Pathophysiology Flashcards by Chavez Girls

You need to excrete ________ to bring PH levels down

Bicarbonate (CO2)

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CNS depressing drugs can potentially cause..

Respiratory acidosis

-hypoventilation

-not enough bicarbonate being excreted through breathing

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PH under __________ is acidosis

Under 7.35

Normal: 7.35-7.4

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

HCO3-

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

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Respiratory acidosis will lead to

______cardia

confusion

headache

reslessness

Tachycardia

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__________ventilation will cause respiratory alkalosis

Hyperventilation

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Drugs that stimulate the respiratory system can cause…

Respiratory alkalosis

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

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Hyperventilation leads to ______

Hypoventilation leads to ________

Hyper- alkalosis

Hypo- acidosis

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A patient has respiratory alkalosis if PH is above

7.45

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Rapid deep breathing, parasthesia, light headedness, anxiety

are symptoms of

respiratory alkalosis

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Diuretics/Renal Disease (too much excretion)

Vomiting/Diarrhea (Loss of hydrochloric acid)

Or decreased plasma potassium levels

These often cause …..

Metabolic Acidosis

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

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

CO2

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

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

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Slow, Shallow breathing

Confusion

Hypertonic muscles

restlessness

seizure

These are signs of

Metabolic alkalosis

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

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Hyperkalemia

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

Metabolic Acidosis

Note that H+ Follows potassium!

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Uncontrolled diabetes -> Hyperglycemia -> Ketone bodies

These cause ___________

Metabolic acidosis

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Cusmal’s Respiration is often seen with ____________

Metabolic acidosis

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

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What are signs of diabetic ketoacidosis

Excess Thirst

Urination

Fruity Breath

Drowsiness

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When looking at patient stats

HCO3 represents the __________ system

Whereas CO2 represents the ________ system

Metabolic system

Respiratory system

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Patient 1:

PH 7.55 (high PH)

CO2 = 32 (Low)

HCO3 = 20 (Low)

What is the problem?

Respiratory alkalosis

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

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PH 7.47 (High)

PaCO2: 61 (High)

HCO3: 43 (High)

What is the problem?

Metabolic alkalosis w/ partial compensation

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PH 7.26 (Low)

PaCO2 (High)

HCO3 (Normal)

What is the problem?

Respiratory acidosis w/ no compensation

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

restrictive

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

obstructive

Obstructive patients tend to have a _______ lung with ________ FVC1

Large Less

Asthma Chronic Bronchitis Emphysema Cystic Fibrosis These are all examples of

Obstructive disorders

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

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

False, these decrease

What is FEV1? What is FVC?

FEV1 = forced amount of air out of lung in 1 sec FVC= Forced vital capacity = How much air you can exhale TOTAL

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

70%

How does chronic bronchitis obstruct the lung?

Inflamed airways cause excessive mucus production prevent exhalation and trap air

How does emphysema obstruct the lung?

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

What are the 2 types of COPD?

Chronic Bronchitis and emphysema

Emphysema causes ____________ lung tissue compliace

Increased

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

Huffing

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

Chronic bronchitis

GOLDS GRADES AND SEVERITY OF AIRWAY OBSTRUCTION IN COPD

Mild- above 80% predicted FEV1 (normal) Moderate 80-50 Severe 50-30 Very Severe 30 and under

What is predicted FEV1 based on?

Race, weight, height, Gender....

Emphysema patients ___________ oxygen desaturation during exercise Chronic bronchitis patients ____________ oxygen desaturation during exercise

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

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

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

Two kinds of Emphysema:

Panacinar - **Affects alveoli**, affects **whole lung**, primarily lower lobes, **genetic** predisposition Centrilobublar - most common type due to **smoking**, **affects respiratory bronchioles**, primary upper lobes

What is a Bullae?

Hypercompliant "balloon" structure in lung seen in emphysema

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

barrel chest flatter

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

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

Emphysema patients have ___________ breath sounds

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

How does emphysema lead to R sided Heart Failure

Low oxygen -> Pulmonary artery constriction (to try to balance V/Q ratio) -> Pulmonary hypertension -> Too much work for R side of heart

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

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

Why is there increased risk of nocturnal death w/ emphysema

Less ventilation overall during REM sleep leads to cardiac arrythmia

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

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)

Why is pursed lip breathing important for obstructive patients?

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

Why do chronic bronchitis patients have excessive mucus

Goblet and mucoid cell hyperplasia Reduced cillary activity Frequent infections

Who develops hypoxemia sooner, emphysema patients or chronic bronchitis patients

Chronic bronchitis

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

Pulmonary hypertension

Why are chronic bronchitis patients blue

Cyanosis due to hypoxemia

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

wheezing

How is asthma treated?

Corticosteroids Or medications that activate sympathetic NS and supress parasymp NS

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

Bronchodilators

What is the key to diagnosing asthma?

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