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38 Cards in this Set

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What lab values do you expect to find with obstructive lung dz?
decreased FEV1, forced expiratory rate, it's low because patient can't get the air out

Increased TLC, lung is hyperinflated
What is the treatment for obstructive lung dz?
beta agonists (bronchodialators, albuterol), +/- anticholinergics (ipratropium), +/- oxygen
What are the two types of obstructive lung dzs?
COPD (irreversible), asthma (reversible)
What are the three types of COPD?
pulmonary emphysema, chronic bronchitis, bronchiectasis
What are the S/S of pulmonary emphysema?
"pink puffer" pursed-lip breathing, barrel chest, dyspnea, decreased or absent breath sounds, hyperinflated lungs, depressed diaphragm (CXR)
What are the S/S chronic bronchitis?
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"
What is bronchiectasis?
like an aneurysm in the llung, irreversible, focal bronchial dialation, usually w/ infection,

w/ hemoptysis
What diseases do you associate wtih bronchiectasis?
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)
What are Charcot-Leyden crystals and Cruschmann spirals indicative of?
Asthma, eosinophils
What drugs induce asthma?
sulfties, beta blockers, NSAIDS
What lab findings do you find with restrictive lung disease?
decreased total lung capacity (normal or reduced FEV1)
What is the dz? S/S: non-caseating granulomas, dyspnea, cough, night sweats, bilateral hilar adenopathy on CXR, black population
Sarcoidosis
What is ARDs and causes?
diffuse injury to the endothelium of the lung. Caused by sepsis, chest trauma, massive blood transfusion, aspiration of gastric contents, heroine use, diffuse pneumonia
What are the phases of ARDs?
plasma and blood leak into interstitial and interalveolar spaces-->alveolar flooding and atlectasis-->collagen accumulates-->SEVERE fibrosis
What is a key sign of neonate ARDs?
premature baby <34 weeks, Lecithin: sphyingmyelin (high because line the lungs) ratio <2.0
What is the pathology of penuoconiosis?
macrophages try to phagocytose substance-->release ROS-->enzymes and immune mediators-->macrophage dies-->fibrosis occurs-->scarring
What pneumoconiosis show up in the lower part of the lungs?
asbestos & berylliosis
What pneumonconiosis show up in the upper part of the lung?
anthracosis (coal worker's lung) and silicosis
What are the S/S of anthracosis?
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
Why is silicosis bad?
raises your suseptibility to TB, affects upper part of the lung lobes
What causes hypersensitivity pneumonitis?
inhaling allergens that cause inflammation and fibrosis
Ex: farmer's lung, bird fancier's lung, tobacco works, bagassosis
What is the effect of Goodpasture's syndrome in the lung?
autoimmune dz against pulmonary basement membrane-->fibrosis-->pulmonary hemorrage (lung vessels effected)
What is honeycomb lung?
indicative of diffuse idiopathic fibrosis, or hamman rich syndrome or interstitial pneumonia
What is pneumonia?
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
What is the #1 cause of pneumonia?
strep pneumoniae
What lung sounds will you hear with pneumonia?
rales or rhonchi
What is atypical pneumonia caused by?
viruses or mycoplasma pneumoniae (eaton agent)
**tends to be lower lobe, patchy and bilateral
What is the cause and triad of walking pneumonia?
mycoplasma pneumoniae...malaise, sore throat, dry cough
What is indicative of pneumonia + diarrhea?
legionnaires
other S/S: bradycardia, productive cough, mucupurulent sputum
What are the causes of aspiration pneumonia?
1. gastric acid (post drunk)
2. anaerobic bacteria-- peptostreptococccus, bacteriodes, fusobacterium
3. mechanical obstruction
What do carcinoid tumors secrete?
serotonin and histamine producing. Dx by the secretion of 5'-HIAA (sporadically over 24 hr urine sample)
What are the S/S of carcinoid?
flushing, diarrhea, bronchospasm, right heart valve lesions (increased tension in pulm vasculature), hypotension
What are the 4 types of carcinoma (malignant cancer of epithelium origin) in the lung?
adenocarcinoma, squamous cell carcinoma, large cell carcinoma, small cell carcinoma (oat cell carcinoma)
What hormone will sqaumous cell carcinoma secrete?
PTH like peptide-->hypercalcemia
What hormones will small cell carcinoma secrete?
ADH (edema), ACTH (cushings)
What autoimmune disease does small cell carcinoma cause?
Eaton Lamber Syndrome, antibodies to Ca++ channels (muscle weakness)
What are the pathogens that cause lobar pneumonia?
streptococcus pneumoniae and klebseilla
What causes fluffy lobar pneumonia?
Legionnaires