BMS test 2 Flashcards
sneezing and rhinorrhea (mucus) from what in allergic rhinitis
histamine –> trigeminal nerve –> sneeze
histamine, leukotrienes, prostagladings –> mucus
early and late phase of allergic rhinitis
early: mast cell degranulation via IgE, Th2
late: cytokines (IL4,5,13 and leukotrienes) can inflammation of cell and increase VCAM-1 to make infiltrate of eosinophil, neutrophil, t cell
healthy vs allergic rhinitis
healthy: th1, th17, treg –> th2 (AR)
gut dysbiosis in allergic rhinitis
increase bacteriodetes, e coli
decrease firmicutes
complications in allergic rhinitis
Eustachian tube dysfunction, chronic rhinosinusitis, adenoid hypertrophy, sleep apnea, learning delays
nasal polyps are made pf
mucus with immune cells
plasma cells, eosinophils, lymphoctytes and mucus secreting glands in stroma
chornic rhinosinusiits
sx and causes
sx: greewn yellow discharge, face pain, halitosis, fatigue, headache, polyps
causes: biofilm, osteitis (bone), bacterial superantigens (s. aureus)
non allergic rhinitis causes
viral, occupation, vasomotor, NARES (eosinophilia), rhinitis medicamentosa, rhinitis during pregnancy (estrogen increases hylaurpnic acid), vasulitide autoimmune and granulomatous disease
vasomotor rhinitis causes
nerve dysregulate, c fibers
PNS: mucus; Ach
SNS: vascular tone; NE and NPY
temp, cold, spicy, alcohol, strong odors
pharyngotonsillitis
viral or bacteria
sx
usually viral (adenovirus, rhinovirus, HIV, EBV)
sometimes bacterial (GABHS, pharyngeal diphtheria, STIs- gonorrhea, syphillis)
fungal (Candida albicans “thrush” cottage cheese plaques
sx: feverm odynophagia, dysphagia, hallitosis, airway obstruction
pharyngeal diphtheria cause and sx
corynebacterium diptheria
pseudomembrane on tonsils
GABHS suppurative and non suppurative complications
retrophayrngeal abscess (speech, neck, lymph)
peritonsillar abscess (uvula deviation)
parapharyngeal abscess (tismus, neck pain)
non suppurative (from endotoxins):::
scarlet fever (rash and strawberry tongue)
acute rheumatic fever (mycariditis, endocarditis)
post strep glomerulonephrtiits
PANDAS (kids, tics)
recurrent acute tonsillitis vs chronic tonsillitis causes
s pneumonia, s aureus, h influenza
chronic >3 months: s aureus, h influenza, bacteroides
tonsilloliths
microbial biofilms form in tonsillar crypts –> tonsiltis and halitosis
aphthous ulcer from
HHV-6 (herpes)
supra glottis / epiglottitis
cause
sx
H influenza type B
red flag
fever, drool, odynophagia, inspiratory stridor
laryngitis
cause
parainfluenza virus
bacterial if complication of virus (s pneumonia, h influenza, m catarrhalis)
non infectious i.e. GERD or vocal trauma
bacterial tracheitis
cause and sx
s aureus
airway obstruct, high fever, toxicity
spirometry in obstructive vs restrictive lung disease
obstructive (air trapped; cant exhale)
- FEV1/ FVC reduced <0.7
- increase RV, FRC (residuals)
-normal TLC
restrictive (trouble inhaling)
-physiologic FEV1/FVC
-reduced RV and FRC
-decrease TLC
extra vs intrapulmonary restrictive lung disease
and early to late sx
extra: obesity…
intra: ARDS…
early; inflammatory/ alveolitis - ground glass appearance
late; fibrosis- honeycomb lung
bronchial asthma 3 factors
inflame + hyperresponsive + reversible obstruction
hyperresponsive: narrowing via agents acting on smooth muscle i.e. histamine and increased wall thickness via edema and mucus and collagen deposits
early vs late asthma
early: bronchoconstriction, PGD2, leukotrienes, histamine
late: neutrophils (proteases), eosinophils (MBP)
key findings in asthma
Charcot leyden crystals (MBP) and curschmann spirals
spirometry in asthma
normal between exacerbations (early)