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Respiratory Pathology

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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