patho test 3

rhinovirus is most prevalent in

early fall and late spring

rhinovirus is the most common source of colds in

5-40 year olds

how many know serotypes of the rhinovirus are there

100+

acquire lifetime immunity to an individual serotype

rhinovirus

respiratory syncytial virus is prevalent in what months

winter & spring

viruses most common in children under 3 years old

respiratory syncytial and parainfluenza

parainfluenza accounts for 75% of the cases for

croup / acute laryngotracheobronhitis

H. influenza is a secondary complication of

viral pneumonia

acute bacterial rhinosinustis can be due to

h. influenza or streptococcus pneumonia

h. influenza is the name for any infection caused by

bacteria

h. influenza can be the cause of

epiglottis

peptostreptococcus can cause

chronic rhinosinusitus

fusobacterium can cause

chronic rhinosinusitus

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

strands of influenza virus

subtype hemagglutinin (HA) is an

attachment protein that aids viral entry

subtype neuraminidase (NA) aids

viral replication and release from host cel

fatty liver & encephalitis

reyes syndrome

triavelent inactivated influenza vaccine

TIIV

live attenuated influenza vaccine

LAIV

what is LAIV

a type of flu vaccine in the form of nasal spray

how often is a new flu vaccine made

yearly

lobar pneumonia

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

bronchopneumonia

patchy infection involving more than one lobe

community acquired pneumonia

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

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

examples of pneumonia in immunocompromised persons

bone marrow/organ transplantation, cancers, on immunosuppressant drugs

squamous cell carcinoma consists of

24-40% of bronchogenic carcinomas

bronchogenic carcinomas

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

adenocarcinoma makes up how much of bronchogenic carcinomas

25-40%

mostly in male smokers

squamous cell carcinoma

squamous cell carcinoma originates in

central bronchi

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

squamous cell carcinoma

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

adenocarcinoma

more peripheral in location & associated with areas of scarring

adenocarcinoma

small cell carcinoma makes up ____ of bronchogenic carcinomas

20-25%

small cell carcinoma

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

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

small cell carcinoma

large cell carcinoma makes up

10-15%

large polygonal cells, tend to occur at lung periphery

large cell carcinoma

large cell carcinoma has poor

prognosis because of early spread

expiratory grunt

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

nasal flaring

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

inspiratory retractions

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

extra-thoracic airway obstruction affects

nose, pharynx, larynx, upper trachea

extra-thoracic airway obstruction produces

turbulence of airflow and audible inspiratory crowing sound, stridor

intrathoracic airway obstruction

bronchi and bronchioles

intrathoracic airway obstruction produces

audible wheezing or whistling sound

respiratory distress syndrome (RDS)

hyaline membrane disease; common in premature infants

bronchopumonary dysplasia (BPD)

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

croup or acute laryngotracheobornchitis is a

viral infection that affects larynx, trachea and bronchi

commonly seen in children 3 months to 5 years old

croup

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

croup

epiglottitis

life threatening supraglottic infection that may cause airway obstruction and asphyxia

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

epiglottitis

bronchiolitis is caused by

respiratory syncytial virus

most commonly seen in children under 2

bronchiolitis

symptoms of bronchiolitis

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

hydrothorax

clear fluid serous transudate (congestive heart failure)

exudates

pleural fluid with specific gravity > 1.020 (infections)

empyema

purulent pus drainage with direct infection or lung abscess rupture

chylothorax

effusion of lymph into thoracic cavity

hemothorax

presence of blood; requires drainage

atelectasis

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

pneumothorax

lung compression

without surfactant

increased recoil of lung

extrinsic (atopic) asthma is initiated by

type 1 hypersensitivity rxn after exposure to extrinsic antigen or allergin

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

atopic asthma

intrinsic (nonatopic) asthma

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

exercise induced asthma occurs in _____ of cases

40-90%

severe (refractory) asthma

less than 5% increased risk for fatal attacks

chronic obstructive bronchitis

small airway obstruction

emphysema

enlargement of airspaces and destruction of lung disease

loss of lung elasticity, enlargement of alveolar air spaces

emphysema

hyperinflation of lungs with increased TLC is an example of

emphysema

causes of _____ include smoking, inherited a1 antitrypsin deficiency

emphysema

bronchiectasis

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

saccular bronchiectasis

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

cylindrical bronchiectasis

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

varicose bronchiectasis

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

localized bronchiectasis

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

generalized bronchiectasis

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

some disorders that may cause generalized bronchiectasis

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

pulmonary embolism

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

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

medium emboli

breathlessness and pleuritic pain; blood streaked sputum

massive emboli

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

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

pulmonary embolism

secondary pulmonary hypertension

associated with cardiac or pulmonary diseases

acute respiratory distress syndrome (ARDS) results from

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

breathing becomes more difficult; impaired gas exchange and hypoxia

ARDS

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

ventilation-perfusion mismathching

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

can have anesthetic affect on CNS

CO2 narcosis

achalasia

lower esophageal sphincter doesn’t releax

barrett esophagus

strictures caused by scar tissue, spasm and edema

hiatal hernia

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

heartburn

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

esophageal diverticulum

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

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

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