Pathophys Flashcards
A disease characterized by cough producing sputum for at least 3 months and 2 consecutive years.
Chronic Bronchitis
Pathology of Chronic Bronchitis (4)
1) ^ size of mucus glands
2) goblet cell hyperplasia w/ low #cilia
3) Cilia dysfunction/disruption of mucus blanket
4) Bronchiolar narrow
Etiology Of Bronchitis
-Long term irritation of tracheobronchial (smoking)
Smoking ____ goblet cells to secrete ____ mucus
Stimulate, more
Smoke ____ ciliary action leading to _____
Inhibits, chronic cough
Characteristics of bronchitis
1) “blue Bloater” b/c decreased PaO2
2) ^ PaCO2, normal pH
3) Polycthemia
4) ^ PAP and RVH
Exacerbation of CB
1) Increased sputum
2) V/q Abn.
3) hypoxemia
4) Increase RR
Alveoli Hyperinflated
Emphysema
Characteristic of Emphysema
1) Pink Puffer
2) SOB and thin build
3) Accessory muscles
4) ^ A-P diameter chest
Etiology Of emphysema
Uncertain with age, smokers with CB
Prognosis of CB and Emphysema
- loss of lung fields
- Age is accurate predictor of death
Common cause of death in CB and Emphysema
CHF
resp failure
Pneumonia
PE
A disease characterized by increased responsiveness of trachea and bronchi to stimuli
Asthma
What happens during an asthma attack?
1) Lumen narrowed
2) Bronchial smooth muscle spasm
3) Inflammation of mucosa
4) Overproduction of mucus
Pathology of asthma
Allergic or intrinsic: for patients under 35
Nonallergic: pts over 35
Characteristics of asthma
1) nocturnal awakening
2) ^RR and accessory muscle
3) Wheezing
4) unproductive cough with chest tightness
Asthma attack lasting for hours
Status asthmatics
What happens in status asthmaticus?
Pt exhausted from breathing
- quiet chest
- medical emergency
- need to be ventilated
Characteristics of Restrictive Disorders
Lungs prevented from expanding fully
Symptoms of Restrictive Disorders
- SOB
- Non-productive cough
- very thin
How much VO2 need for work of breathing for normal and restrictive disorders.
5%
25%
Clinical Syndrome caused by acute lung injury and characterized by sever hypoxemia and increase alveoli permeability.
ARDS
Ards is associated with __.
Multi-organ Failure
Etiology of ARds
- Trauma
- Fat emboli
- Transplant
- Shock
- Pneumonias
- Aspiration
- Drugs
Chronic inflammation inducing fibrosis, destruction, and distortion of lung parenchyma.
Pulmonary fibrosis
Pulmonary fibrosis considered to be a progression of
Interstitial lung disease (IDL)
Most aggressive interstitial lung disease
IPF
Result of failure of lung repair process
Interstitial pulmonary fibrosis
Signs and Sxs of pulmonary fibrosis
- rapid shallow breathing
- dyspnea on exertion
- fatigue
- loss of appetite
- weight loss
- decreased breath sounds
- digital clubbing……
- cyanosis
Collapse of alveoli
Atelectasis
Caused by obstruction of bronchial airway or insufficient surfactant
Atelectasis
Collapsed, airless alveoli ____ lung compliance and _______ work of breathing
Reduce, increase
Inflammatory process of lung from infection of lower respirator tract
Pneumonia
3 types of pneumonia
1) lobar
2) Bronchopneumonia
3) Walking
Chest pain related to ischemia of myocardium
Angina Pectoris
Where does angina pectoris refer?
b/w scalp Jaw Ear Teeth UE Neck
CHD in post menopause ____ than pre
2-3x higher
Women more likely to die from ____ wishin few weeks post
Heart attack
Death within one year of initial MI
Women
Men
38%
25%
Ratio of women who die from CVD
1 out of 2
Ratio of women who die from CA
1 out of 27
Who dies more from CVA
Women
3 types of angina pectoris
Stable, unstable, and variant
Which angina occurs during physical activity
Stable
Characterized by substantial, non-radiating pain. 5-15 mins.
Stable angina
Occurs during low level exercise
Unstable angina
Unstable angina episodes are
More frequent and longer
Unstable angina indicates
CAD progression
Is unstable angina responsive to NTG
Nawww
occurs as rest/ during walking
Variant angina
Characteristic of variant angina
Intense pain, long duration, can lead to MI
What is prescribed for stable, unstable and variant angina?
NTG
Hospitalization
Ca+ channel blockers
Necrosis of portion of Myocardium
MI
What is the pain of MI like?
Radiates, waxes and wanes. Doesn’t go away with NTG
Full wall thickness MI
Transmural
Only portion of wall involved in MI
Subendocardia (no q wave)
Small infarction with no complications during recovery
Uncomplicated MI
Conditions of complicated MI
1) dysrythmia
2) heart failure
3) thrombosis
4) Damage to structures
Cardiogenic shock followed by death if
40% or greater of L ventricle involved.
What can occur 1-2 weeks post MI
Ventricular wall rupture
MI signals for women
1) Nausea
2) Fatigue
3) Dizziness
4) Pain waist up, jaw and neck, sleeping
MI Risk factors for women
Low HDLS High triglycerides Diabetes Smoking (biggest) Estrogen/menopause
How is MI Dx
Echocardiography
Blood clot from a stent
In-stent thrombosis
Syndrome where heart is unable to pump sufficient blood to supply body
CHF
CHF is
A group of clinical manifestations
Left ventricular heart failure termed
CHF
R ventricular heart failure referred to as
Cor pulmonale
Cor pulmonale is caused by
Pulmonary patho
CHF symptoms develop
Gradually
RV backs up into….
LV backs up into…
RA then periphery
Lungs
R side CHF Sx
- dependent edema
- hepatomegaly
- ascites
- fatigue
- weight gain
- cyanosis
- low urine output
L side CHF Sx
- dyspnea
- fatigue
- rales
- enlarged heart
- tachypnea
- cyanosis
- irritability
- restless
- confusion
Oral anticoagulant that inhibit production of reduced form of vitamin K
Warfarin
What is warfarin indicated for
DVT, acute MI, emboli
