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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
How long should someone avoid air travel after a pneumothorax
At least 2 weeks after healing
26
What is another name for pleuritis
Pleurisy
27
What is pleuritis
Inflamed pleura secondary to infection, injury, tumor, TB, abscess, influenza, and RA
28
What are the signs and symptoms of pleuritis (7)
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
29
What is wet pleuritis
Fluid between pleural layers changes less likely to be painful but may interfere with breathing
30
What is dry pleuritis
No change in the fluid between the pleural layers
31
How do you treat pleuritis
Aspirin or NSAIDs
32
What is a pleural effusion
Pleural fluid between pleural layers
33
What causes a pleural effusion
Impaired secretion/drainage of the fluid
34
What cause the impaired secretion/drainage of the fluid (3)
1. Transudates 2. Exudates 3. Drug induced effusion
35
What is transudate
Fluid leaking out of capillaries due to increased pressure in capillaries pushing fluid out
36
What is exudate
Fluid that leaks around the cells and capillaries due to inflammation
37
What are the signs and symptoms of pleural effusions with small amount of fluid
Detected only on x-ray
38
What are the signs and symptoms of pleural effusions with large amounts of fluid
Dyspnea on exertion, nonspecific chest discomfort, pleuritic chest pain, sharp stabbing chest pain
39
How do you treat pleural effusions (4)
1. Thransthoracic aspiration 2. Treatment of the underlying disease 3. Antibiotics 4. Pleurectomy and pleurodesis if recurrent and if benefits outweigh the risks
40
What is a pulmonary embolism and infarct
Clot lodged in a pulmonary artery blocked blood supply to lung parenchyma
41
What can the clot be (5)
1. Blood 2. Air 3. Fat 4. Bone marrow 5. Tumor cells
42
What causes a PE
DVT or embolism from other sources
43
What are the risk factors of forming a PE
Blood stasis, hypercoaguable states, over 60, obesity, clotting abnormalities
44
What is a pulmonary infarction
Emboli arising in the lungs (uncommon) and bronchial arteries continue to circulate oxygenated blood
45
A clot arising from any other area embolizes where
To the lungs
46
What does a clot embolizing to the lungs cause
Obstruction of the pulmonary vasculature causing vasoconstriction and vascular resistance
47
Signs and symptoms of a nonspecific PE (8)
1. Dyspnea 2. Pleuritic chest pain 3. Apprehension cough 4. Hemoptysis 5. Diaphoresis 6. Tachypnea 7. Fever 8. Sudden death
48
How do you treat a PE
Prevention, thrombolytic therapy, filter, thrombectomy or embolectomy
49
What is pneumonia
Inflammation of the lung parenchyma
50
What causes pneumonia
Infection, inhaled chemicals, smoke, dust, gases, aspiration
51
What are the risk factors for pneumonia
Smoking, chronic bronchitis, DM, dehydration, hospitalization, and bedridden
52
What does pneumonia cause
In a compromised person there is a full immune and inflammatiry response, endotoxins are released, and inflammation and edema occur
53
What do the endotoxins that are released do
Damage the membranes
54
What does the inflammation and edema do
Clogs airways with debris and exudate
55
True or False: | Aspiration pneumonia is often right side
True
56
Where is the bacterial pneumonia
Lung parenchyma especially in the lower lobes due to gravity
57
True or False: | Walking pneumonia is often viral
True
58
What is legionnaire's disease
Type of pneumonia caused by environmental spread of bacteria
59
Signs and symptoms of pneumonia (6)
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
When do symptoms usually resolve with pneumonia
1-2 weeks
61
How do you treat pneumonia
Antibiotics, rest, and fluids
62
What is Pneumocystis Carinii Pneumonia (PCP)
Opportunistic infection associated with AIDS that is progressive and often fatal
63
What happens with Pneumocystis Carinii Pneumonia (PCP)
Parasitic attachment to the alveolar lining and consolidation occurs and disrupts gas exchange
64
What are the signs and symptoms of Pneumocystis Carinii Pneumonia (PCP) (4)
1. Fever 2. Impaired gas exchange 3. Progressive dyspnea 4. Nonproductive cough
65
How do you treat Pneumocystis Carinii Pneumonia (PCP)
Meds
66
What is pulmonary tuberculosis
Infectious inflammatory systemic disease that causes infection of the lungs with mycobacterium tuberculosis resulting in granulomas, necrosis, and cavity formation
67
What is primary TB
Usually asymptomatic involving the middle/lower lung areas
68
What is secondary TB
Usually brought on by lowered resistance to infection usually involving the upper lobes
69
What causes TB
Inhalation of the infected airborne particles that are able to lie dormant for decades within the body
70
What happens when the TB bacterium is inhaled
Bacilli are implanted on the alveoli and a tubercle forms around the organism growing for 2-12 weeks
71
What are the signs and symptoms of TB
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
How do you treat TB
Prophylactic and active treatment, meds, chemotherapy
73
What is a lung abscess
Localized accumulation of purulent exudate
74
What are risk factors for lung abscess
Complication of pneumonia, alcohol related aspiration, altered level of consciousnes, impaired gag reflex, poor dental care, tracheal/NG tubes
75
What causes a lung abscess
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
Signs and symptoms of a lung abscess
Productive cough, foul smelling sputum, persistent fever, chills, dyspnea, pleuritic chest pain, cyanosis, clubbing
77
What happens if there is cavitation with a lung abscess
A severe cough with copious purulent sputum and hemoptysis
78
How do you treat a lung abscess
Antibiotics, good nutrition, chest PT, and bronchoscopic drainage
79
What is acute bronchitis
Inflammation of the trachea and bronchi that has a short duration of 1-3 weeks and self limiting
80
What are the signs and symptoms of acute bronchitis early on
Upper respiratory infection or cold, fever, cough, sore throat, laryngitis, and chest pain
81
What are the signs and symptoms of acute bronchitis later on
Productive cough with purulent sputum, wheezing, and constitutional symptoms
82
How do you treat acute bronchitis
Cough suppressants, rest, humidity, nutrition, and hydration
83
What is another name for respiratory distress syndrome (RDS)
Hyaline membrane disease
84
True or False: | Respiratory distress syndrome is the most common respiratory disorder in premature infants
True
85
True or False: | Respiratory distress syndrome is almost always present in infants born before 37 weeks gestation
True
86
What causes respiratory distress syndrome
Immature lungs not having an adequate amount and regeneration of surfactant resulting in the alveoli collapsing increasing effort to breathe
87
What are the signs and symptoms of respiratory distress syndrome
Begins 1-2 hours after birth last 48-72 hours respiratory failure is common so provide O2 therapy and assisted ventilation
88
True or False: | Secretions increase 2-3 days after onset of respiratory distress syndrome
True
89
How do you treat respiratory distress syndrome
Corticosteroids and surfactant replacement and chest PT
90
What is bronchopulmonary dysplasia
Chronic lung disease affecting children who were preterm newborns
91
What causes bronchopulmonary dysplasia
Linked with positive pressure ventilation and O2 therapy during the neonatal period
92
What are the signs and symptoms of bronchopulmonary dysplasia
Signs of chronic lung disease, rales, wheezing, cyanosis, hypoxemia, abnormal postnatal chest x-rays by 1 month
93
How do you treat bronchopulmonary dysplasia
O2 therapy (long term), chest PT and airway clearance
94
When does someone with bronchopulmonary dysplasia develop normal pulmonary function
3-5 years old
95
True or False: | Someone with bronchopulmonary dysplasia will require long term O2
True
96
What is a pancoast tumor
Tumor caused by non small cell lung cancer in the right or left pulmonary apex
97
What can a pancoast tumor cause (2)
1. Pancoast syndrome | 2. Horner's syndrome
98
What is pancoast syndrome
Compression of the brachial plexus
99
What is Horner'r syndrome
Compression of the cervical ganglion/sympathetic ganglion resulting in drooping of an eyelid
100
True or False: | A Pancoast tumor is dangerous because it compresses the neurovascularture of the neck
True

Clin Med III (9 decks)

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