Chapter 22: respiratory tract infections, neoplasms, and childhood disorders Flashcards by matthew tarzwell

What are the three components of respiration

1) ventilation
2) perfusion
3) diffusion

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What are the two types of shunts?

1) anatomical: blood bypasses lungs

2) physiological: mismatch of ventilation and perfusion resulting in in adequate supply of O2

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What is the percentage of water and solutes in snot?

95 percent water

5 percent solutes
- proteins, salts, immune cells

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How much snot is produced day?

1-2 L

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What are the five most common respiratory infections?

common cold
rhinosinusitis
influence
pneumonia
TB

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List five viruses, the season they are prevalent in for the common cold

1) RHINOVIRUS: early fall, late spring
2) SYNCYTIAL VIRUS: winter spring
3) CORONAVIRUS: winter spring
4) ADENOVIRUS: winter spring
5) PARAINFLUENZA

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What part of the respiratory infection does the common cold affect? What is the one exception?

the upper resp tract

PARAINFLUENZA infects lower then upper

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What 2 common cold viruses affect children under 3?

SYNCYTIAL virus

PARAINFLUENZA

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What common cold virus affects people ages 5-50

RHINOVIRUS

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What are the risk factors for the common cold?

age
previous exposure
season

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What are the two ways the common cold can be transmitted?

aerosolization (less dangerous)

fomite transference
- contaminated obj

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How is incubation of the common cold?

5-7 days

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When is the common cold transmittable?

0-3 days after symptom onset

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What are the portals of entry for the common cold?

nasal mucosa

conjunctiva (most common)

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Describe the manifestations of the common cold

sore/scratchy throat

Nasal congestion or runny rhinorrhea

sneezing/coughing

malaise, fatigue, h/a, myalgia

fever in children, less common in adults

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What type of treatment approach is used for the common cold?

symptomatic

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What are the six risk factors for rhinosinusitis/sinusitis?

ALL OBSTRUCT DRAINAGE

1) upper resp tract infections
2) allergic rhinitis
3) nasal polyps
4) pressure changes
5) decongestant misuse
6) swimming and diving

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What are the three types of rhinosinusitis/sinusitis?

ACUTE:
viral
bacterial (less common, inc duration)
fungal (rare)

SUBACUTE (4-12 wks)

CHRONIC (>12 wks)

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What are the three common organisms (2 viruses, one bacteria) that cause acute rhinosinusitis/sinusitis?

rhinovirus

haemophilus influenza

streptococcus pneumonia

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What is the common cause of chronic rhinosinusitis/sinusitis?

fstaphylococcus aureus

allergens

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Describe the manifestations of rhinosinusitis/sinusitis

similar to cold/allergic rhinitis

1) maxilla pain/pressure inc on bending
2) h/a, PURULENT nasal discharge, FEVER, dec smell
3) PAIN IN TEETH

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list the 4 ways that rhinosinusitis/sinusitis is treated

1) abx if necessary
2) intranasal corticosteroids
3) topic alpha-adrenergic decongestants
4) surgery for chronic

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After AIDS, what is the last uncontrolled pandemic killer of humans?

Influenza

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What age group is influenza infection highest in?

Children

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What age group is mortality for influenza greatest in?

elderly

What are the two types of influenza that can cause epidemics?

Influenza A and B

What is the more mild form of influenza

influenza C

Explain what the antigen drift is in relation to influenza

RNA segments alter during replication creating new subtypes make it difficult to vaccinate

How is influenza spread?

inhalation of droplets

Describe the incubation period and contagious period for influenza

INCUBATION: 1-4 days CONTAGIOUS: 24 hrs prior and days after symptom onset

List the symptoms of influenza in order of pathogenesis.

1) rapid onset of upper resp infection 2) epithelial dmg is possible resulting in rhinorrhea 3) malaise 4) fever, chills 5) myalgia, h/a, cough, sore throat

List six complications of the flu

``` SINUSITIS OTITIS MEDIA BRONCHITIS BACTERIAL PNEUMONIA VIRAL PNEUMONIA REYE SYNDROME ```

What is reye syndrome?

rare but often fatal condition of... encephalitis and liver swelling

What is otitis media?

middle ear inflammation

What groups of the population (4) is the flu shot recommended for?

1) > fifty years old 2) immunosuppressed 3) chronic health issues 4) high risk environment

When is the flu shot contraindicated?

What is the sixth leading cause of death in Canada?

pneumonia

What is pneumonia?

resp disorder involving inflammation of the structures of the lung

What are the 2 general causes of pneumonia?

1) Infectious | 2) non-infectious (ex gastric secretions aspirated)

List the five risk factors for pneumonia

1) impaired immune system 2) chronic lung disease 3) airway instrumentation - tracheostomy 4) mechanical ventilation 5) strong microorganism

What is it called when you get pneumonia r/t mechanical ventilation?

VAP: ventilation assisted pneumonia

What is the criteria to be diagnosed with community acquired pneumonia?

must be acquired outside hospital or within 48 hours of admission

What are the most common causes of community acquired pneumonia? (microorganisms) (4)

STREPTOCOCCUS PNEUMONIA haemophilus influenza staphylococcus aureus gram neg bacilli

What are the most common causes of hospital acquired pneumonia? (nosociomal)

``` pseudomonas aeruginosa staphylococcus aureus enterbacter species klebsiella pneumonia Escherichia coli seratia species ```

What part of the respiratory tract does hospital acquired (nosociomal) pneumonia usually affect?

lower respiratory tract

What is the most common organism for community acquired pneumonia? What is this type of pneumonia called?

Streptococcus pneumonia Pneumococcal pneumonia

where does streptococcus pneumonia colinze?

in the mucous membrane of the nasopharynx may not progress

What feature of streptococcus pneumoniae increases its durability?

has a polysaccharide capsule that delays digestion by phagocytes

List the manifestations of pneumonia

1) fever 2) malaise 3) chills 4) productive cough 5) dec AE and crackles 6) pleuritic pain 7) elderly may not have fever, but instead loss of appetite and conffusion

What is legionnaire disease?

it Is pneumonia caused by inhalation of aerosolized contaminated water/soil

What are some objects that could cause the spread of legionnaire disease?

air conditioners | large water tanks

What bacteria causes legionnaire disease?

Legionella pneumophila

Describe the manifestations of legionnaire disease

same as pneumonia, but rapid onset 1) dry cough 2) diarrhea 3) CNS alterations 4) arthralgia

What is the usual cause of primary atypical pneumonia?

mycoplasma pneumoniae

Describe the manifestations of primary atypical pneumonia

Patchy lung involvement typical pneumonia symptoms but: 1) minimal lung consolidation as confined to alveoli and pulm institium 2) moderate amount of sputum 3) minimal rise in WBC

What is the biggest risk and the implication of this risk of primary atypical pneumonia?

damage to the lung epithelium predisposing lungs to other infections

What organism is the causes the most deaths on its own?

What bacteria causes TB? describe its characteristics

Mycobacteria tuberculosis hominus 1) airborne droplet 2) waxy cell wall (abx resistance) 3) aerobic (O2 rich environment)

List 3 risk factors for TB

1) living in a country with high incidence 2) crowded/confined living conditions 3) immunocompromised

Describe the pathogenesis of TB

1) airborne droplet inhaled and settles in alveoli 2) macrophage engulfs, bacteria multiply inside until macrophage ruptures 3) more WBC and fibroblasts accumulate 4) formation of granuloma 5) lymphocytes activated in a delayed hypersensitivity response to release cytokines that can kill bacilli (can also dmg lung tissue)

Describe what primary TB is.

not previously unsensitised. often asymptomatic and develop latent TB (non active, non contagious) 5 percent progress to active TB

Describe the manifestations of primary TB

``` Fever pleuritic pain wt loss fatigue night sweats cough/dyspnea ```

What is secondary TB?

it is reinfection or reactivation of primary tb lesion cell mediated hypersensitivity dmgs airway causing cavitation

Describe the manifestations of secondary TB

``` low grade temp night sweats fatigue anorexia wt loss cough dyspnea orthopnea (SOB ```

What is a potential complication of secondary TB?

pleural effusion

Describe the treatment for TB

multidrug regimen with chemo DRUGS: izonazid, rifampin, pyrazinamide, ethambutol VACCINE: BCG bacillus calmette-buerin

Explain what a positive TB skin test indicates

It is triggered by a cell mediated immune response it indicates past exposure, not necessarily current infection/active

What are paraneoplastic syndromes?

syndromes caused by secretions from tumor anorexia, cachexia, and fever are often considered this

Chapter 22: respiratory tract infections, neoplasms, and childhood disorders Flashcards

(68 cards)