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All Path Review 700 > Unit 5: Respiratory > Flashcards

Unit 5: Respiratory Flashcards

1
Q

Atelectasis

A

Collapse (or incomplete expansion) of alveoli

ie collapsed lung

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2
Q

Atelectasis: Causes

A

Deficient surfactant
Lung compression
Resorption of air distal to obstruction

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3
Q

Cystic Adenomatoid Malformation

A

Multiple adenomatous cysts in terminal bronchioles

Congenital, rare

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4
Q

Tracheal Diverticulum

A

Sac or pouch in tracheal wall

Congenital or acquired (chronic coughing)

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5
Q

Pulmonary Lobar Sequestrations

A

Congenital lung disorder characterized by cystic or solid masses in the thorax

Presents as lung infections
Men more than women

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6
Q

Intralobar Sequestrations

A

AKA intrapulmonary
Mass of lung tissue within the visceral pleura
Isolated from tracheobronchial tree; supplied by systemic artery

Originally thought to be congenital; now maybe acquired

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7
Q

Extralobar Sequestrations

A

AKA extrapulmonary
Mass of lung tissue not connected to bronchial tree; located outside the visceral pleura.
Supplied by abnormal artery

Congenital

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8
Q

Infant Respiratory Distress Syndromes

A

AKA hyaline membrane disease

Deficiency in surfactant

Usually in preemies

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9
Q

Adult Respiratory Distress Syndrome

A

AARDs

Changes in the lungs that lead to respiratory failure

Caused by injury to endothelial cells or alveolar lining cells

May cause cardiac failure. High (2/3) mortatlily

Causes: shock, trauma, burns, acute cardiac failure, pneumonia, toxic lung injury, aspiration

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10
Q

Acute Bronchitis

A

Inflammation of the bronchia and trachea (upper respiratory)

Short duration, self-limiting

Chemical irritation, viral or bacterial infection

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11
Q

Upper Respiratory Tract Infections

A

Bronchitis, colds, sinusitis, tonsilitis, otitis media

Mostly viral, mostly self-limiting
Runny nose, coughing, sneezing, sore throat

Good prognosis

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12
Q

Colds

A

Acute, afebrile, self limiting, viral URI

Rhinovirus (50%), coronavirus, adenovirus etc

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13
Q

Sinusitus

A

Inflammation of paranasal sinuses

Acute, subacute, recurrent, chronic

Viral, bacterial, fungal, alergies

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14
Q

Tonsilitis

A

Viral Inflammation of the tonsils (lymphoid tissue)

Sore throat, painful swallowing, swollen lymph nodes, fever, white patches on tonsils

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15
Q

Otitis Media

A

Inflammation of the middle ear

Fluid build up, bacterial movement from sinuses along eustachian tubes (which in more horizontal in children)

Bacterial, viral, RSV, influenza

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16
Q

Pharyngitis

A

Inflammation of the pharynx (lymphoid tissue)

Viral or bacterial

Sore throat, painful swallowing, muscle ache, fever

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17
Q

Croup

A

A form of laryngitis
Infection/inflammation of the false vocal cords

Bacterial, viral. Usually parainfluenza

Barking cough, stridor (wheeze with inspiration), drooling, severe throat pain

Usually resolves on its own, but can result in fatal upper airway obstruction

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18
Q

Epiglottitis

A

A form of laryngitis
Inflammation/infection of the epiglottis

Most commonly caused by H. influenza
Rare

Respiratory tract obstruction. May require intubation
Muffled voice, sore throat, drooling, stridor, cervical lymphadenopathy

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19
Q

Streptococcus Pneumonia

A

Lower respiratory tract infection

Most common cause of pneumonia, bacterial meningitis, otis media, etc.

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20
Q

SARS

A

Severe Acute Respiratory Syndrome

Viral
Highly contagious, potentially fatal

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21
Q

Respiratory Failure

A

Lung disease caused by failure of either gas exchange mechanism and/or ventilatory pump of the lungs

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22
Q

Type 1 Respiratory Failure

A

Low O2 and low-to-normal CO2 (decreased O2 intake, but gas exchange still possible)

Caused by damage to lung tissue (pulmonary edema, pneumonia, acute respiratory distress)

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23
Q

Type 2 Respiratory Failure

A

Low O2 and High CO2 (O2 intake and gas exchange both affected)

Diminished alveolar function: COPD, chest wall deformity, respiratory muscle weakness

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24
Q

V/Q Ratio

A

Ventilation Perfusion Ratio

Ratio of alveolar ventilation to amount of blood coming into the alveoli (ie the two determinants of blood O2 and CO2 concentratioin)

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25
Q

Pneumothorax

A

Accumulation of air or gas in the pleural cavity due to a defect in the visceral pleura or chest wall.

May result in a collapsed lung (atelectasis)

Primary or secondary (COPD, CF, emphysema, trauma)

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26
Q

Pneumothorax: Sx

A 
dyspnea
sharp, pleuritic chest pain
hypotension
weak and rapid pulse
SOB
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27
Q

Pneumothorax: Pathogenesis

A

Air enters pleural cavity
Separation between visceral and parietal pleura
Destroys negative pressure of the pleural space
Lung collapses

Mediastinal shift may compress the other lung as well

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28
Q

Spontaneous pneumothorax

A

Generally occurs due to blebs and bullae, but also can occur due to TB, abscess, and other lung diseases.

Tall skinny smoker guys?

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29
Q

Traumatic pneumothorax

A

Results from chest trauma

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30
Q

Open pneumothorax

A

“Sucking chest wound”

A type of traumatic pneumothorax that occurs with the pressure in the pleural space equals barometric pressure.

Open wound between outside world and pleural space. Loss of negative pressure.

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31
Q

Tension pneumothorax

A

Valve-like rupture allowing inspiration but not expiration

Constantly increasing pressure may collapse lung pressure, displace other organs

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32
Q

Pneumonia

A

Inflammation of the lung parenchyma

Lower respiratory tract infection

50% viral; also bacterial, toxic, aspiration

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33
Q

Most common cause of community acquired pneumonia

A

Strep. pneumoniae

also Haemophilus influenza

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34
Q

Most common cause of hospital acquired pneumonia

A

Staph. aureus

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35
Q

Atypical pneumonia

A

“Walking pneumonia”

Less severe

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36
Q

Pneumonia: Sx

A 
Chest pain
Hacking productive cough
Rust-coloured or green sputum
Dyspnea
Fatigue 
Fever
Myalgia
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37
Q

Pneumonia: possible complications

A

Pleuritis
Chronic lung disease
Abscesses

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38
Q

Pleuritis

A

Inflammation of pleura
May lead to pleural effusion, pyothorax, empyema
Possible result: restrictive lung disease

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39
Q

Pyothorax

A

Empyema in pleural cavity

40
Q

Empyema

A

Accumulation of pus within a naturally existing anatomical cavity.

41
Q

Honeycomb lungs

A

Appearance of lungs after fibrosis, destruction of parenchyma

Result of chronic lung disease

42
Q

Pneumocystis jirovecii

A

Formally PCP (pneumocystis carinii pneumonia)

Progressive, often fatal pneumonia
Affects mostly the immunocompromised

Fungal

43
Q

Legionnaire’s Disease

A

Rare infectious pneumonia

Massive consolidation and necrosis of lung tissue.
80% mortality if untreated.

Legionella pneumophila

44
Q

Pulmonary TB

A

Infectious, inflammatory systemic disease

Mycobacterium tuberculosis

From lungs may disseminate to lymph nodes and other systems

45
Q

TB: pathogenesis

A

Inhale infected droplets
Granulomas with caseous necrosis (Ghon complex)
Latent TB
Active TB

46
Q

What type of hypersensitive reaction is TB?

A

Type IV

Cell-mediated delayed type

47
Q

TB: Sx

A 
85% have respiratory Sx 
Cough
Hemoptysis
Chest pain
Weight loss
Anorexia
Fever

Can also have CNS, GI, Sx

48
Q

Potts Disease

A

Spinal TB

Back pain, stiffness, arthritis, possible LB paralysis

49
Q

Miliary TB

A

Widespread dissemination of TB throughout lungs and body

50
Q

Lung Cancer

A

Malignancy of the epithelium of respiratory tract

Leading cause of death worldwide
5 year survival 10-15%

51
Q

Small cell lung cancer (SCLC)

A

AKA oat cell lung cancer

20% of all lung cancers

Highly aggressive
Almost always in smokers
60% widespread metastases at time of Dx

52
Q

Non-small cell lung cancer (NSCLC)

A

80% of all lung cancers

Include squamous cell carcinoma, adenocarcinoma (most common), large cell carcinoma

40% metastatic at time of Dx

53
Q

Most common sites of lung cancer metastases

A

Liver and brain (MC)

Also bones, kidneys, adrenals

54
Q

Sarcoidosis

A

Non-caseating granulomas developing in a wide range of tissues

Idiopathic
Autoimmune

Usually good prognosis

55
Q

Most common location of sarcoidosis

A

Lungs
Hilar lymph nodes
Also: uvea, skin, liver
Rarely: heart, nervous system

56
Q

Sarcoidosis: Sx

A

5% Asymptomatic

45% systemic (fever, anorexia, joint pain)

50% pulmonary (dyspnea, cough, hemoptysis)

20-60% uveitis

Painful inflamed nodules

57
Q

Absestosis

A

Pulmonary fibrosis, pleural fibrosis, pleural plaqueS, caused by exposure to asbestos

58
Q

Mesothelioma

A

Rare lung cancer that develops from cells of pleural lining (mesothelioma)

Asbestosis

Almost always fatal

59
Q

Pleural Effusion

A

Increase of Transudate or exudate in the pleural space

Congestive heart failure, cirrhosis with Ascites, nephrotic syndrome, or injuries that increase vascular permeability.

60
Q

Pleurisy

A

Aka pleuritis

Inflammation of pleura caused by infection, injury or tumor

Idiopathic, or complication of lung disease (especially pneumonia), TB, influenza, SLE, RA

61
Q

Dry Pleurisy

A

No change in serous fluid between visceral and parietal layers –> two layers rub together –> pain

62
Q

Wet pleurisy

A

Aka pleurisy with effusion

No chaffing so no pain

Increased serous fluid

Can become infected

63
Q

Pneumoconioses

A

Lung diseases caused by inhalation of mineral dusts, fumes, or other particulates

Mostly occupational

Coal workers lungs
Silicosis
Asbestosis

64
Q

Pneumoconioses: biochemical composition of inhaled dust

A

Coal dust: inert

Silica: reactive; prominent injury

Asbestos: insoluble; get stuck

65
Q

Coal miners lung

A

Black lung

Pneumoconiosis caused by inhaled coal dust, which is then ingested by macrophages.

Somewhat expectorated

66
Q

Silicosis

A

Pneumoconiosis caused by inhaling silica dust

Dust ingested by macrophages, which release substances that stimulate formation of collagenous nodules

Nodules destroy lung parenchyma and cause massive fibrosis.

67
Q

Common complication of silicosis

A

TB

68
Q

Asbestosis

A

Asbestosis particles are inhaled and engulfed by macrophages.

Inflammation

Increased risk of cancer, especially mesothelioma

69
Q

Pulmonary embolism

A

Thrombi lodge in right side of heart into pulmonary vessels, where it may occlude pulmonary circulation.

Most commonly originate in proximal leg.

May cause cor pulmonale

70
Q

Pulmonary embolism: Sx

A

Severe and sudden chest pain

LOC

71
Q

Pulmonary Arterial Hypertension (PAH)

A

High blood tension in pulmonary arteries

Sx: fatigue, weakness, chest pain, peripheral edema, SOB

5-10 mmHg above normal (which is 15-18 mmHg)

72
Q

Primary PAH

A

Rare pulmonary arterial hypertension

Neonates, women

Idiopathic. Possible family history

73
Q

Secondary PAH

A

Pulmonary arterial hypertension associated with respiratory and/or cardiovascular disorders that increase presume of pulmonary arteries

74
Q

Pulmonary Edema

A

Excess fluid (interstitial, alveoli) in lungs, which inhibits gas exchange

75
Q

Pulmonary Edema is most commonly associated with

A

Left sided heart failure
Acute hypertension
Mitral valve disease

76
Q

Pulmonary Edema predisposes the development of

A

Pneumonia

77
Q

Pulmonary Edema: Sx

A

Asymptomatic intially

Anxiety
Cold Sx
Cough, dyspnea, exercise intolerance 
Wheezing
Productive cough with frothy sputum
78
Q

COPD

A

Chronic obstructive pulmonary disease

Spectrum of disorders that cause airway obstruction that is not fully reversible.

Chronic bronchitis
Bronchiectasis
Emphysema

79
Q

Chronic bronchitis

A

Productive cough lasting 3 months/year for two consecutive years

“Blue bloaters”

Inflammation and scarring –> mucous production –> HT smooth muscle –> obstruction. Also impaired cilia

Increased chance of infection just compounds the problem.

80
Q

Emphysema

A

Destruction of lung parenchyma and pathological accumulation of air in the lungs.

“Pink puffers”

Loss of elasticity in bronchioles –> trapped air

81
Q

Blebs and bullae

A

Pockets of trapped air associated with emphysema

82
Q

Severe dyspnea, hypoxemia and hypercapnia are associated with:

A

Emphysema

83
Q

Bronchiolitis

A

Middle respiratory syndrome affecting epithelial cells of bronchi and bronchioles (not alveoli)

Edema and desquamation of epithelial cells –> blockage. Wheezing fever SOB

Infants and small children

Usually viral

84
Q

Bronchiectasis

A

Complication of CF, chronic bronchitis, or any disorder that causes narrowing of the lumen.

Inability to clear mucous –> chronic infection, inflammation –> dilation, fibrosis, HT of bronchial walls

85
Q

Bronchiectasis may lead to

A

Emphysema

86
Q

Bronchiectasis: Sx

A 
Persistent productive cough
Abundant purulent sputum 
Dyspnea
Fatigue
Anemia
Weight loss 
Fever 
Clubbing
87
Q

Allergic rhinitis

A

Allergies

Acute vasomotor response mediated by histamines released by mast cells coated with IgE

Type I HS Rxn

88
Q

Asthma

A

Airway hyper-responsiveness
Mucous plugs, bronchial spasms, vascular congestion

Reversible COPD

Wheezing coughing SOB

89
Q

Repeated asthma attacks may lead to

A

Barrel chest
Elevated shoulders
HT mm of respiration

90
Q

Status asthmaticus

A

Asthma attack that doesn’t respond to normal care

Medical
emergency

91
Q

Influenza

A

Viral respiratory infection

Fever, coryZa, headache, malaise

92
Q

Influenza: complications

A

Pneumonia
Encephalitis
Myocarditis
Renal disease

93
Q

Cystic fibrosis

A

Recessive disorder of the exocrine glands
Viscous mucous secretions, pancreatic enzyme insufficiency, salty sweat

80-90% pulmonary 
Chronic productive cough
Purulent sputum 
Hypoxia
Clubbing
Frequent infection
94
Q

Obstructive sleep apnea

A

Upper airway blocked causing temporary absence of breathing during sleep

95
Q

Central sleep apnea

A

Apnea caused by decreased respiratory muscle activity

96
Q

Mixed sleep apnea

A

Starts central

Then obstructive

All Path Review 700 (7 decks)

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