Respiratory Tract: Non-neoplastic Flashcards
1
Q
What infections affect the lower airways?
A
- Pneumonia - Community Acquired Pneumonia - Hospital Acquired Pneumonia - Aspiration Pneumonia
2
Q
What is pneumonia?
A
- Inflammation of the lung parenchyma - Inflammatory cells and fibrins in alveolar air spaces - Clinical features - fever, rigours, SOB, pleuritic chest pain, purulent sputum, cough. - Morphology - lobar, multifocal/lobular, interstitial.
3
Q
What is community-acquired pneumonia?
A
- Relatively common, especially in the elderly - Strep. pneumonia most common organism - Haemophilius influenzae also causes it. - Staph. Aureus complicated the viral infection. - Morphology - lobar or bronchopneumonia
4
Q
What is hospital acquired pneumonia?
A
- Any pneumonia contracted by a patient at least 48-72 hours after hospital admission. - Usually bacterial gram negative bacilli and staph. aureus. - Severe and can be fatal - most common cause of death in ITU. - Clinical symptoms - fever, increased WBC count, cough with purulent sputum, chest x-ray changes.
5
Q
What is aspiration pneumonia?
A
- Develops after inhaling foreign material such as bacteria or gastric content (from vomiting/choking). - More common in the elderly, stroke patients, dementia and anaesthesia. - Morphology - right middle and right lower lobe.
6
Q
What are upper airways infections?
A
- Acute inflammatory process that affects mucous membranes of the respiratory tract. - Types of infection - rhinitis, laryngitis, tonsillitis and sinusitis. - Symptoms - headache, sore throat and discharge. - Commonly viral - can get secondary bacterial infection.
7
Q
What are obstructive disorders?
A
- Emphysema - COPD - Asthma - Bronchiectasis.
8
Q
What is emphysema?
A
- Irreversible enlargement of the airspaces distal to the terminal bronchiole - destruction of their walls without obvious fibrosis. - Pathogenosis - mild, chronic inflammation throughout the airway, protease (antiprotease imbalance), rate of smoking and genetics. - Clinical features - dysponoea, cough, wheezing, weight-loss, expiratory airflow limitation, ‘barrel-chest’ lungs expand in size.
9
Q
What is COPD?
A
- Persistant cough with sputum production. - For at least 3 months in 2 consecutive years with no other identifiable cause. - Irritation and inflammation of the airways. - Causes - long-standing irritation by inhaled substances, hypertrophy of submucosal glands in trachea and bronchi (increased goblet cells), mucous hypersecretion and alteration in the small airways. - Symptoms - persistent cough, sputum productions, dysponea on exertion, hypercapnia, hypoxemia, mild cyanosis.
10
Q
What Is asthma?
A
- Chronic inflammatory disease of the airways - Widespread but variable bronchoconstriction and airflow limitation. - Increased airway responsiveness - episodic bronchoconstriction, inflammation of bronchoconstriction, inflammation of bronchial walls, increased mucous secretion. - Symptoms - chest tightness, wheezing, dysponea, cough +/- sputum, increase in airway obstruction, difficulty breathing.
11
Q
What is bronchiectasis?
A
- Permanent destruction and dilation of the airways associated with severe infections or obstructions. - Result of: post infection (TB, measles, bronchial obstruction). - Clinical features - persistent cough, purulent sputum, haemoptysis.
12
Q
What is a restrictive disorder?
A
- Characterised by reduced expansion with decreased total lung capacity, decreased air expired after maximal inspiration. - Clinical features - dysponea, tachypnoea, end-inspiratory ‘crackles’, cyanosis with wheezing, reduction in gas diffusing capacity, lung volume and compliance (elasticity), pulmonary hypertension and right-sided heart failure. - Morphology - bilateral infiltrative lesions, irregular lines ‘ground-glass shadows’. Scarring and gross destruction of the lung, end-stage/honeycomb lung.
13
Q
What are vascular disorders?
A
- Pulmonary embolism - Pulmonary oedema.
14
Q
What is a pulmonary embolism?
A
- Blockage of main or branch pulmonary artery. - Usual source is DVT from calf. - Morphology - central/peripheral emboli, pulmonary haemorrhage/infarction. - Clinical features - abrupt onset pleuritic chest pain, SOB, hypoxia, increased pulmonary vascular resistance.
15
Q
What is pulmonary oedema?
A
- Accumulation of fluid in the air spaces and parenchyma of the lungs. - 2 types - haemodynamic oedema (increased venous pressure, decreased ancotic pressure, liver failure) and oedema due to alveolar injury (infections/trauma or shock). - Clinical features - SOB, pink frothy sputum. - Morphology - initial fluid accumulation in basal regions, englarged alveolar capillaries, intra-alveolar granular pink precipitate. ‘Heavy, wet lungs’.
