CR Conditions

Question 1

Describe the 2 types of valvular heart disease

Answer 1

1. Stenosis or fusion of valve leaflets = valves fail to open completely = impedes forward flow
2. Regurgitation = valves fail to close in systole = reverse blood flow

Question 2

Name 3 risk factors for dilated cardiomyopathy

Answer 2

Increased volume with pregnancy, chronic alcohol use, chemo drugs

Question 3

Name 4 symptoms of cardiac tamponade

Answer 3

Small decrease in systolic BP on inspiration, low cardiac output, jugular vein distension, muffled heart sounds

Question 4

What are the consequences of aortic stenosis?

Answer 4

Heart murmur, hypertrophy, angina, syncope (transient LOC)

Question 5

Describe the 4 types of pneumothorax

Answer 5

Open - air into pleural space
Tension - flap opens on inspiration and closes on expiration (air trapped = increased pressure on heart = bad)
Spontaneous - spontaneous rupture
Hemothorax - collapse due to blood in pleural space

Question 6

Describe congestive heart failure and its 2 types.

Answer 6

Heart unable to pump blood at rate required by tissues of the body or able to but at elevated filling pressures
Types:
Systolic - deterioration of contractile function
Diastolic - can’t accommodate ventricular volume

Question 7

What is a flail chest? What type of breathing is expected?

Answer 7

2 or more consecutive ribs broken in 2 or more places = paradoxical breathing (segment moves opposite to thorax)

Question 8

Describe the 2 types of pleural effusion

Answer 8

Transudative - pleural fluid content unchanged just increased amount (ex. heart failure, kidney)
Exudative - the content is different and amount is greater (ex. blood, pus, tumour)

Question 9

What are the 3 types of pulmonary embolism?

Answer 9

Air embolism - may be result of trauma, surgery
Thromboembolism - venous thrombi from deep veins in LE
Fat embolism - mostly associated with # of long bones

Question 10

What is one possible result of aortic aneurism

Answer 10

Aortic dissection - tear in inner wall of aorta = blood flows between layers of aorta wall and forces layers apart

Question 11

Name the contraindications for percussions/chest PT

Answer 11

ribs, prone to hemorrhage, metastatic bone cancer, osteoporosis, burns, subcutaneous emphysema of neck and thorax, poor/unstable CV condition, recent skin graft or flap, resectable tumour, pneumothorax

Question 12

Describe the terrible triad (myocardial)

Answer 12

Ischemia - inverted T waves, occurs within seconds, reversible
Injury - elevated ST, occurs in 20-40min, reversible
Infarction - abnormal Q waves, QRS complexes, 2hrs post onset, not reversible

Question 13

What is the result of L vs R sided heart failure?

Answer 13

Left = damming of blood in pulmonary circulation
Right = damming of blood in systemic and portal venous systems

Question 14

Describe the 2 types of lung cancer.

Answer 14

Small cell = in bronchial mucosa, rapid spread, mets early
Non-small cell = squamous cell (small spread, in central portion near hilum, mets late); adenocarcinoma (slow-mod spread; early mets through lungs, brain, organs); large cell (rapid spread, wide spread mets, poor prognosis)

Question 15

Name and describe the 3 mechanisms of atelectasis.

Answer 15

Blockage of bronchus/bronchiole = lung prevented from expanding (paralysis, diaphragmatic disorders, hypoventilation, mucous or airway obstruction)
Compression = external force prevents from expanding (ex. pneuma, pleural effusion, tumour)
Post anaesthetic = effects and prolonged recumbency

Question 16

Describe ARDS and its pathology

Answer 16

Acute rest failure with severe hypoxemia - result of pulmonary or systemic problem
Path = lung injury causes inc. permeability on alveolar cap membrane = leakage of fluid and blood into lung interstitium and alveoli

Question 17

Hypoxemic vs. hypercapnic resp failure

Answer 17

Hyoxemic = gas exchange failure (dec. blood O2, no change in CO2) (d/t ARDS, pneumonia, obstructive disease, PE)
Hypercapnia = ++CO2 in blood, dec. O2 (d/t dec. ventilation, acute upper or lower airway obstruction, weak resp muscles, SCI)

Question 18

Describe the 2 types of asthma.

Answer 18

Extrinsic - allergic or atopic (most common): normally due to allergen = mast cells release mediators causing bronchospasm; kids > adults
Intrinsic - non allergic: hypersensitivity to bacteria, virus, drugs, cold air, exercise, stress; adults > kids

Question 19

What are the main characteristics of COPD?

Answer 19

Progressive airway obstruction (not fully reversible); gas exchange normal; hyper inflated; dec. elastic recoil; middle aged to older adults

Question 20

What are the results of emphysema?

Answer 20

Dec. surface area for gas exchange; air trapping; hyperventilation flattens diaphragm (mechanical disadvantage)

Question 21

What is bronchiectasis?

Answer 21

Irreversible destruction and dilation of airways with chronic bacterial infection

Question 22

Describe tuberculosis

Answer 22

Infectious, inflammatory systemic disease that affects the lungs (may disseminate to involve kidneys, growth plates, meninges, lymph nodes, etc.)

Question 23

What are 2 possible causes of pulmonary edema?

Answer 23

Inc. hydrostatic pressure d/t heart or kidney failure (pushes fluid out of vessels)
Inc. alveolar permeability (drug induced, ARDS, noxious gas)

Question 24

Name 5 effects of cystic fibrosis.

Answer 24

Defective Cl-, recurrent chest infections, consolidation, atelectasis, thickened bronchial walls

Question 25

Name 3 causes and 3 effects of chronic venous insufficiency

Answer 25

Causes: DVT, trauma, obstruction
Effects: damaged or destroyed valves lead to stasis; progressive edema; thickening brown skin (blood pooling) and ulcers