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INTERNAL MED FINAL > RESPIRATORY SYSTEM & PROBLEMS AFFECTING MULTIPLE SYSTEMS > Flashcards

RESPIRATORY SYSTEM & PROBLEMS AFFECTING MULTIPLE SYSTEMS Flashcards

1
Q

Which structures are in the upper airway?

A

Nasal cavities, sinuses, pharynx, tonsils, larynx

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2
Q

Which structures are in the lower airway?

A

Conducting airways (trachea, bronchi, & bronchioles)

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3
Q

How many lobes of the lung are there?

A

5

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4
Q

What is the ability to move air in & out of lungs via pressure gradient?

A

Ventilation

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5
Q

What is the gas exchange that supplies O2 to blood & body tissues & removes CO2?

A

Respiration

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6
Q

What is the most common condition caused by pulmonary disease or injury? Define it.

A

Hypoxemia: deficient oxygenation of arterial blood

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7
Q

What is the broad term meaning diminished availability of oxygen to body tissues?

A

Hypoxia

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8
Q

The level of arterial oxygenation can be measured either directly by blood gas sampling to measure ___________ ___________ (PaO2) & ___________ ____________ (SaO2) or indirectly by ___________ ___________ (SpO2).

A
  • Partial pressure
  • Percentage saturation
  • Pulse oximetry
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9
Q

What is the normal value of PaO2?

A

80-100 mm Hg

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10
Q

What is the normal value of SaO2 & SpO2?

A

95-100%

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11
Q

What is the term for % of hemoglobin molecules in peripheral blood saturated w/ O2?

A

SpO2

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12
Q

What is the measurement of O2 bound to heme protein of hemoglobin?

A

SaO2

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13
Q

T/F: SpO2 levels are determined by arterial blood gas analysis.

A

F (SaO2)

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14
Q

Elastic ___________ is decreased by intermolecular collagen crosslinks.

A

Recoil

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15
Q

Chest wall ____________ decreases w/ aging bc of changes in joints of ribs & spine.

A

Compliance

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16
Q

Diminished gas exchange is primarily due to increased physiologic ____________ ____________.

A

Dead space

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17
Q

Where are cilia located to sweep away mucus & debris?

A

Primary bronchus

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18
Q

When is maximal lung function (as measured by forced expiratory volume) attained?

A

Early 20s

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19
Q

At what age is there especially an overall decrease in lung function?

A

55

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20
Q

What is the acute lung injury where an inflammatory pulmonary response to offending organism & agent is present?

A

Pneumonia

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21
Q

What are the 3 types of offending organism or agent associated w/ pneumonia?

A
  • Bacterial, viral, fungal, mycoplasmal (viral & bacterial) infection
  • Inhalation of toxic or caustic chems, smoke, dusts, gases
  • Aspiration of food, fluids, or vomit
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22
Q

What is the term for pneumonia at the level of the lobe? What about for more distally at bronchioles & alveoli?

A
  • Lobe: lobar pneumonia
  • Bronchioles & alveoli: bronchopneumonia
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23
Q

What are the 4 major routes of infection of pneumonia?

A
  • Airborne pathogens
  • Circulation
  • Sinus infection
  • Aspiration
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24
Q

About 30% of pneumonias are ____________ & are prevalent in older adult.

A

Bacterial

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25
Q

About 50% of pneumonias are _____________ & are not usually life-threatening.

A

Viral

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26
Q

About 20% of pneumonias are caused by ______________.

A

Mycoplasma

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27
Q

What type of pneumonia is when fluids or other material from oral cavity or GI tract is aspirated into lower respiratory tract?

A

Aspiration

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28
Q

In viral pneumonia, which virus is common in infants along w/ influenza?

A

RSV (respiratory syncytial)

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29
Q

What is the most prevalent bacterial pathogen in pneumonia?

A

Strep

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30
Q

Most cases of pneumonia are preceded by upper respiratory infection, it often follows ____________.

A

Influenza

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31
Q

Pneumonia has productive cough w/ ____________-colored sputum in bacterial & watery sputum in viral.

A

Rust

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32
Q

T/F: Older adults have fewer symptoms of pneumonia & may present w/ vague symptoms.

A

T

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33
Q

How many weeks of inflammation of trachea & bronchi occur in acute bronchitis?

A

1-3

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34
Q

What kind of infection typically causes acute bronchitis?

A

Viral

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35
Q

What is the common, preventable & treatable disease that has persistent respiratory symptoms & airflow limitation usually caused by exposure or noxious particles or gases?

A

Chronic obstructive pulmonary disease

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36
Q

In the US, what 2 main conditions is COPD referred to?

A
  • Chronic bronchitis
  • Emphysema
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37
Q

What are some common signs & symptoms of COPD?

A
  • Constant cough
  • Shortness of breath
  • Can’t breathe deep
  • Excess sputum
  • Wheezing
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38
Q

What is used to determine presence & extent of COPD?

A

Pulmonary function tests (PFTs)

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39
Q

What measures how much air lungs can hold & how well respiratory system can move air into & out of lungs?

A

Spirometry

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40
Q

Which medications are used for COPD?

A
  • Bronchodilators
  • Inhaled steroids
  • Anti-inflammatory agents
41
Q

What is the condition of productive cough lasting for at least 3 months a year for 2 consecutive years?

A

Chronic bronchitis

42
Q

Irritants cause mucous hypersecretion & hypertrophy of mucus-producing glands in ____________ ____________.

A

Large bronchi

43
Q

T/F: Obstruction in chronic bronchitis increases PaCO2.

A

T

44
Q

What is the enlargement of air spaces beyond terminal bronchiole that’s associated w/ loss of elasticity in distal airways, airway collapse, & gas trapping?

A

Emphysema

45
Q

Out of these, which is the most common type of emphysema? - Paraseptal - Centriacinar - Irregular - Panacinar

A

Centriacinar

46
Q

What is the major etiologic factor of emphysema?

A

Cigarette smoking

47
Q

What is the reversible obstructive lung disease characterized by inflammation & increased reactivity of smooth muscle of airways to various stimuli, causing bronchoconstriction & airflow resistance?

A

Asthma

48
Q

Asthma is a chronic condition w/ ____________ exacerbations.

A

Acute

49
Q

What are the 2 main types of asthma?

A
  • Extrinsic (allergic)
  • Intrinsic (nonallergic)
50
Q

Mechanisms of airway obstruction by immune system in asthma include IgE & which 2 types of cells?

A
  • T-helper
  • Mast
51
Q

70% of people w/ sleep apnea are ___________.

A

Obese

52
Q

What is the most common type of sleep apnea?

A

Obstructive

53
Q

Which type of sleep apnea has significant daytime symptoms?

A

Obstructive

54
Q

What refers to co-occurrence of obstructive sleep apnea & COPD?

A

Overlap syndrome

55
Q

What are the 3 types of sleep apnea?

A
  • Obstructive
  • Central
  • Mixed
56
Q

T/F: Fever, bradycardia, & hypermetabolic state seen in acute inflammation.

A

F (tachycardia)

57
Q

Which elevated levels are seen in acute inflammation?

A
  • Serum protein
  • WBCs
58
Q

What is the normal value of WBCs?

A

5k-10k / mm3

59
Q

What type of inflammation are these symptoms seen in? - Low-grade fever - Malaise - Weight loss - Anemia - Fatigue - Leukocytosis - Lymphocytosis

A

Chronic

60
Q

Chronic inflammation has increased ____________ ____________ rate which decreases when disease improves.

A

Erythrocyte sedimentation

61
Q

Which kind of immunodeficiency do patients encounter more often?

A

Acquired

62
Q

Which disease are these symptoms a sign of? - Weight loss, muscular weakness, anorexia, anemia - Bone erosion or liver, GI, pulmonary, vascular obstruction - Increased intracranial pressure in brain - Hemorrhage - Cachexia

A

Neoplasm

63
Q

What are all of these classified as? - Medication errors - Adverse drug reactions - Allergic drug reactions - Overdoses

A

Adverse drug events

64
Q

T/F: Most ADEs are medication reactions or side effects.

A

T

65
Q

Dose-related ADEs are _____________ drug injuries while non dose-related are unpredictable or _____________.

A
  • Predictable
  • Idiosyncratic
66
Q

Which type of ADEs are associated w/? - Drug toxicity from overdose - Variations in pharmacological preparation - Pre-existing liver disease - Comorbidities - Drug interactions

A

Dose-related

67
Q

Which type of ADEs are associated w/? - Hypersensitivity - Acute anaphylaxis

A

Non dose-related

68
Q

Potential ADEs are referred to as ______________ _____________ & are medication errors that do not cause harm to client or caught by staff prior.

A

Near misses

69
Q

T/F: Drug-drug interaction occurs when medications interact favorably or unfavorably.

A

F (unfavorably)

70
Q

T/F: Side effects & overdosage toxicity are both predictable just depending on the range.

A

T

71
Q

Over 11.4 million people misuse which type of drug?

A

Opioids

72
Q

T/F: Older adults are 2x as likely to go to ED because of ADEs.

A

T

73
Q

What are the 3 common signs of drug toxicity?

A
  • Rashes
  • Fever
  • Jaundice
74
Q

Which risk factor of drug toxicity has the most prevalent effect?

A

Age

75
Q

Low ___________ stores increase proportion of drug that is free & active.

A

Albumin

76
Q

Approx 30% of patients 65 yrs & older are prescribed 5 or more drugs & ___ in 5 drugs may be inappropriate, increasing to 1/3 among those in aged care facilities.

A

1

77
Q

What is the progressive, autoimmune disease that affects synovial tissue & joints?

A

RA

78
Q

What is the threatening organ dysfunction caused by deregulated host response to infection w/ systemic inflammation?

A

Sepsis

79
Q

What is when sepsis is associated w/ organ dysfunction distant from site of infection?

A

Severe sepsis

80
Q

T/F: Septic shock is accompanied by hypertension despite adequate fluid infusion.

A

F (hypotension)

81
Q

What is bacteremia?

A

Bacteria in blood

82
Q

In pathogen-associated molecular patterns of sepsis, pattern-recognition proteins that recognize infectious organisms can be found in cell membranes or ___________.

A

Cytosol

83
Q

Which type of molecules are associated w/ damage-associated molecular patterns?

A

Non-infectious

84
Q

Which levels are elevated in sepsis? How about in septic shock?

A
  • Sepsis: lactate
  • Septic shock: BUN, creatinine, WBCs
85
Q

What is the most common cause of death in the ICU?

A

Multiple organ dysfunction syndrome

86
Q

What is the normal range of pH?

A

7.35-7.45

87
Q

When is cell function impaired seriously in regards to pH?

A

< 7.2 or > 7.55

88
Q

Which acid does the lung excrete within minutes to hours?

A

Carbonic acid H2CO3

89
Q

Which base does kidneys reclaim within 3-5 days?

A

Bicarbonate HCO3-

90
Q

Which test measures amount of dissolved O2 & CO2 in arterial blood & indicates acid-base status by measurement of arterial blood pH?

A

Arterial blood gas test

91
Q

As H+ increases (acidosis), pH ____________.

A

Decreases

92
Q

As CO2 increases, pH ____________.

A

Decreases

93
Q

What are the 4 classes of acid-base imbalance?

A
  • Respiratory acidosis
  • Respiratory alkalosis
  • Metabolic acidosis
  • Metabolic alkalosis
94
Q

Respiratory acidosis is nearly always due to ___________ & subsequent retention of CO2.

A

Hypoventilation

95
Q

What is most commonly seen in? - COPD - Asthma - Depressed CNS - Impaired diaphragm

A

Respiratory acidosis

96
Q

What occurs as a result of loss of acid (hypocapnia) w/o compensation due to increased ventilation?

A

Respiratory alkalosis

97
Q

Renal failure often leads to metabolic ___________ since kidney not able to excrete ammonium & phosphoric acid.

A

Acidosis

98
Q

What occurs when abnormal loss of acid or excess accumulation of bicarbonate occurs through volume loss, vomiting, postop loss, & use of diuretics?

A

Metabolic alkalosis

99
Q

T/F: Older adults are prone to respiratory acidosis & alkalosis.

A

T

INTERNAL MED FINAL (6 decks)

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