1) Why the man feel dyspneu and cough with green

sputum and fever ?

The phlegm is produced in the throat have chemical
substances which varies depending on the climate,
genetic and immune system conditions. Usually a
viscous solution containing gel which is a solution
glicoprotein, immunoglobulin, lipids, etc. Sputum color
to indicate the severity of the symptoms of cough:
1. A healthy Sputum clear or white color
2. yellow phlegm a sign of symptoms common cold
cough fever
3. green phlegm a sign of pneumonia indication
4. Sputum brown signs of heavy smokers and heavy
cough
5. bloody phlegm a sign of tuberculosis.
mechanism Fever
In response to pyrogenic stimuli, the monocytes,
macrophages, and Kupffer cells secrete a chemical
substance known as endogenous pyrogens IL-1
(interleukin 1), TNF (tumor necrosis factor ), IL-6
(interleukin 6), and INF (interferon) which works on the
hypothalamic thermoregulatory center to increase the
benchmark thermostat. The hypothalamus maintains
the temperature at which point a new benchmark and
not in normal temperature. For example, endogenous
pyrogens increase benchmark points to 38.9 C, the
hypothalamus feel that the normal temperature of 37
C prademam too cold, and this organ trigger cold

response mechanisms to increase body temperature

(Ganong, 2002).
Various reports showed that the increase in body
temperature is directly related to the level of cytokine
pyrogen produced to address a variety of stimuli.
Stimulation of endogenous like exotoxin and endotoxin
induce leukocytes to secrete endogenous pyrogens,
and the potent include IL-1 and TNF, in addition to IL6 and IFN. The endogenous pyrogens will work on the
central nervous system level OVLT (Organum
vasculosum laminae terminalis) surrounded by the
medial and lateral parts preoptic nucleus, anterior
hypothalamus, and septum palusolum. In response to
these cytokines occurs then the OVLT synthesis of
prostaglandins, especially prostaglandin E2 through
pathways of arachidonic acid metabolism COX-2
(cyclooxygenase 2), and raises the body temperature,
especially fever (Nelwan in Sudoyo, 2006).
The mechanism of fever may also occur through nonprostaglandin pathway through the vagus afferent
signals mediated by local products MIP-1
(machrophage inflammatory protein-1) can not be
inhibited by antipyretics (Nelwan in Sudoyo, 2006)
http://repository.usu.ac.id/bitstream/123456789/2144
5/4/Chapter%20II.pdf
2) Why in the lung examination the doctor get dim and
wet ronchi in the bronchial basis ?
3) What causes his RR increased until 32/minutes and HR
110/minutes?

4) Why in rontgen photo is found infiltrat in both og the

lung ?
5) Why the doctor ask the patient to do gram staining and
sputum culturing ?
6) Why in routine blood examination get leukositosis ?
7) How to score the penumonia severity index ?
8) What is diagnosis and different diagnosis ?
9) What are the etiologies from the scenario ?
10) What are clasification of pneumonia ?
11) What are risks factor possible causes pneumonia ?
12) What are additional examination ?
13) What are treatments ?