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84 Cards in this Set

  • Front
  • Back
List 7 respiratory infections.
1. Common cold

2. Sinusitis

3. Influenza

4. Pneumonias

5. Tuberculosis

6. Fungal Infections

List the conducting airways?
1. Nasal passages

2. mouth

3. pharynx

4. larynx

5. trachea

6. bronchi

7. bronchioles

8. protective anatomy = cilia, mucociliary blanket, glottis/laryngeal muscles (can close up)
What is a lobule?
The smallest functional unit of the lung.

Terminal respiratory bronchioles, alveolar sacs, alveolar ducts.

Protective anatomy = lymphatic system, macrophages.
What is the pleura?
Lines the thoracic cavity and encases lungs.

Serous fluid separates pleural layers.

Potential are for inflammation. (Pleural effusion)
What is the common cold essentially?
VIRAL infection of UPPER respiratory tract (not the lower/alveoli)
What are the modes of transmission for the common cold?
1. Person to Person

2. Virus also exist on fomites (inanimate objects)
How is the common cold spread from person to person?
Shed primarily from nasal mucosa.

Shed at incubation period and start of sx.
How is the common cold spread from fomites?
Virus exists on fomites.

Contact from fomite to hands and fingers.

Hands/fingers then may have contact with eyes and nasal mucosa.
How long can the cold virus survive on a fomite?
5 or more hours.
What is a bigger factor in the spread of the common colds; fomite contact or sneezing?
How many viruses are responsible for the common cold? Why is this relevant?
Over 200 viruses responsible. This is why despite immunity we get them again and again.
Do people usually display a fever when they have a common cold?
No, they typically have no fever. Fever is associated more with a flu or very severe cold.
What is the incubation period for the common cold?
2-5 days
When is someone with a common cold the most contagious? By when are they not contagious at all?
Most contagious in the first 2-3 days.

Not contagious at all by days 7-10.
The S&S of the common cold develop over ? days and last up to ? days.
The S&S of the common cold develop over 2-3 days and last up to 10 days.
The common cold is self limiting. What does this mean?
It alleviates on it's own.
Common cold infection tends to be what? List 3 examples.

1. Rhinovirus (this is the key player for people between the age of 5-40yo)

2. Respiratory Syncytial Virus (RSV)

3. Parainfluenza virus
When is the rhinovirus infection typically seen?
In the early fall or late spring.
How many types of rhinovirus exist?
Over 100
What two viruses associated with the common cold are typically seen more in children?
Respiratory Syncytial Virus

Parainfluenza Virus
When is the RSV infection typically observed?
Winter and Spring.
When is the parainfluenza virus typically seen?
Fall and late spring.
What is the diagnosis and tx for the common cold?
Based upon S&S (can only really tx sx)

OTC cold remedies


NOT antibiotics

Chicken Soup (Vapors, fluids)
What is the best way to prevent the common cold?
Hand washing
Normally the sinuses are a ? environment.
What is sinusitis?
Inflammation of paranasal sinuses.
What essentially are sinuses? List the paranasal sinuses.
Essentially air pockets located in the bones of the skull.

1. Frontal
2. Ethmoid
3. Sphenoid
4. Maxillary
How many people are effected by sinusitis in the U.S. each year?
30 million adults and children in the U.S. each year.
Sinusitis may be in what 3 categories?
Inflammation results in blocked sinuses and infection.
May be:

1. Acute

2. Subacute

3. Chronic
How long does acute sinusitis last?
2-3 weeks
How long does subacute sinusitis last?
Lasting 3 weeks to 3 months.
What does subacute sinusitis cause?
Reversible changes to epithelium.
How long does chronic sinusitis last?
Lasting >3 months.
What does chronic sinusitis cause?
Irreversible change of mucosa.
Infections in people with sinusitis is caused by what?
Infection from:

1. Bacteria

2. Viruses

3. Fungi
Normally what does the sinus mucosa do? What happens when there is an obstruction?
Sinus mucosa cilia moves mucous and debris into nasal cavity.

Obstruction of sinuses due to inflammation impairs mucous mvmt and leads to infection.
What facilitates microbe growth in the sinuses?
Low O2 content.
What are the causes of sinusitis?
Anything that causes obstruction: like polyps, NG tubes, Asthma, and foriegn bodies.

Anything that impairs ciliary functions: like smoking, GERD, Air pollution, bulimia, cystic fibrosis, excess mucosa

Anything that results in xs mucous production: like bronchitis, rhinitis, cold, upper respiratory tract infection

Weakened immune system: from HIV, chemotherapy, etc.
What are the ACUTE S&S of sinusitis?
1. Common cold-like

2. Facial pain, pressure

3. Purulent nasal discharge; decreased smell
What are the CHRONIC S&S of sinusitis?
1. Postnasal drip

2. Loss of smell, bad breath (from organisms)

3. Headache
What are some complications associated with sinusitis?
Intracranial abscesses, meningitis, orbital movement

(these are esp. associated with chronic sinusitis)
How is sinusitis diagnosed?
Symptom history and physical exam (including nose and throat)

Nasal endoscopy: indicated in persons who don't respond to therapy as expected.
List 4 txs for sinusitis.
1. Anti-microbial

2. Decongestants (help drain)

3. Corticosteroids to reduce inflammation

4. Surgery to correct obstruction, if any.
Essentially what is the flu?
VIRAL infection of UPPER and LOWER respiratory tract.

(remember a cold is just the upper)
Rates of flu infection are highest in who?
Highest in children.
What happens about every 30 yrs with influenza?
We see pandemic flus -> around the globe -> tons infected, tons die...many pandemics first seen in SE asia.
What virus family isa assoc with the flu?
Orthomyxoviridae family (SS RNA virus)
What are the 3 broad types of virus?
Types A, B, and C.
What types of flu virus cause epidemics?
Only A and B cause epidemics.

C causes mild respiratory illness...not epidemics
How is type A flu classified?
By surface Ags (proteins).

H = hemagglutin

N = neuraminidase

Each has antigen subtypes (15 for H, 9 for N)
What is antigenic DRIFT?
H and N surface Ags vary SLIGHTLY yearly, causing new infection. So you can get infected every year. This is just part of the way that the virus replicates itself.
What is antigenic SHIFT?
ABRUPT, MAJOR change in H and/or N Ag, resulting in new protein that is completely unrecognized by immune system.

This causes a PANDEMIC.
Antigenic shift and drift occur more with type ?.
With type A
Generally what 3 strains cause flu yearly?
Two type A and one B.

Vaccine determined by worldwide surveillance to determine likely strains causing disease.
What are some of the risk factors for the flu?
1. Elderly : > 65 yo

2. Chronic illness (COPD, CHF, diabetes mellitus, renal failure)

3. Immunosuppression (HIV, CA, transplant)

4. Close contact (nursing homes, health care workers)
What is the incubation period for the flu?
1-4 days.
When is a person with the flu infectious?
Infectious 1 day before sx onset (so don't even know yet), remain infectious for ~5 days after onset.
What are the sx in the early stages of the flu?
ABRUPT ONSET of FEVER (unlike cold) and chills, malaise, muscle aches, headache, profuse watery discharge, nonproductive cough, sore throat.
What are the 3 types of infection associated with the flu?
1. Uncomplicated rhinotracheitis

2. Viral pneumonia

3. Respiratory viral infection complicated by bacterial infection
What is uncomplicated rhinotracheitis?
This is what most people assoc with the flu.

Upper resp. tract infection and inflammation.

Necrosis and shedding of ciliated and serous mucous cells.
What are the sx of uncomplicated rhinotracheitis?
Abrupt fever, chills, body aches, watery discharge, sore throat, dry cough.
When does uncomplicated rhinotracheitis peak? When does it resolve?
In 3-5 days...resolves by 7 to 10 days.
List 4 complications associated with the flu.
1. Sinusitis

2. Otitis media (ear inflammation)

3. Bronchitis

4. Bacterial pneumonia
Describe viral infection complicated bacterial infection? What are the sx?
Associated with sinusitis, otitis media, bronchitis, and pneumonia.

Sx: Same as uncomplicated plus chest pain, purulent sputum, hypoxemia (low O2 in blood), dyspnea
What are the complications associated with viral infection complicated by bacterial infection?
Confusion and death
Describe viral pneumonia?
Small droplets bypass upper lung causing rapid infection in lower lung.

Immune system slow to mobilize.

Sx: fever, malaise, hypoxemia, resp. failure, death.
How is the flu diagnosed?
Sx and Ag detection test.
How is the flu prevented?
Vaccines (for people most at risk...colds, immunosuppressed)
How is the flu treated?
1. Limit infection to upper resp. tract (best scenario, best outcome)

2. Supportive: fluids, nutrition, rest, keep warm

3. Antiviral agents

4. Tx bacterial infection, if necessary (so if complicated)
What is pneumonia?
inflammation of the lung parenchyma. (alveoli and bronchioles)
What is the etiology for pneumonias?
Infectious and Non-infectious agents.

(bacteria, viruses, fungi)
(fumes, aspiration)
Describe the pathogenesis of pneumonia?
Organism enters lower airways, evades host defenses, causes infection.
(virulent organism, large inoculum, impaired defenses, combo of these factors)
What are the routes of entry for pneumonia?
1. Inhalation from ambien air

2. Aspiration from upper airway

3. Direct spread from contigous sites

4. Spread from blood
What are the normal host defenses against pneumonias?
1. Nasopharyngeal

2. Glottic and cough reflexes

3. Mucociliary blanket

4. Pulmonary macrophages

(so bacteria has to get around these)
What is 'typical' pneumonia?
Bacterial pneumonia.
Describe bacterial (typical) pneumonia?
Multiply extracellularly in alveoli.

Cause inflammation and accumulation of fluid/debris in alveoli.

Sx= chills, fever, malaise, purulent sputum, elevated WBCs
What is 'atypical' pneumonia?
Viral or mycoplasmal pneumonia.
Describe viral or mycoplasmal (atypical) pneumonia?
Patchy inflammatory changes confined to alveolar septum and interstitium of lung

Less striking sx than typical
Pneumococci is common for causing what?
Bacterial pneumonia
In what two ways can pneumonia be acquired?
1. Community-acquired

2. Hospital-acquired (nosocomial)
Describe community acquired pneumonia?
Infections from organisms found in community.

Begins outside hospital or w/in 48 hours after admission.
Describe hospital acquired (nosocomial) pneumonia?
Infections from organisms found in hospital or nursing home.

Infection was not present or incubating on admission.
How is community-aqd pneumonia diagnosed?
Chest X-rays, WBC elevation, sputum culture (to figure out what is causing infection)
Hospital aqd pneumonia infections occur when?
Occurs > 48 hours post-admission.