Respiratory

Inflamed, twitchy airways that intermittently squeeze shut — and the exam-defining deterioration ladder: wheeze → quiet chest → silent chest.

Emphysema and chronic bronchitis converge on one problem — air the patient can’t get back out — and the oxygen question the exam loves has a right answer.

Infection fills the alveoli with pus, blood keeps flowing past air sacs that no longer ventilate — and in the elderly the only warning may be new confusion.

A clot from a leg vein wedges in a pulmonary artery — sudden dyspnea with clear lungs, and one of the most preventable causes of hospital death.

One bacterium, two states: latent TB is silent and non-infectious; active TB is the airborne-precautions, four-drug, directly-observed-therapy story every nurse must know cold.

An inflammatory insult makes the alveolar-capillary membrane leak — the lungs flood from the inside, blood shunts past drowned alveoli, and turning up the oxygen does not help. Survival rides on protecting the lung while it heals.

The lungs stop getting enough oxygen in — or enough carbon dioxide out. Type 1 is a PaO₂ problem, Type 2 is a PaCO₂ problem, and the sleepy patient with a normal SpO₂ is the one the monitor misses.

Air, blood, or a broken chest wall stops the lung from expanding — and one untreated version, tension pneumothorax, stops the heart. The nurse who reads the water-seal chamber correctly is the safety system.

Fluid where only a slick film belongs — and the nurse’s job is to read the dull chest, prepare the tap, and watch the hour after it.

A virus that strips the airway lining in two days — the window for antivirals, the reason for droplet precautions, and the doorway for bacterial pneumonia.

High pressure in the lung’s arteries makes the right ventricle push against a wall — and when it finally fails, the lung disease has become heart disease.

As the throat muscles relax in sleep, a crowded airway collapses again and again; oxygen falls, the brain jolts awake to reopen it, and the night is spent fighting to breathe — leaving daytime sleepiness, high blood pressure and a patient who is dangerous to sedate.

Most lung cancer is smoking-related and silent until advanced. Non-small cell lung cancer (about 85%) can be cured by surgery when caught early; small cell lung cancer (about 15%) grows fast, spreads early and causes paraneoplastic syndromes such as SIADH. Hence annual low-dose CT screening for eligible adults.

A respiratory infection caused by SARS-CoV-2 that ranges from no symptoms to critical illness. It spreads before symptoms start. Older age is the strongest risk factor for severe disease. High-risk outpatients need an antiviral within days of symptom onset. Hospitalized patients who need oxygen get dexamethasone. Health care staff use an N95-or-higher respirator, gown, gloves and eye protection.

A group of more than 200 disorders that scar and stiffen the lung interstitium, so oxygen crosses into the blood poorly. Idiopathic pulmonary fibrosis is the most common type. It has no known cause, no cure and a poor prognosis. Expect progressive breathlessness, a dry cough, high-pitched crackles, clubbing, a restrictive pattern with a low DLCO, and oxygen that drops with exertion. Antifibrotics slow decline but do not reverse scarring.

Cystic fibrosis is an autosomal recessive disease of the CFTR chloride channel: secretions lose water and become thick, plugging airways, pancreatic ducts, bile ducts and the intestine, and sweat becomes salty. The sweat chloride test (60 mmol/L or greater) is the standard diagnostic test. Care centers on daily airway clearance, treating Pseudomonas and other infections, pancreatic enzymes with meals and fat-soluble vitamins, CFTR modulators for eligible mutations, and watching for CF-related diabetes, DIOS, hemoptysis and pneumothorax.