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38 Cards in this Set
- Front
- Back
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What lab values do you expect to find with obstructive lung dz?
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decreased FEV1, forced expiratory rate, it's low because patient can't get the air out
Increased TLC, lung is hyperinflated |
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What is the treatment for obstructive lung dz?
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beta agonists (bronchodialators, albuterol), +/- anticholinergics (ipratropium), +/- oxygen
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What are the two types of obstructive lung dzs?
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COPD (irreversible), asthma (reversible)
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What are the three types of COPD?
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pulmonary emphysema, chronic bronchitis, bronchiectasis
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What are the S/S of pulmonary emphysema?
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"pink puffer" pursed-lip breathing, barrel chest, dyspnea, decreased or absent breath sounds, hyperinflated lungs, depressed diaphragm (CXR)
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What are the S/S chronic bronchitis?
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prolonged exposure to non-specific bronchial irritants
at least 3 months for 2 yrs "blue bloater" hypoxemic right heart failure-->edema wet, productive cough and dypnea "rhonchi in the bronchi" |
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What is bronchiectasis?
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like an aneurysm in the llung, irreversible, focal bronchial dialation, usually w/ infection,
w/ hemoptysis |
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What diseases do you associate wtih bronchiectasis?
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diseases with recurrent bronchial infections
1. Kartagener Syndrome (dz of cilia)--+ situs inversus (cilia determines side of organ in embryology) + male sterlity + hearing deficits 2. Cystic Fibrosis + malabsorption (pancreas isnt secreting), gallstones (stasis) |
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What are Charcot-Leyden crystals and Cruschmann spirals indicative of?
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Asthma, eosinophils
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What drugs induce asthma?
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sulfties, beta blockers, NSAIDS
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What lab findings do you find with restrictive lung disease?
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decreased total lung capacity (normal or reduced FEV1)
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What is the dz? S/S: non-caseating granulomas, dyspnea, cough, night sweats, bilateral hilar adenopathy on CXR, black population
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Sarcoidosis
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What is ARDs and causes?
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diffuse injury to the endothelium of the lung. Caused by sepsis, chest trauma, massive blood transfusion, aspiration of gastric contents, heroine use, diffuse pneumonia
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What are the phases of ARDs?
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plasma and blood leak into interstitial and interalveolar spaces-->alveolar flooding and atlectasis-->collagen accumulates-->SEVERE fibrosis
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What is a key sign of neonate ARDs?
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premature baby <34 weeks, Lecithin: sphyingmyelin (high because line the lungs) ratio <2.0
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What is the pathology of penuoconiosis?
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macrophages try to phagocytose substance-->release ROS-->enzymes and immune mediators-->macrophage dies-->fibrosis occurs-->scarring
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What pneumoconiosis show up in the lower part of the lungs?
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asbestos & berylliosis
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What pneumonconiosis show up in the upper part of the lung?
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anthracosis (coal worker's lung) and silicosis
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What are the S/S of anthracosis?
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chronic inhalation of coal dust, Black Lung Dz, bronchiectasis, pulmonary hypertension, severe restrictive lung dz, right heart failure, respiratory failure, affects upper part of the lung
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Why is silicosis bad?
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raises your suseptibility to TB, affects upper part of the lung lobes
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What causes hypersensitivity pneumonitis?
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inhaling allergens that cause inflammation and fibrosis
Ex: farmer's lung, bird fancier's lung, tobacco works, bagassosis |
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What is the effect of Goodpasture's syndrome in the lung?
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autoimmune dz against pulmonary basement membrane-->fibrosis-->pulmonary hemorrage (lung vessels effected)
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What is honeycomb lung?
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indicative of diffuse idiopathic fibrosis, or hamman rich syndrome or interstitial pneumonia
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What is pneumonia?
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infection of lung perhenchyma, alveolar spaces and interstitial tissues
S/S--depends on the type Risk factors: alcoholism, institutionalism, smoking, COPD, immune compromise, extremes of age |
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What is the #1 cause of pneumonia?
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strep pneumoniae
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What lung sounds will you hear with pneumonia?
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rales or rhonchi
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What is atypical pneumonia caused by?
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viruses or mycoplasma pneumoniae (eaton agent)
**tends to be lower lobe, patchy and bilateral |
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What is the cause and triad of walking pneumonia?
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mycoplasma pneumoniae...malaise, sore throat, dry cough
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What is indicative of pneumonia + diarrhea?
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legionnaires
other S/S: bradycardia, productive cough, mucupurulent sputum |
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What are the causes of aspiration pneumonia?
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1. gastric acid (post drunk)
2. anaerobic bacteria-- peptostreptococccus, bacteriodes, fusobacterium 3. mechanical obstruction |
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What do carcinoid tumors secrete?
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serotonin and histamine producing. Dx by the secretion of 5'-HIAA (sporadically over 24 hr urine sample)
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What are the S/S of carcinoid?
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flushing, diarrhea, bronchospasm, right heart valve lesions (increased tension in pulm vasculature), hypotension
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What are the 4 types of carcinoma (malignant cancer of epithelium origin) in the lung?
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adenocarcinoma, squamous cell carcinoma, large cell carcinoma, small cell carcinoma (oat cell carcinoma)
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What hormone will sqaumous cell carcinoma secrete?
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PTH like peptide-->hypercalcemia
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What hormones will small cell carcinoma secrete?
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ADH (edema), ACTH (cushings)
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What autoimmune disease does small cell carcinoma cause?
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Eaton Lamber Syndrome, antibodies to Ca++ channels (muscle weakness)
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What are the pathogens that cause lobar pneumonia?
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streptococcus pneumoniae and klebseilla
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What causes fluffy lobar pneumonia?
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Legionnaires
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