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Clinical Medicine III (Fall 2017) > Reading Outline (beginning of "revised" section in Special Diagnostic Testing...) > Flashcards

Reading Outline (beginning of "revised" section in Special Diagnostic Testing...) Flashcards

1
Q

a cough can either be ____ or ____ based on length of time it has persisted

A

acute or chronic

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2
Q

an acute cough has persisted for…

A

less than 3 weeks

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3
Q

a chronic cough has persisted for…

A

over 8 weeks

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4
Q

two types of cough

A
  1. dry

2. productive

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5
Q

a dry cough often spirals into…

A

a self-perpetuated cough

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6
Q

is a dry cough generally valued?

A

nope

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7
Q

a dry cough may be seen in…

A

tumor, asthma

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8
Q

a productive cough clears…

A

airways

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9
Q

a productive cough might be present in…

A

infections

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10
Q

the release in a productive cough is termed

A

sputum

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11
Q

a bloody sputum might be present in

A

infection, tumor, infarction

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12
Q

a purulent (pussy) sputum might be indicative of

A

infection

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13
Q

a non-purulent sputum may indicate

A

airway irritation

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14
Q

what is dyspnea

A

shortness of breath

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15
Q

what does dyspnea indicate

A

poor ventilation/perfusion

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16
Q

causes of dyspnea (3)

A
  1. increased awareness of normal breathing (anxiety)
  2. increased work to breathe
  3. abnormal ventilatory function
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17
Q

what is orthopenea

A

dyspnea when laying down

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18
Q

chest pain can present in __#?___ different ways

A

3

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19
Q

chest wall pain can be described as (2)

A
  1. superficial

2. localized

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20
Q

visceral chest pain can indicate involvement of (3) things..

A
  1. pulmonary
  2. cardiac
  3. GI
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21
Q

where is pulmonary chest pain generally

A

directly over the involved lung field

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22
Q

can pulmonary chest pain be anterior, lateral, or posterior?

A

yee

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23
Q

is it possible for chest pain to mimic other neuromuscular/musculoskeetal causes of neck/shoulder pain?

A

yes

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24
Q

chest pain can radiatate: yay or nay

A

yay

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25
Q

what is cyanosis

A

bluish tint

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26
Q

for cyanosis, what is seen for PaO2 and Hgb

A

PaO2: low
Hgb: decreased

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27
Q

is gas exchange good or bad for cyanosis

A

poor

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28
Q

what parts are specifically blue for cyanosis

A

mucous membranes (tongue, lips)

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29
Q

in cyanosis, arterial saturation is often…

A

less than 75%

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30
Q

for cyanosis, how is peripheral oxygen extraction described

A

excessive

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31
Q

what is cyanosis often associated with

A

cold external temps, anxiety, heart failure, shock

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32
Q

Clubbing is a dumbed down word for

A

Hypertophic Pulmonary Osteoarthropathy

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33
Q

clubbing appears as

A

thick and wide terminal phalanges

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34
Q

what happens regarding the nail and neail bed

A

the angle between the nail and nail bed is lost

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35
Q

in clubbing, pulmonary problems often lead to…

A

hypoxia

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36
Q

clubbing is common in…(4)

A

cystic fibrosis, lung abscess, pulmonary fibrosis, congenital heart disease

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37
Q

what is the 2nd most common cause of disability in adults under 65

A

lung disease

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38
Q

two types of respiratory diseases

A
  1. obstructive

2. restrictive

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39
Q

three obstructive diseases

A
  1. COPD
  2. Asthma
  3. Chronic Bronchitis
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40
Q

two restrictive diseases

A
  1. Extrapulmonary Disorder

2. Parenchyma Disorders

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41
Q

what is an obstructive pulmonary disease

A

increased airway resistance

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42
Q

what is a restrictive pulmonary disease

A

lungs prevented from expanding fully

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43
Q

85-90% of all COPD deaths are caused by…

A

smoking

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44
Q

in COPD, what happens to the bronchial wall

A

inflamed and fibrosis

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45
Q

in COPD, what happens to the submucosal glands

A

hypertrophy and hyperscretion

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46
Q

in COPD, what happens elastic lung fibers and alveolar tissue

A

loss of elastic lung fibers and alveolar tissue

47
Q

after inspiration in COPD, what happens to recoil of tissue

A

fail to get normal recoil of tissue after ispiration

48
Q

in COPD, is there a decreased ability to get air out

A

yes

49
Q

for COPD what are the goals (increase/decrease) for all of these?

  1. oxygenation
  2. activity tolerance
  3. CO2 retention
  4. airway edema/inflammation
  5. secretions
  6. anxiety/depression
A
  1. increase
  2. increase
  3. decrease
  4. decrease
  5. decrease
  6. decrease
50
Q

is prognosis good or poor to COPD

A

poor

51
Q

is there a cure for COPD

A

no

52
Q

what can increase survival rate for COPD

A

O2

53
Q

what is asthma

A

a reversible obstructive lung disease

54
Q

what happens during asthma

A

chronic airway inflammation, narrowing

55
Q

in asthma, do airways overreact or underreact

A

overreact

56
Q

what is the most common chronic disease in adults and children

A

asthma

57
Q

two main types of asthma

A
  1. extrinsic

2. intrinsic

58
Q

extrinsic asthma is also called ___ asthma

A

allergic

59
Q

intrinsic asthma is also called ___ asthma

A

non-allergic

60
Q

what is intrinsic asthma triggered by

A

unknown trigger (secondary to respiratory infection)

61
Q

asthma is most likely to occur before (age?)

A

5 y/o

62
Q

asthma is more common in girls/boys?

A

boys (3x) (rates even out after puberty)

63
Q

in asthma, what do airway spasms lead to

A

mucous plugs the airway –> distal air trapped

64
Q

in asthma, distal air being trapped leads to…

A

VQ mismatch, hypoxemia, increased work to breathe

65
Q

in asthma, is airway inflammation always present?

A

yes

66
Q

in asthma, is chest tightness present?

A

yeah

67
Q

in asthma, is wheezing common

A

yes

68
Q

in asthma, is tachypnea common

A

yes

69
Q

two medications for asthma

A
  1. bronchodilators

2. anti-inflammatory agents

70
Q

is bronchial asthma a bad or good prognosis

A

good

71
Q

what can asthma progress to

A

COPD (in small amount of individuals)

72
Q

can severe asthma be life threatening?

A

yes

73
Q

what is Status Astmaticus

A

acute asthma attack

74
Q

Status Astmaticus is a severe…

A

bronchospasm

75
Q

is Status Astmasticus a medical emergency

A

yes

76
Q

during status astmasticus, what happens to breath sounds

A

diminished/absent

77
Q

what can status astmaticus lead to

A

hypoxemia, acidosis

78
Q

what can happen is status astmaticus is untreated

A

respiratory and cardiac arrest

79
Q

what is chronic bronchitis

A

history of a productive cough of at least 3 months in duration for 2 consecutive years

80
Q

in chronic bronchitis, what happens to the bronchial lining

A

inflammation and scarring

81
Q

in chronic bronchitis, what happens as proximal airways collapse

A

air becomes trapped in distal airways

82
Q

what is emphysema

A

enlarged airspaces and accumulated air in tissue

83
Q

primary etiology of emphysema

A

smoking

84
Q

what protein deficiency may be the cause of emphysema

A

genetic AAT

85
Q

in emphysema, the increased release of _____ leads to destroyed elastin, loss of elasticity, and recoil

A

elastase

86
Q

is there a problem with mucous production in emphysema

A

no

87
Q

instead of mucous production problems, what happens in emphysema

A

airway narrowing/collapse

88
Q

what happens to alveolar walls in emphysema

A

destroyed

89
Q

does work of breathing increase for emphysema

A

yes

90
Q

two main types of emphysema

A
  1. centriacinar

2. pantracinar

91
Q

what populations is centriacinar seen in

A
  • smokers
  • men
  • chronic bronchitis
92
Q

two sub branches of centriacinar

A
  1. centrilobular

2. panlobular

93
Q

what is the most common type of centracinar

A

centrilobular

94
Q

what part of the lung is effected in centrilobular

A

upper lung

95
Q

in centrilobular, _____ are destroyed, but _____ stays intact

A

bronchioles destroyed, alveolar sac stays intact

96
Q

what develops around the airways in centrilobular

A

inflammation and edema

97
Q

what part of the lung is most affected by panlobular

A

lower lung

98
Q

what happens to the lobe in panlobular

A

entire lobe destroyed

99
Q

what happens to the airspaces in panlobular

A

destroyed

100
Q

panlobular usually begins in the ____ and expands ___

A

begins in alveoli and expands centrally

101
Q

panlobular creates ____

A

bullae

102
Q

Pantracinar is associated with…

A

AAT deficiency

103
Q

is cough common with emphysema

A

no

104
Q

what type of chest is seen with emphysema

A

barrel

105
Q

in emphysema, ___ is seen at rest

A

dyspnea

106
Q

in emphysema auscultation, what do breath sounds sound like

A

decreased in all lungs fields

107
Q

what type of breathing is recommended for emphysema

A

pursed-lip

108
Q

prognosis for emphysema

A

eventual death from cardiac complications

109
Q

what is bronchiectasis

A

extreme bronchitis

110
Q

pathophysiology of bronchiectasis

A

irreversible airway destruction and dilation of medium sized bronchi and bronchioles (chronic inflammation of the bronchial wall)

111
Q

bronchiectasis is associated with…

A

chronic bacterial infections

112
Q

pathophysiology of bronchiolitis

A

severe lower airway inflammation

113
Q

who is generally affected by bronchiolotis

A

children under 2

Clinical Medicine III (Fall 2017) (3 decks)

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