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Pathophysiology 2 > CARDIORESPIRATORY - PRODUCTIVE DISEASE (pnemonia & bronchiectasis & CF) > Flashcards

CARDIORESPIRATORY - PRODUCTIVE DISEASE (pnemonia & bronchiectasis & CF) Flashcards

1
Q

What is PNEUMONIA ?

A

Its an Inflammatory condition of the lungs leading to abnormal alveolar filling with consolidation and exudation.

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2
Q

Explain the pathology of PNEUMONIA.

A

During a pulmonary infection > acute inflammation, resulting in migration of neutrophils out of capillaries and into the air spaces (alveoli).
These cells PHAGOCYTOSE and release ANTIMICROBIAL ENZYMES and inhibitors resulting in more Inflammation and Oedema.

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3
Q

What are the different classification of PNEUMONIA ?

A
  1. ) COMMUNITY ACQUIRED PNEUMONEA (CAP)
    - Its acquired in a community setting ( burning chemicals )

2.) HEALTH CARE ASSOCIATED PNEUMONIA (HCAP)
- Its acquired when patients are being nursed within 90 days of being treated.
(not in a hospital or community setting)

  1. ) HOSPITAL ACQUIRED PNEUMONIA (HAP)
    - Acquired within 48hr or more of admission as they weren’t incubated
  2. ) VENTILATOR ASSOCIATED PNEUMONIA (VAP)
    - Occurs 48 - 72 hr post Intubation.
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4
Q

Name some possible causes of PNEUMONIA.

A
  • BACTERIA / FUNGI / VIRUS
  • PARASITES
  • CHEMICALS
  • ASPIRATION
  • INHALATION
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5
Q

What are the 4 stages of PNEUMONIA ?

And Briefly explain what happens in each stage.

A
  1. ) CONGESTION (INFLAMMATORY STAGE)
    - This occur in the first 24hr, it’s characterised by vascular engorgement ( heavy lungs )
  2. ) RED HEPITIZATION (DUE TO THE LIVER LIKE CONSISTENCY)
    - Occur after 2/3 days. Massive exudation develops whereby the alveolar spaces is filled with RBC & WBC. The affected areas appears red / firm and airless.
  3. ) GREY HEPITIZATION (LOSS OF RBS = LOSS OF RED COLOR)
    - Occur after 4/6 days. RBC disintegrate and the fibrin continues to exudate.

4.) RESOLUTION (PHYSIO IS INVOLVED)
- Occurs 6+ days
The consolidated exudate within the alveolar space undergoes progressive digestion to produce debris to be reabsorbed and ingested by MACROPHAGES or coughed out.

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6
Q

What are the signs and symptoms of PNEUMONIA

A
  • FEVER
  • MALAISE
  • FATIGUE
  • PRODUCTIVE COUGHING
  • DYSNOPOEA ( difficulty breathing )
  • WHEEZING
  • CHEST PAIN
  • RAPID HEARTBEAT
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7
Q

What is the general management for PNEUMONIA ?

A
  • ANTIBIOTICS / COUGH SUPPRESANTS ( medication )
  • O2 SUPPORT ( The disease causes a O2 diffusion disorder )
  • HYDRATION / IV FLUIDS ( This is due to lack of appetite & dehydration )
  • REST ( the body need to focus on fighting the infection )
  • VACCINATION
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8
Q

What are the 5 markers for diagnosing PNEUMONIA ?

A
  1. ) TEMPERATURE > 37.8*C
  2. ) HR > 100bpm
  3. ) ABSENCE OF ASTHMA
  4. ) CRACKLES
  5. ) DECREASED BREATH SOUNDS
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9
Q

What is BRONCHIECTASIS ?

A

Its when there is a permanent abnormal dilation in one or more of the lungs bronchi.

( extra mucus is secreted in the airways that are dilated = more prone to infection )

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10
Q

What is the Pathogenesis of BRONCHIECTASIS ?

VISCIOUS CYCLE

A
  1. ) Impaired mucociliary clearance leads to accumulation of secretions.
  2. ) Accumulation of secretions leads to infection by bacteria.

3.) Infection by bacteria leads to :
INCREASED mucus production / impaired ciliary performance / inflammatory response.

  1. ) Excessive Inflammatory response causes tissue damage.
  2. ) Tissue damage produces dilated bronchi including loss of ciliated epithelium.
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11
Q

BRONCHIECTASIS can be Idiopathic.

Name possible causes of Bronchiectasis ?

A
  • INFECTION ( in childhood )
  • CYSTIC FIBROSIS
  • IMMUNODEFIECIENCY
  • CILLARY DYSFUNCTION
  • INFLAMMATORY CONDITIONS
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12
Q

How is BRONCHIECTASIS Diagnosed ?

A
  1. ) Use CHEST X-RAY
  2. ) BLOOD & SPUTUM MICROBIOLOGY
  3. ) PULMONARY FUNCTION TESTS
  4. ) Use a HIGH RESOLUTION COMPUTED TOMOGRAPHY
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13
Q

What are the 3 types of Bronchiectasis ?

A
  1. ) SACCULAR BRONCHIECTASIS
    - Occurs in large Bronchi that become larger ( like a balloon )
  2. ) CYLINDRICAL BRONCHIECTASIS
    - Involves medium sized Bronchi which are symmetrically dilated.
  3. ) VARICOSE BRONCHIECTASIS
    - Constriction and dilation causes the Bronchi to deform.
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14
Q

What are some BRONCHIECTASIS signs and symptoms ?

A
  • CHANGE IN SPUTUM PRODUCTION
  • DYSNOPEA ( difficulty breathing )
  • HIGH TEMPERATURE
  • INCREASED WHEEZING
  • MALAISE / FATIGUE
  • REDUCED PULMONARY FUNCTION
  • DECREASED EXERCISE TOLERANCE
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15
Q

What are some possible management and treatment for BRONCHIECTASIS

A
  • PHYSIOTHERAPY
  • IV / ORAL / NEBULISED ANTIBIOTICS
  • BRONCHODILATORS
  • STEROIDS
  • NASAL SPRAYS
  • SURGERY
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16
Q

What is CYSTIC FIBROSIS ?

A

Its an Inherited autosomal recessive (genetic) disease due to a gene mutation.
( affects mucus / sweat /digestive juices )

17
Q

A defect in the CYSTIC FIBROSIS TRANSMEMBRANE PROTEIN (CFTP) will results in :

A
  1. ) RESPIRATORY DISEASE
    - abnormally concentrated fluid in the lungs leads to viscous secretions in the airways.
  2. ) HIGH IN NA+ SWEAT
    - chloride ions are not absorbed, preventing Na+ absorption
  3. ) PANCREATIC INSUFFICIENCY
    - (normal enzymes) Abnormal ion transport leads to dehydration of pancreatic secretion.
  4. ) GASTROINTESTINAL DISEASE
    - Intraluminal water deficiency causes problems with bowel movements
18
Q

How do you Diagnose someone with CF ?

A
  1. ) GENETIC TESTING ( carrier testing )
    - Mouthwash / blood test can determine if they’re a carrier of the faulty gene for CF.
  2. ) HEAL PRICK TEST
    - all babies born have been screened for CF
  3. ) SWEAT TEST
    - People with CF have problems in the transport of Chloride ions, which results in higher concentration of chloride ion (as salt) in sweat.
19
Q

What are the symptoms of CF at birth ?

A

-1.) SERIOUS BOWEL OBSTRUCTION ( MECONIUM ILEUS )
- Meconium is a thick, black substance that is too thick to be passed through causing
blockage in bowels.

  1. ) SIGNS OF JAUNDICE
    - build up of bilirubin in the blood and tissue causing the eyes and skin to be yellow.
20
Q

What are some LUNGS / DIGESTIVE / OTHER symptoms of CF ?

A
  • PERSISTENT COUGH
  • CROSS INFECTION
  • LUNG INFLAMMATION ( WHEEZING / SOB )
  • RECCURING CHEST & LUNG INFECTION
  • IMPAIRED DIAPHRAGM DUE TO LIVER ENLARGEMENT
  • LARGE SMELLY STOOLS
  • MALNUTRITION / STUNTED GROWTH
  • DIABETES
  • URINARY INCONTINENCE
  • INFERTILITY
  • LIVER FAILURE
21
Q

What are the different treatment and management for CF?

A
  • MEDICATIONS ( steroids / antibiotics )
  • DIETRY ADVICE
  • EDUCATION
  • PSYCHOLOGICAL SUPPORT
  • PHYSIOTHERAPY
  • EXERCISE
  • LUNG TRANSPLANT

Pathophysiology 2 (10 decks)

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