Pathophysiology Exam 3: Respiratory, Renal, & Heat-related Illness

Ventilation-perfusion (V/Q) mismatch

Imbalance between airflow and blood flow in the lungs that impairs gas exchange

Impaired diffusion

Reduced gas exchange caused by decreased alveolar surface area or increased membrane thickness

Lung compliance

Ability of the lungs to expand during inspiration

Residual volume

Amount of air remaining in the lungs after expiration that may increase in COPD

Hypercapnic drive

Normal respiratory stimulation primarily triggered by increased carbon dioxide levels

Chronic hypercapnia

Long-term elevated CO2 may reduce central chemoreceptor responsiveness and increase reliance on oxygen sensing

Hypoxic hypoxia

Inadequate tissue oxygenation caused by low oxygen levels in arterial blood

Anemic hypoxia

Inadequate tissue oxygenation caused by reduced hemoglobin or oxygen-carrying capacity

Circulatory hypoxia

Inadequate tissue oxygenation caused by insufficient blood flow

Histotoxic hypoxia

Inability of tissues to use available oxygen due to toxic substances

Acute hypoxia

Sudden inadequate tissue oxygenation causing early restlessness and agitation with possible dyspnea and cyanosis

Chronic hypoxia

Prolonged inadequate tissue oxygenation that may cause finger clubbing and polycythemia

Hypercapnia

Elevated CO2 in the blood causing respiratory acidosis and neurological changes

Aspiration

Entry of foreign material into the respiratory tract that may cause obstruction or lung inflammation

Airway obstruction

Partial or complete blockage of airflow causing respiratory distress and potentially severe hypoxia

Pleural effusion

Fluid accumulation in the pleural space compresses the lung and causes diminished breath sounds and dyspnea

Transudative effusion

Accumulation of relatively clear low-protein fluid in the pleural space

Exudative effusion

Accumulation of protein-rich inflammatory fluid in the pleural space

Empyema

Accumulation of infected purulent fluid in the pleural space

Chylous effusion

Accumulation of milky lymphatic fluid in the pleural space

Hemothorax

Accumulation of blood in the pleural space often caused by trauma

Pneumothorax

Air enters the pleural space causing lung collapse and decreased breath sounds

Tension pneumothorax

Trapped pleural air increases pressure and compresses thoracic structures causing mediastinal shift and hypotension with possible shock

Atelectasis

Collapse of alveoli decreases gas exchange and increases risk of pneumonia particularly after surgery

Pulmonary embolism

Embolus obstructs pulmonary arterial blood flow causing sudden dyspnea and impaired perfusion

Thrombotic embolism

Blood clot travels through circulation and obstructs a pulmonary vessel

Amniotic fluid embolism

Amniotic fluid enters maternal circulation and triggers severe cardiopulmonary complications

Rhinosinusitis

Inflammation of the paranasal sinuses causing congestion and facial tenderness with excessive secretions

Influenza A

Influenza type associated with potentially severe infection and antigenic shifts that produce new strains

Influenza B

Influenza type that undergoes mutations but not the same antigenic shifts as influenza A

Antigenic shift

Major change in influenza A viral antigens that can produce new strains

COVID-19

Coronavirus infection associated with respiratory and systemic symptoms including fever and loss of taste or smell

Pneumonia

Inflammation of lung tissue commonly caused by infection or aspiration that impairs gas exchange

Lobar pneumonia

Infection involving a specific lung lobe causing consolidation and possible rust-colored sputum with marked hypoxia

Bronchopneumonia

Patchy infection and consolidation involving bronchi and surrounding lung tissue with gradual symptom development

Interstitial pneumonia

Inflammation primarily affecting tissue between alveoli often associated with viral or atypical infections

Community-acquired pneumonia (CAP)

Pneumonia acquired outside the hospital setting, less than 48 hrs

Hospital-acquired pneumonia (HAP)

Pneumonia developing at least 48 hours after hospital admission that is often bacterial and difficult to treat

Consolidation

Alveoli fill with inflammatory fluid and cellular material causing lung tissue to become dense

Pleurisy

Inflammation of the pleura producing sharp pain with breathing

RSV

Viral respiratory infection associated with interstitial or atypical pneumonia

Mycoplasma pneumonia

Atypical bacterial pneumonia commonly affecting older children and young adults

Legionnaires' disease

Pneumonia caused by Legionella bacteria associated with contaminated water systems

Tuberculosis (TB)

Mycobacterial infection that produces a chronic immune response and granuloma formation

Type IV hypersensitivity in TB

Delayed T-cell-mediated immune response that contributes to granuloma formation

Granuloma

Collection of immune cells surrounding tuberculosis bacteria to contain infection

Caseous necrosis

Tissue destruction within the center of a tuberculosis granuloma

Ghon complex

Tuberculosis lesion involving a primary pulmonary focus and affected regional lymph nodes

Secondary tuberculosis

Reactivation or reinfection that may cause persistent cough and hemoptysis with night sweats and weight loss

Acid-fast bacilli (AFB) test

Sputum testing used to detect acid-fast organisms such as tuberculosis bacteria

PPD skin test

Screening test identifying an immune response consistent with TB exposure or infection without distinguishing active from latent disease

Asthma

Reversible airway obstruction caused by bronchial hyperresponsiveness and bronchoconstriction resulting in wheezing and dyspnea

Bronchial hyperresponsiveness

Excessive airway reaction to triggers such as smoke or cold air or exercise

Airway remodeling

Structural airway changes from repeated inflammation that may contribute to persistent airflow limitation

COPD

Progressive respiratory disease characterized by persistent airflow obstruction and lung tissue damage

Chronic bronchitis

Chronic bronchial inflammation and excess mucus production causing productive cough for at least three months in each of two consecutive years

Mucous gland hyperplasia

Increased mucus-producing cells contribute to airway obstruction in chronic bronchitis

Ciliary dysfunction

Damage to airway cilia reduces mucus clearance and increases infection risk

Cor pulmonale

Right-sided heart dysfunction or failure resulting from pulmonary hypertension caused by lung disease

Pulmonary hypertension

Increased pulmonary arterial pressure that raises the workload on the right ventricle

Emphysema

Destruction of alveolar walls and loss of elastic recoil cause air trapping and decreased gas exchange

Air trapping

Incomplete exhalation causes excessive air retention and lung hyperinflation

Hyperresonance

Abnormally hollow percussion sound caused by excessive air in the lungs

Barrel chest

Increased anterior-posterior chest diameter caused by chronic lung hyperinflation, seen in emphysema

Pursed-lip breathing

Breathing technique that creates expiratory back pressure to help prevent airway collapse

Small cell lung carcinoma

Aggressive lung cancer strongly associated with smoking and early metastasis and paraneoplastic syndromes

Non-small cell lung carcinoma

Group of lung cancers often involving peripheral lung tissue

Paraneoplastic syndrome

Systemic manifestations caused by substances released by cancer cells rather than direct tumor invasion

Acute respiratory distress syndrome (ARDS)

Severe inflammatory lung injury causing fluid accumulation in alveoli and impaired oxygenation

Acute respiratory failure

Inability of the respiratory system to adequately oxygenate blood or eliminate carbon dioxide

Postvoid residual

Amount of urine remaining in the bladder after urination used to evaluate retention

Stress incontinence

Increased abdominal pressure during coughing or sneezing causes urine leakage

Urge incontinence

Involuntary detrusor contractions cause sudden urinary urgency and leakage

Reflex incontinence

Neurological dysfunction disrupts voluntary bladder control causing involuntary urination

Overflow incontinence

Excessive urine retention causes bladder overdistention and leakage

Functional incontinence

Physical or cognitive impairment prevents appropriate toileting despite a functioning urinary system

Mixed incontinence

Combination of multiple forms of urinary incontinence

Transient incontinence

Temporary urine leakage caused by a reversible condition

DRIP causes of incontinence

Delirium or dementia or dehydration; restricted mobility or retention; infection or inflammation or impaction; polypharmacy or psychological problems

Neurogenic bladder

Impaired nerve signaling disrupts normal bladder storage and emptying causing retention or incontinence

Flaccid neurogenic bladder

Impaired detrusor contraction prevents complete emptying and causes retention

Spastic neurogenic bladder

Abnormal neurological control causes involuntary bladder contractions and inconsistent retention or incontinence

Autonomic dysreflexia

Abnormal autonomic response in susceptible spinal cord injury patients that may be triggered by bladder distention and cause severe hypertension

Interstitial cystitis

Chronic bladder pain and inflammation without an active urinary infection

Nonulcerative interstitial cystitis

Chronic bladder inflammation associated with pinpoint bleeding areas

Ulcerative interstitial cystitis

Chronic bladder inflammation associated with Hunner lesions and significant pain

Hunner lesions

Inflamed bladder lesions associated with ulcerative interstitial cystitis

Urethritis

Infection or inflammation of the urethra commonly causing burning during urination

Cystitis

Infection or inflammation of the bladder producing urgency and frequency with suprapubic discomfort

Pyelonephritis

Kidney infection causing systemic symptoms including fever and chills with flank pain and CVA tenderness

Vesicoureteral reflux

Abnormal backward flow of urine from the bladder toward the kidneys increasing infection risk

Ascending UTI

Bacteria spread upward through the urinary tract potentially reaching the kidneys

Bacteremia

Presence of bacteria in the bloodstream that may occur when a urinary infection spreads

Urosepsis

Sepsis originating from a urinary tract infection that causes life-threatening organ dysfunction

Nephrolithiasis

Kidney stone formation that may obstruct urine flow and cause severe pain when entering the ureter

Ureteral colic

Severe intermittent flank pain caused by a stone obstructing the ureter

Hydronephrosis

Urine accumulation within the kidney due to obstruction causes dilation and possible renal damage

Renal cell carcinoma

Malignant kidney tumor associated with painless hematuria and potential metastasis to the lungs and liver and bones and brain

Bladder cancer

Malignant bladder tumor commonly associated with painless hematuria and smoking or chemical exposure

Noninvasive bladder cancer

Malignant bladder cells remain confined to superficial tissue without invading deeper muscle