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Pulmonary
Unit 3 Test
72
Pathology
Undergraduate 2
04/03/2012

Additional Pathology Flashcards

 


 

Cards

Term
Pulmonary Infections are increased by: (5 things)
Definition

- Altered cough reflex (Myasinthia gravis, CF)

- Injury to mucociliary apparatus (smoking)

- Accumulation of secreations (in the mouth, nose, or lungs, made wors by ventilator or trach  tubes)

- Altered alveolar macrophage funcition

- Pulmonary edema and congestions

Term
Common cold is also called _____ and is an URT _____ infection. Other strains are: _____, _____, _____ (seen mostly in kids), _____, and _____.
Definition

Infectious rhinitis

viral

rhinovirus

parinfluenze

RSV

coronavirus

adenovirus

Term

Clinical manifestations of infectious rhinitis are:

 

This URT viral infection may last weeks and needs to be treated with antibiotics. T/F?

 

 

Definition

Congestion, Runny Nose, Clear secretions, sneeze.

 

False: This infection is self-limiting and lasts 7 days without treatment.

Treat Symptoms

Term
Complications of rhinovirus include:
Definition

- makes mucosa more prone to infections

- bronchitis

- ear infection

- pneumonia

- sinusitis

- asthma

Term
Sinusitis is defined as:
Definition
the blockage (inflammation and infection) of connections between sinus cavities.
Term

Sinusitis has _____ exudate and may be caused by:

 

If acute, it may last _____ weeks; if chronic, _____.

 

 

Definition

Purulent


URTI, allergic rhinitis, barotrauma, swimming, diving, excessive use of nose sprays

 

4-12; >12

Term

Clinical manifestations of sinusitis include:

 

Treatment is:

Definition

Pain, headache (that increases when bening forward), purulent nasal discharge, decreased smell, fever)

 

Antibiotics (must culture bacteria/virus first), decongestants, antihistamines, mucolitics (to help sneeze/cough), saline nasal wash, surgery to take out scar tissue

Term

Influenza is a URT or LRT viral infection??

 

Describe Type A and Type B.

Definition

Could be either!

 

Type A: hemophalus influenza

- two proteints (hemaglutinan and neurominidase) that cause virus to adhere to cells and cause infection

- able to mutate easily and frequently so vaccines aren't very useful

Type B: seen mostly in kids...

Term

The transmission of influenza is by _____ and _____.

 

Viral and Bacterial influenza usually start from _____.

Definition

aerosol and direct contact

 

an uncomplicated URTI

Term
Clinical manifestations of Influenza include:
Definition

Fever chills, malaise

Aches

Runny nose

Unproductive cough when viral

Productive cough when bacterial

Term
Treatment for influenza is:
Definition

Mostly symptomatic

Rest

Liquids

Antiviral drugs

Term

Pneumonia is defined as:

 

This causes more deaths than any other respiratory drug? T/F

Definition

an infection of the lung parenchyma (tissue of the lungs) and inflammation of the lung (alveoli fill with fluid, blood cells, or pus, causing the ability of O2 and CO2 diffusion to be limited)

 

TRUE

Term
Pneumonia may be caused by _____, _____, _____, or _____.
Definition
Bacteria, virus, irritants, or aspiration
Term
Describe parenchyma Consolidation r/t pneumonia...
Definition

This is when the lung tissue becomes hard due to infection.

The permeability of the alveolar membrane is altered and it decreases alveoloar surface area for diffusion.

Term
Pneumonia decreases the _____ ratio which is normally _____. __________ cause this ratio to decrease, whereas __________ cause this ratio to increase.
Definition

V/Q

0.8-0.9

Decreased airflow and ventilation

damaged or decreased airflow (decreasing perfusion)

Term
What are the three classifications of pneumonia?
Definition

Aspiration Pneumonia: bacteria in mouth that goes down to the lungs

Lobar Pneumonia: the entire lobe is effected and has greater consolidation

Bronchopneumonia: individual bronchioles are affected

Term

What fungal pneumonia has a high incidence amoung HIV positive patients?

 

What other types of pneumonia are there?

Definition

Pneumocystis Jiroveci

 

 

Viral (influenza), bacterial mycoplasmal, chronic, immune deficiencies

Term
Clinical Manifestations of pneumonia are:
Definition

Fever

Chills

Cough

Respiratory Crackles

Pleural Friction Rub

Blood tinged/rusty sputum

Term

Treatments of pneumonia are:

 

They usually work in _____ hours.

 

Vaccines are important for _____ and need a different vaccine if _____.

Definition

Antibiotics/antifungals/antiviral, etc.

 

48-72 hours


high risk groups, including health care workers

under 2 yoa

 

Term
What are the three main complications associated with pneumonia?
Definition

Lung absceses (infected area filled with pus).

 

Empyema: pus throughout the lung

 

Bacterial spread to: cardiac valves, kidneys, brain, pericardial sack, joints, splee

Term

Tuberculosis is caused by _____ _____.

 

We've been seeing an increase since the 80s, esp in _____ and _____. But, there has been a decrease in the past year. T/F?

Definition

Mycobacterium Tuberculosis

 

immigrants; immunosuppressed


TRUE

Term
Risks for TB include
Definition

Poverty

Crowding

Chonic Illness

Incidence is high in southern Africa

Mexico, Phillipines, Vietnam

Term
Clinical Manifestations of TB include the 3 things:
Definition

Granulomas: area that's walled off from collagen and scarring

 

Cavitations: liquid that explodes in a cavity

 

Ghon Focus: lesion in lung

Term
The Primary Symptoms of TB include:
Definition

Fever

Weight Loss

Fatigue

Night Sweats

Term
Secondary Symptoms (if infection shows up agina or if person is reinfected) of TB include:
Definition

Reinfection

Reactivation

Lung Apicses

Pleuritic Pain

Hemoptysis (coughing up blood)

Term
2 Ways to diagnose TB include:
Definition

TB Skin test (which can have false negatives and positives because it only shows if the person has antibodies for TB, not if they actually have it or not)

 

Chest X-Ray

Term
Treatment of TB can take _____ if healthy and up to _____ if unhealthy. The antibiotics associated with TB include: (5). Why is there a problem with the treatment of TB?
Definition

2 months

6-12 months

Isoniazid, Rifampin, Pyrazinamide, Ethambutol, Streptomycin

Most TB patients are illegial; hard to see doctor with no insurance and risk to their living status.

Term
The most frequently diagnosed cancer and greatest cause of cancer mortality both in the US and the world is:
Definition
PULMONARY NEOPLASMS
Term
4 risks for pulmonary neoplasms include:
Definition

Cigarettes (#1)

Industrial hazards (radon, asbestos, nickel, silicon, plastics, coal, iron)

Air Pollution (diesel fuel)

Genetics

Term
It is hard to diagnose Pulmonary neoplasms early because the symptoms are somewhat nondescript. These symptoms include:
Definition
Cough, weight loss, dyspnea, chest pain, Lymph nodes become firm in chest and neck, pain in pleura and chest walls
Term
Diagnosis of pulmonary neoplams can be done with:
Definition

X-rays

Sputum exam (will see the neoplastic cells)

Broncial washing (bronchoscopy)

Term

The best treatment of a Pumonary Neoplasm is _____. The problem with this is that the cancer is _____.

 

Other treatments include:

 

The 5 year survival is about _____%.

Definition

surgery

too far advanced; typically bilaterally and it is hard to remove that much of the lungs


chemo and radiation; immunotherapy; prevent causativ agents; early diagnosis

 

15%

Term
Problems from cancer that the tumor is not actually causing are called _____. 1-10% of people with cancer experience weird hormone activation, including these hormones:
Definition

Paraneoplastic Syndromes


ADH, ACTH (adrenocorticotropic hormone - cortisol), parathyroid hormone, calcitonin, gonadotropins (estrogen, testerone), serotonin, bradykinin

Term

Bronchiectasis is _____ and occurs when _____. Risks for this include:

Clinical Manifestations are:

Treatment is:

Definition

when the bronchi and bronchiles are permanently dilated

something gets in there and blocks passages and causes enlargement

- infection, obstruction, CF, immunodeficiencies

- cough, foul-smelling sputum, dyspnea, orthopnea (when laying down)

- get rid of infection oxygen/dilate airways, chest therapy to break up obstruction

Term
_____ is characterized by blood clots blocking the pulmonary vessel. _____ is the cause in 95% of cases.
Definition

Pulmonary Emboli

DVT

Term
Risks of Pulmonary Emboli include:
Definition

Immobility

Cancer

CVD

Hypercoagulable State

indwelling central lines

Term

If a pt has a large PE, _____ die within _____.

Additionally, they will experienc

 

Small PE pt experience: 

Definition

15-18%

3 months


electromechanical dissociation (EKG no rhythm and no perfusion. Feels like an MI)

 

Transient chest pain, dyspnea, fever, cough, hemoptysis

 

 

Term
Virchow's Triad is important characteristic in _____. The triad encompasses:
Definition

Pulmonary Emboli


Venous Stasis: immobility (traveling), obesity, pregnancy, skickle cell

Hypercoagubility: genetic increased; oral contraceptives

Injury to epothelial tissues: anything that damages endothelium

Term

The BEST treatment for Pulmonary Emboli is: _____

 

Methods include:

Definition

PREVENTION


Early amb, elastic stockings, compression hose, anticoagulants, "Umbrella" filter

Term
Pulmonary HTN is defined as: _____. Normally it is about ____-_____ of the SBP; with pulmonary HTN, the BP increases to _____ of the SBP.
Definition

High BP in the lungs


1/8-1/10


1/4 (25mmHg rest, 30 during exercise

Term
Risks for Pulmonary HTN include: (6)
Definition

o   Chronic obstructive or interstitial lung disease

o   Heart disease

o   Recurrent thromboemboli (if clot blocks blood flow, BP up)

o   Connective tissues disease

o   Obstructive sleep apnea

o   Amphetamines, cocaine

Term

Describe the pathophys of Pulmonary HTN

Definition

o   Medial surface of arteries hypertrophy

o   Atheromas form on the pulmonary artery

o   R ventricular hypertrophy because it’s working harder and harder (more resistance)

Term
Clinical Manifestations of Pulmonary HTN include:
Definition

o   Dyspnea

o   Fatigue

o   Chest Pain

o   Respiratory distress

o   Cyanosis

o   R vent hypertrophy

o   Cor Pulmonale: R side heart disease that starts from lung disease

o   Thromboemboli

Term
Digoxin, Prostacyclins, endothelial receptor antagonists, and inhaled nitric oxide may be important treatment in:
Definition
Pulmonary HTN
Term
Treatment of Pulmonary HTN includes:
Definition

o   Oxygen

o   Anticoagulation

o   Lung transplant

§  Can be idiopathic, can be genetic

§  May just need new lungs

o   Diuretics

o   Digoxin

o   Prostacyclins: reduces platelet aggregation and is a vasodilator

o   Endothelial receptor antagonists

§  Dec damage done to endothelium

o   Inhaled nitric oxide

Term

Four types of Obstructive pulmonary diseases include:

 

S/S

Definition

Emphysema (alveolar wall destruction and overinflation)

Chronic bronchitis (inflamation of airways)

Astma (airways are hyperresoponsive)

COPD

 

SOB, wheezing

Term
Hypersensitivity of the airways in conjunction with tightness, spastic contraction of bronchile smooth muscle and edema are characteristic of:
Definition
Asthma
Term
Asthma is characterized by:
Definition
Hypersensitivity of the airways in conjunction with tightness, spastic contraction of bronchile smooth muscle, and edema 
Term

Asthma is the result of:

Definition

o   Antigen-Antibodies

o   Mast Cells

o   Chemical Mediators (genetic factors)

§  Histamines

§  Leukotrienes

§  Eosinophilic chemotactic factor

§  Bradykinin

Term
Differentiate between Atopic and Nonatopic Asthma
Definition

Atopic: allergic asthma

Nonatopic: no specificity; patterns of inflammation (day vs night) with certain triggers (exercise, smoking, occupaitonal, drugs)

Term
Type 1, IgE mediated hypersensitivity reactions that are triggered by specific things is characteristic of _____.
Definition
Atopic Asthma
Term
This is triggered by drugs (NSAIDs), recurrent rhinitis (nasal polyps), and may also be related to your occupation
Definition
Non-atopic asthma
Term
Asthma has _____ phases. Briefly describe them.
Definition

2 Phases: early and late


Early: bronconstriction, mucus, Edema

Late: chemical mediators (lots of them)

Term

In asthama,

the bronchioles collapse during _____;

_____ is reduced;

and the _____ and _____ increase.

Definition

expiration

maxiumum expiratory rate

functional residual capacity and residual volume increase

Term
There is NO genetic component to asthma. T/F?
Definition
FALSE
Term
An emergency situation in which there is uncontrollable bronchoconstriction/spasm leading to hypoxia and acidosis is called _____.
Definition
Satus asthmaticus
Term
Describe some quick relief and some long term managment of asthma.
Definition

Quick Relief:

- beta agonists, corticosteroids (for inflammation), and anticholinergic meds

 

Long term mgmt.

- anti-inflammatories, long-acting bronchodilators, leukotriene (signalling molecules for bronchoconstriction) modifiers/inhibitors

Term
A persistant cough with sputum production; lasting for 3 mo/year for 2 years; Cor pulmonale; and possible cancerous transformations are characteristic of: 
Definition
Chronic Bronchitis
Term

Describe the pathophis of chronic bronchitis:

Definition

·      Irritations from inhalants

o   Smoke

o   Dust

o   Smog

·      Mucosal glands hypertrophy

·      Hypersecretion of mucous

o   Proteases?

o   Matrix metalloproteinases?

o   Goblet cells hypertrophy?

Term
Blue bloaters are people who have _____ and are cyanotic with a productive cough, possible cor pulmonale, and infections
Definition
Chronic Bronchitis
Term
Excess air in the lungs, irreversible enlargement, chronic irritation to lungs (cilia, macrophages, and mucous), and chronic obstruction (alveolar destruction) is characteristic of _____.
Definition
Emphysema
Term
Describe the pathophys of emphysema:
Definition

·      Protease (breaks down protein)/Anti-protease imbalance

·      Deficiency of alpha 1 antitrypsin

o   Normally inhibits proteases; anti-protease

o   Pi locus on chromosome 14

·      Oxidant/antioxidant

·      Smoking increases ROS

·      Loss of elastic recoil

·      Inflammation

Term
When the lungs become over-distended, the pt will experience Dyspnea, a cough, and a wheeze. Other symptoms include weight loss, respiratory acidosis, Right HF, pneumothorax, and possibly a coma. These pts are known as _____ and characterizes _____.
Definition

Pink puffers

 

Emphysema

Term
Describe differences between chronic bronchitis and emphysema:
Definition

 

Chronic Bronchitis

Emphysema

40-45 yoa

50-77 yoa

Mild, late dyspnea

Early, severe dyspnea

Early, copious cough

Late cough

Cor Pulmonale (RHF) common

Cor Pulmonale (RHF) occurs late

Increased airway resistance

Elastic recoil decreased

Heart often enlarged

 

Term
If a person appears confused, has visual impairment and is hyperventilation, they might be experiencing _____.
Definition
Mild Hypoxemia
Term
Severe hypoxemia patients will present with the following symptoms:
Definition

o   Personality change

o   Uncoordinated

o   Impaired judgment

o   Delirium

o   Stupor

o   Death

Term

Cyanoisis is defined when the arterial blood contains _____ of deoxygenated _____ per _____ of blood.

 

It will apear blue primarily in:

Definition

> 5 grams

 

hemoglobin

 

100 ml


Lips, nail beds, ears, cheeks

Term
A hypercapnic pt will experience dyspnea when the Co2 levels reach _____, and may experience lethergy and comatose when it reaches _____, and finally respiratory depression at _____.
Definition
Term
Early symptoms of Hypercapnea include:
Definition

·      Increased cerebral blood flow

o   Headache

o   Increased CSF pressure

o   Papilledema

·      Warm, flushed skin

·      LOC changes r/t increased CSF pressure

Term
Arterial blood gases will be at the following levels when a patient is experiencing hypercapnia (pH, PO2, PCO2, HCO2):
Definition

o   pH = 7.35-7.45

o   PO2 = 80-100

o   PCO2 = 35-45

o   HCO2 = 22-28

Term
Describe treatments for a patient who is experiencing hypercapnia
Definition

·      Treat cause

·      Airway clearance to remove obstruction

·      Bronchodilator

o   Esp if asthma

·      Antibiotics

o   If related to swelling from infection

·      Oxygen supplementation

·      Mechanical ventilation

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