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medicine > hypoxia and cyanosis > Flashcards

hypoxia and cyanosis Flashcards

1
Q

Reduction in oxygen saturation

A

HYPOXIA

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2
Q

Factors that may bring about hypoxia

A

o Dysfunction of cardiovascular and respiratory
system.
o Inadequate inspired oxygen supply/gas
o Inadequate RBC and hemoglobin

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3
Q

CAUSES AND TYPES OF HYPOXIA

A 
• Anemic Hypoxia
• Carbon monoxide intoxication
• Respiratory hypoxia
• Hypoxia secondary to high altitude
• Hypoxia secondary to right to left extrapulmonary
shunting
• Specific organ hypoxia
• Increased O2 requirements
• Improper O2 utilization
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4
Q
  • Reduction in hemoglobin concentration

* Decline in oxygen carrying capacity

A

anemic hypoxia

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5
Q

level of PaO2 in anemic hypoxia

A

Normal

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6
Q

T or F
In anemic hypoxia, same quantity of oxygen is removed but with greater
degree of decline of PO2 in venous blood than
normal case.

A

True

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7
Q

there is

accumulation of carboxyhemoglobin and this carboxyhemoglobin is unable to transport oxygen

A

Carbon monoxide intoxication

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8
Q

if there is decrease transport of O2 the

haemoglobin oxygen dissociation curve is usually shifted to

A

left.

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9
Q

T or F

CO has higher affinity to RBCs

A

T

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10
Q

shift to left: Oxygen has _____ attachment to RBCs

A

increased

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11
Q

T or F

There is a greater degree of tissue hypoxia in anemia than CO intoxication

A

F

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12
Q

Alkalosis is associated with shift to the

A

left dissociation curve

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13
Q
  • Caused by pulmonary disease

* PaO2 declines in respiratory failure

A

RESPIRATORY HYPOXIA

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14
Q

When respiratory failure is persistent, the hemoglobin-oxygen (Hb-O2)
dissociation curve is displaced to the

A

right

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15
Q

are likely to be more
marked when depression of PaO2 results from
pulmonary disease than when the depression
occurs as the result of a decline in the fraction of
oxygen in inspired air (FIO2)

A

consequent cyanosis

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16
Q

Normal FIO2

A

21

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17
Q

Common findings in advanced pulmonary

disease:

A

o Ventilation-Perfusion mismatch or V-Q
mismatch

o Hypoventilation (elevated PaCO2

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18
Q

PaCO2 falls secondary to anoxia-induced hyperventilation and the Hb-O2 curve is displaced to the

A

left

19
Q

High V-Q mismatch in the

A

upper lobe

20
Q

low V-Q mismatch in the

A

lower lobe

21
Q

These two forms (V/Q mismatch and
Hypoventilation) of respiratory hypoxia are
usually correctable by

A

inspiring 100% O2 for several minutes

22
Q

Respiratory locations where there is no gas

exchange

A

dead space - trachea

23
Q

conditions that may present with Shunting

A

atelectasis or AV connections in the lungs

24
Q

Main difference of V/Q mismatch and

shunting:

A

Shunting cannot be corrected by

100% oxygenation

25
Q

At higher altitude arterial saturation _______

rapidly and symptoms becomes more serious

A

declines

26
Q

At 8,000 ft., the FIO2 is about

A

120 mmHg,
alveolar PO2 is approx. 80 mmHg and SaO2 is
normal.

27
Q

At 16,000 ft. FIO2 is

A

85 mmHg, alveolar PO2 is

50 mmHg and SaO2 is 75%.

28
Q

At 5000m,

A

un-acclimatized individuals usually

cease to be able to function normally.

29
Q

o Develops in person with chronic hypoxemia
secondary to prolonged residence at a high
altitude (>13, 000 ft, 4200m)

A

• CHRONIC MOUNTAIN SICKNESS

30
Q

Manifestations of chronic mountain sickness

A 
Blunted respiratory drive, decrease in 
ventilation, erythrocytosis, cyanosis, 
weakness, right ventricular enlargement 
secondary to pulmonary HPN and even 
stupor
31
Q

• Caused by congenital cardiac formation such as
Tetralogy of Fallot, transposition of great arteries
and Eisengmenger’s syndrome

A

HYPOXIA SECONDARY TO RIGHT & LEFT

EXTRAPULMONARY SHUNTING

32
Q

• PaO2 is normal but venous and tissue PO2 are
reduced.
• Reduced tissue perfusion and greater tissue O2
extraction
• Pathophysiology leads to an increased arterialmixed venous O2 difference, or (A-V) gradient

A

Circulatory hypoxia

33
Q

conditions that may cause circulatory hypoxia

A

heart failure, shock

34
Q

specific organ hypoxia is usually brought about by:

A 
Arterial obstruction 
(atherosclerosis) Raynaud’s phenomenon 
(vasoconstriction)
35
Q

• Venous obstruction and the resultant congestion
and reduce arterial inflow
• Edema (increases the distance of O2 diffusion)
• Attempt to maintain adequate perfusion of vital
organs in shock or heart failure.
• Signs and symptoms of shock includes cold and
clammy skin due to decrease in blood supply

A

specific organ hypoxia

36
Q

Elevated oxygen consumption without

corresponding increase in perfusion

A

INCREASED OXYGEN REQUIREMENTS

37
Q

manifestations: Increased oxygen requirements

A

• Skin is warm and flushed, cyanosis is absent

differs from other types of hypoxia

38
Q

• Reduced tissue perfusion, increased tissue

extraction of O2

A

INCREASED OXYGEN REQUIREMENTS

39
Q

MECHANISM OPERATING IN INCREASED OXYGEN

DEMAND

A

o Increased cardiac output and ventilation
o Preferentially directing the blood to the exercising muscle
o Increasing O2 extraction from the delivered blood
o Reducing pH of the tissues and capillaries, shifting the Hb-O2curve to right

40
Q

IMPROPER OXYGEN UTILIZATION is also called

A

histotoxic hypoxia

41
Q

• Reduction of PaO2

A

o Cerebrovascular resistance decreases
o Cerebral blood flow increases in an attempt
to maintain O2 delivery to the brain

42
Q

However, when the reduction of PaO2 is

accompanied by hyperventilation,

A

There would be a reduction of PaCO,
cerebrovascular resistance rises causing a
fall in cerebral blood flow → tissue hypoxia
intensifies

43
Q

o May cause impaired judgment and motor

incoordination maybe seen

A

• Acute Hypoxia

44
Q

o May cause fatigue, drowsiness, apathy,
inattentiveness, delayed reaction time and
reduced work capacity

A

• Longstanding Hypoxia

medicine (14 decks)

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