Bio 212 Course Notes – Exam 4
Ch 36-37 – Disorders of Respiratory and Ventilation/Gas Exchange
Ch 41-43 – Renal and Urinary Disorders
Ch 45-47 – GI Disorders
Ch 36 - Disorders of the Respiratory System
***Review Ch 35 for normal structure/function of the respiratory system
Respiratory infections
Pneumonias – inflammation of the parenchymal structures of the lung in the lower respiratory
tract
4-10 million cases in the US per year
6th leading cause of death
Etiologic agents include infectious and non-infectious agents
o Inhalation or blood spread of pathogens
o Inhalation of irritating gases and fumes
o Aspiration of gastric contents
Classified by type of agent and/or involvement
o Typical – multiplies within the alveoli
Bacteria
o Atypical – multiplies in the septum
Viral, fungal
o Lobar – confined to one lobe
o Broncho – more widespread
Types of pneumonia
o Community acquired
Infection occurs prior to hospitalization, diagnosed within 48 hours
S. pneumoniae, H. influenza, S. aureus
Influenza virus, RSV, adenovirus
o Hospital acquired
Not present or incubating at the time of admission, occurs after 48 hours
20-50% mortality rate
P. aeruginosa, S.aureus, Enterobacter, Klebsilla, E.coli
, o Immunocompromised
Humoral deficiency – bacterial
Cellular deficiency – viral, fungal, mycobacteria, protozoa
o Acute bacterial
Most common – S. pneumoniae
o Legionnaire Disease
Discovered in 1976
L. pneumophilia
o Primary atypical
Most common – Mycoplasma pneumoniae
Less severe than typical
Manifestations:
o High fever, chills
o Fatigue
o Sputum producing cough, often greenish
o Bronchial inflammation
o Shortness and rapid breath due to decreased gas exchange
o Tachycardia
o Nausea, vomiting, diarrhea
Complications (primarily bacterial)
o Sepsis
o Pleuritis, effusion
Diagnosis
o Blood tests, chest x-rays, pulse oximetry, sputum testing
Treatment
o Fluids and electrolytes
o Antibiotics
o Antiviral drugs
o Fever reducers
o Cough suppressants
o Possible hospitalization if severe
,Tuberculosis – bacterial infection caused by Mycobacteria tuberculosis which is spread by
airborne particles in respiratory fluids of individuals with active TB
Foremost cause of death from a single infectious agent on the planet
2 billion people infected globally
9.4 million new cases per year
2 million latent infections estimated
Drug resistant strains are now common
Primary TB
o Often asymptomatic
o Most develop a latent TB infection as the immune system walls off the bacteria in
granulomas called Ghon complexes
Often found at the low end of the upper lobes or the high ends of the lower
lobes
Obligate aerobes
Secondary TB
o Reinfection or reactivation of the dormant bacteria
o Manifestations:
Fever, weight loss, fatigue, cough, pleuritic
Diagnosis
o Tuberculin skin tests
False positives and false negatives
o Chest X-rays
o Bacteriologic studies of sputum or respiratory secretions
Treatment
o Multiple drug therapy
o Prophylactic treatment for those at risk
, Ch 37 – Disorders of Ventilation and Gas Exchange
Disorders of Lung Inflation
Pleural effusion – abnormal collection of fluid in the pleural cavity
Normally fluid enters cavity through capillaries in the parietal pleura, interstitial spaces
of the lungs and through small holes in the diaphragm and is removed by the lymphatic
vessels in the parietal pleura
o If formation exceeds removal – accumulation occurs
Types and etiologies:
o Exudative – transudate or exudate
Bacterial pneumonia, viral infections, pulmonary infarction, malignancies
o Empyema – fluid from infection, leukocytes, proteins, cellular debris
Bacterial pneumonia, ruptured lung abscess, subdiaphragmatic infections
o Chylothorax – lymph filled with chylomicrons
Trauma, inflammation, malignancies, obstruction
Most common in the fetus and neonates
Manifestations:
o Dyspnea
o Diminished breath sounds
o Hypoxemia
Diagnosis: Chest imaging, thoracentesis
Treatment: Treat underlying cause
Hemothorax – pleural effusion in which blood accumulates in the pleural cavity
Etiologies: chest trauma, complications from surgery, malignancies, rupture of a great
vessel
Minimal – ~250 mL, often clears in 10-14 days via normal reabsorption
Moderate - ~1/3 of the pleural space, signs of lung compression and loss of BV
o Requires immediate drainage and fluid replacement
Large - ~1/2 of the pleural space, often caused by a high pressure bleed
o Requires drainage and surgery to stop the bleed
Manifestations:
Pneumothorax – presence of air in the pleural cavity – causes full or partial lung collapse
Spontaneous
o No obvious cause – rupture of an air filled bleb on the lung surface
o Tall, smoking, family history
o Secondary – associated with lung disease
Ch 36-37 – Disorders of Respiratory and Ventilation/Gas Exchange
Ch 41-43 – Renal and Urinary Disorders
Ch 45-47 – GI Disorders
Ch 36 - Disorders of the Respiratory System
***Review Ch 35 for normal structure/function of the respiratory system
Respiratory infections
Pneumonias – inflammation of the parenchymal structures of the lung in the lower respiratory
tract
4-10 million cases in the US per year
6th leading cause of death
Etiologic agents include infectious and non-infectious agents
o Inhalation or blood spread of pathogens
o Inhalation of irritating gases and fumes
o Aspiration of gastric contents
Classified by type of agent and/or involvement
o Typical – multiplies within the alveoli
Bacteria
o Atypical – multiplies in the septum
Viral, fungal
o Lobar – confined to one lobe
o Broncho – more widespread
Types of pneumonia
o Community acquired
Infection occurs prior to hospitalization, diagnosed within 48 hours
S. pneumoniae, H. influenza, S. aureus
Influenza virus, RSV, adenovirus
o Hospital acquired
Not present or incubating at the time of admission, occurs after 48 hours
20-50% mortality rate
P. aeruginosa, S.aureus, Enterobacter, Klebsilla, E.coli
, o Immunocompromised
Humoral deficiency – bacterial
Cellular deficiency – viral, fungal, mycobacteria, protozoa
o Acute bacterial
Most common – S. pneumoniae
o Legionnaire Disease
Discovered in 1976
L. pneumophilia
o Primary atypical
Most common – Mycoplasma pneumoniae
Less severe than typical
Manifestations:
o High fever, chills
o Fatigue
o Sputum producing cough, often greenish
o Bronchial inflammation
o Shortness and rapid breath due to decreased gas exchange
o Tachycardia
o Nausea, vomiting, diarrhea
Complications (primarily bacterial)
o Sepsis
o Pleuritis, effusion
Diagnosis
o Blood tests, chest x-rays, pulse oximetry, sputum testing
Treatment
o Fluids and electrolytes
o Antibiotics
o Antiviral drugs
o Fever reducers
o Cough suppressants
o Possible hospitalization if severe
,Tuberculosis – bacterial infection caused by Mycobacteria tuberculosis which is spread by
airborne particles in respiratory fluids of individuals with active TB
Foremost cause of death from a single infectious agent on the planet
2 billion people infected globally
9.4 million new cases per year
2 million latent infections estimated
Drug resistant strains are now common
Primary TB
o Often asymptomatic
o Most develop a latent TB infection as the immune system walls off the bacteria in
granulomas called Ghon complexes
Often found at the low end of the upper lobes or the high ends of the lower
lobes
Obligate aerobes
Secondary TB
o Reinfection or reactivation of the dormant bacteria
o Manifestations:
Fever, weight loss, fatigue, cough, pleuritic
Diagnosis
o Tuberculin skin tests
False positives and false negatives
o Chest X-rays
o Bacteriologic studies of sputum or respiratory secretions
Treatment
o Multiple drug therapy
o Prophylactic treatment for those at risk
, Ch 37 – Disorders of Ventilation and Gas Exchange
Disorders of Lung Inflation
Pleural effusion – abnormal collection of fluid in the pleural cavity
Normally fluid enters cavity through capillaries in the parietal pleura, interstitial spaces
of the lungs and through small holes in the diaphragm and is removed by the lymphatic
vessels in the parietal pleura
o If formation exceeds removal – accumulation occurs
Types and etiologies:
o Exudative – transudate or exudate
Bacterial pneumonia, viral infections, pulmonary infarction, malignancies
o Empyema – fluid from infection, leukocytes, proteins, cellular debris
Bacterial pneumonia, ruptured lung abscess, subdiaphragmatic infections
o Chylothorax – lymph filled with chylomicrons
Trauma, inflammation, malignancies, obstruction
Most common in the fetus and neonates
Manifestations:
o Dyspnea
o Diminished breath sounds
o Hypoxemia
Diagnosis: Chest imaging, thoracentesis
Treatment: Treat underlying cause
Hemothorax – pleural effusion in which blood accumulates in the pleural cavity
Etiologies: chest trauma, complications from surgery, malignancies, rupture of a great
vessel
Minimal – ~250 mL, often clears in 10-14 days via normal reabsorption
Moderate - ~1/3 of the pleural space, signs of lung compression and loss of BV
o Requires immediate drainage and fluid replacement
Large - ~1/2 of the pleural space, often caused by a high pressure bleed
o Requires drainage and surgery to stop the bleed
Manifestations:
Pneumothorax – presence of air in the pleural cavity – causes full or partial lung collapse
Spontaneous
o No obvious cause – rupture of an air filled bleb on the lung surface
o Tall, smoking, family history
o Secondary – associated with lung disease
