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Pathophysiology > Patho Quiz 6 (BP, Shock, Respiratory) > Flashcards

Patho Quiz 6 (BP, Shock, Respiratory) Flashcards

1
Q

What does an “A-line” measure?

A

“A-lines” or arterial lines measure blood pressure constantly by means of a catheter inserted into an artery.

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2
Q

What are long-term regulations of systemic BP that the body utilizes?

A

Extracellular fluid, RAAS, SNS, Na+ regulation, Natriuretic hormones, circulating enzymes and peptides

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3
Q

What is the cause of primary HTN?

A

Primary HTN is idiopathic in nature (no known cause).

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4
Q

HTN is an independent risk factor for __ , ___ , ___ (3).

A

Renal failure, CVA, CAD

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5
Q

High blood pressure increases the workload of the left ventricle because it increases what?

A

Afterload.

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6
Q

What is the first line medication class to combat primary HTN?

A

Thiazide diuretics (ACEI, ARBs, BBs, CCBs may be used in combination).

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7
Q

What are the causes of secondary HTN? (6)

A

Renal disease, pregnancy, obesity/sleep apnea, endocrine disorders, coarctation of the heart (congenital heart defect)

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8
Q

What is the goal in treating a hypertensive emergency?

A

Get MAP down by 25% in 1 hour with IV drugs.

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9
Q

What qualifies as a HTN emergency?

A

Sudden increase in either or both systolic or diastolic blood pressure with evidence of end-organ damage

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10
Q

What is a common cause of orthostatic hypotension?

A

Volume depletion (dehydration).

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11
Q

What is true of HTN urgency?

A

Exceedingly high BP levels are present–will not be treated aggressively.

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12
Q

Shock is defined by what?

A

Tissue perfusion (NOT BP).

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13
Q

Which signs do all three types of shock share (cardiogenic, hypovolemic, and septic)?

A

Hypotension and low urine output.

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14
Q

What the signs of shock? (7)

A
  • Narrowed pulse pressure
  • Tachycardia
  • Hyperventilation
  • Decreased urine output
  • Cool, clammy skin
  • ALOC
  • Dilated pupils
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15
Q

How does the body compensate during shock? (3)

A
  • Increased vascular resistance
  • Increased HR
  • Increased force of contraction
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16
Q

What occurs during the progressive stage of shock?

A

Oxygen-free radicals (chemical disruption involving Oxygen molecule float around in blood stream), release of inflammatory cytokines, and activation of the clotting cascade system.

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17
Q

What are the common causes of obstructive shock? (3)

A

Pulmonary embolism, cardiac tamponade, and tension pneumothorax.

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18
Q

Define sepsis

A

An inflammatory response to widespread infection

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19
Q

Name and describe the stages of septic shock

A
  • Initial Phase (Hyperdynamic): warm stage-shunting of blood to core
  • Progressive Phase (Hypodynamic): cold stage-BP and CO drop
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20
Q

What are the four criteria to indicate Systemic Inflammatory Response Syndrome (SIRS)?

A
  • HR>90
  • RR>20
  • WBC below 4,000 or above 12,000
  • Temp less than 36 or above 38 C
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21
Q

What are complications of shock? (4)

A
  • Acute Respiratory Distress Syndrome (ARDS)
  • Disseminated Intravascular Coagulation (DIC)
  • Acute Kidney Injury
  • Multiple Organ Dysfunction Syndrome (MODS)
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22
Q

What is the rationale for the appearance of a rapid heart rate in shock?

A

SNS stimulation

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23
Q

Neurogenic shock is a result of ______.

A

Loss of sympathetic activation of arteriolar smooth muscle, caused by medullary depression (brain injury, drug overdose) or lesions of sympathetic nerve fibers (spinal cord injury)

24
Q

Where does gas exchange occur?

A

Terminal bronchioles and alveoli.

25
Q

What is the role of surfactant?

A

Keeps alveoli from collapsing on itself and causing atelectesis.

26
Q

What is dead space?

A

Volume of air filling lung which is not involved in gas exchange.

27
Q

What is the ratio of tidal volume v. total lung volume?

A

500 mL : 6 L

28
Q

What are the three types of dead space?

A

Anatomic (everyone has some), alveolar, physiologic

29
Q

What is the difference between PAO2 and PaO2?

A

PAO2: amount of Oxygen entering the the alveoli
PaO2: amount of Oxygen leaving the alveoli and going into the arteries

30
Q

What do the central chemoreceptors in the medulla respond to to regulate the respiratory system?

A

PaCO2 and decrease in pH

31
Q

What do the peripheral chemoreceptors in the aortic arch and carotid bodies respond to to regulate the respiratory system?

A

PaO2 and decrease in pH

32
Q

What is the ideal ventilation : perfusion ratio?

A

0.8

33
Q

What are the characteristics of a pulmonary embolus with regards to V/Q mismatch?

A

Ventilation without perfusion

34
Q

What are the four ways CO2 are transported?

A
  • Dissolved in plasma
  • As carbonic acid in the plasma
  • As bicarbonate
  • As carbamino compounds on the hemoglobin molecule
35
Q

Define hypoventilation

A

Air is insufficient to provide O2 and remove CO2, results in increased PaCO2

36
Q

Define hyperventilation

A

Increase of air entering the alveoli leads to hypocapnia (reduced CO2 in blood)

37
Q

What are the four categories of hypoxia?

A
  • Hypoxic hypoxia (high altitude)
  • Anemia hypoxia (low hemoglobin)
  • Circulatory hypoxia (low CO, shock)
  • Histologic hypoxia (poisoning)
38
Q

Define acute respiratory failure

A

State of disturbed gas exchange resulting in low PaO2 (<60) and PaCO2 >50 with a pH less than 7.30, when the pt. is breathing room air

39
Q

What is a PaO2 goal during respiratory failure?

A

> 60 mmHg

40
Q

What is Virchow’s Triad and when does it occur?

A

Occurs during VTE (DVT, PE)

  • Venous stasis
  • Hypercoagulability
  • Intimal wall injury
41
Q

What is the difference between the two types of asthma?

A
  • Intrinsic (non-allergic): develops in middle age, repetitive respiratory infections
  • Extrinsic (IgE-mediated): develops in children, allergic rhinitis, family history
42
Q

What is the difference between symptoms of a minor asthma attack v. a severe attack?

A

Minor: Wheezing on EXHALATION
Severe: Wheezing on INHALATION

43
Q

Define chronic bronchitis

A

Chronic or recurrent productive cough >3 months over 2+ successive years with hypersecretion of bronchial mucus.

44
Q

Define Cor Pulmonale

A

Right sided HF as a result of pulmonary diseases

45
Q

What is one of the treatments used in chronic bronchitis (especially in younger patients)?

A

Theophylline (liquid caffeine) which causes bronchodilation and vasoconstriction

46
Q

What virus can lead to bronchiolitis in children?

A

RSV

47
Q

What is the end treatment goal for CF patients?

A

Lung transplant

48
Q

What is the most dangerous complication of epiglottitis?

A

Complete airway obstruction (closes off top off trachea)

49
Q

What are the cardinal symptoms of Croup?

A

Barking cough with inspiratory stridor

50
Q

A pulmonary assessment that reflects increased resistance to airflow due to narrowing, or internal or external obstruction of the passages would cause:

A

Decreased forced expiratory volume

51
Q

What does SOB, coarse breath sounds, and a productive cough likely indicate?

A

Chronic bronchititis

52
Q

What is a common finding of Acute Respiratory Distress Syndrome (ARDS)?

A

Severe hypoxemia caused by intrapulmonary right-to-left shunting of blood

53
Q

What is the cause of Infant Respiratory Distress Syndrome?

A

They do not yet produce surfactant (premie babies)

54
Q

How can Bronchitis and Pneumonia be differentiated?

A

Through a chest X-RAY (Pneumonia will show up, Bronchitis won’t)

55
Q

Pneumonia can occur in what parts of the body?

A

Lungs, brain, liver, spinal cord, etc.

Pathophysiology (4 decks)

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