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45 Cards in this Set
- Front
- Back
Asthma
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Chronic inflammatory disorder of the airways. Airways narrow and restricts air flow in and out of the lungs.
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Two airway problems associated with Asthma
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Inflammation and Bronchospasms.
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Asthma Pathogenisis
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Exposure to allergen --> Type 1 IgE Mediated Hypersensitivity Reaction
--> Mast cells release histamine, interleukins, leukotrienes and prostaglandins --> Activates Immune cells: eosinphils, macrophages, T-lymphocytes --> Results in airway inflammation & bronchospasm |
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Early Phase Response in Asthma
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Immediate bronchoconstriction upon exposure. •Mediators released from mast cells
•Sx develop in 10-20 min •Subside 1-2 hours |
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Late Phase Response in Asthma
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•Develops 4-8 hours after exposure to asthma trigger
•Involves inflammation & increased hyper-responsiveness •Prolongs asthma attack •Lasts for several days to weeks |
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COPD
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Chronic airflow obstruction. includes: Emphysema, Chronic Bronchitis, Unremitting Asthma
•As COPD progresses, pts often have some degree of both emphysema and chronic bronchitis 4th leading cause of death F>M |
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Emphysema
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• Enlargement of airways distal to terminal bronchiole
•Destruction of alveolar walls/septum •Destruction of capillary bed •Collapse of bronchioles during expiration •Loss of lung elasticity |
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S/S Emphysema
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•“Pink Puffer” = cyanosis absent even late in disease; compensate by ↑ RR
•Barrel Chest 1:1 Chronically elevated PC02 level |
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Chronic Bronchitis
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•Airway obstruction caused by airway inflammation
•Excess mucus produced = Hypertrophy & hyperplasia of mucus secreting glands •Loss of ciliary function |
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S/S Bronchitis
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Cyanosis
•Barrel Chest 1:1 •↑ Sputum = Lots of sputum produced •Pursed Lip Breathing, •ABG’s ↓ PO2 ↑ PCO2 Respiratory Acidosis •Increased hemoglobin |
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Complications of COPD
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Cor Pulmonale (causes vasoconstriction of pulmonary capillary bed), Respiratory Failure, Lung Cancer
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Pneumonia
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•Inflammation/Infection of lower respiratory tract
•Pathogens: Bacteria, Viruses, Protozoa, Fungi •Alveoli & bronchioles fill with pus + other liquids •Consolidates = solidifies 6th cause of death, Leading infectious cause of death in US |
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How pathogens gain access to the lungs
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Inhale Pathogen
Aspirate Pathogen from Naso/Oropharynx or GI, Hematogenous Spread |
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Community Acquired Pneumonia
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Streptococcus Pneumonia (Typical bacteria), Mycoplasma Pneumonia (Atypical), Legionella Pneumonia (Atypical), and virus
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Hospital Acquired
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•Infection acquired in the hospital
•Occurs > 48 hours after admission to hospital •Pathogens: Pseudomonas Aeruginosa |
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Strep Pneumonia
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•Pneumococcal Pneumonia *most common cause of bacterila pneumonia
•Accounts for 50-75% of cases •Often follows URI |
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Legionella Pneumophilia
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named after American legion convention. Rare in healthy people.
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S/S Legionella Pneomophilia
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•CNS: HA, Confusion
•GI: N, V, D •Hyponatremia |
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Mycoplasm
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•Atypical pathogen
•Characteristics of both virus and bacteria, does not produce consolidation transmitted by close contact. >5, <35 |
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S/s Mycoplasm Pneumonia
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•Mild “Walking” Pneumonia
•Dry Hacking Cough •Cough may persist > 6 weeks •Scant mucoid sputum |
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Tuberculosis
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•Infectious Disease caused by Mycobacterium tuberculosis
•Slow growing •Resistant to destruction |
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TB Transmission
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Airborne infection spread by droplet nuclei. • Upper airway prevents most inhaled organisms from reaching lungs 10% develop active disease. more easily transmitted in a close/confined space or repeated exposure
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Primary TB
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initial infection that results from inhaling droplet nuclei. Person infected w/ tuvercle bacilli but pathogen is dormant/walled off
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Secondary TB
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Reactivation of previously healed lesion; Active TB
•90% of cases result from reactivation of a previously healed lesionb |
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Ghon Focus
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Single, white/gray circumscribed lesion
Contains tubercle bacilli, macrophages and other immune cells |
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caseous necrosis
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soft, yellow, cheesy mass formed when T-Lymphocytes attack Ghon Focus
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S/s of Primary TB
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•Positive PPD
•Negative Sputum Culture •Negative Chest x-ray •No symptoms •Not contagious |
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S/s Secondary TB
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•Positive PPD
•Positive Sputum Culture •Positive Chest -ray •Are contagious |
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PPD
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•Purified Protein Derivative
•Used to screen for TB •Measures delayed hypersensitivity reaction(Type IV) • Does NOT differentiate between primary infection & active disease |
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PPD Interpretation
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0-4mm Negative, 5-9mm positive for high risk groups, >15mm positive for people with no risk factors
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Lung Cancer
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•Malignant neoplasm marked by the uncontrolled growth of cells
poor prognosis avg. 5 yr. survival rate. |
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Risk factors of lung cancer
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1. Smoking: Responsible for > 85% of cases
2. Second Hand Smoke, 3. Radon: 2nd leading cause of lung cancer, 4. occupation Exposure: commonly Asbestos Asbestos exposure plus smoking is 50- |
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Bronchogenic carcinoma
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•Constitutes 90-95% of all lung cancer
•Originates in epithelial lining of major bronchi •Subdivided into four major categories Small Cell Carcinoma Squamous cell Carcinoma Adenocarcinoma Large Cell Carcinoma |
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Small Cell Carcinoma
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•Represents 20-25% of cases
•Referred to “oat cell” carcinoma because cells look like oats under microscope •Strongly associated with smoking •Rapid onset, very aggressive, highly malignant •Associated with secretion of hormones: ACTH, ADH, PTH •Avg survival after dx = 9-10 months |
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Squamous Cell Carcinoma
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•Accounts for 25-40% of cases
•Found mostly in men •Correlates closely with smoking •Originates in central bronchi as an intraluminal growth |
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Adenocarcinoma
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•Accounts for 20-40% of cases
•Most common type found in women who are non-smokers |
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Large Cell Carcinoma
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•Accounts for 10-15% of cases
•Highly anaplastic (undifferentiated) •Poorly differentiated; poor prognosis |
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Peumothorax
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•Accumulation of air in pleural space
•Air causes build up of positive pressure •Produces either a partial or complete collapse of the affected lung •Normally pleural space contains NO air |
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Spontaneous Pneumothorax - primary
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•Caused by rupture of air-filled bleb (blister)
•Usually found on top of lung •Occurs in healthy young males who are tall |
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Spontaneous Pneumothorax - seondary
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•More serious than primary
•Usually occurs 2nd to an underlying lung disease •Emphysema, Asthma, TB, Lung Ca., Cystic Fibrosis |
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Traumatic Pneumo -
Open Pneumo |
• Penetrating type injury --> gunshot wound or stab wound
•Air leaks into pleural space from opening on chest wall (outside) |
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Traumatic Pneumo -
Closed Pneumo |
•Non-Penetrating Injury ==> fx rib penetrates visceral pleura
•Air leaks into pleural space from opening within the lung |
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S/S traumatic Pneumo
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•↓ Chest expansion on affected side
•↑ RR •SOB/Dyspnea |
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Tension Pneumo
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•Occurs in either spontaneous or traumatic pneumo
•Injury acts like one-way valve •Permits air to enter on inspiration & closes on expiration •Pressure builds up •Affected lung collapses •Unaffected lung gets compressed (compression atelectasis) •Mediastinal structures shift towards unaffected side |
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Pulmonary Embolism
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•Embolism travels from venous circulation to right side of heart
•Right heart pump blood clot into pulmonary circulation •Obstructs blood flow to lungs •Decreased oxygenation of blood ==> Hypoxemia almost all arise from DVT |