patho test 3

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1

rhinovirus is most prevalent in

early fall and late spring

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2

rhinovirus is the most common source of colds in

5-40 year olds

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3

how many know serotypes of the rhinovirus are there

100+

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4

acquire lifetime immunity to an individual serotype

rhinovirus

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5

respiratory syncytial virus is prevalent in what months

winter & spring

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6

viruses most common in children under 3 years old

respiratory syncytial and parainfluenza

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7

parainfluenza accounts for 75% of the cases for

croup / acute laryngotracheobronhitis

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8

H. influenza is a secondary complication of

viral pneumonia

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9

acute bacterial rhinosinustis can be due to

h. influenza or streptococcus pneumonia

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10

h. influenza is the name for any infection caused by

bacteria

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11

h. influenza can be the cause of

epiglottis

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12

peptostreptococcus can cause

chronic rhinosinusitus

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13

fusobacterium can cause

chronic rhinosinusitus

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14

subtype hemagglutinin (HA) and subtype neuraminidase (NA) are

strands of influenza virus

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15

subtype hemagglutinin (HA) is an

attachment protein that aids viral entry

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16

subtype neuraminidase (NA) aids

viral replication and release from host cel

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17

fatty liver & encephalitis

reyes syndrome

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18

triavelent inactivated influenza vaccine

TIIV

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19

live attenuated influenza vaccine

LAIV

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20

what is LAIV

a type of flu vaccine in the form of nasal spray

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21

how often is a new flu vaccine made

yearly

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22

lobar pneumonia

infection found contained within a part or all of a lung lobe

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23

bronchopneumonia

patchy infection involving more than one lobe

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24

community acquired pneumonia

infections begin in an individual outside of a hospital or nursing home setting

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25

pneumonia in immunocompromised person

compromised hosts are without many of the functioning defenses that protect us from morbidity and mortality when exposed to infective agents

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26

examples of pneumonia in immunocompromised persons

bone marrow/organ transplantation, cancers, on immunosuppressant drugs

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27

squamous cell carcinoma consists of

24-40% of bronchogenic carcinomas

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28

bronchogenic carcinomas

aggressive, locally invasive, metastatic tumors that arise from epithelial lining of bronchi;

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29

adenocarcinoma makes up how much of bronchogenic carcinomas

25-40%

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30

mostly in male smokers

squamous cell carcinoma

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31

squamous cell carcinoma originates in

central bronchi

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32

amenable to early detection; metastasis outside the thorax occurs later than in other bronchogenic cancers

squamous cell carcinoma

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33

most common type found in US; most common form found in women and nonsmokers

adenocarcinoma

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34

more peripheral in location & associated with areas of scarring

adenocarcinoma

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35

small cell carcinoma makes up ____ of bronchogenic carcinomas

20-25%

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36

small cell carcinoma

distinctive small, round oval cells that grow in clusters; strong association with cigarette smoking, highly malignant

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37

70% have undergone metastases at time of diagnosis; brain involvement common

small cell carcinoma

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38

large cell carcinoma makes up

10-15%

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39

large polygonal cells, tend to occur at lung periphery

large cell carcinoma

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40

large cell carcinoma has poor

prognosis because of early spread

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41

expiratory grunt

when child tries to raise the functional residual capacity by closing the glottis at the end of expiration

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42

nasal flaring

method used by infants to take in more air; reduces nasal resistance and maintains airway potency (open)

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43

inspiratory retractions

pulling in the soft tissue surround the cartilaginous and bony thorax is seen when the airway is obstructed

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44

extra-thoracic airway obstruction affects

nose, pharynx, larynx, upper trachea

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45

extra-thoracic airway obstruction produces

turbulence of airflow and audible inspiratory crowing sound, stridor

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46

intrathoracic airway obstruction

bronchi and bronchioles

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47

intrathoracic airway obstruction produces

audible wheezing or whistling sound

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48

respiratory distress syndrome (RDS)

hyaline membrane disease; common in premature infants

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49

bronchopumonary dysplasia (BPD)

chronic pulmonary disease that develops in premature infants who were treated with mechanical ventilation

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50

croup or acute laryngotracheobornchitis is a

viral infection that affects larynx, trachea and bronchi

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51

commonly seen in children 3 months to 5 years old

croup

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52

usually follows a cold, observe stridor and a wet, barking coughs, symptoms lessen with moist air

croup

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53

epiglottitis

life threatening supraglottic infection that may cause airway obstruction and asphyxia

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54

child sits with mouth open and chin thrust forward; can be caused by haemophilus

epiglottitis

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55

bronchiolitis is caused by

respiratory syncytial virus

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56

most commonly seen in children under 2

bronchiolitis

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57

symptoms of bronchiolitis

breathlessness, rapid or shallow breathing, wheezing, cough and inspiratory retraction

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58

hydrothorax

clear fluid serous transudate (congestive heart failure)

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59

exudates

pleural fluid with specific gravity > 1.020 (infections)

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60

empyema

purulent pus drainage with direct infection or lung abscess rupture

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61

chylothorax

effusion of lymph into thoracic cavity

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62

hemothorax

presence of blood; requires drainage

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63

atelectasis

incomplete expansion of lung due to airway obstruction, lung compression or increased recoil of lung

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64

pneumothorax

lung compression

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65

without surfactant

increased recoil of lung

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66

extrinsic (atopic) asthma is initiated by

type 1 hypersensitivity rxn after exposure to extrinsic antigen or allergin

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67

usual onset in childhood/adolescent, family history of atopic allergy; often other allergic disease are present

atopic asthma

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68

intrinsic (nonatopic) asthma

triggered by infections, exercise, hyperventilation, cold air, drugs, chemicals, airborne pollutants, gastroesophageal reflux

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69

exercise induced asthma occurs in _____ of cases

40-90%

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70

severe (refractory) asthma

less than 5% increased risk for fatal attacks

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71

chronic obstructive bronchitis

small airway obstruction

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72

emphysema

enlargement of airspaces and destruction of lung disease

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73

loss of lung elasticity, enlargement of alveolar air spaces

emphysema

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74

hyperinflation of lungs with increased TLC is an example of

emphysema

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75

causes of _____ include smoking, inherited a1 antitrypsin deficiency

emphysema

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76

bronchiectasis

uncommon COPD type, permanent dilation of bronchi due to muscle or elastic tissue destruction with infection and inflammation

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77

saccular bronchiectasis

proximal 3rd-4th generation bronchi affected, dilated bronchi end in blind sacs with collapse and fibrosis of distal lung tissue

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78

cylindrical bronchiectasis

uniform, moderate dilation of 6th-8th generation of airways, milder disease

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79

varicose bronchiectasis

2nd-8th generation of bronchi affected; bronchi resemble varicose veins; variable symptoms; not as severe

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80

localized bronchiectasis

caused by tumors, foreign material and mucus plugs, affects any area of lung

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81

generalized bronchiectasis

affects lower lobes, bilateral; due to inherited or acquired disorders

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82

some disorders that may cause generalized bronchiectasis

decreased mucociliary function with cystic fibrosis, TB infection, exposure to toxic gases

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83

pulmonary embolism

blood-borne substance lodges in pulmonary artery branch obstructing flow; 1o arise from deep vein thrombosis (DVT) in lower exterminates

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84

pulmonary embolism results in

bronchi constriction, lower ventilation and or gas exchange, loss of surfactant that can lead to pulmonary hypertension and right heart failure

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85

medium emboli

breathlessness and pleuritic pain; blood streaked sputum

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86

massive emboli

crushing substernal pain, shock, lower BP, neck vein distention, skin cyanosis, often fatal

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87

treated with thrombolytics and then long-term heparin/warfarin treatment

pulmonary embolism

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88

secondary pulmonary hypertension

associated with cardiac or pulmonary diseases

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89

acute respiratory distress syndrome (ARDS) results from

aspiration, drugs/toxins/therapeutic agents, infections or trauma/shock

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90

breathing becomes more difficult; impaired gas exchange and hypoxia

ARDS

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91

what happens during ARDS

produce different epithelial cell injury with increased permeability of alveolar- capillary membrane; leads to edema fluid accumulation, surfactant inactivation & impervious hyaline membrane

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92

ventilation-perfusion mismathching

areas receive blood but no air OR air but no blood; seen with COPD, pneumonia, atelectasis, restrictive lung diseaseca

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93

can have anesthetic affect on CNS

CO2 narcosis

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94

achalasia

lower esophageal sphincter doesn’t releax

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95

barrett esophagus

strictures caused by scar tissue, spasm and edema

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96

hiatal hernia

abnormal gap around the wall of the esophagus can produce herniation of stomach into the thoracic cavity h

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97

heartburn

servere, appears 30-60 min after eating, worsened by bending at waist

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98

esophageal diverticulum

out pocketing of esophageal wall caused by weakness of muscularis; can retain food within diverticulum

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99

helicobacter pylori gastritis

antrum and body, very common in US; gram negative motile rod-shaped bacterium that moves through mucous layer of stomach; produces ammonia to buffer stomach acid; produces enzyme and toxins that produce inflammation and elicit immune response

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100

autoimmune gastritis

least common; found in fundus and body, associated with pernicious anemia; autoimmune destruction of parietal cells, hypochloremia, increased PH, risk of developing gastric carcinoma

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