Resp - Path (Pulmonary hypertension, Sleep apnea, & Lung physical findings) Flashcards
See Pg. 608 in First Aid 2014 Sections include: -Pulmonary hypertension -Sleep apnea -Lung-physical findings
What is normal pulmonary artery pressure?
Normal pulmonary artery pressure = 10-15 mmHg
What defines pulmonary hypertension?
Pulmonary hypertension >= 25 mmHg at rest
What are 3 effects of pulmonary hypertension?
Results in arteriosclerosis, medial hypertrophy, and intimal fibrosis of pulmonary arteries
What causes primary pulmonary hypertension?
Primary - due to an inactivating mutation in the BMPR2 gene (normally functions to inhibit vascular smooth muscle proliferation)
Which type of pulmonary hypertension is associated with a poor prognosis?
Primary
Give 6 causes of secondary hypertension, briefly noting the pathogphysiology of each.
Secondary - (1) due to COPD (destruction of lung parenchyma) (2) mitral stenosis (increased resistance –> increased pressure) (3) recurrent thromboemboli (decreased cross-sectional area of pulmonary vascular bed) (4) autoimmune disease (e.g., systemic sclerosis, inflammation –> intimal fibrosis –> medial hypertrophy) (5) left-to-right shunt (increased shear stress –> endothelial injury) (6) sleep apnea or living at hight altitude (hypoxic vasoconstriction)
What is the course of complications stemming from pulmonary hypertension?
Course: severe respiratory distress –> cyanosis and RVH –> death from decompensated cor pulmonale
What is the definition of sleep apnea? What major effect does it have?
Repeated cessation of breathing > 10 seconds during sleep –> disrupted sleep –> daytime somnolence
What are the PaO2 changes in sleep apnea patients?
Normal PaO2 during the day; Nocturnal hypoxia
What are 3 effects of nocturnal hypoxia?
Nocturnal hypoxia–> systemic/pulmonary hypertension, arrhythmias (atrial fibrillation/flutter) , and sudden death
What is central versus obstructive sleep apnea?
Central sleep apnea - no respiratory effort; Obstructive sleep apnea - respiratory effort against airway obstruction
What are 2 conditions associated with obstructive sleep apnea?
Associated with obesity, loud snoring
What are 3 treatment options for sleep apnea?
Treatment: (1) weight loss (2) CPAP (3) surgery
How does sleep apnea relate to erythropoiesis?
Hypoxia –> increased EPO release –> increased erythropoiesis
What defines obesity hypoventilation syndrome, and what causes it?
obesity (BMI > 30 kg/m^2) –> hypoventilation –> low PaO2 and high PaCO2 during waking hours
Which of the following physical lung finds are associated with Pleural effusion, and how: (1) breath sounds (2) percussion (3) fremitus (4) tracheal deviation?
(1) decreased (2) dull (3) decreased (4) no change
Which of the following physical lung finds are associated with Atelectasis (bronchial obstruction), and how: (1) breath sounds (2) percussion (3) fremitus (4) tracheal deviation?
(1) decreased (2) dull (3) decreased (4) toward side of lesion
Which of the following physical lung finds are associated with Spontaneous pneumothorax, and how: (1) breath sounds (2) percussion (3) fremitus (4) tracheal deviation?
(1) decreased (2) hyperresonant (3) decreased (4) no change
Which of the following physical lung finds are associated with Tension pnemothorax, and how: (1) breath sounds (2) percussion (3) fremitus (4) tracheal deviation?
(1) decreased (2) hyperresonant (3) decreased (4) away from side of lesion
Which of the following physical lung finds are associated with Consolidation (lobar pneumonia, pulmonary edema), and how: (1) breath sounds (2) percussion (3) fremitus (4) tracheal deviation?
(1) Bronchial breath sounds; late inspiratory crackles (2) Dull (3) Increased (4) no change
What is a structural lung condition to associate with Atelectasis?
Atelectasis (bronchial obstruction)
What are 2 examples of conditions causing consolidation?
Consolidation (lobar pneumonia, pulmonary edema)
