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Cardiopulm Final > Pathophysiology > Flashcards

Pathophysiology Flashcards

1
Q

You need to excrete ________ to bring PH levels down

A

Bicarbonate (CO2)

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2
Q

CNS depressing drugs can potentially cause..

A

Respiratory acidosis

-hypoventilation

-not enough bicarbonate being excreted through breathing

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3
Q

PH under __________ is acidosis

A

Under 7.35

Normal: 7.35-7.4

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4
Q

If a patient is compensating for respiratory acidosis, what will be high?

A

HCO3-

(this is a akaline substance and it helps make the PH less acidic).

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5
Q

Respiratory acidosis will lead to

______cardia

confusion

headache

reslessness

A

Tachycardia

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6
Q

__________ventilation will cause respiratory alkalosis

A

Hyperventilation

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7
Q

Drugs that stimulate the respiratory system can cause…

A

Respiratory alkalosis

Note: can also be caused by anxiety, pain, fever, or **sepsis **

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8
Q

Hyperventilation leads to ______

Hypoventilation leads to ________

A

Hyper- alkalosis

Hypo- acidosis

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9
Q

A patient has respiratory alkalosis if PH is above

A

7.45

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10
Q

Rapid deep breathing, parasthesia, light headedness, anxiety

are symptoms of

A

respiratory alkalosis

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11
Q

Diuretics/Renal Disease (too much excretion)

Vomiting/Diarrhea (Loss of hydrochloric acid)

Or decreased plasma potassium levels

These often cause …..

A

Metabolic Acidosis

Please note that **low hydrogren levels often follow low potassium levels **

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12
Q

If someone has metabolic acidosis, what are they retaining too much of?

A

CO2

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13
Q

If someone is compensating for metabolic alkalosis, what will you see?

A

Higher PaCO2 in order to try to make the blood more acidic

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14
Q

Slow, Shallow breathing

Confusion

Hypertonic muscles

restlessness

seizure

These are signs of

A

Metabolic alkalosis

Note: You’re breathing slow and shallow to retain CO2

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15
Q

Hyperkalemia

Liver disease can cause excess HCL acid, this could lead to…

A

Metabolic Acidosis

Note that H+ Follows potassium!

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16
Q

Uncontrolled diabetes -> Hyperglycemia -> Ketone bodies

These cause ___________

A

Metabolic acidosis

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17
Q

Cusmal’s Respiration is often seen with ____________

A

Metabolic acidosis

Rapid Deep breathing in an attempt to excrete CO2 and bring PH back to normal

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18
Q

What are signs of diabetic ketoacidosis

A

Excess Thirst

Urination

Fruity Breath

Drowsiness

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19
Q

When looking at patient stats

HCO3 represents the __________ system

Whereas CO2 represents the ________ system

A

Metabolic system

Respiratory system

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20
Q

Patient 1:

PH 7.55 (high PH)

CO2 = 32 (Low)

HCO3 = 20 (Low)

What is the problem?

A

Respiratory alkalosis

w/ partial compensation (partial because PH is not back to normal, but HCO3 is low)

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21
Q

PH 7.47 (High)

PaCO2: 61 (High)

HCO3: 43 (High)

What is the problem?

A

Metabolic alkalosis w/ partial compensation

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22
Q

PH 7.26 (Low)

PaCO2 (High)

HCO3 (Normal)

What is the problem?

A

Respiratory acidosis w/ no compensation

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23
Q

If vital capacity is under 80% of what is predicted, then you have a _______ lung disorder

A

restrictive

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24
Q

If vital capacity is over 120% what is predicted you have a ________ lung disorder

A

obstructive

25
Q

Obstructive patients tend to have a _______ lung with ________ FVC1

A

Large

Less

26
Q

Asthma

Chronic Bronchitis

Emphysema

Cystic Fibrosis

These are all examples of

A

Obstructive disorders

27
Q

T or F, an obstructive lung patient will have increased Residual Lung Volume

A

T

28
Q

T or F, an obstructive lung patient will have increased Inspiratory and Expiratory reserve volume

A

False, these decrease

29
Q

What is FEV1?

What is FVC?

A

FEV1 = forced amount of air out of lung in 1 sec

FVC= Forced vital capacity = How much air you can exhale TOTAL

30
Q

If FEV1/FVC is under _______, you’ve got obstrutive lung disease

A

70%

31
Q

How does chronic bronchitis obstruct the lung?

A

Inflamed airways cause excessive mucus production prevent exhalation and trap air

32
Q

How does emphysema obstruct the lung?

A

Alveoli become less efficient at gas exchange (destruction of alveioli wall) and trap air

33
Q

What are the 2 types of COPD?

A

Chronic Bronchitis and emphysema

34
Q

Emphysema causes ____________ lung tissue compliace

A

Increased

35
Q

What is better for COPD patient’s, huffing or coughing?

A

Huffing

36
Q

Productive cough on most days for 3 months during 2 consecutive years is the diagnositc criteria for ___________

A

Chronic bronchitis

37
Q

GOLDS GRADES AND SEVERITY OF AIRWAY OBSTRUCTION IN COPD

A

Mild- above 80% predicted FEV1 (normal)

Moderate 80-50

Severe 50-30

Very Severe 30 and under

38
Q

What is predicted FEV1 based on?

A

Race, weight, height, Gender….

39
Q

Emphysema patients ___________ oxygen desaturation during exercise

Chronic bronchitis patients ____________ oxygen desaturation during exercise

A

Develop

MAY DEVELOP (W/ chronic bronchitis sometimes the exercise helps them clear the secretions)

40
Q

At the beginning of Emphysema, their SPO2 is normal at rest, why?

A

Because they’re able to compensate by breathing faster.

Exercise will make SPO2 drop whem they cant keep up w/ demand ‘

THIS IS WHY PACED BREATHING IS IMPORTANT FOR EMPHYSEMA

41
Q

Two kinds of Emphysema:

A

Panacinar - Affects alveoli, affects whole lung, primarily lower lobes, genetic predisposition

Centrilobublar - most common type due to smoking, affects respiratory bronchioles, primary upper lobes

42
Q

What is a Bullae?

A

Hypercompliant “balloon” structure in lung seen in emphysema

43
Q

Emphysema patients might have a ___________ chest deformity causing a ______ diaphram

A

barrel chest

flatter

44
Q

Emphysema patient’s have a increased residual volume and an increased ____________

A

Functional residual volume - (basically Residual volume + expiratory reserve volume)

45
Q

Emphysema patients have ___________ breath sounds

A

DECREASED

(too much air, sound doesn’t travel well!)

46
Q

How does emphysema lead to R sided Heart Failure

A

Low oxygen ->

Pulmonary artery constriction (to try to balance V/Q ratio) ->

Pulmonary hypertension ->

Too much work for R side of heart

47
Q

Why are emphysema patient’s more prone to clots and pulmonary embolism?

A

Relative increase in hematocrit because less oxygen in blood = more RBC = Thicker blood

48
Q

Why is there increased risk of nocturnal death w/ emphysema

A

Less ventilation overall during REM sleep leads to cardiac arrythmia

49
Q

On a patient w/ emphysema, what will you see on their chest xray

A

More ribs = hyperinflated

5-7 is normal

7+

(I think these numbers are talking about how many ribs you can see covering the lung, more ribs = bigger lung)

50
Q

Why is pursed lip breathing important for obstructive patients?

A

Maintain positive airway pressure in lungs to prevent collapse upon rapid exhalation

51
Q

Why do chronic bronchitis patients have excessive mucus

A

Goblet and mucoid cell hyperplasia

Reduced cillary activity

Frequent infections

52
Q

Who develops hypoxemia sooner, emphysema patients or chronic bronchitis patients

A

Chronic bronchitis

53
Q

Chronic bronchitis leads to __________ which leads to R sided heart failure/cor pulmonale

A

Pulmonary hypertension

54
Q

Why are chronic bronchitis patients blue

A

Cyanosis due to hypoxemia

55
Q

What will you hear often w/ asthma patients (more on expiration)

A

wheezing

56
Q

How is asthma treated?

A

Corticosteroids

Or medications that activate sympathetic NS and supress parasymp NS

57
Q

Reversability of asthma w/ ____________ is greater than other obstructive lung diseases

A

Bronchodilators

58
Q

What is the key to diagnosing asthma?

A

When they take a bronchodilator you see a 12% increase in FEV1

59
Q
A

Cardiopulm Final (8 decks)

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