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Pathophysiology > Module 6 & 7 > Flashcards

Module 6 & 7 Flashcards

1
Q

Pharyngitis & Laryngitis

A
  • Pharyngitis is an inflammation of the pharynx that is a sore throat, which is often the result of a viral infection and associated with acute nasal infections. Laryngitis is an inflammation of the larynx (voice box), usually caused by a viral infection or a bacterial infection.
  • Causes
    • Viral > Common cold, flu, mono
    • Bacterial > Group A Streptococcus
      • Where else have we seen this?
        • Rheumatic fever
    • Allergies, GERD, Dehydration, Tumor, Smoking
  • Signs and Symptoms
  • Pain, dysphagia, lymphadenopathy, fever, white patches, fatigue
  • Sore Throat Symptoms & Treatments Slideshow
  • Testing
    • Rapid strep
    • Throat culture
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2
Q

Pharyngitis & Laryngitis

A
  • Most sore throats are caused by virus & associated with colds & flu
  • Common S/S:
    • Strep throat: sudden sore throat, high fever, fatigue, & swollen tonsils/lymph nodes.
    • Cough & runny nose is usually associated with colds/flu
  • Strep throat is treatable with antibiotics unlike colds/flu
    Why?
  • Serious complications can occur after prolonged, untreated strep infection such as ?
    • Rheumatic Fever
    • Infective Endocarditis?
  • Laryngitis – voice box is involved
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3
Q

Strep Throat complications

A
  • Complications
    • Rheumatic Fever &…
  • Post-Streptococcal Glomerulonephritis
    • Commonly effects children
    • Inflammation of the glomeruli
      • AB-Antigen complexes “clog up the filter”
  • S/S
    • Red or cola-colored urine due to damaged filter (hematuria)
    • Hypertension
    • Decrease in GFR
  • Tx
    • Antibiotic therapy
    • Control the symptoms
      • High blood pressure and kidney failure
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4
Q

Mononucleosis causes

A
  • Fever
  • Fatigue
  • Sore throat
  • Swollen lymph glands
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5
Q

Mononucleosis

A
  • B cell infection
  • Causes
    • EBV > Mucosal transmission > Incubation period 4-8 weeks
    • U.S: 95% of population has EBV Ab by age 35-40
      • What else was caused by EBV?
      • Burkitt’s Lymphoma, Hodgkin’s Lymphoma
  • Signs and Symptoms
    • Malaise, HA, Fatigue, Arthralgia, viral S/S, dysphagia
    • Triad: Fever, Pharyngitis, Lymphadenopathy
    • Enlarged spleen > 0.1 - 0.2% of mono patients have spleen rupture
  • Testing
    • Monospot/EBV test - detects heterophil Ab
  • -spleen can get enlarged and rarely will the spleen rupture
  • not high likely hood that the spleen will burst
  • test detects heterophil antibody Ab
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6
Q

Gerd

A
  • Gastroesophageal reflux disease (GERD) is a chronic digestive disease. GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe (esophagus)
  • Causes
    • Abnormal esophageal sphincter
    • Foods, EtOH, Medications, Stress, Smoking
    • Obesity, Peptic Ulcer
  • Signs and Symptoms
    • Heartburn>2x week –worse at night,
    • “chest pain”, dysphagia, sore throat
    • Cough: Acid in the distal esophagus stimulates a vagally mediated esophagealtracheobronchial cough reflex
    • Barrett’s esophagus  metaplasia
    • 1% have a chance of getting cancer
  • Testing
    • Endoscopy
    • Barium X-ray
  • -GERD=heartburn
  • Caffine is a possible aggrivation of heartburn, and spicy foods, high acid content, high fatty foods, can all exasperater gerd
  • smoking can also exasperate gerd
  • pepperment can lead to gerd, it causes the lower esophagus to?
  • normal epithelial of esophagus is simple stratified squamous (not good at protecting against stomach acid) (simple columnar epithelial tissue can take place to try and protect itself)
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7
Q

Tx for Gerd

A
  • Prop upper body up when sleeping
  • Eat smaller meals
  • Less fatty foods (fat relaxes LES)
  • Chew gum?-more saliva
  • Antacids
  • H2 blockers
  • PPI’s
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8
Q

H2 Blockers and PPI’s

A

1) H2 Blockers
- What do they block?
- Histamine to reduce the influence on the parietal cells to produce HCl
- 1 hr to 12 hrs
2) Proton Pump Inhibitors
- How do the work?
- Bind to the pump to stop HCl production
- Delayed onset
- Longer lasting 24 hrs to 3 days

  • H is the histamine. We have histamine receptors in the stomach, pretty much everywhere
  • histamine is allergies & running nose
  • histamine in blood vessels causes them to become leaky
  • H2 receptors can find in parietal cells of stomach
  • go over how H2 Blockers work
  • if you block H2 Receptor proton generation goes down
  • If you block gastrin receptor
  • If you block Ach?
  • Proton pump
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9
Q

Dysphagia

A
  • difficulty or discomfort in swallowing- Causes
    • Stress, Esophageal Strictures (narrowing of the esophageal lumen), Tumor, Thyroid (goiter), GERD
    • Neurological – Parkinson’s disease, Achalasia (failure of the LES to relax due to neuron dysfunction)
  • Signs and Symptoms
    • Odynophagia (painful swallowing), choking  aspiration, “stuck” food, weight loss
  • Testing
    • Endoscopy
    • Barium X-ray
    • CT
  • Usually see in older adults
  • stress can cause difficulty swallowing
  • hasimotos or any type of thyroid problem, anything that bothers the esophagus.
  • Painful swallowing is odynophagia
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10
Q

Tonsillitis

A
  • Inflammation of the tonsils
  • Lymph tissue – function declines after puberty (rare in adults)
  • Causes
    • Viral > most cases, EBV
    • Bacterial > group A beta hemolytic strep
  • Signs and Symptoms
    • Pain, lymphadenopathy, white patches, fever, laryngitis
    • Swelling > airway
    • Abscess
    • Strep > mc
  • Testing
    • Swab > Lab
    • CBC
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11
Q

Sore throat remedies

A

1) Salt water gargle
Salt osmotically shifts water from bacteria and inflammation
2) Humidifiers
Moisturizes the air and the throat
3) Honey to beverages
Has mild antibacterial properties
4) Chloraseptic ©Throat Spray
Phenol – active ingredient; relieves pain and irritation
5) Ricola Herbal Throat Drops©
Menthol – cooling/soothing effect on sore throat

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12
Q

Speech areas in the brain

A
  • Speech Center
    • Located on the left hemisphere Right handed and most left handed ppl
    • (90% of ppl)
  • Broca’s Area
    • Speech production
    • Responsible for motor control of the anatomic structures for speech
    • Tongue, lips and jaws
  • Wernicke’s area
    • Understanding of written and spoken language
    • Creates plan of speech
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13
Q

Stroke

A
  • What is it?
  • Most common artery involved in a stroke
    • Middle cerebral artery
      • Supplies most of the temporal lobe, anterolateral frontal lobe, and parietal lobe.
      • What was in the temporal lobe again?
    • Speech center
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14
Q

Broca’s vs. Wernicke’s Aphasia

A
  • Language deficit from lesions in same hemisphere as Wernicke and Broca areas
    = Lesion to Broca = nonfluent aphasia
    slow speech, difficulty in choosing words
  • Lesion to Wernicke = fluent aphasia
    speech normal and excessive, but makes little sense
  • Anomic aphasia
    • problems recalling words, names, and numbers
    • circumlocutions (speaking in a roundabout way) in order to avoid a name the person cannot recall or to express a certain word they cannot remember. Sometimes the subject can recall the name when given clues. Additionally, patients are able to speak with correct grammar; the main problem is finding the appropriate word to identify an object or person.
    • Sometimes subjects may know what to do with an object, but still not be able to give a name to the object. For example, if a subject is shown an orange and asked what it is called, the subject may be well aware that the object can be peeled and eaten, and may even be able to demonstrate this by actions or even verbal responses
  • Fluent aphasia means they talk just fine the words flow of tongue but they don’t make any sense
  • Brocas aphasia is super slow
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15
Q

Take a deep breath

A
  • Can live without food
  • Can live without water
  • Can not live without breath
  • Breathing happens unconsciously
  • How do we breathe without thinking about it?
    • Involuntary/Voluntary control
    • Receptors
      • Central: pH, PaCO2, PaO2 from the CSF
        • CO2 diffuses across BBB
        • Become insensitive if CO2 levels remain high long term
      • Peripheral: pH, PaCO2, PaO2 from the carotid bodies
        • Sensitive to PaO2 the most
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16
Q

Cough

A
  • Protective reflex to clear airways
    • Acute: URI, allergies, aspiration
    • Chronic: >3 weeks
      • Smokers: chronic bronchitis
      • Nonsmokers: asthma, allergies, GERD
      • CA (Cancer)
  • Hemoptysis - coughing up blood
    • Infection, inflammation, CA, infarction
  • -Cough is protective, it can mean a ton of different things
  • aspiration is inhaling something into trachea
  • chronic cough an ACE inhibitors can cause chronic cause. They increase K levels know why this is
  • coughing up blood could be a number of things
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17
Q

Pulmonary function tests

A
  • Vital Capacity (VC)
    Maximum amount exhaled after max inhalation
  • Residual Volume
    Air remaining in the lungs after the most complete expiration possible
  • Total Lung Capacity (TLC)
    The amount of air in your lungs plus IRV+RV
  • Inspiratory Reserve Volume (IRV)
    Max Inhalation
  • Expiratory Reserve Volume (ERV)
    Max exhalation
  • Forced Expiratory Volume x 1 sec (FEV1)
    Max exhalation over 1 sec.
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18
Q

Breathing terms

A
  • Dyspnea: Difficult or labored breathing; SOB, air hunger
    • S/S Stridor Video Clip
      • Stridor (upper airway – inspiration only – high pitched), Wheeze (lower airway – inspiration and expiration – lower pitched), anxious/distressed expression
      • Flaring nostrils
      • Accessory muscles – scalenes, SCM, traps, pecs
      • Gasping
  • Orthopnea: dyspnea on lying down
  • PND: Paroxsymal Nocturnal Dyspnea
    • Waking up at night with dyspnea
  • Dyspnea can see DIB difficulty in breathing?
  • stridor is a good sign, its better than no sounds
  • wheeze: bronchiole?
  • orthopnea: you would write patient has 3 pillow orthopnea
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19
Q

Respiratory Patterns

A

1) Kussmaul
- Consistent very deep breathing, increase or normal RR, large tidal volume (TV)
- Metabolic acidosis (often DKA)
2) Labored
- Slow RR, Large TV, prolonged in & ex (large airways)
- Obstruction
3) Restricted
- Restrictive lung diseases - difficulty with getting air in
* Cheyne strokes
- Periodic breathing, alternate between apnea & tachypnea
* Physiologic in neonates
* Pathologic in diminished brain stem perfusion, damage to respiratory centers
* Associated with near death

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20
Q

Tuberculosis (TB)

A
  • Infectious lung disease – used to be called ‘Consumption’
    • Airborne droplets
  • Pandemic > 1/3 population
    • ~ 3 million deaths per year
    • 2005: 14,093 cases in the U.S.
    • Leading cause of death from a curable infectious disease
  • Causes
    • Mycobacterium tuberculosis > incubation period 2-8 weeks
    • Decreased immune system > High rate of co-infection with HIV
    • Crowded living quarters, poverty, lack of medical care, drug resistance
  • Signs and Symptoms
    • Active > asymptomatic during early stages
      • Cough that produces purulent sputum develops slowly
      • Night sweats, fatigue, fever/chills, pleurisy, caseous necrosis
    • Systemic > can affect any other organs
    • Infection > asymptomatic, granulomas (Ghon)
  • Airborne droplets most common way to spread TB
  • TB is on the comeback
  • Long incubation period up to a month
  • mycobacterium TB acid fast stain
  • caseous necrosis is cheeselike necrosis
  • TB can go systemic and systematic?
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21
Q

Testing for TB

A
  • Testing
    • TB skin test – Doesn’t indicate if active TB or has had TB in the past
    • Chest X-ray
    • Culture & Sensitivity test
  • Outside of the U.S.
    TB vaccine is given
    This would give a positive result for the TB skin test
  • Only thing this test tells you is if a person has had some type of immune reaction to the antigens in TB. They will have memory cells and a positive skin test.
    Someone that has a TB vaccine they will test positive for it.
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22
Q

A person may contract pulmonary tuberculosis from?

A

Inhaling droplets from a cough or sneeze by an infected person

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23
Q

Ghon Complex - Granulomas of TB

A

Granuloma is a walled off calcified area

  • bacteria can go dormant for a long time
  • Dead lung tissue
  • Area of caseous necrosis can become reactivated later in life
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24
Q

TB Tx

A

Tx

  • Combination of 4-6 drugs at once to reduce the chance of antibiotic resistance
  • First line of drugs:
    • Isoniazid (false positive for hematuria) (can turn urine orangy)
    • Rifampin
    • Pyrazinamide
    • Streptomycin
    • Ethambutol
  • 6-9 months of Tx to cure the disease
  • HCPs:
    • Wear a disposable particulate respirator mask
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25
Q

Pneumonia

A
  • Inflammatory process that can involve all or part of the lungs
  • 6th leading cause of death in the U.S.
  • Cause:
    • Infection of respiratory tract (i.e. bacteria, viruses, fungi)
  • At risk populations:
    • People w/ underlying chronic diseases
    • Immunocompromised patients
    • Nosocomial infections
  • S/S:
    • High fever, cough, malaise, breathlessness
    • Symptoms vary upon individual, severity of infection and causative agent
    • Crackles
  • Tx:
    • Antibiotics for bacteria, No effective Tx for viral pneumonia
    • Supplemental O2
26
Q

Acute Bronchitis

A
  • Inflammation of the bronchial tree caused by infection or irritating factors (i.e. smoke)
  • Causes
    1) Secondary to URI
    2) Non-infectious > environmental toxins, smog, cigarette smoke, GERD
  • Signs and Symptoms
  • Productive cough, chest pain/congestion, wheezing, fever/chills, DIB
  • Testing
    • Clinical
    • Chest X-ray
    • Pulmonary functional tests
  • Tx
    • Antibiotics, rest

*Could lead to chronic bronchitis

27
Q

COPD (Chronic Obstructive Pulmonary Disease)

A

3 main types:

1) Chronic Bronchitis
2) Emphysema
3) Asthma

28
Q

COPD Chronic Bronchitis

A
  • Inflammation of the bronchi (and bronchioles) with excess mucus production
  • Chronic Bronchitis > 3 months for 2 or more consecutive years
  • Airway obstruction & hyperplasia of mucus-producing glands
  • Causes
    1) Long term pulmonary disorders
    2) Smoking
    3) Scarring and damage of tissue
  • Signs and Symptoms
    1) Blue Bloaters
    • Hypoxemia and polycythemia
    • Right heart failure - bloated
      2) Productive cough, SOB, DIB, wheezing
  • Testing
    1) Pulmonary Functional tests
    2) Chest X-ray/CT
    3) Sputum culture
29
Q

Chronic Bronchitis Tx

A

1) Stop smoking
2) Inhaled bronchodilators
3) Continuous O2

30
Q

COPD-Emphysema

A
  • Alveolar destruction – NOT alveolar collapse
  • Causes
    1) Smoking/Secondhand smoke
    2) Genetic (Alpha 1 antitrypsin deficiency) - The wild-type protein binds to and inhibits trypsin and also the blood protease elastase. In the absence of alpha1-antitrypsin, elastase degrades the fine tissue in the lung that participates in the absorption of oxygen, eventually producing the symptoms of emphysema.
  • Signs and Symptoms
    1) Pink Puffers - Increased RR
    2) Cough, dyspnea, fatigue, weight loss, clubbing (pic later), barrel chest
  • Testing
    1) Pulmonary Functional Tests
    2) Decrease in tidal volume
    3) Chest X-ray
    4) Arterial Blood Gases test
31
Q

COPD Emphysema Tx

A

Tx- O2

  • Similar to chronic bronchitis (bronchodilators, stop smoking)
  • Pursed lipped breathing
  • increases exhalationg
32
Q

COPD – Chronic Bronchitis vs. Emphysema

A
  • Blue Bloater: Chronic Bronchitis
    ↓ventilation & ↑ cardiac output
  • Pink Puffer: Emphysema
    ↑ ventilation & ↓ cardiac output
33
Q

COPD – Chronic Bronchitis vs. Emphysema

A
  • Blue bloater: Chronic bronchitis Excessive mucus production with airway obstruction resulting from hyperplasia of mucus-producing glands, goblet cell metaplasia, and chronic inflammation around bronchi.
    Unlike emphysema, the pulmonary capillary bed is undamaged Instead, the body responds to the increased obstruction by decreasing ventilation and increasing cardiac output.
  • There is a dreadful ventilation to perfusion mismatch leading to hypoxemia and polycythemia.Because of increasing obstruction, residual lung volume gradually increases (the “bloating” part). They are hypoxemic/cyanotic because they actually have worse hypoxemia than pink puffers
  • Pink puffers: EmphysemaDestruction of the airways distal to the terminal bronchiole–which also includes the gradual destruction of the pulmonary capillary bed and thus decreased inability to oxygenate the blood.
    So, not only is there less surface area for gas exchange, there is also less vascular bed for gas exchange–but less ventilation-perfusion mismatch than blue bloaters (hence: pink if compared to bronchitis).
  • The body then has to compensate by hyperventilation (the “puffer” part).Some of the pink appearance may be due to the work (use of neck and chest muscles) these folks put into just drawing a breath.
34
Q

Asthma

A
  • Inflammatory airway disorder with bronchoconstriction
  • Mast cells produce histamine > contraction of smooth muscle > smooth muscle hypertrophy
  • Causes
    1) Allergies
    2) URI
    3) Exercise
    4) Cold air
    5) Pollution
  • more common in
35
Q

V/Q: Ventilation and Perfusion

A
  • Ventilation (V) = air flow
  • Perfusion (Q) = blood flow
  • Healthy V/Q = 0.8 - 0.9 average
  • Apex V/Q = 3.43
  • Base V/Q = 0.64
  • When standing (gravity)
36
Q

V/Q: Ventilation and Perfusion

A
  • V/Q mismatch: Major cause of hypoxemia
  • V/Q1: Poor perfusion of well ventilated area, alveolar dead space, Pulmonary Embolism (PE), hypotension
  • Alveolar dead space = an area where alveoli are ventilated but not perfused
37
Q

Pulmonary Embolism (PE)

A
  • Occlusion of a portion of the pulmonary vascular bed by an embolus
  • Can cause infarction
  • If no infarction, clot will be dissolved by fibrinolytic system
  • Causes
    • DVT (deep veinous thrombosis) > 90% are due to clots formed in leg and pelvis veins (lower extremities above knee)
  • Signs and Symptoms
    1) Sudden onset > chest pain, SOB
    2) Wheezing, Cyanosis, Syncope
    3) S/S DVT’s > often asymptomatic
  • So, PE can be difficult to diagnose
38
Q

Pulmonary Embolism (PE) testing

A
  • Testing
    1) Chest X-ray
    2) (CT) MDCTA - High-resolution Multidetector Computed Tomographic Angiography is preferred study now
    3) V/Q scan – used to be the preferred study
39
Q

Pulmonary Embolism (PE) Tx

A

1) Prevention
2) Leg elevation, bed exercises, position changes, early postoperative ambulation, pneumatic calf compression
3) Anticoagulant medication
- Low molecular weight Heparin
- Warfarin
- Coumarin
- Life threatening, fibrinolytic agent will be used:
i. e. Streptokinase

40
Q

What is Cystic Fibrosis and its causes?

A
  • an inherited disorder that causes severe damage to the lungs and digestive system.
  • Causes
    1) Autosomal recessive (chromosome 7) > Chloride metabolism
    • Cl- remains inside cell and via osmosis, dehydrates mucus
      2) 1 in 28 in U.S. are carriers
      3) Multi-organ disease, but primarily lungs
    • Respiratory failure is almost always the cause of death
      4) Thick mucus overproduction due to decreased chlorine secretion
      5) Neutrophils
  • Create damaging proteases
  • Damage lung tissue
41
Q

Cystic Fibrosis s/s, testing, Tx

A
  • Median age of Dx: 6 months
  • Median survival age: 42
  • Signs and Symptoms
    1) persistent cough, wheezing, frequent infections (pneumonia), clubbing and barrel chest develop over time
    2) Failure to Thrive (FTT) - low weight based upon age due to malabsorption of nutrients and meconium ileus
    3) Frequent loose, oily stools due to pancreatic dysfunction
    4) Possible diabetes due to pancreatic autodigestion
    5) Possible infertility due to vas deferens occlusion
  • Testing
    1) Sweat test > sweat chloride conc. >60 mEq/L
    • Sweat gland dysfunction - genetic protein regulates chloride to the cytoplasm
      2) Genetic testing
  • Tx
    1) Mucus clearance
    2) Antibiotics
    3) Pancreatic enzymes before meals throughout lifetime (missing in 90% of CF patients)
42
Q

Fibrotic Lung Disorders

A
  • Causes
    1) Silicosis > mining (quartz in rocks), construction, sand blasting
  • Oldest known occupational lung disease
    2) Asbestosis > Inc. risk mesothelioma (lung cancer)
    3) Sarcoidosis > Autoimmune development of granulomas
    4) Dust, Animal Droppings
    5) Pulmonary Infections > acute and chronic
  • Signs and Symptoms
    • Cough, wheezing, DIB, chest pain, clubbing
  • Testing
    1) Chest X-ray/CT
    2) PFT’s (pulmonary functional tests)
    3) Bronchoscopy
43
Q

Silicosis

A

By polarized light microscopy silica crystals can be seen as the etiology for most pneumoconioses (even those in coal miners)–Here they are seen as bright white crystals of varying sizes.

44
Q

Asbestosis

A

This long, thin object is an asbestos fiber. Many houses and offices still contain building materials with asbestos, particularly insulation.

45
Q

Bronchiectasis

A
  • Persistent abnormal dilation of the bronchi
  • Usually in conjunction with another respiratory condition
  • Causes
    1) Infection > acute or chronic
    2) CF, TB
  • Signs and Symptoms
    1) Productive cough > foul-smelling, blood
    2) DIB, fatigue, clubbing, cyanosis
  • Testing
    1) Chest X-ray/CT
    2) Sputum culture
    3) CBC
    4) Sweat test
    5) TB test
46
Q

Bronchiectasis occurs when?

A

Bronchiectasis occurs when there is obstruction or infection with inflammation and destruction of bronchi so that there is permanent dilation. Once the dilated bronchi are present, as seen here grossly in the mid lower portion of the lung, the patient has recurrent infections because of the stasis in these airways. Copius purulent sputum production with cough is typical.

47
Q

Atelectasis

A
  • Collapsed lung
  • Signs and Symptoms
    1) DIB, chest pain, cough
  • Risk > pneumonia
  • Testing
    1) Chest X-ray/CT
  • Tx
    1) Remove obstruction
    2) Chest physiotherapy
    3) Incentive Spirometry
48
Q

Bronchiolitis, Croup, Epiglottitis

A
  • Bronchiolitis: inflammation of bronchioles (2-12 months)
    1) RSV > respiratory syncitial virus
    2) Also common after lung transplants
    3) Bronchiolitis obliterans –
    4) fibrotic process that occludes airways
  • Croup: inflammation and swelling around vocal cords (6mos.-5yrs)
    1) Laryngotracheobronchitis > Parainfluenza virus
    2) Barking cough, stridor
  • Epiglottitis: inflammation of epiglottis (2-7 yrs)
    1) Drooling, leaning forward to breath, fever, stridor
    2) H. influenza used to MC before vaccine made available
    3) Medical emergency due to potential obstruction of airway
  • Signs and Symptoms
    • Wheezing, retractions, cyanosis, cough, tachypnea
  • Testing
    • Chest X-ray, ABG’s, Nasal cultures > RSV, CBC
49
Q

Pulmonary Hypertension

A
  • Causes
    1) Atherosclerosis – smaller lumen = increased pressure
    2) Left - sided heart failure
    3) PE, Valvular defect, ARDS, Cirrhosis
  • Signs and Symptoms
    • SOB esp. with exertion, chest pain, fatigue, edema
    • JVD, HSM
  • Testing
    1) CXR/CT
    2) EKG
    3) PFT
50
Q

ARDS & Respiratory Failure

A
  • Acute lung inflammation and diffuse alveolocapillary injury
    • Decreased O2 to lungs
    • Over 30% of ICU patients are complicated by this syndrome
    • 40% mortality rate for increased fluids alveoli > “crackles”
  • Signs and Symptoms
    • Tachypnea, hypotension, SOB, arrhythmias, ALOC > Respiratory Failure > MODS (Multiple Organ Dysfunction Syndrome)
    • V/Q mismatch
    • Respiratory Failure (inadequate gas exchange) PaO2 50, pH
51
Q

ARDS & Respiratory Failure

A
  • Pneumonia, Shock, Aspiration, Trauma (inhaled toxic fumes)…
  • Endothelial damage > neutrophil and macrophage activity
    • create toxic mediators that extensively damage the alveolocapillary membrane
    • increase capillary permeability
    • creates pulmonary edema
    • also creates pulmonary vasoconstriction > more V/Q mismatching
  • Epithelial damage  type II alveoli cells damaged
    • decreased surfactant
    • alvoeli and respiratory bronchioles collapse
  • Chemical mediators can spread to other organs > MODS
52
Q

SIDS - Sudden Infant Death Syndrome

A

The sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.

M>F, almost always at nighttime sleep, ↑during winter, often times a respiratory infection precedes SIDS


53
Q

SIDS - Sudden Infant Death Syndrome Etiology

A
  • Unknown etiology - triple-risk model:
    1) an infant must have some sort of biological vulnerability, such as a heart or brain defect,
    2) combined with an environmental stressor, such as stomach sleeping,
    3) and be in a critical developmental period.
54
Q

Coccidioidomycosis- Valley Fever

A

Coccidioides immitis-fungal infection acquired by inhaling the arthrospores in dust in southwest

  • 60% of patients are asymptomatic & resolve on their own
  • 150,000 cases annually in U.S.
  • S/S:
    1) Flu-like symptoms
    2) Fever
    3) Chest pain
    4) Cough
    5) Night sweats
    6) SOB
    7) Erythema nodosum (painful nodules in the lower legs
  • Complications: Disseminated disease
    • disease spread throughout body
55
Q

Coccidioidomycosis- Valley Fever Erythema nodosum (painful disorder of subcutaneous fat)

A
  • Infection
    1) Streptococcal infection
    2) Primary infection of Tuberculosis
    3) Mycoplasma pneumoniae
    4) Histoplasma capsulatum
    5) Yersinia
    6) Epstein-Barr virus
    7) Coccidioides immitis
    8) Cat scratch disease
  • Autoimmune disorders, including:
    1) Inflammatory bowel disease
    2) Behçet’s disease
    3) Sarcoidosis
  • Pregnancy
    Medications, including:
    1) Sulfonamides
    2) Penicillins
    3) Oral contraceptives
    4) Bromides
    5) Hepatitis B vaccination
  • Cancer, including:
    1) Non-Hodgkins lymphoma
    2) Carcinoid tumours
    3) Pancreatic cancer
56
Q

Coccidioidomycosis

A

This well-formed granuloma has a large Langhans giant cell (fusion of macrophages) in the center. Two small spherules of Coccidioides immitis are seen in the giant cell.

57
Q

Silicosis

A

lung fibrosis ( thickening and scarring of connective tissue) caused by the inhalation of dust containing silica

58
Q

Asbestosis

A

lung disease resulting from the inhalation of asbestos particles, marked by severe fibrosis and a high risk of mesothelioma (cancer of the pleura)

59
Q

Sarcoidosis

A
  • chronic disease of unknown cause characterized by the enlargement of lymph nodes in many parts of the body and the widespread appearance of granulomas derived from the reticuloendothelial system
  • Autoimmune development of granulomas
60
Q

RSV > respiratory syncitial virus

A

Bronchiolitis

61
Q

Types of cardiomyopathy

A

1) Dilated
2) Hypertrophic
3) Restrictive
4) Arrhythmogenic right ventricular dysplasia

62
Q

Cardiomyopathy

A

a condition where the heart muscle is abnormal.

  • s/s
    1) Early stages > asymptomatic
    2) Breathlessness w/exertion or even at rest
    3) swelling of legs, ankles, and feet
    4) Bloating of the abdomen due to fluid buildup
    5) Cough while lying down
    6) Fatigue
    7) Irregular heartbeats that feel rapid, pounding or fluttering
    8) Chest pain
    9) Dizziness, lightheadedness and fainting

Pathophysiology (22 decks)

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