Pulmonary Patho - restrictive lung diseases, ABG and V/Q

Question 1

what is there a decrease of in restrictive lung disease?

Answer 1

decrease in lung tissue compliance

Question 2

what is atelectasis? what are the three different types? what are each caused by?

Answer 2

• lung collapse
  1. compression = due to external pressure
  2. obstruction = obstruction to alveoli or poor ventilation
  3. surfactant impairment = not enough surfactant produced

Question 3

in what individuals is atelectasis common in? what are clinical manifestations of it?

Answer 3

• post surgery and immobilized individuals
• leukocytosis, dyspnea, fever

Question 4

what is bronchiectasis? what does it usually occur in conjunction with? what is it commonly associated it?

Answer 4

• abnormal chronic dilation of the alveoli
• occurs in conjuction with diseases that cause bronchial inflammation
• commonly associated with systemic disorders

Question 5

what is the primary symptom of bronchiectasis? what complications is the disease associated with? what other two symptoms are common?

Answer 5

• productive cough
  -lower resp tract infections and found smelling sputum
• hemoptysis and clubbing

Question 6

what is bronchiolitis? what age group is commonly affected by it? in adults what does it usually occur with?

Answer 6

• inflammation of the bronchioles
• common in children
• in adults it usually occurs with chronic bronchitis

Question 7

in a healthy adult, what can cause bronchiolitis?

Answer 7

viral resp tract infection and inhalation of toxic gases

Question 8

what can bronchiolitis be a serious complication of? what can it lead to? what does this condition cause?

Answer 8

• stem cell and lung transplant
• can lead to bronchiolitis obliterans
• condition causes tissue scarring

Question 9

what are the clinical manifestations of bronchiolitis?

Answer 9

non productive cough, low grade fever, use of accessory muscles to breath, increased ventilatory rate

Question 10

what is pulmonary edema? what are the three common causes of it?

Answer 10

• water in the lungs
  1. left sided heart disease
  2. capillary injury,
  3. obstruction in lymph system

Question 11

what are the clinical manifestations of pulmonary edema? what are the symptoms of severe edema?

Answer 11

hypoxemia, dyspnea, pink frothy sputum, hypoventilation, hypercania

Question 12

what is acute respiratory distress syndrome? (ARDS)? what does is result from?

Answer 12

• acute inflammation to the lungs and alveocapillary injury
• pulmonary injury or systemic inflammation

Question 13

what are the phases that ARDS progresses through?

Answer 13

1. exudative
2. proliferative
3. fibrotic

Question 14

within what time frame does the exudative phase occur? what occurs during this phase?

Answer 14

• 72 hours
• release of pro inflammatory cytokines
• decrease in ventilatory rate, surfactant, and tidal volume

Question 15

within what time frame does the proliferative phase occur? what is there a proliferation of? what other significant issue occurs?

Answer 15

• 4 to 21 days
• there is a proliferation of T2 pneumocytes, fibroblasts and myofibroblasts
• progressive hypoxemia

Question 16

within what time frame does the fibrotic phase occur? what is fibrosis? what occurs during this phase? what can the fibrosis do in severe cases?

Answer 16

• within 14 to 21 days
• fibrosis is scarring of connective tissue
• fibrosis of the lungs
• in severe cases the scar tissue can obliterate important lung structures

Question 17

what is ventilation?

Answer 17

air going into the lungs

Question 18

what is perfusion?

Answer 18

blood flow to the tissues

Question 19

how is the V/Q ratio at the apex of the lung different from the base?

Answer 19

• APEX: greater ventilation and less perfusion (wasted ventilation)
• BASE: greater perfusion and less ventilation (wasted perfusion)

BUT BOTH V AND Q ARE GREATER AT THE BASE BECAUSE OF GRAVITY

Question 20

what is the V/Q ration used for?

Answer 20

to asses the efficiency of gas exchange in different regions of the lung

Question 21

what is alveoli like in the apex of the lung?

Answer 21

the alveoli are larger in the apex of the lung

Question 22

what are normal values for pH, PaO2, PaCO2, bicarbonate, base excess and lactate in the blood?

Answer 22

1. pH = 7.35 - 7.45
2. Pa oxygen = 10.3 - 13. 5
3. Pa CO2 = 4.7 - 6.0
4. Bicarbonate = 22 -28
5. BE = -2 to +2
6. Lactate = .5 - 1

Question 23

if a patient has low PaO2 but normal PaCO2, what does this indicate?

Answer 23

it indicate type 1 respiratory failure

Question 24

if a patient has low PaO2 but high PaCO2, what does this indicate?

Answer 24

indicates type 2 respiratory failure

Question 25

if you have low pH and high PaCo2, what does this indicate?

Answer 25

it means the body is retaining CO2 and not converting it to bicarbonate

Question 26

what does a raised bicarbonate level indicate? what disease is this usually common in?

Answer 26

• carbon dioxide retention
• common in COPD

Question 27

what would ABG look like in a patient with respiratory alkalosis? what diseases in this common in?

Answer 27

• high pH
• low Carbon Dioxide
• hyperventilation and pulmonary embolism

Question 28

how can you differentiate between a patient with pulmonary embolism and one with hyperventilation?

Answer 28

• patient with hyperventilation also has increased levels of oxygen
• patient with pulmonary embolism has decreased oxygen level