Advanced Patient Assessment Practice Exam

What procedure is performed by a pulmonologist to obtain organisms that may be present deep in the lung in patients with pneumonia?

1. Bronchoalveolar lavage (BAL)

2. Tracheal intubation with lavage

3. Sputum induction with hypotonic nebulized solution

4. None of the above

The correct answer is: Bronchoalveolar lavage (BAL)

The procedure performed by a pulmonologist to obtain organisms deep within the lung in patients with pneumonia is bronchoalveolar lavage (BAL). This technique involves the introduction of sterile saline into a specific segment of the lung through a bronchoscope, followed by the aspiration of the fluid. This process allows for the collection of respiratory secretions from the alveolar space, which can then be analyzed for the presence of pathogens, including bacteria, fungi, and viruses. BAL is particularly useful in cases of pneumonia when standard sputum cultures may not provide adequate samples for diagnosing the causative organisms due to the difficulty in obtaining sputum from lower airways. It enables clinicians to target specific areas of the lung and retrieve samples that may have a higher yield of infectious agents, especially in complicated cases where conventional methods fall short. Other procedures mentioned, such as tracheal intubation with lavage and sputum induction with hypotonic nebulized solution, do not specifically target organisms deep in the lungs as effectively as BAL. Depending on the clinical scenario, these options might be utilized for different purposes, such as obtaining secretions from the upper airway or enhancing sputum production in patients with obstructive lung diseases, but they are not as effective for deep lung sampling in pneumonia cases