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Bolile Respiratorii
Bolile Respiratorii
Cuprins
Cuprins........................................................................................................................................ 1
Infeciile arborelui respirator.........................................................................................................3
Etiologie: ................................................................................................................................. 3
Simptomatologie....................................................................................................................... 3
Examenul obiectiv.................................................................................................................... 4
Investigaii paraclinice.............................................................................................................. 4
Broniectaziile.............................................................................................................................. 4
Etiologie:.................................................................................................................................. 4
Simptomatologie....................................................................................................................... 4
Examenul obiectiv:................................................................................................................... 4
Investigaii paraclinice:.............................................................................................................4
Diagnosticul diferenial.............................................................................................................4
Evoluie. Complicaii.................................................................................................................5
Infeciile parenchimului pulmonar.................................................................................................5
Pneumoniile acute.................................................................................................................... 5
Clasificare dup etiologie:....................................................................................................5
Patogenic 2 tipuri de pneumonii:..........................................................................................5
Pneumonia pneumococic...........................................................................................................5
Tabloul clinic............................................................................................................................ 6
Examenul plmnului: sindrom de condensare neretractil......................................................6
Inspecie: diminuarea amplitudinii micrilor respiratorii de partea bolnav..........................6
Palpare: accentuarea transmiterii vibrailor vocale n zona afectat.....................................6
Percuie: matitate sau submatitate........................................................................................6
Ascultaie: suflu tubar i raluri crepitante..............................................................................6
Investigaii paraclinice.............................................................................................................. 6
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Examenul sngelui...............................................................................................................6
Examenul de urin................................................................................................................ 7
Examenul sputei................................................................................................................... 7
Radiografia toracic..............................................................................................................7
Evoluie. Complicaii.................................................................................................................7
Complicaii................................................................................................................................ 7
PNEUMONIA STAFILOCOCIC.................................................................................................7
Infecia pulmonar survine pe 2 ci:.........................................................................................7
Tabloul clinic............................................................................................................................ 8
Examenul obiectiv:................................................................................................................... 8
Investigaii paraclinice:.............................................................................................................8
Evoluie. Complicaii.................................................................................................................8
BRONHOPNEUMONIA............................................................................................................... 9
Examenul plmnului:.............................................................................................................. 9
Investigaii paraclinice:.............................................................................................................9
Examenul radiologic:................................................................................................................ 9
PNEUMONIILE VIRALE ATIPICE.............................................................................................9
Etiologie:.................................................................................................................................. 9
Tabloul clinic............................................................................................................................ 9
Examenul plmnului:.............................................................................................................. 9
Investigaii paraclinice:.............................................................................................................9
Radiografia pulmonar:.......................................................................................................... 10
Evoluie. Complicaii............................................................................................................... 10
ABCESUL PULMONAR............................................................................................................. 10
Etiologie:................................................................................................................................ 10
Exist 3 stadii evolutive:......................................................................................................... 10
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BRONHOPNEUMONIA
boal grav, mortalitate mare
febr 40C, delir, stare general alterat
tuse cu expectoraie vscoas, uneori hemoptoic
dispnee simptomul dominant polipnee superficial cu bti ale aripilor nasului
tahicardie, hTA
Examenul plmnului:
submatitate sau matitate
raluri crepitante i subcrepitante, ronflante i sibilante, suflu tubar patologic
Investigaii paraclinice:
Leucocitoz cu neutrofilie
VSH accelerat
hemocultura
Probe renale, hepatice
Ionograma, gazele sanguine
Examenul sputei
Examenul radiologic:
Opaciti multiple rotunde, contur estompat, diseminate pe ambele arii pulmonare
PNEUMONIILE VIRALE ATIPICE
30% din totalul pneumoniilor acute
Etiologie:
Virusul sinciial la copii
Mycoplasma pneumoniae la adult
Tabloul clinic
debut insidios, progresiv, rar brusc
astenie, cefalee, catar rinofaringian, dureri musculare
frisoane mici i repetate, febr
tuse uscat, rebel la tratament, n chinte
expectoraie puin abundent, mucoas
dispnee minim la adult, prezent la copil
Examenul plmnului:
raluri ronflante, sibilante, rare subcrepitante la baze
submatitate, murmur vezicular diminuat
Uneori examenul pulmonar este NORMAL
discordan ntre intensitatea simptomelor i srcia semnelor fizice
Investigaii paraclinice:
VSH accelerat
numrul de GB este normal sau sczut
examenul sputei: mononucleare, flor microbian absent
medii speciale de cultur pentru M. Pneumoniae
teste serologice
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Radiografia pulmonar:
opaciti hilifuge, intensitate subcostal, neomogene
de la hil spre bazele pulmonare, n form de evantai
Evoluie. Complicaii
vindecare
tusea poate persista pn la 2-3 sptamni
infecia bacterian secundar
complicaii hematologice: anemia hemolitic autoimun, trombopenie, CID
miocardita ICG
meningita, meningoencefalita
ABCESUL PULMONAR
supuraie colectat ntr-o cavitate pulmonar neoformat, produs printr-o inflamaie acut
netuberculoas
Etiologie:
bacterii aerobe stafilococi, pneumococi
bacterii anaerobe
cale bronic sau hematogen
Factori favorizani: pacieni tarai (alcoolism, DS, CH etc), frigul, oboseala, tulburrile de
ventilaie pulmonar (obstrucia bronic cancerul bronhopulmonar)
Exist 3 stadii evolutive:
1) faza de focar nchis
2) vomica
3) faza de focar deschis
1.
Faza de focar nchis:
debutul bolii aspectul unei pneumonii
tuse seac, suprtoare, expectoraie n cantitate mic
dispnee, durere toracic cu sediu fix, surd, persistent
FEBR 38-39C
astenie fizic, alterarea strii generale
Examenul obiectiv:
tahicardie, dispnee cu polipnee
dindrom de condensare: matitate, crepitante
examenul plmnului poate fi normal
Investigaii paraclinice:
sdr inflamator: VSH, GB, PCR
hemocultura
Ex radiologic:
opacitate dens, omogen, cu limite imprecise, intensitate subcostal
2.
Vomica
faza de deschidere n bronhii
eliminarea coninutului purulent sub frm de:
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