Final: Ch 23 CF, Restrictive Lung Disease, Pulmonary Embolism, PA HTN, ARDS, RF Flashcards Preview

Pathophysiology > Final: Ch 23 CF, Restrictive Lung Disease, Pulmonary Embolism, PA HTN, ARDS, RF > Flashcards

Flashcards in Final: Ch 23 CF, Restrictive Lung Disease, Pulmonary Embolism, PA HTN, ARDS, RF Deck (40):
1

genetics of cystic fibrosis

autosomal recessive mutation

mutated CF transmembrane regulator channel (Cl-)

2

impacts of CF on sweat glands and airways

sweat glands: CFTR doesn't reabsorb secreted Cl-, so very salty sweat

airways: CFTR doesn't allow Cl- to enter airways, causing lower water content of sputum

3

respiratory and pancreatic symptoms of CF

respiratory: viscous sputum, chronic bronchitis, respiratory infections

pancreatic: may include exocrine pancreatic insufficiency

4

diagnosis of CF

sweat test: conductivity and chem analysis

genetic test for CFTR mutation

5

treatment of CF

postural drainage to clear secretions

antibiotics for infection

deoxytibonuclease breaks down DNA in sputum

oral replacement of pancreatic enzymes

6

interstitial (restrictive) lung disease causes

inflammation and fibrotic changes to lung tissue

environmental, drugs, immune

alveolar macrophages secrete TGF and fibroblast GF

fibrosis results

7

symptoms of interstitial (restrictive) lung disease

lower lung volumes and diffusion capacity

dyspnea, tachypnea, cyanosis

low FVC and TLC

normal or even high FEV1/FVC

8

diagnosis and treatment of interstitial (restrictive) lung disease

Dx: CXR, biopsy

Rx: steroids for inflammation

9

idiopathic pulmonary fibrosis

unknown cause, smoking risk factor

CXR: patchy infiltrates

survival 3-5 yrs

10

sarcoidosis

systemic disorder

granulomas form in lung, nodes, or other organs

genetic or environmental

11

symptoms of sarcoidosis

SOB

non-productive cough

chest pain

weight loss

fatigue

12

Dx/Rx of sarcoidosis

Dx: H&P, CXR

Rx: remove cause, steroids

13

pulmonary embolism

any blood-borne substance that lodges in the PA

ex. fat, amniotic fluid, air

14

most common cause of pulmonary embolism

emboli from DVT of legs

15

risk factors for DVT

venous stasis - immobilization

trauma

smoking

BCP

16

symptoms of pulmonary embolism

chest pain

dyspnea

bloody sputum

tachycardia, tachypnea

can cause cardiovascular collapse

17

Dx of pulmonary embolism

lung scans, CT, angiography

high D-diamer (fibrin degeneration product) indicates clotting

18

Rx of pulmonary embolism

prevent DVT (anticoagulant therapy)

vena cava plication: insertion of filter in vena cava to catch clots

intermittent pneumatic compression boot

19

normal pulmonary artery pressure is, and what causes elevations

28/8 (15 mean)

high resistance, blood flow, LAP

20

2 types of PA HTN

primary

secondary

21

primary PA HTN

rare, but progressive and deadly

triggers: HIV, autoimmune, hypoxia

familial is autosomal dominant mutation of TGF-beta receptor (SMC proliferation)

22

secondary PA HTN

secondary to another disease

high pulmonary venous pressure (mitral stenosis, Lt HF)

high pulmonary blood flow (ASD, VSD, PDA)

high resistance (PE, hypoxic pulmonary vasoconstriction)

23

symptoms of 2ndary PA HTN

dyspnea

peripheral edema

fatigue

Rt HF

24

Dx/Rx of 2ndary PA HTN

Dx: CXR, echo, Rt heart cath

Rx: vasodilators

25

Dx/Rx of primary PA HTN

Dx: pulmonary HTN without another cause

Rx: O2, Ca channel blockers, prostacyclin

26

Cor Pulmonale

Rt HF from lung disease

PA HTN --> RV hypertrophy --> failure

Rx: treat lung disease, give O2

27

ARDS

highly fatal

common pathway from a range of lung problems

28

pathologic changes of ARDS

alveolar-capillary memb. disrupted

proteins, fluid, and WBC enter interstitium & alveoli to cause hypoxia

surfactant inactivated (hypoxia, alveolar collapse)

29

Rx: of ARDS

supportive

give O2

use PEEP

30

respiratory failure

failure of lungs to deliver O2, or to remove CO2 from blood

31

causes of respiratory failure

impaired:

ventilation

diffusion

V/Q matcing

32

hypoxemic respiratory failure

V/Q mismatch seen in COPD

severe hypoxia when low V/Q areas exist

impaired diffusion: thickening of respiratory memb.

O2 therapy

33

hypercapnia/hypoxemic respiratory failure

hypoventilation decreases minute alveolar ventilation

central (drug OD, head injury), peripheral (Gullian-Barre), mucsular distrophy

produces hypercapnea but not hypoxia until severe

34

symptoms of respiratory failure

hypoxia: cyanosis, seizures

polycythemia: when chronic hypoxia

hypercapnea: air hunger and headache

35

Dx of respiratory failure

ABG

pulse oximeter

PA catheter for MV O2

36

treatment of respiratory failure

O2 therapy

positive pressure mechanical ventilation

intubation of trachea

mask methods?

37

CXR of pleural effusion vs pneumothorax

PE: white out on affected side

Pneumothorax: blackout on affected side

38

Why does incentive spirometer work for atelectasis

Produces negative intrapleural pressure to pull open collapsed alveoli

39

PA HTN produces rt or lt HF?

Rt HF

40

Distinguish obstructive from restrictive lung disease

Obstructive has a low FEV1/FVC

restrictive has a normal to high FEV1/FVC