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Pathology 2420 Part 2 > Respiratory Health > Flashcards

Respiratory Health Flashcards

1
Q

What are the basic functions of the Respiratory Tract?

A
  • oxygenation of the blood
  • removal of waste products (carbon dioxide)
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2
Q

What do the basic functions of the Respiratory Tract require?

A
  • ventilation (movement of air)
  • perfusion (movement of blood)
  • gas exchange
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3
Q

What are the different parts of the Respiratory Tract?

A
  • trachea
  • bronchi (main, primary, secondary)
  • bronchioles (terminal, respiratory)
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4
Q

What are the Lung Acinus?

A

the most distal part of the lung, or Lung Aveolus

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5
Q

What are Pneumocytes?

A

epithelial cells of the lungs

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6
Q

What do the endothelial cells do in the lungs?

A

line capillary cells

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7
Q

What is the Alveolar Capillary Membrane?

A

Site of gas exchange

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8
Q

What is Pneumonia?

A

Inflammation of the lung secondary to infection

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9
Q

How do infectious organisms enter the lung?

A
  • inhalation
  • aspiration
  • blood
  • direct inoculation: surgery
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10
Q

What are factors that determine if infection will occur?

A
  • dose & virulence of the organism
  • impaired local defence mechanism
  • impaired systemic defence mechanism
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11
Q

What are our local defences?

A

Defences there to target an infectious particle that we don’t want in the lung

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12
Q

What are our systemic defences?

A

defences that pretain to our immune system

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13
Q

What occurs when the local defence mechanisms are impaired within our lungs?

A
  • loss of cough reflex
  • injury to the mucociliary apparatus
  • interference to alveolar macrophages
  • accumulation of fluid or secretions within alveoli
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14
Q

What is our cough reflex?

A

designed to help clear infections particles and other unwanted substances that aren’t suppose to be going into the lung

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15
Q

What is our Mucociliary Apparatus?

A

designed to impede the access of infectious particles and other infectious substances into the lungs

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16
Q

What does the accumulation of fluid do?

A

Allows for the development of infectious particles

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17
Q

What occurs when the Systemic Defence Mechanisms are impaired?

A

Immunocompromised host

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18
Q

How do you diagnose Pneumonia?

A
  • Clinical Presentation
  • Chest X-ray
  • Bloodwork
  • Microbiology Studies: blood and sputum culture
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19
Q

What is the clinical presentation of Pneumonia? (5)

A
  • cough
  • fever
  • chills
  • malaise
  • pain on inspiration
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20
Q

What are the two morphological presentations of Pneumonia?

A
  • lobar
  • broncho
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21
Q

What are the different types of Pneumonia?

A
  • Community acquired
  • hospital acquired
  • aspiration
  • immunocompromised host
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22
Q

What are the different types of Bacterial Community Acquired Pneumonia?

A
  • streptococcus pneumoniea: most common
  • haemophilus influenzae
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23
Q

What is an atypical pneumonia syndrome?

A

Mycoplasma

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24
Q

What is Hospital Acquired Pneumonia?

A
  • nosocomial pneumonia
  • life threatening
  • E. Coli
  • Pseudomonas aeruginosa
  • Staphylococcus aureus
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25
Q

What are the signs and symptoms of Aspiration Pneumonia?

A
  • altered level of consciousness
  • impaired laryngeal-pharyngeal/esophageal/gastric function
  • Periodontal disease
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26
Q

What is aspirated in Aspiration Pneumona?

A
  • stomach acid
  • particulate matter
  • anaerobic (oral flora) bacteria
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27
Q

What occurs when an Immunocompromised Host obtains Pneumonia?

A
  • immune defences are suppressed by disease
  • immunosuppressive therapy for organ transplantation
  • Chemotherapy
  • Irradiation
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28
Q

What are the Opportunistic Infectious agents for Pneumonia in Immunocompromised Host?

A
  • rarely cause infection in normal hosts
  • bacteria
  • Viruses
  • Fungi
29
Q

What are the Complications of Pneumonia?

A
  • Abscess
  • Empyema
  • Septicemia
30
Q

What is Abscess?

A

Tissue destruction of the lung by infectious fluid cumulation

31
Q

What is Empyema?

A

When the pleural fluid that surrounds the lung becomes infected, and there is an accumulation of pus in the cavity

32
Q

What is Septicemia?

A

Pneumonia that spreads to the blood

33
Q

What effect does Antibiotics have on Abscess, Empyema, Septicemia?

A

It has no effect, they need to be drained

34
Q

What is Tuberculosis? (4)

A
  • major cause of morbidity and mortality world wide
  • causative organism is Mycobacterium Tuberculosis
  • mostly occurs in developing countries
  • flourishes in settings of poverty, crowded living conditions, and in people with chronic debilitating diseases and/or immunocompromise
35
Q

What are the types of Tuberculosis?

A
  • pulmonary
  • extrapulmonary
36
Q

When is Tuberculosis infectious?

A

When the TB bacilli can be demonstrated in the lower respiratory tract sampling (ex. sputum)

37
Q

What does person-to-person transmission depend on?

A
  • # viable bacilli
  • aerosolization of small droplet nuclei
  • host susceptibility
38
Q

What is a TB skin test?

A
  • test that detects the presence of cellular immunity to an intracutaneous antigen
  • intradermal injection of a purified protein derivative of tuberculin
  • positive test of 10 mm or more induration at 48, 72, or 96 hours
39
Q

What does a positive TB skin test mean?

A
  • prior or current infection
  • prior immunization
40
Q

What are the main types of Chronic Obstructive Pulmonary Disease (COPD)?

A
  • Chronic Bronchitis
  • Emphysema
41
Q

What is Chronic Bronchitis?

A

when a patient has a productive cough on most days of the week for three months of the year for two or more successive years

42
Q

What is the Etiology of Chronic Bronchitis?

A

cigarette smoking (most cases)

43
Q

What is the process of Chronic Bronchitis?

A

1) smoking
2) Irritation of airways
3) Protective changes
4) Airway obstruction
5) decreased ventilation

44
Q

What is Emphysema?

A
  • damage of the acinus
  • destruction of the alveolar wall
  • abnormal & permanent enlargement of the airspaces
  • often occurs with Chronic Bronchitis
45
Q

What is the Etiology of Emphysema?

A

cigarette smoking (many but not all cases)

46
Q

What is the process of Emphysema?

A

1) smoking
2) proteases & elastases released
3) Damage of elastic tissue
4) dilated distal acini with impaired elastic recoil
5) airflow obstruction
6) decreased ventilation

47
Q

What are the clinical features of COPD? (6)

A
  • dyspnea
  • chronic productive cough
  • wheezing, chest tightness
  • frequent colds/flu
  • low energy, weight loss
  • cyanotic (blue)
48
Q

What is a nickname for Chronic Bronchitis?

A

Blue bloater

49
Q

What is a nickname for Emphysema?

A

Pink Puffer

50
Q

How do we diagnose COPD?

A
  • Spirometry
  • Chest x-ray
51
Q

What are the consequences of COPD? (7)

A
  • recurrent respiratory infections
  • acute respiratory failure
  • barotrauma/pneumothorax
  • pulmonary hypertension
  • heart disease
  • lung cancer
  • malnutrition/cachexia
52
Q

What are the Risk Factors for Lung Cancer? (6)

A
  • smoking
  • Industrial hazards
  • air pollution
  • radiation therapy
  • genetic factors
  • region of old pulmonary scars
53
Q

What are the two types of Primary Malignant Lung Neoplasms?

A
  • non-small cell lung cancer
  • small cell lung cancer
54
Q

What is Small Cell Lung Cancer? (5)

A
  • usually centrally-located hilar or mediastinal tumours with rapid growth
  • almost always occur in pts who smoke
  • most have already metastasized by the time they are diagnosed
  • paraneoplastic syndromes not common
  • aggresive
55
Q

What is the treatment for Small Cell Lung Cancer?

A

Chemotherapy

56
Q

What is the Prognosis for Small Cell Lung Cancer?

A

Exceptionally poor

57
Q

What are the two types of Non-small Cell Lung Cancer?

A
  • Squamous cell carcinoma
  • Adenocarcinoma
58
Q

What is Non-small Cell Squamous Cell Carcinoma?

A
  • usually centrally-located tumours; tend to grown within the lumen
  • may cavitate due to central necrosis
  • most common cancer in male pts who smoke
59
Q

What is Non-small Cell Adenocarcinoma?

A
  • usually peripherally located
  • most common lung cancer to occur in female pts and non-smoking pts
  • targeted molecular therapies may be used
60
Q

What is the clinical presentation of Lung Cancer? (5)

A
  • 5% asymptomatic
  • local symptoms: cough, dyspnea, chest pain, hemoptysis
  • Spread to adjacent thoracic structures
  • Distant Metastasis
  • Non-specific symptoms: anorexia, fatigue, weight loss
61
Q

What are Paraneoplastic Syndromes?

A

When our immune system recognizes that there is a cancer in our body, and it targets not only the tumour but parts of our body

62
Q

What are Paraneoplastic Syndromes associated to Small Cell Carcinomas?

A
  • Syndrome of inappropraite ADH secretion (SIADH)
  • Cushing syndrome
  • Lambert-eaton myasthenic syndrome
63
Q

What are Paraneoplastic Syndromes associated to Squamous Cell Carcinoma?

A

Hypercalcemia (Parathyroid hormone or prostaglandin E)

64
Q

What are Paraneoplastic Syndromes associated to both Small Cell and Squamous Cell Carcinomas? (3)

A
  • Peripheral neuropathy
  • Myasthenia gravis
  • Digital Clubbing
65
Q

How is Lung Cancer Diagnosed? (7)

A
  • history and physical examination
  • Chest X-ray & CT
  • Sputum cytology
  • Bronchoscopy
  • Endoscopic ultrasound-guided transbronchial or transeophageal biopsy of the lymph nodes
  • transthoracic biopsy
  • Pleural fluid cytology
66
Q

What is Sputum diagnoses best used for?

A

diagnosing a Central Tumour

67
Q

What is the treatment for Non-small cell Lung CA? (4)

A
  • surgery (early)
  • Chemotherapy & radiation (advanced)
  • Targeted molecular therapy (advanced)
  • Immune therapy (advanced)
68
Q

What is the treatment for Small Cell CA?

A

Chemotherapy & radiation

69
Q

What does the Prognosis of Lung Cancer depend on?

A
  • stage
  • subtype
  • location
  • performance status of the pt
  • age and sex of pt
  • genetic changes that predict response to targets therapies

Pathology 2420 Part 2 (6 decks)

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