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BIO483 Modules

Terms in this set (44)

Dyspnea
Difficulty breathing
Stridor/wheeze
Stridor
Upper airway
Inspiration only
High pitched
Wheeze
Lower airway
Inspiration/expiration
Low pitch
Orthopnea
Dyspnea while laying down
Paroxsymal Nocturnal Dyspnea (PND)
Waking up at night with dyspnea
Kussmaul Breathing
Consistent very deep breathing
Increased/normal RR
Large TV
Labored Breathing
Slow RR
Large TV
Prolonged inspiration/expiration
Obstruction
Cheyne-Strokes Breathing
Periodic breathing
Alternate between apnea/tachypnea
Tuberculosis (TB)
Incredibly infectious (airborne droplets)

Causes:
Mycobacterium tuberculosis -> 2-8 weeks
Decreased immune system -> high rate HIV infection
Crowded living quarters, poverty, substance abuse

S/S:
Active -> asymptomatic in early stages, productive cough, caceous necrosis, night sweats, fatigue
Systemic -> affect other organs
Latent -> slow to progress, unnoticed until granulomas

Tests:
TB skin test (bump = +)
CXR, C&S

Tx:
Combo of 4-6 drugs to reduce risk of antibiotic resistance

Gohn Complex - lesions of calcified infection
Pneumonia
At Risk:
People w/ underlying chronic diseases, immunocompromised, nosocomial

Causes:
Infection of respiratory tract

S/S:
High fever, cough, malasie, breathlessness, hemoptysis
Inspiratory crackles, percussion dullness, egophony (EEEE -> AAAA)
Tactile fremitus (vibration while saying "blue moon")
Whispered pectoriloguy (whispered sound amplified)

Tx:
Antibiotics
Nothing for viral
Supplemental O2
Acute Bronchitis
Inflamm of bronchial tree

Causes:
Secondary to viral URI/bacterial infection
Non-infectious

S/S:
Self-limiting
Productive cough, chest pain, wheezing, fever/chills, DIB

Tests:
Clinical
CXR, PFT

Tx:
Antibiotics, antipyretics
Rest, humidity
COPD Diseases
Chronic bronchitis, emphysema, asthma

Risk factors: smoke, occupational exposures, pollution, genetic
Chronic Bronchitis
COPD
Inflamm of bronchi
Hypersecretion of mucus and productive cough >3 months for 2+ years

Causes:
Long term pulmonary disorders, smoking, scarring/lung tissue damage

S/S:
Blue bloaters (hypoxemia, polycythemia)
Right sided HF
Productive cough, SOB, DIB, wheezing

Tests:
PFT, CXR/CT, sputum culture

Tx:
Stop smoking, inhaled bronchodilators, continuous O2
Emphysema
COPD
Alveolar destruction/elastin breakdown

Causes:
Primary -> genetic (a-1 antitrypsin deficiency) inhibits trypsin and elastase
Secondary - smoking directly inhibits a-1 antitrypsin

S/S:
Pink puffers (increased RR)
Cough dyspnea, fatigue, weight loss, clubbing, barrel chest

Tests:
PFT (decreased TV), CXR, ABG

Tx:
Bronchodilators, stop smoking
Pursed lip breathing (increases exhalation)
Clubbing
Megakaryoctye clumps lodge in vascular beds of fingertips
Release platelet-derived growth factor
Asthma
COPD - can be reversible

Causes:
Allergies, URI, exercise, cold air, pollution, GERD, obesity

S/S:
Cough, wheezing, mucus production, SOB
Status asthmatics -> hypoxemia worsens, decreased expiratory flow, acidosis
Silent chest (no audible air movement)
Pulsus paradoxus -> decrease systolic blood pressure >10mm Hg

Tests:
PFT w/ and w/o bronchodilator

Tx:
Bronchodilator (B-2 agonist)
Inhaled steroids
Ventilation
V
Air flow
Normal: 4L/min
Perfusion
Q
Blood flow
Normal: 5L/min
Healthy V/Q
0.8-0.9 L/min
Apex V/Q
3.43 L/min
Base V/Q
0.64 L/min
V/Q < 1
Low ventilation
High perfusion
Shunting: atelectasis, asthma, PE, pneumonia
V/Q > 1
High ventilation
Low perfusion
Alveolar dead space: PE, hypotension
Pulmonary Embolism (PE)
Occlusion of portion of pulmonary vascular bed by embolus
Can cause infarction

Causes:
DVT -> 90% formed leg/pelvis

S/S:
Sudden onset, chest pain, SOB, wheezing, cyanosis, syncope
DVT's often asymptomatic

Tests:
CXR, high resolution multidetector computed tomographic angiography (MDCTA), V/Q scan

Tx:
Continuous circulation/restrict immobilization
Anticoagulants
Streptokinase MOA
Saddle Embolism
Obstructs arterial branches and everything else
Usually instantly fatal
Streptokinase MOA
Activates fibrinolysis with tPA
Silicosis
Restrictive
Stone cutters, sand blasters, manufacturing jobs
Initial accumulation -> small nodules form, can be asymptomatic for up to 20 years
As disease progresses, so do symptoms
Leads to ball of fibrotic tissue -> respiratory failure
Bright white crystals seen on microscopy
Asbestosis
Restrictive
Long, thin asbestos fiber seen in microscopy
Increase risk for mesothelioma
Sarcoidosis
Autoimmune
Development of granulomas
Fibrotic Lung Disorders
Silicosis, asbestosis, sarcoidosis

S/S:
Cough, wheezing, DIB, chest pain, clubbing

Tests:
CXR/CT, PFT, bronchoscopy
Cystic Fibrosis (CF)
Autosomal recessive (chromosome 7)
Thick mucus overproduction due to decreased Cl- secretion
Impaired cilia mobility

S/S:
Meconium ileus in newborns
Persistent cough, wheezing, frequent infections, clubbing, barrel chest
FTT
Frequent loose, oily stools (pancreatic dysfunction)

Tests:
Sweat test -> high Cl- concentration
Genetic testing

Tx:
Mucus clearance (chest PT)
Antibiotics/pancreatic enzymes throughout lifetime
Chloride Transport in CF
1) Channel does not open
2) Channel floating within cell, not in membrane

Cl- stuck inside cell, Na+/H2O follows -> dehydrated mucus

Cl- stay in sweat gland, Na+ follows
Bronchiectasis
Persistent abnormal dilation of bronchi
Usually secondary condition

Causes:
Acute/chronic infection
CF, TB

S/S:
Foul-smelling chronic productive cough
DIB, fatigue, clubbing, cyanosis

Tests:
CXR/CT, sputum culture, CBC, sweat test, TB test
Atelectasis
Adhesive, compressive, obstructive

S/S:
DIB, chest pain, cough

Tests:
CXR/CT

Tx:
Remove obstruction
Chest physio
Incentive spirometry
Adhesive Atelectasis
Usually in premies
Failure to produce surfactant
Requires replacement therapy
Compressive Atelectasis
External pressure on lungs forces air out
Tumor, enlarged heart, elevated diaphragm
Obstructive Atelectasis
Foreign object that prevents air from escaping
Bronchiolitis
Inflam of bronchioles (2-12 months)

Causes:
Respiratory syncitial virus (RSV) - kids
Post lung transplant -> bronchiolitis obliterans -> permanent scarring causes occlusion
Croup
Inflam/swelling around vocal cords (6 months-5 years)

Causes:
Laryngotracheobronchitis -> parainfluenza virus

S/S:
Barking cough, stridor
Epiglotitis
Inflam of epiglottis (2-7 years)

S/S:
Drooling, hunched forward to breathe, fever, stridor
Medical emergency
Pulmonary Hypertension (HTN)
S/S:
SOB during exertion, chest pain, fatigue, edema
Cor Pulmonale

Test:
CXR/CT, EKG, PFT
Causes of Pulmonary HTN
Increased pulmonary flow
Pulmonary venous congestion
Mechanical arterial occlusion
Alveolar hypoxia causing pulmonary vasoconstriction
Destruction of capillary bed
Idiopathic
Acute Respiratory Distress Syndrome (ARDS)
Acute lung inflam/diffuse alveolocapillary injury

Causes:
Pneumonia, shock, aspiration, trauma -> increased alveoli fluids -> crackles

S/S:
Tachypnea, hypotension SOB, arrhythmias, ALOC -> repsiratory failure -> MODS
V/Q mismatch

Tests:
ABG, CBC, CXR/CT, sputum cultures

Endothelial damage -> neutrophil/macrophage acitvity

Epithelial damage -> decreased surfactant
Valley Fever
Causes:
Coccidioides immitis - fungal infection by inhaling arthrospores in dust in SW
Steptococcal
Primary TB infection
EBV

S/S:
Flu-like, fever, chest pain, cough, night sweats, SOB, erythema nodosum (painful nodules in lower legs)

Tests:
2 small spherules of Coccidioides immitis seen in giant cell (fusion of macrophages)
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