer: neoplasm of the larynx
The larynx is the most common site for head
and neck tumors
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
48
Atelectasis
Atelectasis (collapsed lung): airless or
collapsed state of the pulmonary tissue
 Caused by an obstruction in bronchial tree;
may be mucous plug, foreign object, or
bronchogenic cancer
 Complication – pneumonia
 Risk factors: obesity, upper abdominal or
chest surgery, neuromuscular weakness or
any pulmonary disease
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
49
Pulmonary Disorders


Pulmonary embolism: occurs when a blood
clot or other material, such as a foreign body
or tumor, lodges in and blocks an artery in the
pulmonary circulation
Pneumonia: inflammation of the lungs due to
infection
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
50
Pulmonary Embolism

Occurs when embolism is lodged in artery
and interrupts blood supply



Uncomplicated embolism - cough, chest pain, lowgrade fever and apprehension
More extensive - dyspnea, tachypnea (at least 20
breaths/minute), chest pain, occasional
hemoptysis
Massive embolism - sudden onset of cyanosis,
shock and death
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
51
Pneumonia
Causes of Pneumonia:
Bacterial infection





Pneumococci
Staphylococci
Group A hemolytic streptococci
Haemophilus influenzae type B
Klebsiella pneumoniae types 1 and 2
Atypical pneumonia caused by legionella,
mycoplasma and chlamydia agents
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
52
Clicker Question





Stasis of blood flow from immobility, injury to
a vessel, or predisposition to clot formation
increase the risk of
a. pulmonary embolism.
b. chronic obstructive pulmonary disease
(COPD).
c. emphysema.
d. all of the above.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
53
Pneumonia (cont’d.)
Causes of Pneumonia:
Virus




Adenoviruses
Influenza viruses
Syncytial viruses
May also be caused by damage to lungs,
such as inhalation of poisonous gas such as
chlorine or aspiration of foreign matter
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
54
Severe Acute
Respiratory Syndrome


Severe acute respiratory syndrome
(SARS): Highly contagious new mutation of
the Corona virus
Symptoms:




Sudden onset of fever
Mild sore throat
Muscle aches
Dry, unproductive cough
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
55
Health Hazards of
Common Molds

Common molds: fungal growths that grow
naturally indoors or outdoors, especially
where there is a constant supply of moisture
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
56
Pulmonary Disorders
Pulmonary abscess: area of contained
infectious material in the lung
Causes:
 Often a complication of pneumonia caused by
bacteria
 Aspiration of food, foreign object, bronchial
stenosis or neoplasms
 Septic embolism is carried to lung via
pulmonary circulation
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
57
Pulmonary Disorders (cont'd.)


Legionellosis (Legionnaires disease):
pneumonia caused by the bacterium
Legionella pneumophila
Pontiac fever: milder form of legionellosis
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
58
Pulmonary Disorders (cont'd.)


Respiratory syncytial virus pneumonia
(RSV): inflammatory and infectious condition
of the lungs
Histoplasmosis: fungal disease originating
in the lungs caused by inhalation of dust
containing Histoplasma capsulation
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
59
Clicker Question





The pneumonia-like disease caused by
bacteria that thrive in warm aquatic
environments and are inhaled from moisture
droplets in air conditioning units is called
a. histoplasmosis.
b. pulmonary abscess.
c. flail chest.
d. Legionella infection.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
60
Groups at risk for RSV




Children younger than three years old
Elderly individuals
Patients with compromised respiratory
systems
Infants who were premature or who have a
congenital cardiac defect or preexisting
pulmonary disorder
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
61
Influenza
Influenza:
Highly contagious, acute viral disease that occurs in
annual outbreaks
At risk of complications of influenza:







Persons over 50 years of age
Residents of nursing homes
Patients with chronic pulmonary cardiac disorder (including
asthma)
Patients with chronic metabolic disease (diabetes), renal
dysfunction, hemoglobinopathies, immunosuppression
Children and teens receiving long-term aspirin
Health care employees
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
62
Chronic Obstructive Pulmonary Disease
(COPD)
Acute and chronic bronchitis: inflammation of
the mucous membrane lining the bronchi
 COPD includes:






Chronic bronchitis
Bronchiectasis
Asthma
Emphysema
Cystic fibrosis
pneumoconiosis
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
63
Effects of Smoking









Cancer of oral cavity, larynx, esophagus
Lung cancer
Peptic ulcer
Chronic bronchitis
Emphysema
Myocardial infarction
Systemic atherosclerosis
Cancer of pancreas
Cancer of bladder
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
64
Chronic Obstructive Pulmonary Disease
(cont'd.)


Bronchiectasis: permanent, irreversible
dilation or distortion of one or more bronchi,
resulting from destruction of muscular and
elastic portions of bronchial walls
Pulmonary emphysema: chronic obstructive
pulmonary disorder characterized by
destructive changes in alveolar walls and
irreversible enlargement of alveolar air
spaces
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
65
Causes of Bronchiectasis







Pneumonia
Recurrent airway infections
Tuberculosis
Bronchial obstruction
Inhalation of corrosive gas
Complication of cystic fibrosis or other childhood
infection such as measles and pertussis
Immune deficiency
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
66
Pneumothorax and Hemothorax


Pneumothorax: collection of air or gas in the
pleural cavity that results in a collapsed or
partially collapsed lung
Hemothorax: accumulation of blood and
other fluids in the pleural cavity
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
67
Pneumothorax

Symptoms of Collapsed Lung






Severe shortness of breath
Sudden sharp chest pain
Falling blood pressure
Rapid weak pulse
Shallow and weak respirations
May be cyanotic and anxious
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
68
Tuberculosis


Pulmonary tuberculosis: chronic, acute, or
subacute infection of the lungs by
Mycobacterium tuberculosis
Acquired by inhaling a dried droplet nucleus
that contains the tubercle bacillus
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
69
Infectious Mononucleosis


Infectious mononucleosis
(Epstein-Barr virus infection): acute
herpesvirus infection (glandular fever)
Symptoms:




Lymphadenopathy
Fever that typically peaks in afternoon
Listlessness, malaise, chills, anorexia
Sore throat, fever, headache, fatigue, and cervical
generalized lymphadenopathy
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
70
Adult Respiratory Distress Syndrome


Adult respiratory distress syndrome
(ARDS): severe pulmonary congestion
characterized by acute respiratory distress
and hypoxemia
Symptoms:

Sudden, severe dyspnea with rapid, shallow
respirations
 Inspiratory intercostals and suprasternal
retractions along with cyanosis or mottled skin
 May also have rales, rhonchi and wheezes
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
71
Adult Respiratory Distress Syndrome
(cont’d.)



ARDS - trauma causes increased capillary
permeability in the lungs, pulmonary edema,
and resulting respiratory failure
Alveoli fill within 12 - 24 hours of injury, and
then tend to collapse at end of expiration,
leaving less pulmonary tissue for gas
exchange
Result: low pulmonary compliance,
pulmonary hypertension, hypoxemia
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
72
Clicker Question





The Epstein-Barr virus is the cause of
a. infant respiratory distress syndrome
(IRDS).
b. COPD.
c. infectious mononucleosis.
d. adult respiratory distress syndrome ARDS.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
73
Lung Cancer


Lung cancer: cancerous condition caused by
repeated carcinogenic irritation to bronchial
epithelium, leading to increased rates of cell
division
Leading cause of death worldwide in both
men and women, 30% of all cancer deaths
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
74
Lung Cancer (cont’d.)
4 major types:
Non-small cell lung cancer (NSCLC)

Squamous cell carcinoma - 30% of all lung cancers
 Adenocarcinoma - 40%
 Large cell carcinoma - 10%
Small cell lung cancer (SCLC) - occurs almost
exclusively in smokers

Small cell carcinoma - 20%
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
75
Clicker Questions





Severe hypoxemia in a patient who has
recently experienced trauma is called shock
lung or
a. IRDS.
b. COPD.
c. infectious mononucleosis.
d. ARDS.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
76
Lung Cancer (cont’d.)
Prognosis for patients with lung cancer is
generally poor


5-year for all stages and types of lung cancer
combined is 15%
Prevention:
• Cessation of smoking
• Avoidance of exposure to second hand smoke
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
77
Clicker Question

A)
B)
Early detection of lung cancer has been
proven to improve survival.
True
False
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
78
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.
79