Pulmonary Diseases Flashcards
1
Q
A persistent, dry cough could indicate what pathologies?
A
tumor, congestion, hypersensitive airways
2
Q
A productive cough with purulent sputum (yellow or green) could indicate what pathology?
A
infection
3
Q
A productive cough with non purulent sputum (clear or white) could indicate what pathology?
A
non-specific airway irritation
4
Q
A cough with rust-colored sputum could indicate?
A
pneumonia
5
Q
Hemoptysis could be a sign of:
A
- Infection
- Inflammation
- Abscess
- Tumor
- Infarction
6
Q
Tracheobronchial pain often occurs due to inflammatory lesions, irritating foreign material +/- tumors. Where dues it typically refer?
A
Neck and anterolateral chest at same levels as the points of irritation in the air passages.
7
Q
How does phrenic nerve damage affect the diaphragm?
A
Ipsilateral diaphragm paresis
8
Q
Diaphragmatic pleural pain referrs where?
A
Peripherally to the costal margins, centrally to the shoulder and upper trap
9
Q
I present with
- Decreased ventilation
- Confusion
- Sleepiness and unconsciousness
- Diaphoresis
- Shallow, rapid breathing (blow off CO2)
- Restlessness
- Cyanosis
who am I?
A
Respiratory Acidosis
10
Q
I present with
- Hyperventilation
- Lightheadedness
- Dizziness
- Numbness + tingling of the face, fingers and toes
- Syncope
- Severe: muscular tetany + convulsions
Who am I?
A
Respiratory alkalosis
11
Q
What is COPD?
A
Several airway disorders that have abnormal airway structures (narrowing) resulting in obstruction of air exiting and entering the lungs.
12
Q
What are the predisposing factors for COPD?
A
- Smoking
- Air pollution
- Occupational exposure
- Genetics
- Infections
- Allergies
- Aging
- Potentially harmful drugs/chemicals
13
Q
I present with
- Mild fever (1-3 days)
- Malaise
- Back and muscle pain
- Sore throat –> laryngitis
- Productive cough f/b wheezing
Who am I?
A
Acute Bronchitis
14
Q
I present with
- Persistent, productive cough (**worse in am/pm)
- Reduced chest expansion**
- Wheezing
- Periodic fever
- Dyspnea
- Cyanosis
- **Decreased exercise tolerance **
who am I?
A
Chronic Bronchitis
15
Q
Chronic bronchitis is defined by
A
a cough for at least 3 months/year for 2 consecutive years
16
Q
What is bronchiectasis?
A
Permanent dilation of bronchi and destruction of bronchi walls
Often results after infections
17
Q
I present with…
- Chronic “wet” cough with abundant foul-smelling secretions
- Hemoptysis
- Occasional wheezing
- Dyspnea
- Sinusitis
- Weight Loss
- Anemia
- Malaise
- Recurrent fever/chills
- Fatigue
Who am I?
A
Bronchiectasis
18
Q
What is emphysema?
A
permanent overdistension and loss of normal elastic tension in lung tissue.
19
Q
I present with
- SOB/dyspnea on exertion/orthopnea/use of accessory muscles
- Chronic cough
- Barrel chest (increased A/P diameter)
- Weight loss
- Malaise
- Prolonged expiratory periods (w/grunting)
- Wheezing
- Pursed-lip breathing
- Increased RR
- Peripheral cyanosis
A
Emphysema
20
Q
Triggers for Asthma include
A
- Respiratory infections, colds
- Cigarette smoke
- Allergic reactions to pollen mold, animal dander, feather, dust, food, insect
- Indoor/outdoor pollutants
- Physcial exertion or vigorous exercise
- Exposure to cold air or sudden temperature changes
- Excitement, strong emotion, psychological or emotional stress
21
Q
When assessing for asthma you will listen for:
A
- Wheezing (however light)
- Irregular breathing with prolonged expiration
- Noisy, difficult breathing
- Episodes of dyspnea
- Clearing the throat (tickle at the back of the throat or neck)
- Cough with or without sputum production, especially in the absence of a cold +/- occurring 5-10 minutes after exercise.
22
Q
When assessing a patient with asthma - you should look for:
A
- Skin retraction (clavicles, ribs, sternum)
- Hunched over body posture; inability to stand, sit straight or relax
- Pursed-lip breathing
- Nostrils flaring
- Unusual pallor or unexplained sweating
23
Q
When assessing a patient with asthma - you should make sure you ask about…
A
- Restlessness during sleep
- Vomiting
- Fatigue unrelated to working or playing
24
Q
What are some causes of pneumonia?
A
- Aspiration of food, fluids, vomit
- Inhalation of toxic/caustic chemicals, smoke, dust, gasses
- A bacterial, viral or mycoplasma infection
25
Some risk factors for pneumonia include:
- Age (very young or old)
- Absence of pneumococcal vaccine
- Smoking
- URI
- Altered consciousness
- Endotracheal intubation/NG tube
- Recent chest surgery
- Prolonged immunity
- Immunosuppressive therapy
- Nonfunctional immune system
- Severe periodontal disease
- Prolonged exposure to virulent organisms
- Malnutrition, dehydration
- Chronic diseases
- Prolonged debilitating disease
- Inhalation of noxious substances
- Aspiration w/poor immune system
- Chronically ill w/older adults
26
# I present with
* Sudden/sharp pleuritic chest pain aggravated by chest movement.
* Shoulder pain
* Hacking, productive cough (rust colored or green, purulent sputum)
* Dyspnea
* Tachypnea w/decreased chest excursion (affected sided)
* Cyanosis
* Headache
* Fever + chills
* Generalized aches and myalgia
* Painful + swollen knees possibly
* Fatigue
* Confusion in older adult
| Who am I?
Pneumonia
27
Who is at an increased risk of developing Tuberculosis, a bacterial infection?
- Healthcare workers
- Older adults/Infants/children <5
- Overcroweded housing/homelss
- Incarceration
- US born non-Hispanic African Americans
- Immigrants from Southeast, Central Asia, Ethiopia, Latin America, Eastern Europe
-Reduced immunity or malnutrition + HIV positive lung cancer or head/neck cancer
RA
DM +/- end-stage renal disease
Hx of GI disease
28
# I present with
* Fatigue
* Malaise
* Anorexia
* Weight-loss
* Low-grade fever
* Night sweats
* Frequent productive cough
* Dull chest pain, tightness, or discomfort
* Dyspnea
| Who am I?
Tuberculosis
29
What is scleroderma?
Restrictive lung disease of unknown etiologic origin, leads to inflammation and fibrosis of many organs.
30
What are the s&s associated with scleroderma?
* Dyspnea on exertion
* Nonproductive cough
* Peripheral edema
* Orthopnea
* Paroxysmal nocturnal dyspnea
* Hemoptysis
31
Where does lung cancer commonly metastasize?
- Brain
- Long bones
- Vertebrae (esp thoracic)
- Liver
- Adrenal Glands
32
Where is the LOCAL metatasis of lung cancer?
- Pleura
- Pulmonary parenchyma or bronchi
33
Lung Cancer Risk Factors Include
- Age >50Y
- Smoking or other tobacco use
- Previous tobacco-related cancer
- Passive (environmental) smoke
- Low consumption of fruits and veggies
- Genetic predisposition
- Exposure to air pollution, toxic chemicals, fumes, or radon gas
- Previous lung diseases
34
# I present with..
* Any change in respiratory patterns
* Recurrent pneumonia or bronchitis
* Hemoptysis
* Persistent cough
* Change in cough or development of hemoptysis (for a chronic smoker)
* Hoarseness or dysphagia
* Dyspnea
* Wheezing
* Sharp chest, upper back, shoulder, scapular, rib or arm pain aggravated by inspiration or accompanies by respiratory S&S
* Sudden, unexplained weight loss; anorexia; fatigue
* Chest, shoulder or arm pain; bone aching, joint pain
* Atrophy and weakness of the arm and hand muscles
* Fecal breath odor
| Who am I?
Lung Cancer
35
In the early and undiagnosed stages of cystic fibrosis, what signs and symptoms are present?
- Persistent coughing and wheezing
- Recurrent pneumonia
- Excessive appetite, poor weight gain
- Salty skin/sweat
- Bulky, foul-smelling stools
36
Older children/young adults with cystic fibrosis can present with:
- Infertility
- Nasal polyps
- Periostitis (periosteum inflammation)
- Glucose intolerance
37
# Pulmonary involvement of what disease includes:
- Tachypnea
- Sustained chronic cough with mucus production + vomiting (due to coughing)
- Accessory muscle use
- Cyanosis and digital clubbing
- Exertional dyspnea with decreased exercise tolerance
Cystic Fibrosis
38
Further complications of cystic fibrosis include
- Pneumothorax
- Hemoptysis
- Right-sided heart failure secondary to pulmonary hypertension
39
The PE Rule-Out Criteria (PERC) includes:
- Age <50Y
- Heart rate <100bpm
- Oxygen sat >/=95%
- NO hemptysis
- NO estrogen use
- NO prior DVT/PE
- NO unilateral leg swelling
- NO surgery or trauma req. hospitalization within the past 4 weeks
40
Well's Criteria for PE
- Clinical symptoms of DVT
- Other Dx less likley than PE
- Heart rate >100
- Immobilization 3+ days or more or surgery in the past 4 weeks.
- Previous history of DVT/PE
- Hemoptysis
- Malignancy
| Score 2+ = PE likely; Score 0 or 1 = PE unlikely
41
# I present with...
- Dyspnea
- Pleuritic (sharp, localized) chest pain
- Diffuse chest discomfort
- Persistent cough
- Hemoptysis
- Apprehension, anxeity, restlessness
- Tachypnea
- Tachycardia
- Fever
| who am I?
Pulmonary Embolism
42
# I present with...
- Peripheral edema (BLEs)
- Chronic cough
- Central chest pain
- Exertional dyspnea or dyspnea at rest
- Distention of neck veins
- Fatigue
- Wheezing
- Weakness
| who am I?
Cor pulmonale
43
Pulmonary arterial hypertension can occur secondary to...
- PE
- Chronic lung disease
- Sickle-cell disease
- Grave's disease
- Polycythemia
- Collagen vascular hypertension
- Portal hypertension
- Heart abnormalities
- Sleep apnea
44
Dry Pleurisy
no change in the fluid between pleural layers
45
Wet pleurisy
abnormal increase of fluid between pleural layers
46
Risk Factors for Pleurisy
- Pneumonia
- TB
- Lung Abscess
- Influenza
- Systemic lupus erythematosus
- RA
- Pulmonary infarction
47
# I present with...
- Pain (ipsilateral shoulder, upper trap, neck, lower chest wall, and abdomen)
- Cough
- Dyspnea
- Fever, chills
- Tachypnea
| Who am I?
Pleurisy
48
