Respiratory Disorders Flashcards
Transmission of the Common Cold
Person to person
Fingers
Children
Portal of entry - nasal mucosa and conjunctival surface of eye
Three days after onset of symptoms = most contagious
Incubation 5 days
Survive more than 5hr on skin and surfaces
Common Cold: Causes
Viral infection of the upper respiratory tract
Rhinovirus, parainfluenza, syncytial, coronaviruses, adenovirusess
Common Cold: manifestations and treatment
Sore scratchy throat Profuse and watery rhinnorhea Congestion Sneezing and coughing Malaise and fatigue Headache
Rest
Antipyretic for children
OTC symptom management
Rhinosinusitis: causes
Conditions that obstruct or narrow the Ostia that drain sinuses
Viral upper respiratory tract infection or allergic rhinitis
Nasal polyps
Barotrauma
Swimming
Decongestant abuse
Dental infection
Rhinosinusitis: manifestations and treatment
Similar to common cold
Acute - rhinitis, facial pain, headache, purulent nasal drainage, fever, pain on bending
Chronic - nasal obstruction, fullness in ears, post nasal drip, hoarseness, chronic cough, loss of taste and smell, dull constant headache
Antibiotics
Intranasal corticosteroids
Mucolytic agents
Symptom relief
Influenza: Etiology
Viruses in the orthomyxoviridae family
A and B cause epidemics C is a mild infection
Antigen drift - rna alters during replication generating new H and N subtypes
Population is partially protected due to previous immunity
Epidemics
Antigen shift - rna recombination replaces both H and N antigens leaving all individuals susceptible
Pandemics
Influenza: transmission
More contagious than bacterial infections
Inhalation of droplet nuclei
Not contact
Infectious from 24hr before symptom onset to 5-10 days after sumps appear
1-4 day incubation
Influenza: pathogenesis
Healthy person - upper respiratory tract infection
Viral pneumonia
Viral leading to susceptibility to bacterial pneumonia
Attacks mucous secreting cells and epithelial cells damaging to expose basal layer allowing ECF to escape
Further down the bronchial tree secretions thicken promoting bacterial adhesion
Severe shedding of bronchial and alveolar cells
Promotes bacterial adhesion
Influenza: manifestations
Abrupt onset Fever Chills Rapid onset of profound - Malaise Muscle aching Headache Profuse watery nasal discharge Nonproductive cough Sore throat
Weakness cough and malaise may persist for weeks after resolution
Children - fever and febrile convulsions
Influenza: complications
Viral pneumonia - rapid progression of fever Tachypnea, cyanosis, hypotension, pulmonary fibrosis and death
Secondary complications - sinusitis, otitis media, bronchitis
Bacterial pneumonia - feeling better before return of fever, shaking, chills, chest pain, productive cough
Reye sydrome - rare complication in children given aspirin
Fatty liver and encephalitis
Influenza: immunization
Changed yearly in response to prediction
Effectiveness depends on age and immunocompetence and accuracy of prediction
Reduces severity and likelihood of catching it
Recommended - over 6months, high risk people, over 50, chronic health issues, immunosuppressive
Contraindicated - less than 6months, anaphylactic hypersensitivity, acute febrile illness, history of guillain barre syndrome
Pneumonia
Inflammation of parenchyma structures of the lung; lower lungs
Typical or atypical lobar or bronchopneumonia community or nosocomial
Risk factors - impaired host defences, chronic lung disease, airway instrumentation, mechanical ventilation
Community acquired pneumonia
Outside the hospital or dx within 48hr after admission
Bacterial or viral Streptococcus pneumoniae Haemophilus influenza Staphylococcus aureus Gram negative bacilli Etc
Hospital acquired pneumonia
After 48hr in hospital
Can determine from previous cultures and know which antibiotics have been effective
Bacteria Pseudomonas aeruginosa Staphylococcus aureus Enter after species Klebsiella pneumoniae Escherichia coli
Acute Bacterial Pneumonia (Typical)
Lobar - consolidation of part of all of a lobe
Bronchopneumonia - more than one lobe patchy
Lung below main bronchi is normally sterile despite frequent air entry of microorganism
Risk Factors: Loss of cough reflex Damage to ciliates endothelium Impaired immune defences Antibiotic therapy Diabetes Smoking Chronic bronchitis Viral infections
Acute Bacterial Pneumonia: Pneumococcal Pneumonia
Most common
Streptococcus pneumoniae - attaches and colonized in mucus membranes of nasopharynx, but may not progress and will be carriers
Pyrogenic infection of the lungs, ears, sinuses, and meninges
Polysaccharide capsule - prevents digestion by phagocytes
Acute Bacterial Pneumonia: Pneumococcal Pneumonia
Manifestations and risk factors
Malaise, severe shaking chills, fever, watery sputum, limited breath sounds, fine crackles, pleuritic pain,
Sputum may become blood tinged to purulent
Asplenic person
Children with sickle cell
Acute Bacterial Pneumonia: Legionnaire Disease
Legionella pneumonphila
Transmission occurs when stagnant water containing the pathogen is aersolized into droplets and inhaled
Not airborne or person to person
Acute Bacterial Pneumonia: Legionnaire Disease
Manifestations and risk factors
Rapid onset - malaise, weakness, lethargy
Fever, dry cough, diarrhea, confusion, arthralgia, hyponatremia
Consolidation of lung tissues
Lack of normal temp pulse relationship
Tuberculosis: risk factors
Mycobacterium tuberculosis
Airborne droplet nuclei
Waxy cell wall - increases resistance to antibiotics and disinfection; slow to grow
Aerobic
Living in a country with high incidence
Crowded confined living conditions
Immunocompromised
Tuberculosis: Pathogenesis
Infected droplet nuclei inhaled and settles in alveoli
Macrophages engulf the bacilli and initiate cell mediated immune response - cannot completely kill
Bacilli continue to multiply
T-lymphocytes are activated in delayed hypersensitivity reaction releasing cytokines that kill bacilli and damage lung tissue
Ghon focus - circumscribed granuloma toys lesion containing remaining live and dead bacteria and immune cells
Ghon complex - combination of primary lung lesion and lymph node granulomas
Casious necrosis - [Continuous multiplication and cope of dead cells
Primary Tuberculosis: risk factors and manifestations
Forms in person previously unsensitized
Often asymptomatic and will develop latent TB - not active or transmissible
Risk factors: immunocompromised and very young children
Manifestations Insidious onset Fever Pleuritic pain Weight loss Fatigue Night sweats Cough Dyspnea Hematogenic dissemination - rare erosion of a blood vessel and transmission to other areas
Reactivated Tuberculosis: risk factors and manifestations
Reinfection from inhaled droplet nuclei or reactivated of healed primary ghon complex
A healthy person with latent TB becomes immunocompromised
Cavitation as the focus expands and epithelial damage can occur
RIsk factors: impaired body defence, cell mediated hypersensitivity response damages airway tissue creating cavitation
Manifestations: Pleuritic pain Low grade fever Night sweats Easy fatigue Anorexia Weight loss Cough (dry to purulent to blood tinged) Dyspnea Orthopnea Complication - pleural effusion
Risk factors of lung cancer
Smoking Chemical toxins Familial predisposition Site of metastasis Disease of the aging over 65yrs
