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patho 2 exam > exam 2 > Flashcards

exam 2 Flashcards

1
Q

Hypoxemia

A

low oxygen content in the blood

Low O2 Saturation

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2
Q

Hypoxia

A

a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level

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3
Q

ACS

A

an umbrella term for a range of symptoms associated with sudden, reduced blood flow to the heart

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4
Q

ISCHEMIC HEART DISEASE (IHD)

A

Also referred to as Coronary heart disease (CHD) or coronary artery disease (CAD),atherosclerotic heart disease (ASHD)
Includes:
Heart attacks/Myocardial infarction
Angina: Stable and unstable

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5
Q

what causes IHD?

A

Atherosclerosis of the coronary arteries (most common)
A progressive inflammatory disorder of the arterial wall characterized by localized lipid deposits
Coronary thrombus or emboli
Coronary spasm
Complications of connective tissue disorders

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6
Q

Ischemic Cardiomyopathy

A

ischemic
Disease of the heart muscle, reduced contractility
chronic narrowing of the coronary arteries which, in turns, diminishes blood supply to the heart

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7
Q

Causes of Ischemic Cardiomyopathy

A

Caused by CAD which causes an insufficient blood flow/ to the heart resulting myocyte ischemia

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8
Q

constant cardiac ischemia results?

A

irreversible myocyte damage
This damage results in cardiac remodeling
Myocardial fibrosis
Arrhythmias
Possible cardiac conduction system impairments
Cell death
Ultimately these patients develop clinical congestive heart failure

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9
Q

Stable Angina

A

Caused by a mismatch between O2 delivery and O2 need
Brought on by exertion or other form of stress
Occurs at a predictable heart rate
Reduction in stress reduces symptoms
Crushing or squeezing substernal sensation with possible radiation down the left arm

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10
Q

Unstable Angina

A

Brought on by exertion or other form of stress
Onset is unpredictable
Thought to occur because of acute plaque changes, and/or coronary artery vasospasm

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11
Q

Plaque Rupture

A

Exposes thrombogenic lipids to the blood

Stimulates localized thrombus formation with ischemic outcomes i.e. CA occlusion

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12
Q

Occlusive event

A

Damage is dependent on coronary artery involved, time until treated

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13
Q

Cardiomyopathy

A

Disorder within the cardiac myocytes themselves which results in abnormal cellular and hence cardiac performance

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14
Q

Dilated Cardiomyopathy

A

abnormal cardiac morphology
dilated heart has undergone significant remodeling
Begins as a “ballooning” of the LV
This ballooning often leads to a dilation of the other chambers
lead to heart failure

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15
Q

Dilated Cardiomyopathy results

A

A heavier than normal heart
Hypertrophied cardiac myocytes
Loss of myofibrils, reduced mitochondrial function, contraction
Fibrosis occurs
Chamber walls are thinned
Produces systolic dysfunction and reduced EF

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16
Q

Hypertrophic Cardiomyopathy

A

Characterized by a thicken LV wall with a non-dilated LV chamber.
Septal wall can also hypertrophy disrupting normal LV outflow tract
Normal blood pressures are perceived as excessive by functionally defective myocytes

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17
Q

Obstructive HCM

A

The septal wall thickens and the LV free wall of the ventricles stiffen, obstructing blood flow into the aorta

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18
Q

Nonobstructive HCM

A

The walls of the LV stiffens, reducing LVEDV (preload) and SV
Blood flow is not blocked

19
Q

Restrictive / Infiltrative Cardiomyopathy

A

Characterized by restricted diastolic filling/loss of compliance i.e. diastolic dysfunction
EDVs are diminished/chambers cannot expand
BUT ESVs and EFs are normal; SV is compromised
Systolic function is normal

20
Q

Potts disease

A

TB of the spine

21
Q

What classify COPD?

A

Emphysema
Chronic obstructive bronchitis
Chronic, unremitting asthma

22
Q

Sign of COPD

A

dyspnea, sputum production, and chronic cough, reduced function.

23
Q

Spirometry COPD

A

COPD is diagnosed when the FEV1/FVC ratio is <0.70 after a bronchodilator has been given

24
Q

Emphysema etiology?

A

Pathologic accumulation of air in the lungs
Disease of exhalation
Characterized by air trapping in the lungs
Diaphragmatic function becomes compromise

25
Q

Emphysema lab value?

A

Causes an increase in residual volume (RV), total lung capacity (TLC) and a decrease in the FVC1/FVC ratio
TLC → Flattened diaphragm (length-Tension relationship)

26
Q

A-1AT deficiency and cigarette smoking

A

Destruction of individual alveoli
Development of “super” alveoli
Destruction of connective tissue supports for the very smallest airways allowing them to collapse during expiration

27
Q

type of obstructive COPD ?

A

Asthma
COPD (chronic obstructive pulmonary disease), which includes emphysema and bronchitis
Bronchiectasis

28
Q

gentic A-1AT deficiency can also cause

A

emphysema and liver disease

29
Q

Emphysema

A

Creates hyperinflated lungs with enlarged alveoli (super alveoli)
Forced expiration causes smaller airways to collapse during expiration
Leads to “air trapping” in the alveoli
Alveolar attachments are destroyed by cigarette smoke
Alveolar contraction becomes increasing difficult
Patient exhales even harder-causes collapse of small airways

30
Q

Lab value Emphysema

A

FEV1/FEV < .5

31
Q

signs of emphysema

A 
SOB at rest
Thin, cachectic
addictied to O2
Deformed chest with prolonged expiration
Absent or non-productive cough
32
Q

drugs for emphysema

A 
β2 agonists or anticholinergics
antiinflammatory agents
Antibiotics
mucolytic expectorants
mast cell membrane stabilizers
antihistamines 
glucocorticoids
33
Q

pink puffers

A 
CO2 retention
no cyanosis
purs lip breathing
ineffective cough
orthopenic
uses accessory muscles to breathe
leads to right sided failure to cor pulmonale
34
Q

what classifies Chronic Bronchitis

A

Productive cough lasting at least 3 months per year for 2 consecutive years
FEV1/FEV < 75% (suggests obstruction) plus chronic cough suggests bronchitis

35
Q

chronic Bronchitis leads to?

A

Destruction of ciliary cells lining airways occurs
Smooth muscle hypertrophy, atrophy of epithelial cells
↓ r4 !!
Airway collapse may occur leading to reduced alveoli ventilation, hypoxia and acidosis

36
Q

chronic bronchitis tend to have?

A 
Be polycythemic (why?) cyanotic, and have peripheral edema from right ventricular failure
Have cor pulmonale 2O to ↑ pulmonary vascular resistance
37
Q

chronic bronchitis are also called?

A

blue bloters

38
Q

Chronic bronchitis meds

A

Bronchodilators (B-2 agonists)
Mucolytics
NSAIDs

39
Q

Asthma

A

Episodic, reversible, obstructive lung disease characterized by bronchospasms resulting from an exaggerated inflammatory
Bronchial hyperreactivity

40
Q

Extrinsic Asthma

A

Result of an allergic reaction to specific triggers
Mast cells, sensitized by IgE antibodies, degranulate and release bronchoactive mediators (histamines) after exposure to a specific antigen

41
Q

intrinsic asthma

A

Has no known allergic cause or trigger

Has an adult onset

42
Q

Bronchial Provocation Test

A

Methacholine

Positive test: 20% ↓ in FEV1

43
Q

Asthma meds

A

bronchodilators (B2 agonists) and anti-inflammatory agents

Low dose corticosteroids

patho 2 exam (1 decks)

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