Respiratory diseases

Question 1

Signs of chronic bronchitis

Answer 1

JVD (blood beginning to back up in the vena cava due to increased workload of the heart/narrowed capillaries/pulmonary hyptertension)
Pedal edma
Acities
Blue bloater

Question 2

What makes bronchitis chronic?

Answer 2

Symptomatic for several months over 2 years

Question 3

How does bronchitis occurs?

Answer 3

Increased mucus production
Mucus blockes bronchioles which decreases ability to ventilate
Aveoli retain CO2, decreased oxygenation and decreased aveoli ventilation
This is due to the decreased concentration gradient

Question 4

[CO2]->H+ and bronchitis

Answer 4

This is why bronchitis patients breathing fast, to blow off CO2 and increase blood acidity

Question 5

How does chronic bronchitis lead to pulmonary hypertension?

Answer 5

Chronic bronchitis causes capillaries to narrow due to scar tissue (from surface tension at aveoli). Therefore, the resistance increases

Question 6

The scaring to the type 1 and type 2 cells for emphysema causes___

Answer 6

The aveoli to become less stretchy
Decreased elastcity
Decreased recoil

Question 7

Due to decreased elasticity-more

Answer 7

residual volume, because less elasticity and recoil

Question 8

Polycyhemia

Answer 8

Increase in red blood cell production to become more oxygenated (see with emphysema patients)

Question 9

Why do you have to be careful giving O2 to COPD patients?

Answer 9

Some (around 10% of) COPD patients have a desensitized hypercarbic drive so use hypoxic drive
Therefore, the O2 can knock out drive (look at the chemoreceptors on aortic/carotid arch)

Question 10

S/S of respiratory infection

Answer 10

Febrile, cough (sputum-yellow/green), rhonchi, flushed/dry, wheezing? gradual onset

Question 11

Infectous process causes ___ to secrete mucus

Answer 11

Goblet cells

Question 12

What contributes to the color of mucus?

Answer 12

WBCs

Question 13

Hemoptysis

Answer 13

Blood tinged sputum

Question 14

Tb patient population

Answer 14

Immocompromized
Communial living
Poor healthcare

Question 15

ARDS

Answer 15

Acute respiratory distress syndrome

Question 16

Meconium

Answer 16

Bowel movement from fetus into amnoitic fluid that causes aspiration of the fetus

Question 17

Examples of ARDS

Answer 17

Aspiration
Infectous process (sepsis)
Menconium

Question 18

Accumulation of plasma in the aveolar space

Answer 18

Pulmonary edema

Question 19

Number 1 causes of pulmonary edema

Answer 19

Cardogenic-left ventricular event

Question 20

Non cardiogenic pulmonary edema causes

Answer 20

Chronic renal failure (#1 cause in Boston)-dialysis patients
Profound hypothermia
HAPE
ARDS
Inhalation injury
Salt water drowning

Question 21

S/S Pulmonary edema

Answer 21

Rales
Pink frothy sputum
Cardiac wheezes

Question 22

Obsturction of a pulmonary vessle by a clot, usually originate in the lower extremities or the right side of the heart

Answer 22

Pulmonary embolous

Question 23

Do you hear adventitous breath sounds with a pulmonary embolous?

Answer 23

No, because not clogging up the airway. More of a vascular event that an respiratory pathology

Question 24

S/S pulmonary embolous

Answer 24

Pleuritic chest pain-sudden onset
Increased RR but NOT increased WOB
Mild hemoptysis
Syncope or near syncope

Question 25

Predispositions to pulmonary embolous

Answer 25

Recent surgeries
Long bone fractures
Deep vein thrombosis
Sedentary-venostatis
Atrial fibrillation
Neoplasm
Birth control pills
pregnant
Smoking

Question 26

Mechanisms for pulmonary hypertension

Answer 26

1) Increased pulmonary resistance (thickening of vessel walls, scar tissue (COPD), pulmonary embolous)
2) Increased Blood flow into pulmonary circuits (septal wall defect)
3) Increased pulmonary venous pressure (left sided heart issue, myopathy, aortic stenosis, mitral valve defect)
Toxins can affects 1, 2 and 3

Question 27

Myopathy

Answer 27

Heart muscle is not strong enough to push blood around

Question 28

Aortic stenosis

Answer 28

Narrowing of the aorta

Question 29

S/S Pulmonary hypertension

Answer 29

Fatigue
Near syncope
When right sided failure-pedal edema, JVD, ascites

Question 30

Things patient with pulmonary hypertension may be on:

Answer 30

Vasodilators (viagra-so may see women on these)
Diuertics ( to get fluid out of the system)
Anticoagulants
On a pump (Flulan influsion)

Question 31

Predispositions to a spontaneous pneumothorax

Answer 31

COPD
Fibritic lung disease
Tall, lanky white males (bleb,weakend area of the lung that may rupture)

Question 32

Cystic fibrosis

Answer 32

Sodium potassium pump issue, causes mucus to thicken up
Happens in lungs and intestines
Overproduction of mucus

Question 33

Difference between inspiratory and expiratory stridor

Answer 33

Inspiratory: Supraglottic (above vocal cords)
Expiratory: Subglottic (below vocal cords)

Question 34

Croup

Answer 34

Viral illness that has migrated up from lungs into trachea
Subglottic
Barking cough
Low grade fever

Question 35

Epiglottitis

Answer 35

In the hypopharynx
Supraglottic
Bacterial, febrile
5-12 years

Question 36

Dysphaga

Answer 36

Difficulty swallowing

Question 37

Spectrum of respiratory compromise

Answer 37

Respiratory distress-SOB but breathing on their own, gas exhange is sufficient to meet needs
Tx-supplemental O2
Respiratory failure-Gas exchange is failing to meet metabolic needs, hypoxic, agitative, combative, eventually results in hypercarbia and patient will be lethargic
Tx-supplemental O2 until legatheric, then can ventillate
Respiratory distress-agonal, apnea
Tx-BVM