Contemp exam II respiratory

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darbydo88
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Contemp exam II respiratory
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2011-02-25 18:36:48
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respiratory diseases
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  1. Serves as the passage for air exchange (2)
    nasal cavity and lungs
  2. Loss of fxn results in Respiratory system when?
    Inflammation causes an overabundance of mucus
  3. structured communities of bacteria bound together by a carb. matrix and surrounded by water channels that deliver nutrients and remove waste
    biofilm
  4. 3 characteristics of biofilm
    • adheres to inanimate objects or living surfaces
    • difficult to kill with antibiotics
    • Complex and may serve as a reservoir of infection
  5. Upper respiratory tract infections involve what anatomical structures (4)
    • Nose
    • Sinuses
    • Larynx
    • Pharynx
  6. Lower respiratory tract infections involve what anatomical structures (4)
    • Trachea
    • Lungs
    • Bronchi
    • Bronchioles
  7. Upper Respiratory Tract Diseases (5)
    • Upper Respiratory tract infection (common cold)
    • Allergic Rhinitis (hay fever)
    • Influenza (flu)
    • sinusitis
    • Tonsilitis/Pharyngitis
  8. Modes of transmission for Upper Respiratory tract diseases
    • Direct oral contact
    • Inhalation of Air born dropplets
    • Indirect contact of hands or articles freshly soilded with discharge of nose or throat of infected person
  9. DH tx for Upper Respiratory tract disease
    • Practice standard precautions
    • delay tx until no longer infected
  10. Lower Respiratory Tract Diseases
    • Pneumonia
    • TB
    • COPD (emphasema, chronic bronchitis)
    • Asthma
    • Cystic fibrosis
  11. Acute Lower Respiratory Tract Disease
    Pneumonia
  12. Chronic Lower Respiratory Tract disease
    • TB
    • Asthma
    • COPD
    • Cystic Fibrosis
  13. Which upper Respiratory diseases are mostly viral?
    • Influenza (flu)
    • Upper respiratory tract infection (cold)
    • Pharyngitis/tonsilitis
  14. Which upper respiratory disease is bacterial
    sinusitis
  15. Etiology of Pneumonia
    • Viral
    • Bacterial (Staphylococcus aureus, streptococcus pneumoniae)
    • Fungal (pneumocystis jirovecii)
  16. Most prevelent pneumonia caused by
    virus
  17. nosocomial bacterial penumonia caused by
    staphylococcus aureus
  18. community bacterial pneumonia caused by
    streptococcus pneumoniae
  19. tx for virus
    supportive bed rest and fluids
  20. tx for bacteria
    antibiotics
  21. tx for fungus
    sulfa drugs
  22. What is CAP
    Community Aquired Pneumonia (obtained from person to person)
  23. Role of oral bacteria in Pneumonia
    serve as a resevoir for lung infections
  24. DH Care for Pneumonia
    • Control Oral Disease (daily biofilm removal +on prosthetic appliances)
    • Educate Healthcare Personnel
    • Maintain standard precautions
    • Teach use of antimicrobial mouthrinses
  25. Etiology of TB
    microbacterium tuberculosis
  26. Transmission TB
    Air born
  27. Symptoms of Clinically Active TB
    • Low grade fever
    • night sweats
    • fatigue
    • weight loss
    • persistant cough
    • chest pain
    • hoarsness
    • hemoptysis
  28. Signs of LTI (latent Tuberulosis infection)
    • ususally none
    • detected by mantoux (tuberculin skin test)
  29. TB risk factors (7)
    • HIV patients
    • IV drug abusers
    • Residents/employees of shared habitations
    • Healthcare workers
    • Immigrants
    • Medically underserved
    • Ethnic background
  30. Drug therapy for TB
    • 6 month min
    • 2 drug regimen of isoniazid, rifampin, rifapentine, pyazinamide
  31. Latent TB drug therapy
    Isoniazid for 9 months
  32. Incubation period of TB
    2-10 weeks
  33. Oral manifestations of TB
    Classic Lesion-painful, deep irregualr ulcer on dorsum of the tongue
  34. DH Care for TB
    • Patient history prep (ask about history and symptoms, meds, and length of tx)
    • medical consulatation
    • standard procedures (min. aerosols, use rubber dam, avoid ultrasonic scaler and air polisher)
  35. tx for clinically active sputum-positive tb
    • do not treat in dental office
    • urgent care must be performed in a hospital setting
    • after several weeks on prescribed meds, with physician clearance, patient may be treated as a healthy person
  36. tx for past hx of tb
    consult w physician
  37. tx of positive tb skin test
    • consult with physician
    • continue w/ tx if disease is absent
    • may be placed on prophylactic isoniazid for 6-12 months
  38. tx for signs and symptoms of tb
    • do not treat
    • refer to a physician
  39. dyspnea
    difficulty breathing
  40. A chronic inflammatory, respiratory disease consisting of recurrent episodes fo dyspnea, coughing, wheezing and is related to bronchial inflammation and muscle constriction
    Asthma
  41. Asthma is classified according to
    • Symptoms
    • severity
    • frequency
    • lung capacity
  42. Average dental practice will see how many asthma patients?
    100
  43. Traditional Classification of Asthma
    • Extrinsic, Atopic (allergic triggers from outside the body)
    • Intrinsic, Nonallergic(nonallergic triggers from within the body) ie stress
  44. NAEPP classification of Asthma
    • Mild intermittent
    • mild persistent
    • moderate persistent
    • severe persistent
  45. based of severity and frequency of symptoms as well as pulmonary fxn assessment
    NAEPP
  46. Drug or food induced (nonallergic, nonatopic)
    • aspirin
    • NSAIDS
    • beta blockers
    • foods
    • tartrazine (yellow food dye)
  47. other classes of asthma
    • drug or food induced
    • exercised induced
    • infection induced
  48. signs and symptoms of Asthma attack
    • chest tightness, difficulty breathing, sense of suffocation
    • wheezing
    • cough
    • flushed appearance, sweating
    • confusion due to lack of oxygen
    • dilated pupils
    • inability to complete a sentence in one breath
  49. emergency care for asthma
    • stop tx
    • rule out foreign body obstruction
    • assist patient with inhaler
    • administer supplemental oxygen
    • initiate emergency procedures
  50. Pathogenesis of Atopic (allergic) asthma
    Immunoglobulin E mediated hypersensitivity rxn
  51. local anaphylaxis: allergen binds to the mast cell in the nasal cavity and results in?
    allergen binds to the mast cell in teh bronchiole: results in?
    • hay fever
    • asthma
  52. Systemic Anaphylaxis
    allergen (penicillin, bee venom, food substance ) binds to mast cells troughout the body: results in anaphylactic shock
  53. Drugs for Asthma
    • Anti-inflammatory agents
    • bronchodilators
    • Combined anti-inlammatory and bronchodilator
  54. Long term controller drugs for asthma
    anti-inlammatory (systemic corticosteroids)...oral issues
  55. Rescue drugs
    bronchodilators
  56. Drugs to avoid for asthma patients
    • Aspirin containing meds
    • sulfite containing local anesthetic
    • NSAIDS
    • Narcotics/barbituates (these decrease respiratory fxn)
    • Erythromycin
  57. oral manefestations of asthma
    • xerostomia
    • dental caries
    • gingivitis
    • reflux
    • enamel erosion
    • candidasis
  58. What meds are contraindiated for asthma
    What analgesic should you use
    • aspirin and NSAIDS
    • acetominophen
  59. recomends for asthma patients
    • fluouride
    • wash mouth after using inhaler
  60. Two types of COPD
    • chronic bronchitis
    • emphysema
  61. Primary etiology of COPD
    • smoking
    • environmental work environment
  62. other risk factors
    • smoking
    • envirnmnetal pllutants
    • viral infections
    • allergy
    • genetic factors
    • periodontal disease
  63. excessive respiratory tract mucus production sufficient to cause a cough with expectoration fro at least 3 month of the year for 2 or more years
    chronic bronchitis
  64. distension of teh air spaces distal to terminal bronchioles due to destruction of alveolar walls (difficulty breathing only upon expiration)
    emphysema
  65. signs and symptoms of bronchitis
    • chronic cough
    • copious sputum
    • sedentary, overweight, cyanotic, edematous, breathless
    • blue bloater
  66. signs and symptoms of emphysema
    • difficulty in breathing upon exertion
    • minimal, nonproductive cough (dry, no mucus)
    • barrel chest
    • weight loss
    • puses lips forcibly expel air
    • pink puffer
  67. does COPD have a cure
    no
  68. medical tx
    • adequate nutrition
    • plenty of water
    • exercise regularly
    • decrease exposure to pollutants
    • have pneumonia and influenza vaccines
    • bronchodilators and other asthma meds
  69. Oral Manifestations (4)
    • halitosis
    • nicotine stomatitis
    • periodontal infections oral cancer
    • extrinsic tooth stains
  70. Before Tx of COPD patient
    • review history
    • avoid tx if infection os present
    • adequate breathing
    • identify symptoms of exacerbation
  71. Clinical Adaptaion
    • shorter appt length
    • adjust chair up
    • no sulfites or nitrous oxide
  72. Patient instruction
    encourage smoking cessation
  73. complex, genetic, life-limiting disorder that involves the pancreas, liver and lungs
    Cystic fibrosis
  74. characteristics of cystic fibrosis
    • mucous secretions of the lungs and digestive tisssus (obstructs the pancreas, liver, and lungs)
    • Pulmonary impairment leading to restrictive lung disease (RLD)
    • Respiratory Failure
  75. pneumothorax
    collapsed lung
  76. pseudomonas aeruginosa
    bacterial infection in patients with cystic fibrosis
  77. Medical tx for cystic fibrosis
    • regular physical activity
    • diet should include enzyme supplements and liquds with high salt intake
    • antibiotics for infections
    • PULMOZYME (mucus thinning soln)
    • NSAIDS
    • Mucus secretion removal
  78. Oral manefestations of Cystic Fibrosis
    • gingivitis with dry mouth
    • diffuse erythema
    • thickinging and elargement of salivary glands
    • lower lip enlarged (swollen and dry)
    • halitosis
  79. adaptations for DH care
    • adjust the chair
    • don't use a rubber dam

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