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Pathophysiology > Exam 2: chapter 29 > Flashcards

Exam 2: chapter 29 Flashcards

1
Q

what are some generalized clinical presentations of respiratory dysfunction?

A

o Dyspnea
-Orthopnea
- Paroxysmal nocturnal dyspnea (PND) (at night gasping for air; change
positions to breathe)
o Cough
- Acute cough normally resolves within 2-3 weeks of onset
- Chronic cough is persistent
- Smoking is a contributing factor, but so is GERD, asthma, ace inhibitors (end in -pril)
o Abnormal sputum
- Hemoptysis (coughing up blood)
->Can indicate infection, inflammation, cancer, or PE
o Abnormal breathing patterns
- Kussmaul respirations (hyperpnea)
- Cheyne-Stokes respirations
o Hypoventilation results in hypercapnia
o Hyperventilation results in hypocapnia
o Clubbing
o Pain
o Cyanosis
- Peripheral vs central

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2
Q

what is a pneumothorax?

A

Pneumothorax (collapsed lung): air leaks into the space between the lung and the chest
wall

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3
Q

what is a closed pneumothorax?

A

Closed pneumothorax: Pleural cavity pressure is less than atm p

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4
Q

what is a open pneumothorax?

A

Open pneumothorax: Pleural cavity is equal to atm p

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5
Q

what is a tension pneumothorax

A

Tension pneumothorax (medical emergency): Pleural cavity pressure is more than atm p

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6
Q

An acute lung injury (ALI) is characterized by…

A

acute lung inflammation and diffuse alveolocapillary injury

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7
Q

ALIs can be caused by….

A

Caused by sepsis, multiple trauma, pneumonia, burns, etc

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8
Q

ALIs can result in….

A

pulmonary edema

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9
Q

What are the three phases of an acute lung injury

A

Three phases
- Exudative (72 hrs): produces a ton of fluid
- Proliferative (4-21 days)
- Fibrotic (14-21 days): scarring

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10
Q

ALI manifestations

A
  • Dyspnea and hypoxemia
  • Hyperventilation and respiratory alkalosis
  • Decreased tissue perfusion, metabolic acidosis, and organ dysfunction
    -Increased work of breathing, decreased tidal volume, and hypoventilation
  • Hypercapnia, respiratory acidosis
  • Respiratory failure, decreased CO, hypoTN, death
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11
Q

COPD is characterized by….

A

persistent airflow limitation

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12
Q

COPD is usually

a. untreatable
b. progressive
c. not preventable

A

b. progressive

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13
Q

Which of the following is the most common chronic lung disease in the world?

a. pulmonary fibrosis
b. asbestosis
c. pneumonitis
d. COPD

A

d. COPD

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14
Q

list risk factors of COPD

A

-Tobacco smoke
-Occupational dust and chemicals
-Air pollution
-Any factor affecting lung growth during gestation/childhood

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15
Q

what is emphysema?

A

Abnormal permanent enlargement of the gas-exchange airways accompanied by destruction
of alveolar walls without obvious fibrosis

-Inherited deficit of alpha-one antitrypsin protein
(protein that protects the lungs)

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16
Q

what are some physiological changes seen in emphysema?

A

Loss of elastic recoil
Barrel chest

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17
Q

Why does barrel chests happen?

A

Air exchange becomes difficult in damaged alveoli, air becomes trapped

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18
Q

What is chronic bronchitis?

A

Hypersecretion of mucus and chronic productive cough that lasts for at least 3 months of the year and for at least 2 consecutive years

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19
Q

explain why people with chronic bronchitis experience hypersecretion of mucus and a chronic productive cough.

A

Inspired irritants increase mucus production and the size and number of mucus glands
Mucus is thicker than normal

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20
Q

What are some treatment options for chronic bronchitis

A

Bronchodilators, expectorants, and chest PT used to Tx

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21
Q

What is asthma?

A

Chronic inflammatory disorder of the airways

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22
Q

explain the pathophysiology of asthma

A

Inflammation results from hyperresponsiveness of the airways

Can lead to obstruction and status asthmaticus

23
Q

what are some symptoms of asthma?

A

Symptoms including expiratory wheezing, dyspnea, tachypnea

24
Q

What are some treatments for asthma

A

Peak flow meters, corticosteroids, beta-agonists, and anti-inflammatories
used to Tx

25
Q

describe the difference between latent Tb and active TB

A

Persons with latent TB infection are not infectious and cannot spread TB infection to others. They are infected with M. tuberculosis but do not have TB disease. they don’t have symptoms

Persons with TB disease (active TB) are considered infectious and may spread TB bacteria to others. they have symptoms

26
Q

the name of the bacteria that causes TB

A

Mycobacterium tuberculosis

27
Q

TB is spread by….

A

airborne transmission

28
Q

what are tubercle formations?

A

Tubercles are nodules that contain caseous necrosis, which forms in the lungs as a result of an infection with Mycobacterium tuberculosis in patients with tuberculosis.

29
Q

what test helps indicate if a patient has mycobacterium tuberculosis?

A

a positive TB skin test (PPD)

a positive skin test does not mean they are currently active but indicates further assessment with a chest X-ray

30
Q

what are some risk factors for pulmonary embolus?

A

Occlusion of a portion of the pulmonary vascular bed by a thrombus, embolus, tissue fragment, lipids, or an air bubble

31
Q

pulmonary emboli commonly arise from the ______in the ______

a. arteries: heart
b. surface veins; right arm
c. deep veins; lower legs
d. deep veins; upper legs

A

c. deep veins; lower legs

32
Q

Define the Virchow triad.

A

implicates three contributing risk factors in the formation of thrombosis

33
Q

What are the three contributing risk factors in the formation of a thrombosis

A

Venous stasis, hypercoagulability, and injuries to the endothelial cells that line the vessels

34
Q

pathophysiology of cystic fibrosis

A

CF is caused by a mutation in the CF transmembrane conductance regulator (CFTR) gene. When mutations occur in one or both copies of the gene, ion transport is defective, and results in a buildup of thick mucus throughout the body, leading to respiratory insufficiency, along with many other systemic obstructions and abnormalities. an altered ion transport allows for bacterial colonization of the respiratory tractThese pathogens cause an overwhelming inflammatory response. Ultimately, chronic infection and this repetitive inflammatory response can lead to airway destruction

35
Q

A patient has enlargement of the distal segments of the fingers. Which disease is associated with this condition?
A. Cystic fibrosis
B. Acute pneumonia
C. Sickle cell disease- doesn’t have anything to do
D. Acute myocardial infarction

A

A. Cystic fibrosis

36
Q

A patient has a history of emphysema and has hyperinflated lungs. Which of the following would be TRUE regarding this patient?

A. Increased compliance
B. Decreased surfactant
C. Increased elastic recoil
D. Increased airway resistance

A

D. Increased airway resistance
- Two mechanisms: bronchoconstriction and mucous production

37
Q

Which of the following is TRUE regarding the pathophysiology of asthma?
A. IgA is the major factor.
B. There is decreased vascular permeability.
C. Inflammation results in hyperresponsiveness.
D. Smooth muscle dilation occurs.

A

C. Inflammation results in hyperresponsiveness.

38
Q

A patient has right ventricular enlargement secondary to pulmonary hypertension. Which of the following would be the most likely diagnosis?

A. Cor pulmonale
B. Acute bronchitis
C. Pulmonary embolism
D. Pulmonary thromboembolism

A

A. Cor pulmpnale

39
Q

__________ is defined as pus within the pleural cavity.

A. Hemoptysis
B. Hypoxemia
C. Atelectasis
D. Empyema

A

D. Empyema

40
Q

__________ refers to the bluish discoloration of the skin caused by desaturation of hemoglobin.

A. Hypoxia
B. Cyanosis
C. Hypoxemia
D. Anemia

A

B. cyanosis

41
Q

Presence of fluid in the pleural space is known as a pleural __________.

A. effusion
B. edema

A

A. effusion

42
Q

__________ is the passage of fluid and/or solid particles into the lung.

A. Aspiration
B. Pneumonia
C. Bronchiectasis
D. Atelectasis

A

A. Aspiration

43
Q

__________ is an infection of the lower respiratory tract, resulting in inflammation of the alveoli, caused by bacteria, virus, fungi, protozoa, or parasites.

A. Emphysema
B. Pneumonia
C. Bronchitis
D. COPD

A

B. Pneumonia

44
Q

Asthma can be described by all of the following characteristics EXCEPT:

A. asthma involves variable airflow obstruction
B. asthma is not reversible
C. asthma involves constriction of the airways
D. asthma involves bronchial hyperresponsiveness

A

B. asthma is not reversible

45
Q

Chronic bronchitis is defined as:

A. acute infection or inflammation of the airways or bronchi that is usually self-limiting
B. permanent enlargement of gas-exchange airways accompanied by destruction of alveolar walls
C. persistent airflow limitation that is reversible with medications and other treatment
D. hypersecretion of mucus and chronic productive cough for at least 3 months of the year for at least 2 consecutive years.

A

D. hypersecretion of mucus and chronic productive cough for at least 3 months of the year for at least 2 consecutive years.

46
Q

__________ is defined as the collapse of lung tissue/ alveoli.

A. Aspiration
B. Atelectasis
C. Pulmonary edema
D. Bronchiolitis

A

B. Atelectasis

47
Q

__________ __________ occurs with alveolar hypo-perfusion and/or ventilation issues, resulting in an excess of carbon dioxide in the blood.

A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis

A

B. Respiratory acidosis

48
Q

________ is a symptom, known as the subjective experience of breathing discomfort; while __________ is breathing discomfort that occurs specifically when an individual lies flat.

A. orthopnea; dyspnea
B. dyspnea; orthopnea

A

B. dyspnea; orthopnea

49
Q

_________ is a protective reflex that can rid the airway of a foreign body. We would label this reflex as part of __________ immunity.

A. Cough; adaptive
B. Cough; innate

A

B. Cough; innate

50
Q

The term _______ is the result of chronic hypoxemia and is described as the bulbous enlargement of distal extremities.

A. hypercapnia
B. cyanosis
C. ischemia
D. clubbing

A

D. clubbing

51
Q

A __________ is the presence of air or gas in the pleural space caused by a rupture in the visceral pleura.

A. pneumonia
B. pneumothorax
C. pleural effusion
D. empyema

A

B. pneumothorax

52
Q

Pulmonary edema is defined as excess ___________ in the lungs.

A. oxygen
B. arterial blood flow
C. fluid
D. carbon dioxide

A

c. fluid

53
Q

In emphysema, the barrel chest/ hyper-expanded chest is caused by __________.

A. hypocapnia
B. hypoxemia
C. air trapping
D. high blood pressure

A

c. air trapping

54
Q

Cor pulmonale occurs secondary to pulmonary artery hypertension and resultant __________ ventricular failure.

A. right
B. left

A

A. right

Pathophysiology (25 decks)

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