Respiratory Diseases and Disorders Flashcards
1
Q
What are the etiologies of a common cold (or an upper respiratory infection)?
A
rhinovirus out of about 200 rhinoviruses may be transmitted via respiratory droplets
2
Q
What are the clinical features of a common cold (or an upper respiratory infection)?
A
S/S:
- sore throat, nasal congestion or discharge, coughing, headache, low-grade fever
DIAGNOSTIC TESTS:
- signs and symptoms present
- sputum and nasal discharge cultures rule out more serious conditions
3
Q
What’s the treatment and prognosis of a common cold (or upper respiratory infection)?
A
TREATMENT:
- cough suppressants, antihistamines, decongestants, expectorants
PROGNOSIS:
- incidence and complications higher in immunocompromised groups
4
Q
What are the predisposing factors and etiologies of sinusitis?
A
PREDISPOSING FACTORS:
- deviated septum/nasal polyps, common cold, allergies, regular swimming
ETIOLOGIES:
- viral, fungal, or (more commonly) bacterial infection of sinuses
5
Q
What are the clinical features of sinusitis?
A
S/S:
- pain in frontal/maxillary/ethmoid sinuses, purulent discharge, fever
DIAGNOSTIC TESTS:
- sinus radiography may reveal fluid-filled areas
- discharge culture may identify or rule out bacterial pathogens
6
Q
What’s the treatment and prognosis of sinusitis?
A
TREATMENT:
- corticosteroids, antihistamines, decongestants, antibiotics if bacterial
- possible sinusotomy
PROGNOSIS:
- generally good if acute
7
Q
What are the etiologies of pharyngitis?
A
hypersensitivity, irritating agents, viral infections, sexually transmitted bacteria -> inflammation of pharynx
8
Q
What are the clinical features of pharyngitis?
A
S/S:
- sore throat, fever, dysphonia, dysphagia, cervical lymphadenopathy
DIAGNOSTIC TESTS:
- physical examination reveals red and swollen pharynx
9
Q
What’s the treatment and prognosis of pharygnitis?
A
TREATMENT:
- antiinflammatory drugs, antibiotics (if bacterial)
- surgical resection of tonsils or adenoid gland if chronic
PROGNOSIS:
- may respond well to treatment
- possible complication of peritonsillar abscess
10
Q
What are the etiologies of nasopharyngeal carcinoma?
A
high-salt diets, EBV infection -> epithelial malignancy in nasopharyngeal cavity
*unique in that it’s not strongly linked to tobacco use
11
Q
What are the clinical features of nasopharyngeal carcinoma?
A
S/S:
- nasal obstruction with epistaxis, otitis media, and neck mass
DIAGNOSTIC TESTS:
- biopsy reveals histology
- MRI, CT, and PET may reveal size and metastasis
12
Q
What’s the treatment and prognosis of nasopharyngeal carcinoma?
A
TREATMENT:
- radiation therapy with or without chemotherapy
PROGNOSIS:
- because NPC is usually asymptomatic until later stages, prognosis usually bad during diagnosis
13
Q
What are the etiologies of laryngitis?
A
viral/bacterial/fungal URI, irritating agents, using voice too much -> inflammation of larynx and vocal cords
14
Q
What are the clinical features of laryngitis?
A
S/S:
- aphonia, sore throat, dysphagia, fever, malaise
DIAGNOSTIC TESTS:
- laryngoscopy reveals inflammation
15
Q
What’s the treatment and prognosis of laryngitis?
A
TREATMENT:
- reduce causative factors, possible corticosteroids, possible antibiotics if bacterial
PROGNOSIS:
- generally good
16
Q
What are the etiologies of a deviated septum?
A
congenital defect or getting punched in the face -> crooked nasal septum
17
Q
What are the clinical features of a deviated septum?
A
S/S:
- mild breathing problems
DIAGNOSTIC TESTS:
- nasal speculum may reveal crooked nasal septum
18
Q
What’s the treatment and prognosis of a deviated septum?
A
TREATMENT:
- rhinoplasty or septoplasty
PROGNOSIS:
- fairly good
19
Q
What are the etiologies of nasal polyps?
A
allergic rhinitis -> overproduction of fluid in nasal mucosal epithelium -> benign polyp
20
Q
What are the clinical features of nasal polyps?
A
S/S:
- anosmia, mild breathing difficulties, possible sinus pain
DIAGNOSTIC TESTS:
- nasal speculum reveals polyps
21
Q
What’s the treatment and prognosis of nasal polyps?
A
TREATMENT:
- surgical resection, possible rhinoplasty
PROGNOSIS:
- generally good, but likely to recur
22
Q
What are the etiologies of anosmia?
A
intracranial tumor, olfactory nerve damage, nasal polyps, allergic rhinitis -> loss of smell with impaired taste
23
Q
What’s the treatment and prognosis of anosmia?
A
TREATMENT:
- remove nasal polyps
- desensitization therapy (if allergic rhinitis)
PROGNOSIS:
- if neurogenic, probably lifelong
24
Q
What are the etiologies of epistaxis?
A
URIs, sinusitis, direct trauma, hypertension, congestive heart failure, coagulopathy -> nosebleed
25
What's the treatment and prognosis of epistaxis?
TREATMENT:
- apply pressure, rhino rocket, cauterization, sclerosing therapy, possible ligation
PROGNOSIS:
- generally good
26
What are the etiologies of benign laryngeal tumors?
using voice too much, acid reflux, and tobacco use -> papilloma and polyp of larynx
27
What are the clinical features of benign laryngeal tumors?
S/S:
- dysphonia, possible stridor
DIAGNOSTIC TESTS:
- laryngoscopy reveals polyp or papilloma
- biopsy reveals histology
28
What's the treatment and prognosis of benign laryngeal tumors?
TREATMENT:
- surgical excision of polyp/papilloma
PROGNOSIS:
- varies if benign or malignant
29
What are the etiologies of laryngeal cancer?
chronic alcohol or tobacco use, HPV infection, asbestos, being >60 years old -> squamous cell carcinoma of larynx
30
What are the clinical features of laryngeal cancer?
S/S:
- hoarseness, dysphagia, cough, referred ear pain, stridor
DIAGNOSTIC TESTS:
- fiberoptic endoscopy and panendoscopy reveals tumors
- biopsy reveals histology
31
What's the treatment and prognosis of laryngeal cancer?
TREATMENT:
- partial laryngectomy or total laryngectomy (impairs speech and swallowing) or chemoradiation therapy
PROGNOSIS:
- best if diagnosed early, but other primary cancers likely to develop due to alcohol/tobacco use
32
What are the etiologies of hemoptysis?
trauma, tumors, congestive heart failure, coagulopathy, inflammatory conditions, and infections -> spitting up bloody sputum
33
What are the clinical features of hemoptysis?
S/S:
- spitting or coughing up bloody sputum
DIAGNOSTIC TESTS:
- rhinoscopy, endoscopy, and pulmonary angiography can help reveal source of bleeding
- coagulation studies may suggest decreased clotting factors (if coagulopathy)
34
What's the treatment and prognosis of hemoptysis?
TREATMENT:
- antibiotics and cough suppressants if minor
- ligation of involved vessels if severe
PROGNOSIS
- in 75% of cases, hemoptysis usually doesn't indicate severe disease
35
What are the etiologies of atelectasis?
mucous plug, foreign body, or tumor -> obstruction of bronchial tree
tumor compresses lungs -> lungs unable to expand fully (compressive)
inflammation leads to increased intrapleural fluid -> lung unable to expand fully (pleural effusion)
36
What are the clinical features of atelectasis?
S/S:
- dyspnea, possible cyanosis, substernal retraction
DIAGNOSTIC TESTS:
- auscultation reveals diminished breathing
- chest radiography reveals mediastinal shift towards collapse
- bronchoscopy may identify foreign object if obstructive
37
What's the treatment and prognosis for atelectasis?
TREATMENT:
- airway suctioning (if obstructive)
- antibiotics and surgical drainage (if pleural effusion)
- analgesics for chest pain
PROGNOSIS:
- complications may include pneumonia
38
What are the etiologies of a pulmonary embolism?
thrombi, air, fat globules, tissue clumps, or bacterial clusters moves to right heart -> occlusion of pulmonary artery
39
What are the clinical features of a pulmonary embolism?
S/S:
-dyspnea, chest pain, possible tachypnea, possible cyanosis and shock
DIAGNOSTIC TESTS:
- CT angiography reveals poor pulmonary circulation
- Echocardiogram may reveal impaired right-sided heart and pulmonary artery function
- Auscultation reveals pleural rub and rales
40
What's the treatment and prognosis of a pulmonary embolism?
TREATMENT:
- oxygen therapy, anticoagulants
- compression stockings may prevent thrombi
PROGNOSIS:
- generally good if mild, but high mortality rate with massive PE
41
What are the etiologies of pneumonia?
- (if bacterial): staphylococci, group A hemolytic streptococci, pneumococci, Haemophilus influenza, Klebsiella pneumoniae
- (if atypical): chlamydia, legionella, mycoplasma
- (if viral): adenoviruses, influenza type A/B, respiratory syncytial viruses
- > general inflammation of lungs
42
What are the clinical features of pneumonia?
S/S:
- fever, cough, dyspnea, cyanosis, bloody sputum, chest pains, tachypnea
DIAGNOSTIC TESTS:
- chest radiography reveals dense opaque area
- sputum and blood cultures can be positive for suspected pathogens
43
What's the treatment and prognosis of pneumonia?
TREATMENT:
- antibiotics, antivirals, and antifungals if bacterial, viral, or fungal
- analgesics and oxygen therapy
PROGNOSIS:
- usually good in healthy individuals, but higher mortality rates are seen in chronically ill groups
44
What are the etiologies of a pulmonary abscess?
bacterial pneumonia, aspiration pneumonia, or septic emboli -> pus cell forms in lungs
45
What are the clinical features of a pulmonary abscess?
S/S:
- alternating chills and fever, chest pain, cough, bloody/purulent sputum
DIAGNOSTIC TESTS:
- chest radiography reveals abscess
- blood and sputum cultures may identify causative bacteria
46
What's the treatment and prognosis of a pulmonary abscess?
TREATMENT:
- antibiotics and resection of abscess
PROGNOSIS:
- good in healthy individuals, but high mortality rates seen in chronically-ill groups
47
What are the etiologies of legionellosis?
Legionella pneumophila bacterium reproduce in body-temperature waters -> transmitted via aerosolized water droplets
48
What are the clinical features of Legionellosis?
S/S:
- (if Pontiac fever, early onset and short duration) high fever, myalgia
- (if Legionnaire's, later onset and longer duration) fever, myalgia, chest pain, dyspnea, vomiting, diarrhea
DIAGNOSTIC TESTS:
- chest radiography reveals dense opaque area
- blood studies indicate elevated WBC and ESR
- sputum cultures positive for Legionella pneumophilus
49
What's the treatment and prognosis of Legionellosis?
TREATMENT:
- doxycycline or erythromycin if mild, azithromycin or levofloxacin if severe
- analgesics, antipyretics, antiemetics
PROGNOSIS:
- usually good with treatment in healthy individuals, but guarded in immunocompromised groups
50
What are the etiologies of respiratory syncytial virus (RSV) pneumonia?
respiratory syncytial virus transmitted via respiratory droplets -> infects lungs, reproduces more freely in infants and seniors
51
What are the clinical features of respiratory syncytial virus (RSV) pneumonia?
S/S:
- nasal congestion, coughing, fever, dyspnea
DIAGNOSTIC TESTS:
- nasal lavage positive for RSV cultures
52
What's the treatment and prognosis of respiratory syncytial virus (RSV) pneumonia?
TREATMENT:
- antipyretics, oxygen therapy
PROGNOSIS:
- pretty good
53
What are the etiologies of histoplasmosis?
Histoplasma capsulatum fungus transmitted via dust inhalation -> reproduces in lungs
54
What are the clinical features of histoplasmosis?
S/S:
- initially asymptomatic
- dyspnea, fever, extreme lethargy
DIAGNOSTIC TESTS:
- chest radiographs reveal pulmonary opacity
- blood tests identify histoplasma capsulatum
55
What's the treatment and prognosis of histoplasmosis?
TREATMENT:
- antifungal drugs
PROGNOSIS:
- usually self-limiting, but fatal if progressive
56
What are the etiologies of influenza?
orthomyxovirus A/B/C transmitted via respiratory droplets -> incubates for 1-3 days
57
What are the clinical features of influenza?
S/S:
- fever, headache, sore throat, coughing, malaise, myalgia
DIAGNOSTIC TESTS:
- nasopharyngeal culture will be positive for orthomyxovirus A/B/C
58
What's the treatment and prognosis of influenza?
TREATMENT:
| -
59
What's the treatment and prognosis of influenza?
TREATMENT:
- vaccine-preventable
- antipyretics/analgesics may help relieve symptoms
PROGNOSIS:
- generally self-limiting, but older and immunocompromised populations face increased mortality
- risk of Reye's syndrome with aspirin
60
What are the etiologies of chronic bronchitis?
bacterial infection or frequent smoking -> progressive deformity of bronchi
61
What are the clinical features of chronic bronchitis?
S/S:
- (progressive) productive cough, dyspnea, upper chest pain
DIAGNOSTIC TESTS:
- rales heard during auscultation
- rule out pneumonia via chest radiography
62
What's the treatment and prognosis for chronic bronchitis?
TREATMENT:
- treat against causative pathogens
- postural drainage, low-oxygen therapy, aerosolized corticosteroids
PROGNOSIS:
- guarded
63
What are the etiologies of bronchiectasis?
cystic fibrosis, childhood pulmonary infections, recurrent airway infections
-> dilated and distorted bronchi
64
What are the clinical features of bronchiectasis?
S/S:
- productive cough, dyspnea, hemoptysis, halitosis
DIAGNOSTIC TESTS:
- hi-res CT and chest radiography show dilated bronchi
65
What's the treatment and prognosis of bronchiectasis?
TREATMENT:
- antibiotics if bacterial
- bronchodilators, postural drainage, acapella therapy
PROGNOSIS:
- varies with cause
- complications include cor pulmonale and pulmonary hypertension
66
What are some contributing factors of emphysema?
frequent smoking, chemical irritants, recurrent pulmonary infections -> damaged and dilated alveoli leading to poor CO2 diffusion
67
What are the clinical features of emphysema?
S/S:
- (insidious) barrel chest, dyspnea, tachypnea, circumoral cyanosis
DIAGNOSTIC TESTS:
- pulmonary function tests reveal poor expiratory maneuver volumes
- chest radiography reveals translucent lungs
- auscultation reveals rhonchi
68
What's the treatment and prognosis of emphysema?
TREATMENT:
- low-oxygen therapy
- beta2-adrenergic sympathomimetic drugs (albuterol) and inhaled corticosteroids
PROGNOSIS:
- poor
69
What are the etiologies of pneumoconiosis?
continual asbestos exposure (asbestosis), coal exposure (anthracosis), or silica exposure (silicosis) -> dust in lungs impacts gas exchange
70
What are the clinical features of pneumoconiosis?
S/S:
- dyspnea, nonproductive cough to productive cough
DIAGNOSTIC TESTS:
- chest radiography reveals scarring and possible dust deposition
71
What's the treatment and prognosis of pneumoconiosis?
TREATMENT:
- beta2-adrenergic sympathomimetic drugs, inhaled corticosteroids, oxygen therapy
- possible lung transplant
PROGNOSIS:
- damage is irreversible, increased risk of lung cancer
72
What are the etiologies of pleuritis?
infections or trauma -> pleural effusion (wet) or decreased pleural fluid with congestion and edema (dry)
73
What are the clinical features of pleuritis?
S/S:
- sharp pain with inspiration, cough, fever, chills
DIAGNOSTIC TESTS:
- auscultation reveals pleural rub
- chest radiography or CT indicates if wet or dry
74
What's the treatment and prognosis of pleuritis?
TREATMENT:
- antibiotics (if bacterial)
- analgesics, chest splinting, thoracostomy
PROGNOSIS:
- pretty good
- possible sequela of pleural adhesions
75
What are the etiologies of a pneumothorax?
- (if spontaneous) alveoli disease, lungs over-expand and tears
- (if traumatic) stab wound, gunshot wound, or crushing wound results in lung penetration
- > positive interpleural pressure
76
What are the clinical features of a pneumothorax?
S/S:
- anxiety, dyspnea, intense chest pain, falling blood pressure and rapid/weak pulse
DIAGNOSTIC TESTS:
- chest radiographs reveal mediastinal shift and air in pleural cavity
77
What's the treatment and prognosis of a pneumothorax?
TREATMENT:
- Fowler position, dressing wound if traumatic, thoracostomy
PROGNOSIS:
- varies with degree of collapse and time to receive care
78
What are the etiologies of a hemothorax?
trauma, blood vessel rupture, or coagulopathy -> hemorrhaging WITHIN pleural cavity
79
What are the clinical features of a hemothorax?
S/S:
- anxiety, chest pains, dyspnea, falling blood pressure, rapid/weak pulse
DIAGNOSTIC TESTS"
- chest radiographs show blood in pleural cavity
80
What's the treatment and prognosis of a pneumothorax?
TREATMENT:
- Fowler position, thoracostomy
PROGNOSIS:
- guarded based on extent of injury and time to get treated
81
What are the etiologies of a flail chest?
direct trauma -> fracture of three or more ribs
82
What are the clinical features of a flail chest?
S/S:
- paradoxical breathing, dyspnea, cyanosis, extreme anxiety, severe pain
DIAGNOSTIC TESTS:
- chest radiography confirms rib fractures
83
What's the treatment and prognosis of a flail chest?
TREATMENT:
- endotracheal tube with mechanical ventilation
- rib fixation
PROGNOSIS:
- best with prompt treatment
84
What are the etiologies of pulmonary tuberculosis?
Mycobacterium tuberculosis transmitted via droplet nuclei -> caseous necrosis and fibrosis -> TB inactive for years
85
What are the clinical features of pulmonary tuberculosis?
S/S:
- fever, lethargy, nonproductive to productive cough, weight loss, chest pain, hemoptysis
DIAGNOSTIC TESTS:
- Mantoux text indicates TB antibodies
- chest radiography reveals tubercules
- sputum culture positive for tuberculosis
86
What's the treatment and prognosis of pulmonary tuberculosis?
TREATMENT:
- isoniazid
- rifampin, ethambutol, or pyrazinamide
PROGNOSIS:
- excellent with early treatment
87
What is the etiology of mononucleosis?
Epstein-Barr virus orally transmitted via saliva or blood -> infects WBC
88
What are the clinical features of mononucleosis?
S/S:
- lymphadenopathy, fever, sore throat, fatigue, coated tonsils
DIAGNOSTIC TESTS:
- blood smear reveals atypical WBC
- serum test reveals EBV antibodies
89
What's the treatment and prognosis of mononucleosis?
TREATMENT:
- antipyretics and bed rest during acute phase
PROGNOSIS:
- recovery complete within 3 to 4 months
90
What are the etiologies of adult respiratory distress syndrome?
other pathology causes cell injury -> inflammatory processes leads to further injury -> alveoli fills with fluid and collapses
91
What are the clinical features of adult respiratory distress syndrome?
S/S:
- (sudden onset) severe hypoxemia, cyanosis, dyspnea
DIAGNOSTIC TESTS:
- auscultation reveals rhonchi and rales
- arterial blood gas tests reveals hypercapnia and acidosis
- chest radiographs reveal bilateral alveolar infiltration
92
What's the treatment and prognosis of adult respiratory distress syndrome?
TREATMENT:
- treat underlying pathology
- suction airways if needed, establish airways, low oxygen supplementation
- mechanical ventilation with PEEP
PROGNOSIS:
- guarded, but 60-75% may recover without complications
93
What are the etiologies of sarcoidosis?
(unclear) genetic factors, immunologic disorder, viral disorder -> multisystem granulomas (small lesions of inflammation)
94
What are the clinical features of sarcoidosis?
S/S:
- asymptomatic OR nonproductive cough, mild chest pain, joint pain, weight loss, fever
DIAGNOSTIC TESTS:
- granulomas often found incidentally through chest radiography or CT
95
What's the treatment and prognosis of sarcoidosis?
TREATMENT:
- generally not needed. but corticosteroids may relieve symptoms
PROGNOSIS:
- spontaneous resolution in >90% of cases within 1 year
96
What are the etiologies of lung cancer?
cigarette smoking, second-hand smoking, air pollution -> small cell lung cancer (SCLC, almost exclusive to smokers) or non-small cell lung cancer (NSCLC)
97
What are the clinical features of lung cancer?
S/S:
- chronic cough, possible hemoptysis, dyspnea, weight loss, chest pain
DIAGNOSTIC TESTS:
- chest radiography and CT may identify tumor size and metastasis
- biopsy reveals histology
- NSCLC staged with TNM, while SCLC is either limited or extensive
98
What's the treatment and prognosis of lung cancer?
TREATMENT:
- surgical resection, lobectomy, or pneumonectomy with combined chemoradiation therapy
PROGNOSIS:
- 5-year survival rate is just 15%
- high risk of brain or bone metastasis
99
What are the etiologies of croup?
viral or bacterial infection of larynx, trachea, and bronchi in children -> edema, vocal cord spasm
100
What are the clinical features of croup?
S/S:
- fever, sore throat, stridor, high-pitched cough, dyspnea, circumoral cyanosis
DIAGNOSTIC TESTS:
- blood and throat cultures may help identify pathogen
- laryngoscopy distinguishes from epiglottitis
101
What's the treatment and prognosis for croup?
TREATMENT:
- antibiotics if bacterial
- antipyretics
PROGNOSIS:
- greaat with prompt intervention
102
What are the etiologies of epiglottitis?
Haemophilus influenzae type B (Hib) infection or thermal injury to epiglottitis -> edema
103
What are the clinical features of epiglottis
S/S:
- sore throat, cough, fever, stridor, dyspnea from laryngeal obstruction
DIAGNOSTIC TESTS:
- radiography of neck and endotracheal intubation may reveal epiglottis inflammation
104
What's the treatment and prognosis of epiglottis?
TREATMENT:
- establish airway with tracheostomy or endotracheal intubation
- antibiotics if bacterial
PROGNOSIS:
- good with treatment, risk of asphyxiation without
105
What are the etiologies of acute tonsillitis?
usually group A beta-hemolytic streptococcal infection of tonsils
106
What are the clinical features of acute tonsillitis?
S/S:
- severe throat, fever, chills, cough, joint pain, exudate from tonsil crypts, submandibular lymphadenopathy
DIAGNOSTIC TESTS:
- throat culture may be positive for streptococcal infection
- blood tests show elevated WBCs
107
What's the treatment and prognosis of acute tonsilitis?
TREATMENT:
- penicillin if streptococcal
- possible tonsillectomy
PROGNOSIS:
- good with therapy
108
What are the etiologies of adenoid hyperplasia?
genetic factors, hypersensitivity, recurrent infections -> enlarged adenoid glands
109
What are the clinical features of adenoid hyperplasia?
S/S:
- snoring, nasally voice, conductive hearing loss
DIAGNOSTIC TESTS:
- nasopharyngoscopy or radiography reveals enlarged adenoid
110
What's the treatment and prognosis of adenoid hyperplasia?
TREATMENT:
- possible adenoidectomy
PROGNOSIS:
- good to treatment
111
What are the etiologies of asthma?
hereditary factors -> bronchial hypersensitivity -> mucous secretion, edema, and bronchospasm in response to allergens OR stress/heavy exercise
112
What are the clinical features of asthma?
S/S:
- (sudden and acute) productive or nonproductive cough, wheezing, tachypnea and dyspnea
DIAGNOSTIC TESTS:
- chest radiography during asthma attack may reveal hyperinflated lungs
- blood tests reveal elevated IgE
113
What's the treatment and prognosis of asthma?
TREATMENT:
- beta2-adrenergic sympathomimetic drugs (albuterol)
- possible
PROGNOSIS:
- poor is status asthmaticus
114
What's are etiologies of bronchiolitis?
respiratory syncytial virus transmitted via respiratory droplets -> inflammation of bronchioles
115
What are the clinical features of bronchiolitis?
S/S:
- cough, fever, posttussive emesis, possible apnea in infant
DIAGNOSTIC TESTS:
- viral culture may help determine pathogen
116
What's the treatment and prognosis of bronchiolitis?
TREATMENT:
- albuterol, epinephrine, or hypertonic saline via nebulizer
- possible supplemental oxygen
PROGNOSIS:
- good with prompt treatment
- linked with higher chance of asthma
