Respiratory system Flashcards
1
Q
What is the most common inherited genetic disease in white people?
A
Cystic Fibrosis
2
Q
What is the etiology of cystic fibrosis?
A
- autosomal recessive
- spontaneous mutation
3
Q
Which chromosome carries the defect for cystic fibrosis?
A
Chromosome 7
4
Q
What happens in cystic fibrosis?
A
the defective gene allows chloride to pass in and out of the plasma membrane of epithelial cells (kidney, gut, airways). salt accumulates in the cells lining the lungs and digestive tissues making mucus abnormally thick and sticky.
-leads to: - dehydrated and increased viscosity of mucous gland secretion. - elevation of sweat electrolytes (NaCl). - pancreatic enzyme insufficiency.
5
Q
What is the clinical manifestation of cystic fibrosis?
A
- variable
- access to healthcare decreases severity
- abnormally high sodium and chloride concentration in sweat
6
Q
What are the pancreatic symptoms of cystic fibrosis?
A
- thick secretions block pancreatic ducts
- eventual fibrosis
- prevents pancreatic enzymes from reaching duodenum leading to impaired digestion and absorption of nutrients. (lower intake of nutrients)
- bulky, frothy, malodorus stool
7
Q
What percentage of people with CF will have pancreatic symptoms?
A
80-90%
8
Q
What is Meconium ileus?
A
baby’s first poo
9
Q
What does meconium ileus have to do with CF?
A
it is a GI symptom and is extra thick that they can’t get out
10
Q
What are the GI symptom of CF?
A
- prolapse of the rectum
- intestinal obstruction from thick, dry stool
- poor nutrition
- weight loss
- growth retardation
11
Q
What are the pulmonary symptoms of CF?
A
- chronic cough
- purulent sputum (causes chronic infections)
- mucus is an excellent medium for bacterial growth
- hypoxia
- clubbing
- cyanosis
- chronic pulmonary infection
- barrel chest
- pectus carinatum
- kyphosis
- respiratory failure
12
Q
What is universal in all men with CF?
A
they are infertile. also common in women
13
Q
What are the musculoskeletal symptoms of CF?
A
- mm pain
- decreased bone density
14
Q
How is CF diagnosed?
A
- genetic testing
- clinical presentation
- sweat test
- pancreatic enzyme tests
- pulmonary function test
15
Q
What is the tx for CF?
A
- variable depending on systems involved
- antibiotics
- meds
- chest physio
- adequate nutrition
- supplementation
- lung transplant
16
Q
Will CF progress to a new lung if a lung transplant occurs?
A
yes
17
Q
What is the prognosis for CF?
A
- improving
- median survival rate = 37 yrs old
18
Q
What is a bronchogenic cyst?
A
- a rare birth condition
- a cyst in the middle of the chest near the carina
- can be asymptomatic
19
Q
Describe the bronchogenic cyst
A
- extrapulmonary
- fluid filled mass lined with respiratory epithelium and limited by walls that contain mm and cartilage.
20
Q
Where is the most common location for a bronchogenic cyst?
A
middle of the mediastinum
21
Q
What does a bronchogenic cyst do in a newborn?
A
compresses a major artery and cause respiratory distress
22
Q
What is an extralobar sequestration?
A
-a chunk of lung tissue not connected to bronchial tree
23
Q
Is an extralobar sequestration congenital or acquired?
A
congential
24
Q
Where is the extralobar sequestration located?
A
outside the visceral pleura
25
What is the difference between extralobar sequestration and intralobar sequestration?
intralobar is w/in the visceral pleura and extralobar is outside the visceral pleura
26
How does extralobar sequestration manifest?
dyspnea and cyanosis in newborns. recurrent bronchopulmonary infection in older children
27
Where is intralobar sequestration usually located?
in the lower lobe
28
What does intralobar sequestration present with?
chronic reccurent pneumonia, end-stage fibrosis and honeycomb cystic changes.
29
what is the common cold also known as?
infectious rhinitis
30
Is the common cold viral or bacterial?
viral
31
What is the most common cause of common cold?
rhinovirus
32
Which viruses cause the common cold?
- rhinovirus
- coronavirus
- adenovirus
- parainfluenza virus
- other
33
What does coryza mean?
cold-like symptoms
34
If influenza viral or bacterial?
viral
35
What causes influenza?
influenza virus - many strains
36
What are the risk factors for influenza?
- children
- elderly
- chronic disease
- pregnancy
- other disorders
37
What is conjunctivitis?
lining in the eye - pink eye
38
What are some complications of influenza?
- pneumonia
- encephalitis
- myocarditis
- renal disease
39
What is sinusitis?
-inflammation of the paranasal sinuses
40
How do you classify sinusitis?
acute, subacute, recurent, and chronic
41
What is the etiology of sinusitis?
viral, bacterial, fungal infection
| -recurrent allergies
42
What are some clinical manifestations of sinusitis?
- purulent rhinorrhea
- pressure and pain
- nasal congestion and irritation
- tenderness, swelling, erythema
- toothache
- headache
- cough
- tearing
- malaise
43
What is acute bronchitis?
inflammation of trachea and bronchi
| -short duration, self limiting with few pulmonary signs
44
What can cause acute bronchitis?
- chemical irritation (ie. smoke, fumes, gas)
- viral infections (ie. influenza, measles, chickenpox, whooping cough)
- bacterial infection
45
What is a complication of acute bronchitis?
pneumonia
46
What is pneumonia?
inflammation of the lungs
47
What causes pneumonia?
infection, inhalation, aspiration, and non-infectious agents
48
What are the classifications of pneumonia?
- community acquired - Streptococcus pneumonia, Haemophilus influenze
- Hospital acquired - staphylococcus aureus
- immunocompromised people
49
What are upper respiratory flora?
bacteria that live in your body
| -streptococcus, staphylococcus, haemophilus
50
What are the pathogens that cause pneumonia?
- upper respiratory flora
- enteric saprophytes
- extraneous pathogens
51
What are the listed pathogens that cause pneumonia?
- E. coli
- Mycobacterium tuberculosis
- streptococcus
- staphylococcus
- haemophilus
52
What are the classifications of pneumonia?
- alveolar pneumonia - involves alveoli; focal or diffuse
- interstitial - involves septa; usually diffuse and bilateral
- bronchopneumonia - limited to segmental bronchi
- lobar pneumonia - widespread or diffuse
53
Is alveolar pneumonia bacterial or viral?
bacterial
54
Is interstitial pneumonia bacterial or viral?
mycoplasma or virus
55
What are the routes of infection for pneumonia?
- inhalation
- aspiration of infected secretion from URT ie. staph or strep
- aspiration of infected particles from GI, food or drinks, etc
- hematogenous spread - from sepsis (high bacterial load)
56
What is the pathogensis for pneumonia?
- invading microorganisms cause alveolar macrophages to release biochemical mediators
- inflam response does not eliminate pathogen
- microorganisms multiply and release damaging toxins
- inflam and immune respons damages parenchyma
- may lead to scarring and loss of function
57
What are the clinical manifestations of pneumonia?
- may look like a URI
- sudden, sharp or sticking pleuritic chest pain
- hacking, productive cough
- rust or green-colored sputum (bacterial infection)
- fluid w/in lungs
- dyspnea
- tachypnea
- cyanosis
- headache
- fatigue
- fever
- chills
- aching
- myalgia
58
What are some complications of pneumonia?
- pleuritis
- abscesses
- chronic lung disease
59
What is pneumocysitis carinii pneumonia (PCP)?
-a progressive, often fatal pneumonia
60
What is the etiology of PCP?
- idiopathic
- possibly environment
- infected humans, animals, fungi, protozoa
61
What are the risk factors for PCP?
- immunosuppression
- chemotherapy
- transplantation
- malnutrition
62
What is a lung abscess?
Localized accumulation of purulent exudate within the lung
63
How does a lung abscess develop?
Usually develops as a complication of pneumonia
64
What is the etiology of a lung abscess?
Aspiration of oral secretions by patients with gingivitis or poor oral hygiene
65
What are the most common pathogens of a lung abscess?
- Streptococci and staphylococci
| - Mycobacteria or fungi
66
Pathogenesis of a lung abscess?
- Pathogens first causes inflammation, which leads to tissue necrosis and then abscess formation.
- The abscess usually ruptures into a bronchus and leaves an air and fluid filled cavity
67
Clinical manifestations of lung abscess?
- Productive cough
- Foul-smelling sputum
- Persistent fever
- Chills
- Dyspnea
- Chest pain
- Cyanosis
- Clubbing
- Hemoptysis
68
What is COPD?
Chronic Obstructive Pulmonary Disease
| Chronic airflow limitation that is not fully reversible
69
What is Chronic Bronchitis?
A productive cough lasting for at least 3 months per year for two consecutive years.
70
What is Emphysema?
Destruction of lung parenchyma and pathological accumulation of air in the lungs
71
Pathogenesis of Chronic Bronchitis?
- Inflammation and scarring of bronchial lining leads to obstruction of airflow and increased mucous production
- Irritants cause an increase in size and number of mucous producing glands and hypertrophy of smooth muscle cells
- Leads to obstruction of airways
- Impaired ciliary function predisposed to infection
- Infection results in increased mucous production, bronchial inflammation and thickening
72
Clinical manifestation of Chronic Bronchitis?
- Productive cough
- Sputum production
- SOB
- Recurrent infection
- Fever
- Malaise
- Cyanosis
73
What are blebs and bullae?
Pockets of air caused by emphysema
74
Pathogenesis of emphysema?
- Destruction of elastin protein in the lung leads to permanent enlargement of acini
- Loss of elasticity causes narrowing or collapse of bronchioles which traps air in lungs
- Leads to breathing difficulties
- Hypoxemia and hypercapnia
75
Clinical manifestations of emphysema?
- Marked exertional dyspnea
- Dyspnea at rest
- Thin, barrel chest, hypertrophy of accessory muscles of respiration
- Tachypnea
- Anxiety
- Wheezing
- Cough
76
What is the prognosis for emphysema?
- Poor
| - Mortality rate 10 years after diagnosis is greater than 50%
77
What is Bronchiectasis?
Progressive form of obstructive lung disease characterized by irreversible destruction and dilation of airways
78
What type of infections is Bronchiectasis associated with?
Bacterial
79
What causes Bronchiectasis?
- Any condition that produces a narrowed lumen of the bronchioles
- TB, viral infections, pneumonia
- Immunodeficiencies
- CF
80
What can Bronchiectasis lead to?
Fibrosis and emphysema
81
What are some clinical manifestations of Bronchiectasis?
- Persistent coughing with large amounts of purulent sputum
- Dyspnea
- Fatigue
- Weight loss
- Anemia
- Fever
- Hemoptysis
- Weakness
- Clubbing
- Foul-smelling sputum
82
How is Bronchiectasis treated?
- Bronchodilators
- Antibiotics
- Corticosteroids
- Hydration
- Surgery
83
What is Allergic Rhinitis?
A collection of signs and symptoms, mostly in the nose and eyes, which occur in response to breathing in allergens
84
What allergens can trigger Allergic Rhinitis?
Dust, dander, mold, cockroaches, pollen, grass, trees
85
What is Allergic Rhinitis also known as?
Hay fever or seasonal allergies
86
What other condition does Allergic Rhinitis often coexist with?
Asthma
87
What type of hypersensitivity is Allergic Rhinitis?
Type 1
88
Symptoms of Allergic Rhinitis?
- Itching nose, mouth
- Conjunctivitis
- Sneezing
- Sinus and nasal obstruction
- Coughing, wheezing
89
How is Allergic Rhinitis treated?
- Antihistamines
- Decongestants
- Injections
90
What is asthma?
An increased responsiveness of bronchial tree to stimuli
91
Asthma can be classified as a reversible condition.Which one?
COPD
92
What causes asthma?
Many complex factors including biochemical, autonomic, immunologic, infectious, endocrine and psychological
93
What is the most common chronic disease in adults and children?
Asthma
94
Who is most at risk of developing asthma?
Puerto Ricans, African Americans and Native Americans
95
What are the risk factors for asthma?
- Environment
- Large families
- Pets
- Antibiotics
- Age
- Gender
- Low birth weight
96
What are the three different types of asthma?
1. Extrinsic
2. Intrinsic
3. Occupational
97
What type of asthma mainly develops in adults?
Intrinsic
98
What type of asthma is caused by hypersensitivity disorders?
Extrinsic
99
What are the clinical manifestations of asthma?
- Cough
- SOB
- Wheezing
100
Repeated asthma attacks may lead to what?
- Barrel chest
- Elevated shoulders
- Hypertonicity of accessory muscles of respiration
101
What is Status asthmaticus?
An acute asthma attack that cannot be altered with routine care - often an emergency
102
How many deaths are attributed to asthma each year?
4,000
103
What are pneumoconioses?
Lung diseases caused by inhalation of mineral dusts, fumes and various organic or inorganic particulate matter
104
What type of particles can cause pneumoconioses?
Coal, iron, silica and asbestos
105
What determines the severity of pneumoconioses?
- Duration of exposure
- Concentration of particles
- Size, shape and solubility of particles
106
Which form of pneumoconioses has TB as a common complication?
Silicosis
107
Which form of pneumoconioses is associated with an increased risk of lung cancer?
Asbestosis
108
Clinical manifestations of pneumoconioses?
- Progressive dyspnea
- Chest pain
- Chronic cough
- Expectoration of mucus
109
What is a pneumothorax?
An accumulation of air or gas in the pleural cavity caused by a defect in the visceral pleura or chest wall
110
What is atelectasis?
A collapse of a lung, or lungs
111
What is secondary pneumothorax a result of?
COPD, CF or other lung pathologies
112
What is the pathogenesis of a pneumothorax?
- Air enters the pleural cavity
- Lung collapses and there is a separation between the visceral and parietal pleura → destroys the negative pressure of pleural space → lung collapses towards the hilum
- Result is SOB and mediastinal shift towards the unaffected side → compress the opposite lung
113
What are the 5 types of pneumothorax?
1. Spontaneous
2. Traumatic
3. Open
4. Iatrogenic
5. Tension
114
Which type of pneumothorax is caused by blebs and bullae?
Spontaneous
115
Which type of pneumothorax can be caused by CPR?
Iatrogenic
116
Clinical manifestations of pneumothorax?
- Dyspnea
- Sharp, pleuritic chest pain
- Fall in blood pressure
- Weak and rapid pulse
117
How long after treatment for pneumothorax do you have to wait before you can fly?
2 weeks
118
How do you treat pneumothorax?
Oxygen and surgery
119
What is pleurisy?
Inflammation of the pleura
120
What is pleurisy also known as?
Pleuritis
121
What can cause pleurisy?
Infection, injury or tumour
122
What does pleurisy often occur alongside?
Pneumonia, TB, abscesses, influenza, SLE, RA
123
Symptoms of pleurisy?
- Sharp, sticking pain
- Worse on inspiration, coughing, sneezing, movement
- Cough
- Fever
- Chills
- Tachypnea
124
What are the 2 types of pleurisy?
Wet and dry
125
What type of pleurisy is less likely to cause pain?
Wet
126
What type of pleurisy is more likely to become infected?
Wet
127
Where does pain in diaphragmatic pleurisy refer to?
Neck, upper traps or shoulder
128
What is pleural effusion?
Increased fluid between visceral and parietal pleura
129
What pathologies can lead to pleural effusion?
Congestive heart failure; liver disease; kidney disease; trauma; malignancy; PE
130
What condition is secondary to alveolar hypoventilation ?
Ventilatory failure
131
What four areas of the body can lead to ventilatory failure if they become dysfunctional?
1. Neural control of respiration
2. Respiratory muscles
3. Chest wall
4. Airways
132
What are some pathologies that can lead to ventilatory failure?
- Poliomyelitis
- Spinal cord injury
- Tetanus toxin
- Myasthenia gravis
- Muscular dystrophy
133
What is ARDS?
Acute Respiratory Distress Syndrome
134
What can cause ARDS?
- Shock – trauma, burns, acute cardiac failure
- Pneumonia
- Toxic lung injury – fumes, drugs, bacterial endotoxins
- Aspiration of fluids
135
What is Lung cancer?
A malignancy of the epithelium of the respiratory tract
136
What is Lung cancer also known as?
Bronchogenic carcinoma
137
What percentage of lung cancer is caused by smoking?
Up to 90%
138
What is the 5 year survival rate for lung cancer
About 15%
139
What are the 2 main types of lung cancer?
1. Small cell lung carcinoma
| 2. Non Small cell lung carcinoma
140
Which type is also known as oat cell lung cancer?
Small Cell
141
Which type of lung cancer mainly occurs in non-smokers?
Adenocarcinoma
142
Which type of lung cancer mainly occurs in smokers?
Small Cell
143
What type of lung cancer is most prevalent?
Non Small cell
144
What are the 3 subtypes of Non Small Cell?
1. Adenocarcinoma
2. Squamous Cell carcinoma
3. Giant Cell carcinoma
145
Which of these 3 subtypes is the most common?
Adenocarcinoma
146
Where does lung cancer most often metastasis to?
The brain, bones, kidneys and adrenal glands
147
What are some of the bronchial manifestations of lung cancer?
- Coughing
- Wheezing
- Dyspnea
- Hemoptysis
148
What is hepatomegaly?
Metastasis to the liver
149
What are some of the systemic manifestations of lung cancer?
- Weight loss
- Cachexia
- Anorexia
- General malaise
150
What is a Paraneoplastic syndrome?
A condition that arises as a result of the tumour but not directly caused by the cancer itself
