Patho Exam 1

What is pathophysiology?

  • Science of disease processes

What is homeostasis?

  • Internal balance/equilibrium within the body

What is a compensatory mechanism?

  • Body’s ability to adapt and reorganize in response to an injury or challenge

Describe negative feedback systems.

  • Regulatory mechanism, brings the body back to homeostasis

Describe positive feedback systems.

  • Amplification of a stimuli, farther from homeostasis

What is epidemiology?

  • Study of disease occurrence in human populations

What is etiology?

  • Cause of reason for the event

What does it mean if a disease is idiopathic?

  • There is no cause

What does intrinsic mean?

  • Belonging to an exclusive part

What does extrinsic mean?

  • Originating outside of where it was found

What is pathogenesis?

  • The outcome and progression of a disease

What are clinical manifestations?

  • Signs and symptoms of disease

Compare signs versus symptoms.

  • Signs are what we can see/detect, where the symptoms are what the patient experiences

Compare acute versus chronic conditions.

  • Acute is short but severe, while chronic is a longer form with periods of remission and exacerbation

What are surface markers within the plasma membrane, also called antigens?

  • glycoproteins

What surface markers indicate blood types?

  • glycoproteins

What is responsible for ⅓ of the cell’s energy expenditure?

  • The sodium potassium pump

How can the sodium/potassium pump be altered?

  • Pharmaceutically with drugs

What is the ion concentration of body fluids in the sodium/potassium pump?

  • Three sodium ions pumped out, two potassium ions pumped in

Where and when are more mitochondria present?

  • Exercise, liver, muscles

Describe aerobic versus anaerobic.

  • Aerobic is processes requiring oxygen, where anaerobic does not require oxygen

What is a byproduct of anaerobic respiration?

  • Lactic acid

What events can lead to excessive acidosis of the body?

  • Ischemic events

What is mitochondrial DNA subject to mutation by?

  • Oxygen-derived free radicals

What intracellular disease involves energy depletion and severe muscle weakness?

  • Mitochondrial disease

What organelle is responsible for recycling and involved in metabolic disease?

  • Lysosomes 

Lack of what organelle leads to the accumulation of harmful substances?

  • Lysosomes 

What terminal genetic disorder of the neurological system affects pediatric, genetic, mediterranean, and jewish populations?

  • Tay sach’s disease

Lysosome deficiency leads to accumulation of what toxin that leads to progressive neurological decline?

  • ganglioside

What degrades polypeptides and proteins?

  • proteasomes

What degrades long-chain fatty acids?

  • peroxisomes

Which form of RNA makes proteins?

  • rRNA

Which form of RNA is the protein blueprint from the nucleus?

  • mRNA

Which form of RNA is responsible for the assembly of proteins?

  • tRNA

What is the disorder in which rRNA stops making proteins?

  • Severe hypoxia

Which organelle is responsible for the processing and packaging of proteins?

  • Golgi apparatus

Which organelle is responsible for transport, structural support, and movement?

  • Microtubules and filaments

What happens during the translating phase of protein synthesis?

  • tRNA attaches to amino acids, mRNA directs ribosome to synthesize proteins

Which type of RNA is used in the COVID19 vaccines from Pfizer and Moderna?

  • mRNA

Hypoxia may limit a cell’s ability to generate ATP. What cellular disruption may occur when ATP levels fall?

  • Decreased protein synthesis



Describe the primary level of prevention.

  • Preventing exposure to injury or disease

Describe the secondary level of prevention.

  • Reducing impact and affect

Describe the tertiary level of prevention. 

  • Managing long term illness

What cellular adaptation involves tissue shrinkage?

  • atrophy

What cellular adaptation involves cell enlargement?

  • hypertrophy

What cellular adaptation involves multiplication of cells?

  • hyperplasia

What cellular adaptation involves damaged cells replaced with abnormal cells?

  • metaplasia

What cellular adaptation involves abnormal, disorganized cells?

  • dysplasia

Where is the point of maximal impulse in correlation to the heart?

  • The apex of the heart

What noncancerous condition occurs when the prostate gland cells increase in number due to testosterone stimulation in elderly males?

  • Benign prostatic hyperplasia

Which cellular adaptation is always pathological?

  • metaplasia

Barrett’s Esophagus is caused by what cellular adaptation in the stomach?

  • metaplasia

Endoscopic results reveal metaplastic changes in the duodenum. What describes these cellular changes?

  • Metaplasia, replacement of one cell type by another

What type of neoplasm is well differentiated and doesn’t metastasize?

  • Benign neoplasm

What type of neoplasm is poorly differentiated, messy, out of control, and metastasizes?

  • Malignant neoplasm

What are some causes of cell injury?

  • Physical agents, biologic agents, radiation, nutritional imbalances, chemical, poisoning, drugs, free radical formation

What are some intracellular accumulations that fill up stressed cells?

  • Lipids, glycogen, abnormal proteins, pigments, calcium deposits

What symptoms would you see before the person loses consciousness?

  • Drowsiness, confusion, light or heavy breathing

Endothelial injury caused by the forces of hypertension can initiate development of what disease?

  • atherosclerosis

What chemical binds tightly to hemoglobin, decreasing it’s capacity for oxygen carrying and initiating poor ventilation?

  • Carbon monoxide



What are some conditions that cause pathological calcifications?

  • Arteriosclerosis, aortic sclerosis, microcalcification in breast lesion

What is necrosis?

  • Tissue death

What is apoptosis?

  • Programmed cell death

What is ischemia?

  • Inadequate blood supply to a body part

What is a free radical?

  • Uncharged molecule having an unpaired valence electron

What is coagulative necrotic cell death?

  • Firm and opaque

What is liquefactive necrotic cell death?

  • Walled off, liquid goo

What is caseous necrotic cell death?

  • Cased off, cheese globules

What is fatty necrotic cell death?

  • Opaque, chalky, soapy

What are the different types of gangrene?

  • Wet (coagulative), dry (liquefactive), and gas 

What is a gangrene?

  • A mass of tissue necrosis

What is a gangrene caused by?

  • Lack of blood supply, tissue death

What are the steps of carcinogenesis?

  • Initiation, promotion, progression

What is simple diffusion?

  • Diffusion across a concentration gradient without energy

What is facilitated diffusion?

  • Diffusion across a membrane with a carrier protein

What is active transport?

  • Transport across a membrane using a protein pump

What is vesicular transport?

  • Movement across a membrane using a vesicle

What is osmosis?

  • Movement of water from high to low concentration

What are the stages of mitosis?

  • Prophase, metaphase, anaphase, telophase

What is meiosis?

  • Sexual reproduction

What areas of the body contain smooth muscle?

  • Digestive tract, blood vessels, bladder, uterus, airways

Why is smooth muscle important?

  • Helps body maintain homeostasis



Compare general adaptation syndrome to local adaptation syndrome.

  • Full body reaction versus a localized/minimized response

What stage does fight or flight occur in the stress response?

  • Alarm stage

Which substances are released by the adrenal medulla during the stress response?

  • Epinephrine, norepinephrine, cortisol, beta endorphins

How do sympathomimetics affect the body?

  • Increase heart rate, force cardiac contraction, elevate blood presure

What does cortisol do?

  • Regulation of body’s stress response

Why are endorphins released during times of stress or exercise?

  • Body’s natural pain reliever

What happens if the body fails to adapt?

  • Body will begin to shut down in exhaustion stage

What is the purpose of the major histocompatibility complex?

  • To distinguish self cells versus antigens from an invader

What is passive acquired adaptive immunity?

  • Injection of premanufactured immunoglobulins, short term

What is an example of passive acquired adaptive immunity?

  • Hepatitis B immunoglobulin

Compare B lymphocytes to T lymphocytes.

  • B is humoral, T is cell-mediated

How does immunocompetence develop?

  • Diet, aging, exposure to disease or medication

How are T cells involved in immunocompetence and at what stage of life?

  • Memory cells to fight off infections starting in childhood

Where do B lymphocytes mature?

  • Plasma cells

What are CD4+ cells?

  • T helper cells

What are CD4+ cells’ role in the immune system?

  • Involved in cell-mediated and antibody-mediated immunity, influencing all other cells of the immune system

What are CD8 cells?

  • Cytotoxic T cells

What are CD8 cells’ role in the immune system?

  • Directly attacks antigens

What are antigen presenting cells? 

  • Training cells to build up adaptive immunity



Why are antigen presenting cells essential in cell-mediated immunity?

  • Allows T cells to react and recognize

How can active acquired adaptive immunity be achieved without contracting an infectious disease?

  • Immunization 

What is meant by the term “humoral” immunity?

  • Antibody based immunity

Which blood type is the universal donor?

  • O-

Which blood type is the universal recipient?

  • AB+

What is maternal/fetal hemolytic disease?

  • Mother’s blood incompatible with fetus blood

What is autoimmunity?

  • Body forms antibodies against itself, causing organ dysfunction

What is the key difference between autoimmunity and what happens in HIV?

  • Autoimmunity attacks healthy cells, HIV attacks white blood cells, weakening immune system

What is the alarm stage of the stress response?

  • Hormonal changes, fight or flight

What is the resistance stage of the stress response?

  • Coping and adapting to stressor

What is the exhaustion stage of the stress response?

  • Unsuccessful coping and adapting

What do overactive immune systems cause?

  • Autoimmune disease, allergies, hypersensitivity reactions

What is innate immunity?

  • Natural resistance born with, secondary

What is adaptive immunity?

  • Developed after exposure to antigens, tertiary

What is the primary line of defense?

  • Physical barriers, coughing, sneezing, vomit, diarrhea

What is the secondary line of defense?

  • Innate immunity, natural cellular immunity

What is the tertiary line of defense?

  • Adaptive immunity, acquired cellular and antibody immunity

What is an antigen?

  • Elicits an immune response, recognized by body as foreign

What is the only immunoglobulin that crosses the placenta and responsible for the secondary immune response?

  • IgG

What is the immunoglobulin found in tears, saliva, and breast milk?

  • IgA

What is the immunoglobulin responsible for the primary immune response, and the largest responder?

  • IgM

What immunoglobulin causes symptoms of allergic reaction, involved with eosinophils?

  • IgE

What immunoglobulin is found in skin, and digestive + respiratory tracts, binding with basophils in hypersensitivity reactions?

  • IgD

Which immunoglobulins are involved in a type 1 hypersensitivity reaction?

  • IgE

What is a type 1 hypersensitivity reaction?

  • Immediate hypersensitivity, hay fever

Which immunoglobulins are involved in a type 2 hypersensitivity reaction?

  • IgG, IgM

What is a type 2 hypersensitivity reaction?

  • Cytotoxic hypersensitivity

Which immunoglobulins are involved in a type 3 hypersensitivity reaction?

  • IgG, IgM

What is a type 3 hypersensitivity reaction?

  • Immune complex deposition

What is a type 4 hypersensitivity reaction?

  • Delayed allergic reaction

What is the underlying physiology of rheumatoid arthritis?

  • Body develops antibodies against joint tissues

What are the clinical manifestations of rheumatoid arthritis?

  • Tender, symmetrical, swollen joints, fatigue, fever, malaise

What is the underlying physiology of scleroderma?

  • Immune complexes deposit in skin and connective tissues

What are the clinical manifestations of scleroderma?

  • Skin looks stretched and tight, no wrinkles

What causes myasthenia gravis?

  • Antibodies develop against acetylcholine receptors in muscles

What is the underlying physiology of myasthenia gravis?

  • ACH receptors degenerate

What are the clinical manifestations of myasthenia gravis?

  • Weakening muscle movement

What are the clinical manifestations of raynaud’s?

  • Tricolor change in fingertips from the cold

What are the clinical manifestations of Systemic Lupus Erythematosus?

  • Skin rash, joint inflammation, kidney and lung damage, butterfly rash

What causes HIV?

  • retrovirus

What is the underlying physiology of HIV?

  • HIV attacks CD4 cells and macrophages, debilitating body immune systems

What are the clinical manifestations of HIV?

  • Flu like syndrome

How do we treat HIV?

  • HAART, PrEP to prevent HIV




What is bone marrow’s role in hematology?

  • Produces all the different cells

What is the kidney’s role in hematology?

  • Excretes erythropoietin when hypoxia detected

What is the liver’s role in hematology?

  • Prevents excessive bleeding, stores extra iron

What is the spleen’s role in hematology?

  • Destroys old/abnormal RBCs, breaks down hemoglobin, stores platelets

What does a high reticulocyte count indicate?

  • Bone marrow is working hard to keep up with RBC loss

What is the lab test where blood is examined in a smear and counted?

  • Complete blood count

What is the normal range of a CBC for women?

  • 3.6-5.0 million

What is the normal range of a CBC for men?

  • 4.2-5.4 million

What is the normal range of a WBC count?

  • 5,000-10,000 mm3

What is the normal range of platelets?

  • 90,000-450,000 mm3

What is the percentage of RBCs to total blood volume?

  • hematocrit

What is the normal percentage range of hematocrit for women?

  • 37-47%

What is the normal percentage range of hematocrit for men?

  • 40-50%

What is the normal range of hemoglobin for women?

  • 12-15 g/dL

What is the normal range of hemoglobin for men?

  • 14-16.5 g/dL

What are the anemias from decreased production of red blood cells?

  • Iron deficiency, vitamin B12 deficiency, aplastic anemias

What are the anemias from increased destruction of red blood cells?

  • Sickle cell anemia

What mineral is necessary for hemoglobin production?

  • iron

Which anemia is caused by decreased iron consumption, absorption, increased bleeding, and causes microcytic RBCs?

  • Iron deficiency anemia

What are the clinical manifestations of iron deficiency anemia?

  • Cyanosis in sclera, brittle nails, anorexia, headache, irritability, stomatitis, pica, fatigue

How do you treat iron deficiency anemia?

  • Treat the cause, diet, supplementation

What is another saying for vitamin B12 deficiency anemia?

  • Pernicious anemia

Which anemia causes macrocytic RBCs?

  • Vitamin B12 deficiency anemia

Which anemia allows failure to activate the enzyme moving folic acid so cell division and growth can occur?

  • Vitamin B12 deficiency anemia

What are the clinical manifestations of vitamin B12 deficiency anemia?

  • Pallor, jaundice, beefy tongue, paresthesia, loss of deep tendon reflexes, anorexia

How do you treat vitamin B12 deficiency anemia?

  • Diet, supplementation

Which anemia involves bone marrow depression of all blood cells?

  • Aplastic anemia

What are potential causes of aplastic anemia?

  • Autoimmune, medication, viruses, genes

What are the clinical manifestations of aplastic anemia?

  • Fatigue, pallor, dyspnea, leukocytopenia, thrombocytopenia

How do you treat aplastic anemia?

  • Blood transfusions, bone marrow transplant

What chains are abnormal and “sickle” when stressed with sickle cell disease?

  • Hemoglobin 

When do sickled cells go back to their normal shape?

  • When the stressor is removed

Compare sickle cell trait versus sickle cell disease.

  • Sickle cell trait some cells are sickled, sickle cell disease all cells are sickled

What type of genetic disorder is sickle cell disease?

  • Autosomal recessive

What are some stressors of sickle cell crisis?

  • Hypoxia, dehydration, infection, pregnancy, high altitude, abnormal temps, strenuous exercise, stress, anesthesia

What are the clinical manifestations of sickle cell crisis?

  • Severe pain, dyspnea, tachycardia, angina, fatigue, jaundice, pallor, priapism

How do you treat a sickle cell crisis?

  • Pain management, remove the stressor/trigger

What type of genetic disorder is thalassemia?

  • Autosomal dominant

What disorder pertains to abnormal hemoglobin from a lack of one of two proteins that make up hemoglobin?

  • thalassemia

What are the clinical manifestations of thalassemia?

  • Miscarriage, delayed growth, bone deformities, fatigue, jaundice, splenomegaly, heart failure

What disease pertains to a rare and life threatening high amount of erythrocytes?

  • Polycythemia vera

What are the clinical manifestations of polycythemia vera?

  • Flushed reddish facial skin, itching, hypertension, tachycardia, thrombosis, hyperkalemia, headaches

How do we treat polycythemia vera?

  • Phlebotomy with apheresis, hydration, anticoagulants, chemo, radiation

What disease is defined by decreased levels of WBCs below 5000?

  • leukocytopenia

What disease is defined by decreased levels of neutrophils under 500? 

  • neutropenia

What are the causes of neutropenia

  • Drug suppression, radiation, congenital conditions, bone marrow cancer, spleen destruction

What are the clinical manifestations of leukocytopenia and neutropenia?

  • Infections and ulcerations

What disease is also known as mono?

  • Infectious mononucleosis 

What virus is mono caused by?

  • Epstein barr virus from the herpes family

How is mono spread?

  • saliva

What is the timeline of infectious mononucleosis?

  • Incubation 4-8 weeks, illness 2-3 weeks, full recovery after 2-3 months

What is cancer of leukocytes?

  • Leukemia 

What type of leukemia affects children, responds well to chemo, and has a good prognosis?

  • Acute lymphoid leukemia

What type of leukemia affects adults, responds fairly well to chemo, and has a worse than ALL prognosis?

  • Acute myeloid leukemia

What type of leukemia affects adults, responds poorly to chemo, and most live many years after a diagnosis?

  • Chronic lymphoid leukemia 

What type of leukemia affects adults, responds poorly to chemo, and has a poor prognosis?

  • Chronic myeloid leukemia

What are some clinical manifestations of leukemia?

  • Pancytopenia, weight loss, pain, shortness of breath, weakness, fatigue, swollen lymph nodes, easy bleeding

How do we diagnose leukemia?

  • Bone marrow biopsy

How do we treat leukemia?

  • Chemotherapy, hematopoietic stem cell transplant

What are the tumors present in hodgkin’s lymphoma?

  • Reed steinberg cells

Which lymphoma is more common?

  • Non-hodgkins lymphoma

Where do the tumors originate in hodgkin’s lymphoma?

  • Upper body lymph nodes

Does hodgkin’s lymphoma spread predictably or unpredictably?

  • Predictably 

What are the clinical manifestations of hodgkin’s lymphoma?

  • Fever, night sweats, weight loss, large painless lymph nodes, painful lymph nodes after alcohol consumption

What cancer does not include reed-sternberg cells?

  • Non-hodgkin’s lymphoma 

Which lymphoma has a better prognosis?

  • Hodgkin’s lymphoma

What are the expected causes of non-hodgkin’s lymphoma?

  • H. pylori, epstein barr virus

What type of cancer is multiple myeloma?

  • Plasma cell cancer

What are the clinical manifestations of multiple myeloma?

  • Often no symptoms, elevation of serum total protein, bone pain, decreased bone density, hypercalcemia

How do you treat multiple myeloma?

  • Watchful waiting, chemotherapy, stem cell transplant

What is abnormal hemostasis?

  • Inappropriate clotting, insufficient clotting

What is normal hemostasis?

  • Prevention of blood loss



What are the stages of hemostasis?

  • Vessel spasm, platelet plug, blood coagulation, clot retraction, clot dissolution

What is the cause of idiopathic thrombocytopenia purpura?

  • No cause

What are the clinical manifestations of idiopathic thrombocytopenia purpura?

  • Large ecchymoses, peechiae, purpura, mucosal bleeding, anemia, hemorrhage

How do we diagnose idiopathic thrombocytopenia purpura?

  • Low platelet count and increased megakaryocytes

How do we treat idiopathic thrombocytopenia purpura?

  • Drug therapy, platelet transfusions, splenectomy

What is the patient with thrombotic thrombocytopenia purpura deficient in?

  • Enzyme necessary to cleave vWF

What are the clinical manifestations of thrombotic thrombocytopenia purpura?

  • Failure to clot, fever, renal failure, transient neurologic abnormalities

What are the complications of thrombotic thrombocytopenia purpura?

  • Kidney failure, stroke, myocardial infarction

What causes thrombotic thrombocytopenia purpura?

  • Idiopathic, hereditary, bone marrow transplant, cancer, medications, pregnancy, HIV

How do you treat thrombotic thrombocytopenia purpura?

  • Plasma removal, infusion of fresh frozen plasma, drug therapy

What is the difference between Hemophilia A and B?

  • A: deficiency of factor VIII, B: deficiency of factor IX

What type of genetic disorder is hemophilia?

  • X linked recessive

What are the clinical manifestations of hemophilia?

  • Excessive bleeding, joint + muscle hemorrhages, easy bruising, prolonged hemorrhage post-surgery

How do you treat hemophilia?

  • Synthetic form of factor VIII (A), blood transfusions

What is the most common hereditary bleeding disorder?

  • Von willebrand disease

What disease has decreased platelet adhesion and aggregation?

  • Von willebrand disease

How do you treat von willebrand disease?

  • Bleeding precautions, control bleeding, fresh frozen platelets

What causes disseminated intravascular coagulation?

  • Sepsis, foreign body, emboli from placenta or amniotic fluid, hepatitis, pancreatitis, blood transfusion reaction, cancer

What are the clinical manifestations of disseminated intravascular coagulation?

  • Clotting, hemorrhage, bleeding, pain, CVA

How do you treat disseminated intravascular coagulation?

  • Prevention (high mortality), anticoagulant then clotting factors, blood transfusions

How are erythrocytes produced?

  • Bone marrow

What are the functions of erythrocytes in the body?

  • Oxygen transport

What is the lifespan of red blood cells?

  • 120 days

What is it called when a red blood cell count is higher than normal?

  • erythrocytosis

What organ produces erythropoietin?

  • kidney

What hormone stimulates the production of red blood cells from the bone marrow?

  • Erythropoietin 

What is the stimulus for release of erythropoietin and then the release of reticulocytes?

  • hypoxia

Most coagulation factors are proteins synthesized in the…

  • liver

What is the process resulting in the conversion of plasminogen into fibrin?

  • fibrinolysis

What is Disseminated Intravascular Coagulation?

  • Widespread coagulation followed by massive bleeding, inappropriate immune response

Do people with hemophilia require transfusions of clotting factors?

  • yes

Do the intrinsic and extrinsic clotting pathways result in two different types of clots?

  • no

Is the liver responsible for the production of the majority of clotting factors?

  • yes

Do clots have to be dissolved in a timely fashion to ensure appropriate hemostasis?

  • yes

Does thrombocytopenia predispose an individual to inappropriate bleeding?

  • yes

Which vitamin is most closely associated with the physiology of hemostasis?

  • Vitamin K

Platelet plug formation involves adhesion and what else of platelets?

  • Activation, aggregation

What is the term used to describe the state of exaggerated hemostasis that predisposes individuals to thrombosis and blood vessel occlusion?

  • Hypercoagulable state

What is the organ most closely associated with platelet storage and destruction? 

  • spleen

What drug is most closely associated with inhibition of platelet aggregation?

  • asprin

Is sickle cell disease an acquired defect of red blood cell production?

  • no

Where does erythropoiesis occur?

  • Bone marrow

When does the hemoglobin levels of neonates increase during birth?

  • Immediately after birth

Do pregnant women need increased iron intake to prevent anemia?

  • yes

What is the laboratory test that measures the volume of red blood cells in 100 mL of blood?

  • hematocrit

What type of anemia affects not only red blood cell production but also that of platelets and white blood cells?

  • Aplastic anemia

The plus or minus suffix of an individual’s blood type refers to the presence of absence of which antigen?

  • Rh

Neonates often experience high serum levels of what after birth and require more phototherapy?

  • bilirubin




What does it look like when someone is having an asthma attack?

  • Prolonged expiration, accessory muscle use, distant breath sounds, diaphoresis, rhonchi if upper airways involved

What areas facilitate oxygen diffusion?

  • Alveoli 

What are the anatomical structures of the upper airways?

  • Nasal cavity, nasopharynx, oropharynx

What are the anatomical structures of the lower airways?

  • Larynx, epiglottis, glottis, trachea, bronchus, bronchioles, alveoli

How is pneumonia acquired from the community?

  • S. pneumoniae, influenza with secondary infection

How is pneumonia acquired within a hospital?

  • Enterobacteria, pseudomonas, s. Aureas, after 48 hours of admission

Which lobe has the highest risk for aspiration?

  • Right middle lobe

How many lobes are on each side of the lungs?

  • 3 right, 2 left

How does gas exchange work?

  • Take in oxygen, remove carbon dioxide

What do the lungs protect against?

  • Microbes, temperature, dryness

What are some other functions of the lungs?

  • Angiotensin conversion, blood reservoir, inactivate vasoactive enzymes

What are the functions of the upper airways?

  • Blood warms air, mucus membranes moistens, cilia hairs filter air

What are the functions of the lower airways?

  • Speech, protection, support, breathing, gas exchange

What is the series of hyaline cartilage rings to prevent collapse during negative thoracic pressure?

  • Trachea 

What is the order of bronchi?

  • Primary, secondary, bronchi, bronchioles, alveoli

Is there normal flora in the lower respiratory structures?

  • No 

What happens in the alveoli?

  • Gas exchange

How does the diaphragm aid in respiration?

  • Contraction for ventilation

How do the accessory muscles aid in respiration?

  • Retraction and contractions for ventilation, labored breathing

When is an intubated patient eventually switched to a trach?

  • 14-21 days

What is the difference between the visceral and parietal pleura?

  • Visceral on lungs, parietal on thoracic wall

What fluid does the pleural cavity contain?

  • Serous fluid

What does ACE convert? What does it control?

  • Angiotensin 1 to 2, blood pressure

How does the sympathetic nervous system work in respiration?

  • Bronchodilation, blood vessel constriction

How does the parasympathetic nervous system work in respiration?

  • Airway constriction, blood vessel dilation

Are there any pain receptors in the lungs? Where?

  • Pleura

What is ventilation?

  • The act of breathing

What is perfusion?

  • Movement of blood through pulmonary circulation

What is intrapulmonary pressure?

  • Pressure in the airways and alveoli

What is atmospheric pressure?

  • Pressure outside the pleural cavity

What is intrapleural pressure?

  • Always negative in relation to alveolar pressure

What is intrathoracic pressure?

  • Pressure in thorax

What is compliance?

  • Able to inflate, stretch, and return to original position

What is the impact of bedrest on respiration?

  • Supine position prohibits full ventilation and lung expansion

What factors affect diffusion?

  • Difference in pressure, surface area available, thickness of alveoli wall

What is the ventilation to perfusion ratio?

  • Ratio of amount of air reaching alveoli to amount of blood reaching alveoli

Does gravity affect lung pressure or lung compliance?

  • No 

What is dyspnea?

  • Difficulty breahing

What is hemoptysis?

  • Coughing up blood

What is hypoxia?

  • Low oxygen in tissue

What is hypoxemia?

  • Low oxygen in blood under 90%

What is hypercapnia?

  • High CO2 in tissue over 45 mmHg

What are the early signs of hypoxia?

  • Symptoms of restlessness, Tachycardia, Respirations increased, Elevated blood pressure, Skin and mucous membranes pale, Sounds in lungs (adventitious)

What are the late signs of hypoxia?

  • Confusion and stupid, Respirations decreased, Arrhythmias, Skin and mucous membranes cyanotic, Heart rate decreased, hypotension

What disease affects nasal passages and the pharynx?

  • Rhinitis 

What disease affects maxillary and frontal sinuses?

  • Sinusitis 

What disease affects the larynx and trachea in kids?

  • Croup 

What causes acute bronchitis?

  • Bacteria, virus, toxins

What are the clinical manifestations of acute bronchitis?

  • Frequent cough, pleuritic chest pain, fever, malaise, sputum production, rhonchi

What is aspiration pneumonia?

  • Breathing in anything but air

What disease entails the inflammation of parenchymal structures of the lungs? (alveoli and bronchioles)

  • pneumonia

What is the difference between typical and atypical pneumonia?

  • Typical has consolidation of alveoli, no consolidation in atypical

What are the clinical manifestations of pneumonia?

  • Cough, hypoxemia, hypercapnia, pleuritic pain, diminished breath sounds, dyspnea, exercise intolerance, dullness with percussion, increased fremitus

How do we diagnose pneumonia? 

  • Chest xray, CBC with diff, ABG, pulse ox, sputum culture

What is the disease with intermittent and reversible airway obstruction, with hyperactive airways?

  • asthma

What are extrinsic causes of asthma?

  • Hypersensitivity reaction to outside antigen

What are intrinsic causes of asthma?

  • Without allergy, exercise, emotions, smoking, asprin

How do we diagnose asthma?

  • History, physical, pulmonary function test

What are the clinical manifestations of asthma?

  • Wheezing, cough, dyspnea, chest tightness

What is chronic bronchitis?

  • Obstruction of small airways, blue bloater

What is emphysema?

  • Enlargement of air spaces, pink puffer

What is the most common cause of COPD?

  • Smoking 

What are the clinical manifestations of COPD?

  • Dyspnea, cough, sputum, adventitious breath sounds, hypoxia, cyanosis, fatigue, barrel chest, clubbing, purse lipped breathing, hyperresonance

What are the exacerbations of COPD?

  • Tripod position, accessory muscle use, increased cough, increased sputum, worsened dyspnea, increased infections

What is cystic fibrosis?

  • Genetic disorder affecting the mucus producing glands

What is a spontaneous pneumothorax?

  • Primary or secondary, rupture bleb on surface of lung

What is a pneumothorax?

  • Presence of air in the pleural space

What is a traumatic pneumothorax?

  • Penetrating or blunt force trauma, air able to escape



What is a tension pneumothorax?

  • Intrapleural pressure exceeds atmospheric pressure, trauma, air trapped, medical emergency

What is an iatrogenic pneumothorax?

  • Complication of a medical procedure

How do we diagnose a pneumothorax?

  • History, physical, chest xray, ABG

What are the clinical manifestations of a pneumothorax?

  • Chest pain, tachypnea, asymmetrical movement, retractions, hyperresonance, whistling

What is atelectasis?

  • Incomplete expansion of a lung

Compare primary versus acquired atelectasis.

  • Primary when newborn, acquired in adults from an airway obstruction

What are the clinical manifestations of atelectasis?

  • Tachypnea, dyspnea, tachycardia, cyanosis, intercostal retractions, diminished or absent breath sounds on affected area

What is a pulmonary embolism?

  • Emboli that lodges in branch of pulmonary artery

Where do most pulmonary emboli come from?

  • Deep vein thrombosis

How do we diagnose a pulmonary embolus?

  • VQ scan, D-dimer testing, chest CT, pulmonary angiography

What are the clinical manifestations for a small pulmonary embolism?

  • asymptomatic

What are the clinical manifestations for a medium pulmonary embolism?

  • Breathlessness, pleuritic pain, anxiety, fever, cough with blood

What are the clinical manifestations for a large pulmonary embolism?

  • Sudden collapse, crushing pain, shock, loss of consciousness, hypoxia, cyanosis, hypotension

What is pulmonary hypertension?

  • Abnormal elevation of pressure within the pulmonary arterial system

What triggers pulmonary hypertension?

  • Chronic hypoxia

How do you diagnose pulmonary hypertension?

  • Chest xray, echo, ultrasound, right cardiac catheterization, PFT, chest CT

What are the clinical manifestations of pulmonary hypertension?

  • Shortness of breath, syncope, decrease exercise tolerance, right heart failure