CardioResp Final Flashcards
Which type of COPD has rhonchi as one of the breath sounds?
Chonric bronchitis
What is emphysema?
Destruction and enlargement of the lung alveoli, decreasing the surface area for gas exchange and distal air trapping.
What are the physical exam findings with patients who have emphysema?
Quiet chest with decreased breath sounds
Thin, older patient
Prominent accessory breathing muscles
Severe dyspnea
What can be used to diagnose and monitor COPD?
Pulmonary Function Tests (PFTs)
What has a dose dependent relationship with COPD?
Cigarette smoking
What genetic factor may create a deficiency that could lead to COPD?
A severe a1-antitrypsin deficiency which works by slowing down proteases that break down proteins. If it’s deficient, proteases go crazy and start breaking down lung tissue
Is COPD reversible?
NO and it affects 10 million + people in the USA
What are chest xray findings that may suggest COPD?
Flattened/blunted costophrenic angles and hyperinflated lungs (air trapping)
What are the two main types of restrictive lung diseases?
Extrinsic (problems outside the lung)
Intrinsic (problems in lung tissue)
Random question: what is Pickwickian Syndrome?
Low levels of oxygen and high levels of CO2 in the blood.
Aka Obesity Hypoventilation Syndrome
How may the intrinsic lung tissue become damaged?
Idiopathic Pulmonary Fibrosis
Sarcoidosis
Asbestosis
What 3 diseases could be the cause of neuromuscular dysfunction that would affect the intercostal muscles/diaphragm
ALS
Guillain-Barre Syndrome
Myasthenia Gravis
In which condition would you see ground glass appearance and honeycombing in the lungs from a CXR?
Interstitial lung disease - a restrictive lung condition w/pulmonary fibrosis
What level of forced vital capacity suggests restrictive defect? (Hint: percentage)
Is the FEV1/FVC ratio affected in restrictive lung diseases?
No, it is normal. Unlike obstructive disease
What is restrictive lung disease?
Trouble filling the lungs fully because the total lung capacity has been decreased?
Ejection Fraction
A measure of how much blood is being pumped out by the heart with each contraction
What is the normal or preserved EF? (%)
50-60%
What is used to measure the ejection fraction?
ECHO
Which type of heart failure has a decreased Ejection Fraction
Systolic heart failure
Describe diastolic heart failure
Thickening of the myocardium such that the ventricle cannot fully relax and fill properly during diastole
Describe systolic heart failure
The ventricle is large and dilated such that it does not have the elasticity required to pump blood out into the circulation. EF is decreased
What factor does heart failure exponentially increase with?
Age
T/F Heart failure is a syndrome, not a disease, and there is no single causative agent of it
True
List the main causes of heart failure
Coronary Artery Disease Myocardial Infarction Hypertension Valvular dysfunction Cardiomyopathy Lung diseases High output failure
What is the predominant cause of heart failure in men and women in industrialized countries?
CAD
What is myocardial infarction?
Death or damage to myocytes (from CAD) leading to a weakly or unevenly beating ventricle
What is the most common valvular dysfunction leading to heart failure?
Aortic Stenosis
What is dilated cardiomyopathy?
Failure d/t reduced contractile force, which causes back up into the lungs
What is hypertrophic cardiomyopathy?
A genetic disorder that causes heart failure d/t disorientation of cells and noncompliant ventricle
Leads to diastolic (filling) dysfunction
What is Cor Pulmonale?
High vascular resistance in the lungs leading to right ventricular failure (d/t COPD, pulmonary embolism, pulmonary hypertension)
What are some clinical findings or diseases that can trigger heart failure when underlying structural damage already exists?
Severe anemia
Thyroid disease
Tachycardia/arrhythmia
What is the affect of renin?
It combines with angiotensinogen to eventually increase angiotensin II and aldosterone to promote salt and water retention, in order to increase blood pressure (renin-angiotensin-aldosterone cascade)
Is chronic bronchitis a pathologic or clinical diagnosis?
Clinical diagnosis
