PCP Expansion - Respiratory (Common Diseases) Flashcards
When should an MDI be used over nebulizing medication?
In patients with a fever and a history of respiratory illness.
Define croup
Laryngotracheitis or croup is an inflammation of the larynx and trachea, specifically sub-glottic structures, located around and below the vocal cords
What population is most likely to contract croup?
Children around 6 months to 3 years old of age
When does croup mostly occur?
During the fall and winter
What percentage of croup cases are mild?
85% of the cases are mild
What symptoms would appear at the onset of croup?
- Cold-like symptoms
- Runny nose and congestion
What symptoms are present during croup?
- Hoarseness
- Stridor
- Fever
- Intercostal and supraclavicular retractions
- Barking or seal-like cough
What treatments can be given for croup
EMR
- Administer oxygen
- Transport early
- Ask for PCP or ACP help
PCP
- Administer EPINEPHrine via nebulizer
- Administer dexamethasone if there is NO IMPROVEMENT from EPINEPHrine
(Requires clinicall consultation)
ACP
- Consider the need for invasive airway management
- Consider the need for antipyresis with acetaminophen
What are the most common causes of pulmonary edema?
- Congestive heart failure (CHF): from MI or difficulty contracting from increased afterload
- Valve failure: blood does flow correctly and back up to pulmonary circulation
- Dysrhythmia: atrial fibrillation
What are the less common causes of pulmonary edema?
- Trauma
- Liver disease
- Use of drugs
- Pneumonia
- Drowning
- Sepsis
- Cancer
What mechanisms contribute to pulmonary edema?
- Hydrostatic pressure
- -
How does hydrostatic pressure contribute to pulmonary edema?
- Build up of pressure in the capillaries
- An increase in volume causes increase in pressure
- Fluid gets pushed out into the capillaries causing pulmonary edema
- As pressure builds up, fluid gets pushed outside the capillaries, into the interstitial space, and into the alveoli
How do osmotic effects contribute to pulmonary edema?
- Water moves from an area of low solute concentration to an area of high solute concentration
- Example: Liver Failure
- Low albumin causes decreased solute in the blood
- H20 moves into the interstitial space because of low solute (in this case albumin) in the blood
How does poor lymphatic drainage contribute to pulmonary edema?
- Normally, H20 in the interstitial space is drained by the lymphatic system
- Lymphatic drainage can be caused by cancer, asthma, smoking, lung disease, etc
How does poor capillary permeability contribute to pulmonary edema?
- Capillary damage can occur in pneumonia and sepsis
- Capillaries are more “leaky” and fluid escapes more readily
What are symptoms of pulmonary edema?
- Dyspnea
- Inspiratory crackle
- Low Sp02
- Wheezing
- Productive cough with pink or frothy sputum
- Worse when supine
What is Emphysema cause by?
Smoking, but also exposure to irritants, chemicals, pollutants
What are common causes of COPD after smoking?
- Pollution
- Occupational exposure
- Genetic disease
Describe COPD
It is basically a mix of two different respiratory pathologies that cause persistent respiratory symptoms in patients. This is due to airflow limitations that are not fully reversible, and hence, the term “chronic” in the description of the disease
The main contributors are emphysema and chronic bronchitis
How can pulmonary edema be managed?
- Oxygen
- BVM
- CPAP
What is Emphysema caused by?
Smoking, but also exposure to irritants, chemicals, pollutants
List some features of Emphysema
- Destruction of lung tissue
- Loss of surface area for gas exchange
- Affects alveoli and bronchioles
Describe Emphysema
Enlargement of airspaces with destruction of alveolar walls
Describe Chronic Bronchitis
Productive cough that occurs for months and repeats at least yearly
