Chapter 30, 31 Flashcards
the most common port of entry for cold viruses is
conjunctival surfaces of the eyes
influenza could lead to
pneumonia
3 types of pneomina
community acquired, hospital acquired and immunocompromised
community acquired pneumonia is what bacteria
streptococus
hospital acquired pneumonia is
VAP
immunocomprimised pneumonia
defects in cellular immunity predispose to infections with viruses, fungi, mycobacterium and protozoa
example of immunocomprimised pneumonia in AIDS
pnuemocystis carini
pneumonia is the most common cause of death from
infectious disease
pneumococcal _________ _______ most common,
streptococcus pneumoniae
pneumococcal virulence is a function of its ______ which prevents or delays _______ by phagocytes
capsules, digestion
people at risk of pneumococcal
elderly, trauma patient/immunocomprimised
spleen play a major rode in both _____ production and ______ activity
antibody, macrophage
symptoms of pneumococcal
malaise, severe shaking chill, fever, crackles
in elderly pneumococcal they may only have 2 symptoms
mental status change and appetite change
people who should get vaccine for pneumococcal
elderly, sickle cell and splenectomy
tuberculosis is an _______ disease
inhaled
tuberculosis anergy
false negative reaction
anergy in immunocomprmised people it can mean that the person
has a true lack of exposure to the tuberculosis or is unable to mount an immune response to the test
ghon complex
nodules in lung tissue and lymph nodes
initial TB infection results in granulomatous lesion or ______ focus containing
macrophages, T cells and inactive TB bacteria
Ghon
2 types of lung cancer
small cell and non small cell
one of the key manifestations of center is
ectopic hormones secreted by tumor cells (paraneiplastic disorders)
ADH
syndrom of inapprotipate ADH
ACTH
cushings
PTH
related protein hypercalecemia
clubbing
fingers swell by nail
respiratory disorders have in infants and children why?
immature musculoskeletal system
2 types of respiratory obstruction in children
extrathoracic airways (upper)
intrathoracic airways (lower)
extrathoracic airways (upper) have inspiratory retractions as ribs are moved outward and body wall
does not expand with rib cage
intrathoracic airways (lower) rib cage retractions as ribs are pulled inward but air
does not leave lungs
premature babies are deficient in
surfactant
when a premature baby has a lack of surfactant they are not strong enough to
inflate their alveoli
T/F: premature infants are at greater risk of developing respiratory distress syndrome than term infants
T (why? bc premies are lacking type 2 alveoli which leads to no surfactant)
epiglottis medical emergency how does the child apper
toxic, lethargic, difficulty swallowing, muffle voice, drooling, fever, distress
if you see a child presenting with symptoms of epiglottis medical emergency what should you avoid
aggressive examination (do not look at throat or lay down unless at the hospital)
hypventialtion causes
hypercapnia and hypoxia
hypoventialltion can be caused by
depression of respiratory center, diseases of respiratory nerves/muslces, thoracic cage disorders
causes of respiratory failure
hypoventilation, ventilation/perfusion mismatching, impaired diffusion
impaired diffusion leads to
hypoxemia (not hypercapnia)
impaired diffusion is caused by
interstitial lung diease, ARDS, pulmonary edema, pneumonia
hypoxemia is low
O2
hypoxemia may present with cyanosis but why should you NOT rely on cyanosis
may be late and is unreliable in dark skin tones
mild hypoxemia produces few manifestations a slight impairment of _______ performance, and visual activity, hyperventilation and impaired ________, a patient may have complete personality change where grandma is nice but becomes _________
mental, judgement, comabtive
hypercapnia is a increase in
CO2
hypercapnia is caused by
respiratory acidosis
hydrothorax
serous fluid
empyema
pus
chylothorax
lymph
hemothorax
blood
pneumothorax
air
death can be cause with what pneumothorax
tension
one of the key signs of tension pneumothorax is
tracheal deviation
tension pneumothorax could lead to what kind of shock
obstruction
tension pneumothorax CPR and epi will or won’t fix it
wont
tension pneumothorax could happen because of
trauma, fall, car crash
atelectasis is
incomplete expansion of a lung or portion of the lung
atelectasis is very common
post op
when treating atelectasis you need to have your patient do/give to them
pain meds, mobility, deep breaths
3 types if obstructive airway disorders
bronchial, emphysema, cystic fibrosis
the tone of the ________ smooth muscles surrounding the airways determines airway radius
bronchial
the presence or absence of airway ______ influences airway patency
secretions
treatment for asthma is
B2 agonists
B2 agonists are broncho
dilator
factors contributing to the development of asthma attack
allergies, infections, exercise, drugs, hormones, airborne pollutants
___ die from asthma a day
10
in asthma you have airway
inflammation
responses to airway inflammation is
increased airway responsiveness
bronchospasm
airflow limitation
extrinsic asthma is related to
type 1 hypersensitivity
what causes acute response in extrinsic asthma
mast cells inflammatory mediators
intrinsic asthma can be caused by
infection, exercise, hyperventilation, cold air, inhaled irritants, aspirin
what are results in narrowing of the airway and airflow obstruction
bronchospasm, airway inflammation and hyperrespinsiveness
asthma manifestaions
chest constriction, wheezing, dyspnea, use of accessory muscles, pulsus paradoxus, nonproductive coughing
status asthmatics (severe asthma)
bronchospasm not reversed by usual measures, life threatining
ominous signs of impending death
silent chest, no audible air movement, PCO2 greater than 70
peak flow meter tells asthma patient
how acute the attack is
peak flow meter tells
FEV
COPD
emphysema, chronic bronchitis
emphysema
loss of lung elasticity and abnormal enlargement of air spaces distal to terminal bronchioles, destruction of alveolar wall and capillary beds
cause of emphysema
smoking
genetic type of emphysema
alpha 1 antitrypsin deficieny
chronic bronchitis
chronic productive cough of more than 3 months duration for 2 years, obstruction of small airways
mechanisms of COPD
obstructive airflow, decreased surface area for gas exchange, airway collapse, obstructed exhalation, air trapping
emphysema
trouble getting air out
bleb
distruction of alveloi
a bleb can develop ________ if it were to burst and leak into intraplueral space
pneumothorax
chronic bronchitis
chronic irritation of airways, increased number of mucous cells, productive cough
pink puffers
emphysema
blue bloaters
bronchitis
pink puffers increases respiration to maintain
oxygen levels
pink puffers may like
pursed lip breathing
do not give _______ ____ high O2 ammounts
pink puffers
blue bloaters cannot increase respiration enough to maintain
O2 levels
blue bloaters get
cyanosis, polycythemia, cor pulomale
blue bloaters cannot
breath enough
cystic fibrosis is autosomal
recessive
cystic fibrosis affects what group
caucasians
cystic fibrosis involves _____ transport proteins
chloride
cystic fibrosis fluid secretion in the ______ glands and epithelial lining of the respiratory, GI and reproductive tracts
exocrine
cystic fibrosis have high concentrations in sweat
NaCl
cystic fibrosis have a thick
mucous
cystic fibrosis life expectancy is
shorter
interstitial lung disease
characterized by restrictive changes in the lung; injury to the alveolar epithelium followed by inflammatory process
interstitial lung disease is restictive or obstructive
restrictive
interstitial lung disease have a low
FEV1
pulmonary embolism can be
thrombus, air, fat, amniotic fluid
pulmonary embolism can happen after a
long flight
pulmonary embolism oral contraceptives + smoking=
3x risk
pulmonary embolism: you can have an umbrella put in __________ to prevent clots from going into lungs
vena cava
cor pulmonale
right heart failure resulting from primary lung diease and longstanding primary or secondary pulmonary hypertension
ARDS
acute respiratory distress syndrom
ARDS is not a diease it happens
in response to something
ARDs exudate enters alveoli and blocks
gas exchange and makes inhalation more difficult
ARDS neutrophils enter the alveoil
release inflammatory mediators, release proteolytic enzymes
ARDS is know as
white out
ARDs have high probability that when alveolus is not functioning its a
shunt
hypoxemia respiratory failure is caused by
chronic obstructive pulmonary diease, restrictive lung diease, severe pneumonia, atelectasis, impaired diffusion
hypoxemia you have
tachycardia and restlessness
hypercapnia and hypoxemia go
hand in hand
hypercapnia and hypoxia can come from
upper airway obstruction
- infection
- tumors
weakness or paralysis of respiratory muscles
- brain injury
- drug over dose
- Guillain Baree
- Shock
- spinal cord injury
and chest wall injury
