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Pathophysiology > Week 8 - Respiratory > Flashcards

Week 8 - Respiratory Flashcards

1
Q

clinical manifestations of repiratory diseases

A 
dyspnea
abnormal breathing patterns
hypo- & hyperventilation
cough
hemoptysis
cyanosis
pain
clubbing
abnormal sputum
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2
Q

dyspnea s&s

A

flaring nostrils
accessory muscle use
retraction of intercostal spaces

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3
Q

cheyne stokes

A

alternating periods of deep and shallow breathing

apnea for 15-60 seconds then rapid resps

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4
Q

cheyne stokes results from

A

injury to brainstem

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5
Q

during hypoventilation

A

co2 removal does not keep up with co2 production an paco2 increases causing hypercapnia, results in respiratory acidosis

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6
Q

causes of hypercapnia

A
  1. Depression of resp. centre by drugs
  2. Diseases/trauma of the medulla
  3. Spinal cord disruption
  4. Diseases of neuromuscular junction or respiratory muscles
  5. Thoracic cage abnormalities
  6. Large airway obstruction
  7. Increased work of breathing
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7
Q

hypoxemia causes

A 
decreased oxygen content of inspired gas
hypoventilation
diffusion abnormalities
abnormal ventilation-perfusion ratios
pulmonary right-to-left shunt
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8
Q

acute cough

A

resolves within 2-3 weeks, URI

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9
Q

chronic cough

A

more than 3 weeks

postnasal drip, bronchitis

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10
Q

hemoptysis

A

coughing up blood caused from damage to lung parenchyma

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11
Q

asthma

A

chronic inflammatory disease of the airways, morbidity and mortality has risen over last 2 decades

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12
Q

asthma patho

A

Inflammation resulting in hyper-responsiveness of the airways to environmental triggers.
Produces bronchial smooth muscle spasm, edema formation, tenacious mucus production, ->obstruction

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13
Q

s&s asthma

A 
Dyspnea, tachypnea
Wheezing on inspiration and expiration
Tachycardia
Circumoral cyanosis
Accessory muscle use
Diaphoresis
Pallor
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14
Q

asthma drugs

A 
1st->bronchodilators
2nd->long acting bronchodilators
3rd->anticholinergic agents
4th->inhaled corticosteroids
5th->oral steroids
6th->IV steroids
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15
Q

s&s copd

A 
Dyspnea
Cyanosis
Productive cough
Respiratory fatigue
Severe accessory muscle use
Orthopnea
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16
Q

chronic bronchitis

A

Chronic bronchitis is hypersecretion of mucous and productive cough (at least 3 months of the year for at least 2 years)
Patients have decreased exercise tolerance, infection is common

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17
Q

emphysema

A

Abnormal permanent enlargement of gas exchange airways
Obstruction results from changes in lung tissues
Loss of elastic recoil in alveolus and narrowed bronchiole

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18
Q

emphysema s&s

A 
Dyspnea on exertion -> marked dyspnea
Little cough and little sputum production
Use of accessory muscles for ventilation
Often very thin
Braces for easier breathing
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19
Q

emphysema dx & tx

A

Pulmonary function tests indicate obstruction to expiratory phase of ventilation
TLC (total lung capacity) may be twice normal
ABG normal until late in disease

Smoking cessation most important tx
Inhaled anticholinergic agents
Relaxation exercises, reconditioning and breathing retraining helpful

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20
Q

tuberculosis

A

Infection of lower respiratory tract caused by mycobacterium tuberculosis, an acid-fast bacillus
Main reason for recent increases is AIDS - very susceptible to respiratory infections
Multidrug-resistant TB now present
Due to not taking medications and mutation of bacteria

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21
Q

tb patho

A

Transmitted in airborne droplets
Inspired bacilli cause pneumonitis (lung inflammation)
Neutrophils and macrophages seal colonies of bacilli into a tubercule
Infected tissues inside tubercule die and form a cheeselike substance (all within 10 days)
May lie dormant for years to whole lifetime
Poor nutritional status, IDDM, long term steroids

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22
Q

tb manifestations

A

Often asymptomatic
Fatigue, weight loss, lethargy, anorexia, low-grade fever in afternoon
Cough- purulent sputum, progresses to hemoptysis
Night sweats, general anxiety

23
Q

croup

A

Subglottic edema from the infection (in an already narrow airway)
Increased resistance to airflow -> increased work of breathing-> may cause dynamic collapse of upper airway
Watch for rhinorrhea, sore throat, low-grade fever-> seal-like barking cough
Most resolve spontaneously after a few days
If obstruction severe, needs immediate help

24
Q

croup s&s

A

Sore throat
Low-grade fever
Seal-like, barking cough

25
Q

croup dx & tx

A

Some controversy over treatment
If no stridor, then little treatment
Now evidence of value of single dose of steroid with half-life of 36-72 hours
Science neither supports or refutes use of mist

26
Q

pneumonia

A

Infection of the lower respiratory tract

caused by bacteria, viruses, fungi, protozoa, or parasites

27
Q

pneumonia risk factors

A

elderly, immunocompromised, lung disease, alcoholism, altered consciousness, smoking, intubation, malnutrition, immobilization

28
Q

pneumococcal pneumonia

A

Best understood pneumoniae
Inflammatory response and exudate cause alveolar edema
This media causes multiplication of bacteria and spread of infection
Phagocytosis takes place in consolidated alveoli
Usually infection limited to 1-2 lobes

29
Q

viral pneumonia

A

Mild and self-limiting
Usually sets the stage for another infection (because it provides the perfect environment for bugs to grow)
Primary infection = influenza pneumonia
Caused by another infection such as chic pox, measles

30
Q

pneumonia s&S

A 
cough 
dyspnea 
fever 
chills
malaise 
pleuritic chest pain
31
Q

pneumonia dx

A

Confirmed by chest x-ray
Elevated WBC
Should do sputum Gram stain and possibly blood cultures

32
Q

lun cancer general info

A

Arise from epithelium of respiratory tract
Considered an epidemic in the U. S.
Mortality rate still rising in women, higher even than breast cancer
Most common cause is smoking
Passive smoking = 30% higher risk
Genetic predisposition to lung cancer
Also environmental & occupational risk factors

33
Q

lung cancer manifestations

A

Early symptoms are non-specific
Coughing, sputum production, hemoptysis, airway obstruction, pleural effusions
Disease usually well advanced before medical advice is sought
Only proven reduction method is smoking cessation

34
Q

cystic fibrosis

A

Autosomal recessive inherited disease
In middle of chromosome 7
Gene mutation that results in abnormal expression of cystic fibrosis transmembrane regulator
Results in abnormal secretions that obstruct tracts in respiratory, digestive, and reproductive systems
Generally affects Caucasians
Carriers are healthy

35
Q

cystic fibrosis patho

A

Autosomal recessive inherited disease
In middle of chromosome 7
Gene mutation that results in abnormal expression of cystic fibrosis transmembrane regulator
Results in abnormal secretions that obstruct tracts in respiratory, digestive, and reproductive systems
Generally affects Caucasians
Carriers are healthy

36
Q

cystic fibrosis clinical manifestations

A

Age of diagnosis 6 mos -> 1 year
10% not diagnosed until after age 10
Respiratory problems - persistent cough or wheeze and recurrent pneumonia
GI problems - meconium ilius, failure to thrive, malabsorptive symptoms
Males are typically infertile
Severity not predictable by genotype, affected siblings may be very different

37
Q

cystic fibrosis dx

A

Standard test is sweat test
CF patients secrete high levels of electrolytes in their sweat
sweat chloride concentration > 60 mEq/L

38
Q

4 types of pneumonthorax

A

Spontaneous
Tension
Open
Secondary

39
Q

pleural effusion

A 
Can be fluid
- Exudative
- Transudative
Can be blood
- Hemothorax
Can be pus
- Empyema
40
Q

flail chest results from

A

rib or sternal fractures that disrupt mechanics of breathing

41
Q

pneumothorax

A

accumulation of air in pleural space

42
Q

tension pneumothorax

A

trapping of air in pleural space, life threatening

43
Q

pleural effusion

A

accumulation of fluid in pleural space

44
Q

empyema

A

presence of pus in pleural space

45
Q

aspiration

A

passage of fluid and solid particles into lung

46
Q

atelectasis

A

collapse of alveoli

47
Q

bronchiectasis

A

inflammatory obstruction of small airways

48
Q

bronchiolitis obliterans

A

an inflammatory, fibrotic

process that occurs as a complication of lung transplantation.

49
Q

pulmonary fibrosis

A

excessive amount of connective tissue

in the lung

50
Q

pneumoconiosis

A

inhalation of dust particles in workplace

51
Q

pulmonary edema

A

presence of excess water in the lung
caused by disturbances of capillary hydrostatic pressure,
capillary oncotic pressure, or capillary permeability

52
Q

ALI/ARDS

A

results from an acute, diffuse inflammatory injury
to the alveolocapillary membrane and decreased surfactant
production, which increases membrane permeability and
causes pulmonary edema and atelectasis

53
Q

acute bronchitis

A

acute infection or inflammation of the large
airways or bronchi; it is usually self-limiting and caused by
viruses.

Pathophysiology (12 decks)

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