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Clin Med III > Pulmonary Pathology Part 4 > Flashcards

Pulmonary Pathology Part 4 Flashcards

1
Q

What are the pleural space disorders (3)

A
  1. Pneumothorax
  2. Pleuritis
  3. Pleural effusion
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2
Q

What is a pneumothorax

A

Accumulated air/gas in the pleural cavity due to a defective visceral pleura or chest wall

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3
Q

What happens with a pneumothorax

A

The negative pressure in the lungs is lost it causes the lung to collapse, recoiling towards the hilum

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4
Q

What are the symptoms of a pneumothorax (2)

A
  1. SOB

2. Mediastinal shift away from affected side compressing opposite lung

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5
Q

What is cystic fibrosis

A

An inherited disorder that affects sodium/chloride ion transport in the exocrine glands causing them to make excess substances that are very sticky

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6
Q

True or False:

Cystic Fibrosis is autosomal recessive

A

True

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7
Q

What are does chromosome does cystic fibrosis effect

A

Long arm of chromosome 7

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8
Q

What happens with cystic fibrosis

A

Epithelial cells are impermeable to chloride and salt accumulate in the cells that line the lungs and digestive tissues

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9
Q

What does the salt accumulation result in

A

Dehydrated and increased viscosity of mucous secretions, elevated sweat electrolytes, pancreatic enzyme insufficiency.

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10
Q

How are the lungs effect with cystic fibrosis

A

Obstruction by mucous that leads to infection and atelectasis with hyperinflation then fibrosis and large cystic dilations affecting all bronchi

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11
Q

How do you diagnose in infants

A

Sweat test and they will be classified as failure to thrive and/or respiratory compromised

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12
Q

Pulmonary signs and symptoms of cystic fibrosis early on (8)

A
  1. Dry cough
  2. Wheezing
  3. Dyspnea
  4. Poor exxercise tolerance
  5. Tachypnea
  6. Obstructive emphysema
  7. Atelectasis
  8. Sinusitis
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13
Q

Pulmonary signs of symptoms of cystic fibrosis advanced stage (8)

A
  1. Barrel chest
  2. Kyphosis
  3. Cyanosis
  4. Clubbing
  5. Recurrent bronchitis
  6. Pneumothorax
  7. Hemoptysis
  8. Right heart failure
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14
Q

What are the pulmonary symptoms of a cystic fibrosis exacerbation (6)

A
  1. Increased cough and sputum
  2. Weight loss
  3. Increased RR/work of breathing
  4. Changes on x-ray
  5. Viscous mucus in bronchi
  6. Lung infecton
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15
Q

True or False:

Cystic fibrosis effects the GI, GU, MS, pancreas, and liver

A

True

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16
Q

What is a spontaneous pneumothorax

A

Opening on the lung surface where air leaks from airways into pleural cavity

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17
Q

True or False:

Spontaneous pneumothorax resolves without a chest tube

A

True

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18
Q

What is a tension pneumothorax

A

Lung rupture into the pleural space and air can enter with inspiration but cannot escape

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19
Q

What does a tension pneumothorax cause

A

Compression atelectasis against the mediastinum compressing the heart and great vessels leading to decreased venous return and CO

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20
Q

What is an open pneumothorax

A

Puncture/opening that causes the pleural space air pressure equaling the barometric pressure air comes in and air is forced back out

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21
Q

True or False:

Tension pneumothorax requires a chest tube to treat

A

True

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22
Q

Signs and symptoms of a pneumothorax (6)

A
  1. Dyspnea
  2. Pleural chest pain
  3. Decreased BP
  4. Weak rapid pulse
  5. Abnormal respiratory movements on involved side
  6. Referred pain to ipsilateral shoulder across the chest and over the abdomen
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23
Q

How do you treat a spontaneous pneumothorax

A

No treatment but give bed rest and O2

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24
Q

How do you treat a tension pneumothorax

A

Repair or closure of defect and removing air from the pleural space

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25
Q

How long should someone avoid air travel after a pneumothorax

A

At least 2 weeks after healing

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26
Q

What is another name for pleuritis

A

Pleurisy

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27
Q

What is pleuritis

A

Inflamed pleura secondary to infection, injury, tumor, TB, abscess, influenza, and RA

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28
Q

What are the signs and symptoms of pleuritis (7)

A
  1. Sudden onset of sharp chest pain (worse with inspiration, sneezing and coughing)
  2. Cough
  3. Fever
  4. Chills
  5. Tachypnea
  6. Referred pain
  7. Pleural rub with auscultation
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29
Q

What is wet pleuritis

A

Fluid between pleural layers changes less likely to be painful but may interfere with breathing

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30
Q

What is dry pleuritis

A

No change in the fluid between the pleural layers

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31
Q

How do you treat pleuritis

A

Aspirin or NSAIDs

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32
Q

What is a pleural effusion

A

Pleural fluid between pleural layers

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33
Q

What causes a pleural effusion

A

Impaired secretion/drainage of the fluid

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34
Q

What cause the impaired secretion/drainage of the fluid (3)

A
  1. Transudates
  2. Exudates
  3. Drug induced effusion
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35
Q

What is transudate

A

Fluid leaking out of capillaries due to increased pressure in capillaries pushing fluid out

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36
Q

What is exudate

A

Fluid that leaks around the cells and capillaries due to inflammation

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37
Q

What are the signs and symptoms of pleural effusions with small amount of fluid

A

Detected only on x-ray

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38
Q

What are the signs and symptoms of pleural effusions with large amounts of fluid

A

Dyspnea on exertion, nonspecific chest discomfort, pleuritic chest pain, sharp stabbing chest pain

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39
Q

How do you treat pleural effusions (4)

A
  1. Thransthoracic aspiration
  2. Treatment of the underlying disease
  3. Antibiotics
  4. Pleurectomy and pleurodesis if recurrent and if benefits outweigh the risks
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40
Q

What is a pulmonary embolism and infarct

A

Clot lodged in a pulmonary artery blocked blood supply to lung parenchyma

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41
Q

What can the clot be (5)

A
  1. Blood
  2. Air
  3. Fat
  4. Bone marrow
  5. Tumor cells
42
Q

What causes a PE

A

DVT or embolism from other sources

43
Q

What are the risk factors of forming a PE

A

Blood stasis, hypercoaguable states, over 60, obesity, clotting abnormalities

44
Q

What is a pulmonary infarction

A

Emboli arising in the lungs (uncommon) and bronchial arteries continue to circulate oxygenated blood

45
Q

A clot arising from any other area embolizes where

A

To the lungs

46
Q

What does a clot embolizing to the lungs cause

A

Obstruction of the pulmonary vasculature causing vasoconstriction and vascular resistance

47
Q

Signs and symptoms of a nonspecific PE (8)

A
  1. Dyspnea
  2. Pleuritic chest pain
  3. Apprehension cough
  4. Hemoptysis
  5. Diaphoresis
  6. Tachypnea
  7. Fever
  8. Sudden death
48
Q

How do you treat a PE

A

Prevention, thrombolytic therapy, filter, thrombectomy or embolectomy

49
Q

What is pneumonia

A

Inflammation of the lung parenchyma

50
Q

What causes pneumonia

A

Infection, inhaled chemicals, smoke, dust, gases, aspiration

51
Q

What are the risk factors for pneumonia

A

Smoking, chronic bronchitis, DM, dehydration, hospitalization, and bedridden

52
Q

What does pneumonia cause

A

In a compromised person there is a full immune and inflammatiry response, endotoxins are released, and inflammation and edema occur

53
Q

What do the endotoxins that are released do

A

Damage the membranes

54
Q

What does the inflammation and edema do

A

Clogs airways with debris and exudate

55
Q

True or False:

Aspiration pneumonia is often right side

A

True

56
Q

Where is the bacterial pneumonia

A

Lung parenchyma especially in the lower lobes due to gravity

57
Q

True or False:

Walking pneumonia is often viral

A

True

58
Q

What is legionnaire’s disease

A

Type of pneumonia caused by environmental spread of bacteria

59
Q

Signs and symptoms of pneumonia (6)

A
  1. Sudden sharp pleuritic chest pain
  2. Cough with rusty/green purulent sputum
  3. Dyspnea
  4. Decreased chest excursion on involved side
  5. Confusion
  6. Tachypnea
60
Q

When do symptoms usually resolve with pneumonia

A

1-2 weeks

61
Q

How do you treat pneumonia

A

Antibiotics, rest, and fluids

62
Q

What is Pneumocystis Carinii Pneumonia (PCP)

A

Opportunistic infection associated with AIDS that is progressive and often fatal

63
Q

What happens with Pneumocystis Carinii Pneumonia (PCP)

A

Parasitic attachment to the alveolar lining and consolidation occurs and disrupts gas exchange

64
Q

What are the signs and symptoms of Pneumocystis Carinii Pneumonia (PCP) (4)

A
  1. Fever
  2. Impaired gas exchange
  3. Progressive dyspnea
  4. Nonproductive cough
65
Q

How do you treat Pneumocystis Carinii Pneumonia (PCP)

A

Meds

66
Q

What is pulmonary tuberculosis

A

Infectious inflammatory systemic disease that causes infection of the lungs with mycobacterium tuberculosis resulting in granulomas, necrosis, and cavity formation

67
Q

What is primary TB

A

Usually asymptomatic involving the middle/lower lung areas

68
Q

What is secondary TB

A

Usually brought on by lowered resistance to infection usually involving the upper lobes

69
Q

What causes TB

A

Inhalation of the infected airborne particles that are able to lie dormant for decades within the body

70
Q

What happens when the TB bacterium is inhaled

A

Bacilli are implanted on the alveoli and a tubercle forms around the organism growing for 2-12 weeks

71
Q

What are the signs and symptoms of TB

A

Positive skin test, may be asymptomatic, productive cough longer than 3 weeks, weight loss, fever, night sweats, fatigue, malaise, anorexia, rales over involved area, bronchial breath sounds

72
Q

How do you treat TB

A

Prophylactic and active treatment, meds, chemotherapy

73
Q

What is a lung abscess

A

Localized accumulation of purulent exudate

74
Q

What are risk factors for lung abscess

A

Complication of pneumonia, alcohol related aspiration, altered level of consciousnes, impaired gag reflex, poor dental care, tracheal/NG tubes

75
Q

What causes a lung abscess

A

It is a natural defense against microorganisms that is an inflammatory process that begins and the alveoli fill with exudate leading to death and decat of consolidated tissue

76
Q

Signs and symptoms of a lung abscess

A

Productive cough, foul smelling sputum, persistent fever, chills, dyspnea, pleuritic chest pain, cyanosis, clubbing

77
Q

What happens if there is cavitation with a lung abscess

A

A severe cough with copious purulent sputum and hemoptysis

78
Q

How do you treat a lung abscess

A

Antibiotics, good nutrition, chest PT, and bronchoscopic drainage

79
Q

What is acute bronchitis

A

Inflammation of the trachea and bronchi that has a short duration of 1-3 weeks and self limiting

80
Q

What are the signs and symptoms of acute bronchitis early on

A

Upper respiratory infection or cold, fever, cough, sore throat, laryngitis, and chest pain

81
Q

What are the signs and symptoms of acute bronchitis later on

A

Productive cough with purulent sputum, wheezing, and constitutional symptoms

82
Q

How do you treat acute bronchitis

A

Cough suppressants, rest, humidity, nutrition, and hydration

83
Q

What is another name for respiratory distress syndrome (RDS)

A

Hyaline membrane disease

84
Q

True or False:

Respiratory distress syndrome is the most common respiratory disorder in premature infants

A

True

85
Q

True or False:

Respiratory distress syndrome is almost always present in infants born before 37 weeks gestation

A

True

86
Q

What causes respiratory distress syndrome

A

Immature lungs not having an adequate amount and regeneration of surfactant resulting in the alveoli collapsing increasing effort to breathe

87
Q

What are the signs and symptoms of respiratory distress syndrome

A

Begins 1-2 hours after birth last 48-72 hours respiratory failure is common so provide O2 therapy and assisted ventilation

88
Q

True or False:

Secretions increase 2-3 days after onset of respiratory distress syndrome

A

True

89
Q

How do you treat respiratory distress syndrome

A

Corticosteroids and surfactant replacement and chest PT

90
Q

What is bronchopulmonary dysplasia

A

Chronic lung disease affecting children who were preterm newborns

91
Q

What causes bronchopulmonary dysplasia

A

Linked with positive pressure ventilation and O2 therapy during the neonatal period

92
Q

What are the signs and symptoms of bronchopulmonary dysplasia

A

Signs of chronic lung disease, rales, wheezing, cyanosis, hypoxemia, abnormal postnatal chest x-rays by 1 month

93
Q

How do you treat bronchopulmonary dysplasia

A

O2 therapy (long term), chest PT and airway clearance

94
Q

When does someone with bronchopulmonary dysplasia develop normal pulmonary function

A

3-5 years old

95
Q

True or False:

Someone with bronchopulmonary dysplasia will require long term O2

A

True

96
Q

What is a pancoast tumor

A

Tumor caused by non small cell lung cancer in the right or left pulmonary apex

97
Q

What can a pancoast tumor cause (2)

A
  1. Pancoast syndrome

2. Horner’s syndrome

98
Q

What is pancoast syndrome

A

Compression of the brachial plexus

99
Q

What is Horner’r syndrome

A

Compression of the cervical ganglion/sympathetic ganglion resulting in drooping of an eyelid

100
Q

True or False:

A Pancoast tumor is dangerous because it compresses the neurovascularture of the neck

A

True

Clin Med III (9 decks)

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