Exam 4: Respiratory Diseases Flashcards
Acute rhinitis:
inflammation in the mucous membranes of the nose, generally viral, can be related to allergies
Acute pharyngitis:
usually a virus but can be caused by bacteria such as streptococcus or Group A strep. If caused by bacteria worry about rheumatic heart disease as a complication
Acute sinusitis
inflammation of sinuses, can be acute to chronic caused by virus-bacteria. Symptoms are HA, facial pain, pressure over sinuses, fever. Bending forward increases HA
Tonsillitis:
infection either viral or bacterial, sore throat and difficulty swallowing
COVID
– Can cause upper and lower inflammatory respiratory related issue
Flu -
A, B, C; droplet, aerosols, hand to hand contact. Outbreaks annually, bad for young, old, and immunocompromised. Starts as an upper travels to lower respiratory infections. The virus will break down the hosts protective barriers in both the upper and lower respiratory tract which puts the host at risk for pneumonia or other bacterial infection. Prognosis: vaccination does not necessarily prevent disease but is highly effective at preventing severe disease and complications. PNA is the most common complication
Acute Bronchitis
- Viral most common (Flu, RSV, C-19). Starts URI -> persistent cough (10-20 days), and potential wheezing, mild SOB, MSK pain. Patho: Inflammation and mucus in the bronchi and bronchioles due to an infection without evidence of pneumonia and/or COPD (note sputum color is not indicative of bacterial vs. viral). Self limiting.
Pneumonia (PNA)
Bacteria or virus. Hospital acquired and community acquired. Typical or atypical. Typical cough, fever, leukocytosis. H&P, chest x-ray, CT of chest, sputum culture, WBC lab. Defined: Inflammation of lung tissue in the alveolar space which fills with purulent drainage. Inhale droplets→ droplets enter upper airway and go to lung tissue→ gets to lower respiratory alveoli → mucus and exudate and edema hinder gas exchange
Tuberculosis:
Bacteria; Airborne transmission. Latent TB or inactive TB - body has contained the bacteria. Active TB - clinical presentation of symptoms. Tuberculin skin test to measure a delayed hypersensitivity (type 4). Positive TB test = exposure. Cough persistent >3 weeks, weight loss, night sweats.
Asthma
Chronic airway obstruction, bronchial hyper-responsiveness from mast cell production, airway inflammation, and in some airway remodeling. Cigarette smoke, pollutants, dust, frequent viral respiratory infections. Genetic predisposition to developing IgE mediated response to common allergies. Severity depends on degree of hyperresponsiveness and reversal of bronchial obstruction. Wheezing, cough, dyspnea chest tightness, can be worse at night. SOB, can get mucus plugs, use of accessory muscles, distant breath sounds and diaphoresis are ominous. Diagnostics: PFTs, H&P
COPD
Either Chronic Bronchitis (cannot get air in) and/or Emphysema (cannot get air out) Smoker*, genetics, history of asthma or hyperresponsiveness. By the time disease is detected it is advanced, goal is to slow progression down. Hypoxia symptoms, pursed lip breathing, barrel chest, tripod, WOB & SOB, adventitious BS. Diagnosis: ↑FVC time, ↓FEV1.0, ↓ ratio FEV1.0 to FVC, ↑RV, ↑TLC
Obstructive sleep apnea:
Hypoventilation syndrome. Intermittent cessation of airflow and apnea during sleep. Anatomy = major cause. Pickwickian syndrome = short, thick neck circumference. Loud snoring, choking or gasping during sleep, not restful sleep, daytime sleepiness, morning headaches. Worsened by the use of alcohol and sedative-hypnotic medications. Severe or untreated leads to pulmonary hypertension, cor pulmonale, polycythemia
Cystic fibrosis
Autosomal recessive. Impaired chloride transport from the CFTR gene mutation → ^Na absorption and water from the airways to the blood causing the mucociliary tract to be more viscid or sticky. This same process also occurs along the pancreatic and biliary ducts.
Pleural effusion:
Fluid within the pleural cavity. may be an exudate or transudate, purulent, lymph, or sanguineous. Etiology: heart failure, severe pulmonary infection, or neoplasm. Clinical manifestations: sharp pleuritic chest pain, dullness to percussion, and diminished bs on the affected side. Absent BS over the area of a pleural effusion. ↓Tactile fremitus over a pleural effusion. Empyema (infection) vs hemothorax (blood)
Pneumothorax:
collapsed lung, air in the pleural cavity that causes collapse, chest trauma or rupture of alveoli. Asymmetry, hyperresonance, absent BS, trachea not midline. Spontaneous, traumatic, and tension(some level of closure to create pressure - mediastinal shift)
