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Pharmo Drugs Kim > Chapter 20 Patho > Flashcards

Chapter 20 Patho Flashcards

1
Q
  1. What is pulmonary edema results from?
  2. Excessive fluid administration
  3. Right ventricular failure
  4. Pulmonary embolus.
  5. Excessive movement of fluid from the pulmonary vascular system to the extravascular system and air spaces of the lungs. fluid seeps into the perivascular and peribronchial spaces.
A
  1. Excessive movement of fluid from the pulmonary vascular system to the extravascular system and air spaces of the lungs. fluid seeps into the perivascular and peribronchial spaces.
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2
Q
  1. What simply put pulmonary edema is?
  2. Pulmonary embolus.
  3. Fluid in the alveolar wall and interstitial spaces.
A
  1. Fluid in the alveolar wall and interstitial spaces.
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3
Q
  1. What is interstitial spaces?
  2. Space between the lungs.
  3. Space between bronchials.
  4. Spaces between alveoli
A
  1. Spaces between alveoli
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4
Q
  1. What is as pulmonary edema worsens?
  2. Fluid moves from the alveoli, bronchioles, bronchi, trachea, and coughed out the mouth.
  3. Right ventricular failure
  4. Pulmonary embolus.
  5. Excessive movement of fluid from the pulmonary vascular system to the extravascular system and air spaces of the lungs.
A
  1. Fluid moves from the alveoli, bronchioles, bronchi, trachea, and coughed out the mouth.
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5
Q
  1. What is the fluid from pulmonary edema washes?
  2. Pulmonary embolus.
  3. Fluid in the alveolar wall and interstitial spaces.
  4. Out the surfactant causes alveolar collapse.
A
  1. Out the surfactant causes alveolar collapse.
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6
Q
  1. What is the Major Pathologic or Structural changes?
  • Interstitial edema
  • Alveolar flooding
  • Increased surface tension.
  • Alveolar shrinkage and atelectasis.
  • Frothy white/pink secretions throughout the tracheobronchial tree.

Or

  1. Fluid moves from the alveoli, bronchioles, bronchi, trachea, and coughed out the mouth.
  2. Right ventricular failure
  3. Pulmonary embolus.
  4. Excessive movement of fluid from the pulmonary vascular system to the extravascular system and air spaces of the lungs.
A
  • Interstitial edema
  • Alveolar flooding
  • Increased surface tension.
  • Alveolar shrinkage and atelectasis.
  • Frothy white/pink secretions throughout the tracheobronchial tree.
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7
Q
  1. What the etiology of pulmonary edema can be divided into two catagories.
  2. Space between the lungs.
  3. Space between bronchials.
  4. Spaces between alveoli
  5. Cardiogenic and noncardiogenic
A
  1. Cardiogenic and noncardiogenic
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8
Q
  1. What is the most common cause of cardiogenic pulmonary edema?
  2. Excessive fluid administration
  3. Right ventricular failure
  4. Left sided heart failure. commonly called congestive heart failure or CHF.
  5. Pulmonary embolus.
A

left sided heart failure. commonly called congestive heart failure or CHF.

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9
Q
  1. What is number of people in the US that have CHF
  2. 6 million that about 1.8% of the population
  3. 5 million, that about 1.7% of the population
A
  1. 5 million, that about 1.7% of the population
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10
Q
  1. What is number of new cases of CHF diagnosed annually
  2. 440,000
  3. 340,000
  4. 550,000
A

550,000

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11
Q
  1. CHF is most common and leading cause of hospitalization in the US in
  2. people over the age of 65
  3. people over the age of 60
A

people over the age of 65

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12
Q
  1. CHF is more common among
  2. European people
  3. African Americans
  4. White Americans
A

African americans

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13
Q
  1. What is number of deaths annually in the US due to CHF
  2. 230,000
  3. 300,000
A

300,000

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14
Q
  1. Cardiac pulmonary edema occurs when
  2. The left ventricle is not able to pump out all the blood it receives from the lungs.
  3. Right ventricular failure
  4. Left sided heart failure. commonly called congestive heart failure or CHF.
  5. Pulmonary embolus.
A
  1. The left ventricle is not able to pump out all the blood it receives from the lungs.
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15
Q
  1. What is the normal values for LVEF
  2. 40-50%
  3. 47-60%
  4. 55-70%
A
  1. 55-70%
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16
Q
  1. a LVEF less than 40%
  2. May confirm heart failure

Or

  1. May confirm lung failure
A
  1. May confirm heart failure
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17
Q
  1. LVEF less than 35%
  2. May confirm heart failure

Or

  1. Life threatening and cardiac arrhythmias are likely
A
  1. Life threatening and cardiac arrhythmias are likely
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18
Q
  1. What normal hydrostatic pressure
  2. 20-15 mmHg
  3. 24-56 mmHg
  4. 14-18 mmHg
  5. 10-15 mmHg
A
  1. 10-15 mmHg
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19
Q
  1. What is normal colloid osmotic forces?
  2. 29-38 mmHg
  3. 20-35 mmHg
  4. 25-30 mmHg
A
  1. 25-30 mmHg
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20
Q
  1. What the colloid osmotic pressure is referred to as
  2. The oncotic pressure and is produced by the albumin and globulin in the blood.
  3. Right ventricular failure
  4. Left sided heart failure. commonly called congestive heart failure or CHF.
  5. Pulmonary embolus.
A
  1. The oncotic pressure and is produced by the albumin and globulin in the blood.
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21
Q
  1. Fluid stability is caused by
  2. The left ventricle is not able to pump out all the blood it receives from the lungs.
  3. The balance between hydrostatic and osmotic pressure.
  4. Left sided heart failure. commonly called congestive heart failure or CHF.
  5. Pulmonary embolus.
A
  1. The balance between hydrostatic and osmotic pressure.
22
Q
  1. What breath sounds early pulmonary edema?
  2. Crackles , maybe rhonchi later on

Or

  1. Stridor, wheeze
A
  1. Crackles , maybe rhonchi later on
23
Q
  1. What is vital signs?

Decrease HR, RR, BP

Or

Increase HR, RR, BP

A

increase HR, RR, BP

24
Q
  1. What is physical exam?

Potassium low
Sodium low
Chloride low
Brain natriuretic peptide or BNP is elevated (indicator of heart failure)

Or

Cheyne-stokes respirations.
PND or orthopnea
Cyanosis
Cough and sputum production. frothy and pink.
Peripheral edema
A 
Cheyne-stokes respirations.
PND or orthopnea
Cyanosis
Cough and sputum production. frothy and pink.
Peripheral edema
25
Q
  1. What is the PFT’s?

1. Obstructive or Restrictive

A

Restrictive

26
Q
  1. What is the abnormal lab test
  2. Tumors
  3. Increased venous pressure.

Or

Potassium low
Sodium low
Chloride low
Brain natriuretic peptide or BNP is elevated (indicator of heart failure)

A

Potassium low
Sodium low
Chloride low
Brain natriuretic peptide or BNP is elevated (indicator of heart failure)

27
Q
  1. What is the Lymphatic Insufficiency?
  2. Commonly referred to as Congestive Heart Failure (CHF)

Or

  1. Tumors
  2. Increased venous pressure.
A
  1. Tumors

2. Increased venous pressure.

28
Q
  1. What most commonly caused by left-sided heart failure?
  2. Commonly referred to as Congestive Heart Failure (CHF)

Or

  1. Over transfussion or rapid transfussion of I.V fluids.
  2. Severe malnutrition (hypoproteinemia)
  3. Acute nephritis (renal failure).
A
  1. Commonly referred to as Congestive Heart Failure (CHF)
29
Q
  1. What is Decreased Intrapleural Pressure?
  2. Severe airway obstruction were increase negative pressure is generated.
  3. Sudden removal of pleural effussion.

Or

  1. Over transfussion or rapid transfussion of I.V fluids.
  2. Severe malnutrition (hypoproteinemia)
  3. Acute nephritis (renal failure).
A
  1. Severe airway obstruction were increase negative pressure is generated.
  2. Sudden removal of pleural effussion.
30
Q
  1. What is decreased Oncotic Pressure?
  2. Severe airway obstruction were increase negative pressure is generated.
  3. Sudden removal of pleural effussion.

Or

  1. Over transfussion or rapid transfussion of I.V fluids.
  2. Severe malnutrition (hypoproteinemia)
  3. Acute nephritis (renal failure).
A
  1. Over transfussion or rapid transfussion of I.V fluids.
  2. Severe malnutrition (hypoproteinemia)
  3. Acute nephritis (renal failure).
31
Q
  1. What is inotropic agents?
  2. CPAP/BiPAP is huge in treatment of CHF.
  3. Decreases vascular congestion
  4. Increases oxygenation.
  5. Decreases work of breathing
  6. Hopefully eliminates the need for intubation and mechanical ventilation

Or

Increase cardiac muscle contractility and cardiac output
Pumping heart harder and faster
Dobutamine - mild
Digitalis
Dopamine - moderate
Norepinephrine (levophed) severe
Milrinone
A 
Increase cardiac muscle contractility and cardiac output
Pumping heart harder and faster
Dobutamine - mild
Digitalis
Dopamine - moderate
Norepinephrine (levophed) severe
Milrinone
32
Q
  1. What is antidysrhythmic agents?
  2. CPAP/BiPAP is huge in treatment of CHF.
  3. Decreases vascular congestion
  4. Increases oxygenation.
  5. Decreases work of breathing
  6. Hopefully eliminates the need for intubation and mechanical ventilation

Or

Bradycardia : atropine
Tachycardia: procainamide, metoprolol, or bretylium

A

Bradycardia : atropine

Tachycardia: procainamide, metoprolol, or bretylium

33
Q
  1. What Oxygen Therapy is done?
  2. Treat Hypoxia
  3. Decreases cardiac workload
  4. Decreases work of breathing
  5. Caused by capillaries SHUNTING
  6. Partially refractive to O2 therapy

Or

  1. CPAP/BiPAP is huge in treatment of CHF.
  2. Decreases vascular congestion
  3. Increases oxygenation.
  4. Decreases work of breathing
  5. Hopefully eliminates the need for intubation and mechanical ventilation
A
  1. Treat Hypoxia
  2. Decreases cardiac workload
  3. Decreases work of breathing
  4. Caused by capillaries SHUNTING
  5. Partially refractive to O2 therapy
34
Q
  1. What is the Lung Expansion Therapy?
  2. CPAP/BiPAP is huge in treatment of CHF.
  3. Decreases vascular congestion
  4. Increases oxygenation.
  5. Decreases work of breathing
  6. Hopefully eliminates the need for intubation and mechanical ventilation

Or

Bradycardia : atropine
Tachycardia: procainamide, metoprolol, or bretylium

A
  1. CPAP/BiPAP is huge in treatment of CHF.
  2. Decreases vascular congestion
  3. Increases oxygenation.
  4. Decreases work of breathing
  5. Hopefully eliminates the need for intubation and mechanical ventilation
35
Q
  1. What is Aerosolized Medication?
  2. Treat Hypoxia
  3. Decreases vascular congestion
  4. Increases oxygenation.

Or

  1. Bronchodilators (Both adrenergic and cholinergic.
  2. Bronchospasm cased by increased airway secretions.
A
  1. Bronchodilators (Both adrenergic and cholinergic.

2. Bronchospasm cased by increased airway secretions.

36
Q
  1. Decrease hydrostatic pressure.
  2. Positioning the patient in fowlers. (Sitting upright)

Or

  1. Positioning the patient in low. (Sitting uplift)
A
  1. Positioning the patient in fowlers. (Sitting upright)
37
Q
  1. What are the medications Preload Reducers?
  2. Nitroglycerin (Bid), Minitra, Nitrostat, Diuretic, Furosemide (Lasix), Morphine Sulfate
  3. Captopril, Enalapril (Vasotec), Nitroprusside (Nitropress)
A
  1. Nitroglycerin (Bid), Minitra, Nitrostat, Diuretic, Furosemide (Lasix), Morphine Sulfate
38
Q
  1. What are the medications Afterload Reducers?
  2. Nitroglycerin (Bid), Minitra, Nitrostat, Diuretic, Furosemide (Lasix), Morphine Sulfate
  3. Captopril, Enalapril (Vasotec), Nitroprusside (Nitropress)
A
  1. Captopril, Enalapril (Vasotec), Nitroprusside (Nitropress)
39
Q
  1. Which of the following is considered the hallmark of bronchietasis?
  2. Pursed-Lip breathing
  3. Malnutrition.
  4. Large quantities of foul-smelling sputum.
  5. Bronshospasm
A
  1. Large quantities of foul-smelling sputum.
40
Q
  1. In pulmonary edema, fluid first moves into the:
I. Alveoli.
II. Perivascular interstitial space.
III. Bronchioles.
IV. Peribronchial interstitial spaces
A. II only
B. I only
C. II & IV only
D. I & III only
A

C. II & IV only

41
Q
  1. Albumin may be given to a pulmonary edema patient to:

A. Increase the Oncotic pressure.
B. Decrease the hydrostatic pressure
C. Increase capillary permeability
D. Decrease blood pressure.

A

A. Increase the Oncotic pressure.

42
Q
  1. Which of the following is the best test to detect a pulmonary embolism.

A. Ventilation/perfussion scan.
B. Spiral C.T scan.
C. CXR.
D. PFT.

A

B. Spiral C.T scan.

43
Q
  1. In the Midwestern part of the U.S., what is the most common fungal infection of the lungs?

A. Coccidioimycosis
B. Blastomycosis
C. Histoplasmosis
D. Cryptococcal infection

A

C. Histoplasmosis

44
Q
  1. A patient who has an uncontrolled T.B. infection will show all of the following signs EXCEPT:

A. Weight loss
B. High fever
C. Bloody sputum
D. Night sweats

A

B. High fever

45
Q
  1. All of the following are causes of the cardiogenic pulmonary edema EXCEPT.
A. Myocardial infarction.
B. Mitral valve disease
C. Allergic reaction to drug
D. Congential heart defects
E. Mahamed doesn't think allergies have anything to do this it!
A

C. Allergic reaction to drug

46
Q
  1. The best treatment to reverse Pulmonary Edema using a Respiratory Therapy modality would be:

A. Nasal cannula with O2 at 2 lpm
B. CPAP with 100% O2
C. SVN with Duoneb
D. IPPB with Albuterol

A

B. CPAP with 100% O2

47
Q
  1. You draw ABG’s on a patient in the ER. They are on a 48y.o. female patient that weighs 480 lbs and complains of a sudden onset of dyspnea. She recently had gastric bypass surgery 7 days ago and states she has not gotten out of bed much. The results are as followed: pH 7.50, PaCO2: 24, HCO3: 26, PaO2: 47.

A. Respiratory Acidosis with Mild Hypoxemia
B. Respiratory Alkalosis with Mild Hypoxemia
C. Metabolic Alkalosis with Moderate Hypoxemia
D. Respiratory Alkalosis with Moderate Hypoxemia

  1. What is the first thing you should do for the above patiewnt?

I. SVN with Albuterol
II. CPAP
III. Non-rebreather mask with 100% O2
IV. SVN with 2cc of Mucomyst 20%

  1. What clinical condition could be responsible for these ABG’s?

A. Asthma exacerbation
B. Chronic emphysema
C. Pulmonary emboli
D. Pneumonia

A

D. Respiratory Alkalosis with Moderate Hypoxemia

II. Non-rebreather mask with 100% O2

C. Pulmonary emboli

48
Q
  1. An Albuterol nebulizer treatment is affective in treatment a patient with pulmonary edema.

A. True
B. False

49
Q
  1. Therapeutic intervention of Pulmonary Edema should include?
A. Preload reducers
B. Afterload reducers
C. Inotropic agents
D. Oxygen therapy
E. Noninvasive positive pressure ventilation
F. All of the above
A

F. All of the above

50
Q
  1. The diuretic, Lasix, is an example of what in the treatment of Pulmonary Edema.

A. Preload reducers
B. Afterload reducers
C. Inotropic agents
D. Antidysrhythmic

A

A. Preload reducers

Pharmo Drugs Kim (23 decks)

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