Conditions - Gold

Question 1

Congestive Heart Failure

Answer 1

Heart unable to pump sufficient amount of blood, causing body to respond with increase in blood volume, cardiac filling pressure, heart rate, and cardiac muscle mass.

May have pulmonary edema, nocturnal dyspnea, orthopnea, S3 gallop, dry cough, exertional dyspnea with low level exercise, sudden weight gain, cyanotic extremities, SOB.

L sided heart failure associated with signs of pulmonary venous congestion. R sided heart failure associated with signs of systemic venous congestion.

Question 2

Cystic Fibrosis

Answer 2

Causes exocrine glands to overproduce thick mucus, which causes obstruction.
Autosomal recessive genetic disorder (both parents are carriers)
Decreased FEV1 and FVC; increased FRC and RV.
Chest PT should be performed several times a day and include postural drainage, percussion, vibration, breathing and assisted coughing techniques, and ventilatory muscle training.
Most common cause of death is respiratory failure, usually in 40s

Question 3

Emphysema

Answer 3

Accumulation of air in the lungs found with COPD. Can destroy alveolar walls, forming pockets of air that increase dead space and diminish gas exchange.
Results from long history of chronic bronchitis, recurrent alveolar inflammation, or genetic predisposition.
Barrel chest appearance, increased subcostal angle, rounded shoulders due to tight pecs, and rosy skin coloring.
Symptoms are persistent cough, wheezing, difficulty, breathing (especially expiration), and increased RR.
FEV1, FVC, and VC decreased; TLC, RV, and FRC increased.

Question 4

Myocardial Infarction

Answer 4

Occurs when there is poor coronary artery perfusion, ischemia, and subsequent necrosis of cardiac tissue.
Risk factors include pt or family hx of heart disease, smoking, physical inactivity, stress, hypertension, elevated cholesterol, DM, and obesity.
Clinical presentation may include deep pain or pressure in the substernal area with or without pain radiating to the jaw or into L arm or back.

Question 5

Peripheral Vascular Disease

Answer 5

Narrowing of lumen of blood vessels causing reduction in circulation, usually due to atherosclerosis.
Risk factors include phlebitis, injury or surgery, autoimmune disease, DM, smoking, hyperlipidemia, inactivity, hypertension, family hx, increased age, and obesity.

Question 6

Restrictive Lung Disease

Answer 6

Caused by pulmonary or extrapulmonary restriction that causes impaired lung expansion and abnormal reduction in pulmonary ventilation.
Can be caused by tumor, interstitial pulmonary fibrosis, scarring within the lungs, pleural effusion, chest wall stiffness, structural abnormality, and respiratory muscle weakness.
Pathogenesis includes decrease in lung and chest wall compliance, decrease in lung volumes, and an increase in the work of breathing.
Impaired VC, FVC, and TLC. ERV and FRC often decreased.