Respiratory System PDF

 Organism: group A B hemolytic streptococci (most common)  Symptoms: sore throat, difficulty in swallowing, ear ache, FAHM  Signs: tachycardia, enlargement of cervical lymph nodess  Types: a) Acute follicular tonsillitis: the suppurative inflammation is confined to the lymp...

 Organism: group A B hemolytic streptococci (most common)  Symptoms: sore throat, difficulty in swallowing, ear ache, FAHM  Signs: tachycardia, enlargement of cervical lymph nodess  Types: a) Acute follicular tonsillitis: the suppurative inflammation is confined to the lymph follicles, pus accumulates in the crypts and appears on the surface as yellowish dots  B) acute parenchymatous tonsillitis: the suppurative inflammation is diffuse in the tonsils and surrounding tissues  C) peritonsillary abscess (quinzy): an abscess is formed in tonsil and peritonsillar tissue. Unilateral -trismus (lock jaw) -dysphagia -deviation of uvula to other side Complications: 1- spread of infection to the surrounding tissue 2- chronic tonsillitis, due to repeated infection 3-rheumatic fever, or diffuse glomerulonephritis  Age: children  Organism: exotoxic corynebacterium diphtheriae  Mode of infection: droplet infection  Incubation period: 1-7 days  Effect: - local: pseudomembrane in URT - systemic: due to dissimination of exotoxin into circulation that evokes lesions in many organs of the body Pathological features: 1- edema and congestion 2- toxins: necrosis of epithelium + fibrinopurulent exudate = dirty grayish white pseudomembrane Complications: 1- laryngeal obstruction due to edema 2- suffocation which may be fatal unless tracheostomy is done. It is due to separation of a part of the pseudomembrane obstructing air passages 3- Toxaemia: toxic myocarditis, bilateral renal tubular necrosis, suprarenal hemorrhage  Papilloma of larynx: arise from vocal cord - Papilloma in adults: single and precancerous - Papilloma in children: multiple, not precancerous, usually of viral origin, recurrent after removal (reassurance)  Ccc by increased irritability of tracheobronchial tree to various stimuli resulting in paroxysmal contraction of bronchial airways  Cp: expiratory dyspnea, wheeze and cough Extrinsic asthma Intrinsic asthma IgE mediated -non immune hypersensitivity mediated e.g RT reaction on exposure infection or drugs extrinsic antigen -starts on the first 2 decades of life -Adults -+ family history -Increased serum - no family history levels of IgE and -normal serum levels eosinophils of IgE Mast cell degranulation mediated by antigen cross-linking of IgE bound to IgE Fc receptors (FcRI).  Marked vasodilatation of blood vessels  Bronchospasm  Increased mucous secretion  Def: consolidation of lung tissue by the presence of an intra alveolar inflammatory exudate of infective origin  Classification:  - lobar pneumonia, bronchopneumonia  - bacterial, viral, fungal, rickettsial, chlamydial and protozoal  Patchy consolidation  With suppurative inflammation of the bronchi and surrounding alveoli  Occurs in extremes of life (infancy and old age)  In children it usually complicates measels, whooping cough and gastroentritis  Causative organism: staphylococci, streptococci, pneumococci and H influenza  Multiple patches of consolidation  Multilobar bilateral basal  Microscopic: the bronchi, bronchioles and adjacent alveoli are filled by suppurative exudate  1- lung abscess  2- spread: pleura (empyema), pericardium ( suppurative pericarditis)  3- healing by fibrosis ( lung fibrosis)  4- blood spread (pyeamic abscess) in other organs  Def: fibrinous inflammation affecting an entire lobe of the lung  Organism: pneumococci, staph, strept, H.influenza  Pathologic features: congestion, hepatization (consolidation), resolution  Age: early childhood  Organism: respiratory syncitial virus  Gross : hemorrhagic consolidation of both lungs  Microscopic: marked congestion and diffuse alveolar damage  Secondary infection with pyogenic bacteria transforms the disease into severe suppurative bronchopneumonia