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Advanced Patho EXAM 2

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Question
Answer
What is the first and second process of respiration?   1st=alveolar respiration 2nd=perfusion  
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Describe ventilation.   Air into lungs/exchange of gases  
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Why does perfusion have to occur?   has to occur for oxygen to get to tissues and into blood  
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What is a pulmonary emboli (PE)?   Undissolved detached material that occludes blood vessels of the pulmonary vasculature  
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Most PEs originate from?   DVTs or from the deep veins of the lower extremities  
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What are other types of PEs, other than DVTs?   fat, air, amniotic fluid, CA (tumor), foreign material  
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What are risk factors for PEs?   sepsis, parasitic, immobility, pregnancy, trauma, heart failure, estrogen use; and virchows triad  
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What is virchow's triad?   hyperocaguability venous stasis/sluggish blood flow damage to venous wall  
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What is COPD?   chronic and recurrent obstruction of airflow of the pulmonary airways that cause a mismatch of ventilation and perfusion  
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What is the major cause of COPD?   cigarette smoking  
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COPD consists of what two disease/illness?   emphysema and chronic bronchitis  
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What are the s/s of emphysema?   progressive exertional dyspnea, SOB, accessory muscles, pursed lip breathing, cough, may hunch forward to breathe better, prolonged expiration, barrel chest  
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What causes chronic bronchitis?   repeated infections, genetic predisposition, inhalation of irritants  
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What are the s/s of chronic bronchitis?   usually overweight, SOB with exertion, excess sputum, edema, smoking HX, chills, aches, fatigue, cough, increased sputum production in a.m.  
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How does heart disease affect the lungs?   Right or left sided heart failure can lead to pulmonary congestion and impaired gas exchange  
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How does lung disease affect the heart?   due to poor gas exchange, lung disease can lead to hypoxia which causes vasoconstriction of pulmonary vessels, which elevates pulm artery pressure & increases workload on R ventricle  
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Most common pneumonia is caused by what?   strep pneumoniae  
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How does pneumonia enter the system (3 ways/sources)?   (1) aspiration of oropharyngeal secretions, (2) inhalation of contaminants (virus), or (3) contamination from the systemic circulation  
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How does pneumonia affect breathing?   There is inflammation of the alveoli and bronchioles which impairs gas exchange  
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In the oxyhemoglobin dissociation curve, what causes a shift to the left?   hypothermia, alkalosis, decreased PaCO2  
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In the oxyhemoglobin dissociation curve, what causes a shift to the right?   hyperthermia,anemia, decreased cardiac output  
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How do chemoreceptors work to protect the body?   they are defense mechanisms  
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Where are the central chemoreceptors located?   in the medullary center  
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What do chemoreceptors respond to?   Changes in pH, CO2 and O2 levels  
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Describe Obstructive Pulmonary Disorders.   characterized by airway obstruction and limitation in expiratory flow  
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List the types of Obstructive Pulmonary Disorders.   Asthma,Acute and Chronic bronchitis, or Emphysema  
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Describe Restrictive Pulmonary Disorders.   Result from inflammatory conditions that affect lung structures and produce lung fibrosis and a stiff lung  
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List the types of Restrictive Pulmonary Disorders.   ARDS,Infant Acute Respiratory Distress Syndrome, Pneumothorax, Pneumonia  
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What is tidal volume (TV)?   the volume of air inspired (or exhaled) with each breath; usually about 500mL in avg adult  
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What is FEV1?   the forced expiratory volume that can be exhaled in 1 second  
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What is residual volume?   air left after max exhale  
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What is ventilation-perfusion?   the matching of adequate volume of air in the alveoli to adequate pulmonary blood flow  
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What are two important substances that help the alveoli function correctly?   Surfactant and alpha1 antitrypsin  
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What is a nl Va/Q?   4/5  
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What does a high Va/Q? indicate?   means they are hyperventilated, alveolar ventilation not perfused, ↓ PCO2, NL PaO2  
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What does a low Va/Q indicate?   it means they are underventilated, ↓ PaO2 (hypoxia)  
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What is infant respiratory distress syndrome (aka hyaline membrane disease)   a lack of surfactant leading to increased alveolar surface tension and decreased lung compliance  
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How can infant respiratory distress syndrome be fatal?   the infant can die from exhaustion  
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At what pregnancy week is surfactant produced in greater qualities?   after week 32  
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