Respiratory Tract Infections

Question 1

gas exchange in the lungs

Answer 1

O2 transported into the body tissues, CO2 transported out
-happens in the alveoli

Question 2

effective gas exchange depends on:

Answer 2

ventilation, perfusion, diffusion happening simultaneously
-problems will cause hypoxemia or hypercarbia

Question 3

pulmonary perfusion

Answer 3

-bronchial arteries bring O2 rich blood to lung tissues
-pulmonary arteries transport all of the right ventricle output to the alveoli

Question 4

pressures of fluid balance:

Answer 4

hydrostatic, colloid osmotic pressure
-excessive hydrostatic=edema
-also regulated by capillary permeability

Question 5

tidal volume

Answer 5

normal air breathed in and out at rest

Question 6

inspiratory reserve volume (IRV)

Answer 6

max air that can be inhaled

Question 7

expiratory reserve volume (ERV)

Answer 7

max air that can be exhaled

Question 8

residual volume (RV)

Answer 8

air left in the lungs after expiration

Question 9

vital capacity (VC)

Answer 9

IRV+TV+ERV

Question 10

normal FEV/FVC

Answer 10

75%, 3/4

Question 11

obstructed FEV/FVC

Answer 11

25%, 1/4
-abnormally low FEV

Question 12

restricted FEV/FVC

Answer 12

83%, 25/3
-abnormally high FEV

Question 13

ventilation

Answer 13

movement of air

Question 14

perfusion

Answer 14

movement of blood

Question 15

matching Q and V

Answer 15

Q (perfusion) and V (ventilation) should always be equal

Question 16

perfusion without ventilation

Answer 16

no air coming in (ex: atelectasis/collapsed lung)
-low ventilation-perfusion ratio
-mismatch

Question 17

ventilation without perfusion

Answer 17

no blood coming in (ex: pulmonary embolism, dead air space)
-high ventilation-perfusion ratio
-mismatch

Question 18

transport of O2 in the lungs

Answer 18

1) transfer from alveoli to capillaries in the lungs
2) Hb binding and transporting of O2
3) dissociation from Hb in the tissue capillaries as O2 is delivered
-blood transports O2 to cells, returns CO2 to the lungs

Question 19

O2-Hb dissociation curve

Answer 19

normal: steep curve of O2 being released from Hb and into the tissues and plateaus where O2 is loaded onto Hb in the lung
-body temp, PCO2 and pH shift the curve to the right
-decreased body temp, PCO2, increased pH shift the curve to the left
-early plateau with anemia

Question 20

pneumonia

Answer 20

infection of the lung that affects gas exchange
-classified by different types
-know the causing agent

Question 21

typical pneumonia

Answer 21

from bacteria in the alveoli (ex: S. pneumoniae, influenzae)

Question 22

atypical pneumonia

Answer 22

from viruses, fungi, foreign material (ex: aspiration)

Question 23

community-acquired pneumonia (CAP)

Answer 23

infection outside of a healthcare facility

Question 24

hospital-acquired pneumonia (HAP)

Answer 24

infection 48+ hours after ADMISSION

Question 25

healthcare-acquired pneumonia (HCAP)

Answer 25

infection 48+ hours after DISCHARGE

Question 26

ventilator-associated pneumonia (VAP)

Answer 26

infection 48-72 hours after intubation -open epiglottis

Question 27

compromised pneumonia

Answer 27

from suppressed immune systems, artificial airways, mechanical ventilation

Question 28

otherwise healthy pneumonia

Answer 28

older adults, young children, smokers

Question 29

pneumonia manifestations

Answer 29

obstructed bronchioles: inflammation and fluid in the alveoli cause no gas exchange and increased exudate -cough, fever, chills, tachycardia, tachypnea, dyspnea, productive cough -atypical: no exudate, less coughing

Question 30

pneumonia diagnosis

Answer 30

chest radiograph (white shadows), blood cultures, WBC count, CURB-65 -C=confusion (1 point) -U=blood urea waste (1 point) -R=respiratory rate (1 point) -B=blood pressure (1 point) -points show severity, mortality

Question 31

what is true about tuberculosis? a) it is infectious b) it is airborne c) it is from an allergy to pollen d) it is a chronic airway disorder e) it mostly affects the lungs

Answer 31

a, b, e

Question 32

tuberculosis disease process

Answer 32

inhalation or ingestion of the MTb bacteria>slow spread through lymph and blood>waxy, thick bacteria ingested by macrophages and walled off by proteins>latent phase>Ghon Tb (hallmark diagnosis)

Question 33

primary phase of tb

Answer 33

initial exposure, 3-6 week development, inactive bacteria/not contagious if contained, can become latent

Question 34

latent phase of tb

Answer 34

from primary phase, inactive bacteria, not contagious, asymptomatic

Question 35

secondary phase of tb

Answer 35

only from reinfection/reactivation: active bacteria, contagious

Question 36

progressive primary phase of Tb

Answer 36

not contained by immune system, active bacteria, contagious, miliary Tb development

Question 37

which symptoms indicate a person has active tuberculosis? a) coughing for over 3 weeks b) sharp chest pain c) shallow breathing d) night fever e) fatigue f) anorexia g) weight loss

Answer 37

a, d, e, f, g

Question 38

Tb diagnosis

Answer 38

positive protein skin test (Manto test), Quantiferon test, positive sputum cultures, nodules on radiographs

Question 39

Tb treatment

Answer 39

antimicrobials, drugs for 6-9 months -treatment takes awhile to get rid of bacteria