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Pathophysiology > Alterations of Respiratory System > Flashcards

Alterations of Respiratory System Flashcards

1
Q

What are possible causes of hemoptysis?

A

bronchitis, TB, abscess, neoplasms and other conditions causing hemorrhage

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2
Q

Define hypoventilation

A

decreased alveolar ventilation causing increased PaCO2

Can be caused by obstruction or altered neuro status

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3
Q

What are the complications of hypoventilation?

A

hypercapnia, respiratory acidosis

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4
Q

Define hypercapnia

A

increase in CO2 in the blood
Can result in low pH >electrolyte abnormalities>dysrhythmias
Can lead to somnolence and coma due to intracranial pressure changes

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5
Q

How does hypoxemia differ from hypoxia ?

A

Hypoxemia=reduced oxygenation. of arterial blood

Hypoxia=reduced oxygenation of tissues

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6
Q

What is normal blood pH

A

7.35-7.45

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7
Q

What are obstructive lung diseases?

A

Asthma, Cystic fibrosis

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8
Q

What are the chronic obstructive pulmonary diseases?

A

Emphysema
Chronic Bronchitis
Bronchiesctasis

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9
Q

What is the patho of asthma

A
  • Inflammation caused by Hyper-responsiveness of airways to environmental triggers
  • Bronchial smooth muscle spasm
  • Edema formation
  • Tenacious mucus production and obstruction
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10
Q

What are the S&S of an asthma attack

A

congestion, wheezing, dyspnea, tachycardia, tachypnea, circumoral cyanosis, disphoresis, pallor, use of accessory muscles

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11
Q

In what order should asthma drugs be given in?

A
  1. bronchodilators
  2. Long acting bronchodilators
  3. Anticholinergics
  4. Corticosteroids
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12
Q

What defines a COPD

A

Chronic inflammation and obstruction of airflow from the lungs

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13
Q

How does airway collapse and air trapping present diagnostically?

A

Decrease in forced expiratory volume

Increase in residual volume and total lung capacity

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14
Q

What are the clinical manifestations of emphysema?

A

Dyspnea on exertion or at rest (little cough or sputum production)
Use of accessory muscles for ventilation
Often v thin with prolonged respirations
Hyperresonant sounds with percussion

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15
Q

What are the S&S of chronic bronchitis?

A

wheezing, dyspnea, productive cough and possible hypoxemia with exercise
Cyanosis, cor pulmonae, polycythemia, chronic hypoventilation

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16
Q

What is cor pulmonale

A

Form of heart failure commonly caused by COPD in which the right side fails due to long term pulmonary hypertension

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17
Q

What are treatments for COPD?

A

Bronchodilators, anticholinergics, chest physio, resp training, oxygen admin for severe hypoxemia
(Antibiotics for chronic bronchitis)

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18
Q

What is the patho of tuberculosis?

A
  • Transmitted in airborne droplets of bacilli causing pneumonitis
  • Macrophages and neutrophils seal bacilli into tubercle, infected tissues inside die within 10 days
  • Can lie dormant for years
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19
Q

What increases one’s risk for tuberculosis?

A

Poor nutritional status, insulin dependant diabtetes, long term steroids, AIDs

20
Q

What are the clinical manifestations of tuberculosis?

A

Asymptomatic when latent
Fatigue, weight loss, lethargy, anorexia, low grade fever in afternoon and night sweats
Late symptoms-dyspnea, chest pain, cough with purulent sputum and hemoptysis

21
Q

What are treatments for tuberculosis?

A

Antibiotics (isoniazid, rifampin, ethambutol) to control and prevent

22
Q

Which pulmonary infection causes a characteristic barking cough and subglottic edema

A

Croup

23
Q

What is the treatment for croup?

A

May resolve spontaneously in a couple days
If no stridor, little treatment. Can use steroid with half life of 36-72 hours
Use of misted air?

24
Q 
A pt presents with congestion, dyspnea and cough. The HCP listens to the patient's lungs and discovers crackles and wheezes bilaterally.
What does the HCP suspect is the cause?
a) Viral Pneumonia 
b) Strep pneumonia 
c) tuberculosis
A

a) Viral pneumonia
Viral pneumonia often begins with a cough and congestion and in abcense of a fever. Viruses affect both sides of the lungs creating a more homogenous inflammatory response

25
Q

What are risk factors for pneumonia?

A

Elderly, immmunocompromised, lung disease, alcoholism, altered conciousness, smoking, intubation, malnutritin, immobilization

26
Q

What are the types of

  1. Community acquired pneumonias
  2. Nosocomial pneumonias
A
  1. strep, flu, chlamydia

2. staph, aeruginosa

27
Q

Why might someone get worse after beginning antibacterials for pneumonia?

A

Lysis of pneumococcal (strep) bacteria releases toxic bacteria proteins, worsening symptoms

28
Q

What negative effect does the immune response contribute to in pneumonia?

A

The release of inflammatory mediators and immune complexes can damage bronchial mucous membranes and alveolocapillary membranes causing terminal bornchioles to fill with infectious debris and exudate
-Leads to dyspnea and hypoxemia

29
Q

How does viral pneumonia create desirable environment for future infections?

A
  • It damages ciliated epithelial cells which normally prevent pathogens from reaching LRT
  • Invades bronchial mucous glands and sloughing of destroyed bronchial epithelium occurs, preventing mucociliary clearance
  • Bronchial walls become edematous and infiltrated with WBCs
30
Q

What if CF?

A

Autosomal recessive inherited disease in chromosome 7 resulting in abnormal expression of cystic fibrosis transmembrane regulator

31
Q

Define:

Compression atelectasis

A

Lung collapse caused by external pressure on lung tissue

ex. tumors, fluid, air, or even abdominal distention!

32
Q

Define:

Absorption atelectasis

A

from gradual absorption of air from obstructed or hypoventilated alveoli, inhalation of concentrated O2 r anesthetic agents

33
Q

Define:

Sufactant impairment atelectasis

A

decreased production or inactivation of surfactant necessary to reduce tension in the aveoli
Can be due to premature burth, acute resp distress syndrome, anesthesia or mechanical ventilation

34
Q

Define:

Transudative pleural effusion

A

Presence of fluid in the pleural space
Transudate is watery and diffuse out of capillaries due to conditions lowering intravascular hydrostatic or capillary oncotic pressure which promotes diffusion of fluid out of the capillaries.
(ex. left sided CHF, liver and kidney disorders causeing hypoproteinemia)

35
Q

Define:

Exudative pleural effusion

A

Less watery fluid in the pleural space with high contents of WBCs and plasma proteins
Due to infection, inflammation or malignancy that increases capillary permeability

36
Q

What denotes

  1. emphyema
  2. hemothorax
  3. chylothorax
A
  1. pus
  2. blood
  3. chyle (fatty lymph)
37
Q

What is the patho of CF?

A
  • Abnormal secretions in respiratory, digestive and reproductive tracts
  • Resp failure caused by plugging, chronic inflammation and infection (causing microabcesses, pneumonia and cysts)
  • Mucus secreting cells are increased in number and size and mucus is more viscous
  • Resp failure common cause of death
38
Q

What are S&S of CF?

A

Persistent cough, resp problems, recurrent pneumonia, wheeze
GI problems, malabsorptive symptoms, meconium ileus

39
Q

Sweat test denotes a pt secretes high levels of electrolytes in their sweat
What level of [Cl] mEq/L is above normal and what does this mean?

A

> 60mEq/L denotes cystic fibrosis

40
Q

What is the treatment for CF

A

High caloric diet high in fat soluble vitamins

Chest physio, bronchodilators, antibiotics, lung transplant

41
Q

What is the difference between a pneumothorax and atelectasis?

A
  • Pneumothorax is build up of air in the pleural space caused by a rupture in the visceral or parietal pleura
  • Atelectasis is the collapse of lung tissue
42
Q

Define:

Primary (spontaneous) pneumothorax

A

-Caused unexpectedly bay rupture of blebs (blister like formations) on the visceral pleura

43
Q

Define:

Secondary pneumothroax

A

Caused by trauma such as rib fracture, stab or bullet wounds that tear the pleura, rupture of bleb or bulla in COPD or mechanical ventilation

44
Q

Define:

Iatrogenic pneumothorax

A

commonly caused by transthoracic needle aspiration

45
Q

What is an open and a tension pneumothorax?

A

Open- air pressure in pleural space=barometric pressure, bc air drawn in through inspiration is forced back out
Tension- air is permitted into pleural space in inhalation, but prevented from removal in expiration. Air pressure exceeds barometric pressure. Can cause compression atelectasis against the mediastinum displacing the heart

Pathophysiology (9 decks)

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