Module 15 Exam 3 Flashcards
what is orthopnea
ability to breathe easily only in an upright position
What are the locations of upper respiratory tract diseases
nose, sinuses, pharynx, larynx
what are the locations of lower respiratory tract diseases
diseases of the trachea, lungs
what is an example of an acute upper respiratory disease? lower?
- rhinitis, sinutitis, pharyngitis, influenza
- acute bronchitis, pneumonia
what is an example of a chronic upper respiratory disease? lower?
- allergic rhinitis
- TB, asthma, COPD, cystic fibrosis
what are the modes of transmission of upper respiratory diseases
- inhalation of airborne droplets
- indirectly contaminated hands or articles freshly soiled with discharge
what is acute bronchitis
an acute respiratory infection that involves large airways (trachea, bronchi)
what is the primary symptom of acute bronchitis
cough with or without phlegm, may last up to 3 weeks
what is pneumonia
an infections and subsequent inflammation of the lungs, caused by viruses, bacteria, fungi, mycoplasma, or parasites (respiratory tract of healthy person is able to defend)
what is the etiology of pneumonia
viral and bacterial and fungal
what is the most common cause of pneumonia
fungal
pneumocystits pneumonia (PCP)
pneumocystitis jirovecii
what is a community aquired pneumonia
-occurs in any individual in the community, person to person tranmission
what is a healthcare associated pneumonia (nosocomial)
- occurs 48-72 hrs after admission to healthcare facility
- main cause of death in hosp pts
- bacteria in perio pockets may serve as a resivoir for lung infection
what is nursing home acquired pneumonia caused by
- due to dysphagia from a decrease in saliva, cough reflex or swallowing disorders, aspiration of saliva
what is a hospital aquired pneumonia caused by
ventilator associated: no ability to clear oral secretions by swallowing of coughing
non ventilator- biofilm forms of endotrach tubes
what is medical management of pneumonia
bacteria: antibiotic
virus: bed rest and fluids
fungal: sulfa drugs
what are the symptoms and signs of viral pneumonia
- mild symptoms
- cough, sputum
- mild fever
- dyspnea
what are the signs and symptoms of bacterial pneumonia
- sudden onset
- cough, purulent
- high fever
- dyspnea
- pleuritic chest pain
what is tuberculosis
chronic infectious and communicable disease with world wide public health significance as a cause of disability and death
what groups have a high risk of contracting TB
- close contact w/ people w/TB
- reside and work in institutional settings
- from countries that have a high TB incidence
- provide medical or dental care for any of the high risk groups
what is the etiology of TB
mycobacterium tuberculosis
what is the transmission of TB
- travel in airborne droplet nucei in saliva or mucus
- inhalation
where does the local TB infection begin
lung alveoli
where does the TB survive best
high oxygen tension, such as the lungs
what are the 2 tests to determine exposure to TB
-Tuberculin skin test (mantoux test, PPD)
-interferon gamma release assay
blood test
When a test to determine TB exposure are positive what is done
- chest xray
- physical exam
- preliminary diagnosis, sputum exam
- definitive diagnosis: when seen in sputum, is is not confirmed but suspected, it must be grown in lab to confirm
what are oral manifestations of TB
mucosal leison, painful deep, irregular ulcer on dorsum of tongue, leisons can also occur on palate, lips, buccal mucosa, gingiva, glandular swellings
what things do we do to implement infection control measures in dental hygiene care with TB
- update med history
- recognize signs, symptoms of tb
- follow CDC guidelines
- update written protocol
do you treat a pt with active tb
no
what do you do as far at tx in a patient with a history of tb
- use caution, discuss signs and symptoms
- consult with physician, to confirm
- tx is permitted when pt is free of clinically active disease
what is asthma
-chronic respiratory disease consisting of recurrent episodes of dyspnea, coughing, wheezing leading to bronchial inflammation and muscle constriction
what is extrinsic (allergic or atopic) asthma
- triggers outside of body
- exaggerated response from inhalation of allergen
- activation of airway epthelial mast cells
what is the most commmon type of asthma
extrinsic
what is intrinsic (non allergic) asthma
- triggers from within the body
- triggers:emotional stress, GERD
- usually seen in adults
What is drug or food induced (non allergenic, non atopic*
- aspirin
- NSAIDS
- beta blockers
- food (nuts, shellfish, milk, strawberries)
- tartrazine(yellow food dyes0
- metabisulfide preservative in food and drugs
what is exercise induced asthma
- vigorous physical activity
- thermal changes during inhalation of cold are may provoke irritation and airway hyperactivity
what is infection induced asthma
-lung infectoins may provoke symptoms
What is one type of IgE mediated hypersensitivity reaction
atopic asthma
what is IgE
- one of 5 types of antibodies
- primary defense against allergens, breaks them down and removes from body
people with asthma are beleived to hyperreact and produce more what
IgE antibodies, results are symptoms of asthma
What are the steps in an IgE mediated hypersensitivity reaction
1-inital exposure to allergen IgE produced and binds to mast cells
2-on subsequent exposures antigen binds to mast cells
3-mast cells release asthma mediators
4-asthma mediators cause bronchoconstricion, vasodilation, mucus producton
what is local anaphylaxis
- allergen binds to mast cell in nasal cavitiy resuling in nasal rhinitis
- allergen binds to mast cell in bronchiole reusling in asthma
what is systemic anaphylaxisi
-allgergen binds to mast cells throughout the body resuling in anaphylaxis
what are signs and symptoms of an asthma attack
- chest tighness
- ineffectiveness of brochodilator
- wheezing, cough
- dilated pupils
- flushed
- confusion
- tachypnea
- tachycardia
how to prepare for possible emergency care in a asthma attack
- signs and symptoms
- stop tx
- rule out obstruction
- assist with inhaler
- administer 02
- monitor vital signs
what are drugs to avoid that are asthma attack triggers or decrease respiratory function
aspirin, sulfite, NSAIDS
narcotics barbituates
what are the two main asthma medication types
- long term control
- quick releif meds
what are oral manifestations of beta 2 agonist inhalers?
- decrased salivary flow and biofilm pH
- causes and increase in GERD
What should you do before tx with patient who has asthma
-remined them to bring inhaler, assess risk level, have 02 available, stress free environment
what should you do during tx with a pt with asthma
- prevent triggering hypersensitive airway with isolation
- use local without sulfites
- fl2 tx
what is COPD
pulmonary disorders that obstruct airflow
what are the 2 most common diseases of COPD
chronic bronchitis and emphysema
what is the primary etiology of COPD
tobacco smoke with occupational and environmental pollutants as contributing factors
What is the etiology of chronic bronchitis
- excessive respiratory tract mucus production sufficient to cause a cough with expectoration for at least 3 months o the year for 2 or more years
in chronic bronchitis difficulty breathing is present on
inspiration and expiration
what are the signs and symptoms of chronic bronchitis
- chronic cough
- copious sputum
- chest radiograph abnormalities
- sedentary , overweight, cyanotic, edematous
which disease is termed a blue bloater
chronic bronchitis
what disease is termed a pink puffer
emphysema
what is the etiology of emphysema
-distention of the air spaces distal to terminal bronchioles dues to destruction of alveolar walls
pts with ephysema have problems with breathing on
expiration
what are signs and symptoms of emphysema
- difficulty breathing on exertion
- barrel chest
- nonproductive cough
- weight loss
- chest x-ray abnormalities
what is the medical managment of COPD
no cure, decrease exacerbations (stop smoking, eliminate pollutants, adequate nutrition, drink water, exercise)
what are the 5 stages of COPD
at risk, mild, moderate, severe, very severe
what are oral manifestations of COPD
-similar to pts with asthma
What should we do before tx of a COPD patient
- precautions when cardiovascular problems present
- assess severity of COPD
- no N20
- tx preformed only on those with stable breathing
- ID patients who may experience exacerbation of symptoms under stress
- montiory b.p
- appt length may need to be modified
In COPD what should you do during tx
- antimicrobial preprocedural r inse
- avoid use of power driven scalers
- local without epi
what should you do in education of COPD patients
- stop smoking
- promote OH care
- discuss link between COPD and perio
- teach and promote oral self care exam
- frequent appts
what is cystic fibrosis
-autosomal recessive gene disorder, progressive, ultimately fatal, involves pancreas liver, lung
what is affected in cystic fibrosis
gene disorder, affects salt and water in epithelial cells of the respiratory tract and exocrine glands and results in thickened secretions
what happens to the respiratory tract in cystic fibrosis
- airways are always filled with phlegm, similar to pus, leading to chronic sinusitis, opportunisitc lung infection
what happens to the pancreas and intestinal tract in cystic fibrosis
-thick mucus clogs pancreatic ducts, prevent release of enzymes, food isnt properly digested or absorbed
what is the medical management of cystic fybrosis patients
- antibiotics including inhalation solution
- bronchodilators and anti-inflammatory agents
- chest physiotherapy
what is dental hygiene care of cystic fibrosis patients
-oral manifestations: gingivitis associated with dry mouth,
facilitate breathing: adapt chair, no rubber dam
