Term
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Definition
Characterized by decreased compliance of lung tissue.
Can cause ventilation and perfusion mismatch or can affect the alveolocapillary membrane (decreased diffusion of O2 from alveoli to body).
Ex: pulmonary fibrosis, inhalaton disorders, ARDS, pumoconiosis (ex asbestosis). |
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Term
| CM of restrictive lung disease |
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Definition
dyspnea
increased respiratory rates
decreased tidal volume
Pulmonary function testing reveals a decrease in forced vital capacity (FVC- the maximum amount of gas that can be displaced from the lung during a forced expiration). |
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Term
| Obstructive pulmonary disease |
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Definition
Airway obstruction that is worse with expiration. Requires more force to exhale.
Ex: Asthma, Chronic bronchitis, emphysema. |
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Term
| CM Obstructive pulmonary disease |
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Definition
dyspnea
wheezing
increased work of breathing
ventilation-perfusion mismatching
decreased forced expiratory volume |
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Term
| Acute Respiratory Distress Syndrome (ARDS) |
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Definition
sudden and severe form of respiratory failure that is characterized by acute lung inflammation and widespread alveocappillary injury and shunting (mismatching of ventilation to perfusion ratio).
Inadequate perfusion of well perfused areas of the lung causing hypoxemia. |
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Term
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Definition
Severe trauma
sepsis
penumonia
aspiration of acids
CABG
pancreatitis
DIC
Fat embolism |
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Term
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Definition
| dyspnea, rapid shallow respirations, inspiratory crackles, respiratory alkalosis, decreased lung compliance, hypoxemia unresponsive to O2, diffuse alveolar infiltrates without cardiac disease. |
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Term
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Definition
| presence of air or gas in the pleural space caused by a rupture in the visceral pleura (which surrounds the lungs) or the parietal pleura and chest wall. |
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Term
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Definition
Primary/spontaneous-caused by the spontaneous rupture of blister/bleb like formations on the visceral pleura, and can occur at any time during sleep, rest, or exercise.
Secondary- caused by chest trauma.
Tension- site of pleural rupture acts as one way valve allowing air in with inspration but not out. LIFE THREATENING due to air pressure build up pushing on heart and other lung.
Open- communicating wound from outside through to pleura. Air in and back out of wound. |
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Term
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Definition
Inflammatory d/o that is reversible.
Familial d/o tht occurs at all ages.
Theory that lack of exposure to infectious agents in childhood makes child more susceptible to asthma. |
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Term
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Definition
Family history
Allergen exposure
Urban living
Exposure to air pollution
Cigarette smoke
Recurrent respiratory viral infections
Allergic rhinitis
Atopic dermatitis |
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Term
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Definition
| allergen exposure leads to mast cell degranulation, with the release of a large number of inflammatory mediators such as histamine, prostaglandins, and leukotrienes. The resulting inflammatory process produces bronchial smooth muscle spasm, vascular congestion, edema formation, production of thick tenacious mucus, impaired mucociliary function, and increased contractile response of bronchial smooth muscle. |
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Term
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Definition
Individuals are asymptomatic between attacks.
chest constriction, expiratory wheezing, dyspnea, nonproductive coughing, prolonged expiration, tachycardia, and tachypnea.
With severe attacks (status asthmaticus) accessory muscles are used and wheezing is heard during both inspiration and expiration. |
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Term
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Definition
hyper secretion of mucus and chronic productive cough that continues for at least three months of the year (usually the winter months) for at least two consecutive years.
Air trapping is due to hypersecretion of mucus.
Primary risk factor is smoking. |
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Term
| Patho of Chronic Bronchitis |
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Definition
| Inspired irritants increase mucus production. The mucus produced is thicker and more tenacious than normal. Ciliary function is impaired by sticky mucus. Increased susceptibility to infection. Bronchial walls become inflammed and thickened from edema and accumulation of mucus cells. |
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Term
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Definition
Decreased exercise tolerance
Intermittent wheezing
SOB
Productive cough
Prolonged expiration
Cyanosis
Chronic hypoventilation
Polycythemia
Cor Pulmonale |
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Term
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Definition
Abnormal permanent enlargement of gas exchange airways accompanied by destruction of alveolar walls without obvious fibrosis.
Major mechanism is loss of elastic recoil.
Causes: Smoking, air pollution, and childhood URI.
CM: barrel chest, dyspnea, prolonged expiration, |
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Term
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Definition
| Autosomal recessive inheritance deficiency of the enzyme alpha one antitrypsin. |
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Term
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Definition
Breakdown of elastin in the alveolar septa. Septal destruction eliminates portions of the pulmonary capillary bed and results in ventilation perfusion mismatching and hypoxemia (increased air vol. in alveoli). Destruction of elastin in the bronchial walls reduces the elastic recoil of airways, expiration becomes difficult and reduces the volume of air that can be expired passively.
Pt has to push to get air out. |
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Term
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Definition
Infection of the lower respiratory tract caused by bacteria, viruses, fungi, protozoa, or parasites. It is the sixth leading cause of death in the US.
Pathogen is inhaled, is aspiated from oropharyngeal secretions, or is a bood born infxn moved to lungs.
Risk factors: advanced age, immunocompromised, underlying lung disease especially COPD, alcoholism, smoking. |
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Term
| Common agents for community acquired pneumonia |
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Definition
Streptococcus pneumoniae (most common)
Mycoplasma pneumoniae (young people/walking pneumonia). |
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Term
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Definition
| Starts with upper respiratory infection followed by cough, dyspnea, fever, malaise, pleuritic cp, rust colored sputum (strep pneumonia only). |
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Term
| Physical exam for pneumonia |
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Definition
Inspiratory crackles
Increased tactile fremitus- vibration of the chest wall during speaking that is palpable on physical examination.
Egophony- increased resonance of voice sounds, with a high-pitched bleating quality. |
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Term
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Definition
Infection caused by Mycobacterium Tuberculosis that usu affects the lungs.
is highly contagious (person to person) and is spread by airborn droplets.
TB in tubercle form can lay dormant for life. However if pt becomes immunocompromised, has poor nutrition, aging, bacilli can escape and cause active infection. Or if pt is exposed again. |
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Term
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Definition
| Microorganisms lodge in the lung periphery, usu the upper lobe, and multiply and cause non-specific pneumonitis. Some infiltrate the lymph system where they encounter lymphocytes. Inflammation in the lung causes cell mediated response in the area, engulf the bacilli and preventing spread of the disease. Sealing off the colonies forms tubercle. Infecting tissues with tubercle die and form a cheeselike material called caseation necrosis. Collagenous scar tissue then grows around the turbercle, completing isolation of the bacilli. The immune response is complete after 10 days. This is called the primary exposure- pt does not have active lung disease but does have + TB test. pt should have prophylactic antibiotics to prevent secondayr exposure which is active TB of lungs. |
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Term
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Definition
fatigue
weight loss
lethargy
anorexia
low grade fever in afternoon (diurnal)
cough with purulent sputum
dyspena
night sweats
anxiety
CP
hemoptosis |
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Term
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Definition
acute infection or inflammation of the airway or bronchi caused mainly by viruses.
Self limiting, resolves with time, rest, and fluids.
CM: cough, chills, cp related to cough, normal chest x-ray. |
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Term
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Definition
caused by aspiration of acidic fluids (OJ or gastric).
Bronchial damage that occurs includes inflammation, loss of cilliary action, and bronchospasm.
If acid substance enters alveoli it can damage membrane and lead to hemorrhagic pneumonitis.
Lung becomes stiff and surfactant production is decreased.
If severe can be life threatening. |
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Term
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Definition
occlusion of portion of the pulmonary vascular bed by an embolus that can be a thrombus, tissue fragment, lipid, or air bubble. The most common are thrombi dislodged from the deep veins of the thigh and pelvis.
Can cause infarction of lung tissue.
CM: dyspnea, tachycardia, anxiety.
**provider needs to look closely at pt's history to suspect DVT** |
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Term
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Definition
| R ventricular failure secondary to pulmonary artery HTN (lung disease) and consists of right ventricular enlargement; hypertrophy, dilation, or both. |
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Term
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Definition
An acute laryngotracheobronchitis.
Mostly seen in kids 6mo-5y.
More common in boys.
Mostly caused by parainfluenza virus.
Most cases resolve spontaneously. |
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Term
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Definition
| Starts with rhinorrhea, sore throat, and low grade fever for a few days. Then the child develops a barking cough, hoarse voice, and inspiratory stridor. |
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Term
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Definition
A severe, life-threatening, rapidly progressive infection of the structures above the insertion point of the glottis.
Almost always caused by H. influenza B (HIB).
HIB vaccine has decreased incidence
significantly. |
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Term
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Definition
| a child between 2-7yo suddenly develops high fever, irritability, sore throat, a “hot potato voice”, inspiratory stridor, and severe respiratory distress. Will often present in the “Tripod position”(forward leaning), with drooling and dysphasia (inability to swallow). DO NOT EXAMINE THROAT!! |
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Term
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Definition
common viral-induced lower respiratory tract infection that occurs almost exclusively in infants and young toddlers.
Mostly seen between Nov and April.
Most common pathogen is RSV. |
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Term
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Definition
| viral infection causes necrosis of the bronchial epithelium and destruction of ciliated epithelial cells. Cell-mediated hypersensitivity to viral antigens causing inflammation, edema, plugs in bronchioles, and bronchospasm which leads to air trapping (can cause atelectesis). |
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Term
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Definition
tachypnea
expiratory wheezing
cough
rhinorrhea
mild fever
varying grades of resp. distress
poor feeding
rales
ronchi |
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Term
| Sudden Infant Death Syndrome (SIDS) |
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Definition
remains a disease of unknown cause however is probably d/t immature ventilaroty and arousal response to hypoxia.
Is the most common cause of unexplainable infant death.
Sudden death of infant under 1yo.
Incidence peaks 3-4mo, unusual after 6mo.
More common in males
Almost always at night
Increased frequency during winter (r/t inc rate of respiratory infections).
Risk factors: preterm/low birth weight, multiple births, sibling of prior SIDS victim, maternal smoking during preg.
3/4 cases have NO known risk factors. |
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Term
| Nephrolethiasis (Kidney stones) |
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Definition
Masses of material in the kidney that obstruct the flow of urine.
Crystals,proteins,or other substances.
Most common: Ca oxalate or Ca phosphate.
Alkalin pH (heavy soda diet) increases risk of Ca phos stones. |
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Term
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Definition
1)supersaturation of one or more salts in the urine
2)precipitation of the salts from a liquid to a solid state
3)growth through crystallization or agglomeration (sometimes called aggregation)
4)the absence of stone inhibitors |
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Term
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Definition
Renal colic (comes and goes with parastalysis of ureter), described as moderate to severe pain often originating in the flank and radiating to the groin.
Hematuria |
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Term
| Painful bladder syndrome/interstitial cystitis (PBS/IC) |
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Definition
Persistent/chronic cystitis that includes non-bacterial infectious cystitis and noninfectious cystitis.
Most common in women ages 20-30 |
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Term
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Definition
Autoimmune Rxn that is associated with derangement of bladder mucosa. Antiproleferative factor blocks normal growth of cells of the wall of the bladder increasing bladder sensation (pain).
Fibrosis of bladder wall is accompanied by Hunner Ulcers (hemorrhagic). Bladder volume may decrease d/t fibrosis. |
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Term
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Definition
bladder fullness
frequency (including nocturia)
small urine volume
chronic pelvic pain
NEGATIVE URINE CULTURES
Sx last longer than 9 mo. |
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Term
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Definition
Infectionof renal pelvis and interstitum.
Common causes include urinary obstruction and reflux from bladder, stones, pregnancy, instrumentation.
Most cases occur in women.
Usually from E. coli, Proteus, or Pseudomonas (last 2 typically from instrumentation or urinary surgery). |
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Term
| Patho of Acute Pyelonephritis |
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Definition
Infxn spreads by ascending from bladder along ureters, but spread my also occur by way of blood stream.
Infxn causes inflammation that effects pelvis, calicies, and medula of kidney, renal edema, and purulent urine.
In severe cases, localized abscess may occur. |
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Term
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Definition
| with fever, chills, and flank or groin pain. Symptoms characteristic of a UTI, including frequency, dysuria, and costovertebral (CVA) tenderness. |
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Term
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Definition
inflammation of the glomerulus of the kidney.
Most often caused by Strep infection.
Immune mediated type II & III hypersensitivity causes antigen/antibody complexes to deposit in glomerulus.
Occurs 7-10 days after infection of the skin or throat(pharyngitis/impetigo) and commonly affects children.
Symptoms usually occur 10-21 days after infection. |
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Term
| CM Acute Glomerulonephritis |
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Definition
hematuria
red blood cell casts
proteinuria
decreased GFR
oliguria
HTN
edema of the eyes or feet and ankles |
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Term
| Chronic Glomerulonephritis |
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Definition
Glomerular disease is the most common cause of chronic kidney disease and ESRD (end-stage renal disease).
Chronic associated with DM, SLE, hypercholesterolemia, proteinuria. |
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Term
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Definition
The excretion of 3.5 grams or more of protein in the urine per day leads to severe loss of serum protein.
More common in children than adults. |
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Term
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Definition
many CM are related to loss of serum proteins and sodium retention:
Edema
hyperlipidemia
lipiduria
Vit D deficiency
hypothyroidism
hypercoagulability |
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Term
|
Definition
1) Overflow incontinence- loss of urine with overdistention of the bladder. It can be associated with neurologic injuries, pelvic organ prolapse or enlargement and BPH.
2) Stress Incontinence-loss of urine with sudden increase of intra-abdominal pressure (laughing, sneezing or coughing). Often related to pelvic floor relaxation. GIGGLE incontinence.
3) Urge incontinence- loss of urine following abrupt onset of the urge to void. May be associated with or involuntary contraction (instability) of the detrusor muscles. GOTTA GO/GOTTA GO incont.
4) Mixed incontinence-combination of stress and urge incontinence. Most often in older women.
5)Functional incontinence-loss of urine due to dementia or immobility. |
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Term
| Polycystic kidney disease |
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Definition
Autosomal dominant- no signs until later in life. Hypertension, heart valve defects, and cerebral & aortic aneurysms may develop.
Autosomal recessive- born with. |
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Term
| Potter syndrome (Bilateral Renal Agenesis) |
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Definition
Lack of both kidneys at birth.
Mostly males.
Fatal.
associated with a specific group of facial anomalies: wide-set eyes, parrot-beak nose, low-set ears, and receding chin. |
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Term
| Immunoglobulin A nephropathy (Berger nephropathy) |
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Definition
Most common type of childhood glomerulonephritis.
Occurs twice as often in males.
Rare in blacks.
No systemic immunologic disease present.
Deposits of IgA in glomerular capillaries.
Usually reversable.
CM: recurrent gross hematuria, mild proteinuria. |
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Term
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Definition
Primary is idiopathic.
Secondary results from systemic disease, drugs, toxins.
More in males.
Peak incidence 2-3 yo. |
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Term
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Definition
Perorbital edema
diminished frothy/foamy urine
dirrhea
anorexia
protein deficiency
increased susceptibility to infection |
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Term
| Wilm's tumor (nephroblastoma) |
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Definition
Rare embryonal tumor of the kidney arising from mesoderm.
Epigenetic and genetic changes that lead to abnormal proliferation of the renal stem cells.
Most commonly occuring solid tumor in children.
10% will have other congenital anomolies like anaridia (lack of iris) and other genitourinary changes. |
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Term
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Definition
Enlarging asymptomatic upper abdominal mass that is firm.
vague abdominal pain
hematuria
fever
hypertension |
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Term
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Definition
Child has never been continent.
Mostly nocturnal.
Matter of developmental maturity.
Most will outgrow by age 6.
Familial tendency.
Possibly attributed to sleep arousal/prolonged non-REM sleep, OSA. |
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Term
| Seconday Enuresis (acquired) |
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Definition
Dryness at least 3-6mo after toilet training and becomes incont again.
mostly d/t UTI, neuro changes, d/o that cause increased output (DM), new baby in house. |
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