Lecture 10 Resp non-neoplastic Flashcards Preview

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Flashcards in Lecture 10 Resp non-neoplastic Deck (84):
1

What are in the walls of trachea and bronchi?

Cartilage

2

What is in the wall of bronchioles?

Smooth muscle

3

What is in the upper airways?

Nose, accessory air sinuses, nasopharynx and larynx

4

What is in the lower airways?

Trachea, bronchi, bronchioles, terminal bronchioles, alveoli.

5

Define upper resp infections?

Acute inflammatory process that affects muscous membranes of the resp tract

6

Upper resp infection examples?

Rhinitis, laryngitis, tonsillitis and sinusitis.

7

What are the symptoms of an upper airway infection?

Malaise, headache, sore throat, discharge.

8

Upper resp infections are commonly...

Viral but can get secondary bacterial infections

9

How do virus's cause symptoms?

Attach to resp mucosa, invading tissue causing necrosis, inflam and swelling

10

Define pneumonia

Inflammation of lung parenchyma caused by viral/bacterial infection where airsacs fill with pus& ?solid

11

How does pneumonia work?

Consolidation of affected part, exudate with inflam cells and fibrin in alveolar air spaces.

12

What causes pneumonia?

infectious agents, inhaled chemicals, chest wall trauma.

13

Clinical features of pneumonia?

Fever, rigours, SOB, pleuritic chest pain, purulent sputum, cough.

14

Morphology (forms) of pneumonia?

Lobar, multifocal/lobular (bronchopenumonia) or interstitial (focal diffuse)

15

What are the 6 categoies/settings for pneumonia?

Community acquired, hospital acquired, aspirational pneumonia, chronic pneumonia, necrotising pneumonia/lung abscesses. in immunocompromised

16

Which setting is relatively common?

Community

17

What is the most common cause for community acquired?

Strep.pnemonia

18

What 3 organisms cause community acquired?

Step. pnuemoniae, haemophilus influenzae, S.aureus

19

Morphology of community acquired?

Lobar or bronchopneumonia

20

What is hospital acquired pneumonia also know as?

nosocomial pneumonia

21

Define hospital acquired pneumonia

Any pneumonia contracted by patient at least 48-72 hrs postadmission

22

What organism usually cause hospital acquired?

Gram neg bacilli and S.aureas

23

Which pneumonia can be severe/fatal & is most common cause of death in ITU?

Hospital acquired pneumonia

24

Symptoms of hospital acquired pneumonia?

Fever, ^WCC, cough with purulent sputum. Chest x-ray changes

25

How does aspiration pneumonia develop?

After inhalation of foreign material. Elderly, strokes, dementia, anaesthetic

26

Morphology of aspiration pneumonia

Right middle and right lower lobe

27

What organisms causing aspiration pneumonia?

Oral flora +/- other bacteria

28

Define obstructive disorders?

Partial or complete obstruction at any level from the trachea to bronchioles

29

Examples of obstructive disorders?

Asthma, COPD (Emphysema and chronic bronchitis), Bronchiectasis

30

What is extrinsic asthma?

Responds to inhaled antigen - atopic

31

What is intrinsic asthma?

Non-immune, cold, exercise, aspirin.

32

What happens in the early phase of asthma?

Bronc constriction, ^ mucus, Vasodilation

33

What happens in late phase reaction?

Inflam, epithelial damage, more bronc-conc

34

Morphology of asthma?

Lung overinflation + small areas of atelectasis. Mucus plug in bronchi/bronchioles. Airway remodelled

35

Define chronic bronchitis

Persistent cough with sputum production, for at least 2 consecutive years, no cause found.

36

What causes chronic bronchitis (obstructive disorder)

Long-standing irritation from inhaled substances (e.g. smoke, dust, cotton, silica). 2) Hypertrophy of submuc glands& ^goblet cells. 3) mucus hypersecretion

37

Morphology of chronic bronchitis?

Mucous membrane hyperaemia, swelling, oedema. Excess mucus. Bronchioles narrowed (mucus plug, inflam&fibrosis).

38

Clinical signs of CB?

Persistent cough, productive sputum. Dyspnea on exertion. Hypercapnia, hypoxemia.

39

What can chronic bronchitis lead to?

Cor pulmonale, cadiac failure, atypical metaplasia/dysplasia

40

Define dyspnea?

Difficulty breathing

41

Define hypercapnia?

CO2 retention

42

Define hypoxemia?

Low O2 conc

43

Define Cor Pulmonale

Abnormal enlargementof right side of heart as result of lung/pulmonary vessel disease

44

Define emphysema?

Irreversible enlargement of the airspaces, distal to terminal bronchiole, wall destruction without obvious fibrosis

45

Types of emphysema?

Centriacinar / panacinar / paraseptl / irregular

46

Symptoms of emphysema?

Dyspnoea, cough, wheezing, weightloss, expiratory limitaions.

47

What are pink puffers?

People who die from cor pumonale, congestive heart failureor pneumothorax

48

Morphology of emphysema?

Largeapical bullae or blebs, voluminous lungs and large alveoli.

49

What substances are imbalances in emphysema?

Protease-antiprotease. Oxidants and anti-oxidants

50

Define bronchiectasis

Permanent destruction and dilation of airways associated with severe infections/obstructions

51

Morphology of bronchiectasis

Dilated (as walls have been destroyed), and inflamed. Loss of cilla, increase mucus.

52

Define aetiology

Causes of a disease

53

Aetiology of bronchiectasis

CF, Kartageners, post infectious: TB, measles, bronchial obstruction (TB/FB)

54

What is kartageners disease?

Defects in cilla action

55

Symptoms of bronchiectasis?

Persistent cough, purulent sputum +++, haemoptysis

56

What is haemoptysis?

Coughing up blood

57

Define restrictive lung disease

Reduced expansion with decreased total lung capacity, inflammation and fibrosis of the pulmonary connective tissue.

58

Define pneumonitis

Inflamof walls of alveoli

59

With restrictive lung disease FVC...

is reduced. (amount of air that can be blown out after maximal inspiration.

60

Clinical features of restrictive lung disease?

Dyspnea, tachypenea, end-inspiratory crackles. Cyanosis without wheezing. May lead to cor pulmonale.

61

Morphology of restrictive lung disease. Xrays?

Bilateral infiltrative lesions - small nodules, irregular lines (ground glass shadows). Scarring and gross destruction of lung -> honeycomb lung.

62

What disease results in ground-glass shadows and honeycomb lungs?

Restrictive lung disease

63

Give 3 restrictive disorders

Chest wall abnormalities, connective tissue disorders and penumonconioses

64

What are the two vascular disorders effecting breathing?

Pulmonary embolism and pulmonary oedema

65

Define pulmonary embolism

blockage of main or branch pulmonary artery by an embolus.

66

Where are emboli that cause pulmonary embolisms normally from?

DVT of the leg (95% of cases)

67

What does the body compromise when suffering from pulmonary embolism?

Respiratory compromise and haemodynamic compromise

68

Morphology of pulmonary embolism?

Central/peripheral emboli, pulmonary haemorrhage or pulmonary infarction

69

What is the clinical course for vascular embolism

Abrupt onset pleuritic chest pain, SOB, hypoxia, ^ pulmonary resistance -> right ventricular failure.

70

Define pulmonary oedema

Accumulation of fluid in the air spaces and paenchyma of the lungs

71

What is pulmonary oedema due to?

Alveolar injury, infections, shock/trauma.

72

What are the oedema of undetermined origin?

Neurogenic/high altitude

73

What causes haemodynamic oedema?

^ venous pressure (left ventricle failure), decreased oncotic pressure (from nephrotic syndrome) or liver failure.

74

Define dependent oedema

Initial fluid accumulation in basal regions

75

Morphology of pulmonary oedema

Engorged alveolar capilaries, intra-alveolar granular pink precipitate, alveolar microhaemorrhages, hemosiderin-laden macrophages, heavy wet lungs

76

Clinical features of pulmonary oedema?

SOB, punk frothy sputum, CXR findings.

77

Name the two expansion disorders

pneumothorax and atelectasis

78

Define pneumothorax

Air in pleural cavity -> collapse lung

79

What ^ the risk of pneumothorax?

Emphysema, asthma, TB, trauma and idiopathic

80

Define Atelectasis

Incomplete expansion of lungs which reduces oxygenation and predisposes to infection. REVERSIBLE

81

What are the two types of respiratory failure?

Type I- hypoxia with normal or low PCO2
Type II- hypoxia with high PCO2

82

What causes type I resp failure?

Pneumonia, pulmonary oedema, asthma, pulmonary fibrosis

83

What causes type II resp failure?

Asthma, COPD, reduced resp drive, neuromuscular disease, thoracic wall disease (kyphoscoliosis).`

84

Which type of resp disease should caution with O2 be taken?

Type II respiratory failure.