Exam 2 patho

Upper respiratory tract

Nose, pharynx, larynx

Lower respiratory tract

Trachea, bronchi, bronchioles, lungs

Alveoli are the site of ___ ________

Gas exchange

What does surfactant do?

Reduces surface tension

How many lobes do the right and left lung have

Right lung has 3 lobes, left lung has 2 lobes

Incubation period definition

Time between when a person is exposed to a germ and when they start showing symptoms

Atelectasis definition

Collapsed alveoli

Upper or Lower?: Infectious rhinitis

Upper

Incubation period of infectious rhinitis

2-3 days

What causes infectious rhinitis?

Rhinovirus (HIGHLY contagious)

What can infectious rhinitis lead to?

A secondary bacterial infection

Manifestations of infectious rhinitis

Sneezing, nasal congestion + discharge, sore throat, nonproductive cough, malaise, myalgia, low-grade fever, hoarseness, headache, and chills

Upper or Lower?: Rhinosinusitis

Upper

What is rhinosinusitis?

Inflammation of the sinus cavities

What happens when infected with rhinosinusitis?

Lining of the sinuses get swollen and inflamed, exudate builds up, leading to drainage getting blocked

Manifestations of rhinosinusitis

Facial pain, nasal congestion, fever, and sore throat

Upper or Lower?: Epiglottitis

Upper

What is epiglottitis?

Inflammation of the epiglottis, LIFE-THREATENING

What causes epiglottitis?

Haemophilus influenzae type B (HiB) (common infection in children) and throat trauma

What happens when infected with epiglottitis?

Epiglottis becomes inflamed and swollen, pushing down and blocking the trachea. Causes airway obstruction, leading to trouble breathing (tripod position)

Manifestations of epiglottitis

Fever, sore throat, dysphagia, drooling w/ mouth open, tripod position, inspiratory stridor, respiratory distress, central cyanosis, anxiety, and pallor

Tripod position

A sitting position where the person leans forward, supports themselves with their hands on their knees, or on a surface like a chair or table

Upper or Lower?: Laryngitis

Upper

What is laryngitis?

Inflammation of the larynx

What is the larynx?

Voice box

What causes laryngitis?

Infection, increased upper respiratory exudate and overuse of the voice

Manifestations of laryngitis

Hoarseness, weak voice or voice loss, tickling sensation and raw feeling in the throat, sore throat, dry cough, difficulty breathing

Upper or Lower?: Laryngotracheobronchitis

Upper

What is laryngotracheobronchitis also known as?

Croup

What is croup?

Common viral infection in children, usually parainfluenza and adenoviruses

What happens when infected with croup?

Larynx and surrounding area swell, leading to airway narrowing, obstruction, and respiratory failure

Manifestations of croup

Nasal congestion, SEAL-LIKE BARKING COUGH, hoarseness, inspiratory stridor, dyspnea, anxiety, central cyanosis

Upper or Lower?: Influenza

Both

What is influenza?

A viral infection that affects the upper and lower respiratory tract. Spreads fast and changes often

Most common and severe type of influenza in the US?

Type A

Type B and type C influenza

B: less severe. C: usually causes small outbreaks

When is the flu season in the U.S.?

October through march

Population at risk for influezna

Children, elderly, and the immunocompromised

Incubation period of influenza

1-4 days

Manifestations of influenza

Fever, headache, chills, dry cough, body aches, nasal congestion, sore throat, sweating, malaise

How do you prevent the transmission of influenza?

Hand washing, isolation, avoid big crowds, annual vaccination

Upper or Lower?: Acute bronchitis

Lower

What is acute bronchitis?

Inflammation of the tracheobronchial tree or large bronchi

What causes acute bronchitis?

Viruses, bacterial, irritant inhalation, and allergic reactions

Manifestations of acute bronchitis

Productive or non-productive cough, dyspnea, wheezing, low-grade fever, pharyngitis, malaise, chest discomfort

Upper or Lower?: bronchiolitis

Lower

What is bronchiolitis?

Common acute inflammation of the bronchioles, usually respiratory syncytial virus (RSV)

High risk population for bronchiolitis?

Children younger than 1 years old during the winter months (IMPORTANT)

What can bronchiolitis lead to?

Atelectasis and respiratory failure

What happens when infected with bronchiolitis?

Virus infects bronchioles causing swelling and mucus buildup. The airways narrow, and can lead atelectasis

Manifestations of bronchiolitis

Nasal drainage, nasal congestion, cough, wheezing, rapid and shallow respirations, CHEST RETRACTIONS, dyspnea, fever, tachycardia, and malaise

Difference between acute bronchitis and bronchiolitis

Acute bronchitis: inflammation of the tracheobronchial REE or large bronchi. Bronchiolitis: acute inflammation of the bronchioles (can lead to atelectasis + respiratory failure, and RSV is main cause)

Upper or Lower?: Pneumonia

Lower

What is pneumonia?

Inflammation damages bronchial and alveolar membranes

Most common cause of pneumonia

Aspiration of oropharyngeal secretions

Most common and deadly type of pneumonia

Streptococcus pneumoniae

Most common viral cause of community-acquired pneumonia (CAP)

Influenza

Manifestations of pneumonia

Productive or nonproductive cough, fatigue, pleuritic pain, dyspnea, fever, chills, crackles/rales, pleural rub, tachypnea, and mental status changes in elderly

How to prevent pneumonia

Hand washing, avoiding crowds, vaccinations, turning, coughing, deep breathing, and smoking cessation

Complications of pneumonia

Septicemia, pulmonary edema, lung abscess, and acute respiratory distress syndrome

Viral pneumonia

Usually mild, can lead to secondary bacterial pneumonia (nonproductive with low grade fever)

Bacterial pneumonia

More common than viral, most often due to streptococcus pneumoniae (productive with higher fever)

Aspiration pneumonia

From aspirated fluid entering the lungs. Causes: impaired gag reflex, improper lower

Lobar pneumonia

Confined to a single lobe (described based on the affected lobe)

Bronchopneumonia

Most frequent type, a patchy pneumonia across several lobes

Interstitial (atypical) pneumonia

Occurs in the areas between the alveoli, routinely caused by viruses or by uncommon bacteria

Nosocomial pneumonia

Develops more than 48 hours after a hospital admission

Community-acquired pneumonia

Acquired outside the hospital or healthcare setting

Ventilator-associated pneumonia

Occurs in patients that have been on mechanical ventilation for more than 48 hours

Upper or Lower?: Tuberculosis

Lower

What causes tuberculosis?

Mycobacterium tuberculosis

How is tuberculosis spread?

Airborne droplets

Why can tuberculosis sometimes trigger a type IV hypersensitivity?

Bacteria travels to lymph nodes

Caseous necrosis

Cheese-like dead tissue inside granulomas

Ghon complex

Calcified lesion seen on chest x-ray (tubercle + infected lymph node)

Manifestations of tuberculosis

Productive cough, hemoptysis, night sweats, fever, chills, UNEXPLAINED WEIGHT LOSS, anorexia

How to prevent tuberculosis

Vaccination, respiratory precautions, adequate ventilation, appropriate isolation

What is asthma?

Chronic condition with intermittent reversible airway obstruction

What triggers asthma?

Infections, smoke, allergens, cold air, stress, etc

Causes of asthma?

Airway inflammation, bronchoconstriction, bronchospasm, bronchial edema, and mucus overproduction

What is extrinsic asthma?

Asthma caused by IgE response to allergens. Triggers are pollen, dust, food and meds. Typically starts in childhood/adolescence

What is intrinsic asthma?

Not caused by allergens. Starts after the age 35. Triggers are infections, air pollution, stress, cold air, exercise, and smoke

What is nocturnal asthma?

Usually occurs within 3-7 AM. May be related to circadian rhythms

When does exercise induced asthma occur?

10-15 minutes after activity, and can linger for an hour

What is occupational asthma?

Asthma related to a reaction to substances at work

What is drug-induced asthma frequently caused by?

Aspirin, as it prevents the a powerful bronchoconstrictor from being released. Potentially fatal attack up to 12 hours post-ingestion

Stage 1 in Asthma

Peaks within 15-30 minutes, often starts with coughing

Stage 2 of asthma

Peaks within 6 hours of symptom onset. Due to airway swelling and mucus buildup

Manifestations of asthma

Wheezing, SoB, dyspnea, chest tightness, cough, tachypnea, anxiety

What is Status asthmaticus?

A severe, life-threatening asthma attack. Lasts a long time and doesn’t respond to usual meds

What can status asthmaticus lead to?

Respiratory alkalosis (early stage) and respiratory failure (late stage)

What does COPD stand for?

Chronic Obstructive Pulmonary Disease

What is COPD?

Chronic, irreversible lung disease. Causes progressive airway obstruction and tissue damage

What can COPD cause?

Cor pulmonale

What is cor pulmonale?

Right-sided heart failure from lung disease

What causes COPD?

Smoking (most common), pollution, chemical irritants, and genetic mutation. Often goes unnoticed early - symptoms can be masked by smoking

What does emphysema do?

Alveolar walls get destroyed leading to large, overinflated air sacs; elastic recoil lost, making pushing air out hard, causing air to be trapped. The lungs become hyperinflated.

Causes of emphysema

Smoking, genetic predisposition (like alpha-1 antitrypsin deficiency), and enzyme deficiency preventing normal lung repair

Manifestations of emphysema

Dyspnea upon exertion, diminished breath sounds, wheezing, chest tightness, tachypnea, hypoxia, hypercapnia, increased anterior-posterior thoracic diameter (from 1:2 to 1:1)(BARREL CHEST), activity intolerance, anorexia, and malaise

What is bronchitis characterized by?

Inflammation of the bronchi, a productive cough, and excessive mucus production/secretions