Exam 3 Flashcards
1
Q
What is hyperlipidemia?
A
Elevated levels of lipids, mainly cholesterol and triglycerides, in the blood.
2
Q
What is the cause of hyperlipidemia?
A
Consuming too much fat (saturated, unsaturated, and trans) and low levels of HDL
3
Q
Signs and sx of hyperlipidemia
A
Angina, MI, xanthoma/xanthelasma, obesity, glucose intolerance, hyperinsulinemia, arcus senilis
4
Q
Labs that show hyperlipidemia
A
Total Cholesterol over 150, LDL over 100, HDL below 60, and Triglycerides above 150
5
Q
What can hyperlipidemia lead to?
A
Atherosclerosis
6
Q
What is hypertension (HTN)?
A
Elevation of BP that is often called the silent killer
7
Q
What is the cause of Primary HTN?
A
There is no known cause
8
Q
What is the cause of Secondary HTN?
A
Side effect of another systemic disorder like kidney disease
9
Q
Signs and sx of HTN
A
Headache, BP greater than 130/80, S4 heart sound, retinal blood vessel changes
10
Q
What is the pathophysiology of HTN?
A
High BP causes endothelial lining damage. Heart resistance against the left ventricle can occur leading to hypertrophy
11
Q
What are complications of HTN?
A
Damage to major organs, intracerebral hemorrhage, left ventricular myocardial ischemia and infarction, heart failure, thrombi/embolic brain obstruction, hypertensive retinopathy, renal disease, atherosclerosis
12
Q
What is atherosclerosis?
A
The build-up of plaque in the arterial walls
13
Q
What causes atherosclerosis?
A
Endothelial injury, oxidizing free radicals, HTN, diabetes, HLD
14
Q
What are the risk factors of atherosclerosis?
A
Obesity, high fat diet, tobacco, high stress, no exercise
15
Q
What is Peripheral Arterial Disease (PAD)?
A
A disorder that involves arteriosclerosis and atherosclerosis in the peripheral regions of the body outside the coronary arteries
16
Q
What causes PAD?
A
Atherosclerosis
17
Q
What is the pathophysiology of PAD?
A
There is reduced blood flow in the arteries that can lead to tissue ischemia. Since there is a lack of oxygen cells go through anaerobic metabolism which creates 2ATP and lactic acid.
18
Q
Signs and sx of PAD
A
Pain in the extremities, intermittent claudication (especially with exertion), pallor of the leg, paresthesia, palpable coolness of leg, pulselessness, paresis
19
Q
What is an Aneurysm?
A
Weakening in an artery wall that causes a localized area of bulging or dilation
20
Q
What causes an aneurysm?
A
Damage to the artery lining
21
Q
Signs and sx of an aneurysm
A
Headache, seizure, abrupt loss of consciousness.
AAA: nausea, vomiting, bowel or bladder disturbances, back pain, flank pain.
22
Q
What is an Aortic Dissection?
A
A disorder that causes splitting of the layers of the wall of the aorta. The wall has a gap filled with blood
23
Q
What is the cause of an aortic dissection?
A
Genetic predisposition, HTN, and atherosclerosis
24
Q
What is the pathophysiology of aortic dissection?
A
The wall of the aorta is composed of collagen, elastin, and smooth muscle that breaks down when aging. During an aortic dissection, the wall undergoes splitting of the layers between the tunica intima and media.
25
Signs and sx of aortic dissection
Sudden chest pain that radiates to the back, syncope, sudden hypotension, tachycardia.
26
What is Angina Pectoris?
Squeezing pain in the chest that occurs when there is a lack of blood flow to the myocardium
27
What is Stable Angina?
Chronic chest pain that the client has experienced in the past and feels similar to past episodes
28
What is Unstable Angina?
Cardiac chest pain that is occurring for the first time in a client. It is usually more severe
29
What causes angina?
myocardial ischemia as a result of coronary arterial atherosclerosis
30
Signs and sx of angina
An episode of retrosternal crushing/squeezing chest pain with radiation to the left arm, jaw, back, and epigastric area with a duration of 1-15 minutes. Chest pain occurs with exertion and is accompanied by dyspnea, diaphoresis, and pallor
31
What are the complications of angina?
Myocardial infarction
32
What is an Acute Myocardial Infarction?
An acute coronary syndrome that occurs when the heart tissue endures prolonged ischemia without recorvery
33
What is the cause of acute myocardial infarction?
Coronary artery atherosclerosis
34
What is a Type 1 MI?
An MI occuring spontaneously due to atherosclerotic plaque rupture and thrombotic obstruction of coronary artery
35
What is a Type 2 MI?
An MI due to lack of oxygen availability for cardiac muscle, leading to ischemia and infarction
36
What is a Type 3 MI?
An MI death without biomarkers
37
What is a Type 4 MI?
An MI due to stent insertion
38
What is a Type 5 MI?
An MI due to CABG
39
Signs and Sx of MI?
Increased respiratory rate, steady retrosternal crushing chest pain with radiation to the left arm, jaw, back, and epigastric region. Pallor, diaphoresis, and dyspnea occur (commonly during exertion). Syncope, slowed HR, low BP, Levine's sign, diminished peripheral pulses, and respiratory distress is present
40
What are the biomarkers of an MI?
Elevated cTnI and cTn T, elevated CPK-MB. ECG shows elevated or depressed ST segments and inverted T waves
41
What are the complications of MI?
Dysrhythmias, papillary muscle rupture, thromboembolism, ventricular aneurysm and rupture, pericarditis, and heart failure.
42
What is Deep Vein Thrombosis DVT?
Thrombus develops in a deep leg vein accompanied by inflammation
43
What is Virchow's Triad?
Predisposing factors to DVT: venous stasis, vessel injury, and hypercoagulability
44
Signs and sx of DVT
Tenderness, warmth, redness, swelling, and ropiness over a vein in the leg. May have a positive Homan's sign
45
What is Chronic Venous Insufficiency?
Veins are unable to keep blood moving in a unidirectional flow up to the heart. Incompetent veins allow venous stasis and risk for thrombus formation
46
What is the cause of chronic venous insufficiency?
Damage to the valves in the deep veins of the leg that is caused by pregnancy, prolonged standing, obesity, immobility, or trauma
47
Signs and sx of chronic venous insufficiency
Stasis dermatitis, heaviness of the legs, the sensation of fullness in the legs, fatigue, edema and dusky discoloration
48
What are Varicose Veins?
Dilated, distended superficial veins that are incompetent and have retrograde blood flow
49
What is the cause of varicose veins?
High pressure within the superficial veins that weakens venous valves. Can be caused by pregnancy, prolonged standing, crossed legs, sedentary activities
50
Signs and sx of varicose veins
Heaviness and sensation of fullness in the legs, aching, muscle cramps, itching, increased fatigue in lower leg muscles. Visible tortuous dilated veins
51
What is Left Ventricle Ejection Fraction?
Percentage of blood propelled out of the left ventricle with each contraction
52
What is preload?
The volume of blood in the heart at the end of diastole
53
What is afterload?
The amount of resistance that the ventricle must overcome in order to pump blood out of the heart
54
What is Cardiac Contractility?
The myocardium's ability to stretch and contract in response to the filling of the heart with blood
55
What is Heart Failure?
A clinical condition resulting from a weakened ventricular muscle that is unable to sufficiently pump blood to meet the needs of the tissues
56
What are the causes of heart failure?
Ischemic heart disease, chronic HTN, chronic pulmonary disease (cor pulmonale), pulmonary HTN, cardiomyopathy, dysrhythmias, heart valve abnormalities (mitral regurgitation and aortic stenosis), pulmonary embolism
57
What are the risk factors of heart failure?
Adults over 65, African Americans, family hx and genetics, diabetes, obesity, smoking, sedentary lifestyle, sleep apnea, congenital heart defects, viruses, alcohol abuse, kidney conditions, and medicines
58
What is the backward effect of left-sided ventricular failure?
Hydrostatic pressure builds up to the left atrium, pulmonary veins, and pulmonary capillaries
59
What is the forward effect of left-sided ventricular failure?
Stimulations of baroreceptors, RAAS, and antidiuretic hormone. Which causes vasoconstriction and holds onto fluid
60
Signs and sx of left-sided ventricular failure
Cough, dyspnea, orthopnea, PND, pulmonary crackles, cyanosis, decreased peripheral pulses, cool and pale extremities, decreased cerebral perfusion, pulmonary edema
61
What is the backward effect of right-sided ventricular failure?
Increased hydrostatic pressure in the right atrium which causes congestion in the vena cavas
62
What is the forward effect of right-sided ventricular failure?
There is decreased flow to the pulmonary artery, decrease gas exchange which can lead to hypoxemia
63
Signs and sx of right-sided heart failure
Jugular vein distention, ascites, GI disturbances, hepatomegaly, splenomegaly, peripheral edema, ankle edema, sacral edema
64
What is Mitral Stenosis?
The mitral valve is too stiff, thickened, fibrotic, and narrowed and there is left atrium overload
65
What is the cause of mitral stenosis?
RHD
66
Signs and sx of mitral stenosis
Dyspnea on exertion and cough
67
What is Mitral Insufficiency?
The valve fails to close completely and is floppy
68
What is the cause of mitral insufficiency?
MI or genetics
69
Signs and sx of mitral insufficiency
Dyspnea on exertion, cough, and pulmonary edema
70
What is Aortic Stenosis?
Calcified aortic valve that can cause left ventricle hypertrophy
71
What is the cause of aortic stenosis?
Aortic sclerosis and congenital defect
72
Signs and sx of aortic stenosis
Dyspnea, chest pain, and syncope
73
What is Aortic Insufficiency?
A weak valve that fails to close and leaks back into the ventricle
74
What is the cause of aortic insufficiency?
Congenital defect and aortic sclerosis
75
Signs and sx of aortic insufficiency
Cough, dyspnea, orthopnea, PND, pulmonary crackles, decreased cerebral perfusion, pulmonary edema
76
What is Pulmonary Stenosis?
Narrowing/stiffness of the valve
77
What is the cause of pulmonary stenosis?
Pulmonary HTN
78
What is Pulmonary Insufficiency?
Incompetent valve that is unable to close all the way
79
What is the cause of pulmonary insufficiency?
Pulmonary HTN since it causes the valve to endure high pressure thus making the valve weak
80
What is Tricuspid Stenosis?
Narrowing of the valve that hinders blood flow
81
What causes tricuspid stenosis?
RHD, endocarditis, IV drug users
82
Signs and sx of tricuspid stenosis
Systemic edema
83
What is Tricuspid Insufficiency?
Dilation of the tricuspid valve causes regurgitation and right-sided heart failure
84
What causes tricuspid insufficiency?
RHD, endocarditis, and IV drug users
85
Signs and sx of tricuspid insufficiency
Systemic edema
86
What is Systemic Inflammatory Response Syndrome (SIRS)?
An overwhelming inflammatory reaction of the body initiated by a severe insult to the body
87
What are the compensatory mechanisms for SIRS?
Increased respiratory rate, cardiac output, and heart rate. GI and urine output are reduced.
88
What is Compensatory Anti-Inflammatory Response Syndrome (CARS)?
The period of reduced immunity and increased susceptibility to infection
89
What is Sepsis?
AKA Septicemia is a body-wide infection that overwhelms the immune system and causes severe multiorgan compromise
90
What is the cause of sepsis?
Any organism: viral, bacterial, fungal, or parasite
91
What is Septic Shock?
A state of severe sepsis with persistent, life-threatening hypotension that is refractory to fluid replacement and vasopressors and produces lactic acid
92
What is the cause of septic shock?
Infection of great severity
93
What is Cardiogenic Shock?
Poor heart contractility that causes poor output. Severe hypotension lower than 90mm Hg systolic for 30 minutes
94
What causes cardiogenic shock?
MI, cardiac tamponade
95
What are the compensatory mechanisms for cardiogenic shock?
Simulation of SNS and RAAS
96
Signs and sx of cardiogenic shock
low urine output, peripheral cyanosis, and altered mental status
97
What is Hypovolemic Shock?
Decreased circulating volume
98
What are the causes of hypovolemic shock?
Extensive bloodloss, diarrhea, vomiting, or burns
99
Signs and sx of hypovolemic shock
Inadequate tissue perfusion, cyanosis, tachycardia, reduced urine output, confusion or agitation, poor skin turgor, and thirst
100
What are the compensatory mechanisms for hypovolemic shock?
SNS and RAAS
101
What is Anaphylactic Shock?
Extreme manifestations of an allergic reaction
102
What causes anaphylactic shock?
Exposure to an allergen
103
Signs and sx of anaphylactic shock
Stridor and wheezing are heard, laryngospasm, angioedema
104
What is the cause of Neurogenic Shock?
SNS is disrupted by a spinal cord injury, brain injury, or during anethesia
105
Signs and sx of neurogenic shock
Hypotension, bradycardia, low cardiac output, tissue ischemia
106
What is Shock?
The inability of the heart and lungs to perfuse tissues with severs hypotension and hypoperfusion
107
What is acute rhinitis?
A disorder that results in inflammation and irritation of the mucous membranes of the nasal passages
108
What is the cause of acute rhinitis?
Rhinovirus
109
Signs and sx of acute rhinitis
Stuffed nose, nasal discharge, sneezing, sore throat, red nasal turbinates
110
What is acute pharyngitis?
Inflammation of the pharynx
111
What is the cause of acute pharyngitis?
Virus or GABHS
112
Signs and sx of acute pharyngitis
Malaise, fever, and sore throat.
Red and swollen pharyngeal membrane and tonsils. Lymphoid follicles swollen with white exudate
Cervical lymph nodes are tender
113
What is acute sinusitis?
Infection of facial maxillary and frontal sinuses, causing inflammation and the obstruction of the sinus cavity
114
What is the cause of acute sinusitis?
Accompanies URI or allergic reaction. Caused by virus, bacteria, or both
115
Signs and sx of acute sinusitis
Headache, malaise, fever, stuffy and runny nose, sore throat, earache, facial pain or pressure over sinus area
116
What is acute tonsilitis?
Infection and inflammation of tonsils
117
What is the cause of acute tonsilitis?
GABHS, viruses like EBV, adenovirus, herpes simplex virus, or cytomegalovirus
118
Signs and sx of acute tonsilitis
Sore throat, fever, malaise, anorexia, pain and dysphagia, earache may be present. Red and inflames pharynx, white exudate over tonsillar tissue, cervical lymphadenopathy
119
What is acute epiglottitis?
Infection and inflammation of the epiglottis
120
What is the cause of acute epiglottitis?
Bacteria, viruses, or fungi
121
Signs and sx of acute epiglottitis
Severe sore throat with inability to speak and difficulty breathing. Drooling of saliva, red and swollen inflamed pharynx and tonsils, and swollen epiglottis
122
What is laryngitis and tracheitis?
Infection and inflammation of the larynx and trachea
123
What is the cause of laryngitis and tracheitis?
Usually caused by a virus, but may be bacterial in nature
124
Signs and sx of laryngitis and tracheitis
Sore throat and dysphagia, hoarseness or complete loss of voice, stridor may be heard, brassy cough, wheezing upon exertion, and yellow or green sputum
125
What is Acute Bronchitis?
Infection and inflammation of the bronchi
126
What causes acute bronchitis?
Bacterial or viral infection (influenza A or B, parainfluenza, respiratory syncytial virus, and coronavirus), but can also be triggered by inhalation of toxic gases or chemicals
127
What are the risk factors of acute bronchitis?
Smoking and exposure to pollutants and URI
128
What is the pathophysiology of acute bronchitis?
The bronchial tree undergoes an inflammatory response to a pathogen or irritant. The mucous membrane becomes edematous and diminishes bronchial mucociliary function
129
Signs and sx of acute bronchitis
Cough, fever, sore throat, general malaise, rhonchi heard over lungs
130
What is pneumonia?
Inflammation of the lung tissue in which alveolar air spaces fill with purulent, inflammatory cells and fibrin
131
What is the cause of pneumonia?
Bacteria, community-acquired pneumonia (CAP) caused by streptococcus pneumoniae, aspiration pneumonia caused by anaerobic bacteria swallowed from the oropharynx
132
What are risk factors for pneumonia?
Lung cancers or tumors, COPD, and bronchiectasis, smoking, alcohol or drug intoxication, influenza infection
133
Signs and sx of pneumonia
Dyspnea, fever, cough, chills, malaise, myalgias, leukocytosis, tachycardia, tachypnea
134
What is tuberculosis (TB)?
Infection or inflammation of the lungs
135
What causes TB?
M. tuberculosis
136
What are risk factors of TB?
Immunosuppressed persons, persons living in crowded environments, people with diabetes, smoking, people on systemic or inhaled steroids
137
What is the pathophysiology of TB?
Droplets of infected person pass down the airway and eventually settle in the bronchial tree.
138
What respiratory disease can be dormant?
TB
139
What is asthma?
AKA hyperreactive airway disease is a chronic inflammatory disorder that causes reversible airway constriction because of bronchial hyperreactivity
140
What is the cause of asthma?
Genetic mutations, environmental factors, allergens, occupational exposure to chemical agents, viral infections, GERD, exercise
141
What is the pathophysiology of asthma?
There is episode of spastic reactivity in the bronchioles.
142
Signs and sx of asthma
Wheezing, cough, dyspnea, prolonged exhalations, use of accessory muscles, and chest tightness
143
What is Chronic Obstructive Pulmonary Disease?
A combination of chronic bronchitis, emphysema, and hyperreactivity
144
What is the cause of COPD?
Smoking, occupational and environmental exposures to chemicals and dusts, genetic susceptibility, IV drug users, connective tissue diseases, pneumocystis jioveci
145
What is Chronic Bronchitis?
Hypersecretion of mucous in the large and small airways, hypoxia, and cyanosis (blue boater)
146
What is Emphysema?
Overdistension of alveoli with trapped air, which creates obstruction to expiratory airflow, loss of elastic recoil of alveoli, and high residual volume of carbon dioxide in the lungs, pink puffer
147
Signs and sx of COPD
Dyspnea, cough, wheeze, tachypnea, crackles, and cyanosis
148
What is pneumothorax?
AKA collapsed lung, is the presence of air in the pleural cavity that causes the collapse of a large section or whole obe of lung tissue
149
What is Primary Spontaneous Pneumothorax?
Occurs in people without underlying lung disease and in the absence of an inciting event
150
What is Secondary Spontaneous Pneumothorax?
Occurs in people with a wide variety of lung diseases
151
What is Traumatic Pneumothorax?
Occurs because of a penetrating wound of the thoracic cage and underlying pleural membrane
152
What is Tension Pneumothorax?
Occurs when there is an escalating buildup of air within the pleural cavity that compresses the lung, bronchioles, and cardiac structures
153
What is Iatrogenic Pneumothorax
Occurs because of a complication of medical or surgical procedures
154
Signs and sx of pneumothorax
Chest pain, dyspnea, asymmetry of the chest, intercostal muscle retractions, lack of breath sounds, and increased respiratory rate
155
What is a Pleural Effusion?
An abnormal collection of fluid within the pleural cavity that compresses lung tissue and inhibits lung inflation
156
What is the cause of a pleural effusion?
Transudates, exudates
157
What is the pathophysiology of pleural effusion?
Disruption of balance between hydrostatic and oncotic forces in the lung tissue
158
Signs and sx of pleural effusion
Dyspnea, increased rate of breathing, pleuritic chest pain, lack of breath sounds, asymmetrical chest expansion with inhalation
159
What is Coal Miner's Pneumoconiosis
Caused by coal dust which stimulates an inflammatory reaction in the lungs
160
What is the pathophysiology of coal miner's pneumoconiosis?
The particle become engulfed by alveoli macrophages and remain in the lungs
161
Signs and sx of coal miner's pneumoconiosis
Cough, dyspnea on exertion, wheezes, gray sputum
162
What is Asbestos lung disorder?
Caused by inhalation of fin asbestos crystals
163
What is the pathophysiology of asbestos?
Crystals stimulate a chronic inflammatory reaction with eventual fibrotic changes in the lungs
164
Signs and sx of asbestos
Dyspnea, cough, crackles, finger clubbing, signs of right ventricle failure, and sx occur decades after exposure
165
What is Silicosis?
Caused by inhalation of fine quartz crystals
166
What is the pathophysiology of silicosis?
Crystals stimulate chronic inflammatory reaction with eventual fibrotic changes in the lungs
167
Signs and sx of silicosis?
Dyspnea, cough, crackles, wheezes, finger clubbing, signs of right-sided ventricular failure, sx occur after decades
168
What is Pulmonary Edema?
Accumulation of fluid around the alveoli that inhibits oxygen transfer at alveolar-capillary interface
169
Signs and sx of pulmonary edema
Cough, dyspnea, stridor, pink and frothy sputum, crackles in both lungs
170
What is a Pulmonary Embolus?
A clot that has traveled to the pulmonary arterial circulation and caused obstruction to blood flow through the lungs
171
What is the cause of pulmonary embolus?
DVT
172
Signs and sx of pulmonary embolus
Dyspnea, chest pain, increased respiratory rate, sudden respiratory distress, tachycardia
173
What is Pulmonary HTN?
Abnormally high pressure within the pulmonary arteries
174
What is the cause of Primary Pulmonary HTN?
A genetic disorder caused by the abnormal structure of the pulmonary blood vessel
175
What is the cause of Secondary Pulmonary HTN?
Increase in pulmonary artery pressure because of elevated pulmonary venous pressure, increased pulmonary blood flow, pulmonary vascular obstruction, or hypoxemia
176
Signs and sx of Pulmonary HTN
Syncope, dyspnea on exertion, fatigue, and dizziness on exertion
177
What is Adult Respiratory Distress Syndrome?
Pulmonary dysfunction characterized by diffuse alveolar injury, pulmonary capillary damage and bilateral pulmonary infiltrates
178
What is Adult Respiratory Distress Syndrome a sequela to?
Trauma, sepsis, drug overdose, massive transfusion, acute pancreatitis, or aspiration
179
Signs and sx of adult respiratory distress syndrome
Severe respiratory distress, coarse, loud crackles, tachycardia, elevated BP
