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M3 > CMD - Dyspnea > Flashcards

CMD - Dyspnea Flashcards

1
Q

subjective experience of breathing discomfort that consists of qualitatitively distinct sensations that vary in intensity

A

Dyspnea

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2
Q

The motor cortex responding to unput from the control center sends neural messages to the ventilator muscle and a ____ to the sensory cortex

A

corollary discharge

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3
Q

respiratory sensations are the consequence of interactions between the efferent or outgoing, motor output from the brain to the ventilatory musces

a. feedforward
b. feedback
c. corollary discharge
d. NOTA

A

A

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4
Q

afferent, or incoming, sensory input from receptors throughout the body (feedback)

a. feedforward
b. feedback
c. corollary discharge
d. NOTA

A

B

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5
Q

3 impulses in the sensory cortex

A

feedback
feedforward
error signa

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6
Q

4 afferents to the sensory cortex

A

Chemoreceptors
Mechanoreceptors
Metaboreceptors
Motor cortex

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7
Q

The corollary discharge is sent from

a. sensory cortex
b. motor cortex
c. ventilatory muscles
d. Mechanoreceptors

A

B

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8
Q

2 factors leading to dyspnea intensity

A

Dyspnea affective component

Dyspnea quality and unpleasantness

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9
Q

Breathing is controlled by the respiratory center located in the

a. brainstem
b. pons
c. medulla

A

C

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10
Q

The following statement is true

a. The respiratory center in the pons control breathing
b. Dyspnea is a result of cortical stimulation
c. the respiratory center is stimulated by abnormalities in blood gases as detected by lung mechanoerceptors
d. AOTA

A

B

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11
Q

Disorders of the ventilatory pump include

a. increased airway resistance or stiffness
b. decreased compliance
c. J receptors
d. A and B
e. B and C

A

D

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12
Q

______ is Increased neural output by the motor cortex sent to the sensory cortex

A

corollary discharge

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13
Q

Location of sensory afferents involved in dyspnea

A

carotid bodies

medulla

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14
Q

carotid bodies and medulla are activated by (3)

A

hypoxemia
acute hypercapnia
acidemia

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15
Q

location of mechanoreceptors involved in dyspnea

A

Lungs

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16
Q

lung mechanoreceptors are stimulated by

A

bronchospasm, sensation of chest tightness

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17
Q

These recpetors are sensitive to interstitial edema, are activated by acute changes in pumonary artery pressure, and contribute to air hunger

A

J receptors and pulmonary vascular receptors

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18
Q

Location of metaboreceptors involved in dyspnea

A

skeletal muscle

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19
Q

3 parameters in assessment of dyspnea

A

quality of sensation
sensory intensity
baseline dyspnea index

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20
Q

chest tightness or constriction EXCPET

a. Asthma
b. CHF
c. COPD
d. NOTA

A

C

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21
Q

Increased work or effort of breathing EXCEPT

a. CPD
b. asthma
c. neuromuscular disease
d. chest wall disease
e. NOTA

A

E

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22
Q

Air hunger, need to breath urge to breathe

a. asthma
b. COPD
c. PE
d. pulmonary fibrosis
e. neuromuscular disease

A

E

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23
Q

Air hunger, need to breath urge to breathe

a. asthma
b. COPD
c. CHF
d. AOTA

A

D

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24
Q

Inability to get a deep breath, unsatisfying breath

a. CHF
b. PE
c. chest wall disease
d. AOTA
e. NOTA

A

C

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25
Q

Heavy breathing, rapid breathing, breathing more can be found in

a. sedentary status in healthy individual
b. patient with cardiopulmonary disease
c. both
d. neither

A

C

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26
Q

Modified borg scale is used in

a. quality of sensation
b. sensory intensity
c. affective dimension

A

B

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27
Q

Chronic respiratory disease questionnaire are used as a methods which indirectly assess dyspnea due to other factors that limit it

A

Baseline Dyspnea Index

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28
Q

Evokes a stronger affective response then does increased work of breathing

A

Air hunger

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29
Q

What are the most common obstructive lung diseases

A

asthma and COPD

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30
Q

True of dyspnea caused by diseases of the airways EXCEPT

a. Asthma and COPD are characterized by expiratory airflow obstruction
b. leads to hypoxemia and hypocapnia
c. Asthma and COPD causes hyperinflation of lungs and chest wall
d. NOTA

A

B; hypercapnia

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31
Q

Cause of hypoxemia and hypercapnia in asthma and COPD

A

V/Q mismatch

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32
Q

more common as a consequnce of the different ways in which oxygen and carbon dioxide bind to hemoglobin

a. hypoxemia
b. hypoxia
c. hypercapnia
d. hypocapnia

A

A

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33
Q

Stiffen the chest wall

a. COPD
b. Kyphoscoliosis
c. Myasthenia gravis
d. Guillain-Barre Syndrome

A

B

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34
Q 
Weaken ventilatory muscles
A. Myasthenia gravis
B. Guillain-Barre
C. both
D. Neither
A

C

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35
Q

interstitial lung disease is associated to

a. increased stiffness
b. increased work of breathing
c. both
d. neither

A

C

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36
Q

Effect of coronary artery disease and nonischemic cardiomyopathies effect on

left ventricular end- diastolic volume

a. Increase
b. Decrease

A

A

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37
Q

Effect of coronary artery disease and nonischemic cardiomyopathies effect on

left ventricular end- diastolic volume

a. Increase
b. Decrease

38
Q

Effect of coronary artery disease and nonischemic cardiomyopathies effect on

left ventricular end diastolic pulmonary capillary pressures

a. Increase
b. Decrease

39
Q

Effect of coronary artery disease and nonischemic cardiomyopathies effect on

pulmonary capillar pressures

a. Increase
b. Decrease

40
Q

Diastolic dysfunction is shown by LV

a. stiffness
b. dilation
c. hypertrophy
d. NOTA

41
Q

Diastolic dysfunction show by stiff LV may lead to severe dyspnea with relatively mild degrees of physical activity particularly if it is associated with:

A

Mitral Regurgitation

42
Q

Pulmonary thromboembolic disease and primary diseases of pumonary circulation cause dyspnea via the ff EXCEPT

a. increased pulmonary-artery pressure
b. stimulation of pulmonary receptors
c. increased LV end diastolic pressure
d. A and B
e. B and C

43
Q

T/F hyperventilation is common in diseases of pulmonary vasculature

44
Q

Diseases of the pericardium causing dyspnea

A

Constrictive pericarditis and cardiac tamponade

45
Q

Associated with increased pulmonary vascular pressure:

a. constrictive pericarditis
b. coronary artery disease
c. both
d. neither

46
Q

these will be activated if cardiac output is compromised with lactic acidosis

A

metaboreceptors

chemoreceptors

47
Q

Mild to moderate anemia are associated with breathing discomfort during exercise. This is most likely due to

a. Mechanoreceptors
b. Metaboreceptors
c. both
d. neither

A

B; lactic acidosis during exercise is detected by metaboreceptors in the skeletal muscles.

Why not chemoreceptors? chemoreceptors are those in the carotid and medulla

48
Q

Mechanisms of breathlessness in Obesity

A

high cardiac output

impaired ventilatory pump function

49
Q

True of COPD EXCEPT

a. increased work of breathing
b. increased drive to breathe
c. hypoxemia
d. acute hypercapnia

50
Q

True of COPD

a. acute hypercapnia
b. stimulation of pumonary receptors
c. stimulaton of vascular receptors
d. metaboreceptors

51
Q

True about asthma except

a. increased work of breathing
b. stimulation of vascularreceptors
c. increased drive to breathe
d. hypoxemia

52
Q

True about Asthma EXCEPT

a. hypoxemia
b. acute hypercapnia
c. stimulation of pulmonary receptors
d. metaboreceptors

53
Q

True about Interstitial lung disease except

a. Increased work of breathing
b. incrreased drive to breathe
c. hypoxemia
d. acute hypercapnia
e. AOTA

54
Q 
True about interstitial lung disease
A. stimulation of vascular receptors
B. Metaboreceptors
C. Stimulation of Pulmonary Receptors
D. AOTA
55
Q

True of pulmonary vascular disease EXCEPT

a. Increased drive to breathe
b. hypoxemia
c. acute hypercapnia
d. stimulation of vascular receptors

A

C

ito lang 3 ang meron siya

56
Q

True of deconditioning

a. Acute hypercapnia
b. hypoxemia
c. metaboreceptros
d. increased dirve to breathe

A

C ito lang

57
Q

True of anemia

a. hypoxemia
b. acute hypercapnia
c. stimulation of pulmonary receptors
d. metaboreceptors

A

D ito lang

58
Q

Cardiogenic pulmonary edema EXCEPT

a. acute hypercapnia
b. stimulation of pulmonary receptors
c. metaboreceptros
d. hypoxemia

A

C and increased work of breathing ang wala sa kanya

59
Q

not present in Noncardiogenic pulmonary edema

a. acute hypercapnia
b. stimulation of vascular receptors
c. both
d. neither

A

C; and ito lang

60
Q

difference of cardiogenic and non-cardiogenic pulmonary edema

a. acute hypercapnia present only in cardiogenic
b. stimulation of vascular receptors present in cardiogenic but not in non-cardiogenic
c. both
d. neither

61
Q

dyspnea in the upright position

62
Q

platypnea can be found in (2)

A

left atrial myxoma

hepatopulmonary symptom

63
Q

Orthopnea can be found in (3)

A

-CHF
-mechanical impairment of the -diaphragm from obesity
asthma due to GERD

64
Q

Nocturnal dyspnea suggest

A

CHF

Asthma

65
Q

Acute intermittent episodes of dypnea sugest

A

Myocardial ischemia
bronchospasm
Pulmonary embolism

66
Q

Chronic persistent dysnpea seen in

A

-COPD
-interstitial lung disease
chronic thromboembolic -disease

67
Q
  • supraclavicular retractions
  • use of accessory muscles
  • tripod position

are all evidence of

A

increased work of breathing

68
Q

Increased work of breathing is indicative of

A

increased airway resistance/stiffness of the lungs and chest wall

69
Q

systolic pressure decreases by >10mmHg

A

pulsus paradoxus

70
Q

pulsus paradoxus is seen in (3)

A

COPD
acute asthma
pericardial disease

71
Q 
Chest percussion:
dullness is indicative of the ff except 
a. pleural effusion
b. mass
c. hemothorax
d. pneumothorax
72
Q

Hyperresonance of the chest on percussion is

a. normal
b. sign of emphysema

73
Q

When do you hear rales?

A

Interstitial edema/ fibrosis

74
Q

Signs of elevated right heart pressure (3)

A

jugular venous distension
edema
accentuated pulmonic component of S2

75
Q

LV dysfunction is observed in which heart sounds?

76
Q

Give a sign of diaphragmatic weakness

A

Paradoxical movement of the abdomen

77
Q

Rounding of the abdomen during exhalation suggest

A

pulmonary edema

78
Q

clubbing of the digits is an indication of

A

pulmonary fibrosis

79
Q

Do you see clubbing in COPD?

80
Q

Collagen vascular disease that can be associated with pulmonary mx

A

Raynaud’s disease

81
Q

Hyperinflation of lung is due to

A

obstructive lung disease

82
Q

what is common in interstitial edema or fibrosis, diaphragmatic dysfunction or impaired chest wall motion

A

low lung volume

83
Q

in the CXR,prominent pulmonary vasculature in the upper zone indicate

A

pulmonary venous hypertension

84
Q

CXR: enlarged pulmonary artery suggest

A

Pulmonary arterial hypertension

85
Q

CXR: Enlarged cardiac silhouette suggest

A

dilated cardiomyopathy or valvular disease

86
Q

Bilateral pleural effusion on CXR suggest

A

CHF

collagen vascular disease

87
Q

Unilateral pleural effusion on CX suggest

A

malignancy
pulmonary embolism
heart failure

88
Q

intermittent symptom of astma and normal PE and lung function

A

Bronchoprovocation

89
Q

assess CHF in acute dyspnea but can also be elevated in the presence of right ventricular stain

90
Q

Favors cardiac cause of dyspnea EXCEPT

a. heart rate is >85% of predicted maximum
b. bp becomes excessively high or decreases during exercise
c. ischemic changes seen on ECG
d. patient achieves predicted max ventilation but had an increase in dead space

91
Q

True of treatment of dyspnea EXCEPT

a. goal is to correct underlying problem and lessen the intensity of the symptoms
b. supplemental oxygen if saturation is <90%
c. pulmonary rehabilitation
d. no benefit for anxiolytics and antidepressants

M3 (66 decks)

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