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cardiopulm final > respiratory pathophysiology > Flashcards

respiratory pathophysiology Flashcards

1
Q

so if a patient pH < 7.35 , HCO3 > 28 , and PaCO2 is > 45 what is the correct acid/base interpretation

normal values:
pH 7.35-7.45
HCO3= 22-26
PaCO2= 35-45

A

well pH is acidosis bc less then 7.35 and if can only be acidic if PaCO2 is high or HCO3 is low

so respiratory acidosis with partial compensation from bicarb

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2
Q

is PaCO2 an acid or base

A

acid

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3
Q

is HCO3 an acid or base

A

base

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4
Q

someone with respiratory acidosis will have bradycardia or tachycardia

A

tachy

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5
Q

if you are having hyperventaliation will your pH go up or down

A

up

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6
Q

if a patient presents with pH > 7.45 , HCO3 < 24 , and PaCO2 < 35 what acid/base interpretation is this

normal values
pH= 7.35 -7.45
HCO3= 22-26
PaCO2= 35-45

A

pH is high so it is alkalosis / basic , HCO3 is normal and PaCO2 is low

so respiratory alkalosis with no compensation

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7
Q

if someone has excessive excretion of acids due to renal disease , loss of hydrochloric acid from prolonged vomiting and decreases plasma potassium levels which can lead to arrthymias what acid/base interpretation could they have

A

metabolic alkalosis bc decrease potasium levels and loss of hydrochloric acid

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8
Q

if a patient presents with pH > 7.45 , HCO3 > 28 and PaCO2 > 45 what acid/base interpretation is this

normal values
pH= 7.35-7.45
HCO3= 22-26
PaCO2= 35-45

A

pH is high so alkalosis , HCO3 is high so could be causing the alkalosis bc HCO3 is a base and PaCO2 is high so it could be compensating

so metabolic alkalosis with partial compensation

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9
Q

what acid/base interpretation can hyper kalemia lead to

A

metabolic acidosis

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10
Q

if a patient presents with pH < 7.35 , HCO3 < 22 and PaCO2 < 35 then what acid/base interpretation is it

norms
ph= 7.35 - 7.45
HCO3= 22-26
PaCO2= 35-45

A

pH is low so acidosis, bi carb is low and PaCO2 is low …. since bi car is low it is make it acid bc there is less base , is the PaCO2 was high then it would be respiratory

metabolic acidosis

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11
Q

if pH is low it indicates what ?
if high ?

A

low - acidosis
high - alkalosis

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12
Q

if CO2 is high and pH is low what does that indicate? is it hypoventilation or hyperventilation

A

respiratory acidosis (hypoventalation)

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13
Q

if CO2 is low and pH is high what acid/base interpretation does this indicate? hyperventilation or hypoventilation>

A

respiratory alkalosis (hyperventalation)

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14
Q

if HCO3 is high and pH is high what acid/base interpretation does this indicate

A

metabolic alkalosis

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15
Q

if HCO3 is low and pH is low what acid/base interpretation does this indicate

A

metabolic acidosis

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16
Q

patient 1: pH= 7.55 , CO2= 32 , HCO3= 20 what acid/base interpretation does this indicate

A

pH is high , CO2 is high ad HCO3 is low

so respiratory alkalosis with partial compensation

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17
Q

patient 2: pH= 7.47 , CO2= 61 , HCO3= 43 what acid/base interpretation does this indicate

A

pH is high , CO2 is high ad HCO3 is high

matabolic alkalosis with partial comp

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18
Q

patient 2: pH= 7.26 , CO2= 55 , HCO3= 24 what acid/base interpretation does this indicate

A

pH is low , CO2 is high ad HCO3 is normal

respiratory acidosis with no compensation

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19
Q

patient 2: pH= 7.32, CO2= 19 , HCO3=9 what acid/base interpretation does this indicate

A

pH is low , CO2 is low ad HCO3 is low

metabolic acidosis with partial compensation

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20
Q

if FEV1/ FVC is < 70% what disease can we suspect

A

obstructive for sure

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21
Q

what is decreased and what is increased in obstructive disorders

A

vital capacity, inspiratory reserve volum and expiration reserve volume is decreased

residual volume , total lung capacity , and functional residual volume is increased

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22
Q

what is the normal percent for forced vital capacity ? if it is over the normal what does that indicate and if it is under the norm what does that indicate

A

80%-120%

< 80% means restrictive lun disease
>120% means obstructive lung disease

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23
Q

what are the 2 main types of COPD

A

chronic bronchitis and emphysema

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24
Q

if somenoe has destruction of terminal bronchioles and alveolar wall and increase lung tissue compliance what disease do they most likely have

A

emphysema

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25
Q

if someone has excessive mucous production , airway narrowing and a productive cough on most days for the 3 months for 2 consecutive years what disease do they most likely have

A

chronic bronchitis

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26
Q

how will an emphysema patient present during exercise

A

develop oxygen desaturation

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27
Q

how will an chronic bronchitis patient present during exercise

A

oxygen saturation may decrease with exercise

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28
Q

someone will emphysema have ____ of the terminal airwyas

A

dilation

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29
Q

what type of emphysema affeects the alveoli which causes a loss of surface for air exchange and is predominately in the lower lobes

A

panacinar

30
Q

what type of emphysema affects the respiratory bronchioles and is most commonly due to smoking and is primary in the upper lobes

A

centrilobular

31
Q

patients with emphysema will present with __ chest deformity form hyperinflation and increased compliance (poor elastic recoil)

A

barrel

32
Q

what is the key sign that a patient may have emphysema

A

FEV1 is < 80%

forced expiratory volume

33
Q

at the end stages of emphysema ___ leads to pulmoanry artery hypertension which affects which side of the heart ?

A

hypoxemia (decreased O2 in the blood) and right side of the heart

34
Q

there is going to be a ___ retention for patients with emphysema bc the right side of the heart is failing

A

Na (sodium)

35
Q

what will be the difference on the xray finding with someone wiht emphysema

A

more ribs > 7

36
Q

what is the reason to do purse lip breathing with pateints with COPD

A

it maintains intrabrinchial pressure and slows flow rate

37
Q

if a pateint has excessive mucus production , cough with chronic sputum , cyanosis or polycythemia what disease may they have

A

chronic bronchitis

38
Q

what does goblet and mucoid hyperplasia do

A

produces excessive mucus

39
Q

someone with chronic bronchitis will have pulmonary hypertension whcih will lead to what ??

A

R ventricular failure and cause cor pulmonale , juglar vein distension and fluid retention

“blue bloater”

40
Q

airway obstruction causes an ___ in resistance

A

increase

41
Q

when breathing rapidly , __ pressure is needed to overcome the resistance to flow and the volume of each breath gets ___

A

greater
smaller

42
Q

what is the causes of obstruction for asthma patient

A

reduced lumen of bronchi due to bronchospasm and increased bronchial wall thickness

43
Q

what is a bronchospasm

A

smooth mm contraction of airways

44
Q

if someone has an hyper inflated lungs what are 3 things that it can causes

A

air trapping
difficult breathing
reduced FEV1

45
Q

pollen, animals , feather , mold and food are all what kind of triggers of asthma

A

extrinsic

46
Q

what is bronchiectasis

A

dilation of the bronchial walls

47
Q

what are the 3 types of bronchiectasis

A

cylindrical , varicose and saccular

48
Q

what is restrictive disorders of the lung characterized by

A

reduction in vital capacity

49
Q

what are the 5 things that are decreased with restrictive disorders

A

vital capacity
residual volume
functional residual capacity
tidal volume
total lung capacity

50
Q

restrictive disorders can be pulmonary and is related to the lung themselves by what disease

A

pulmonary fibrosis

51
Q

restrictive disorders can be extrapulmonary and is related to what

A

SCI

52
Q

in RLD the compliance of the lung is ___, which increases the ___ of the lung and limits ____

A

reduced
stiffness
expansion

53
Q

in RLD there is a ___ pressure required than normal to give the same increase in volume

A

greater

54
Q

what are some acute pulmonary restrictive disorders

A

atelectasis
pneumothorax
pneumonias
acute respiratory distress syndrome

55
Q

someone with kyphosis or scoliosis may have a hard time ___ the ribs

A

expanding

56
Q

pleural effusion , abdominal ascites and intrathoracic surgical implants are examples of what lung disorder

A

restrictive

57
Q

what is a partial collapse of lung parenchyma (alveoli)

A

atelectasis

58
Q

what type of ateletasis is alveolar collapse , perhaps related to surface tension changes

A

microactelectasis

59
Q

what are some signs that may be included with a patient with microactelectasis

A

reduced chest wall excursion
crackles
bronchical sounds (consolidation)
tracheal and mediastinal shift on xray

60
Q

what are 2 disorders that can come after microactelectasis

A

respiratory distress syndrome
L ventricular failure

61
Q

when does obstructive atelectasis happen

A

when bronchus is totally occluded

62
Q

obstructive atelectasis is when air __ to the obstruction is re absorbed by the ___

A

distal
alveoli

63
Q

obstructive actelectasis is usually associated with ___ shift towards the side of the lung collapse

A

tracheal

64
Q

what is bronchial pneumonia usually caused by

A

staphlococcal or strep

65
Q

what is lobar pneumonia usualt causes by

A

pneumococcus

66
Q

what is the main difference with bronchial and lobar pneumonia

A

bronchial is little consoldiation and lobar is consolidation

67
Q

what is the same with bronchial and lobar pneumonia

A

fever and SOB and coughing

68
Q

which pneumonia produces large amaounts of sputum when they cough

A

bronchial

69
Q

what will you see on xray for bronchial pneumonia

A

patchy infiltrates on xray

70
Q
A

cardiopulm final (8 decks)

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