Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 1: Patho/Pharm > Respiratory Patho > Flashcards

Respiratory Patho Flashcards

1
Q

Hypoxia
Definition

A

Low oxygen at the tissues

Ex. lung disease or systemic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hypoxemia
Definition

A

Low partial pressure oxygen in blood
PaO2 < 60mmHg

Etiology: Lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Respiratory Failure
Two types

A
  1. Type I - Hypoxemia
    - PaO2 low < 60mmHg
    - normal or low PaCO2 (compensation , increase RR)
    - more common
    - Lung etiology
  2. Type II - Hypercapnic
    - PaCO2 > 50mmHg
    - PaO2 < 60mmHg
    - problem with respiratory drive (air trapping)
    - not always lung etiology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acute Respiratory Distress (ARD) Syndrome
Definition

A

Life threatening
Inflammation systemic –> inflammation alveoli –> destruction alveolar membrane, inflammation (vascular permeability, edema) –> decrease air exchange (CO2 and O2)

*Cannot eliminate CO2
*Cannot inhale O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Community Aquired Pneumonia
CAP
Etiology

A

Most common cause is viral –> bacterial

Viruses
- Influenza
- RSV
- COVID
- rhinovirus
- metpneumovirus

Bacterial
- Most common
- Streptococcus pneumoniae (+), Chlamydia pneumoniae (atypical), Mycobacterium pnuemoniae (atypical)

  • Others:
  • Legionella (atypical)
  • STaphylococcus aureus (+)
  • hemophilus influenzae B (-)
  • Moraxella catarrhalis (-)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Types of Pneumoniae

A
  1. viral
  2. bacterial
  3. Fungal
  4. aspiration pneumoniae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pathophysiology
Pnuemoniae

A

Inhalation/infection pathogen
- upper airway
- evade primary defense
1. IgA mucous
2. cilia
3. coughing

infection lower airway and alveoli
- replication
- toxin production -> damage alveoli membrane/epithelium -> immune response
- macrophage phagocytize -> activation complement, neutrophils, adaptive immune response
- pro-inflammatory mediators (TNF alpha, IL, IFN gamma, ROS) damage epithelium

Damaged epithelium
- inflammation
- vascular permeability, edema
- increased blood flow, increased WBC, increase inflammation

Pulmonary edema -> exudate -> impaired gas exchange
- ARDs
- death
- Type I hypoxemic respiratoyr failrue (decrease PaO2, normal/low PaCO2 initially –> high PaCO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Community acquired pneumonia
Labs, Diagnostic Imaging, Blood Work

A

Gold standard: Xray
- Anterior/posterior and lateral
- heart blocks LLL
- consolidation

Clinical signs and symptoms
- dry cough
- dyspnea
- +- fever
- fatigue
- tachycardia
- decreased SpO2

CURB65 Score
- Confusion (Ox3)
- Uremia (BUN > 20)
- RR (> 30)
- Blood pressure < 90/60
*3 hospital
*2 secondary care
*1 home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CAP
Treatment
*Low risk case

A

Pathogens:
S. pneumoniae +
mycoplasm
chlamydia (atypical)

First line:
Amoxicillin TID for 7-10 days

Second line:
macrolide antibiotics (azithromycin, clarithromycin) (atypicals)
doxycycline (MRSA +-)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CAP Treatment
Comorbidities, LTC or Abx last 30 days

A

DUAL ANTIBIOTIC TREATMENT
amoxicillin/cef + Macrolide/doxycycline
*clavulanate is required for anaerobic coverage

Pathogens:
S. pneumonia
mycoplasm
chlamydia
H. influenzae -

First line: (amoxicillin/Cef + macrolide/doxycycline)
Amoxicillin
Amoxicillin with clavulanate
Cefuroxime
Cefprozil

doxycycline
azithromycin
clarithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CAP Treatment
Aspiration

A

Polymicrobial

Amoxicillin/Clavulanate + Clindamycin/Doxycycline?

*anaerobic coverage is required for aspiration
addition of clavulanate is required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CAP resistant to treatment

A

Fluroquinolones
Gram + / - and pseudomonas

*recent antibiotics
*allergies
* resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Comorbidities with CAP needing dual antibiotic treatment

A

heart, lung, liver, kidney disease
DM
alcoholism
malignancies
asplenia
immunosupression
> 65 years of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

COVID 19 Virus
Definition

A

SAR-COV-2
severe acute respiratory syndrome
corona virus 2

aerosol, droplet/contact
most contagious 7-10 days
highest viral load
most likely detection NAAT and RAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

COVID 19 virus
infection pathophysiology

A

S Spike protein
binds host cell ACE 2 receptors

ACE 2 located on
- heart, kidney, lungs, GI, blood vessels, liver

Transmembrane serine protease II
- cleavage S protein
- invasion host cell
- replication and inflammation response

Complications
- heart myocarditis, arrhythmias
- AKI
- clotting disorders etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Covid 19
Clinical signs and sypmtoms

A

dyspnea
fever
fatigue
dry cough
loss of taste and smell
rhinorrhea
N/V/D

17
Q

Labs and imaging
COVID19

A

RAAT and NAT
- positive likely in first 7 days

Blood work
- INR, PTT high, D dimers high, low platelets (clotting)
- ESR, CRP high
- GFR low

X ray
- glass oppacities, lower lobe infilrates, constilation

18
Q

Management COVID 19

A
  1. NSAIDS, tylenol, fluids, rest
  2. Antivirals
    - paxlovid
    - remdesivir
19
Q

Paxlovid
MOA

A

Paxlovid =
Nirmatrelvir + Rotinavir

Nirmatrelvir
- protease inhibitor
- blocks COVID19 protease

Rotinavir
- protease inhibitor
- blocks digestion of Nirmatrelvir
- keeps it in body longer

20
Q

Paxlovid
Indications

A

mild to moderate COVID19

High risk populations
- heart, liver, kidney, GI, blood vessel disorders
- HTN, CAD, HF, kidney disease
- Intellectual deficit
- lung diseases, CF, CP etc
- Sickle cell
- Diabetes
- Obesity
- liver disease…

21
Q

Paxlovid
SE

A

Nirmatrelvir + Ritonavir

CYP3A4 inhibitor
- cannot take home medications
- clopidogrel (risk of blood clots)
- amiodarone (risk of arrythmmia fatal) etc.
- statins

Reboudn COVID19
- cannot use antiviral again

22
Q

Remdesivir
Indication

A

Unable to take Paxlovid

mild-moderate infection with complication riskR

23
Q

Remdesivir
Route

A

Subcutaneous injection
duration: three days

24
Q

Remdesivir
MOA

A

inhibits COVID19 RNA polymerase
Nucleotide analog
stops the RNA replication

25
Q

Patient Education
Vaccination COVID19

A

every 6 months
prevents hospitalization, severe illness, death

*no seasonal variation with COVID19

26
Q

RSV
Pathophysilogy

A

Respiratory syncytial virus

  • negative sense RNA virus
  • infections brochiole epithelial cells
  • makes synsytials (multi-nucleated merged cells)
  • RSV A and RSV B
  • have antigens 1. RSV-F (fushion protein, the same, vaccination) 2. RSV-G (attachment protein, variable)
  • Trigger IgA and IgG antiboties
  • antibody dependent cell mediated toxicity
  • NK and inflammation of lungs
27
Q

RSV Clinical signs and symptoms

A

Similar to common cold
very infectious, droplet/contact

  • fever
  • fatigue
  • myalgias
  • HA
  • sore throat
  • rhinorrhea
  • dypsnea
  • wheezing
  • coughing
  • sputum
28
Q

RSV
incidence, prevalence

A

infectious
> 65 years 22%
< 5 years 70%

Deaths
> 65 years 85%
< 5 years 3%

Vaccination group
> 60 years
AREXVY vaccine
RSV-Fusion antigen
seasonal vaccination
wait 14 days between RSV vaccine and flu vaccine

29
Q

Atelectasis

A

Collapse of alveolar airways

  1. External pressure
    - pressure outside of the alveoli
    - ex. tumours, fluid volume overload (blood), air (pneumothorax), bowel obstructions
  2. Internal absorption (plug)
    - plugged airway (ex. tumour, foreign body, mucus)
    - air is absorbed into the capillaries
    - collapses the airway
30
Q

Treatment
Atelectasis

A

Prevention
- walking
- turning
- coughing
- deep breathing

31
Q

Pulmonary Edema

A

Fluid in the interstitial spaces -> alveoli

  1. Cardiogenic pulmonary edema
    - most common type
    - LV unable to pump
    - increase pressure in pulmonary circulation
    - hydrostatic pressure pushes fluid out
    - interstitial space -> alveolar space -> decrease gas exchange
  2. Non-Cardiogenic pulmonary edema
    - inflammation triggered by infection/toxin/drug
    - inflammation epithelium, endothelium
    - vascular permeability, edema
    - impaired gas exchange
32
Q

Pulmonary embolism
Clinical Signs and Symptoms

A

Depends on degree of obstruction

mild
- dyspnea
- tachcycardia, palpitations
- anxiety
- pleuritic chest pain (sharp, increase when bend over)

moderate/Severe
- MASSIVE PE = > 50% perfusion blocked
- decrease LV blood
- decrease CO -> hypotensive shock
- dilation RV (thin wall)
- systemic venous pressure increases (back up into venous system)
- syncope
- hypotension
- hemoptysis (infarct)

33
Q

treatment

A

Anti-coagulation therapy
3-6 monts

Year 1: Patho/Pharm (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions