Essentials of Human Diseases and Conditions 4 th edition Seminar 5 Dr. Lena Watson, RN, MBA/HCM

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 1 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. 2 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. 3 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. 4 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. 5 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. 6 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. 7 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. 8 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. 9 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. 10 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 Diseases of the Gastrointestinal Tract

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 11 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 Diseases of the Gastrointestinal Tract (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 12 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 Diseases of the Gastrointestinal Tract (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 13 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. 14 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 Diseases of the Gastrointestinal Tract (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 15 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. 16 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 Diseases of the Gastrointestinal Tract (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 17 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. 18 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 Diseases of the Gastrointestinal Tract (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 19 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 Diseases of the Gastrointestinal Tract (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 20 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 Diseases of the Liver, Biliary Tract, and Pancreas

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 21 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. Diseases of the Liver, Biliary Tract, and Pancreas (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 22 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. 23 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. 24 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. Diseases of the Liver, Biliary Tract, and Pancreas (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 25 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. 26  Pancreatic cancer: A neoplasm, usually an adenocarcinoma, that occurs more often in the head of the pancreas. Diseases of the Liver, Biliary Tract, and Pancreas (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 27 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. 28 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 Diseases of Nutrient Intake and Absorption

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 29 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. 30 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. 31 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. 32 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 Diseases of Nutrient Intake and Absorption (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 33 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. 34 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. 35  Food poisoning: an illness resulting from the ingestion of foods that contain bacterial or toxic substances Diseases of Nutrient Intake and Absorption (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 36 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. 37 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. 38 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. 39 RESPIRATORY SYSTEM Chapter 9

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 40 Causes:  Infection  Circulatory disorders  Tumors  Trauma  Immune diseases  Inflammatory disturbances  Congenital defects  Central nervous system damage or diseases  Environmental conditions Diseases of the Respiratory System

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 41  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 Upper Respiratory Tract Infections

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 42 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. 43  Pharyngitis: acute or chronic infection of the pharynx  Laryngitis: inflammation of the larynx, including the vocal cords Upper Respiratory Tract Infections (cont'd.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 44 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. 45 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. 46 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. 47 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. 48 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. 49 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. 50 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. 51 Pulmonary Embolism  Occurs when embolism is lodged in artery and interrupts blood supply  Uncomplicated embolism - cough, chest pain, low- grade 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. 52 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. 53 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. 54 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. 55  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 Severe Acute Respiratory Syndrome

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 56  Common molds: fungal growths that grow naturally indoors or outdoors, especially where there is a constant supply of moisture Health Hazards of Common Molds

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 57 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. 58 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. 59 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. 60 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. 61 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. 62 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. 63 Acute and chronic bronchitis: inflammation of the mucous membrane lining the bronchi  COPD includes:  Chronic bronchitis  Bronchiectasis  Asthma  Emphysema  Cystic fibrosis  pneumoconiosis Chronic Obstructive Pulmonary Disease (COPD)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 64 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. 65  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 Chronic Obstructive Pulmonary Disease (cont'd.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 66 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. 67 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. 68 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. 69 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. 70 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. 71  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 Adult Respiratory Distress Syndrome

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 72  ARDS - trauma causes increased capillary permeability in the lungs, pulmonary edema, and resulting respiratory failure  Alveoli fill within 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 Adult Respiratory Distress Syndrome (cont’d.)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 73 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. 74 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. 75 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. 76 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. 77 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 Cessation of smoking Avoidance of exposure to second hand smoke Avoidance of exposure to second hand smoke

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 78 Clicker Question  Early detection of lung cancer has been proven to improve survival. A) True B) False

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 79