PATH 179 LO 3 Flashcards
What is sinustits?
viral infection leads to obstruction of drainage of the paranasal sinuses
What are the signs and symptoms of sinustits?
- Pain
- Tenderness
- Fever
What is the radiographic appearance for sinutits?
- soft tissue density lining the walls of the involved sinus
- Air fluid level
What is the treatment for sinusitis?
- if caused by bacteria (antibiotics)
- Nasal sprays and decongestants
- If chronic surgery
What is cystic fibrosis?
hereditary disease characterized by the secretion of excessively viscous mucous by all the exocrine glands
What causes cystic fibrosis?
defective gene in the middle of chromosome 7
-99% of morbidity or mortality occurs as a result of respiratory involvement
What are the signs and symptoms of cystic fibrosis?
- recurrent pulmonary infections
- Meconium ileus
- Cough, wheeze
- Sputum production
- Failure to thrive
What are the radiographic exams for cystic fibrosis?
- x-ray
- CT
What is the radiographic appearance for cystic fibrosis?
- generalized irregular thickening of linear markings
- Almost always hyperinflation
- Appearance of chronic disease in adults
What is the treatment for cystic fibrosis?
- Prophylactic antibiotics
- Chest physio
- Transplant
What is another name for idiopathic respiratory distress syndrome?
Hyaline membrane disease
What causes idiopathic respiratory distress syndrome?
lack of lipoprotein ‘surfactant’ from immaturity or birth trauma
-Pre mature babies or diabetic mothers who have had c-section
what are the signs and symptoms of idiopathic respiratory distress syndrome?
- hypoxia and respiratory distress usually within 6hrs of delivery
- Tachypnea
- poor colour
What are the radiographic exams for idiopathic respiratory distress syndrome?
-x-ray AP/LAT/DECUB CXR
What is the radiographic appearance for idiopathic respiratory distress syndrome?
- artificial surfactant
- Positive pressure ventilators, but may cause over-aeration
What causes croup?
- viral infection
- Produces inflammatory, obstructive swelling in subglottic trachea
What are signs and symptoms of croup?
- Stridor
- Bark-like cough
- Fever
- Sore throat
What are the radiographic exams for croup?
AP soft tissue neck
What is the radiographic appearance for croup?
smooth tapering of airway caused by EDEMA (hour glass shape)
What is the treatment for croup?
- cool humidifaction
- Steam from hot shower for 15-20 mi intervals
- Corticosteroid treatment to decrease swelling
What is epiglottitis?
viral infection of epiglottits
what is epiglottits caused by?
haemophilus influenzae
What are the signs and symptoms of epiglotittis?
- fever
- Stridor
- Sore throat
- Drooling
What is the radiographic examinations for epigglotttis?
upright lat soft tissue neck
What is the radiographic appearance of epiglottitis?
swelling of thickened, rounded epiglottits about the size of adult thumb normal size is adults little finger
What is the treatment of epiglottits?
corticosteroids
Antibiotics
What is Pneumonia?
Inflammation of the lung
What causes pneumonia?
virus or bacteria
What are the signs and symptoms of pneumonia?
- acute, shaking, chills, fever, cough, blood, sputum, weakness, chest pain on breathing.
- Severe chest cold, fever, headache, fatigue, unproductive hacking cough
What is another name for alveolar pneumonia?
Air space pneumonia
What is the radiographic appearance for alveolar pneumonia?
- consolidation of the lung parenchyma with little or no involvement or airways (air bronchogram)
- No evidence of loss of volume b/c air is replaced by an equal amount of inflammatory exudate and b/c airways remain opem
What is bronchopneumonia typically caused by?
Staphylococcal infections
What is the radiographic appearance for bronchpneumonia?
- appears as opacififcations that are scattered through out separated by air-containing lung tissue
- If airway is obstructed, atelectasis is evident
What causes interstitial pneumonia?
viral and mycoplasmal infections
What is the radiographic appearance for interstitual pneumonia?
appears in a linear or reticular pattern
what causes aspiration pneumonia?
- aspiration of gastric or esophageal obstruction.
- General anesthetic tracheostomy, coma or trauma
What is the radiographic appearance of aspiration pneumonia?
- appears as multiple small nodular densities
- Posterior segments of the upper and lower lobes most commonly affected in bed ridden patients
What causes anthrax?
sporelike microbe known as bacillus anthracis
What are the three ways to contract anthrax?
cutaneous (most common), Inhalation (usually fatal), Gastrointestinal
What are the signs and symptoms of anthrax?
similar to flu, progresses into labored breathing, shock or even death
What is the radiographic appearance of anthrax?
mediastinal widening, pleural effusion.
What is lung abscess?
area of necrosis of parenchyma containing pus
What causes lung abscess?
complication of bacterial pneumonia, bronchial obstruction, aspiration, foreign body, blood-spread disease.
-Brain abscess can be a complication if infected material is carried by blood from lung to Lt side of the heart then to the brain.
what are the signs and symptoms of lung abscess?
- fever
- Cough
- Foul sputum
what are some Radiographic examinations for lung abscess?
- X-ray
- CT
What is the radiographic appearance for lung abscess?
- spherical density, dense center with hazy periphery
- Air-fluid level can form within abscess
What is the treatment for lung abscess?
supportive therapy to help lung get rid of purulent material and ensure lung volume
What is Tuberculosis caused by?
- Mycobacterium tuberculosis rod shaped, waxy coat
- Spreads by droplets in air by coughing of an infected patient
- Affects lungs, also GI, GU and skeletal systems
- Common in posterior apical segments
What are the signs and symptoms of TB?
- Cough
- Hemoptysis
- Weak
- Dizzy
- Weight loss
- Night sweats
What are the radiographic exams for TB?
CXR, AP lordotic, TB skin test
What is the radiographic appearance for TB?
Primary (develops at any age):
- Lobar or segmental air-space consolidation
- Enlargement of hilar or mediastinal lymph nodes
- Ghon lesion
Secondary lesion
Can remain inactive for many years
Center can necrosis and look like swiss cheese
What is the treatment for TB?
antibiotics for 6-12 months
What is tuberculoma?
- sharply circumscribed parenchymal nodule, often containing active TB
- Can remain unchanged for a long period of time
- Potentially dangerous if ruptures and spreads
What is the radiographic appearance Tuberculoma?
- Single or multiple pulmonary nodules usually 1-3cm
- Most common in periphery and upper lobes
- Contain central nidus of calcification
What is respiratory syncytial Virus?
- attacks lower respiratory tract and causes necrosis of the epithelium of bronchi and bronchioles which leads to bronchiolitis (produces brinchial spasm and intersitial pneumonia)
- Necrotic material and edema causes bronchial obstruction
What are the signs and symptoms of RSV?
Cold/flu like symptoms, high rate of nosocomial infection
What is the radiographic appearance for RSV?
- Hyperinflation
- Increased interstitial markings
- Appears as interstitial pneumonia
What is the treatment for RSV?
children require hospitalization, antibiotics, antiviral drugs, oxygen therapy
What does SARS stand for?
Severe acute respiratory syndrome
What causes SARS?
unknown
What is the radiographic appearance for SARS?
- lungs appear normal
- As it progresses: early focal infiltrates, then generalized patch areas, eventually consolidation
What is Chronic obstructive pulmonary disease (COPD)?
chronic obstruction of the airways that leads to the ineffective exchange of respiratory gases and makes breathing difficult
What are the risk factors for COPD?
- smoking
- Infection
- Air pollution
- Occupational exposure such as asbestos
What causes chronic bronchitis?
infection or pollution exposure, smoking
What is chronic bronchitis?
- chronic inflammation of bronchi leads to coughing and sputum production
- walls of bronchioles thicken and produce viscous mucous
- Over time mucus glands become hyperplastic
What some signs and symptoms of Chronic Bronchitis?
- Coughing
- Wheezing
- Edema > weight gain
- Cyanosis > blue bloater
what are the radiographic exams for chronic bronchitis?
x-ray
What is the radiographic appearance for chronic bronchitis?
- over half of patients with bronchitis demonstrate no changes on chest films
- Increase in bronchial walls and peribronchial inflammation (‘tram lines’)
What is the treatment for chronic bronchitis?
- Prophylactic anti-biotic therapy - reduces infection
- Bronchodilators reduce spasm and open airways
- Expectorants keep lungs clear
What is emphysema?
airborne irritants damage and coat the alveoli which causes mucosal inflammation and secretion of excess mucus that plugs the air passages
-Tiny air sacs become transformed into bullae
What are the causes of emphysema?
- Smoking
- Chronic bronchitis
- Air pollution
- Long term exposure
- Respiratory irritants
What are the signs and symptoms emphysema?
- prolonged expiration with grunting, weight loss , “pink puffers” from increased cardiac output
- Bullae may rupture and cause a spontaneous pneumothorax and atelectasis
- Decrease in normal movement of diaphragm
What are the radiographic exams for emphysema?
-X-ray
What are is the radiograh appearance for emphysema?
- overinflation, bullae formation
- Flattening of domes
- Barrel chest
- Increase in retrosternal space (distance between the posterior side of the sternum and snterior wall of aorta)
What is the treatment of emphysema?
bronchodilators, antibiotics
What is asthma?
- swelling of mucous membranes
- Wide spread narrowing of the airways, response of tracheobronchial tree to irritants
What are examples of extrinsic asthma?
house dust, pollen, molds, animal dander, fabrics and foods
What are examples of intrinsic asthma?
exercise, heat, cold, emotional upset
What are signs and symptoms of asthma?
- wheezing
- Tightness
- Expectorate cough - mucous
What are the radiograph exams for asthma?
x-ray
What is the radiographic appearance for asthma?
- during acute attack: bronchial narrowing, hyperinflation (flattened domes, lucent lungs)
- Usually normal lung markings
- Long-stranding asthma can be seen as ‘dirty chest’
What is the treatment for asthma?
bronchodilators, expectorants, c-steroids, O2, allergy shots
What is bronchiectasis?
permeant abnormal dilation of one or more large bronchi from destruction elastic and muscular components of the bronchial wall
- Common complication of bronchitis
- Involves basal segments and lower lobes, bilateral (1/2 of the cases)
what causes bronchiectasis?
nearly always the result of bacterial infection
What are the signs and symptoms of bronchiectasis?
- chronic, productive cough
- Acute pneumonia
- Hemoptysis
What are the radiographic exams for bronchietcasis?
x-ray
What is the radiographic appearance for bronchiectasis?
- coarseness and loss of definition of interstitial markings
- advantaged stage: oval, circular cystic spaces (up to 2cm and air fluid levels), ‘honeycomb’ pattern
What is the treatment for bronchiectasis?
vaccines to prevent bacterial and viral infections, antibiotics
What is a solitary pulmonary nodule?
- asymptomatic solitary pulmonary nodule, incidental finding
- May represent a benign granuloma or neoplastic process
- If occurs in patients under 30 - minimal risk of cancer
What are the signs and symptoms of solitary pulmonary nodule?
-usually asymptomatic and a incidental finding
What are the radiographic exams for solitary pulmonary nodule?
- X-ray
- CT
- PET
What is the radiographic appearance of the solitary pulmonary nodule?
-central dense or popcorn calcification - benign process, use low kVp
-Benign tumor=absence of growth
CT scan better demonstrates size, density, position and borders of lesion
-ill defined, irregular or fuzzy margins
-Growth rate = malignant tumor
What is the treatment for solitary pulmonary nodule?
depends if benign or malignant
what is bronchial ademona?
- neoplasm of low grade malignancy
- Occur centrally in major segmental bronchi and cause obstruction
What are signs and symptoms of bronchial ademona?
- hemoptysis
- Recurring pneumonia
What are radiographic exams for bronchial adenoma?
- x-ray
- CT
What is the radiographic appearance for bronchial adenoma?
-Most common findings: peripheral atelectasis and pneumonitis
- Homogenous increase in density corresponding exactly to a lobe
- Increase density in lobe of one or more segments
- Small tumors may be missed
What is the treatment of bronchial adenoma?
- chemo
- Radiation therapy
- Resection
What causes bronchogenic carcinoma?
precise reason unknown. closely linked to smoking and inhalation of carcinogens (air pollution, gases and fumes)
What is the most common type of lung cancer?
Squamous Carcinoma
What is the least common type of lung cancer?
broncholar carcinoma
What are the signs and symptoms of bronchogenic carcinoma?
- coughing
- chest pain
- sputum production
- hemopytsis
- Airway obstruction
- Pleural effusions
- By the time patient shows symptoms disease is already advanced and the signs are of metastatic disease
What are the radiographic exams for bronchogenic carcinoma?
- x-ray
- CT
What is the radiographic appearance for bronchogenic carcinoma?
- depends on site of the tumor and relation to bronchial tree
- Discrete mass may be undetected
- Unilateral enlargement of the hilum, may be the earliest sign
- Lesions similar to that of a lung abscess
- CT is superior to plain images in detecting hilar and mediastinal lymphadenopathy and bronchial narrowing
What is the treatment of bronchogenic carcinoma?
- chemo
- Radiation therapy
- Palliative
Which cancers are most likely to spread to pulmonary Mets?
breast, esophagus, stomach because of close proximity
What are the radiographic exams for pulmonary mets?
- x-ray
- CT
- PET
what is the radiographic appearance for pulmonary mets?
- multiple, round, well circumscribed nodules scattered through out lung
- Fine miliary nodules, highly vascular tumors
- Varied appearance and size
- Solitary masses are often indistinguishable from primary bronchogenic carcinoma
What is the treatment for pulmonary mets?
- surgical resection
- Chemo
- Radiation therapy
- Pallative
