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Pathophysiology > module 7 pulmonary > Flashcards

module 7 pulmonary Flashcards

1
Q
  1. Define the following:
    Dyspnea, Orthopnea, and Paroxysmal nocturnal dyspnea (PND)
  2. What are the Signs and Symptoms of Pulmonary Disease?
  3. What ?’s we should ask patients w/ cough?
A
  1. Dyspnea: Subjective sensation of uncomfortable breathing (can come from lungs, heart, or blood)

Orthopnea: Dyspnea when a person is lying down

Paroxysmal nocturnal dyspnea (PND): Attacks of shortness of breath occurring at night - wakes up.

  1. Dyspnea, Orthopnea, PND
    • Cough, • Sputum, •Hypoventilation (Hypercapnia)
    • Hyperventilation (Hypocapnia)
    • Cyanosis • Clubbing • Pain
  2. how long, what triggers cough, productive, if productive what color smell consistency
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2
Q
  1. What colors can sputum be, and what do the colors generally indicate?
  2. What are cheyne-strokes?
  3. What is kussmaul’s breathing, and what is it response to?
  4. What is diff btw hypoxia and hypoxemia?
  5. What signal protein is responsible for clubbing?
A
  1. • Bloody Hemoptysis (inflammation, cancer,
    ulcers, infections, pulmonary embolism)
    • Yellow (purulent) bacterial infection
    • Foamy white/frothy pink pulmonary edema
    • Green/greenish longstanding lung infection
    • Rust colored tuberculosis, pneumococcal pneumonia
  2. gradual increases and decreases w/ periods of apnea. Caused by brain stem injury and intracranial pressure, strokes.
  3. tachypnea and hyperypnea (fast/deep breathing) Body tries to get rid of CO2. caused by renal failure, metabolic acidosis, diabetic ketoacidosis
  4. hypoxia- decreased O2 to tissues. Hypoxemia - decreased O2 in blood
  5. vascular endothelial growth factor (VEGF)
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3
Q
  1. What is pnuemothorax?
  2. What are two ways this happens?
  3. What are the 3 types?
  4. What is a Tension pneumothorax
  5. Pleural space always has ……. pressure than atmospheric pressure.
  6. How to treat pneumothorax?
  7. What type of person is susceptible to spontaneous pneumothorax?
A
  1. air in thoracic cavity because lung collapses
  2. a. Air gets into thoracic from outside of body via puncture of chest wall, or
    b. air escapes from lung itself into pleural space
  3. spontaneous: no underlying reason
    Secondary pneumothorax: Fault of lung tissues separating from Pleural space.

Open: iatrogenic: from surgery or traumatic.

  1. severe consequence of pneumothorax that pushes lung to opposite side inhibiting blood flow. Can occur in any type of pnuemothorax.
  2. less
  3. Restore pressure by inserting tube to suck air out or thoracostomy
  4. male, tall, thin,smoker
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4
Q
  1. What are the 2 functions of the lungs?
  2. What are the 2 types of lung diseases?
  3. Obstructive pulmonary disease affects the ability of the lungs to …………. .
  4. restrictive is marked by what characteristic?
A
  1. ventilation and profusion
  2. Restrictive pulmonary disorders (can’t expand) and Obstructive pulmonary disorder (hard to exhale)
  3. recoil
  4. still hard lungs
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5
Q
  1. What is PAINT?
  2. What problems could arise with pleural?
  3. What problems could arise with alveoli?
  4. What problems could arise with Interstitial
  5. What problems could arise with neuromuscular?
  6. What problems could arise with thoracic?
A
  1. Acronym to ask yourself what component is causing restrictive lung disease. Pleural, Alveolar, Interstitial, Neuromuscular, and Thoracic
  2. fluid in pleural space won’t let lung expand inside of pleural space. trapped lung, pleural effusion, asbestosis,
    empyema (pus in pleural fluid)
  3. alveoli can’t expand b/c water, blood barrier between pulmonary capillary and alveoli. pulmonary edema, atelectasis
  4. pulmonary fibrosis, pneumonitis between cells
  5. something like MS or ALS
  6. obesity, kyphoscoliosis, ascites. Thoracic trauma
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6
Q
  1. What is Atelectasis, and what are 3 types?
  2. Name 3 causes of Pulmonary Edema:
  3. Describe • Acute respiratory distress syndrome (ARDS)
A
  1. Form of collapsed lung that starts w/ individual alveoli and progresses to large clusters of alveoli collapsing.
    a. Impairment of surfactant (babies),
    b. Absorption (Most common. After surgery)
    c. Compression
  2. Injury/failure of L heart, Acute respiratory distress, blockage of lymphatic vessels
  3. The most severe form of acute lung injury. Characterized by acute lung injury and inflammation to the alveolocapillary membrane develops scar tissue
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7
Q
  1. How do obstructive lung diseases work?
  2. What are 2 most common symptoms/signs?
  3. Name 4 diseases of this category:
A
  1. Airway narrowing and obstruction that is worse with expiration because can’t get all air out
  2. Dyspnea (symptom) and wheezing (sign)
  3. Asthma, Chronic Obstructive Pulmonary Disorder (COPD), Emphysema, and Chronic bronchitis
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8
Q
  1. Athsma is a ………….. airway disease. Most of the time it occurs in ……………. . It is usually an ……………… .
  2. What are the 3 events of athsma that lead to obstruction?
  3. In what ways does athsma manifest?
  4. Name 2 triggers for asthma:
  5. How is asthma diagnosed?
  6. How to treat asthma?
A
  1. reversible, childhood, allergy
  2. a. bronchoconstriction (histamine)
    b. tissue edema
    c. mucous production
3. • Cough
• Expiratory wheeze
• tachypnea (breath shortness)
• Nasal flaring
• Use of accessory muscles
• Exercise intolerance
  1. cold air and exercise
5. Clinical diagnosis (1st 3 are main ways to diagnose)
• Arterial blood gas
• Pulse oximetry
• Chest radiography
• CT
• MRI
• Nuclear imaging
*mot all of these would be ordered unless another disorder needs to be ruled out*
  1. Depends on severity. Prevent attacks.
    Beta agonist – albuterol broncho dilation
    Antihistamine - mast cell stabilizer
    Corticosteroids- decrease inflammation
    Xanthine
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9
Q
  1. Name the 2 diseases of COPD (chronic obstructive pulmonary disorder).
  2. Describe COPD. Is it progressive?
  3. What is biggest. most common cause? how common is it? It is the ……… leading cause of death in the US
  4. How to diagnose COPD
  5. What is the only effective treatment?
A
  1. chronic bronchitis and emphysema
  2. Persistent airflow limitation or obstruction that is NOT reversible. Progressive.
  3. cig smoke, Most common chronic lung disease in the world. 3rd.
  4. a. spirometry (expiratory volume <70%)
    b. Pulmonary function test (PFT),
    c. Arterial blood gas test
    d. alpha 1 antitrypsin (always for young patients)
  5. stop smoking (patient must participate. No drugs will reverse the prob)
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10
Q
  1. why do people develop ARDS?
  2. How does it manifest?
  3. How to diagnose/treat?
  4. What does ARDS lead to?
A
  1. They have suffered acute lung injury that brought inflammation to the alveolocapillary membrane
  2. dyspnea hypoxemia, hyperventialtion, respiratory/metabolic alkalosis
  3. find what caused the initial injury and treat accordingly
  4. acute resp. failure
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11
Q
  1. what criteria to diagnose chronic bronchitis?
  2. how to treat?
  3. what is a key problem in chron. bronchitis (as far as expiration)?
A
  1. hypersecretion of mucous and chronic cough that lasts at least 3 mo’s per year and for at least 2 consecutive years.
  2. bronchodilators, expectorants, chest PT
  3. air trapping
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12
Q
  1. What is emphysema?
  2. There is a loss of elastic …………
  3. is there any way emphysema can be inherited? How? What population would have this?
A
  1. abnormal permanent enlargement of gas exchange airways and destruction of alveolar walls w/o fibrosis (no scar tissue as compared to ARDS)
  2. recoli
  3. Yes if patient lacks alpha 1 antitrypsin (so trypsin breaks down elastin). Young people under 40
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13
Q
  1. Name some pulmonary infectious diseases and their causes:
A
  1. a. acute bronchitis: viral infection that leads to bacterial infection
    b. pneumonia: bacteria infected and inflammed alveoli
    c. tuberculosis: m. tuberculosis
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14
Q
  1. how does pneumonia present (typical and atypical)?
  2. What happens in tuberculosis
  3. What environments promote tuberculosis?
  4. What 3 things must be positive to diagnose tuberculosis?
A
  1. Typical: acute onset, high fever, chills (rigor), and productive cough

Atypical: (aka walking pneumonia), headache, cough,

  1. tubercle formation and caseous necrosis
  2. crowded living, immunodeficient, malnutrition, homelessness, HIV etc.
  3. chest x-ray, skin test, sputum w/ acid-fast bacillus
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Pathophysiology (11 decks)

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