URI

Question 1

sputum

Answer 1

normal: mucus secreted by respiratory tract
trap particles, cilia move it up
yellow does not = infection

Question 2

bronchitis: acute

Answer 2

simple
inflam of bronchi (upper), bacterial or viral (80%), no airflow obstruction, mild and self limited, required only supportive care, better in 3-4 wk
dx: s and PA, cbc for viral v bacterial

Question 3

bronchitis: acute - cm

Answer 3

common cold, pharyngeal erythema, rhinorrhea, muscle aches, cough (3 wk), wheeze (in severe), productive, enlarged lymph

Question 4

bronchitis: acute - tm

Answer 4

broad spectrum abx, expectorants, cough suppressants, hydrate

Question 5

bronchitis: chronic

Answer 5

for 3 mo/1yr for 3yr
cigs
increased airflow obstruction -> COPD
acute exacerbation of chronic (AECB) = acute on chronic
premature morbidity and mortality

Question 6

influenza

Answer 6

viral: a/b/c, can mutate
vaccine: prevent severity, can still get infected
rapid onset: fever, chills, body aches
secondary pna -> can be deadly, can progress if no coughing

Question 7

histamine

Answer 7

stored in mast cells (skin and soft tissue), and basophils (blood)
cause: hives and pruritus, dilation of blood vessels (erythema and hypoT), bronchoconstriction (SOA), sleep/wake cycle, increase stomach acid secretion
cause majority of s with allergic rxn: drug, food, contacts, hives or urticaria

Question 8

histamine: allergic rhinitis

Answer 8

inflam disorder and swlling of mucous membranes in nose
eyes, ears, sinuses, throat; upper and lower airway
triggered by allergens -> bind IgE on mast cells
env: dust, mold

Question 9

histamine: allergic rhinitis - cm

Answer 9

sneeze, rhinorrhea, pruritus, nasal congestion, watery-itchy eyes

Question 10

histamine: acute sinusitis

Answer 10

infection of facial sinuses and nose membranes
inflam -> sinus obstructed by fluid and edema -> bacterial growth and infection
can accompany URI, nasal polyps, deviated septum, allergic reaction
viral = 5-7 days (if S last >7 days, give abx bc probably bacterial)
bacterial = up to 4 wk

Question 11

histamine: acute sinusitis - cm

Answer 11

HA, facial pain or p over sinuses, nasal obstruction, fatigue, purulent drainage (nasal), ear pain, dental pain, cough, decreased sense of smell, sore throat

Question 12

histamine: acute sinusitis - tm

Answer 12

abx - difficult bc drugs have to get to sinuses (7+ day treatment plan plus decongestants)
decongestants, antihistamines, mucolytic to decrease secretions
ent if recurrent -> can have sx
aggressive bc close to brain

Question 13

pharyngitis

Answer 13

palate. tonsils, uvula
culture and rapid strep: bacterial = white spots, viral = no spots

Question 14

pharyngitis: tonsilitis

Answer 14

so swollen -> almost touch, hard to swallow

Question 15

laryngitis

Answer 15

inflam of vocal cords
croup -> barky cough

Question 16

epiglottitis

Answer 16

insp stridor and retractions = diagnose, rapid fever, pain, difficulty swallowing, drool (differentiate from croup = no barky cough)
rare - life threatening: sudden swelling of epiglottis, worsens rapidly, block windpipe, fatal; vaccine (HIB)
s: sore throat, fever, SOB (tripod - sniffing), drool, stridor, cant swallow, muffled voice

Question 17

bronchospasm

Answer 17

sudden constriction of muscles making it difficult to breathe
triggered by URI or asthma -> pacu
treat with bronchodilator, inhaled steroids, anticholinergics