Respiratory
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| What does ABG stand for? | Arterial Blood Gases.
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| What is PAO2? | Partial Pressure of Oxygen
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| What is PACO2? | Partial Pressure of Carbon Dioxide
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| What is Bronchoscopy? | A bronchoscope used for visualization of the tracheobronchial tree.
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| What kind of specimens are obtained for cytological and bacterial studies? | Aspirations, bronchial washings, and Biopsy
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| What is a pulmonary function test? | Measures the ventilation mechanics of the lungs.
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| What does Spirometry measure? | Measures and records the air volume taken in and out of the lungs under normal conditions.
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| What is a Pneumothorax? | Entrance of air into the pleural cavity.
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| What is Atelectasis? | Collapsed lung.
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| Upper Respiratory system includes what? | Nose, Nasal cavity, sinuses, pharynx, and larynx.
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| What is the definition of Influenza? | An acute respiratory disease of the Upper Respiratory Tract
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| Who is most susceptible to Influenza? | School age children & the elderly
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| Cause/Etiology of Influenza is. | Myxovirus Influenzae
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| What kind of a Virus is influenza and what is its shape? | RNA virus (helical)
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| True or False. Influenza is a naked virus. If false what kind of a virus is it? | False. Influenza is an enveloped virus.
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| What is the Influenza's cell made of? | Lipids and Proteins
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| What kind of attachments does the Influenza Virus have? | Spikes
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| What kind of spikes does Influenza have? | H spikes & N spikes
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| What does the H spike do for the Influenza virus? | H spike is used for attachment and attaches to the receptor on the host's cell.
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| What does the N spike do for Influenza? | Its an enzyme that assists in the entry and the exit of virus into the host cell.
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| What is the name of the H spike? | Hemagglutinin (H) spike
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| What is the name of the N spike? | Neuraminidase (N) spike
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| What are the 3 Major types of Influenza virus? | Type A, B, C
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| Describe Type A Influenza | Its most prevalent and causes most pandemics in intervals
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| Describe Type B Influenza | Less widespread and undergoes and antigenic change at a slower rate
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| Describe Type C Influenza | Rare and are mostly isolated cases and are sporadic.
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| Name the two antigenic changes in Influenza. | Drift & Swift
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| What is a Drift? | It is the change or mutation that gives a new strain of the virus.
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| What is a Shift? | A MAJOR change in the Influenza A virus resulting in new H spikes and/or new N spikes. There is no immunity to it.
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| Which antigenic change occurs more often shift or drift? | Shift
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| Which type of Influenza is the ONLY Influenza that changes by shift and drift? | Type A
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| What Influenza virus is referred to as "quadruple reassortant"? | H1N1
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| True or False... H1N1 can be transmitted by food. | False.
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| How is Influenza transmitted? | Fomites & Droplets
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| What is the incubation period of Influenza? | 1-4 days on avg. 2 days
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| How does Influenza affect the body? | Virus affects the respiratory mucosa and causes inflammation and necrosis by shedding epithelium and virus into secretions and causes gaps between cells allowing extracellular fluid to escape
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| Necrosis in the respiratory mucosa can cause a secondary infection how? | Normal flora enters and causes infection
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| Signs and symptoms of Influenza | abrupt fever, fatigue, muscle aches, severe cough, nasal congestion, scratchy dry throat, sore throat. Not everyone has a fever
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| What time frame should individuals stay home when catching influenza? | 24 hours after fever subsides.
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| How is Influenza confirmed? | Nose and throat cultures, serum antibody tilters, and rapid antigen tests
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| what are Other ways Influenza is diagnosed? | based on signs and symptoms, community outbreaks
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| Treatment of Influenza is... | self limiting in about 10 days, keep warm, and stay hydrated
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| What drug was first generation antiviral drug that no longer is effective against Type A Influenza? | Amantadine (symmetrel)
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| CDC has recommended which of the following drugs for 2014 & 2015 | Tamiflu - pill or liquid & Relenza - inhaled route. Best prevention is Vaccination
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| Complications of Influenza? | Pneumonia & Secondary Bacterial Infections (sinusitis, otitis media, bronchitis)
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| What further complications can the senior population face from Influenza? | Worsening of chronic conditions = congestive heart failure, asthma, diabetes, greater risk of serious complications.
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| What are the complications of Reyes Syndrome? | Liver and brain damage, coma and death, CDC recommends no one under the age of 19 should take asprin.
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| Prognosis of Influenza? | Good without complication and should make a full recovery.
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| Prevention of Influenza? | Influenza can be prevented by vaccination if the correct virus is identified.
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| Description of Bronchiolitis (RSV Infection) | Common viral infection of young children.
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| What ages does Bronchiolitis/RSV affect? | 2-12 months & the elderly.
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| When is the most common time Bronchiolitis occur? | during cooler winter months.
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| What kind of epidemic is Bronchiolitis? | Nosocomial
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| Organ systems affected by the Bronchiolitis | involves the bronchi and bronchioles and does NOT involved the alveoli
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| What causes Bronchiolitis? | Viral infection can also be caused by the Rhinovirus.
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| What is the causative agent in RSV? | Myxovirus (same family as measles and mumps) Single strand of RNA, Pleomorphic, enveloped and lacks spikes.
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| what is Synctia? | The clumping of cells which are fused together
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| How is Bronchiolitis transmitted? | Oral droplets, fomites, predisposing factors (asthma & cirgarette smoke).
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| What is the incubation period of bronchiolitis? | 1-4 days
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| What is the Pathogenesis of Bronchiolitis? | inhaled virus, infects respiratory epithelium, death and sloughing of epithelium, bronchioles partially blocked from dead cells, mucus & clotted plasma from (bronchial walls), presence of edema, increased secretions & bronchospasms, obstucts small airways
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| Signs and Symptoms of Bronchiolitis | runny nose and cough, wheezing, may have atelectasis, dyspnea, rales, rapid shallow breathing, chest retractions, nasal flaring, fever (low grade), malaise
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| What is Atelectasis? | Partially or fully collapsed lung.
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| Diagnostic testing for bronchiolitis | cultures of nasal and pharyngeal secretions, isolation of the virus in HEp-2 cells, serum antibody titers, Infants may have maternal antibodies, rapid antigen test,
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| What is the treatment for Bronchiolitis | maintain fluid, supportive and symptomatic monitoring of blood gases, Riboviran - antiviral, RSV immunoglobulins,
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| Complications of RSV infection | Pneumonia secondary super infections
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| Prognosis of RSV infection | Without complications 7-10 day recovery, immunity is weak and short lived usually re-infection is common, vaccine is in the works
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| Definition of Tuberculosis | Slowly developing bacterial lung infection characterized by progressive necrosis of lung tissue. Usually a disease of the lung and can spread throughout the body.
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| Individuals who are high risk of TB | poor homeless, living in crowded conditions, nursing homes residents and prisoners, alcoholics ad IV drug users, immunocompromised individuals are at the greatest risk, people with AIDS are highly susceptible to respiratory infections, not limited....
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| Causes/Etiology of Tuberculosis | mycrobacterium tuberculosis, small rod shaped (bacilli) waxy capsule more resistant to destruction, acid fast - red in color, Aerobic upper portions of lung tissue
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| Generation time? | 18 hours to duplicate, very slow growing, 3 weeks for colonies to form
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| How is TB spread? | Droplets, can survive in dry sputum for weeks, milk not pasteurized, (bovis) - deer,
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| Describe Primary TB | person inhales - bronchioles or the aveoli, silent asymptomatic/not seen on x-ray,
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| Pathophysiology of Primary/Latent Infection | MACS attack, bacteria survive & some present to the Helper T cell mediated, some migrate to the lymph and lymph nodes
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| What is a Granuloma? | inflammation and presence of foreign substance
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| Where does the Granuloma go and what does it form? | granuloma involved migration of the macs and the lymphocytes which attempt to form a wall of bacteria forming a tubercle
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| True of False Primary TB/Latent is Active Disease and can be spread | False
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| How long does it take for Immunes Response to take place? | 6-8 weeks
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| What does the clump of bacteria consist of? | Bacilli surrounded by inflamed cells and scar tissue containing collagen
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| True or False TB in the tubercle is still alive? | True
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| What is caseous necrosis? | infected tissue inside the tubercle, resembles cottage cheese, bacilli is survived after being engulfed by MACS, bacilli thrive in decaying/dead matter
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| Another name for tubercle? | Ghons Lesion
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| What is the first lesion of Primary TB? | Tubercle/Ghons Lesion
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| Where is Ghons Lesion located? | Lungs and Lymph nodes
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| Ghons Lesions can calcify and show up during what? | an x-ray
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| How long can TB stay dormant? | Years
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| When does TB become active? | When conditions are favorable such as in an immune compromised individual.
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| What kind of symptoms are present while infection is in tubercles? | NONE but can be seen on an X-ray
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| Signs and Symptoms of Progressive TB? | Fever, weight loss, fatigue, night sweats, pleuritis, lymphadenitis, sputum containing bacterium,
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| What is secondary TB/reinfection active disease? | occurs when reactivation of TB from dormant tubercles, decrease in the hosts resistance, could occur if individuals inhaled additional droplet nuclei
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| what is cavitation/ liguefaction necrosis? | bacilli become reactivated in result of the destruction of lung tissue, forms cavities in the lungs, bronchi, and vessels, can spread into pleural cavity causing pleuritis & adhesions
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| What are other areas that TB can spread to? | Blood, Lymph, and possibly the digestive system
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| What is another name that TB was called? | Cosumption..... TB consumed the body!
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| What are the signs and symptoms of Primary TB? | Asymptomatic, + TB test, tubercles on chest X-ray
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| What are the signs and symptoms of Secondary Reinfection (ACTIVE) TB? | fatigue, anorexia, weight loss, low grade fever, night swears, cough in the more advanced stages of TB
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| Sputum is noted in active TB .. How is it described? | there is a lot and it is sticks to everything, its copious and tenacious
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| What is hemoptysis? | When sputum contains blood.
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| What are the tests given to check for TB? | Mantoux - intradermal injection, Tine Test - multiple puncture test, Two step - checking for a negative test and testing again at 1-3 weeks later to repeat the negativity. Checking for the presence of antibodies.
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| What does anergic mean? | someone with an immune system so suppressed that their immune system can no longer respond
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| What is Induration (TB)? | Causes a localized hard spot in the skin within 48-72 hours
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| What is the BCG vaccine and who should get it? | It is a vaccine that was once thought to help prevent TB and it is not used in US because it was deemed ineffective. This also could result in a positive TB test.
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