Respiratory Emergencies I Flashcards
(109 cards)
1
Q
At an end-tidal CO2 reading less than ___ the body cannot produce sufficient ___ to support metabolism.
A
- 10 mm Hg;
- ATP;
2
Q
The term ___ usually refers to high-pitched crackles heard in the lung bases at the end of inspiration. These breath sounds can also be referred to as ___ crackles. They may sound like crushing ___.
A
- Rales;
- Fine;
- Cellophane;
3
Q
“___” are any discontinuous noises heard during auscultation of the lungs.
A
- Crackles;
4
Q
The breath sound “___” is caused by the popping open of air spaces (reinflation of groups of ___). It is common to hear this breath sound called “___.”
A
- Fine (or high-pitched) crackles;
- Alveoli;
- Rales;
5
Q
The breath sound “___” is caused by the movement of fluid or secretions in the larger airways (trachea and bronchi). It is common to hear this breath sound called “___.” It may sound similar to ___.
A
- Coarse (or low-pitched) crackles;
- Rhonchi;
- Blowing air through milk with a straw;
6
Q
A ___ sounds like two pieces of wet rubber being drawn over each other, and is heard when a patient has ___ (infection or edema of the pleural membranes).
A
- Pleural friction rub;
- Pleurisy;
7
Q
What are the three components of the Asthma Triad?
A
- Airway edema/inflammation) (treat with corticosteroids);
- Bronchospasm/broncho-hyper-responsiveness (treat with bronchodilators);
- Increased mucus production/airway obstruction (treat with water and expectorants);
8
Q
An acute exacerbation of asthma that remains unresponsive to initial treatment with bronchodilators.
A
- Status asthmaticus;
9
Q
A rule of thumb for the ratio of inhalation time to exhalation time in a patient suffering from asthma.
A
- 1:3;
10
Q
Slang term for a person suffering from chronic bronchitis.
A
- Blue bloater;
11
Q
Slang term for a person suffering from emphysema.
A
- Pink puffer;
12
Q
A rule of thumb for the ratio of inhalation time to exhalation time in a patient suffering from COPD.
A
- 1:2;
13
Q
Full of pus; having the character of pus.
A
- Purulent;
14
Q
When “double pneumonia” occurs, it often presents in the lung ___.
A
- Bases;
15
Q
Pneumonia usually results in ___lateral lung sounds.
A
- Uni;
16
Q
A pulmonary embolism results in pressure on the ___ ventricle.
A
- Right;
17
Q
What three abnormal EKG findings can appear during a PE?
A
- Sinus Tachycardia (~50% of cases);
- Inverted T Waves in V1-V4 (right ventricular strain; ~34% of cases);
- S1Q3T3 (deep, negative deflections of these waves in the associated leads);
18
Q
___ is a serious condition that occurs when a blood clot forms in a vein located deep inside the body.
A
- Deep vein thrombosis (DVT);
19
Q
A(n) ___ is a blood clot (or a piece of plaque that acts like a clot) floating in the circulation. ___ means there is more than one clot or piece of plaque. When the clot travels from the site where it formed to another location in the body and becomes lodged, it is called an ___.
A
- Embolus;
- Emboli;
- Embolism;
20
Q
A local coagulation or clotting of the blood in a part of the circulatory system.
A
- Thrombosis;
21
Q
A shark fin-shaped capnography wave is common in ___ patients.
A
- COPD;
22
Q
Per Melissa Stoddard, ALL critically ill or injured patients will have a(n) ___ derangement.
A
- Acid-base;
23
Q
The majority of CO2 in the body is transported as ___ in plasma (~70%; most of the CO2 is converted in the ___, then exits into the plasma).
A
- Bicarbonate;
- Red blood cells;
24
Q
List in order of fastest-acting to slowest-acting the three systems which work to restore the body’s pH balance when a pH disorder is detected.
A
- Bicarbonate buffer system (nano-seconds);
- Respiratory buffer system (minutes);
- Renal buffer system (hours-days);
25
Generally speaking, pH levels below ___ or above ___ result in death.
1. 6.9;
2. 8.0;
26
Chemical formula of bicarbonate.
1. HCO3-;
27
Measurements of respiratory acidosis/alkalosis are based on the quantity of ___ in \_\_\_, while measurements of metabolic acidosis/alkalosis are based on the quantity of ___ in \_\_\_.
1. PetCO2;
2. Exhaled breath;
3. HCO3-;
4. Arterial blood (ABG);
28
Alveoli is the plural of \_\_\_.
1. Alveolus;
29
Respiration is principally controlled by the action of peripheral chemoreceptors located in the \_\_\_.
1. Carotid and aortic bodies;
30
\_\_\_ cells are responsible for the production of histamine.
1. Mast;
31
An H+ ion can also be referred to as a(n) \_\_\_.
1. Proton;
32
Base excess indicates the excessive or insufficient level of ___ in the system. A negative base excess indicates a base deficit, which is equivalent to a(n) ___ excess. A value outside the normal range (\_\_\_-\_\_\_) suggests a ___ cause for the abnormality.
1. Bicarbonate (HCO3-);
2. Acid;
3. -2 to +2 mEq;
4. Metabolic;
33
The most abundant cation (or positively charged ion) in the extracellular fluid (ECF) is \_\_\_. The most abundant anion (or negatively charged ion) in the ECF is \_\_\_. The most abundant cation in the intracellular fluid (ICF) is \_\_\_.
1. Sodium (Na+);
2. Chloride (Cl-);
3. Potassium (K+);
34
What is the "gold standard" of tests for determining the presence of a PE?
1. CT Pulmonary Angiogram (CTPA);
35
Well's Criteria is used to determine the likelihood of what respiratory condition?
1. Pulmonary Embolism;
36
A normal iNR level is \_\_\_, meaning adequate coagulation potential. Patients taken warfarin will have a ___ level than this.
1. 1 (0.8-1.2)
2. Higher (usually 2.0-3.0);
37
Pneumonia is most often caused by a ___ infection.
1. Bacterial (but can also be viral or fungal);
38
If a person's end tidal CO2 is greater than \_\_\_, they are most likely experiencing respiratory acidosis.
1. 45 mm Hg;
39
If a person's end tidal CO2 is less than \_\_\_, they are most likely experiencing respiratory acidosis.
1. 35 mm Hg;
40
When performing rescue breathing: If your patient's CO2 reading is high, "\_\_\_." If the reading is low, "\_\_\_."
1. You fly (ventilate at a faster rate);
2. Go slow (ventilate at a slower rate);
41
CO2 itself is not an acid, since it doesn't make hydrogen ions (H+). But it does become an acid when in contact with \_\_\_. CO2 in \_""\_ becomes ___ acid.
1. Water;
2. Carbonic (H2CO3);
42
When there is too much acid in the body, the kidneys try to excrete more ___ into the ___ and absorb more ___ back into the body. When you have too little acid in your body, known as alkalosis, your kidneys try to excrete \_(3.)\_ and conserve \_(1.)\_.
1. Hydrogen ions (H+);
2. Urine;
3. Bicarbonate (HCO3-);
43
If a patient's ___ contracts when you gently stroke the upper eyelashes, he or she probably has an intact ___ reflex.
1. Lower eyelid;
2. Gag;
44
PaCO2 is a measurement of the ___ of carbon dioxide in ___ blood. This is measured with an ___ sample, and is represented in \_(units)\_.
1. Partial pressure;
2. Arterial;
3. ABG;
4. mm Hg;
45
PCO2 is the ___ of carbon dioxide as measured by \_\_\_, and is represented in \_(units)\_.
1. Partial pressure;
2. End-tidal capnography;
3. mm Hg;
46
The "Sp" in SpO2 stands for \_\_\_. SpO2 is a measurement of the percentage of oxygenated ___ in the \_\_\_.
1. Saturation in peripheral capillaries;
2. Hemoglobin;
3. Peripheral capillaries;
47
The “Sa” in SaO2 stands for \_\_\_. This is a measurement of the amount of oxygen bound to hemoglobin in ___ blood, and is expressed as a \_(units)\_.
1. Saturation in arterial blood;
2. Arterial;
3. Percentage;
48
The “Pa” in PaO2 stands for\_\_\_. This is a measurement of the partial pressure of oxygen in an ___ sample, and is expressed in \_(units)\_.
1. Partial pressure in arterial blood;
2. ABG;
3. mm Hg;
49
The sensation of breathlessness while lying flat.
1. Orthonpnea;
50
A breathing condition resulting from gradual reabsorption of lower extremity edema after lying down.
1. Paroxysmal nocturnal dyspnea (PND);
51
Right-sided or right ventricular (RV) heart failure usually occurs as a result of \_\_\_.
1. Left-sided failure;
52
An accumulation of fluid in the peritoneal cavity, a condition which can result from right-sided heart failure.
1. Ascites;
53
\_\_\_, sometimes referred to as “water on the lungs,” is the build-up of excess fluid between the layers of the ___ outside the lungs.
1. Pleural effusion;
2. Pleura;
54
The most common chronic disease of childhood.
1. Asthma;
55
10 mm Hg or greater decrease in systolic blood pressure with inspiration.
1. Pulsus paradoxus;
56
The functional tissue of an organ as distinguished from the connective and supporting tissue.
1. Parenchyma;
57
A sudden feeling of cold with shivering accompanied by a rise in temperature, often with copious sweating, especially at the onset or height of a fever.
Rigor;
58
Five skin colors, from best to least perfused.
1. Pink;
2. Pale;
3. Cyanotic;
4. Ashen;
5. Gray;
59
True or False: CPAP decreases both preload and afterload for the myocardium.
1. True;
60
When assessing a child, there are generally four different types of respiratory problems to be considered. Name them.
1. Upper airway obstruction (e.g. croup);
2. Lower airway obstruction (e.g. asthma);
3. Lung tissue disease (e.g. pneumonia);
4. Disordered control of breathing (e.g. brain injury or drug overdose);
61
Inspiratory stridor, hoarseness, barking cough, drooling, snoring and gurgling sounds are all indications of what general category of respiratory problems?
1. Upper airway obstruction;
62
A blood clot formed in situ within the vascular system of the body and impeding blood flow.
1. Thrombus;
63
Name four (of seven listed) significant clinical findings found in Wells' Criteria.
1. Clinical signs of DVT;
2. Alternative dignosis less likely than PE:
3. Previous PE or DVT;
4. Heart rate \> 100 bpm;
5. Surgery or immobilization within four weeks;
6. Hemoptysis;
7. Active cancer;
64
The bicarbonate buffer system is an acid-base homeostatic mechanism involving the balance of \_\_\_, \_\_\_, and ___ in order to maintain pH in the blood and duodenum, among other tissues, to support proper metabolic function.
1. Carbonic acid (H2CO3);
2. Bicarbonate (HCO3-);
3. Carbon dioxide (CO2);
65
In the normal location.
1. In situ;
66
The production of more red blood cells over time, making the blood "thick;" a characteristic of people who have chronic lung disease and chronic hypoxia.
1. Polycythemia;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
67
The production of large amounts of urine by the kidney.
1. Diuresis;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
68
A collection of pus in a sack, formed by necrotic tissues and an accumulation of white blood cells; the immune system creates the sack to prevent spread of the infection.
1. Abscess;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
69
The carbon dioxide contained in the last few millimeters of exhaled air; the unit of measure is a percentage.
1. End-tidal carbon dioxide;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
70
To move inadequate volumes of air into the lungs.
1. Hypoventilate;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
71
Inflammation of the lung; implies lung inflammation from an irritant such as a chemical, dust, or radiation, or from aspiration.
1. Pneumonitis;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
72
The non-striated involuntary muscle found in vessel walls, glands, and the gastrointestinal tract.
1. Smooth muscle;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
73
Full of pus; having the character of pus.
1. Purulent;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
74
The process by which oxygen-depleted blood from the pulmonary circulation releases carbon dioxide and is enriched with oxygen; occurs by diffusion at the interface of the alveoli and the pulmonary capillary bed; newly oxygen-enriched blood enters the cardiac circulation for distribution to the body's tissues.
1. Gas exchange;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
75
The sound of multiple notes during wheezing; caused by the vibrations of many bronchi.
1. Polyphonic;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
76
A chronic inflammatory condition affecting the bronchi that is characterized by excessive mucus production as a result of overgrowth of the mucous glands in the airways.
1. Chronic bronchitis;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
77
A disease of unknown cause that involves progressive paralysis that moves from the feet to the head (ascending paralysis); if paralysis reaches the diaphragm, the patient may require respiratory support; can lead to paralysis within two weeks.
1. Guillain-Barré Syndrome;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
78
A pharmacologic agent that stimulates the beta-2 receptor sites found in smooth muscle; includes common bronchodilators such as albuterol and levalbuterol.
1. Beta-2 agonist;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
79
A common disease of childhood due to upper airway obstruction and characterized by stridor, hoarseness, and a barking cough.
1. Croup;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
80
The process by which cells from a malignant neoplasm break away from their site of origin, such as the lung, and move through the bloodstream or lymphatic system to other body sites, such as the brain.
1. Metastasis;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
81
A mesh filter placed in the inferior vena cava to catch blood clots in patients who are at high risk of pulmonary embolus.
1. Greenfield filter;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
82
Severe shortness of breath occurring at night after several hours of recumbency, during which fluid pools in the lungs; the person is forced to sit up to breathe; caused by left heart failure or decompensation of chronic obstructive pulmonary disease.
1. Paroxysmal nocturnal dyspnea (PND);
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
83
Vibrations in the chest that can be felt with a hand on the chest as the patient breathes.
1. Tactile fremitus;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
84
Nosebleed.
1. Epistaxis;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
85
Coughing up blood.
1. Hemoptysis;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
86
The sound of one note during wheezing, caused by the vibration of a single bronchus.
1. Monophonic;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
87
A noise made during inhalation when the upper airway is partially obstructed by the tongue.
1. Snoring;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
88
A false membrane formed by a dead tissue layer; seen in the posterior pharynx of patients with diphtheria.
1. Pseudomembrane;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
89
A severe, prolonged asthma attack that cannot be stopped with conventional treatment, such as the administration of epinephrine.
1. Status asthmaticus;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
90
A vascular reaction that may have an allergic cause and may result in profound swelling of the tongue and lips.
1. Angioedema;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
91
Heart disease that develops because of chronic lung disease, affecting primarily the right side of the heart.
1. Cor pulmonale;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
92
The devices that collect medication as it is released from the canister of a metered dose inhaler, allowing more medication to be delivered to the lungs and less to be lost to the environment.
1. Spacers;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
93
Surgically opening the trachea to create an airway.
1. Tracheotomy;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
94
Inflammation of the larynx, trachea, and bronchi.
1. Laryngotracheobronchitis;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
95
The hairlike microtubule projections on the surface of a cell that can move materials over the cell surface.
1. Cilia;
## Footnote
-Emergency Care in the Streets, 7th Ed.
96
Excessive accumulation of fluid in the pleural space.
1. Pleural effusion;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
97
A situation in which a portion of the output of the right side of the heart reaches the left side of the heart without being oxygenated in the lungs; may be caused by atelectasis, pulmonary edema, or a variety of other conditions. In hemodialysis, an anastomosis between a peripheral artery and vein.
1. Shunt;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
98
A term used to describe any condition that causes hyperreactive bronchioles and bronchospasm.
1. Reactive airway disease;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
99
A chronic bacterial disease caused by Mycobacterium tuberculosis that usually affects the lungs but can also affect other organs such as the brain and kidneys.
1. Tuberculosis (TB);
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
100
Deep cyanosis of the face and neck and across the chest and back; associated with little or no blood flow; a particularly ominous sign.
1. Cape cyanosis;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
101
Diseases that limit the ability of the lungs to expand appropriately. Skeletal abnormalities (kyphosis and scoliosis) or a common example of these diseases.
1. Restrictive lung diseases;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
102
The functional portions of a gland or solid organ.
1. Parenchyma;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
103
An inflammation of the lungs caused by bacterial, viral, or fungal infections or infections with other microorganisms.
1. Pneumonia;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
104
Poisoning from eating food containing botulinum toxin.
1. Botulism;
## Footnote
*-Emergency Care in the Streets, 7th Ed.*
105
Wheezes are considered a _\_\_\__-inuous breath sound \>\_\_\_Hz.
1. Continuous;
2. 400;
* https://en.wikipedia.org/wiki/Rhonchi*
106
Although no longer considered appropriate terminology in describing auscultation of the thorax, rhonchi has been defined as \_\_\_-inuous breath sounds \< ___ Hz.
1. Continuous;
2. 200;
* https://en.wikipedia.org/wiki/Rhonchi*
107
Name the two types of discontinuous breath sounds defined by the International Lung Sounds Association.
1. Fine crackles;
2. Coarse crackles;
* https://en.wikipedia.org/wiki/Rhonchi*
108
Crackles are defined as discrete sounds that last less than ___ ms, while the continuous sounds (rhonchi and wheezes) last approximately ___ ms.
1. 250;
2. 250;
Major Memory System: A doctor listens to a patient's lung sounds and hears **nails** (250) rattling around inside.
*https://en.wikipedia.org/wiki/Rhonchi*
109
Stridor is a variably high-pitched sound resulting from turbulent airflow due to partial airway obstruction. ___ stridor generally results from obstruction above the glottis, ___ stridor is caused by obstruction in the lower trachea or peripheral airways, and ___ stridor is indicative of partial obstruction at or immediately below the glottis.
1. Inspiratory;
2. Expiratory;
3. Biphasic;
* https://www.emra.org/emresident/article/barking-up-the-wrong-tree-not-all-stridor-is-croup/*
