Respiraotry Flashcards
(31 cards)
Kussmual breathing
Rapid, deep, no pause
Common cause: diabetic ketoacidosis
Cheyene stokes breathing (chain-sdeuks)
Change period o deep and shallow breathing. Pause after big ventilation, then back to apnea
Cause: slow blood glow to brainstem-> reduce impulse to breath
Respiratory failure definition
Lung can’t meet body’s metabolic needs (lack of tissue O2, or failure of CO2 hemostasis)
PaO2: < 60mmHg
PaCO2> 50mmHg
Atelactasis
Alveoli collapse
What is pulmonary hypertension
Physio
Pressure in capillary can push the fluid into interstitial space and into alveoli.
Diffuse infiltrates on CXR
Pulmonary edema (cardiogenic or non-cardiogenic)
Interstitial pneu,otitis or fibrosis
Infections
V/Q
Normal is 0.8
High: blood clot: pulmonary embolus
Low: lung problem: common is asthma
Emphysema
Physio
Reduced elastic recoil
Bronchitis
Inflammation
Bronchial wall thickening
Mucus production
Restrictive lung disease
Physio
Increase elastance, reduced compliance (not as stretchy)
Chronic: inflammation & fibrosis
Acute: exudate and edema
Cause of pulmonary edema
Increased pressure: diuretic, vasodilator, O2
Increased capillary permeability: remove offending agent, O2.
Pneumonia’s treatment
If bacterial: abx
If viral: supportive therapy alone
ABG value
PH
PaCO2
PaO2
HCO3
Normal value
Indication
HCO3 equation
PH: acid base
PaCO2: ventilation
PaO2: oxygenation
HCO3: metabolism
CO2+ H2O–> H2CO3–> H+. + HCO3-
HCO3- is regulated by kidney
Difference between PAO2 vs PaO2
A: alveolar O2
A: arterial O2
Normal A-a: 5-10mmHg
If A-a>10?– V/Q dismatch
Acidemia vs acidosis
Academic: low PH
Acidosis: process of becoming low PH
Steps in acidic/ alkalosis analysis
- Check PH
- HCO3-: high: metabolic
3: PaCO2: high: respiratory
What is anion gap
Elevated anion gap
Anion gaps is used to distinguish different types of metabolic acidosis; measure of sum of Na & K concentrations and sum of HCO3- & Cl- concentration
High anion gap (>11mEq/L) usually is diabetic ketoacidosis
Base in blood
We don’t usually care about base excess
It changes the same direction as HCO3-
Upper respiratory infection includes
Nasophargitis
Pharyngitis
Rhinosinusitis
Epiglottis
Laryngotracheitis
Whooping cough’s S&S
- More common in children
- Episodic cough: paroxysm阵发性,often worse at night
- Whoop sound
COPD key feature
Physio
Chronic progressive airflow limitation
Cause of COPD:
1. Severe respiratory infection as a child
2. Smoking
3. Air pollutants
4. Alpha-1 antitrypsin deficiency
Types of respiratory failure
Type 1: low O2: PaO2< 60mmHg+ normal or low PaCO2+ normal or high PH (means: good ventilation, disease interferes pulmonary O2 exchange)
Type 2: high CO2: PaCO2>50mmHg (usually acidic. Know that renal compensation takes days and weeks)
Bronchodilator
Affect beta-2 receptor (located at lungs): cause bronchial smooth muscle relax–> so dilate
Beta 1 receptor is in heart: so if you use non selective beta agonist, it will affect both
*Bronchodilator: beta 2 agonist, anticholinergic, theophylline, leukotriene inhibitor, corticosteroid
Beta 2 agonist:
1. Short acting: SABA: albuterol
2. Long acting: LABA: salmeterol
Anticholinergic: block parasympathic (cause bronchoconstriction) (relax–> constriction; fight: breath more): atropine, ipratropium
Theophylline: prevent bronchospasm & help diaphragm contraction for COPD pts (how it works is unknown)
Leukotriene inhibitor: control chronic inflammation associated with allergy & asthma: help with inflamamtion, airway edema, smooth muscle constriction
Common cold
S&S
Treatment
Rhinorrhea, cough, sore throat
Treatment: symptom control
–fever or sore throat: antipyretic & analgesic
–rhinorrhea: antihistamines
–nasal obstruction: decongestants
–cough: antittusive & expectorants
