MedComplex-Exam 2 Part 1 (COPD, Pneumo) Flashcards
What is the OFFICIAL definition for CHRONIC BRONCHITIS? Defined as a __________ and production of ______ for a minimum of _____ months a year for at least ____ consecutive years.
chronic cough… sputum…3months…2 years
Which condition is “BULLAE” formation associated with?
Emphysema from Alpha-1-AntiTrypsin Deficiency
What is the term for deterioration of the elastic and reticular fibers of the lungs with the resultant loss of elastic recoil causing ENLARGED ALVEOLAR SPACES?
BULLAE
What is the #1 reason/cause for a pneumothorax?
Emphysema
______: are subpleural air-filled spaces formed by rupture alveoli which can rupture into the pleural cavity, causing a PNEUMOTHORAX.
BLEBS
______ are parenchymal air-filled spaces greater than 1 cm in diameter.
BULLAE
Which condition is associated with CURSCHMANN SPIRALS?
Bronchial Asthma
In Bronchial Asthma: The mucosal infiltrates consists of non-specific inflammatory cells, along with several _______. The mucus sometimes contains whorls of shed epithelial cells called __________
EIOSINOPHILS…Curschmann Spirals
What tissue/bodily fluid do you find Churchmann Spirals in a Bronchial Asthma patient?
mucus
The role of Alpha-1-AntiTrypsin in the body? Alpha-1-Antitrypsin is a ________, also known as an ________, which is essential in protection against naturally occurring ________.
serum protein… antiprotease… proteases
The role of Alpha-1-AntiTrypsin in the body? It is produced by the _____ and circulates in the serum, permeating tissues where it’s primary function is to NEUTRALIZE naturally occurring _______ in normal people who have the protein.
liver…. proteases
The role of Alpha-1-AntiTrypsin in the body? The proteases (that A-1-A neutralize) are produced by bacteria, PMN’s, monocytes, and macrophages during the phagocytic process, and are capable of destroying ______ and reticular fibers in the lung….WITHOUT A-1-A THIS LEADS TO ________ FORMATION IN THE LUNGS!!
elastin…BULLAE
Wait, what are the 4 types of cells that produce elastin eating proteases again?
1.bacteria 2.PMNs 3.Monocytes 4.Macrophages
Bullae are parenchymal air-filled spaces greater than ____ in diameter.
1 cm
What is the underlying association between COPD and poor oral health?
New research have linked PERIODONTAL DISEASE as a possible RISK FACTOR for the development of COPD.
What is the association between poor oral health and COPD??? The onset and progression of COPD is dependent on _______ in almost all cases and repeated _______ infections can worsen the lung disease.
smoking… bacterial
What is the association between poor oral health and COPD??? It is possible that the inflammation caused by ________may contribute to inflammation of the lining of the ________, leading to chronic bronchitis.
periodontal disease….bronchial tubes
What is the association between poor oral health and COPD??? Bacteria such as ________ and ________, seen in dental plaque (along with periodontal disease-associated enzymes in the saliva) may modify oropharyngeal mucosal surfaces to PROMOTE GROWTH of respiratory pathogens, like ________ and _______…SONS OF BITCHES!
Streptococcus and Actinomyces….Pneumococcus and H. influenza!!
What are the 4 diseases that comprise COPD?
1.Chronic Bronchitis 2.Emphysema 3.Bronchial Asthma 4.Bronchiectasis
What is the main cause of chronic bronchitis (90% of cases)?
smoking
What type of cell increases in chronic bronchitis?
goblet cells and there is an increase in mucus
What is the metaplasia in chronic bronchitis? (from what cell type to what cell type?
from columnar epi to stratified squamous epi
Which condition has blue bloaters? Which condition has pink puffers? Which condition has barrel chest?
Blue-Bloaters: chronic bronchitis…pink puffers: Emphysema…barrel= chest: emphaseyma
Bronchitis vs Emphysema: Cyanosis
Bronchitis
Bronchitis vs Emphysema: Pulmonary HTN
Bronchitis
Bronchitis vs Emphysema: Peripheral Edema
Bronchitis
What is a disease characterized by increased responsiveness of the bronchial tree to a variety of stimuli. These attacks are marked by wheezing during expiration, cough, and dyspnea?
Bronchial Asthma
Which WHITE BLOOD CELL goes hand in hand with Asthma?
EOSINOPHILS
What is a permanent dilatation of the bronchi which is the most common complication of chronic bronchitis?
BronCHIectasis
What is a VERY COMMON CLINICAL manifestation of Bronchiectasis?
Halitosis!
What is the species name for Legionella? What is its gram stain? Is it aerobic or anaerobic?
Legion-ella Pneumo-PHILA…gram negative…aerobic (WATER ENVIRONMENTS)
In Legionaires’ disease, No ______ to ______ transmission has been identified
person to person
Legionnaires’ Disease should be suspected in patients who have pneumonia who are over 50 y.o.a., are smokers, or if the sputum gram stains reveals _________ and very few organisms.
neutrophils
What organism is more associated with lung absecsses leading to pneumonia?
Staphlococcus (Aureus)
HOLY CRAPOLA: Staphylococcus aureus pneumonia tends to produce multiple ________….A _______ form of pneumonia….Common in debilitated hospitalized patients….The mortality rate is over ____%.
abscesses… virulent…50%
Which pneumonia causing organism is associated with RUST COLORED SPUTUM?
Streptococcus Pneumonia
Streptococcus Pneumonia: accounts for >___% of all bacterial pneumonias and usually reach the alveoli in droplets of mucus or saliva…..Usually affects the _____ lobes due to GRAVITY.
50%…LOWER
What type of pneumonia causes a “White out”?
pneumococcal lobar pneumonia
Klebsiella pneumoniae infection occurs in middle-aged, alcoholic males. A thick current-red _____ sputum is characteristic.
JELLY
____________ infection occurs in middle-aged, alcoholic males. A thick current-red jelly sputum is characteristic.
Klebsiella pneumoniae
Which pneumonia causing organism is associated with red-jelly sputum?
Kelb-Siella Pneumoniae
_________ is the most common HOSPITAL- acquired pneumonia characterized by vascular lesions that cause infarcts and necrosis of the lung parenchyma, and are the most common causes of lung infections in Cystic Fibrosis pt’s. A common source is contaminated ventilatory equiptment, and the mortality rate is over ___%.
Pseudomonas…70%
Pseudomonas is the most common hospital- acquired pneumonia characterized by vascular lesions that cause infarcts and necrosis of the lung parenchyma, and are the most common causes of lung infections in _________ pt’s.
Cystic Fibrosis
What is the world’s smallest bacteria (same size of virus) and causes walking pneumonia?
Mycoplasma Pneumoniae.
ROUTES: There are lots of bugs in the upper respiratory tract, but If ________ into the lower respiratory tract, they can cause pneumonia.
aspirated
ROUTES: Even some GRAM NEGATIVES from the gut can cause pneumonia by contamination of the ______ to the lungs!!!.
blood
ROUTES: Bacteria, such as Legionella or T.B., as well as various fungi and viruses that are not normally present in the nasopharyngeal flora may cause pneumonia if ______ accidently.
inhaled
ROUTES: Aspiration of infected particles in ______ contents: Such aspiration pneumonia is often caused by AEROBIC OR ANAEROBIC???? bacteria and is common in people who are unconscious, who have neurologic deficits, or are alcoholics who have vomited and have lost control of their ________.
gastric…ANAEROBIC…gag reflex
Hematogenous Spread: Bacteria may be transported to the lungs by the blood. Pneumonia is common in ______ and may develop secondary to UTI’s or GI tract infections.
sepsis
What are the main two points Dr. F mentioned about Alveolar Pneumonia? (what type of organism? What type of immune cell response)
Alveolar pneumonia is bacterial and it has a neutrophil driven
What are the main two points Dr. F mentioned about Interstitial Pneumonia? (what type of organism? What type of immune cell response)
Interstitial Pneumonia viral and mononuclear cell (lymphocytes, monocytes, macrophages, plasma cells)
What are two examples of Alveolar Pneumonia?
1.Broncho Pneumonia 2.Lobar Pneumonia
Interstitial pneumonia which primarily involves the alveolar
_______, which includes VIRAL pneumonia
septae
Are alveolar pneumonias focal or diffuse?
HA TRICKED YA! Focal (Bronchial) OR diffuse (lobar)
Which type of pneumonia (alveolar or interstitial) is most prevalent in debilitated elderly patients who are confined to bed?
alveolar
Pneumonia limited to the segmental bronchi and surrounding parenchyma is called ___________.
Bronchopneumonia
Widespread or diffuse alveolar pneumonia is called _________
Lobar Pneumonia.
Are interstitial pneumonias focal or diffuse?
usually diffuse and often BILATERAL
Periodontal Disease and Pneumonia: What type of pneumonia is associated with hospital patients having perio disease?
Nosocomial pneumonia (hospital acquired)
Periodontal Disease and Pneumonia: What are the three bugs that are causing nosocomial pneumonia in patients with Perio disease/poor oral hygiene?
- Staph Aureus 2.Pseudomonas 3.Klebsiella
Periodontal Disease and Pneumonia: What is the main factor that allows Staph, Pseudomonas, and Kelbsiella to live in the mouth in hospital patients-even thought these bugs aren’t normally there?
ANTIBIOTICS suppressing the normal flora
Periodontal Disease and Pneumonia: Which part of the respiratory tract are the bugs involved in this situation aspirated to?
the LOWER respiratory tract
