Term
| Pulmonary Infections are increased by: (5 things) |
|
Definition
- Altered cough reflex (Myasinthia gravis, CF)
- Injury to mucociliary apparatus (smoking)
- Accumulation of secreations (in the mouth, nose, or lungs, made wors by ventilator or trach tubes)
- Altered alveolar macrophage funcition
- Pulmonary edema and congestions |
|
|
Term
| Common cold is also called _____ and is an URT _____ infection. Other strains are: _____, _____, _____ (seen mostly in kids), _____, and _____. |
|
Definition
Infectious rhinitis
viral
rhinovirus
parinfluenze
RSV
coronavirus
adenovirus |
|
|
Term
Clinical manifestations of infectious rhinitis are:
This URT viral infection may last weeks and needs to be treated with antibiotics. T/F?
|
|
Definition
Congestion, Runny Nose, Clear secretions, sneeze.
False: This infection is self-limiting and lasts 7 days without treatment.
Treat Symptoms |
|
|
Term
| Complications of rhinovirus include: |
|
Definition
- makes mucosa more prone to infections
- bronchitis
- ear infection
- pneumonia
- sinusitis
- asthma |
|
|
Term
|
Definition
| the blockage (inflammation and infection) of connections between sinus cavities. |
|
|
Term
Sinusitis has _____ exudate and may be caused by:
If acute, it may last _____ weeks; if chronic, _____.
|
|
Definition
Purulent
URTI, allergic rhinitis, barotrauma, swimming, diving, excessive use of nose sprays
4-12; >12 |
|
|
Term
Clinical manifestations of sinusitis include:
Treatment is: |
|
Definition
Pain, headache (that increases when bening forward), purulent nasal discharge, decreased smell, fever)
Antibiotics (must culture bacteria/virus first), decongestants, antihistamines, mucolitics (to help sneeze/cough), saline nasal wash, surgery to take out scar tissue |
|
|
Term
Influenza is a URT or LRT viral infection??
Describe Type A and Type B. |
|
Definition
Could be either!
Type A: hemophalus influenza
- two proteints (hemaglutinan and neurominidase) that cause virus to adhere to cells and cause infection
- able to mutate easily and frequently so vaccines aren't very useful
Type B: seen mostly in kids... |
|
|
Term
The transmission of influenza is by _____ and _____.
Viral and Bacterial influenza usually start from _____. |
|
Definition
aerosol and direct contact
an uncomplicated URTI |
|
|
Term
| Clinical manifestations of Influenza include: |
|
Definition
Fever chills, malaise
Aches
Runny nose
Unproductive cough when viral
Productive cough when bacterial |
|
|
Term
| Treatment for influenza is: |
|
Definition
Mostly symptomatic
Rest
Liquids
Antiviral drugs |
|
|
Term
Pneumonia is defined as:
This causes more deaths than any other respiratory drug? T/F |
|
Definition
an infection of the lung parenchyma (tissue of the lungs) and inflammation of the lung (alveoli fill with fluid, blood cells, or pus, causing the ability of O2 and CO2 diffusion to be limited)
TRUE |
|
|
Term
| Pneumonia may be caused by _____, _____, _____, or _____. |
|
Definition
| Bacteria, virus, irritants, or aspiration |
|
|
Term
| Describe parenchyma Consolidation r/t pneumonia... |
|
Definition
This is when the lung tissue becomes hard due to infection.
The permeability of the alveolar membrane is altered and it decreases alveoloar surface area for diffusion. |
|
|
Term
| Pneumonia decreases the _____ ratio which is normally _____. __________ cause this ratio to decrease, whereas __________ cause this ratio to increase. |
|
Definition
V/Q
0.8-0.9
Decreased airflow and ventilation
damaged or decreased airflow (decreasing perfusion) |
|
|
Term
| What are the three classifications of pneumonia? |
|
Definition
Aspiration Pneumonia: bacteria in mouth that goes down to the lungs
Lobar Pneumonia: the entire lobe is effected and has greater consolidation
Bronchopneumonia: individual bronchioles are affected |
|
|
Term
What fungal pneumonia has a high incidence amoung HIV positive patients?
What other types of pneumonia are there? |
|
Definition
Pneumocystis Jiroveci
Viral (influenza), bacterial mycoplasmal, chronic, immune deficiencies |
|
|
Term
| Clinical Manifestations of pneumonia are: |
|
Definition
Fever
Chills
Cough
Respiratory Crackles
Pleural Friction Rub
Blood tinged/rusty sputum |
|
|
Term
Treatments of pneumonia are:
They usually work in _____ hours.
Vaccines are important for _____ and need a different vaccine if _____. |
|
Definition
Antibiotics/antifungals/antiviral, etc.
48-72 hours
high risk groups, including health care workers
under 2 yoa
|
|
|
Term
| What are the three main complications associated with pneumonia? |
|
Definition
Lung absceses (infected area filled with pus).
Empyema: pus throughout the lung
Bacterial spread to: cardiac valves, kidneys, brain, pericardial sack, joints, splee |
|
|
Term
Tuberculosis is caused by _____ _____.
We've been seeing an increase since the 80s, esp in _____ and _____. But, there has been a decrease in the past year. T/F? |
|
Definition
Mycobacterium Tuberculosis
immigrants; immunosuppressed
TRUE |
|
|
Term
|
Definition
Poverty
Crowding
Chonic Illness
Incidence is high in southern Africa
Mexico, Phillipines, Vietnam |
|
|
Term
| Clinical Manifestations of TB include the 3 things: |
|
Definition
Granulomas: area that's walled off from collagen and scarring
Cavitations: liquid that explodes in a cavity
Ghon Focus: lesion in lung |
|
|
Term
| The Primary Symptoms of TB include: |
|
Definition
Fever
Weight Loss
Fatigue
Night Sweats |
|
|
Term
| Secondary Symptoms (if infection shows up agina or if person is reinfected) of TB include: |
|
Definition
Reinfection
Reactivation
Lung Apicses
Pleuritic Pain
Hemoptysis (coughing up blood) |
|
|
Term
| 2 Ways to diagnose TB include: |
|
Definition
TB Skin test (which can have false negatives and positives because it only shows if the person has antibodies for TB, not if they actually have it or not)
Chest X-Ray |
|
|
Term
| Treatment of TB can take _____ if healthy and up to _____ if unhealthy. The antibiotics associated with TB include: (5). Why is there a problem with the treatment of TB? |
|
Definition
2 months
6-12 months
Isoniazid, Rifampin, Pyrazinamide, Ethambutol, Streptomycin
Most TB patients are illegial; hard to see doctor with no insurance and risk to their living status. |
|
|
Term
| The most frequently diagnosed cancer and greatest cause of cancer mortality both in the US and the world is: |
|
Definition
|
|
Term
| 4 risks for pulmonary neoplasms include: |
|
Definition
Cigarettes (#1)
Industrial hazards (radon, asbestos, nickel, silicon, plastics, coal, iron)
Air Pollution (diesel fuel)
Genetics |
|
|
Term
| It is hard to diagnose Pulmonary neoplasms early because the symptoms are somewhat nondescript. These symptoms include: |
|
Definition
| Cough, weight loss, dyspnea, chest pain, Lymph nodes become firm in chest and neck, pain in pleura and chest walls |
|
|
Term
| Diagnosis of pulmonary neoplams can be done with: |
|
Definition
X-rays
Sputum exam (will see the neoplastic cells)
Broncial washing (bronchoscopy) |
|
|
Term
The best treatment of a Pumonary Neoplasm is _____. The problem with this is that the cancer is _____.
Other treatments include:
The 5 year survival is about _____%. |
|
Definition
surgery
too far advanced; typically bilaterally and it is hard to remove that much of the lungs
chemo and radiation; immunotherapy; prevent causativ agents; early diagnosis
15% |
|
|
Term
| Problems from cancer that the tumor is not actually causing are called _____. 1-10% of people with cancer experience weird hormone activation, including these hormones: |
|
Definition
Paraneoplastic Syndromes
ADH, ACTH (adrenocorticotropic hormone - cortisol), parathyroid hormone, calcitonin, gonadotropins (estrogen, testerone), serotonin, bradykinin |
|
|
Term
Bronchiectasis is _____ and occurs when _____. Risks for this include:
Clinical Manifestations are:
Treatment is: |
|
Definition
when the bronchi and bronchiles are permanently dilated
something gets in there and blocks passages and causes enlargement
- infection, obstruction, CF, immunodeficiencies
- cough, foul-smelling sputum, dyspnea, orthopnea (when laying down)
- get rid of infection oxygen/dilate airways, chest therapy to break up obstruction |
|
|
Term
| _____ is characterized by blood clots blocking the pulmonary vessel. _____ is the cause in 95% of cases. |
|
Definition
|
|
Term
| Risks of Pulmonary Emboli include: |
|
Definition
Immobility
Cancer
CVD
Hypercoagulable State
indwelling central lines |
|
|
Term
If a pt has a large PE, _____ die within _____.
Additionally, they will experienc
Small PE pt experience: |
|
Definition
15-18%
3 months
electromechanical dissociation (EKG no rhythm and no perfusion. Feels like an MI)
Transient chest pain, dyspnea, fever, cough, hemoptysis
|
|
|
Term
| Virchow's Triad is important characteristic in _____. The triad encompasses: |
|
Definition
Pulmonary Emboli
Venous Stasis: immobility (traveling), obesity, pregnancy, skickle cell
Hypercoagubility: genetic increased; oral contraceptives
Injury to epothelial tissues: anything that damages endothelium |
|
|
Term
The BEST treatment for Pulmonary Emboli is: _____
Methods include: |
|
Definition
PREVENTION
Early amb, elastic stockings, compression hose, anticoagulants, "Umbrella" filter |
|
|
Term
| Pulmonary HTN is defined as: _____. Normally it is about ____-_____ of the SBP; with pulmonary HTN, the BP increases to _____ of the SBP. |
|
Definition
High BP in the lungs
1/8-1/10
1/4 (25mmHg rest, 30 during exercise |
|
|
Term
| Risks for Pulmonary HTN include: (6) |
|
Definition
o Chronic obstructive or interstitial lung disease
o Heart disease
o Recurrent thromboemboli (if clot blocks blood flow, BP up)
o Connective tissues disease
o Obstructive sleep apnea
o Amphetamines, cocaine |
|
|
Term
Describe the pathophys of Pulmonary HTN
|
|
Definition
o Medial surface of arteries hypertrophy
o Atheromas form on the pulmonary artery
o R ventricular hypertrophy because it’s working harder and harder (more resistance) |
|
|
Term
| Clinical Manifestations of Pulmonary HTN include: |
|
Definition
o Dyspnea
o Fatigue
o Chest Pain
o Respiratory distress
o Cyanosis
o R vent hypertrophy
o Cor Pulmonale: R side heart disease that starts from lung disease
o Thromboemboli |
|
|
Term
| Digoxin, Prostacyclins, endothelial receptor antagonists, and inhaled nitric oxide may be important treatment in: |
|
Definition
|
|
Term
| Treatment of Pulmonary HTN includes: |
|
Definition
o Oxygen
o Anticoagulation
o Lung transplant
§ Can be idiopathic, can be genetic
§ May just need new lungs
o Diuretics
o Digoxin
o Prostacyclins: reduces platelet aggregation and is a vasodilator
o Endothelial receptor antagonists
§ Dec damage done to endothelium
o Inhaled nitric oxide |
|
|
Term
Four types of Obstructive pulmonary diseases include:
S/S |
|
Definition
Emphysema (alveolar wall destruction and overinflation)
Chronic bronchitis (inflamation of airways)
Astma (airways are hyperresoponsive)
COPD
SOB, wheezing |
|
|
Term
| Hypersensitivity of the airways in conjunction with tightness, spastic contraction of bronchile smooth muscle and edema are characteristic of: |
|
Definition
|
|
Term
| Asthma is characterized by: |
|
Definition
| Hypersensitivity of the airways in conjunction with tightness, spastic contraction of bronchile smooth muscle, and edema |
|
|
Term
|
Definition
o Antigen-Antibodies
o Mast Cells
o Chemical Mediators (genetic factors)
§ Histamines
§ Leukotrienes
§ Eosinophilic chemotactic factor
§ Bradykinin |
|
|
Term
| Differentiate between Atopic and Nonatopic Asthma |
|
Definition
Atopic: allergic asthma
Nonatopic: no specificity; patterns of inflammation (day vs night) with certain triggers (exercise, smoking, occupaitonal, drugs) |
|
|
Term
| Type 1, IgE mediated hypersensitivity reactions that are triggered by specific things is characteristic of _____. |
|
Definition
|
|
Term
| This is triggered by drugs (NSAIDs), recurrent rhinitis (nasal polyps), and may also be related to your occupation |
|
Definition
|
|
Term
| Asthma has _____ phases. Briefly describe them. |
|
Definition
2 Phases: early and late
Early: bronconstriction, mucus, Edema
Late: chemical mediators (lots of them) |
|
|
Term
In asthama,
the bronchioles collapse during _____;
_____ is reduced;
and the _____ and _____ increase. |
|
Definition
expiration
maxiumum expiratory rate
functional residual capacity and residual volume increase |
|
|
Term
| There is NO genetic component to asthma. T/F? |
|
Definition
|
|
Term
| An emergency situation in which there is uncontrollable bronchoconstriction/spasm leading to hypoxia and acidosis is called _____. |
|
Definition
|
|
Term
| Describe some quick relief and some long term managment of asthma. |
|
Definition
Quick Relief:
- beta agonists, corticosteroids (for inflammation), and anticholinergic meds
Long term mgmt.
- anti-inflammatories, long-acting bronchodilators, leukotriene (signalling molecules for bronchoconstriction) modifiers/inhibitors |
|
|
Term
| A persistant cough with sputum production; lasting for 3 mo/year for 2 years; Cor pulmonale; and possible cancerous transformations are characteristic of: |
|
Definition
|
|
Term
Describe the pathophis of chronic bronchitis:
|
|
Definition
· Irritations from inhalants
o Smoke
o Dust
o Smog
· Mucosal glands hypertrophy
· Hypersecretion of mucous
o Proteases?
o Matrix metalloproteinases?
o Goblet cells hypertrophy? |
|
|
Term
| Blue bloaters are people who have _____ and are cyanotic with a productive cough, possible cor pulmonale, and infections |
|
Definition
|
|
Term
| Excess air in the lungs, irreversible enlargement, chronic irritation to lungs (cilia, macrophages, and mucous), and chronic obstruction (alveolar destruction) is characteristic of _____. |
|
Definition
|
|
Term
| Describe the pathophys of emphysema: |
|
Definition
· Protease (breaks down protein)/Anti-protease imbalance
· Deficiency of alpha 1 antitrypsin
o Normally inhibits proteases; anti-protease
o Pi locus on chromosome 14
· Oxidant/antioxidant
· Smoking increases ROS
· Loss of elastic recoil
· Inflammation |
|
|
Term
| When the lungs become over-distended, the pt will experience Dyspnea, a cough, and a wheeze. Other symptoms include weight loss, respiratory acidosis, Right HF, pneumothorax, and possibly a coma. These pts are known as _____ and characterizes _____. |
|
Definition
|
|
Term
| Describe differences between chronic bronchitis and emphysema: |
|
Definition
|
Chronic Bronchitis
|
Emphysema
|
|
40-45 yoa
|
50-77 yoa
|
|
Mild, late dyspnea
|
Early, severe dyspnea
|
|
Early, copious cough
|
Late cough
|
|
Cor Pulmonale (RHF) common
|
Cor Pulmonale (RHF) occurs late
|
|
Increased airway resistance
|
Elastic recoil decreased
|
|
Heart often enlarged
|
|
|
|
|
Term
| If a person appears confused, has visual impairment and is hyperventilation, they might be experiencing _____. |
|
Definition
|
|
Term
| Severe hypoxemia patients will present with the following symptoms: |
|
Definition
o Personality change
o Uncoordinated
o Impaired judgment
o Delirium
o Stupor
o Death |
|
|
Term
Cyanoisis is defined when the arterial blood contains _____ of deoxygenated _____ per _____ of blood.
It will apear blue primarily in: |
|
Definition
> 5 grams
hemoglobin
100 ml
Lips, nail beds, ears, cheeks |
|
|
Term
| A hypercapnic pt will experience dyspnea when the Co2 levels reach _____, and may experience lethergy and comatose when it reaches _____, and finally respiratory depression at _____. |
|
Definition
|
|
Term
| Early symptoms of Hypercapnea include: |
|
Definition
· Increased cerebral blood flow
o Headache
o Increased CSF pressure
o Papilledema
· Warm, flushed skin
· LOC changes r/t increased CSF pressure |
|
|
Term
| Arterial blood gases will be at the following levels when a patient is experiencing hypercapnia (pH, PO2, PCO2, HCO2): |
|
Definition
o pH = 7.35-7.45
o PO2 = 80-100
o PCO2 = 35-45
o HCO2 = 22-28 |
|
|
Term
| Describe treatments for a patient who is experiencing hypercapnia |
|
Definition
· Treat cause
· Airway clearance to remove obstruction
· Bronchodilator
o Esp if asthma
· Antibiotics
o If related to swelling from infection
· Oxygen supplementation
· Mechanical ventilation |
|
|
