Respiratory Tract Infections, Neoplasms, and Childhood Disorders Flashcards
What makes up the Conductive Airway?
- nasopharynx
- oropharynx
- larynx
- tracheobronchial tree
nasopharynx
nose/throat cavity
oropharynx
mouth/throat cavity
larynx
voice box
what is another name for the conductive airway? Why?
- Dead Space
- no gas exchange occurs in this area
Ventilation
the flow of gases into the alveoli
-does not mean gas exchange is occuring
Profusion
the flow of blood through pulmonary capillaries
Diffusion
the movement of gases across the alveolar-capillary membrane
What is an example of a ventilation problem?
obstruction in airway, choking
what is an example of a profusion problem?
thrombus/ clot blockage
what is an example of a diffusion problem?
alveoli filled with fluid
Why shouldn’t we treat viral infections with antibiotics?
- leads to the development of antibiotic resistance bacteria
- antibiotics don’t treat viral infections
An URI is an infection of the what?
- Upper Respiratory System
- nose, larynx, oropharynx
A Lower Respiratory Infection involves what?
-lower airway and lungs
Discuss the Rhinovirus
-Most Common cause of the Common Cold
Frequently seen in….
- Early Fall and Late Spring
- b/w ages 5 and 40
Discuss the Parainfluenza viruses
- causes common cold
- mostly affects children under 3 years old
Discuss the Respiratory Syncytial Virus
- causes common cold
- mostly affects children under 3 years old
- during winter and spring
Discuss Coronaviruses and Adenoviruses
- causes common cold
- seen in winter and spring
What is the most common viral pathogen?
Rhinovirus
What virus/viruses commonly cause colds in children?
Parainfluenza Viruses and Respiratory Syncytial Virus
What virus/viruses are more prevalent during the winter and spring months?
Respiratory Syncytial Virus, Coronaviruses, and Adenoviruses
What virus/viruses are more prevalent during the early fall and late spring months?
rhinovirus
What is the greatest contributor to the spread of common cold?
-hands (WASH YOUR HANDS!)
What are the most common portal of entries for common cold causing pathogens?
-mucosa (nasal), conjunctiva (eyes)
When is someone infected with a Common Cold most contagious?
3 days
What is Rhinosinusitis?
- inflammation of the sinuses and nasal pathways
- same thing as Sinusitis
What is Rhinosinusitis caused by?
-infection or allergy obstructs sinus drainage
How does Acute Rhinosinusitis present?
- facial pain
- headache
- purulent nasal discharge
- decreased sense of smell
- fever
How does Chronic Rhinosinusitis present?
- nasal obstruction
- fullness in the ears
- postnasal drip
- hoarseness
- chronic cough
- loss of taste and smell
- unpleasant (bad smelling) breath
- headache
Why may viral rhinosinusitis lead to a secondary bacterial infection?
-rhinorrhea (nasal drainage) accumulates in the sinus cavities, pathogens aren’t filtered out because of the lack of movement of the rhinorrhea in the cavity areas
What are some types of medications used to treat rhinosinusitis? How does each one work?
- Antibiotics : to treat bacterial infection
- Steroids : anti-inflammatory
- Guaifenesin : thins mucus secretions to help expel the mucus
How is the Influenza transmitted?
-inhalation of droplet nuclei / Indirect Contact
What are the 3 types of infections that influenza viruses can cause?
- uncomplicated URI
- viral pneumonia
- respiratory viral infection followed by a bacterial infection
The common cold and influenza initially establish as what?
-URIs
What are the S/S of viral pneumonia?
- abrupt onset
- profound malaise
- fever
- tachypnea ( increased Resp. Rate)
- tachycardia (increased HR)
- cyanosis
- hypotension ( decreased BP)
What are the 3 distinct types of influenza virus? Which two cause epidemics?
- A,B,C
- A and B can cause epidemics
What is the incubation period for the Flu?
1 to 4 days
Is a Virus or Bacterial pathogen more contagious?
viral
Are Colds or the Flu more common?
COMMON colds are more common than the flu
define Pandemic
-an epidemic occurring on a scale that crosses international borders and affects a large number of people
What are our goals for Flu patient?
- limiting the infection to stay as an URI (prevent spread)
- get lots of rest - reduce O2 stress/difficulties
- keep warm to limit viral replication
- keep hydrated (increased water loss w/ tachypnea)
Why should you not treat a low grade fever?
- Low grade = below 102 degrees
- the fever serves a purpose in preventing viral replication
define Afebrile
no fever
define Febrile
fever present
If a fever is present what is suspected? Cold or Flu?
Flu
- usually high
- lasts 3-4 days
If a patient has a headache what is suspected? Cold or Flu?
Flu : headaches frequent
*although if a patient has rhinosinusitis from a cold they could experience headaches
If a patient has slight aches and pains is the Flu or Cold suspected?
Cold
If a patient has severe aches and pains what is suspected?
Flu
A patient is bedridden. Do they more than likely have a cold or the flu?
Flu
-frequently lasts 5-10 days
A patient has sniffles… do they have a cold or the flu?
more than likely a Cold
although rhinorrhea/congestion can be seen with the Flu
A patient is sneezing.. so they more than likely have the flu or a cold?
Cold
*flu can sometimes produce sneezing
A patient has a sore throat… is the flu or a cold suspected?
Sore throat occurs more commonly with a cold, although can sometimes be seen with the flu
A patient has a mild cough… do they have a cold or the flu?
cold
A patient has a severe cough… do they have a cold or the flu?
the flu
A patient is diagnosed with a sinus/ear infection after getting over a sickness… Did they more than likely suffer from a cold or the flu to begin with?
Cold
A patient has a secondary pneumonia infection… would a cold or the flu be the primary infection they had?
Flu
Heart and Kidney Failure are commonly seen as complications from the flu or a cold?
the flu
Influenza immunizations can be given in two forms… what are they?
- TIIV : Trivalent Inactivated Influenza Vaccine
- LAIV : Live, Attenuated Influenza Vaccine
How is a TIIV given to a patient ?
needle injection
How is a LAIV given to a patient?
nasal spray
LAIV is an option for which people?
healthy, non pregnant persons between ages 5 and 49 years old.
Who are encouraged to get Flu Vaccines?
- health care providers and their family members
- pregnant women
- older people (over 65)
- children (under 5, especially under 2)
- people who have chronic health problems (heart disease, asthma)
- people who have an immunodeficiency disorder like HIV
- residents of nursing homes
How old must a baby be before they are able to receive the Flu vaccine?
6 months
Who should not get the Flu vaccine?
- anyone who previously reacted to a flu vaccine (anaphylactic)
- those allergic to eggs
- history of Guillain-Barre syndrome
- anyone with an acute febrile illness
Explain the concept behind the Flu Vaccine.
- CDC and ACIP (advisory committee on immunization practices) annually update its recommendations for the composition of the vaccine
- try to predict what strands will be most prevalent during each flu season
Define Pneumonia
inflammation of the parenchymal tissue (alveoli and bronchioles)
- caused by:
- typically bacteria in the alveoli
- virus
- gastric secretions (aspirations)
What is the most common cause of both community and hospital acquired pneumonia?
the Staphylococcal Aureus (S. Aureus) bacteria
Describe a Lobar Pneumonia
-affects an entire lobe of the lung
Describe a Bronchopneumonia
-patchy distribution over more than one lobe
what are Atypical pneumonias?
viral and mycoplasma infections of alveolar septum or interstitial tissues
What is Guillian-Barre syndrome? What causes it?
- triggered by an infection
- ascending paralysis, runs its course then goes away in the same pattern it came
- patients with this will need to be on a ventilator when the paralysis reaches their upper body
What is Legionnaires’ disease? How is it acquired?
- form of bronchopneumonia
- infection normally transmitted by the environment
- ex: aerosolized water, humidifier, air conditioners, soil
- person to person transmission has not been documented
What is the priority for pneumonia patients?
airway management
Who are at a higher risk for developing pneumonia?
- the immunocompromised
- ICU patients (breathing tube)
What is the incubation period for pneumonia?
-48 hrs
What is Tuberculosis?
- airborne infection caused by Mycobacterium Tuberculosis
- spread by inhaling droplet nuclei circulating in the air
- initiates cell-mediated immune response
What was TB called back in the day?
Consumption
What is Primary TB?
- initial, 1st exposure (un-sensitized)
- inhaled Tubercle Bacillus (TB) cause macrophages to begin a cell mediated immune response
- takes 3-6 weeks to develop positive TB test
- most are asymptomatic but develop latent TB infections
What is Latent TB?
- results in a granulomatous lesions
- TB is surrounded by T-lymphocytes and macrophages which seal off the TB
- Patient is unable to spread disease, remains w/o active disease
How is a definite diagnosis made for TB?
-sputum culture for AFB (acid-fast bacilli)
What are the S/S of and Active TB infection?
- fever
- weight loss
- fatigue
- night sweats
- bloody sputum
What is Secondary TB?
-REINFECTION from inhaled droplet nuclei or REACTIVATION of a previously healed primary lesion
Describe a Tuberculin Skin test.
- aka: PPD
- intradermal injection of tuberculin
- identifies latent TB
SPECIFIC NAMES NOT ON TEST: What is the treatment for TB?
- isoniazid (INH) and Rifampin (RIF)
- medications usually taken for a year
What is Bronchogenic Carcinoma?
lung cancer
-2 types : Small cell and non-small cell
Discuss Small Cell Lung Cancer
- highly linked to smoking
- high tendency to metastasize (esp. into brain)
Discuss Non-Small cell lung cancer
3 different types
- large cell carcinoma
- squamous cell
- adenocarcinoma
Discuss Large Cell Carcinoma
- poor prognosis due to early metastasis
- non-small cell lung cancer
Discuss Squamous Cell lung cancer
- best prognosis in majority of cases
- spreads more centrally
- non-small cell lung cancer
Discuss Adenocarcinoma
- most common type in US
- often seen in women and non-smokers
What are the S/S of Bronchogenic Carcinomas?
- chronic persistent cough
- shortness of breath
- wheezing
- Pleuritic chest pain
Why is lung cancer often not diagnosed until late?
-signs are a similar to chronic bronchitis
Discuss Respiratory Distress Syndrome
-common for premature infants
-attributed to decreased lung compliance (mobility)
Why? :
- pulmonary immaturity
-lack of surfactant (could lead to alveolar collapse)
- protein-rich fluid leaks into the alveoli and blocks
O2 uptake
What is the treatment of Respiratory Distress Syndrome?
- mechanical ventilation
Why are C-section delivered babies more likely to have respiratory problems?
-the process of the baby going through the birth canal releases cortisol which helps to get the lungs ready to start working
Full development of the lungs doesn’t occur until when?
age 8
What are the obstructive disorders of the upper airway in small children?
- croup
- epiglottitis
What are the obstructive disorders of the lower airway in small children?
- acute bronchiolitis
- lower airway infection producing air trapping
Discuss Croup
- more common
- usually benign
- self limited
S/S:
- similar to common cold
- stridor
- wet, barking cough
- occurs at nigh
Treatment:
relieved by exposure to cold/moist air
Discuss Epiglottitis
- rapidly progressive
- life threatening
Danger of airway obstruction and asphyxia
S/S:
- mouth open, chin thrust open
- low-pitched stridor
- difficulty swallowing
- fever
- drooling
- anxiety
Treatment:
- hospitalization
- antibiotics
- intubation/tracheotomy
