CardioResp Final

Question 1

Which type of COPD has rhonchi as one of the breath sounds?

Answer 1

Chonric bronchitis

Question 2

What is emphysema?

Answer 2

Destruction and enlargement of the lung alveoli, decreasing the surface area for gas exchange and distal air trapping.

Question 3

What are the physical exam findings with patients who have emphysema?

Answer 3

Quiet chest with decreased breath sounds
Thin, older patient
Prominent accessory breathing muscles
Severe dyspnea

Question 4

What can be used to diagnose and monitor COPD?

Answer 4

Pulmonary Function Tests (PFTs)

Question 5

What has a dose dependent relationship with COPD?

Answer 5

Cigarette smoking

Question 6

What genetic factor may create a deficiency that could lead to COPD?

Answer 6

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

Question 7

Is COPD reversible?

Answer 7

NO and it affects 10 million + people in the USA

Question 8

What are chest xray findings that may suggest COPD?

Answer 8

Flattened/blunted costophrenic angles and hyperinflated lungs (air trapping)

Question 9

What are the two main types of restrictive lung diseases?

Answer 9

Extrinsic (problems outside the lung)

Intrinsic (problems in lung tissue)

Question 10

Random question: what is Pickwickian Syndrome?

Answer 10

Low levels of oxygen and high levels of CO2 in the blood.

Aka Obesity Hypoventilation Syndrome

Question 11

How may the intrinsic lung tissue become damaged?

Answer 11

Idiopathic Pulmonary Fibrosis
Sarcoidosis
Asbestosis

Question 12

What 3 diseases could be the cause of neuromuscular dysfunction that would affect the intercostal muscles/diaphragm

Answer 12

ALS
Guillain-Barre Syndrome
Myasthenia Gravis

Question 13

In which condition would you see ground glass appearance and honeycombing in the lungs from a CXR?

Answer 13

Interstitial lung disease - a restrictive lung condition w/pulmonary fibrosis

Question 14

What level of forced vital capacity suggests restrictive defect? (Hint: percentage)

Question 15

Is the FEV1/FVC ratio affected in restrictive lung diseases?

Answer 15

No, it is normal. Unlike obstructive disease

Question 16

What is restrictive lung disease?

Answer 16

Trouble filling the lungs fully because the total lung capacity has been decreased?

Question 17

Ejection Fraction

Answer 17

A measure of how much blood is being pumped out by the heart with each contraction

Question 18

What is the normal or preserved EF? (%)

Answer 18

50-60%

Question 19

What is used to measure the ejection fraction?

Answer 19

ECHO

Question 20

Which type of heart failure has a decreased Ejection Fraction

Answer 20

Systolic heart failure

Question 21

Describe diastolic heart failure

Answer 21

Thickening of the myocardium such that the ventricle cannot fully relax and fill properly during diastole

Question 22

Describe systolic heart failure

Answer 22

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

Question 23

What factor does heart failure exponentially increase with?

Answer 23

Age

Question 24

T/F Heart failure is a syndrome, not a disease, and there is no single causative agent of it

Answer 24

True

Question 25

List the main causes of heart failure

Answer 25

``` Coronary Artery Disease Myocardial Infarction Hypertension Valvular dysfunction Cardiomyopathy Lung diseases High output failure ```

Question 26

What is the predominant cause of heart failure in men and women in industrialized countries?

Answer 26

CAD

Question 27

What is myocardial infarction?

Answer 27

Death or damage to myocytes (from CAD) leading to a weakly or unevenly beating ventricle

Question 28

What is the most common valvular dysfunction leading to heart failure?

Answer 28

Aortic Stenosis

Question 29

What is dilated cardiomyopathy?

Answer 29

Failure d/t reduced contractile force, which causes back up into the lungs

Question 30

What is hypertrophic cardiomyopathy?

Answer 30

A genetic disorder that causes heart failure d/t disorientation of cells and noncompliant ventricle Leads to diastolic (filling) dysfunction

Question 31

What is Cor Pulmonale?

Answer 31

High vascular resistance in the lungs leading to right ventricular failure (d/t COPD, pulmonary embolism, pulmonary hypertension)

Question 32

What are some clinical findings or diseases that can trigger heart failure when underlying structural damage already exists?

Answer 32

Severe anemia Thyroid disease Tachycardia/arrhythmia

Question 33

What is the affect of renin?

Answer 33

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)

Question 34

Is chronic bronchitis a pathologic or clinical diagnosis?

Answer 34

Clinical diagnosis