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Primary > Respiratory Issues and Disorders > Flashcards

Respiratory Issues and Disorders Flashcards

1
Q

Respiratory Assessment:

1) Type location of breathing soudns
2) Egophony: E to A = _________
3) Pulmonary funciton test (PFTs) if greater than ____ years of age and cooperative

A

2) consolidation

3) eight

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2
Q

______ disease:

1) Characterized by reduced airflow rates; lung volume within the normal range or larger
2) Typical of a child having trouble exhaling (air trapping) which results in decreased rates and FEV1 (e.g. asthma, chronic bronchiolitis, cystic fibrosis).

A

Obstructive Disease

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3
Q

______ disease:

1) Characterized by reduced volumes and expiratory flow rates
2) Typical of a child that has trouble inhaling air, this affecting the volume (e.g. pneumonia)

A

Restrictive Disease

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4
Q

A disease of the lower respiratory tract that causes inflammation leading to obstruction of the small respiratory airways

A

Bronchiolitis

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5
Q

Typically noted among children less than ____ years of age, this is a viral illness with a respiratory syncytial virus (RSV) being responsible for more than 50% of cases.

A

three

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6
Q

Signs and symptoms Bronchiolitis include:

1) Upper respiratory infection (URI) symptoms lasting for several days
2) Moderate fever to _____ (38.9 degrees Celcius)
3) Gradual development for respiratory distress (nasal flaring, grunting, cyanosis, prolonged expiration)
4) Palpable liver and spleen (Pushed down due to hyperinflated lungs)

A

102 degrees Fahrenheit

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7
Q 
With Bronchiolitis:
The gradual development of respiratory distress (nasal flaring, grunting, cyanosis, prolonged expiration)
a) \_\_\_\_\_\_\_ ( 60 to 80 breaths/ minute)
b) Non- productive cough
c) Paroxysmal wheezing
d) Progressive stridor
e) Restlessness; changes in mental status
f) Cyanosis
A

a) Tachypnea

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8
Q

Laboratory/ Diagnostics: Bronchiolitis

1) Chest x-ray with hyperinflated lungs; may have scattered areas of consolidation
2) ____ ________ of nasal washing may be positive for RSA

A

2) Immunofluorescence analysis (IFA)

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9
Q

Management: Bronchiolitis
1) Infants with mild distress can be treated as outpatients with supportive care
2) Prevention of RSV in high risk infants with Synagis intramuscular every month during RSV season; the criteria for those who should receive palivizumab (Synagis) include
a) Less than two years of age with chronic lung disease
treated within 6 months of RSV season
b) Premature infant (< than ___ weeks gestation) during
the first year of life
c) Infants between ___ to ____-week gestation maybe
treated if the following risk factors are present:
1) daycare attendance
2) School-age siblings
3) Exposure to environmental pollution
4) Abnormal airways
5) Severe neuromuscular problems

A

b) 32 weeks

c) 32 to 35 weeks

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10
Q

A disease characterized by increase responsiveness of the trachea and bronchi to various stimuli and manifested by widespread narrowing of the airways that changes in severity either spontaneously or as a result of treatment

A

Asthma

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11
Q

Pathophysiology: Asthma

1) ______ of smooth muscle
2) Mucosal edema and hyperemia
3) Hypertrophy of mucus glands
4) ____ ______ and plugging of the airway by thick, viscous mucus
5) Thickening of epithelial basement membrane- remodeling

A

1) Hypertrophy

4) Acute inflammation

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12
Q

Causes: Asthma

1) Dust mites
2) Pet (cat, dog)
3) _________ (bug)
4) Indoor molds
5) Exercises
6) Airway irritants
a) Cigarettes
b) Air pollution (including ozone)
c) ____smoke
d) Perfumes
e) Aerosol sprays
f) Paints or sealants
g) Cleaning agents
7) Cold air
8) medications (e.g. aspirin)
9) Food (e.g. yellow dye)
10) ________
11) Respiratory infections

A

3) Cockroaches
6) c) Wood smoke
10 Stress

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13
Q

Signs and symptoms: Asthma

1) Respiratory distress at rest
b) Difficulty speaking in sentences
c) ________
d) Use of accessory muscles
e) Hyperresonance
f) cough
g) chest tightness

A

c) diaphoresis

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14
Q

Signs of asthma

a) Absent breath sounds
b) ____ _____ (> 10 mm Hg change in systolic BP amplitude between inspirations an expiration)
c) Inability to maintain recumbency
d) Cyanosis

A

b) Pulsus paradox

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15
Q

Laboratory/ diagnosis: Asthma

1) Slight white blood cell elevation with eosinophilia
2) Pulmonary function test (PFTs) reveal abnormalities typical of obstructive dysfunction
3) Hospitalization is recommended if:
a) The peak flow is less than _____ liters/ minute initially
b) No improvement in ventilation after aerosol treatment
4) A chest x-ray is unnecessary unless use to rule out other conditions

A

3) a) 60 liters

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16
Q

This form of asthma is?

a) Symptoms: Daily
b) Nighttime awakening: More than once per week but not nightly
c) Rescue inhaler use: Daily
d) Interference with normal activity: Some limitations
e) Lung function: FEV1 60 to 80% predicted

A

Moderate Persistent

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17
Q

This form of asthma is?

a) Symptoms: < 2 days/ weeks
b) Nighttime awakening: < 2 months
c) Rescue inhaler use: < 2 days/ week
d) Interference with normal activity: none
e) Lung function: FEV1 > 80% predicted and normal between exacerbations

A

Intermittent

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18
Q

This form of asthma is?

a) Symptoms: > 2 days/ week
b) Nighttime awakening: 3 to 4 per month
c) Rescue inhaler use: > 2 days per week but not daily
d) Interference with normal activity: Minor limitation
e) Lung function: FEV1 > 80% predicted

A

Mild Persistent

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19
Q

This form of asthma is?

a) Symptoms: Throughout the day
b) Nighttime awakening: Nightly
c) Rescue inhaler use: Several times per day
d) Interference with normal activity: Extremely limited
e) Lung function: FEV1 less than 60% predicted

A

Severe Persistent

20
Q

2007 NHLBI/ NAEPP Asmtha guidelines at a glance:
a) Focus on achieving and maintaining control
b) Variability of asthma: Severity considerations
c) Asthma control
1) Inhales __________ are part of preferred
treatment for persistent asthma across all age groups
2) When stepping up treatment combination therapy is
recommended and ____ ______ _____ _____ are
preferred agent to combine with ICS in patients >12
years of age
3) Managment guidleines by three district age groups:
Zero 4, 5, to 11, 12 years and older
4) More frequent monitoring
1) Initially, every two to four weeks until control
achieved
2) If uncontrolled, escalate treatment steps and follow
up at least every two weeks
3) If continued control for three months, step down
therapy

A

c) 1) corticosteroids (ICS)

c) 2) long-acting B2 adrenergic agonist (LABAs)

21
Q

Components of severity: ________
a) symptoms: < 2 DAYS/ WEEK

b) Nighttime awakening: 0 TO 4 YEARS; 5 TO 11 YEARS
c) SABA use for symptom control: < 2 DAYS/ WEEK
d) Interference with normal activities: NONE
e) Lung function: 0 TO 4 YEARS/ NA; 5 TO 11 YEARS NORMAL FEV1 BETWEEN EXACERBATIONS
f) FEV1 (predicted or peak flow personal best): > 80%
g) FEV1/ FVC: >85%
h) Risk: Exacerbations requiring oral systemic corticosteroids (consider severity and interval since last exacerbation): 0 TO 1 PER YEAR
i) Recommended step for initiating therapy: STEP 1 PREFERRED SABA + PRN FOR BOTH AGE GROUPS

A

Intermittent

22
Q

Components of severity: ________

a) symptoms: DAILY
b) Nighttime awakening: 0 TO 4 YEARS; 3 TO 4 PER MONTH; 5 TO 11 YEARS; > 1 PER WEEK BUT NOT NIGHTLY
c) SABA use for symptom control: DAILY
d) Interference with normal activities: SOME LIMITATIONS
e) Lung function: 0 TO 4 YEARS/ NA
f) FEV1 (predicted or peak flow personal best): 60 TO 80%
g) FEV1/ FVC: 75 TO 80%

h) Risk: Exacerbations requiring oral systemic corticosteroids (consider severity and interval since last exacerbation):
0 TO 4 YEARS: > 2 EXACERBATIONS IN 6 MONTHS REQUIRING ORAL SYSTEMIC CORTICOSTEROIDS, OR > 4 WHEEZING EPISODES PER 1 YEAR LASTING > 1 DAY AND RISK FACTORS FOR PERSISTENT ASTHMA

5 TO 11 YEAS: RELATIVE ANNUAL RISK MAY BE RELATED TO FEV1

i) Recommended step for initiating therapy:
0 TO 4 YEARS: STEP 3 AND CONSIDER SHORT COURSE OF RAL SYSTEMIC CORTICOSERTOIDS/// REFER BEYOND MILD PERSISTENT

5 TO 11 YEARS: STEP 3: MEDIUM DOSE ICS OPTIONAL AND CONSIDER SHORT COURSE OF ORAL SYSTEM CORTICOSTEROIDS

A

Moderate

23
Q

Components of severity: ________
a) symptoms: THROUGHOUT THE DAY

b) Nighttime awakening: 0 TO 4 YEARS; > 1 PER WEEK; 5 TO 11 YEARS; > 1 WEEK
c) SABA use for symptom control: SEVERAL TIMES PER DAY
d) Interference with normal activities: EXTREMELY LIMITED
e) Lung function: 0 TO 4 YEARS N/A
f) FEV1 (predicted or peak flow personal best): < 60%
g) FEV1/ FVC: < 75%

h) Risk: Exacerbations requiring oral systemic corticosteroids (consider severity and interval since last exacerbation):
0 TO 4 YEARS: > 2 EXACERBATIONS IN 6 MONTHS REQUIRING ORAL SYSTEMIC CORTICOSTEROIDS, OR > 4 WHEEZING EPISODES/ 1 YEAR LASTING > 1 DAY AND RISK FACTOR FOR PERSISTENT ASTHMA

5 TO 11 YEARS: RELATIVE ANNUAL RISK MAY BE RELATED TO FEV1

i) Recommended step for initiating therapy:
0 TO 4 YEARS: STEP 3 AND CONSIDER SHORT COURSE OF ORAL SYSTEMIC CORTIOCTEROIDS: REFER BEYOND MILD PERSISTENT

5 TO 11 YEARS: STEP 3: MEDIUM DOSE STEP 5 ICS OPTION AND CONSIDER SHORT COURSE OF ROAL SYSTEMIC CORTICOSTEROIDS

A

Severe

24
Q

Inflammation of the lower respiratory tract as microorganisms gain access by aspiration, inhalation or hematogenous dissemination

A

Pneumonia

25
Q

Etiologies by Cohort: Pneumonia

1) Newborns: Group ___ streptococcus, chlamydia, E. Coli

A

B

26
Q

Etiologies by Cohort: Pneumonia
2) Infant and young children < six years: ____ ____ ___, H. Influenza, Step Pneumoniae ( Community-acquired pneumonia (CAP)}

A

Respiratory syncytial virus (RSV)

27
Q

Etiologies by Cohort: Pneumonia

Preschool through young adulthood: ___ ___, Mycoplasma, Chlamydia

A

Strep Pneumoniae

28
Q

Etiologies by Cohort: Pneumonia

Immunocompromised or malnourished: ____ ____ ___ (PCP) or fungi

A

Pneumocystis carinii pneumonia (PCP)

29
Q

Etiologies by Cohort: Pneumonia

Seventy to _____ % of all pneumonia are viral

A

80%

30
Q

Signs and symptoms fo pneumonia include:

a) fever
b) ___ _____
c) purulent sputum
d) lung consolidation on physical exam
e) malaise
f) Pulse oximetry will note decrease oxygenation in severe distress
g) pleurisy

A

b) Shaking chills

31
Q

Laboratory/ diagnostics for Pneumonia:

a) ___ ___ warranted if cough is productive (age dependent)
b) inflates by chest x-ray (CXR)

A

a) Sputum culture

32
Q

Radiographic Characteristics of Some Bacterial Pneumonia:

1) ______ ____: Lobar consolidation

A

1) H. Influenza

33
Q

Radiographic Characteristics of Some Bacterial Pneumonia:

2) S. Pneumoniae: Lobar _________

A

2) consolidation

34
Q

Radiographic Characteristics of Some Bacterial Pneumonia:

3) ______: Lobar consolidation

A

3) Klebsiella

35
Q

Radiographic Characteristics of Some Bacterial Pneumonia:

4) _________ ________ (__): Diffuse interstitial, alveolar, apical or upper lobe infiltrates

A

4) Pneumocystis jiroveci (PJP):

36
Q

Radiographic Characteristics of Some Bacterial Pneumonia:

5) ___ ______ Patchy infiltrates, pleural effusion

A

5) E. coli:

37
Q

Radiographic Characteristics of Some Bacterial Pneumonia:

6)_________: Patchy infiltrates

A

6) Staphylococcus

38
Q

Radiographic Characteristics of Some Bacterial Pneumonia:

7) __________: Patchy infiltrates, cavitation

A

7) Pseudomonas

39
Q

Management of Community-Acquired Pneumonia (based on etiology)
Pharmacological therapy is based on the infecting organism
a) ________: S. pneumonia

A

a) Penicillin

40
Q

Management of Community-Acquired Pneumonia (based on etiology)
Pharmacological therapy is based on the infecting organism
b. ____ ___ ____ ______ (Zithromax) for M. catarrhalis

A

b) Macrolides such as azithromycin

41
Q

Management of Community-Acquired Pneumonia (based on etiology)
Pharmacological therapy is based on the infecting organism
c. ____ ____ _____: H. Influenzae

A

c. Amoxicillin or cephalosporin

42
Q

Management of Community-Acquired Pneumonia (based on etiology)
Viral Pneumonia
a) Supportive measures: ______ and antipyretics
b) Antibiotics only if secondary bacterial infections are present
c) Humidified Oxygen and chest physiotherapy (PT)
d) Bronchodilators to improve airway clearance

A

a) Hydration

43
Q
  1. An autosomal recessive disorder with a chromosome 7 long ar mutation which produces a defect in epithelial chloride transport resulting in dehydrated, thick secretions
  2. A chronic multipsystem diroder affecting the respiratory, gastoenterology, hepatobiliary, and reproductive tracts
  3. Characterized by recurrent endobronchial infections, progressive obstructive pulmonary disease, and pancreatic insufficiency with intestinal malabsorption
  4. Most common in the Caucasian population
  5. Life expectancy 30 years + (improving)
A

Cystic Fibrosis

44
Q

Signs and symptoms of Cystic Fibrosis:

1) Viscid meconium ( or meconium ileus) in newborn
2) Recurrent respiratory infections
3) Lare, liquid, bulky, foul stool ( steatorrhea)
4) Slat- tasting skin
5) Chronic cough, rhinorrhea
6) __________________
7) Fat-soluble vitamin deficiencies
8) Failure to thrive
9) Delay puberty
10) Infertility

A

6) Hepatosplenomegaly

45
Q

Laboratory/ Diagnostics for Cystic Fibrosis include:

a) ______ _____ sweat test
b) Pulmonary function test (PFTs): Obstructive pattern
c) Hyponatremia, hypochromic dehydration (alkalosis)
d) Chest radiograph: Cystic lesions, atelectasis

A

a) Pilocarpine iontophoresis

46
Q

Management of Cystic Fibrosis include:

1. Referral for _________ management

A
  1. specialty

Primary (44 decks)

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