patho exam resp -- diseases Flashcards
1
Q
pathophysiology sleep apnea
A
partial/complete airway obstruction resulting in hypoxia
2
Q
assessment sleep apnea
A
insomnia, daytime sleepiness, loud snoring, headache, irritability
3
Q
dx sleep apnea
A
document w/polysomnography equipment
4
Q
tx sleep apnea
A
O2 therapy at night, surgical removal of uvula/tonsils/obstructive tissues
5
Q
patho acute bronchitis
A
inflammation of bronchi in lower respiratory tract
6
Q
causes acute bronchitis
A
viral/bacterial infection
7
Q
tx acute bronchitis
A
fluids, rest, anti-inflammatory agents, possibly antibiotics
8
Q
causes of pneumonia
A
acute inflammation of lung caused by bacteria/viruses – most common streptococcus
9
Q
fungi that cause pneumonia
A
aspergillus, pneumocystis carinii
10
Q
transmission of pneumonia
A
aspiration: fluids enter lung carrying organisms from nasal pharynx
inhaling microbes from air
hematogenous spread from other infections in body
11
Q
types of pneumonia
A
community acquired, hospital acquired, aspiration, opportunistic
12
Q
patho pneumonia
A
congestion of fluids at alveoli
red hepatization when lungs become dilated with neutrophiles & RBC
grey hepatization when blood flow decreases and leukocytes w/fibrin consolidate in affected area
13
Q
assessment pneumonia
A
auscultation of lungs, temperature
14
Q
dx pneumonia
A
chest x-ray, sputum culture
15
Q
tx pneumonia
A
antibiotics: zithromax/biaxan mycin
O2, analgesics, antipyretics, fluids
16
Q
tx fungal infection
A
antifungal agents such as amphotericin B
17
Q
causes/r.f. TB
A
mycobacterium tubercolosis – at risk populations HIV, homeless, inner-city, newborns, drug users, lower class
18
Q
transmission TB
A
airborne droplets – sneezing, coughing, speaking close to someone`
19
Q
patho TB
A
bacteria travels to alveoli, then multiplies & engulfed by phagocytes – immune response causes formulation of granuloma, which is followed by necrosis of the lung
20
Q
dx TB
A
skin test, chest x-ray, sputum studies
21
Q
tx TB
A
course: isoniazid, rifampicin, pyrazinamide, ethambutol (2 mos.), followed by isoniazid & rifampicin for 4 more mos.
22
Q
patho empyema
A
pus containing lesion w/in lung caused by necrosis of lung tissue
23
Q
assessment empyema
A
cough w/dark sputum, dyspnea, fever & chills, hemoptysis
24
Q
dx empyema
A
CT, chest x-ray, bronchoscopy
25
tx empyema
antibiotics
26
patho lung cancer
tumor formation within bronchus/upper lobes of lung
27
primary types of lung cancer
small/oat cell, non-small cell (adenocarcinoma, squamous cell)
28
causes lung cancer
80-90% smoking -- remainder inhaled carcinogens
29
types inhaled carcinogens
asbestos, radon, heavy metals, arsenic, air pollution
30
assessment lung cancer
hx smoking/exposure, chronic cough, hemoptysis, dyspnea, wheezing on auscultation, chest pain
31
dx lung cancer
chest x-ray, CT, MRI, bronchoscopy, mediastinoscopy, surgery (open lung biopsy), TNM staging
32
tx lung cancer
surgery, chemo, radiation, biological therapy
33
patho laryngeal cancer
2-3% of cancers -- affects vocal cords, glottis, squamous cells -- metastasizes to lymph nodes
34
causes laryngeal cancer
smoking, alcohol, HPV
35
assessment laryngeal cancer
hoarseness, dyspnea, cough
36
dx laryngeal cancer
laryngeal scope
37
tx laryngeal cancer
radiation & resection
38
patho pleural effusion
fluid in pleural space
39
causes pleural effusion
CHF, liver/renal disease, exudate from tumors/infection
40
assessment pleural effusion
SOB, pain, absent breath sounds
41
dx pleural effusion
chest x-ray
42
tx pleural effusion
thoracentesis
43
types of fluid in pleural effusion
exudate, purulent, transudative
44
causes atelectasis
obstruction from exudates & secretions or collapsed lung
45
tx atelectasis
deep breathing
46
patho pneumothorax
air in pleural space causes complete/partial collapse of lung
47
types of pneumothorax
closed/spontaneous, open, tension, hemathorax
48
tx pneumothorax
chest tube insertion
49
patho closed pneumothorax
rupture of lung visceral pleura allowing lung to collapse
50
causes/r.f. closed pneumothorax
lung blebs, injury for mechanical ventilation, insertion of subclavian catheter, perforation of esophagus, broken ribs, COPD
51
patho open pneumothorax
opening in chest wall
52
causes open pneumothorax
gunshot wound
53
patho tension pneumothorax
tear in pleural space caused by high intrapleural pressures resulting from open/closed pneumothorax
54
causes tension pneumothorax
tracheal deviation, collapsed lung
55
characteristics COPD
progressive -- most common chronic resp disorder -- spectrum of diseases caused by limited airflow/poor oxygenation
56
diseases under COPD
emphysema, chronic bronchitis, chronic asthma, cystic fibrosis, chronic bronchiectasis
57
causes COPD
SMOKING, CF, genetic enzyme deficiency, chronic exposure to chemicals
58
patho COPD
inflammation/destruction of bronchioles & alveolar wall, increased obstruction to airflow, hyperinflation of alveoli/poor oxygenation of bloodstream
59
assessment COPD
hx smoking > 10 yrs, wheezing, risk pulmonary infection, chronic productive cough, barrel chest, SOB on exertion, club fingers
60
patho chronic bronchitis
prolonged exposure to bronchial irritants -- inflammation of bronchi w/enlargement & hypersecretion of mucous glands which leads to airway obstruction
61
r.f. chronic bronchitis
most common in females, whites, city dwellers
62
tx chronic bronchitis
no cure -- avoid resp irritants, bronchodilators, anti-inflammatories, antibiotics, corticosteroids
63
assessment chronic bronchitis
productive cough (worse at night & in cold humid weather), dyspnea, wheezing, cyanosis, hypercapnia, generalized edema -- "blue bloater"
64
patho emphysema
chronic progressive -- lung enzymes reduce elasticity of alveoli & decrease compliance, which weakens expiration -- lung remains partially expanded
65
assessment emphysema
cough, dyspnea, pursed-lip breathing w/prolonged expiration, barrel chest, distant breath/heart sounds, anorexia, weakness, muscle/weight loss, acyantotic until very late in disease process ("pink puffers")
66
complications COPD
frequent resp infections, hypoxemia, hypercapnia, respiratory acidosis
67
patho pulmonary embolism
occlusion of pulmonary vascular bed by embolus (thrombus/tissue fragment/lipids/foreign body/air bubble) -- >90% result from clots formed in leg veins
68
r.f. pulmonary embolism
injuries to epithelial cells that line vessels, genetic factors, immobility (DVT)
69
PE massive occlusion
embolus occludes major portion of pulmonary circulation (i.e. artery)
70
PE w/o infarction
embolus is not severe enough to cause permanent lung injury
71
PE w/infarction
embolus large enough to cause infarction of lung tissue
72
assessment pulmonary embolism
sudden pleuritic chest pain, dyspnea/tachypnea, tachycardia, anxiety, hemotypsis, pleural friction rub, pleural effusion, pulmonary hypertension
73
dx pulmonary embolism
venogram, Doppler studies, ventilation & perfusion scan, d-dimer levels in combo w/spiral CT
74
tx pulmonary embolism
heparin
75
aspiration pneumonia
inflammation of lungs & bronchial tubes d/t inhalation of foreign material
76
r.f. aspiration pneumonia
dysphagia, anesthesia, excessive alcohol intake, coma, being less alert
77
assessment aspiration pneumonia
cyanosis, chest pain, cough w/foul-smelling sputum, hemoptysis, fatigue, fever, SOB, wheezing, rales, tachycardia
78
dx aspiration pneumonia
ABG, blood culture, bronchoscopy, chest x-ray, CBC, CT, sputum culture
79
primary pulmonary hypertension
idiopathic, characterized by pathologic changes in precapillary pulmonary arteries
80
cause/r.f. primary pulmonary HTN
idiopathic -- usually women age 20-40, may have genetic component -- r.f. HIV, collagen vascular diseases, use of appetite suppressants
81
patho pulmonary HTN
pathologic changes in pulmonary vasculature characterized by fibrosis/thickening of vessel wall w/luminal narrowing & abnormal vasoconstriction -- changes cause resistance to blood flow, increasing pressure
82
assessment pulmonary HTN
fatigue, chest discomfort, tachypnea, dyspnea, peripheral edema, jugular vein distention
83
dx pulmonary HTN
chest x-ray shows enlarged right heart border, ECG shows RVH, cardiac catheterization
84
tx pulmonary HTN
lung transplant -- prostacyclin analogs & endothelin-receptor antagonists can improve symptoms -- supplemental O2, digitalis, diuretics as palliatives
85
patho SIDS
sudden death of infant < 1 yr that remains unexplained after complete investigation -- leading cause of death infants 1-12 mos. -- most occurs between 2-4 mos., 90% before 6 mos.
86
cause SIDS
brain abnormalities cause vulnerability
87
prevention SIDS
back sleeping; firm, flat mattress; keep head uncovered; no bed sharing; no pillows/blankets; moderate room temperature
88
r.f. SIDS
maternal age <20 yrs at first pregnancy; late/no prenatal care; short interval between pregnancies; premature/low birth weight babies & multiples; maternal smoking; infants sleeping on stomach
89
apparent life-threatening event (ALTE)
episode in which infants experience apnea, color change, marked change in muscle tone, choking/gagging
90
patho croup
infectious illness involving larynx, trachea, bronchial tubes -- occurs in winter, most common in babies > 6 mos. & boys -- airbone droplets
91
assessment croup
hoarseness, sore throat, hacking cough (worse at night), fever, laryngitis, dehydration, irritability, lack of appetite
92
tx croup
warm mist vaporizer/steam inhalation, saline nasal drops followed by suction, decongestants, cough suppressants, analgesics, prednisone, albuterol, epinephrine, fluids
93
CF
genetic (autosomal recessive) -- affects cells that produce mucus, sweat, saliva, digestive juices, causing secretions to become thick & sticky, occlude tubes/ducts rather than acting as lubricant
94
r.f. CF
family hx, N. Europe ancestry
95
assessment CF (newborn)
blockage of intestine, failure to grow, bulky/greasy stool, frequent resp infections
96
assessment CF (child/adult)
same as newborns, plus salty skin, thick sputum, cough, wheezing, rectal prolapse, clubbing
97
dx CF
sweat test (Cl > 60 mEq/L), PFTs, genetic testing, chest x-ray
98
tx CF
antibiotics, mucus-thinning drugs, bronchodilators, bronchial airway drainage, lung transplant
99
acute respiratory distress syndrome (ARDS)
life-threatening condition causes lung inflammation, fluid build-up in alveoli -- makes lungs heavy & stiff, impairs expansion
100
dx ARDS
ABG shows acute respiratory alkalosis, chest x-ray shows bilateral alveolar infiltrates, PAWP < 18
101
tx ARDS
O2, mechanical ventilation, prone positioning, maintenance of CO & fluid balance, antibiotics
102
patho pulmonary edema
fluid in lungs -- leads to impaired gas exchange, possibly resp failure
103
causes pulmonary edema
cardiogenic (failure of LV to remove blood from pulmonary circulation) or noncardiogenic (injury to lung itself)
104
tx pulmonary edema
3 goals: improve resp function, tx underlying cause, avoid further damage to lung
105
assessment pulmonary edema
dyspnea, hemoptysis, diaphoresis, anxiety, pale skin, orthopnea
106
infant respiratory distress syndrome (IRDS)
premature infants -- developmental insufficiency of surfactant production & structural immaturity of lungs
107
r.f. IRDS
maternal diabetes, second born of premature twins, premature birth
108
assessment IRDS
tachypnea, tachycardia, chest well retractions (recession), expiratory grunting, nasal flaring, cyanosis, apnea
109
tx IRDS
CPAP, IV fluids, mechanical ventilation
110
dx IRDS
chest x-ray shows deacreased lung volumes, absence of thymus, infiltrate in lungs
111
patho asthma
airways narrow/swell & produce extra mucus, causing coughing, wheezing, SOB
112
Exercise-induced asthma
may be worse when the air is cold and dry
113
occupational asthma
triggered by workplace irritants such as chemical fumes, gases or dust
114
Allergy-induced asthma
triggered by particular allergens, such as pet dander, cockroaches or pollen
115
assessment asthma
SOB, chest tightness/pain, cough, wheezing,
116
common asthma triggers
airbone allergens, resp infections, exercise, cold air, air pollutants, stress, sulfites, GERD, menstrual cycle
117
medications that may trigger asthma
beta blockers, aspirin, ibuprofen, naproxen
118
r.f. asthma
family hx, hx of other allergic condition, obesity, smoking/secondhand exposure, maternal hx smoking while pregnant, exposure to air pollution, low birth weight
119
dx asthma
spirometry, peak flow, Methacholine challenge, nitric oxide levels elevated, chest x-ray/CT, sputum eosinophils, stress test for exercise-/cold air-induced
120
methacholine challenge
reaction to inhaled metacholine (known asthma trigger) indicates likely dx asthma
121
mild intermittent asthma
mild symptoms 2 days/week and 2 nights/month
122
mild persistent asthma
more than 2x/week, no more than once daily
123
moderate persistent asthma
once/day, > 1 night/week
124
severe persistent asthma
throughout most days, frequently at night
125
tx asthma (long-term)
inhaled corticosteroids, leukotriene modifiers, long-acting beta agonists, theophylline
126
tx asthma (rescue)
short-acting beta agonists, ipatropium (atrovent), oral/IV corticosteroids
