CSB358 - Cardiac / Respiratory / Toxicity

Question 1

Metabolic Acidosis

Answer 1

A condition in which too much acid accumulates in the body.This happens when your kidneys are unable to remove enough acid from your blood.

Causes of metabolic acidosis can include build-up of body toxins, kidney failure and ingestion of certain drugs or toxins, such as methanol or large doses of aspirin.

Can also be caused by increased CO2 due to decreased resp rate.

Question 2

Identify pathologies associated with abnormal respiratory rate and rhythm

Answer 2

• Dyspnea - shortness of breath/ difficulty in breathing
• Tachypnea - excessive/ rapid rate of breathing
• Bradypnea - abnormally slow rate of breathing.
• Hypoventilation - Insufficient ventilation resulting in incapability of removing CO2 from the body.
• Hyperventilation - excessive exhalation resulting in decreased CO2 within the body.

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Question 3

Hyperventilation

Answer 3

Breathing too fast and exhaling more than is being inhaled. Decreased CO2 levels within the body

Question 3

Hypoventilation

Answer 3

Insufficient ventilation incapable of removing CO2 from the body

Question 4

Define dyspnoea and the pathophysiology

Answer 4

Dyspnoea is the term applied to shortness of breath / difficulty in breathing.

Pathophys: Breathing is controlled in the respiratory control centre in the medulla oblongata and peripherally by chemoreceptors in the aortic arch. Imbalances among sensory inputs such as pulmonary stretch receptors and mechanoreceptors in the diaphragm and skeletal muscles can be perceived as dyspnoea and can increase work of breathing.

Question 5

Non emergent causes of dyspnoea

Answer 5

Pleural effusion
Pneumonia
COPD
Pregnancy
Fever
Obesity
Rib fractures
Anxiety

Question 6

Emergent causes of dyspnoea

Answer 6

Asthma
Pneumothorax
Hypotension
sepsis
bowel obstruction
aspiration
metabolic acidosis
nuero injury

Question 7

Critical causes of dyspnoea

Answer 7

airway obstruction
anaphylaxis
exacerbation of asthma
exacerbation of COPD
Ventilatory failure
Respiratory Arrest
Pulmonary embolus
Acute Pulmonary Oedema

Question 8

Pt has the following symptoms? List differentials.
Abrupt onset of Pleuritic chest pain.
Unilateral lower limb pain
Tachycardia
Temp 38
History of smoking
History of hyper-coagulability
Obesity & is pregnant

Answer 8

Pulmonary Embolism - Any blood clot or substance that is undissolved in the blood, flowing through a vessel until it become too small to pass through, causes an occlusion and restrictive blood flow.

Pneumonia / Chest infection /

Question 9

Pt has the following symptoms? List differentials.

Abrupt onset of exposure to new substance.
Signs of stridor / wheezing / facial swelling
Abdominal pain

Answer 9

Anaphylaxis

Question 10

Describe the mechanism of a cough

Answer 10

Coughing is an innate immune response to irritation and foreign bodies. It consists of inspiration and closing of the epiglottis, a strong contraction and then exhalation, expelling foreign bodies.

Question 11

Pertinent Questions to ask a patient with persistent cough.

Answer 11

Sputum production?
Colour of sputum. Any haemptosis - blood in sputum.
How long has the cough lasted for?
History of smoking?
Occupation - has the patient been exposed to toxic antigens?
Character of cough?

Question 12

Acute cough (less than 3 weeks), what are the differential causes?

Answer 12

Chest infection
Asthma
Pulmonary embolism
Congestive heart failure
Acute bronchitis
upper respiratory tract infections
Acute exacerbations of COPD

Question 14

Sub acute cough (3-8 weeks)

Answer 14

Post infectious
Continued irritation of cough receptors via ongoing or resolving bronchial or sinus inflammation from a preceding viral upper respiratory infection