Module 7 Cough&Dyspnea pt1&2

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1

Tuberculosis

Bug: Mycobacterium Tuberculosis

Caseous Necrosis

Ghon Complex --> Granuloma --> Walled of necrosis where dormant bacteria can live

HIV can lead to TB

Slow growing & hard to kill

2

Pneumonia

Inflammatory process fo lungs

Fluid in alveoli= sucking/cracking sound

When tapping on chest & hear dullness=fluid in lungs

Sound travels better in liquid "blue moon"

Alveoli fill with bacteria, mucus=coughing/dyspnea

3

What is Acute Bronchitis

Sudden inflammation of the Bronchial Tree

4

Causes of Acute Bronchitis

-Non infectious: Irritating factors, environmental toxins, smoking, GERD

-Secondary to Viral URI (upper resp. infection) or bacterial

5

Acute Bronchitis: S/S

- Self limiting: gets better on own

- PRODUCTIVE cough

-Angina (chest pain), congestion, wheezing, fever/chills

6

If Acute Bronchitis is Viral

Will not go away. Cough will not go away. Bacterial will go away quicker

7

3 Types of COPD

1. Chronic Bronchitis

2. Emphysema

3. Asthma

8

Chronic Bronchitis

*inflammation of Bronchiols*

Cannot get air in

Excess mucus secretion & Productive cough

9

Chronic Bronchitis: S/S

Can lead to_____

Blue Bloaters: Hypoxemia --> Rt sided heart failure--> JVD, Bilateral Pedal Edema

- wheezing, SOB, DIB

- Diggital Clubbing

10

Chronic Bronchitis: Testing

-Pulmonary Functional Test

- Chest x-ray/CT

-Sputum culture

11

Chronic Bronchitis: Tx

- Stop smoking

- Continuous O2

- Inhaled bronchodilator

12

Emphysema

Alveolar and pulmonary capillary destruction --> lead to Cor Pulmonale (rt sided heart failure)

Cannot get air out

13

Primary Emphysema

Genetic

Alpha 1 Antitrypsin deficiency (made in liver)--> keeps elastase in check --> destroys healthy lung tissue

14

Secondary Emphysema

From smoking/2nd hand smoke --> inactivates Alpha 1 Antitrypsin = decrease enzyme activity

15

Emphysema & Antitrypsin

Cannot get antitrypsin out of liver

16

Emphysema: S/S

-Decreased Tidal Volume

- UNPRODUCTIVE cough

- Diggital Clubbing

- Excess air in lungs (cant get air out)

- Dyspnea, fatigue, wt loss, pursed lips

17

Asthma

Inflammatory airway disorder of the bronchial musoca w/ bronchial hyperresponsivness & reversible bronchoconstriction

18

Asthma: S/S

- Coughing, wheezing, Mucus production, SOB

- Status Asthmatics--> Hypoxemia= respiratory acidoses= low expiratory flow,

- Pulsus Paradoxus: low systolic BP(too much air in chest)

19

Asthma TX:

Beta 2 Agonist vs Beta 2 Antagonist

Corticosteroids

Beta 2 Agonist àIfhave asthma would want to take, relaxes smooth muscle increasing airways

Beta 2 Antagonist àDoes not help

Corticosteroids decreaseinflammation àSuppress immune system

20

Pulmonary Embolism (PE)

Occlusion of the pulmonary vascular bed by an embolus. Can cause infarction--> if not, will be dissolved by fibrinolytic enzymes

21

Pulmonary Emolism: Causes

- DVT --> 90% from leg/ pulmoary veins

- Virchow's Triad-->

  1. venous stasis
  2. hypercoagability
  3. vascular damage
22

Saddle Embolism

Pulmonary Embolism (PE)

Lt & Rt Pulmonary Artery obstruction

23

Pulmonary Embolism: Testing

(CT) MDCTA