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pathophysiology > patho exam resp -- diseases > Flashcards

patho exam resp -- diseases Flashcards

1
Q

pathophysiology sleep apnea

A

partial/complete airway obstruction resulting in hypoxia

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2
Q

assessment sleep apnea

A

insomnia, daytime sleepiness, loud snoring, headache, irritability

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3
Q

dx sleep apnea

A

document w/polysomnography equipment

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4
Q

tx sleep apnea

A

O2 therapy at night, surgical removal of uvula/tonsils/obstructive tissues

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5
Q

patho acute bronchitis

A

inflammation of bronchi in lower respiratory tract

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6
Q

causes acute bronchitis

A

viral/bacterial infection

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7
Q

tx acute bronchitis

A

fluids, rest, anti-inflammatory agents, possibly antibiotics

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8
Q

causes of pneumonia

A

acute inflammation of lung caused by bacteria/viruses – most common streptococcus

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9
Q

fungi that cause pneumonia

A

aspergillus, pneumocystis carinii

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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

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11
Q

types of pneumonia

A

community acquired, hospital acquired, aspiration, opportunistic

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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

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13
Q

assessment pneumonia

A

auscultation of lungs, temperature

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14
Q

dx pneumonia

A

chest x-ray, sputum culture

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15
Q

tx pneumonia

A

antibiotics: zithromax/biaxan mycin

O2, analgesics, antipyretics, fluids

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16
Q

tx fungal infection

A

antifungal agents such as amphotericin B

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17
Q

causes/r.f. TB

A

mycobacterium tubercolosis – at risk populations HIV, homeless, inner-city, newborns, drug users, lower class

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18
Q

transmission TB

A

airborne droplets – sneezing, coughing, speaking close to someone`

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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

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20
Q

dx TB

A

skin test, chest x-ray, sputum studies

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21
Q

tx TB

A

course: isoniazid, rifampicin, pyrazinamide, ethambutol (2 mos.), followed by isoniazid & rifampicin for 4 more mos.

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22
Q

patho empyema

A

pus containing lesion w/in lung caused by necrosis of lung tissue

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23
Q

assessment empyema

A

cough w/dark sputum, dyspnea, fever & chills, hemoptysis

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24
Q

dx empyema

A

CT, chest x-ray, bronchoscopy

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25
Q

tx empyema

A

antibiotics

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26
Q

patho lung cancer

A

tumor formation within bronchus/upper lobes of lung

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27
Q

primary types of lung cancer

A

small/oat cell, non-small cell (adenocarcinoma, squamous cell)

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28
Q

causes lung cancer

A

80-90% smoking – remainder inhaled carcinogens

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29
Q

types inhaled carcinogens

A

asbestos, radon, heavy metals, arsenic, air pollution

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30
Q

assessment lung cancer

A

hx smoking/exposure, chronic cough, hemoptysis, dyspnea, wheezing on auscultation, chest pain

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31
Q

dx lung cancer

A

chest x-ray, CT, MRI, bronchoscopy, mediastinoscopy, surgery (open lung biopsy), TNM staging

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32
Q

tx lung cancer

A

surgery, chemo, radiation, biological therapy

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33
Q

patho laryngeal cancer

A

2-3% of cancers – affects vocal cords, glottis, squamous cells – metastasizes to lymph nodes

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34
Q

causes laryngeal cancer

A

smoking, alcohol, HPV

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35
Q

assessment laryngeal cancer

A

hoarseness, dyspnea, cough

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36
Q

dx laryngeal cancer

A

laryngeal scope

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37
Q

tx laryngeal cancer

A

radiation & resection

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38
Q

patho pleural effusion

A

fluid in pleural space

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39
Q

causes pleural effusion

A

CHF, liver/renal disease, exudate from tumors/infection

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40
Q

assessment pleural effusion

A

SOB, pain, absent breath sounds

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41
Q

dx pleural effusion

A

chest x-ray

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42
Q

tx pleural effusion

A

thoracentesis

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43
Q

types of fluid in pleural effusion

A

exudate, purulent, transudative

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44
Q

causes atelectasis

A

obstruction from exudates & secretions or collapsed lung

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45
Q

tx atelectasis

A

deep breathing

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46
Q

patho pneumothorax

A

air in pleural space causes complete/partial collapse of lung

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47
Q

types of pneumothorax

A

closed/spontaneous, open, tension, hemathorax

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48
Q

tx pneumothorax

A

chest tube insertion

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49
Q

patho closed pneumothorax

A

rupture of lung visceral pleura allowing lung to collapse

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50
Q

causes/r.f. closed pneumothorax

A

lung blebs, injury for mechanical ventilation, insertion of subclavian catheter, perforation of esophagus, broken ribs, COPD

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51
Q

patho open pneumothorax

A

opening in chest wall

52
Q

causes open pneumothorax

A

gunshot wound

53
Q

patho tension pneumothorax

A

tear in pleural space caused by high intrapleural pressures resulting from open/closed pneumothorax

54
Q

causes tension pneumothorax

A

tracheal deviation, collapsed lung

55
Q

characteristics COPD

A

progressive – most common chronic resp disorder – spectrum of diseases caused by limited airflow/poor oxygenation

56
Q

diseases under COPD

A

emphysema, chronic bronchitis, chronic asthma, cystic fibrosis, chronic bronchiectasis

57
Q

causes COPD

A

SMOKING, CF, genetic enzyme deficiency, chronic exposure to chemicals

58
Q

patho COPD

A

inflammation/destruction of bronchioles & alveolar wall, increased obstruction to airflow, hyperinflation of alveoli/poor oxygenation of bloodstream

59
Q

assessment COPD

A

hx smoking > 10 yrs, wheezing, risk pulmonary infection, chronic productive cough, barrel chest, SOB on exertion, club fingers

60
Q

patho chronic bronchitis

A

prolonged exposure to bronchial irritants – inflammation of bronchi w/enlargement & hypersecretion of mucous glands which leads to airway obstruction

61
Q

r.f. chronic bronchitis

A

most common in females, whites, city dwellers

62
Q

tx chronic bronchitis

A

no cure – avoid resp irritants, bronchodilators, anti-inflammatories, antibiotics, corticosteroids

63
Q

assessment chronic bronchitis

A

productive cough (worse at night & in cold humid weather), dyspnea, wheezing, cyanosis, hypercapnia, generalized edema – “blue bloater”

64
Q

patho emphysema

A

chronic progressive – lung enzymes reduce elasticity of alveoli & decrease compliance, which weakens expiration – lung remains partially expanded

65
Q

assessment emphysema

A

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
Q

complications COPD

A

frequent resp infections, hypoxemia, hypercapnia, respiratory acidosis

67
Q

patho pulmonary embolism

A

occlusion of pulmonary vascular bed by embolus (thrombus/tissue fragment/lipids/foreign body/air bubble) – >90% result from clots formed in leg veins

68
Q

r.f. pulmonary embolism

A

injuries to epithelial cells that line vessels, genetic factors, immobility (DVT)

69
Q

PE massive occlusion

A

embolus occludes major portion of pulmonary circulation (i.e. artery)

70
Q

PE w/o infarction

A

embolus is not severe enough to cause permanent lung injury

71
Q

PE w/infarction

A

embolus large enough to cause infarction of lung tissue

72
Q

assessment pulmonary embolism

A

sudden pleuritic chest pain, dyspnea/tachypnea, tachycardia, anxiety, hemotypsis, pleural friction rub, pleural effusion, pulmonary hypertension

73
Q

dx pulmonary embolism

A

venogram, Doppler studies, ventilation & perfusion scan, d-dimer levels in combo w/spiral CT

74
Q

tx pulmonary embolism

A

heparin

75
Q

aspiration pneumonia

A

inflammation of lungs & bronchial tubes d/t inhalation of foreign material

76
Q

r.f. aspiration pneumonia

A

dysphagia, anesthesia, excessive alcohol intake, coma, being less alert

77
Q

assessment aspiration pneumonia

A

cyanosis, chest pain, cough w/foul-smelling sputum, hemoptysis, fatigue, fever, SOB, wheezing, rales, tachycardia

78
Q

dx aspiration pneumonia

A

ABG, blood culture, bronchoscopy, chest x-ray, CBC, CT, sputum culture

79
Q

primary pulmonary hypertension

A

idiopathic, characterized by pathologic changes in precapillary pulmonary arteries

80
Q

cause/r.f. primary pulmonary HTN

A

idiopathic – usually women age 20-40, may have genetic component – r.f. HIV, collagen vascular diseases, use of appetite suppressants

81
Q

patho pulmonary HTN

A

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
Q

assessment pulmonary HTN

A

fatigue, chest discomfort, tachypnea, dyspnea, peripheral edema, jugular vein distention

83
Q

dx pulmonary HTN

A

chest x-ray shows enlarged right heart border, ECG shows RVH, cardiac catheterization

84
Q

tx pulmonary HTN

A

lung transplant – prostacyclin analogs & endothelin-receptor antagonists can improve symptoms – supplemental O2, digitalis, diuretics as palliatives

85
Q

patho SIDS

A

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
Q

cause SIDS

A

brain abnormalities cause vulnerability

87
Q

prevention SIDS

A

back sleeping; firm, flat mattress; keep head uncovered; no bed sharing; no pillows/blankets; moderate room temperature

88
Q

r.f. SIDS

A

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
Q

apparent life-threatening event (ALTE)

A

episode in which infants experience apnea, color change, marked change in muscle tone, choking/gagging

90
Q

patho croup

A

infectious illness involving larynx, trachea, bronchial tubes – occurs in winter, most common in babies > 6 mos. & boys – airbone droplets

91
Q

assessment croup

A

hoarseness, sore throat, hacking cough (worse at night), fever, laryngitis, dehydration, irritability, lack of appetite

92
Q

tx croup

A

warm mist vaporizer/steam inhalation, saline nasal drops followed by suction, decongestants, cough suppressants, analgesics, prednisone, albuterol, epinephrine, fluids

93
Q

CF

A

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
Q

r.f. CF

A

family hx, N. Europe ancestry

95
Q

assessment CF (newborn)

A

blockage of intestine, failure to grow, bulky/greasy stool, frequent resp infections

96
Q

assessment CF (child/adult)

A

same as newborns, plus salty skin, thick sputum, cough, wheezing, rectal prolapse, clubbing

97
Q

dx CF

A

sweat test (Cl > 60 mEq/L), PFTs, genetic testing, chest x-ray

98
Q

tx CF

A

antibiotics, mucus-thinning drugs, bronchodilators, bronchial airway drainage, lung transplant

99
Q

acute respiratory distress syndrome (ARDS)

A

life-threatening condition causes lung inflammation, fluid build-up in alveoli – makes lungs heavy & stiff, impairs expansion

100
Q

dx ARDS

A

ABG shows acute respiratory alkalosis, chest x-ray shows bilateral alveolar infiltrates, PAWP < 18

101
Q

tx ARDS

A

O2, mechanical ventilation, prone positioning, maintenance of CO & fluid balance, antibiotics

102
Q

patho pulmonary edema

A

fluid in lungs – leads to impaired gas exchange, possibly resp failure

103
Q

causes pulmonary edema

A

cardiogenic (failure of LV to remove blood from pulmonary circulation) or noncardiogenic (injury to lung itself)

104
Q

tx pulmonary edema

A

3 goals: improve resp function, tx underlying cause, avoid further damage to lung

105
Q

assessment pulmonary edema

A

dyspnea, hemoptysis, diaphoresis, anxiety, pale skin, orthopnea

106
Q

infant respiratory distress syndrome (IRDS)

A

premature infants – developmental insufficiency of surfactant production & structural immaturity of lungs

107
Q

r.f. IRDS

A

maternal diabetes, second born of premature twins, premature birth

108
Q

assessment IRDS

A

tachypnea, tachycardia, chest well retractions (recession), expiratory grunting, nasal flaring, cyanosis, apnea

109
Q

tx IRDS

A

CPAP, IV fluids, mechanical ventilation

110
Q

dx IRDS

A

chest x-ray shows deacreased lung volumes, absence of thymus, infiltrate in lungs

111
Q

patho asthma

A

airways narrow/swell & produce extra mucus, causing coughing, wheezing, SOB

112
Q

Exercise-induced asthma

A

may be worse when the air is cold and dry

113
Q

occupational asthma

A

triggered by workplace irritants such as chemical fumes, gases or dust

114
Q

Allergy-induced asthma

A

triggered by particular allergens, such as pet dander, cockroaches or pollen

115
Q

assessment asthma

A

SOB, chest tightness/pain, cough, wheezing,

116
Q

common asthma triggers

A

airbone allergens, resp infections, exercise, cold air, air pollutants, stress, sulfites, GERD, menstrual cycle

117
Q

medications that may trigger asthma

A

beta blockers, aspirin, ibuprofen, naproxen

118
Q

r.f. asthma

A

family hx, hx of other allergic condition, obesity, smoking/secondhand exposure, maternal hx smoking while pregnant, exposure to air pollution, low birth weight

119
Q

dx asthma

A

spirometry, peak flow, Methacholine challenge, nitric oxide levels elevated, chest x-ray/CT, sputum eosinophils, stress test for exercise-/cold air-induced

120
Q

methacholine challenge

A

reaction to inhaled metacholine (known asthma trigger) indicates likely dx asthma

121
Q

mild intermittent asthma

A

mild symptoms 2 days/week and 2 nights/month

122
Q

mild persistent asthma

A

more than 2x/week, no more than once daily

123
Q

moderate persistent asthma

A

once/day, > 1 night/week

124
Q

severe persistent asthma

A

throughout most days, frequently at night

125
Q

tx asthma (long-term)

A

inhaled corticosteroids, leukotriene modifiers, long-acting beta agonists, theophylline

126
Q

tx asthma (rescue)

A

short-acting beta agonists, ipatropium (atrovent), oral/IV corticosteroids

pathophysiology (7 decks)

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