Respiratory System Flashcards
Hypersenstivity Pneumonitis
Fever , Chills , Cough , Dyspnea
Bilateral interstitial opacities, crackles, restrictive pattern.
bronchial lavage has lymphocytic dominance >20% Often >50%.
Obstructive Lung Disease
Asthama, COPD, Old age.
PFT:
- FEV1↓ , FVC ↓ ,
- FEV1/FVC ↓(<70% ; Normal is 70%)
- TLC ↑
- RV ↑↑ , FRC (ERV-RV) ↑
Restrictive Lung Disease
Pulmonary Fibrosis, Pneumoconiosis etc
PFTs:
- FEV1 ↓, FVC ↓,
- FEV1/FVC ↑ (>70-80%)
- TLC ↓, RV ↓, FRC ↓.
SVC syndrome
Superior vena cava syndrome
Flushing of face + Congestion of neck veins.
Caused by pancoast tumor (Adenocarcinoma of Lungs)
NRDS (Neonatal Respiratory Distress Syndrome)
Aka hyaline membrane disease
- Due to insufficient surfactant production by type II pneumocytes due to decrease in lamellar bodies (the specialized organelles that produce surfactant).
- Decrease lecithin/sphingomyelin ratio (i.e., <2.0).
- ↓ surfactant production means ↓ alveolar compliance, ↓ FRC, ↑ Airway resistance & ↑ elastic recoil.
- CXR shows a “reticulogranular” appearance.
Acute respiratory distress
syndrome (ARDS)
Bilateral exudative chest infiltrates and decr O2 sats
in patient following: pancreatitis; aspiration of vomitus; near-drowning episodes (aspiration of fresh/sea water); improper insertion of NG tube into the lungs with feeding initiated; toxic shock syndrome; or general trauma / sepsis.
- Pulmonary decompensation associated with pancreatitis.
- Patient can be ventilated as follows: prone positioning (patient on
stomach) + low-tidal volume setting + permissive hypercapnia.
Pertussis
- Classic whooping cough presents as succession of many coughs
followed by an inspiratory stridor. - Can also present in adults Cough with hypoglycemia or post-tussive emesis, which means vomiting after coughing episodes.
- Pertussis can cause super-high WBC counts in the 30-50,000-range, where there are >80% lymphocytes.
- One way to prevent = vaccination (TDaP)
Cystic Fibrosis
- Autosomal recessive mutation (∆F508) impairs - - CFTR function
- ATP dependant Chloride channel defective
- Chronic, productive cough
- Recurrent sinopulmonary infections (eg,Staphylococcus aureus, Pseudomonas aeruginosa)
- Pancreatic insufficiency (Def Fat Sol Vitamins)
- Male infertility (bilateral absence of vasdeferens)
- Elevated sweat chloride levels
Sarcoidosis
(noncaseating granulomas)
Female with lymphedonopathy
Bilateral hilar adenopathy, uveitis
Hypercalcemia is also seen
Complication:
Granuloma express increased activity of alpha-1 hydroixylase -> increase 1,25 hydroxy vit-D-> ca+2 reabsorbtion in GI lumen, this can cause Nephrolithiasis
Rubeola
High Fever & 3Cs ( Cough, Coryza, Conjuntivitis)
Koplik Spots (2-3days after symptoms)
As fever abates a Maculopapular rash starts at head and descends to cover whole body (like rubella)
Mumps
Classically presents as:
- Parotidits
- Orchitis
- Meningitis
Caused by Paramyxovirus.
Pulmonary Fibrosis
- Progressive dyspnea
- Digital clubbing
- Loud P2 (pulmonary hypertension due to lung disease).
Idiopathic pulmonary fibrosis affects individuals in late adulthood, and lung examination would reveal inspiratory crackles.
Septic Shock
- Fever
- Leukocytosis
- Hypotension
- Tachycardia
Predisposing conditions for aspiration pneumonia
- Altered consciousness impairing cough reflex/glottic closure (eg, dementia, drug intoxication)
- Dysphagia due to neurologic deficits (eg, stroke, neurodegenerative disease)
- Upper gastrointestinal tract disorders (eg, GERD)
- Mechanical compromise of aspiration defenses (eg, nasogastric & endotracheal tubes)
- Protracted vomiting
-Large volume tube feedings in recumbent position
Methhemoglobinemia
- Methemoglobin has Fe+3 (ferric) instead of Fe+2 (ferrous)
- Results usually after the use of oxidizing medications i.e Nitrites, Dapsone, Benzociane etc
- Functional anemia > Cyanosis
- Chocolate brown blood, doesn’t turn red with O2
- Cyanosis with O2 sats showing 85-90%
- Can be inherited in AR form, deficiency of Cytochrome b-5 reductase
Rx: Methylene blue (acquired form)
