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Differential Dx > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

definition: inversely proportional to the hydrogen ion concentration in blood

A

pH

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2
Q

definition: measures effectiveness of ventilation

A

pCO2 (partial pressure of CO2)

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3
Q

What is the inverse to pH?

A

pCO2

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4
Q

definition: measure of metabolic acid-base function

A

HCO3

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5
Q

definition: represents status of alveolar gas exchange

A

paO2

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6
Q

definition: percentage of hemoglobin saturation with oxygen

A

O2 sat

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7
Q

What is the normal pH level?

A

7.35-7.45

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8
Q

What is the normal pCO2 level?

A

35-45 mmHg

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9
Q

What is the normal HCO3 level?

A

22-26 mEq/L

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10
Q

What is the normal paO2 level?

A

80-100 mmHg

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11
Q

What are the panic levels for pH?

A

< 7.2
> 7.6

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12
Q

What are the panic levels for pCO2?

A

< 20
> 70

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13
Q

What are the panic levels for HCO3?

A

< 10
> 40

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14
Q

What is the panic level of pO2?

A

< 40

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15
Q

What is the panic level for O2?

A

< 60-70

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16
Q

What are the causes of respiratory acidosis?

A
  • damage to the medulla
  • airway obstruction
  • loss of lung surface ventilation
  • weak respiratory muscles
  • overdose of respiratory depressants
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17
Q

What is the respiration center of the brain?

A

medulla

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18
Q

What are the s/s associated with respiratory acidosis?

A
  • HYPOventilation
  • confusion
  • fatigue
  • LOC
  • diaphoresis
  • shallow, rapid breathing
  • restlessness
  • cyanosis
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19
Q

What are the causes of respiratory alkalosis?

A
  • HYPERventilation
  • hyperthyroidism
  • overventilation via mechanical ventilator
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20
Q

What are the s/s associated with respiratory alkalosis?

A
  • hyperventilation
  • lightheaded
  • dizziness
  • N/T of the face, fingers, and toes
  • fainting/syncope
  • convulsions
  • arrythmias
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21
Q

What are the 4 items on the pulmonary checklist?

A
  • dyspnea
  • cough
  • clubbing of the nails
  • wheezing/stridor
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22
Q

definition: high-pitched noise caused by a partial obstruction of the airway

A

wheezing

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23
Q

definition: high-pitched sound associated w/ obstruction of the larynx or trachea

A

stridor

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24
Q

How can wheezing be resolved?

A
  • opening the airway
  • narrowing the airway
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25
Q

What are the primary pulmonary pain patterns?

A
  • substernal/chest region over the involved lung
  • side or back
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26
Q

What are the secondary pain patterns that radiate with pulmonary diseases?

A

neck, upper trap, costal margins, t-spine, scapula/shoulder

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27
Q

definition: Pain that refers to neck/ant chest (same level as irritation)

A

tracheobronchial

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28
Q

Explain what pleural pain feels like.

A

sharp and localized that is aggravated with any respiratory movement

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29
Q

What eases pleuritic pain?

A

auto-splinting –> tucking in the arm and laying on the affected side

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30
Q

Where is peripheral diaphragmatic pleural pain found?

A

costal margins and lumbar spine

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31
Q

Where is central diaphragmatic pleural pain found?

A

ipsilateral upper trap/shoulder

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32
Q

What kind of lung disease is CF?

A

genetic

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33
Q

What are blue bloaters?

A

chronic primary bronchitis

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34
Q

What is bronchitis?

A

inflammation of the trachea and bronchi

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35
Q

What are pink puffers?

A

emphysema

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36
Q

What is emphysema?

A

loss of elasticity or over distention

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37
Q

What can cause acute bronchitis?

A

chemical irritation or infection

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38
Q

What is a complication of acute bronchitis?

A

pneumonia

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39
Q

What causes chronic bronchitis?

A

prolonged exposure to irritants

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40
Q

What are complications of chronic bronchitis?

A

respiratory infection and lung disease

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41
Q

What are the s/s associated with bronchitis?

A
  • wheezing
  • dyspnea
  • prolonged expiration
  • obesity
  • cyanosis and cor pumonale consisting of LE edema, elevated jugular venous pressure, R ventricular pressure, and tricuspid insufficiency
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42
Q

What is bronchiectasis?

A

cyclical bacterial infection that is followed by bronchial wall damage

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43
Q

When does bronchiectasis occur?

A

After infections (example: childhood pneumonia or CF)

44
Q

What is a type of bronchitis that is a progressive and chronic pulmonary condition?

A

bronchiectasis

45
Q

What are s/s associated with bronchiectasis?

A
  • chronic wet cough with foul-smelling secretions
  • worse in the morning
  • bloody sputum (hemoptysis)
  • sinusitis
  • occasional wheezing
46
Q

(true/false) Emphysema is not permanent.

A

FALSE (it is)

47
Q

What are the s/s associated with emphysema?

A
  • SOB; DOE
  • Orthopnea (only able to breathe in upright position) after assuming supine position
  • Barrel chest
  • Minimally productive cough
  • Pursed-lip breathing; use of accessory mm
  • Prolonged expirations (often w/ grunt)
  • Peripheral cyanosis
  • Thin appearance
  • Wheezing
  • Diminished breath sounds
48
Q

What are the two components of asthma?

A

allergen sensitization and inflammation

49
Q

What are the types of asthma?

A

conventional, occupational, EIA

50
Q

What is the cause of asthma?

A

Genetic disposition and environmental influences

51
Q

definition: Inflammation of the lungs in response to the offending organism or agent

52
Q

What are causes of pneumonia?

A
  • Aspiration of food, fluids, or vomit
  • Inhalation of toxic/caustic chemicals, dust, or gas
  • Bacterial, viral, or mycoplasmal infection
53
Q

What are risk factors for pneumonia?

A
  • severe cold
  • alcoholism
  • disease
  • poor health
54
Q

What are red flags for pneumonia?

A
  • pleuritis pain
  • recent UTI
  • confusion
  • fever/chills/HA/malaise
  • nausea
  • productive cough (rust-colored or green, purulent sputum)
55
Q

What is mediastinitis?

A

Swelling and irritation/inflammation of the area between the lungs (mediastinum)

56
Q

What are s/s associated with mediastinitis?

A
  • chest pain
  • chills
  • coughing up blood
  • fever
  • malaise
  • SOB
57
Q

How long can TB take to develop symptoms after initial infection?

A

3-10 weeks

58
Q

What are the s/s associated with TB?

A
  • Fatigue/Malaise
  • Anorexia
  • Wt loss
  • Low-grade fever
  • Night sweats
  • Frequent productive cough
  • Chest pain
  • Dyspnea
59
Q

What is scleroderma?

A

inflammation and fibrosis of many organs

60
Q

What condition has the appearance of taut and shiny skin and atrophy of the webbed space?

A

scleroderma

61
Q

What is the secondary site for scleroderma?

62
Q

What is the primary visceral site for scleroderma?

63
Q

What are the s/s associated with scleroderma?

A
  • DOE
  • Nonproductive cough
  • Peripheral edema (secondary to cor pulmonale)
  • Orthopnea
  • Paroxysmal nocturnal dyspnea (CHF)
  • Hemoptysis (coughing up blood)
  • Sclerodactyly (hardening/shrinking of connective tissue of fingers/toes)
64
Q

definition: Malignancy in the epithelium of the respiratory tract (12+ different types)

A

bronchiogenic carcinoma

65
Q

Where are the METS normally found with bronchogenic carcinoma?

A

long bones, t-spine, liver, adrenal glands

66
Q

(true/false) lung cancer cannot cross between the lungs or lobes of lungs.

67
Q

(true/false) Low fruit/vegetable consumption is considered as a risk factor for lung cancer

68
Q

What are the s/s associated with lung cancer?

A
  • Change in respiratory patterns
  • Recurrent pneumonia or bronchitis
  • Hemoptysis
  • Persistent cough
  • Hoarseness/dysphagia
  • Fecal breath odor
  • classic Red Flags for CA
69
Q

Cystic fibrosis is an inherited disease of the ________ that primarily affects what systems?

A

disease of exocrine glands that primarily affects the digestive and respiratory systems

70
Q

What makes mucus abnormally thick and sticky in cases of cystic fibrosis?

A

Accumulation of salt in the cell lining of the lungs and digestive tissues

71
Q

What is cystic fibrosis named after?

A

Named b/c of the cysts & scarring observed on the pancreas (secondary characteristic)

72
Q

Where is the cystic fibrosis gene found?

A

chromosome 7

73
Q

How does cystic fibrosis affect the GI system?

A

causes malnutrition which decreases absorption of the nutrients received

74
Q

What are s/s associated with cystic fibrosis?

A
  • Salty skin/sweat
  • Recurrent pneumonia
  • Persistent cough & wheezing
  • Poor wt gain (despite excessive appetite)
  • Bulky, foul-smelling stools (undigested fats)
75
Q

definition: Rare CA of the pleura related to asbestos exposure

A

mesothelioma

76
Q

(true/false) Mesothelioma is related to smoking.

A

FALSE (it is not)

77
Q

definition: Scarring of lung tissue secondary to inhalation of strong, fine asbestos fibers

A

asbestosis

78
Q

What is “Brown lung disease”?

A

Byssinosis

79
Q

What is the cause of byssinosis?

A

Dust from hemp, flax, and cotton processing

80
Q

What population is at risk for developing byssinosis?

A

textile workers

81
Q

“Allergic alveolitis”, “Farmers Lung”, “Bird-Handlers Lung”

A

hypersensitivity pneumonitis

82
Q

What is the cause of hypersensitivity pneumonitis?

A

Inhalation of organic antigens of fungal, bacterial or animal origin

83
Q

“Dust diseases”

A

pneumoconioses

84
Q

Pneumoconioses develops (gradually, rapidly)

85
Q

What are Miners, construction workers, sandblasters, potters, and foundry/quarry workers most susceptible to forming?

A

pneumoconioses

86
Q

Where is the location of pain for a PE?

A

substernal (but can be anywhere in thorax), shoulder, or upper abdominal

87
Q

What are s/s associated with PE?

A
  • Crushing chest pain
  • dyspnea
  • wheezing
  • marked dec in BP
88
Q

What are red flags and s/s for PE?

A
  • chest, shoulder, or upper abdominal pain
  • dyspnea
  • PMH or risk factors for DVT
  • tachypnea
  • tachycardia
  • Fever (103.5oF)
  • Pleuritic chest pain
  • Diffuse chest discomfort
  • Persistent cough
  • Hemoptysis
  • Apprehension, anxiety, restlessness
89
Q

Cor pulmonale affects the ____ side of the heart.

A

Right side

90
Q

(true/false) Cor pulmonale is not a serious cardiac condition

91
Q

When does cor pulmonale occur?

A

when a massive PE obstructs 60-75% of the pulmonary circulation

92
Q

Cor pulmonale is fostered by what?

A

Fostered by long-term pulmonary hypertension (arteries and right ventricle of the heart)

93
Q

What is pulmonary artery hypertension?

A

High blood pressure in the arteries that supply the lungs

94
Q

Vasoconstriction of the pulmonary arterial vascular bed can lead to _______.

A

endocarditis

95
Q

What are the causes of pulmonary artery hypertension?

A
  • PE
  • Chronic lung disease
  • polycythemia
  • heart abnormalities
96
Q

What is pleurisy?

A

inflammation of the pleura

97
Q

What are red flags for pleurisy?

A
  • Severe, sharp “knife-like” pain with inspiration
  • History of a recent/co-existing respiratory disorder
  • Dyspnea
98
Q

Spontaneous pneumothorax is usually associated with what?

A

Ruptured lung wall

99
Q

When does spontaneous pneumothorax resolve?

A

Within a few days if small

Aspiration if large

100
Q

What usually causes a tension pneumothorax?

101
Q

What type of pneumothorax is a medical emergency?

A

tension pneumothorax

102
Q

Presentation:
- Severe “pleuritic-type” chest wall pain
- extreme SOB
- tracheal deviation (away from the involved side)
- distended neck veins
- tachycardia
- hypotension
- hyperresonance

A

tension pneumothorax

103
Q

What are red flags for possible pneumothorax?

A

Chest pain - intensified with inspiration
Difficult to ventilate/expand ribcage
Hyperresonance upon percussion
Decreased breath sounds

104
Q

What position worsens pulmonary symptoms?

105
Q

What are the 3 P’s to rule out pulmonary involvement?

A
  • no pleuritic pain
  • palpation tenderness
  • pain with position changes (except recumbency)
106
Q

When is shoulder pain caused by a pulmonary origin?

A
  • agg with respiratory movements
  • worsened with supine and recumbent positioning
  • subsides with auto-splinting
107
Q

(true/false) Pneumonia or heart failure are often the final event that starts a downward spiral of pulmonary failure leading to failure of other organ systems

Differential Dx (13 decks)

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