Pulmonology

Question 1

define hypoxemia

Answer 1

reduced levels of ARTIERAL oxygen ( reduced PaO2)

Question 2

define hypoxia

Answer 2

reduced oxygenation of cells in TISSUE

Question 3

define hypercapnia

Answer 3

CO2 retention

Question 4

define dyspnea

Answer 4

subjective sensation of uncomfortable breathing

Question 5

define dyspnea on excretion

Answer 5

shortness of breath with activity

Question 6

define orthopnea

Answer 6

shortness of break with laying down

Question 7

what would kussmaul respirations look like

Answer 7

deep rapid breathing patterns seen in patients with metabolic acidosis

Question 8

what would Cheyne stoke respirations look like

Answer 8

alternating periods of deep and shallow breathing and apnea

Question 9

hypoxia vs hypoxemia

Answer 9

hypoxia is reduced O2 in TISSUES
hypoxemia is reduced O2 in ARTERIES

Question 10

ARDS clinical manifesations

Answer 10

Dyspnea and hypoxemia with poor response to oxygen supplementation

Hyperventilation and respiratory alkalosis

Decreased tissue perfusion, metabolic acidosis, organ dysfunction

Increased work of breathing and hypoventilation
Hypercapnia, respiratory acidosis, worsening hypoxemia

Decreased cardiac output, hypotension, death

Question 11

pathophysiology of pneumonia

Answer 11

infx of lower respiratory tract due to bacteria virus and fungi

Question 12

the risk factors of this pathogen is age, , underlying lung disease, alcohol use, aspiration, chest trauma, endotracheal intubation, immobilization

Answer 12

pneumonia

Question 13

pneumonia can be ___, ____, and _____ acquired

Answer 13

commonly, hospital, ventilator

Question 14

clinical manifestations of pneumonia

Answer 14

Viral upper respiratory tract infection leading to viral or bacterial pneumonia
Cough, pleuritic chest pain, fever, chills, malaise, can progress to sepsis if severe.

Question 15

pathophysiology of asthma

Answer 15

Chronic inflammatory disorder of the bronchial mucosa. can cause hyperresponsiveness and airway constriction. Reverible, episodic attakcs of bronchospasm, bronical inflammation, mucosal edema, increased mucous production
Exposure to antigen leads to activation of innate and adaptive immunity

Question 16

this asthmatic response is dendric cells present antigen to helper t cells which release inflammatory cytokines/chemokines that trigger bronchospasm leading to airway obstructions ( within 30 minutes of exposure and resolves after 1-3 hours)

Answer 16

early asthmatic response

Question 17

this asthmatic response is release chemokines during early response cause recruitment of other WBC leading to inflammation and injury to pulmonary tissue if left untreated. ( within 4-8 hours after early response and results in bronchial hyperresponsiveness)

Answer 17

late asthmatic response

Question 18

clinical manifestations include

Answer 18

asymptomatic between attakcs
Chest tightness, dyspnea, expiratory wheezing, coughing, tachypnea, tachycardia
Respiratory distress, respiratory acidosis, acute respiratory failure

Question 19

ominous signs are described as

Answer 19

: absent breath sounds of chest auscultation.

Question 20

`asthma is treated with

Answer 20

: bronchodilators ( beta agonist) nebulizers or inhalers, steroids, anti-inflammatory meds.

Question 21

is COPD fully reversible

Answer 21

not fully reversible

Question 22

what are the two kinds of COPD

Answer 22

emphysema and chronic bronchitis

Question 23

describe pathophysiology of emphysema

Answer 23

inhalation of irritants loading to inflammation of alveoli, destruction of alveoli via breakdown of elastin within septa and permanent enlargement of gas exchange airways

Question 24

manifestations of emphysema include

Answer 24

pink puffer: dyspnea, minimal cough, increased minute ventilation, pinks kin, pursed lip breathing, accessory muscle use, cachexia, hyperinflation, barrel chest, decreased breath sounds, tachypnea

Question 25

describe pathophysiology of chronic bronchitis

Answer 25

inhalation of irritants lead to inflammation of bronchi goblet cells. Stimulates mucus secretion which becomes thickened and impairs bronchial ciliary function.

Question 26

clinical manifestations of chronic bronchitis include

Answer 26

blue bloater: chronic productive cough, purulent sputum, hemoptysis, mild dyspena initially, cyanosis ( due to hypoxemia), peripheral edema due to cor pulmonale, crackles and wheezes, prolonged expiration, obese

Question 27

most common sx of COPD is

Answer 27

dyspnea on exertion

Question 28

this pulmonary disorder's pathophysiology is when there is an occlusion of a portion of the pulmonary vascular bed by thrombus, embolus, tissue fragments, lipids, foreign body, amniotic fluid, or air bubble

Answer 28

pulmonary embolism

Question 29

a pulmonary embolism is commonly caused by

Answer 29

DVT

Question 30

what is a risk factor of pulmonary embolism

Answer 30

Virchow’s triad: venous stasis, hypercoagulability, injuries to endothelial cells that line vessels

Question 31

what are clinical manifestation of pulmonary embolism

Answer 31

sudden onset pleuritic chest pain, dyspnea, tachypnea, tachycardia, unexplained anxiety, cardiac arrest, death

Question 32

pulmonary embolisms only appear

Answer 32

on CT angiogram

Question 33

another name for croup is

Answer 33

laryngotrachebronitis

Question 34

describe pathophysiology of croup

Answer 34

Infection of upper airway leading to obstruction with swelling of the vocal cords and surrounding structures in children ages 6m to 5years

Question 35

croup is most commonly caused by

Answer 35

viral infections

Question 36

clinical manifestations of coup include

Answer 36

: harsh barking cough (seal like cough), hoarse voice, inspiratory stridor

Question 37

what is the pathophysiology of cystic fibrosis

Answer 37

Gene mutation leads to abnormal chloride channel causing cellst to be unable to transport chloride outside the cells Chloride outside th cell normally attract a layer of water molecules which helps moisturize and thin secretory mucus, without water, the cells make mucus that is thick, dehydrated, prone to sticking together,

Question 38

Thick secretions can obstruct bronchioles ( mucus plugging), result in chronic inflammation, increase risk of infection

Answer 38

cystic fibrosis

Question 39

clinical manifestations of cystic fibrosis include

Answer 39

persistent cough/wheeze, excess sputum production, hemoptysis, recurrent or and severe pneumonia, symptoms of hypoxia such as nail clubbing

Question 40

risk factors of sudden infant death syndrome

Answer 40

preterm or low birth weight, multiple births, positive family history, environmental stress

Question 41

prevention for infant death syndrome include

Answer 41

: Avoid prone sleeping ( on belly) or side sleeping ( ONLY sleep on back), avoid soft bedding, toys, blankets in the crib ( only firm sleep surfaces with fitted sheets) Avoid bed sharing ( baby sleep in designated crib or bassinet), encourage breast feeding and routine immunization