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Alterations of Hematological function in children > PC 604 test 4 > Flashcards

PC 604 test 4 Flashcards

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Sight Words (Ages 4-6) flashcards UMT for Kids flashcards
1
Q

Decreased compliance of the lungs

or RESTRICTIVE DISORDERS OF THE LUNG cause..

A

dyspnea, increased respiratory rate and decreased tidal volume

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2
Q

Pulmonary function tests FOR RESTRICTIVE DISORDERS OF THE LUNG

A

decreased forced vital capacity

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3
Q

Restrictive pulmonary disorders affect

A

alveolocapillary membrane and causes decreased diffusion of O2 from alveoli to blood

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4
Q

Acute (adult) Respiratory Distress Syndrome (ARDS) IS…

A

Acute lung inflammation and diffuse alveolocapillary injury

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5
Q

CAUSES OF Acute (adult) Respiratory Distress Syndrome (ARDS)

A

Causes – severe trauma, sepsis, fat emboli, shock, pancreatitis, pneumonia, DIC.etc.

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6
Q

CLINICAL MANIFESTATIONS OF Acute (adult) Respiratory Distress Syndrome (ARDS)

A

• Marked dyspnea, rapid shallow breathing, inspiratory crackles, respiratory alkalosis (because of rapid breathing), decreased lung compliance, hypoxemia that is unresponsive to O2 therapy, diffuse alveolar infiltrates on xray without cardiac disease,
•

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7
Q

PATHOPHYSIOLOGY OF Acute (adult) Respiratory Distress Syndrome (ARDS)

A

MASSIVE PULMONARY INFLAMMATION THAT INJURES THE ALVEOLI/CAPILLARY MEMBRANE AND PRODUCES PULMONARY EDEMA

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8
Q

EXAMPLES OF RESTRICTIVE DISORDERS OF THE LUNG

A

PULMONARY FIBROSIS
INHALATION DISORDERS
ACUTE REPIRATORY DISTRESS SYNDROME

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9
Q

• Much more frequently seen in primary care

A

Obstructive Pulmonary Disorders

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10
Q

• Airway obstruction occurs that is worse on expiration

A

Obstructive Pulmonary Disorders

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11
Q

EXAMPLES OF OBSTRUCTIVE PULMONARY DISORDERS

A

asthma, chronic bronchitis, emphysema

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12
Q

• All cause dyspnea and wheezing, increased work of breathing, ventilation\perfusion mismatch and decreased forced expiratory volume

A

Obstructive Pulmonary Disorders

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13
Q

• Primary cause: Smoking!

A

Obstructive Pulmonary Disorders

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14
Q

• HOW MANY DEATHS FROM COPD IN 2005

A

• Chronic obstructive lung disease was the underlying cause of 1 in 20 deaths in the United States in 2005

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15
Q

COPD DEATHS MORE PREVELANT AMONG MEN OR WOMEN?

A

• Death rates from COPD decreased among men but increased among women, keeping the death rate from COPD about the same overall.

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16
Q

MORE PREVELANT AMONG WHAT RACE?

COPD

A

• COPD deaths are higher among Whites than Blacks or people of other races.

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17
Q

MOST IMPORTANT CAUSE OF COPD..

A

• Smoking is the most important cause of COPD.

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18
Q

WHAT IS SHUNTING IN Acute (adult) Respiratory Distress Syndrome (ARDS

A

• Mismatching of the ventilation to perfusion ratio

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19
Q

EXPLAIN SHUNTING IN Acute (adult) Respiratory Distress Syndrome (ARDS

A
  • Specifically in ARDS we see an inadequate ventilation of well perfused areas of lung
  • Blood supply is undisturbed but the alveoli are inflamed and we get this shunting because of the alveolar function compromise
  • We see hypoxemia
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20
Q

• Remember the increased volume of the left ventricle means there is a backflow to the lungs THIS IS CALLED//

A

PULMONARY EDEMA

LEFT IS LUNG

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21
Q

• THERE IS Excess water in the lungs, the water escapes the capillary and goes into the alveoli IN WHAT DISORDER?

A

PULMONARY EDEMA

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22
Q

WHAT IS THE Most common cause OF heart failure, particularly left heart failure

A

PULMONARY EDEMA

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23
Q

occurs in many lung disorders

AND Occurs in ARDS

A

PULMONARY EDEMA

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24
Q

WHAT ARE SIGNS AND SYMPTOMS OF PULMONARY EDEMA

A

PULMONARY EDEMA
o Inspiratory crackles
o Lungs dull to percussion because there’s increased fluid inside
o Those with severe pulmonary edema would have a pink frothy sputum
o Hypoxemia
o Hypoventilation

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25
Q

PULMONARY EDEMA IS SEEN IN

A

LEFT SIDED HEART FAILURE AND ARDS

PULMONARY EDEMA

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26
Q

A PNEUMOTHORAX IS

A

Presence or air in the pleural space caused by an opening in the pleura or chest wall.

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27
Q

WHEN THERE IS AN OPENING IN THE PLEURA OR CHEST WALL

A

This destroys the negative pressure that helps the lung recoil after expiration. So the lung collapses

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28
Q

WHAT CAN CAUSE OPENINGS IN THE PLEURA?

A

Spontaneous – bleb
Secondary – trauma
Open
Tension – rupture is one-way valve – air in – collapsing lung and eventually compromising the other lung

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29
Q

WHAT ABOUT THE BLEB?

A
  • When the pleura has opened
  • The lung can have a bleb and the lung tissue where the bleb is opens spontaneously because the wall is a little thinner than the rest of the lung
  • So we have an area where air is getting into the pleural space but there is no disturbance in the pleura or the chest wall.
  • Every breath will bring more air into the space
  • Important to get chest tubes in to get the bleb area repaired or give it a chance to heal
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30
Q

WHAT CAUSES A TENSION PNEUMO THORAX?

A
  • rupture occurs and the air inside keeps filling the pleural space causing a severe collapse and eventually it will affect the other lung as well
  • So every breath in more air goes into the pleura space and cause more collapse so eventually this will compromise both lungs
  • is one-way valve – air in – collapsing lung and eventually compromising the other lung
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31
Q

Inflammatory disorder of airways – reversible

A

WHAT IS ASTHMA?

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32
Q

wHAT AGE GROUPS ARE AFFECTED BY ASTHMA

A

OCCURS IN ALL AGES

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33
Q

HOW MANY GENES HAVE BEEN FOUND TO PLAY A ROLE IS ASTHMA

A

• Have identified over 20 genes that play a role in asthma either in susceptibility or pathogenesis of asthma

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34
Q

WHAT ARE THE RISK FACTORS FOR ASTHMA

A

family history, allergen exposure, urban living, air pollution, cigarette smoke, recurrent URI from viruses, other atopic disorders IgE mediated

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35
Q

CAN ASTHMA OCCUR DUE TO LACK OF EXPOSURE TO INFECTIOUS AGENTS?

A

YES! • Somehow this affects the immune system in such a way that a child that is too clean, that is never allowed to make mud pies, or play in the dirt or play in the sand, is much more susceptible to asthma

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36
Q

CLINICAL MANIFESTATIONS OF ASTHMA

A
  • Between asthma attacks patient is totally asymptomatic
  • During an attack theres chest constriction, expiratory wheezing, dyspnea, non-productive cough, prolonged expiration, tachycardia and tachypnea
  • The bronchospasm can become very severe and if it is not reversible we have a condition called status asthmaticus if it’s not reversed
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37
Q

• Hypersecretion of mucous and chronic productive cough for at least 3 months of each year X 2 years straight (to be able to diagnose it)

A

Chronic bronchitis

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38
Q

What is the primary cause of chronic bronchitis.

A

Smoking

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39
Q

Dring chronic bronchitis airways are inflammed with

A

infiltration of neutrophils , macrophages, and lymphocyte into the bronchial walls

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40
Q

The • The inflammation of asthma

A

leads to hyper responsiveness of the airways

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41
Q

• If we trace the inflammation of asthma

A

we see that exposure to an allergen will lead to mast cell degranulation and this will lead to a release of inflammatory mediators practically histamine, interleukins, prostaglandins, leukotryines and nitric oxide

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42
Q

When inflammatory mediators are released in asthma what results?

A

then vasodilation, and an increase in capillary permeability results

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43
Q

In asthma eosinophils do what/

A

• Eosinophils release toxic chemicals that increase the inflammation and the tissue damage

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44
Q

When inflammation begins in the tissue

A

the bronchial smooth muscle will spasm and there will be vascular congestion, edema, thickened mucous, and impaired ciliary function

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45
Q

What are cilia?

A

• Now cilia are little extensions off of the cell membrane that move ad this movement moves away trash and mucous and debris that may gather in the lung

46
Q

• We also see the increased bronchial __________ in asthma.

A

hyperresponsiveness

47
Q

Chronic Bronchitis is

A

Hyper-secretion of mucous and chronic productive cough for at least 3 months of each year X 2 years

48
Q

•******* Primary cause of bronchitis is

know this card for the test

A

• Primary cause is cigarette smoking

49
Q

The pathophysiology of Bronchitis is

A

• Airway inflammation with infiltration of neutrophils , macrophages, and lymphocyte into the bronchial walls

50
Q

Later in Bronchitis we see

A

bronchial edema, increase in mucous cells, and the production of a thick tenacious mucous and with this very poor ciliary action with an increase in susceptibility to infection

51
Q

• The air trapping that happens in chronic bronchitis is due to this

A

hypersecretion of mucous as opposed to asthma where it is more about inflammation

52
Q

PRODUCTIVE COUGH

Compare clinical manifestations of Chronic Bronchitis and Emphysema

A

In Bronchitis: CLASSIC SIGN

In Emphysema: LATE IN THE COURSE

53
Q

DYSPNEA

Compare clinical manifestations of Chronic Bronchitis and Emphysema

A

In Bronchitis: LATE IN THE COURSE

In Emphysema COMMON

54
Q

WHEEZING

Compare clinical manifestations of Chronic Bronchitis and Emphysema

A

In Bronchitis:INTERMITTENT

In Emphysema MINIMAL

55
Q

HISTORY OF SMOKING

Compare clinical manifestations of Chronic Bronchitis and Emphysema

A

In Bronchitis: COMMON

In Emphysema COMMON

56
Q

BARREL CHEST

Compare clinical manifestations of Chronic Bronchitis and Emphysema

A

In Bronchitis: OCCASIONALLY

In Emphysema COMMON

57
Q

PROLONGED EXPIRATION

Compare clinical manifestations of Chronic Bronchitis and Emphysema

A

In Bronchitis: ALWAYS PRESENT

In Emphysema ALWAYS PRESENT

58
Q

CYANOSIS

Compare clinical manifestations of Chronic Bronchitis and Emphysema

A

In Bronchitis: COMMON

In Emphysema UNCOMMON

59
Q

CHRONIC HYPOVENTILATION

Compare clinical manifestations of Chronic Bronchitis and Emphysema

A

In Bronchitis:COMMON

In Emphysema LATE IN THE COURSE

60
Q

POLYCYTHEMIA

Compare clinical manifestations of Chronic Bronchitis and Emphysema

A

In Bronchitis: COMMON

In Emphysema LATE IN THE COURSE

61
Q

CORPULMONALE

Compare clinical manifestations of Chronic Bronchitis and Emphysema

A

In Bronchitis: COMMON

In Emphysema LATE IN THE COURSE

62
Q

• Don’t get me wrong, there is still inflammation in chronic bronchitis but the primary mechanism of air trapping in chronic bronchitis is

A

the hyper-secretion of mucous

63
Q

chronic bronchitis is associated with these symptoms

A

Bronchial edema

increase in mucous cells

production of a thick tenacious mucous

poor cilliary action with an increase in susceptibility to infection.

64
Q

In emphysema air is trapped within the

A

alveoli

65
Q

The patient with emphysema cannot move air out of the lungs because of

A

ballooning of the alveoli

66
Q

T/F We do not see fibrosis in emphysema?

A

True.

67
Q

Primary cause of emphysema is

A

smoking

68
Q

Besides smoking, name 2 other possible causes of emphysema

A

air pollution, childhood upper respiratory infections

69
Q

Primary emphysema is an inherited disorder that is

A

autosomal RESSIVE

70
Q

PRIMARY EMPHYSEMA IS VERY RARE!

A

YES, IT IS!

71
Q

primary EMPHYSEMA IS A DEFICIENCY OF

A

• Deficiency of the alpha 1 antripson

72
Q

HOW DOES CIGARETTE SMOKING CAUSE EMPHYSEMA

A

Cigarette smoking

Inhibits anti protease

73
Q

Inflammation of the lung due to aspiration of stomach juices

A

PNEUMONITIS

74
Q

Pneumonitis inflammation of

A

BRONCHIAL TREE

75
Q

WHAT “ACTION” IS LOST IN PNEUMONITIS

A

CILIARY

76
Q

IF GASTRIC JUICES ENTER THE ALVEOLI WHAT CAN OCCUR

A

HEMORRHAGIC PNEUMONITIS

77
Q

IN PNEUMONITIS, LUNGS BECOME

A

STIFF ADND LOOSE SURFACTANT PRODUCTION

78
Q

IS PNEUMONITIS LIFE THREATENING?

A

YES!!

79
Q

Infection of the lower respiratory tract – 6th leading cause of death in U.S.

A

PNEUMONIA

80
Q

SEVERE TYPE OF PNEUMONIA IS CAUSED BY

A

STREPTOCOCCAL PNEUMONIAE

81
Q

STREPTOCOCCAL PNEUMONIAE IS CONSIDERED

A

COMMUNITY AQUIRED

82
Q

RISK FACTORS FOR STREPTOCOCCAL PNEUMONIAE ARE

A 
ADVANCED AGE
IMMUNOCOMPROMISED
ALCOHOLISM
SMOKING
DEBILITATING EVENTS
83
Q

WALKING PNEUMONIA IS CAUSED BY

A

MICOPLASM PNEUMONIA

84
Q

NAME 3 ROUTES FOR INFECTION WITH PNEUMONIA

A

INHALED
INFECTION IN THE OROPHARYNX
FROM BLOOD BORNE PATHOGEN

85
Q

CLINICAL MANIFESTATIONS OF PNEUMONIA

A

AN UPPER RESPIRATORY INFECTION
FEVER CHILLS PRODUCTIVE COUGH
RUST COLORED OR BLOODY SPUTUM

86
Q

WHAT WILL YOU AUSCULTATE IN THE LUNGS WITH THE PNEUMONIA PATIENT?

A

INSPIRATORY CRACKLES

87
Q

AN INFECTED LUNG IS DULL TO PERCUSSION

A

YES MAAM, IT SURE IS!

88
Q

THERE IS NO TACTILE FERMENTUS, IS THERE?

A

YES! YES! THERE IS TACTILE FERMENTUS IN THE INFECTED LUNG.

89
Q

WHAT BACTERIA CAUSES TUBERCULOSIS?

A

Infection with mycobacterium tuberculosis

90
Q

TUBERCULOSIS

A

OCCURS IN THE LUNGS IN THE US

91
Q

in other conutries, tuberculosis can appear in other parts of the body due to

A

unpastuerized milk

92
Q

How is tuberculosis spread

A

airborne, droplet. Usually lodges in the upper part of the lung

93
Q

What happens when the tuberculine bacteria enters the lungs

A

• Mild pneumonitis and the bacilli will migrate to the lymph nodes where lymphocytes attack them and initiate an immune response and a cell-mediated response involving macrophages and neutrophils will engulf and isolate the bacilli stopping the spread

94
Q

Tuberculosis may produce a tubercule or

A

granulomatous lesion. The tissue within the lesion may die.

95
Q

What causes scar tissue within the lung from tuberculosis

A

encasiation causes the scar tissue

96
Q

Once the bacilli is isolated, the disease process

A

STOPS

CELL MEDIATION HAS CONTAINED THE EXPOSURE.

97
Q

TB may be dormant for a lifetime and occur in response to

A

decreased immunity or if exposed to more active disease

98
Q

– Active Tuberculosis (Pulmonary that has been around a while) shows symptoms of

A

• Fatigue, wt loss, lethargy, anorexia, a low grade fever particularly in the evening, cough, that is productive of purulent sputum, night sweats and anxiety (not over night type of reaction, this has been around awhile)

99
Q

• Tuberculosis infection rate has declined in the United States to

A

4.8 cases per 100,000 population

100
Q

• Hispanics, blacks, and Asians had TB rates

A

7.3 (Hispanics), 8.3 (blacks), and 19.6 (Asians) times higher than whites in the United States in 2005.

101
Q

• The seven states with the highest incidence of tuberculosis are

A

California, Florida, Georgia, Illinois, New Jersey, New York and Texas.

102
Q

Acute bronchitis is

A

• Acute infection or inflammation – usually viral of airways and bronchi – self limiting

103
Q

Acute bronchitis begins with a

A

cold that “goes to the chest.”

104
Q

Clinical manifestations of acute bronchitis

A

cough,chest pain related to cough

105
Q

Pulmonary embolism

A

occlusion of the pulmonary vascular bed with an embolism.

106
Q

pulmonary embolism usually originates from

A

veins of the legs and pelvis

107
Q

pulmonary embolism may be from

A

blood clots, amniotic fluid, fat from longbone fracture

108
Q

Does an embolism always infarct the lung?

A

Not always

109
Q

clinical manifestations of DVT

A

usually non-specific. chest pain, dyspnea, tachypnea, anxiety
**check history for DVT

110
Q

Corpulmonale is

A

right sided heart failure

111
Q

volume backflow of corpulmonale is to the

A

periphery

112
Q

paroxysmal nocturnal dypnea

PND is a symptom of

A

lung disease or heart failure

Alterations of Hematological function in children (4 decks)

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