Respiratory Pathology

115 terms by LCCrespiratorys

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Antigen

A substance that prompts the generation of antibodies and can cause an immune response; A substance invading the body that stimulates the production of antibodies.

Asthma Pathophysiologic Responses

Increased Mucus Production; Swollen Bronchial Membranes; Smooth Muscle Contraction

First Symptom of Asthma

Release of Histamine resulting in Smooth Muscle Contraction

Asthma Diagnosis

Chronic Inflammatory Pulmonary Disorder characterized by Reversible Obstruction of the Airways

Four Components of Asthma Care Plan

Peak flow monitoring; Avoidance of Triggers; Education; Maintenance Drugs

Pharmacological Goals for Asthma Control

No Chronic Symptoms; No Exacerbations; No limitations; Near normal Pulmonary Function; Minimal use of B2 Agonists

Bronchiectasis

The destruction and widening of the large airways , Results from a dilation of a bronchus or the bronchi, and can be the result of infection.

Two Types of Bronchiectasis

Congenital & Acquired

Cystic Fibrosis

Hereditary disorder characterized by lung congestion and infection and malabsorption of nutrients by the pancreas

cystic fibrosis trans-membrane conductive regulator (CFTCR)

A defect in this gene is believed to be the cause of CF

bronchiolitis

inflammation of the bronchioles, typically caused by viral (RSV)

Bronchiolitis Signs and Symptoms

generally affects infants; tachypnia and accessory intercostal muscle use;

Asthma

A reversible chronic respiratory disease; often arising from allergies; accompanied by labored breathing, airway constriction and remodeling

Chronic Obstructive Pulmonary Disease

a disease of airflow limitation that is preventable and treatable, however; is not fully reversible

Chronic Bronchitis

Productive cough for three of twelve months of the past 2 years

Hypertrophy of Mucosa Gland (Bronchitis)

Mucosal glands are grossly enlarged; mucousa production increases

Sinusitis

acute or chronic inflammation of the mucous membranes of the paranasal sinuses; mucus production is decreased

laryngotracheobronchitis

inflammation of the upper airways with swelling that creates a funnel shaped- elongation of tissue causing a distinct cough, barking cough; CXR: Hourglass or Steeple

laryngotracheobronchitis AKA

Croup AKA

Croup Treatment and Therapy

Cool moist air; O2 if needed; Racemic Epinephrine via Nebulizer; Consider Corticosteroids

etiology of Epiglottitis

Bacterial (Haemophilus influenza)- the origin of Epiglottitis, Menengitis & other respiratory infections

cor pulmonale

Right sided heart failure; an enlargement of the right ventricle due to pulmonary hypertension, usually caused by chronic lung disease

Fungal Pneumonias

Histoplasmosis, coccidiomycosis, Blastomycosis, aspergillosis

Streptococcus Pneumoniae

Most common pathogenic source of pneumonia

Two clinical signs of Chronic Obstructive Pulmonary Disease

Chronic Bronchitis (inflammation of the bronchi) and Emphysema (the loss of elasticity within the lungs)

neutrophils

circulates in blood; most abundant WBC; first responders to microbial infection; lifespan within blood stream 2 days (few hours after entering infected tissue)

Pneumonia Defined

inflammation of the lung caused by infection from bacteria, viruses, fungi, or parasites; or resulting from aspiration of chemicals; consolidation

Community Acquired Pneumonia

Pneumonia not acquired in a hospital or long term care facility

Bronchoaveolar Lavage (BAL)

A bronchoscope passed through mouth or nose into the lungs, a fluid is squirted into a small part of the lung and then recollected for examination.

Risk groups of pneumonia

Elderly (>65), infants, patients w/ HIV, cancer, diabetes, asthma, COPD, smokers, substance abusers

Pneumonia Management

Antibiotics, Supportive- fluids, rest, monitor BP, Pulmonary- Directed cough, bronchodilators, oxygen

Elements of Smoking

Chemical addiction, Habitual Behavior, Psychological Connection

Types of Smoking Cessation

Counseling, Hypnosis, Motivation, Aversion, Pharmacologic

Smoking Quitting Cycle

Pre-contemplation, Contemplation, Determination, Action, Maintence, Relapse

Legionella

Pneumonia from microbial agent found in systems w/ standing h20, can be cause of HAP

Pneumocystis Carinii

pneumonia associated w/ immunocompromised patients (HIV); treatment- Pentamidine

Histoplasmosis region

Oh. river valley- So. Ohio, Kentucky, Tenn., Missouri, Arkansas

Coccidiomycosis region

"valley fever", San juaqin fever, Around US/Mexican border

Aspergilloma

"Fungal balls" that colonize in lung scars

Aspiration pneumonia location

typically Right Middle Lobe

3 types of aspiration pneumonia

Chemical (gastric contents, external agents); Particulate (food, foreign objects); Bacterial ( oropharyngeal secretions ( w/ VAP))

TB attack location

upper lobes (aerobic bacillus), can reoccur

TB risk groups/ locations

urban dwellers, prisons, military barracks, nursing homes, homeless, where there is alot of immigration (Hispanic, African Americans, Asians)

old name for TB

Consumption AKA

Atypical pneumonias

Legionella, aspiration pneumonia, HAP, pneumocystis carinii (PCP), fungal infections, TB

panlobular emphysema

Emphysema affecting all parts of the lobules; usually associated with a1-antiprotease deficiency

Sarcoidosis scenario

atypical, A 25-year-old black woman presents with nonproductive cough, shortness of breath, fatigue, and malaise; she has bilateral hilar lymphadenopathy on chest radiography and elevated ACE levels. What do you diagnose?

hemoptysis

coughing up blood from the respiratory tract

Etiology of Pneumonia

Bacterial, Viral and Mycoplasma

Egophony

an increased resonance of voice sounds heard when auscultating the lungs(often caused by lung consolidation and fibrosis); "Eeee" & "99"

Hypersensitivity Pneumonitis AKA

Extrinsic Allergic Alveolitis AKA

Silicosis

fibrotic disease of the lungs caused by inhalation, retention, and pulmonary reaction to crystallizing silica

Berylliosis

Occupational lung disease, often associated w/exposure to florescent and aerospace (granulomas)

pneumonoconiosis

chronic inhalation of dust particles (generally metallic or mineral dust) results in the formation of fibrotic tissue surrounding the alveoli, limiting their ability to stretch and restricting the intake of air.

-coniosis

Any of various diseases or pathological conditions caused by dust.

Cardinal Sign of Restrictive Airway Disease

Rapid Shallow Breathing

Sarcoidosis

chronic inflammatory disease of unknown cause in which small nodules or tubercles develop in lungs, lymph nodes, and other organs

Pulmonary fibrosis

formation of fibrous scar tissue in the lungs, which leads to decreased ability to expand lungs, may be caused by infection, pneumoconiosis, autoimmune diseases, and toxin exposure

Idiopathic Pulmonary Fibrosis

scarring and stiffening of lung tissue; unknown etiology

Characteristics of Restrictive Lung Disease

Decrease in Compliance; "Stiff lungs"; restricts inspiritory airflow

Principal Cell Types of Lung Cancer

Non-Small Cell(80% of cases) and Small Cell(oat cell)

Adenocarcinoma

a cancerous tumor in a gland that is capable of producing the hormones secreted by that gland.

Metastasis

the process by which cancer cells are spread by blood or lymph circulation to distant organs

Characteristics of Oat Cell Cancer Cells

Small Cytoplasm, Multiple Nuclei, Multiple and large Nucleoli, Course Chromatin

Risk Factors of Lung Cancer

Tobacco Use (90%), Occupational & Environmental Exposures, Genetic Predisposition,Gender, Dietary Factors, COPD, Air polllution

Cell types of Non-Small Cell Carcinoma

Adenocarcinoma, Squamous Cell Carcinoma, Large Cell Carcinoma

Pancoast's Tumor AKA

Superior Sulcus Tumor AKA

Characteristics of Squamous Cell Lung Cancer

Lung Cancer that is slow growing, starts out as a single tumor, associated with Cigarette Smoke

Characteristics of Adenocarcinoma

Lung Cancer that is associated more with women, Occurs in the periphery(glands), Smaller and more spread out

Characteristics of Small Cell Lung Cancer

Fast growing, more spread out, More severe tumors

Malignant Neoplasm

a tumor that is malignant and tends to spread to other parts of the body

Three most common Occupational Interstitial Lung Diseases

Asbestosis, Silicosis, CWP-Coal Workers Pneumoconiosis

Clinical Signs of Lung Cancer

Dyspnea, Hemoptysis, Hoarseness, Cough, Cachectic Appearance

3 types of Neuromuscular Disease

Traumatic, Progressive/Genetic, Spurious

Types of traumatic Neuromuscular Disease

Spinal chord injury, Closed Head Injury, Drug Overdose, Cerebralvascular Accident

types of Progressive/ Genetic Neuromuscular Diseases

Muscular Dystrophy (Duchenne's the worst), Multiple Sclerosis

Spurious Neuromuscular Diseases

Guillain- Barre Syndrome, Myasthenia Gravis, Amyotrophic Lateral Sclerosis, Poliomyelitis

Myasthenia Gravis

neuromuscular junction disorder, DESCENDING PARALYSIS, use Tonsilon Test

Amyotrophic Lateral Sclerosis

degenerates motor neurons, starts peripherally then central, muscles can't contract

Guillain- Barre Syndrome

peripheral polyneuritis 1-3 wks. after viral fever, ASCENDING PARALYSIS

Muscular Dystrophy

genetically transmitted, atrophy of skeletal muscles w/ normal neural tissue, Duchenne's = the worst form

Multiple Sclerosis

demylination of nerve fibers, progressive disease of unknown etiology

Polio/ Post- Polio Syndrome- Poliomyelitis

caused by a viral infection, flu- like symptoms can lead to paralysis, doesn't happen in U.S.

Blastomycosis AKA

Gilchrist's disease AKA

Blastomycosis defined

Fungal pneumonia which occurs by inhalation of the fungus from its natural soil habitat; Generally South-central, South-Eastern and Mid-Western U.S.

Small Cell AKA

Oat Cell AKA

Etiology of Croup

Viral infestation; parainfluenza

Rhinitis

Inflammation of the mucous membranes of the nose due to viruses, bacteria or irritants

Predominantly Pediatric Upper Airway Obstructions

Laryngotracheobronchitis (Croup), Epiglottitis

Spurious Neuro-muscular diseases

Poliomyelitis, Amyotropic Lateral Sclerosis, Myasthenia Gravis, Guillan Barre Syndrome

Wave represented by Sinoatrial Depolarization

P Wave

Wave represented by Ventricular Depolarization and Atrial Repolarization

QRS Wave

Wave represented by Ventricular Repolarization

T Wave

Myocardial Infarction

Tissue death caused by the occlusion of one or more of the Coronary Arteries

Heart problem associated with COPD

Cor Pulmonale (Right side heart failure which leads to peripheral edema)

Thrombocytes Defined

platelets, fragments of cells that contain enzymes and help in clotting

B lymphocytes Defined

form in the bone marrow and release antibodies that fight bacterial infections

Monocytes Defined

A type of white blood cell that is a phagocyte.

Most likely effect idiopathic pulmonary fibrosis has on the lung

Decreases the Static Compliance within the lung

Eosinophils

White blood cells that are responsible for combating infection of parasites in the body

gastroesophageal reflux disease

quite common with asthma patients; acid from the stomach backs up into the esophagus causing inflammation and pain

Obtunded Defined

hard to arouse, appear confused if awake; need lots of stimulation to stay awake

Cachexia defined

general physical wasting and malnutrition associated with chronic disease

Anaphylactic Shock

an acute allergic response that can result in death

Cardiogenic Shock

a disease state where heart damage prevents sufficient blood flow resulting in shock

Septic Shock

shock that results from general infection in the bloodstream

Hypovolemic Shock

Shock resulting from large scale blood loss

pulmonary edema

abnormal accumulation of fluid in the lungs often caused by congestive heart failure

Pulmonary Embolism

A thrombus blocking the pulmonary artery; you will have ventilation but no prefusion; ventilation/perfusion scan often ordered to assess this condition

Symptoms of Myocardial Infarction

Dyspnea; Anxiety; Severe and Heavy Chest Pain in excess of 30 Mins; Nausea

Atherosclerosis

Clogging, narrowing, and hardening of the body's large arteries and medium-sized blood vessels.

Modality to confirm Myocardial Infarction

Electro Cardio Gram (ECG)

Troponin levels

Test levels remain high for 24-48 Hours following Myocardial Infacrction

Shock Defined

Inadequate flow of blood to the body's peripheral tissues

bullae

large cavities left by the septal degeneration of alveoli; Decreasing surface area effecting oxygenation

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