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Pathophysiology I > Chapter 22: respiratory tract infections, neoplasms, and childhood disorders > Flashcards

Chapter 22: respiratory tract infections, neoplasms, and childhood disorders Flashcards

1
Q

What are the three components of respiration

A

1) ventilation
2) perfusion
3) diffusion

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2
Q

What are the two types of shunts?

A

1) anatomical: blood bypasses lungs

2) physiological: mismatch of ventilation and perfusion resulting in in adequate supply of O2

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3
Q

What is the percentage of water and solutes in snot?

A

95 percent water

5 percent solutes
- proteins, salts, immune cells

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4
Q

How much snot is produced day?

A

1-2 L

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5
Q

What are the five most common respiratory infections?

A 
common cold
rhinosinusitis
influence
pneumonia
TB
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6
Q

List five viruses, the season they are prevalent in for the common cold

A

1) RHINOVIRUS: early fall, late spring
2) SYNCYTIAL VIRUS: winter spring
3) CORONAVIRUS: winter spring
4) ADENOVIRUS: winter spring
5) PARAINFLUENZA

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7
Q

What part of the respiratory infection does the common cold affect? What is the one exception?

A

the upper resp tract

PARAINFLUENZA infects lower then upper

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8
Q

What 2 common cold viruses affect children under 3?

A

SYNCYTIAL virus

PARAINFLUENZA

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9
Q

What common cold virus affects people ages 5-50

A

RHINOVIRUS

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10
Q

What are the risk factors for the common cold?

A

age
previous exposure
season

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11
Q

What are the two ways the common cold can be transmitted?

A

aerosolization (less dangerous)

fomite transference
- contaminated obj

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12
Q

How is incubation of the common cold?

A

5-7 days

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13
Q

When is the common cold transmittable?

A

0-3 days after symptom onset

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14
Q

What are the portals of entry for the common cold?

A

nasal mucosa

conjunctiva (most common)

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15
Q

Describe the manifestations of the common cold

A

sore/scratchy throat

Nasal congestion or runny rhinorrhea

sneezing/coughing

malaise, fatigue, h/a, myalgia

fever in children, less common in adults

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16
Q

What type of treatment approach is used for the common cold?

A

symptomatic

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17
Q

What are the six risk factors for rhinosinusitis/sinusitis?

A

ALL OBSTRUCT DRAINAGE

1) upper resp tract infections
2) allergic rhinitis
3) nasal polyps
4) pressure changes
5) decongestant misuse
6) swimming and diving

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18
Q

What are the three types of rhinosinusitis/sinusitis?

A

ACUTE:
viral
bacterial (less common, inc duration)
fungal (rare)

SUBACUTE (4-12 wks)

CHRONIC (>12 wks)

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19
Q

What are the three common organisms (2 viruses, one bacteria) that cause acute rhinosinusitis/sinusitis?

A

rhinovirus

haemophilus influenza

streptococcus pneumonia

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20
Q

What is the common cause of chronic rhinosinusitis/sinusitis?

A

fstaphylococcus aureus

allergens

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21
Q

Describe the manifestations of rhinosinusitis/sinusitis

A

similar to cold/allergic rhinitis

1) maxilla pain/pressure inc on bending
2) h/a, PURULENT nasal discharge, FEVER, dec smell
3) PAIN IN TEETH

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22
Q

list the 4 ways that rhinosinusitis/sinusitis is treated

A

1) abx if necessary
2) intranasal corticosteroids
3) topic alpha-adrenergic decongestants
4) surgery for chronic

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23
Q

After AIDS, what is the last uncontrolled pandemic killer of humans?

A

Influenza

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24
Q

What age group is influenza infection highest in?

A

Children

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25
Q

What age group is mortality for influenza greatest in?

A

elderly

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26
Q

What are the two types of influenza that can cause epidemics?

A

Influenza A and B

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27
Q

What is the more mild form of influenza

A

influenza C

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28
Q

Explain what the antigen drift is in relation to influenza

A

RNA segments alter during replication creating new subtypes

make it difficult to vaccinate

29
Q

How is influenza spread?

A

inhalation of droplets

30
Q

Describe the incubation period and contagious period for influenza

A

INCUBATION: 1-4 days

CONTAGIOUS: 24 hrs prior and days after symptom onset

31
Q

List the symptoms of influenza in order of pathogenesis.

A

1) rapid onset of upper resp infection
2) epithelial dmg is possible resulting in rhinorrhea
3) malaise
4) fever, chills
5) myalgia, h/a, cough, sore throat

32
Q

List six complications of the flu

A 
SINUSITIS
OTITIS MEDIA
BRONCHITIS
BACTERIAL PNEUMONIA
VIRAL PNEUMONIA
REYE SYNDROME
33
Q

What is reye syndrome?

A

rare but often fatal condition of…

encephalitis and liver swelling

34
Q

What is otitis media?

A

middle ear inflammation

35
Q

What groups of the population (4) is the flu shot recommended for?

A

1) > fifty years old
2) immunosuppressed
3) chronic health issues
4) high risk environment

36
Q

When is the flu shot contraindicated?

A

1) <six months old
2) allergic reactions to components
3) acute febrile illness
4) h/o gullaine-barre syndrome

37
Q

What is the sixth leading cause of death in Canada?

A

pneumonia

38
Q

What is pneumonia?

A

resp disorder involving inflammation of the structures of the lung

39
Q

What are the 2 general causes of pneumonia?

A

1) Infectious

2) non-infectious (ex gastric secretions aspirated)

40
Q

List the five risk factors for pneumonia

A

1) impaired immune system
2) chronic lung disease
3) airway instrumentation
- tracheostomy
4) mechanical ventilation
5) strong microorganism

41
Q

What is it called when you get pneumonia r/t mechanical ventilation?

A

VAP: ventilation assisted pneumonia

42
Q

What is the criteria to be diagnosed with community acquired pneumonia?

A

must be acquired outside hospital or within 48 hours of admission

43
Q

What are the most common causes of community acquired pneumonia? (microorganisms) (4)

A

STREPTOCOCCUS PNEUMONIA

haemophilus influenza

staphylococcus aureus

gram neg bacilli

44
Q

What are the most common causes of hospital acquired pneumonia? (nosociomal)

A 
pseudomonas aeruginosa
staphylococcus aureus
enterbacter species
klebsiella pneumonia
Escherichia coli
seratia species
45
Q

What part of the respiratory tract does hospital acquired (nosociomal) pneumonia usually affect?

A

lower respiratory tract

46
Q

What is the most common organism for community acquired pneumonia? What is this type of pneumonia called?

A

Streptococcus pneumonia

Pneumococcal pneumonia

47
Q

where does streptococcus pneumonia colinze?

A

in the mucous membrane of the nasopharynx

may not progress

48
Q

What feature of streptococcus pneumoniae increases its durability?

A

has a polysaccharide capsule that delays digestion by phagocytes

49
Q

List the manifestations of pneumonia

A

1) fever
2) malaise
3) chills
4) productive cough
5) dec AE and crackles
6) pleuritic pain
7) elderly may not have fever, but instead loss of appetite and conffusion

50
Q

What is legionnaire disease?

A

it Is pneumonia caused by inhalation of aerosolized contaminated water/soil

51
Q

What are some objects that could cause the spread of legionnaire disease?

A

air conditioners

large water tanks

52
Q

What bacteria causes legionnaire disease?

A

Legionella pneumophila

53
Q

Describe the manifestations of legionnaire disease

A

same as pneumonia, but
rapid onset

1) dry cough
2) diarrhea
3) CNS alterations
4) arthralgia

54
Q

What is the usual cause of primary atypical pneumonia?

A

mycoplasma pneumoniae

55
Q

Describe the manifestations of primary atypical pneumonia

A

Patchy lung involvement

typical pneumonia symptoms but:

1) minimal lung consolidation as confined to alveoli and pulm institium
2) moderate amount of sputum
3) minimal rise in WBC

56
Q

What is the biggest risk and the implication of this risk of primary atypical pneumonia?

A

damage to the lung epithelium predisposing lungs to other infections

57
Q

What organism is the causes the most deaths on its own?

A

TB

58
Q

What bacteria causes TB? describe its characteristics

A

Mycobacteria tuberculosis hominus

1) airborne droplet
2) waxy cell wall (abx resistance)
3) aerobic (O2 rich environment)

59
Q

List 3 risk factors for TB

A

1) living in a country with high incidence
2) crowded/confined living conditions
3) immunocompromised

60
Q

Describe the pathogenesis of TB

A

1) airborne droplet inhaled and settles in alveoli
2) macrophage engulfs, bacteria multiply inside until macrophage ruptures
3) more WBC and fibroblasts accumulate
4) formation of granuloma
5) lymphocytes activated in a delayed hypersensitivity response to release cytokines that can kill bacilli (can also dmg lung tissue)

61
Q

Describe what primary TB is.

A

not previously unsensitised.

often asymptomatic and develop latent TB (non active, non contagious)

5 percent progress to active TB

62
Q

Describe the manifestations of primary TB

A 
Fever
pleuritic pain
wt loss
fatigue
night sweats
cough/dyspnea
63
Q

What is secondary TB?

A

it is reinfection or reactivation of primary tb lesion

cell mediated hypersensitivity dmgs airway causing cavitation

64
Q

Describe the manifestations of secondary TB

A 
low grade temp
night sweats
fatigue
anorexia
wt loss
cough
dyspnea
orthopnea (SOB
65
Q

What is a potential complication of secondary TB?

A

pleural effusion

66
Q

Describe the treatment for TB

A

multidrug regimen with chemo

DRUGS: izonazid, rifampin, pyrazinamide, ethambutol

VACCINE: BCG bacillus calmette-buerin

67
Q

Explain what a positive TB skin test indicates

A

It is triggered by a cell mediated immune response

it indicates past exposure, not necessarily current infection/active

68
Q

What are paraneoplastic syndromes?

A

syndromes caused by secretions from tumor

anorexia, cachexia, and fever are often considered this

Pathophysiology I (16 decks)

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