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exam2
| Question | Answer |
|---|---|
| What is relief mechanism for acute laryngotracheobronchitis? | humidifier |
| What are the manifestions of acute epiglottis? | inspiratory stridor, fever, tripod position, drooling and difficulty swallowing. |
| A child with acute epiglottis should never be forced to do this? | lie down |
| Epiglottis is caused by what type of microbe? | was influenza now it's strep pneumoniae |
| What are the three treatments for epiglottis infection | tracheotomy, oxygen and antimicrobial therapy endotracheal intubation. |
| Which of the three types of of virues (A, B, C) is most common for influenza | A |
| What are the three types of infection for influenza? | URTI, viral, pnuemonia and bacterial pnuemonia. |
| Which type of viral infection will cause mylagia? | URTI |
| What type of cough is in bacterial pneumonia? | Productive |
| What are the two symptoms of viral p. | tachypena and clubbing |
| What were the three diferent strains for H1N1 | Human, pig and bird |
| H1N1 killed by causing what? | Acute respiratory syndrome |
| Infection of the epiglottis is seen in what age of children | 3-7 |
| Broncholitis is an upper or lower respiratory infection | lower |
| what is the name of the virus that causes Broncholitis | RSV (respiratory syncytal virus) |
| Bronchiolitis is infection of what type of bronchilas? | Small bronchi and bronchioles. |
| What age of children have bronchiolitis | 2-12 |
| what are the symptoms of bronchiolitis | edema in the bronchioles, air trapping, reflex bronchospams, necrosis and obstruction of the bronchioles. |
| What are the clinical features of bronchiolitis | Wheezing, dyspnea and rapid respiration |
| Treatment of bronchiolitis | hospitalization, monitoring ABG. |
| Bronchiolitis causes retraction of what two bony ares during inspiration? | Ribs and sternum |
| Whis is the Septae | Walls of the alveolar |
| What are the three types of microbes that can cause pneumonia | bacterial, fungal and viral |
| pneumonia - where is the infection usually? | Throughout the lob or maybe consolidated in one or more lobe |
| inflamation with the alveoli | typical |
| Inflamation of septae and interstistial fluid | atypical |
| Bronchopneumonia | Patchy infection of the lobe |
| Lobar | consolidated infection of the lobe |
| In typical pneumonia, what kid of WBC is causing inflamation | Neutrophiles |
| In the atypical pneu. what type of WBC is causing inflammation | Mononuclear or monocytes |
| Lobar pneumonia is caused by what bacteria? | Steptococcus pnuemoniae |
| Oxygen exchange not being able to happen because of blockage in the interstitial space has what name? | SARS |
| What origin is the most common acquired pneumonias? | Bacterial |
| what are the three community acquired pneumonial viruses? | RSV, Parainfluenza and influenza virus |
| For lobar pneumonia, which bacteria is most responsible. (26) | Step pneumonia |
| Infection in the pleural cavity | empyema |
| Lobar pneumonia produces what kind of cough sound and what kind of cough output? | Rales and productive cough |
| How is lobar pneumonia dx? | Chest xray and sputum culture. |
| Bacterial pneumonia has two anatomic patters. | Lobar and bronchopneumonia |
| In bronchopneumonia, where is the inflammation develop? 28 | In the alveoli |
| Bronchopneumonia has what kind of cough and sputum? | productive and purulent |
| How is legionnairs's disease spread | Aerosal |
| What is legionnaires caused from | Legionella pneumophilia |
| Who gets legionnaire disease | people with predisposing factors like renal or cardiac disease |
| Describe the symptoms of Lobar pneumonia | dyspnea, tachypnea and pleuritic pain |
| Community acute required pneumonia has infections where? | usually localized in one or more lobes, consolidation, pleural infection |
| Primary atypical pneumonial infection is caused by what bacteria? | Mycoplasmal pneumonia (most common), virus and chlamydia. |
| What are the clinical manifestations of atypical pnuemonia | no consolidation, unproductive cough, light WBC elevation and mild fever. |
| what are the three organisms responsible for nosocomial pneumonia? | pseudomonas spp, enterobacteria, spp and staph aureus. |
| sars - how is is spread and what kind of pneumonia | Atypical pneumonia and droplets |
| How is SARS treated | antivirals, steroids and mechanical ventilation. |
| Untreated legonnaires causes? | consildation and severe congestion |
| SARS is associated with what type of virus? | Coronovirus |
| what does an chest xray in a sars patient show? | patchy areas of interstitial congestion |
| Tuberculosis is caused by what Bacteria? | Mycobacteria |
| What does tuberculosis primarily infect? | Lungs but can affect other organs. |
| In what conditions does tuberculosis occur frequently? | Alcoholism, overcrowded areas, malnutrition and conditions of war. |
| How is primary tuberculosis characterized? | By people who have never had it developed before. |
| What is the Ghon complex? | It is a granuloma |
| What level of hypersensitivity is associated with Tuberculosis | Hyersensitivity IV with development of resistance and hypersensitivity. |
| What does the tuberculosis Ghon complex undergo? | progressive calcification and fibrosis |
| what harbors the mycobacterium in the lung or other organ? | Foci of scaring |
| The ghon complex can involve what other area of the lungs | Lymph nodes |
| Where in the lung does secondary TB develop and how does it heal? | apex / heals with fibrosis or it can spread |
| What is pott's spine? | TB in the spine |
| What effect can TB have on women? | infertility |
| Cavitation into blood vessels can cause? | Hemoptysis containing bacilli |
| Where can TB spread | Meningies, kidnesy, adrenals, bones and fallopian tubes. |
| Kassmauls breathing be caused by what? | Acidosis |
| Acute LTB is relieved by what? | humidifier |
| What is miliary TB | tiny foci that can spread to other organs; seeding |
| Clincal manifestation of TB | malaise, fever, anorexia, weightloss, hemoptysis; low grade fever in the afternoon and then subsides. |
| What test is definitive for TB | acid-fast bacilli sputum test (culture), PCR |
| Screening test for TB | Mantoux test, ZN stain and Chest x-ray |
| What is the primary defect in cystic fibrosis? | CFTR- severity is differnt in people |
| Explain Cystic Fibrosis | Abnormal function in the Cl channel effects fluid secretion in excretion glands and respiratory tract and GI tract. |
| What organs are primarily effected by Cystic Fibrosis | Lungs and pancreas |
| effects of cystic fibrosis on lungs | obstruct airway in small bronchi and bronchioles; infection with p. aeruginosa and s. aureus; bronchiectasis and lung abscess |
| what is Bronchiectasis? | Permanetly dialated bronhi |
| What effect to cystic fibrosis have on the GI system? | Pancreas bile ducts become bloked can cause secondary diabetes; biliary cirrhosis; malabsorption of fat and vitamins |
| What is meconium ileus? | babies unable to pass their meconium |
| What effect does cystic fibrosis have on infertility? | blocks cervix; blocks vas deferens. |
| What is Steatorrhea? | loose fatty stools common in cystic fibrosis |
| What are the dx tests for cystic fibrosis? | Radiography, test for the gene(primary test), sweat chloride test and immunoreactive trypsinogen. |
| What is the main cause of death in CF patient's and their life expectancy? | Respiratory failure;35 |
| What is the tx for cf? | Antibiotics, pancreatic enzymes, mucolytic agents and oxygen therapy for advanced lung disease. |
| what is the most common primary malignant tumor? | Bronchogenic carcinoma |
| what other carcinomas do bronchogenic carcinoma include? | Squamous, adeno and small cell |
| Where does brochogenic carcinoma arise from? | bronchial epithelium cells |
| Which one of the the three bronchiogenic cancers has the lowest prognosis? | Small cell - located in the hilar regions |
| what are the tumor effects of lung cancer? | Obstruction, bleedind and inflamation - hemoptysis, pleural effusion (hemothorax and pneumothorax) and paraneoplastic sydrome. |
| What is the most common sympton of lung cancer? | Hemoptysis |
| Paraneoplastic syndrome can cause what syndrome? | Cushing and hypercalcemia |
| What are signs of lung cancer metastasis | bone pain and fractures |
| what are some dx tests for lung cancer? | CT and MRI; bronchoscoy, mediastinoscopy and biospy. |
| What are some treatments for lung cancer | Sx resection or chemotherapy. Nothing can be done for small cell carcinoma |
| Extrinsic Asthma is trigged by what level of hypersensitivity? | type I |
| How is Extrinisic Asthma triggered? | environmental antigens |
| What does atopy mean and what respiratory disease does it relate to? | Atopy; asthma |
| Instinsic asthma is initiated by what? | hypersensitive tissue in the airway; stress, colds, exercise, drugs, etc. |
| What happens during an acute asthma attack? | inflammation and edema of bronchial walls, increased mucus secretion and bronchoconstriction. |
| What are the clinical manifestation of asthma | wheezing and prolonged expiration. respiratory alkalosis, respiratory failure and hypoxia. |
| What is status asthmaticus | persistent severe attack |
| What would a leukotriene receptor atagonist be used for? | to block inflamation and prevent bronchoconstriction. |
| What is used for an acute asthma attack? | glucocorticoids and bronchodilator inhalers. |
| Emphysema and chronic bronchitis are referred to as what? | COPD |
| small airway disease is called? | bronchiolitis |
| Alveoli are attached to what? | Bronchioles |
| Emhysema causes a break down of what to areas? | Alveolar walls and septae |
| How does cigarette smoke cause emphysema? | it increases macrophages and neutrophiles that excreate elastase. |
| What is the genetic deficiency of alpha 1 antitrypsi? | doesn't produce anti-protease |
| Breakdown of the alveolar elastin causes what? | Surface areas of alveolar is decreased and the small brochioles structer is diminished causing airway obstruction during expiration. |
| What is cor pulmanale | heart failure as a secondary condition to a respiratory failure. |
| What are two things that emphysema can caused due to difficult expiration? | caused barrel chest and air trapping |
| What happens to adjacent alveoli with empysema? | They fuse together forming larger air spaces |
| What is the coming sign with emphysema | dyspnea |
| What is the driving force for respiration in emphysema patients? | hypoxia or low oxygen levels. |
| what happens to CO2 levels in emphysema patients? | it becomes very high and pneumothorax may develop along with pulmonary hypertension. |
| What are two signs of emphysema? | dyspnea; leaning over to breath with pursed lips and barrel chested. |
| what are the three tx for emphysema? | brochodialtors, oxygen therapy and antibiotics |
| How is bronchitis described? | A persistent productive cough lasting 3 consecutive months for 2 consecutive years. |
| what can cause bronchitis? | living in highly industrialized areas; consitant smoking |
| What does bronchitis cause? | Mucosa inflammed and swollen, hypertrophy and hyperplasia of mucosal glands and fibrosis and thickening of bronchial walls. |
| What can develop from bronchitis? | Dyspnea upon exertion, productive cough. |
| What can a patient who smokes and has bronchitis develop? | Hypercapnia and hypoxia and cyanosis |
| How can death from bronchitis happen? | Hypoxemia causes pulmonary hypertension which causes cor pulmonale. Also acute bacterial infection. |
| Treatments for bronchitis | antibiotics, expectorants and bronchodilators. |
| Bronchiectasis is caused from what? | destruction of elastin due to infection or inflammation. |
| What can cause bronchiectasis? | COPD any mucus impaction, cystic fibrosis, pneumonia and TB |
| What is the cough with bronchiectasis? | production of foul smelling, purulent sputum. Also hemoptysis. |
| What are some treatment for bronchiectasis? | antibiotics, bronchodilators, mechanical chest therapy and tx of the primary disease. |
| What is indicative cyanosis? | O2<50 and CO2 > 50 |
| What can cause cyanosis? | Asthma and bronchitis |
| What is ARDS | adult respiratory distress syndrome where the lungs have difficulty expanding |
| First group of restrictive lung disorders | Abnormality in the stucture of the chest wall like kyphosis or scoliosis |
| Second group of restrictive lung disorders | is when the diease of the lung impairs the expansion. |
| What is pneumoconioses | Chronic restrictive disease from long term exposure to irritating particles. causes inflammation and gradual fibrosis. |
| What is pulmonary edema? | collecting of fluid in the intersitial spaces and in alveoli |
| What does pulmonary edema cause? | reduced amount of oxygen going into the blood and interfers with lung expansion. |
| What is the most common cause of pulmonary edema? | Left side of the heart failing. |
| What some non-primary causes of pulmonary edema? | inflammation in the lungs; high hydrostatic pressure and low osmotic pressure; kidney disease. |
| What are some signs of pulmonary edema? | Rales, productive coughing blood-tinged sputum, dyspnea, hypoxemia, cyanosis |
| What are some tx of pulmonary edema? | mechanical respiration. |
| What can be in a pulmonary thrombi? | Fat, air or amniotic fluid |
| Where do most pulmonary throbmi come from? | Thrombi within large deep leg veins. |
| How does pulmonary thrombi cause death? | it gets stuck in the pulmonary artery and that causes acute right heart failure. |
| Why are pulmonary emboli clinically silet? | because they are small |
| what is indicated by small emboli pulmonary infarction? | dyspnea, pleuritic pain |
| Who are at high risk for a pulmonary embolism recurrence | peole who have had it before? |
| what kind of symptoms would a small pulmonary emboli cause? | coughing, dyspnea and transient chest pain |
| what kind of symptoms would a large pulmonary emboli cause? | Chest pain, deeper and faster breathing and dyspnea and couging. hemoptysis and anxiety. |
| what kind of symptoms would a massive pulmonary emboli cause? | Crushing chest pain and shock and distended neck veins. |
| how can a pulmonary emboli be dx? | lung scan, MRI and d-primer (looking for fibrin) |
| Treatment for pulmonary emboli? | streptokinase, stockings, mechanical ventilation and surgical insertion of filter |
| What is atelectasis? | colapsed lung leading to hypoxia and poor gas exchange |
| what happens to the alveoli with atelectasis? | They become airless and poor perfusion |
| What are the symptom with large area of alveli being like this and a small area? | small is asymptomatic; large - dyspnea, increased hr, respiratory rate and chest pain. also the mediasternum may shift. |
| what are the four causes of atelectasis? | obstructive and compression, incrases surface tension of alveoli and postoperative. |
| What is pleural effusion? | exessive fluid in the pleural cavity |
| What is transudative effusion | fluid from blood vessels moving into the pleural space. |
| what are the two types of pleural effusion | transudative and exudate. |
| what are the two causes of pleural effusion? | Hemothorax from trauma or surgery and empyema |
| What are some signs of pleural effusion? | Dyspnea and dull coughing, trachael deviation, pleuritic pain and FRICTION RUB! |
| What is one way that it can be treated? | Thoracocentesis to remove fluid; treat underlying cause |
| What is pneumothorax? | air in the pleural cavity can cause atelectasis |
| What is a closed pneumothorax | air enters pleural space because of a tear in the lung. |
| What happens in a secondary pneumothorax? | A bleb is popped which causes pressure on the lung and can collapse it due to emphysema or some underlying disease |
| a spontaneous pneumothorax | rupture of an unknown caused blel |
| what is an open pneumothorax | opening in the chest wall and lung due to some trauma or mediasternal flutter; difference is air come out! |
| Tension pneumothorax | tear in lung tissue or because of valve defect, the air cannot leave space causing tension on the mediasternum. This shift can cause hypoxia because it surpresses the opposite lung. |
| Clinical signs of pneumothorax | dyspnea, chest and pleural pain, asymetric moving of chest when breathing. |
| What is flail chest | paradoxyl movement of the chest wall during breathing. |
| infant respiratory distress syndrome is called what diseae? | hyaline membrane disease |
| when does hyaline membrane disease occure? | usually related to premature birth; common in diabetic moms and c-sections |
| What is the hyaline membrane disease | lack of surfactant in the infant. It is produced in the 28-36th week. |
| Why is flail chest bad? | It can interfer with the venous return to the heart resulting in hypoxia |
| What does the lack of surfactant do the alveoli membrane | increases it's capillary permeability, this causes fluid to leak into the alveoli and interstitial area. Eventually causing atelectasis |
| What are signs of infant RDS? | fast, shallow respiratory rate; nares are flaring, cyanosis |
| What are some dx testt for hyaline membrane disease? | chest xray and ABG |
| What are some tx for hyaline membrane disease? | glucosteroids to women in premature labor, give the babies synthetic surfactant and ventilate them. |
| What is ARDS associated with? | Multiple organ dysfunction or/and failure. |
| What is ARDS injury come from? | chemical mediators caused injury; increased capillary permeability too. |
| What happens with a hyaline membrane? | Plasma and fibrin leak into the alveolar space and instiial area blocking gas exchange. |
| what are the clinical manifestations of adult rds | dyspnea, shallow breathing, increased heart rate and acidosis |
| Decreased oxygen exchange is called? | Hypoxemia |
| how is respiratory failure defined? | O2<50 and CO2 >50 |
| What are some causes of respiratory failure? | Atelectasis, pulmonary edema, upper airway obstruction, COPD etc. |
Created by:
pharmnurse
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