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Pathophysiology > chapter 5 respiratory disorders > Flashcards

chapter 5 respiratory disorders Flashcards

1
Q

What are examples of respiratory tract infections?

A 
Common cold
Rhinosinusitis (sinus infection)
Influenza (flu)
Pneumonias
Tuberculosis
Fungal Infections
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2
Q

What is a common cold?

A

Viral infection of upper respiratory tract

Most common respiratory infection

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3
Q

How is a common cold spread?

A

Very contagious, mostly spread by touch

Portal of entry: nose and eyes

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4
Q

How long does a common cold last?

A

about 7 days

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5
Q

What is rhinosinusitis (sinusitis)?

A

Infection or allergy obstructs sinus drainage

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6
Q

What are the acute symptoms of rhinosinusitis?

A

facial pain, headache, purulent nasal discharge, decreased sense of smell, fever

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7
Q

What are the chronic symptoms of rhinosinusitis?

A

nasal obstruction, fullness in the ears, postnasal drip, hoarseness, chronic cough, loss of taste and smell, unpleasant breath, headache

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8
Q

What are the symptoms of influenza?

A 
Systemic: fever
Pyschological: Lethargy and lack of appetite
Nasopharynx: Runny nose and sore throat
Respiratory: coughing
Intestinal: Diarrhea
Gastric: Nausea and vommiting
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9
Q

About how many people die from flu related illnesses each year?

A

36,000

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10
Q

How is influenza transmitted?

A

Transmission is by aerosol (3 or more particles) or direct contact

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11
Q

What 3 types of infections does influenza cause?

A
  1. Upper respiratory infection (rhinotracheitis)
    –Like a common cold with
    profound malaise
  2. Viral pneumonia
    –Fever, tachypnea,
    tachycardia, cyanosis,
    hypotension
  3. Respiratory viral infection followed by a bacterial infection
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12
Q

What is Pneumonia?

A

Inflammation of the lung parenchyma

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13
Q

What causes Pneumonia?

A
  • Aspiration of oral secretions
  • Inhalation of infectious organisms
  • Spread of infection from elsewhere in the body by circulation
  • Inhalation of chemical irritants or other non-pathogenic agents

these then cause a Bacterial, viral, fungal, protozoan lung infection

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14
Q

What are the 2 types of Pneumonia?

A

community and hospital

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15
Q

What bacteria and viruses are involved with community acquired pneumonia?

A 
Bacteria:
Streptococcus pneumoniae*
 Staph Aureus
 H. Influenza
 Gram negative bacilli
Viral
Influenza virus
Respiratory syncytial virus (RSV)
Adenovirus
parainfluenza
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16
Q

What bacteria are involved with hospital acquired pneumonia?

A 
Bacteria:
Escherichia Coli
Klebsiella
Pseudomonas
Staphylococcus Aureus
Serratia
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17
Q

When does hospital acquired pnuemonia occur?

A

Occurs 48 hours or more after admission

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18
Q

Is community acquired or hospital acquired pneumonia more common?

A

community

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19
Q

What are the risk factors of Pneumonia?

A 
Age very young or very old
Immunocompromised
Lack of cough reflex
COPD
Immobility
Smoking
Malnutrition
Tracheostomy or endotracheal tube
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20
Q

What is the pathogenesis of pneumonia?

A
  1. Inhalation or aspiration of microorganisms
  2. Survival past normal defense mechanisms
  3. Adherence to bronchial and/or alveolar epithelial lining
  4. either typical bacterial or atypical mycoplasma viral pneumonia develop
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21
Q

What 3 things must a person have to develop pneumonia?

A
  1. Exceedingly virulent organism
  2. Large inoculum (large amount or dose of the virulent organism)
  3. Impaired host or immune response
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22
Q

What is the pathogenesis of typical bacterial pneumonia?

A
  1. Adherence to alveoli or bronchial walls
    ↓
  2. Inflammation within the alveoli
    ↓
  3. large amount of exudates
    ↓
  4. consolidation of exudates in lower alveoli
    ↓
  5. Shunting of perfusion around non-ventilated alveoli
    ↓
  6. Hypoxemia (V
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23
Q

What are the manifestations of typical bacterial pneumonia?

A 
“Typical”
-Sudden onset
    --Fever, chills, pleuritic pain, 
      cough, purulent sputum 
       possibly blood tinged
-Positive sputum culture
-Elevated wbc’s 
-Pleuritic pain
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24
Q

What is the pathogenesis of atypical viral pneumonia?

A
  1. Inflammation of the alveolar septum and interstitial spaces
  2. Influenza virus is the most common etiology
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25
Q

What are the manifestations of atypical viral pneumonia?

A

Atypical”
“flu-like symptoms”
headache, fever, muscle aches, fatigue dry cough

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26
Q

Does bacterial develop from viral or does viral develop from bacterial?

A

bacterial is a complication of viral

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27
Q

What is the etiology of pneumococcal Pneumonia?

A

Streptococcus pneumoniae

-Gram + diplococcus

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28
Q

What are the risk factors of pneumococcal Pneumonia?

A
  • Asplenia or splenectomy

- Immunosuppression or incompetence

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29
Q

What normally follows pneumococcal Pneumonia?

A

a viral infection

30
Q

What are the clinical manifestations of pneumococcal pneumonia?

A
  1. Sudden onset
    —Fever 106° F, malaise,
    chills, watery sputum and
    ↓’d breath sounds
  2. Later
    —Bloody or rust colored
    sputum, pleuritic chest pain
  3. Elderly
    —Loss of appetite and ↓’d
    mental status
  4. Complications
    —Multiple drug resistance
31
Q

Who should get the PCV13 vaccine?

A

Infants and Children

>50 with weak immunity

32
Q

Who should get the PPSV23 vaccine?

A

> 65 years

2 years and older at risk for immune diseases.

33
Q

What is the etiology of legionnaire’s disease?

A

Legionella pneumophilia

34
Q

What are the risk factors of Legionnaire’s Disease?

A

Smoking
Chronic disease
Impaired immune status

35
Q

What are the clinical manifestations of Legionnaire’s Disease?

A
  1. Incubation
    • –2-10 days after exposure
  2. Fever ~104° F, dry cough,
    malaise, weakness, arthralgia and lethargy

3.CNS and GI symptoms

  1. Classic signs and symptoms
    —Pneumonia with
    hyponatremia, diarrhea and
    confusion
36
Q

What is the etiology of tuberculosis?

A

Mycobacterium tuberculosis

37
Q

What are the two types of tuberculosis?

A

primary or secondary

38
Q

What are the risk factors of TB?

A
  1. Immunosuppression
  2. Crowded living conditions
    • -Homeless shelters
    • -Prisons
    • -Drug-treatment facilities
39
Q

What are the steps of initial TB infection?

A
  1. Macrophages begin a cell-mediated immune response
  2. Takes 3–6 weeks to develop positive TB test
  3. Results in a granulomatous lesion or Ghon focus containingMacrophages
    T cells
    Inactive TB bacteria
40
Q

What is the disease process of TB?

A
  1. TB is inhaled
  2. Cell mediated response is a postive tb skin test
  3. the person responses normally or poorly
    - -normal repsonse: dormant lesion
    - - poor response: active diseas
  4. there is a change in immune competence with a dormant lesion and the disease becomes active
41
Q

What percentage of TB is primary (inactive)?

A

95%

42
Q

What is the pathogenesis of primary tb?

A

Inhalation of droplet nuclei containing TB germ
↓
respiratory bronchiole implantation
Cell mediated response

Tubercle is not killed
Positive TB skin test
↓
Granulomatous inflammatory response
↓
Ghon’s focus* or lesion (tb can become inactive)
43
Q

What percentage of TB is secondary (active)?

A

5 %

44
Q

What is the pathogenesis of active tb?

A 
Inflammation & TB replication continue
 ↓
Cavitation
↓
Erosion of surrounding tissue
Bronchioles
Blood vessels
45
Q

What are the clinical manifestations of the primary infection of tb?

A
  • Maybe asymptomatic

- + skin test 2-3 weeks after exposure

46
Q

What are the clinical manifestations of active tb?

A

-Productive cough > 3 weeks
-Systemic symptoms
–Fever, chills, night sweats,
fatigue, loss of appetite
and weight loss

47
Q

What are the later symptoms of tb?

A

-Hemoptysis
-Dyspnea and orthopnea
“consumption”

48
Q

Are most fungal infections of the lung symptomatic or asymptomatic?

A

asymptomatic

49
Q

How is a fungal infection controlled?

A

Infection controlled by host cell-mediated immune response

50
Q

Can a fungal infection of the lung be severe or fatal?

A

yes if the immune system is compromised

51
Q

What is the most common kind of fungal lung infection? Where does it come from? What does it cause?

A
  • Most common kind is Histoplasma capsulatum
  • Causes histoplasmosis
  • Comes from soil with bird excrement
52
Q

What are the 2 types of lung cancer?

A

small cell and nonsmall cell

53
Q

What is small cell cancer of the lung?

A
  • Characterized by small round cells the size of a lymphocyte.
  • Grow in clusters
  • Strongest association with cigarette smoking
54
Q

What is nonsmall cell cancer of the lung?

A
  • Series of cancers cell types

- Squamous cell, adenocarcinoma and large cell carcinoma

55
Q

What are the risk factors of lung cancer?

A

Smoking
Asbestos exposure
Metals and PVC

56
Q

What are respiratory disorders in neonates and infants?

A
  • Respiratory distress syndrome (RDS)
  • Bronchopulmonary dysplasia (BPD)
  • Bronchiolitis
57
Q

What are respiratory disorders in children?

A

Epiglottitis
Croup
Bronchiolitis

58
Q

What is the other name for RDS?

A

Hyaline membrane disease

59
Q

What are the risk factors for Hyaline membrane disease/ RDS?

A
  • Premature birth
  • Caucasian
  • Male gender
  • Insulin dependent mother
  • Early cesarean delivery (before 38 weeks gestation)
60
Q

What is RDS?

A
  • Lack of surfactant; infants are not strong enough to inflate their alveoli
  • Protein-rich fluid leaks into the alveoli and further blocks oxygen uptake
  • Treatment with mechanical ventilation may cause bronchopulmonary dysplasia and chronic respiratory insufficiency
61
Q

What are the clinical manifestations of RDS?

A
  • Respiratory distress within 24 hours of birth
  • Central cyanosis
  • Retractions
  • Grunting expiration
  • increased respiratory rate
  • Fatigue
62
Q

What is the treatment for RDS?

A
  • High dose → O2 fibrosis

- Positive pressure ventilation → barotrauma

63
Q

What is the clinical manifestations of BPD?

A
  • Tachypnea & tachycardia
  • Chest retractions & cough
  • Barrel chest
  • Finger clubbing
64
Q

What is viral croup?

A

Acute Laryngotracheobronchitis

65
Q

What is the etiology of viral croup?

A

Various parainfluenza and adeno viruses

66
Q

What are the clinical manifestations of viral croup?

A

Preceded by common cold s/s

  • Inspiratory stridor
    - -Hoarseness
  • Barking cough
    - -Dyspnea
  • Expiratory wheezing
    - -(severe disease)
67
Q

What is the etiology of epilglottitis?

A

Haemophilus influenzae, type B

68
Q

When is epiglottitis life threatening?

A

2-7

69
Q

What are the clinical manifestations of epiglottitis?

A

-Distinctive position
—Sitting forward, with chin
out and mouth open

-Difficulty swallowing →
drooling

  • Lethargic or anxious
  • High temperature
  • Rapid progression to complete airway obstruction without timely intervention
70
Q

What is the etiology of acute bronchiolitis?

A
  • Viral infection of the lower airways

- Respiratory syncytial virus (RSV) (most common)

71
Q

What is the pathogenesis of acute bronchiolitis?

A
  • Inflammation of the bronchioles

- Edema and airway obstruction

72
Q

What are the clinical manifestations of acute bronchiolitis?

A
  • Upper respiratory symptoms
  • Gradual development of respiratory distress
    • -Tachypnea
  • Wheezy cough
  • Irritability
  • Dyspnea
  • Air trapping
    • -Hypoxemia, respiratory acidosis

Pathophysiology (11 decks)

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