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RTH 112

test #3

QuestionAnswer
over time COPD what happens to the alveoli they lose their elasticity and can't expand and contract normal
why do alveoli distend in COPD they trap air, can get in but not out
COPD history 1.medical conditions 2.smoking 3.chronic cough/SOB
physical exam for COPD patients 1.auscultation 2.BP 3.peripheral perfusion 4.chest (barrel) 5.clubbing 6.peripheral edema
COPD spiromety test FVC indicates restrictive, normal/decreased in emphysema
COPD spirometry test FEV1 indicates obstructive, decresed
what happens to the FEF 25-75% in COPD is down with and obstructive disease
COPD pt's TLC will be higher cause of air trapping
COPD ABG 1.not ventilating=high CO2 2.hypoxemia 3.chronic
what is chronic bronchitis chronic excessive production of mucus in bronchi, source unknown
who usually gets chronic bronchitis e.mphysema pt's
chronic bronchitis major contributing factors 1.smoke 2.air pollution 3.lung disease 4.age
chronic bronchitis is different from acute bronchitis because the cough/disease doesn't go away and can cause damage to the lining of the bronchi
treatment for chronic bronchitis 1.BHT-chest pt 2.bronchodilators 3.antibiotice-inifection 4.O2 5.rehab
test results to confirm chronic bronchitis 1.ABG-hypoxemia/hypercapnia 2.CXR-normal 3.PFT-decreased flow/increased FRC
what is emphysema permentant enlargement of alveoli= rupture walls= destroyed pulmonary capillaries
what causes emphysema 1.somking 2.alpha 1
in emphysema increased intrathorasic pressure causes the alveoli to collapse/ close because of damaged alveoli
emphysema resistance increases
emphysema complianace increaase
tests for emphysema 1.ABG 2.CXR
ABG for emphysema compensated resp. acidosis with moderate hypoxemia
CXR for emphysema 1.hyperlucency 2.decreased vascular markings 3.flattened diaphragm 4.blebe/bullous lesions
blebs weakened pouches in lungs that can rupture= pneumothorax
bullae blebs on pleura
emphysema RV increased
emphysema FRC increased
emphysemaTLC increased
emphysemaVC decreased
emphysema FEV1/FEF25-75% decreased
treatment for emphysema 1.stop smoking 2.BHT 3.bronchodilators/steroids 4.antibiotics 5.pulmonary rehab 6.O2 7.ventilator 8.resections
what immunizations should COPD patients get 1.pneumonia 2.influenza
what can exercise help COPD 1.ease symptoms 2.develop higher tolerence 3.improves tolerance
what can nutrition do to help COPD 1.overweight= harder to breath 2.max body's fuel source 3.fights infection
what is cor pulmonale right heart failure because of long time high blood pressure in pulmonary artery and right ventricle
what causes cor pulmonale high blood pressure in the arteries/veins in the lungs (pulmonary hypertension)
other name for swan ganz catheter 1.pulmonary artery catherization 2.flow directed, balloon tipped catheter
what does a swan ganz catheter do measures heart pressure
treatment for cor pulmonale 1.treat underlying disease 2.O2 3.less salt 4.diuretics 5.meds for pulmonary hypertension 6.lung/heart transplant
what is cystic fibrosis genetic disorder effects exocrine glands=sweat/pancreas/lungs= mucus stagnates= obstruction/atelectasis/bacteria
characteristics of cystic fibrosis 1.family history 2.small for age 3.malnorished look 4.dyspnea on exertion 5.cough up thick secretions
what test are done for cystic fibrosis 1.newborn screening 2.sweat test 3.CXR 4.PFT
cystic fibrosis sweat test >60mEq/L
cystic fibrosis CXR 1.hyperinflation 2.flattened dyphram 3.increased AP diameter
cystic fibrosis PFT 1.decreaased flows (FEV1) 2.increased FRC
cystic fibrosis treatment 1.nutrition 2.BHT 3.O2 4.Antibiotics 5.Pulmozyme 6.lung transplant
what is asthma 1.stimulated bronchospasm 2.increased mucus production 3.mucosal swelling
asthma is different from other obstructive diseases because it is reversable
what happens during an asthma attack 1.narrow airways 2.constricted muscles 3.inflammation 4.damaged airway walls
4 symptoms of asthma attack 1.cough 2.wheeze 3.hypoxemia/hyperventilation 4.increase HR
types of asthma 1.occupational 2.exercise induced
what are asthma prophylactic treatment goals prevent/control 1.avoid triggers 2.meds 3.monitor 4.maintain activity 5.prevent exaspirations
asthma reliever inhaler 1.quick acting to relieve symptoms 2.short lasting
asthma controller inhalor 1.daily prevent symptoms 2.7-14 days for effect 3.not immediate relief
asthma long acting bronchodilator reliever that lasts for 12 hours
goals during asthma attack treat agessively 1.bronchodilators 2.O2 3.IV fluids 4.IV theophylline 5.IV steroids 6.heliox 7.magnesium 8.NIV 9.ventilator
what is status asthmaticus sever asthma attack that doesn't respond to bronchodilators
symptoms of status asthmaticus 1.history 2.retractions/pulsus paroxus 3.ABG=resp. acidosis/failure
what is bronchiectasis chronic dilation of bronchi from inflammation and destroy bronchial wall=mucus forms=infection
3 forms of bronchiectasis 1.varicose 2.cylindrical 3.saccular
what is varicose bronchiectasis bronchi dilate and contract irregularly causing distorted bulbous shape
what is cylindrical bronchiectasis bronchi are dilated and look like a tube=don't taper the squared off ends
what is saccular bronchiectasis bronchi dilate till large cyst like sacs
what is the best test for bronchiectasis air bronchogram
what will and air bronchogram show for bronchiectasis tree in winter pattern
bronchiectasis ABG hypoxemia/hypercapnia
bronchiectasis CXR 1.lung markings from fibrosis 2.flattened diaphragm 3.segmented atelectasis
bronchiectasis PFT 1.mild=no change 2.advanced=high FRC/low FEV1
initial assesment bronchiectasis give away 3 layered sputum
bronchiectasis treatment 1.BHT 2.antibiotics 3.humididty 4.immunizations 5.O2 6.surgical ressection
what is Alpha-1 deficiency inherited disease that can cause emphysema/ liver disease
what causes Alpha-1 deficiency gene that makes ATT is defective
what does ATT neutralize neutrophil elastase
where does ATT accumulate in liver
what is the test to confirm Alpha-1 deficiency Alpha-1 deficiency coded test, blood test from dr, free, sent to lab
treatment for Alpha-1 deficiency 1.Alpha-1 replacement with IV 2.BHT 3.immunizations 4.pulmonary rehab 5.lung volume reduction surgery 6.lung transplant
what is pulmonary edema accumulation of fluid in lung tissue/alveoli because of increased pulmonary vascular pressure
cardiogenic pulmonary edema from left heart failure fluid from capilaries forced into lung
noncardiogenic pulmonary edema 1.increased pulmonary capilary permeability from infection/inflammation 2.increased negative pressure in intrathoracic cavity from rapid re-expansion after pneumothorax/effusion
what causes pulmonary edema 1.left heart failure-cardiogenic 2.noncardiogenic pulmonary permeability increase
affect of fluid on lungs 1.wet/stiff 2.lose A/C surface area 3.pink/frothy secretions fill airway
why can pulmonary edema cause resp. failure where theres fluis there cant be air=failure
what tests can be done to determine pulmonary edema 1.swan ganz catheter to check cardiogenic 2.ABG 3.CXR
pulmonary edema CXR 1.fluffy 2.left vent hypertrophy 3.pulmonary congestion 4.increase vascular markings 5.pleural effusion
pulmonary edema ABG hypoxemia/hypercapnia
treatment for pulmonary edema 1.O2 via positive pressure/NRB/ventilator 2.diuretics 3.meds to reduce hypertension/increase heart contraction
for pulmonary edema what IPPB therapy was done 5-15ml 30-50% ethanol
what is pulmonary embolism occlusion of pulmonary artery=dead space disease=ventilation without perfusion
most common cause of pulmonary embolism blood clot
what other things can cause pulmonary embolism other than blood clot 1.fat piece 2.air tissue piece 3.foreign body
predisposing factors for pulmonary embolism 1.prolonged bed rest 2.condition=stagnate blood 3.pregnancy 4.trauma 5.coagultion disorder 6.DVT-
pulmonary embolism ABG 1.low PO2 2.normal PCO2 even though pt is hyperventilating
single most important test for pulmonary embolism V/Q lung scan-vent normal/ perfusion missing
another test for pulmonary embolism pulmonary angiogram- when V/Q inconclusive
dead space ventilation Vt not involved in perfusion
nonvented pt range dor deadspace ventilagtion 20-40%
vented pt range of dead space ventilation 40-60%
life threatenting dead space range >60%
pulmonary embolism treatment 1.prevent 2.anticoagulant-heprin 3.compression socks 4.screens to filter clots(IVC/Greenfield) 5.positioning/movement 6.O2 7.hypotensive=fluids/vasorpressors 8.urokinase/streptokinase
pulmonary embolism CXR 1.fluffy 2.dilated vasculature 3.peripherial wedge shaped infiltrates
what is ARDS inflammation of alveoli=fill with fluid=colapse
ARDS causes 1.thoracic trauma 2.pulm contusion 3.pullm aspiration 4.inhale toxic fumes 5.pulm infections 6.near drowning 7.sepsis 8.shock
ARDS phase 1 1.dyspnea 2.tachypnea 3.normal CXR 4.O2 normal
ARDS phase 2 1.12-48hr after illness 2.CXR=infiltrates 3.alveolar damage=epithelial breaks=flooding=no diffusion
ARDS phase 3 1.AC membrane leak 2.surficant decrease 3.atelectasis 4.stiff wet noncompliant lungs 5.resp failure start 6.CXR-fluffy/ground glass/honeycomb
ARDS phase 4 1.resp failure 2.fibrosis 3.infection 4.CXR -white out
ARDS ABG refrectory hypoxemia
ARDS PFT worsening compliance
treatments for ARDS 1.O2 2.CPAP/PEEP 3.titrate PEEP/O2 4.ventilator 5.monitor with swan ganz 6.BHT 7.fix underlying problem 8.support give time to heal
why use pressure control ventilation for ARDS 1.reduce baurotrauma 2.pushes air in
why use high frequency ventilation for ARDS 1.small Vt/high frequency 2.adequate ventilation at low pressures oscillator
general treatment for pneumoconiosis 1.limit exposure 2.O2 3.pulm rehab 4.minimize infections 5.stop smoking
what causes asbestosis asbestos=fibrous sillicates from insulation/roofing/break lines
what is asbestosis inhales asbestos fibers inflame/scar till lungs can't function
what cancer can asbestos cause mesothelioma-in plaural/abdominal wall
asbestosis CXR 1.shaggy heart 2.pleural plaques 3.diaphragm calcification
what is silicosis caused by silca=crystalline quartz in 95% of rocks being inhaled
what is silicosis small silica particles eaten by macrphages=damage=release enzymes=inflames=nodules
silicosis CXR eggshell calcification/calcified hilar nodes
what causes black lung from chronic/long exposure to coal dust
what is black lung coal colllects in alveoli=lungs cant get it out=black lesions form=black sputum
what is idiopathic pulmonary fibrosis chronic diffuse lung disease=orgin unknown liance
idiopathic pulmonary fibrosis disease process 1.chronic inflammation 2.avleoli walls thicken 3.wall become fibris 4.scar tissue develops 5.lungs become stiff 6.restrict function/comp
idiopathic pulmonary fibrosis CXR 1.reticular/nodular densities 2.hazy ground glass appearance 3.honeycomb
idiopathic pulmonary fibrosis treatment unknown 1.symptom 2.prevent infection 3.avoid irritants 4.O2
what is sarcoidosis granulomatous disease=granulomas of epithelial cells=in bronchial/subpleural tissue/bronchial mucosa
sarcoidosis typically effects 20-40 yr old african american women
what organs does sarcoidosis effect 1.lymph nodes 2.lung 3.liver 4.spleen 5.skin 6.eyes
sarcoidosis symptoms 1.fever 2.rash 3.joint pain 4.efects eyes 5.coough 6.fatigue 7.dyspnea
routine sarcoidosis test PFT
sarcoidosis PFT 1.restrictive 2.some obstructive 3.decreased compliance 4.low diffusing capacity
sarcoidosis CXR 1.large lymph 2.infiltrates 3.lung leasions 4.uneven fibrosis
sarcoidosis treatments 1.may improve 2.steroids
CXR hyperinflation noted with wheezing= asthma adult onset=LABA/ SABA/ ICS
CXR fibrosis/flatten disphrgm/segmented atelectasis with crackles bronchiectasis=BHT/O2/resection
CXR decreased vascular markings/hyperlucency/flattened diaphragm with diminished BS COPD exaspiration=antibiotics/small O2/meds/stop smoking/BHT
CXR wall thickening with wheeze/ronchi/ bad cough chronic bronchitis=BHT/Pulm rehab/O2
CXR kid Peribronchial thickening and hyperinflation with wheeze asthma=allergy to animals/exercise induced=meds/peakflow
CXR Decreased vascular markings, flattened diaphragm, hyperlucent painter Emphysema/A1 defiency=A1 replacement/meds/O2/transplant
CXR Fluffy opacities, left ventricular hypertrophy, pulmonary venous congestion, pleural effusions, increase vascular markings, Batwing or Butterfly pattern with pink frothy secretions Pulm. edema-NIPPV/lasic/NRB/heart meds
Created by: Kataleshire