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PATHO FINAL EXAM REVIEW

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PATHO FINAL EXAM REVIEW
EXAM 1
Causes of Disease
-
Idiopathic - Arises spontaneously and cause is unknown
Iatrogenic - Caused by medical examination or treatment.
Predisposing factors
Prophylaxis - Measures we take to try to prevent disease from happening
- Ex. Vaccines; baby aspirin every day
Adults - 60% water
Infants - 70% water
Dehydration
- v Skin Turgor - v saliva, dry nose + lips
- Sunken eyes
- Sunken fontanelles (infant)
- v BP, weak pulse, ^ HR
- ^ hematocrit
- Lethargy
- Kidneys - v urine output
Compensation: THIRD-SPACING - fluid shifts from blood to body cavity/tissue (^OP+cap perm)
Sodium (135-145)
-
Elderly have TOO MUCH usually
Moves fluid between IVF + IC
-
Hyponatremia
Loss of fluid into CELLS
Causes
- ^ Cell size
- Fluid loss
- diuretics + low
salt diets
- Hormonal
imbalances
- Excessive water
intake
Effects
- fatigue
- muscle cramps
- abdominal pain
- v OP
- cerebral edema
(^ICF in brain)
- v BP
-
Hypernatremia
Loss of fluid due to EDEMA
Causes
- v cell size
- v ADH + aldosterone
- watery diarrhea
- prolonged periods of
rapid respiration
- ingestion of large
amounts of Na+
Effects
S kin flushed
A gitation
L ow grade fever
T hirst
Chloride
-
Goes with Na+
Bicarb lvls can shift in response to acid base imbalances
-
Hypochloremia
Alkalosis
vomiting
-
Hyperchloremia
Excessive NaCl intake
Potassium (3.5-5)
-
Cation in ICF
Influence acid-base
Hypokalemia
Causes
- excessive diarrhea
- diuretics
- aldosterone/
glucocorticoids
(cushing)
Hyperkalemia
Effects
S skeletal muscle weakening
U wave on EKG
C onstipation / ilias
T oxic effects of digoxin
I rregular / weak pulse
O rthostatic hypotention
N umbness
Causes
- Renal Failure
- K+ sparing drugs
(Spirlacone)
- K+ in ICF leaking
into ECF
- severe acidosis
Effects
- cardiac
dysrythmias
- muscle
weakness
- fatigue, nausea,
parestesia
- impares
neuromuscular
activity
Calcium
-
Vit D needed for Ca+ absorption
Strengthens bones + teeth
Blood clotting
Hypocalcemia
Causes
- hypoparathyroidism
- ^ serum pH
- Renal failure
- Lack of Vit D
Effects
- ^ permeability of
nerve
membranes
- muscle
twitching
- tetany
- weak heart
contractions
Hypercalcemia
Causes
H yperparathyroidism
A ntacids (tums)
M malignant tumors
* Milk-alkali
syndrome
Effects
- depressed
neuromuscular activity
- muscle weakness,
loss of muscle tone
- anorexia, nausea
- v urination
- stronger cardiac
contractions
(dysrhythmias)
Phosphate
-
Inverse relationship w/ Ca+
Hypophosphatemia
Causes
- Metabolism
- Diarrhea
- Excessive
antacids
Hyperphosphatemia
Effects
- bone pain
- stiff joints
- v appetite
- weakness/fatigue
Causes
- Renal failure
Effects
- anxiety
- bone pain
- irregular
breathing
- numbness
Magnesium
-
Regulates neuromuscular function
Regulates blood sugar lvls
Hypomagnesemia
S eizures
T etany
A norexia + Arrhythmias
R apid HR
V omiting
E motions
D ecreased DTR
Normal pH - 7.35-7.45
Normal CO2 - 35-4resp5
Hypermagnesemia
R eflex loss
E KG changes (bradycardia + v BP)
N ausea / vomiting
A ppears flushed
L ethargy
Normal Bicarb - 22-26
Respiratory Acidosis
-
Caused by hypoventilation, excessive alcohol, + lung issues
(Anything that v breathing)
Effects - neurological changes, hyperkalemia, cardiac arrhythmias, ^ urination,
v BP, ^HR, v muscle tone, restlessness, papillary edema, warm skin
Kidneys compensate → absorb bicarb back into blood + excrete H in urine
Respiratory Alkalosis
-
Caused by hyperventilation, anxiety, anemia, pain, fever, sepsis
(Anything that ^ breathing)
Effects - lightheadedness, dizziness/fainting, ^HR, hypokalemia, cardiac arrhythmias
Kidneys compensate → retain H + excrete bicarb
Metabolic Acidosis
-
Caused by DKA, malnutrition, lactic acidosis, shock, kidney/GI illness
Effects - hyperkalemia, cardiac arrhythmias, ^RR (Kussmaul breathing),
headache, v LOC, coma, muscle twitching/burning, flaccid paralysis
Lungs compensate → ^RR to get rid of CO2
Metabolic Alkalosis
-
Caused by vomiting, diuretics
Effects - hypokalemia, cardiac arrhythmias, vRR, tetany, tightening of
muscles, mental status changes, seizures
Lungs compensate → vRR to retain CO2
EXAM 2
Hormones
Growth hormone → anterior pituitary → protein synthesis
ACTH → anterior pituitary → stimulates adrenal cortex to secrete cortisol
TSH → anterior pituitary → stimulates thyroid gland
T3 + T4 → thyroid gland → ^ metabolic rate in all cells
PTH → parathyroid gland → ^ Ca+ absorption + stimulates bone demineralization
Calcitonin → thyroid gland → v release of Ca+ from bone to v Ca+ lvl
FSH → anterior pituitary → Women: growth of ovarian follicles + estrogen secretion
Men: sperm production
LH → anterior pituitary → Women: maturation of ovum + ovulation
Men: secretion of testosterone
Prolactin → anterior pituitary → breast milk production
ADH → posterior pituitary → reabsorption of water by kidneys
Aldosterone → adrenal cortex → Na + water reabsorption by kidneys
Glucagon → pancreas (alpha cells) → ^ blood glucose lvl
Insulin → pancreas (beta cells) → v blood glucose lvl by transporting into cells
Epinephrine → adrenal medulla → visceral + cutaneous vasoconstriction (^HR, ^RR)
Norepinephrine → adrenal medulla → general vasoconstriction
Erythropoietin → kidneys → RBC production
***Negative Feedback System***
Hypoparathyroidism
-
-
Hypocalcemia
- Weak pulse
- Excitability of nerves
Caused by
- Tumor
- Autoimmune disease
- Surgery of gland
Hyperparathyroidism
-
-
Hypercalcemia
- Strong pulse
- Osteoporosis
- Kidney stones
Caused by
- Tumor
- Renal failure
-
Cushing
-
Paraneoplastic syndrome
Addisons
TOO MUCH corticosteroids
^ risk of infection
Weight GAIN (moon face)
Thin limbs + hair
Striae, bruising
Fatigue, weakness, delayed healing
-
DEFICIT of corticosteroids
^ risk of infection
Weight LOSS
Fatigue
Nausea, anorexia, diarrhea
Diabetes Mellitus
-
Cells are STARVED of glucose
-
Body starts to break down other sources of farbs, protein, and fat to get energy →
KETABOLISM
→ Releases biproducts - ketones - in blood → Diabetic Ketoacidosis
→ ^ K+
→ ^ peeing
Type 1 Diabetes
-
Destruction of beta cells in pancreas
Body cannot produce insulin
NOT linked to obesity
Ppl tend to be thin + loose weight bc of fat breakdown (KETABOLISM)
Diabetic Ketoacidosis → Dehydration, rapid deep resp,
metabolic acidosis, electrolyte imbalances
(cramps, nausea, vomiting, lethargy, weakness)
Type 2 Diabetes
-
Body can produce insulin, it just cannot
Not insulin dependant - LIMIT AMOUNT OF GLUCOSE (start patient on pills)
LINKED TO OBESITY
GENETICS
Onset slow and insidious (usually 50+ yrs)
Pancreas is overworked over time and grows tired
-
REMEMBER 3 P’S → Polyphasia, Polydipsia, Polyuria
*Diagnostic tests – Hemoglobin A1C <7 = well managed.*
*REMEMBER: INFECTIONS = ^ GLUCOSE*
Hypoglycemia
-
Insulin shock
Glucose deficit
Hyperglycemia
-
Too much glucose in blood
Chronic Complications of Diabetes
-
Vascular problems (PVS)
-
Microangiopathy (changes in microcirculation - clotting of platelets → heart disease)
-
Peripheral neuropathy
Infections
Cataracts
Pregnancy (genetics)
Goiter
-
Enlargement of thyroid gland (both hypo + hyperthyroidism)
Hypothyroidism
-
Iodine defecit
Hashimoto’s disease
Pale, cool, w/ edema
Cold intolerance
vHR
Weight GAIN
Lethargic, slow
Hyperthyroidism
-
Graves Disease
Flushed and warm
Heat intolerance
^HR
Weight LOSS (^ appetite)
Exophthalmos
Restless, nervous, tremors
Skin Disorders
Psoriasis
→ autoimmune - abnormal T-cell activation
→ chronic inflammation - glucocorticoids
-
Silvery-gray plaques
Itchy + burning lesions on face, scalp, elbows, knees
Scleroderma
→ collagen deposition
-
Inflammation + Fibrosis
Hard, shiny, tight, immobile areas
MAY CAUSE RENAL FAILURE, intestinal obstruction, + resp failure
Pemphigus
→ autoimmune
→ antibodies disrupt cohesion between epidermal cells
-
Mucosa - scaley
Blisters (bullae), skin sheds
Urticaria
→ Hives
→ Type 1 Hypersensitivity reaction
-
anaphylaxis
Atopic dermatitis
→ Eczema
-
Common in infants → rash w/ serous exudate on face, chest, shoulders
-
Adults → dry, scaly + pruritic on flexor surfaces (elbows)
-
Chronic inflammation - IgE lvls
Contact dermatitis
→ Type 4 Hypersensitivity reaction (delayed reaction)
-
Ex. poison ivy, soaps/creams
Cellulitis
→ Bacterial Infection
-
Erysipelas
Red, swollen, painful
Red streaks along lymph vessels
Furuncles (bolis)
→ Bacterial Infection
→ infection of hair follicles
-
Carbuncles - collections
Impetigo
→ Bacterial Infection
-
Orange brown lesions on face
Acute Necrotizing Fasciitis
→ Bacterial Infection
-
Inflammation and tissue necrosis
Fever, ^HR, vBP, confusion, organ failure
Verrucae
→ viral Infection
→ warts
-
Spreads by shedding of skin surface
Genital warts - HPV types 6+11
Herpes Simplex
→ HSV-1 - cold sores or fever blisters
→ HSV-2 - genetal herpes
-
Complications: Keratitis (eyes), Herpetic whitlow (fingers)
Urinary Disorders
UTIs
Causes → E.coli incontinence, retention
Symptoms → dysuria, flank pain, urgency, nocturia hematuria, proteinuria, ^ leukocytes in urine,
fever, malaise, nausea
Upper UTIs
→ pyelonephritis
-
Inflammation of kidneys
Purulent exudate blocks urine flow
Lower UTIs
→ cystitis
-
Inflammation of bladder wall + urethra
Urine cloudy w/ odor
→ urethritis
-
Inflammation of urethra
Glomerulonephritis
→ Inflammation of glomeruli
-
Capillary permeability = leakage of protein + erythrocytes
Congestion + cell proliferation = v GFR , ^BP
Urine dark + cloudy
Nephrotic Syndrome
→ ^ permeability of glomerular capillaries → plasma proteins escape into filtrate
-
v GFR , vBP
MASSIVE EDEMA
Protein, lipids, casts in urine
Urolithiasis
→ stones - calculi formation - obstruct ureters
→ anywhere in urinary tract
-
Hydronephrosis w/ dilation of calyces
Atrophy of renal tissue
-
Hyperuricemia
Acidic urine
Hydronephrosis
→ Caused by Urolithiasis
-
Asymptomatic in early stages
Can cause chronic renal failure
Nephrosclerosis
→ vascular disorder
→ hardening + thickening of arteriole walls + small arteries
-
^BP
Ischemia
Can be lesion in kidney
Polycystic Kidney
→ vascular disorder
→ cysts in kidney
-
Kidneys ^ in size
Compress + destroy kidney tissue
CT scan or MRI
Can cause chronic renal failure
Renal Failure
Acute
→ sudden onset
-
Severe circulatory shock or HF
Bilateral kidney disease
Ischemia
Blocked urine flow beyond kidneys
^ serum urea, nitrogen creatine
Metabolic acidosis
hyperkalemia
Chronic
→ gradual reversal
→ destruction over long period of time
- Chronic kidney disease
Stages:
v Renal reserve
- v GFR
- ^ serum creatinine lvls
Renal insufficiency
- v GFR (20% of normal)
- v erythropoiesis
- ^BP
End-stage
- Negligible GFR
- 3 As - Azotemia, anemia,
acidosis
- Dialysis or kidney transplant
EXAM 3
Cardiovascular Disorders
SA node - pacemaker (sinus rhythm)
AV node
**Slight delay to allow complete ventricular filling.**
Bundle of His
Bundle Branches
Purkinje Fibers
CO - amount of blood that leaves the heart in 1 MINUTE
SV - amount of blood that leaves the heart in 1 CONTRACTION
HR = CO X SV
BP = CO X PR
Preload - AMOUNT of blood filling heart before contraction
Afterload - PRESSURE/force needed to eject blood
Blood Flow of Heart
Body → Vena Cava→ Right Atrium → TRICUSPID VALVE (Lubb sound) → Right
Ventricle → PULMONIC VALVE (Dubb sound) → Pulmonary Artery → Lungs →
Pulmonary Vein → Left Atrium → BICUSPID VALVE (Lubb sound) → Left Ventricle →
AORTIC VALVE (Dubb sound) → Body
***Tricuspid before Bicuspid***
***Aortic before Pulmonic***
Pericarditis
Acute - Inflammation of pericardial sac → fluid build up around heart → heart cannot
expand fully → decreased heart sounds
-
Chest pain and friction rub
-
Pericardial Effusion → jugular vein distention, cardiac tampenod → can lead to HF
Chronic - Inflammation is already present and won’t go down - fibrosis scar tissue
- formation of adhesions between the pericardial membranes
***Often after open heart surgery.***
***Potential for atelectasis (collapsed lung)***
Myocardial Infarction
- indicator of lack of O2
- Serum enzymes and isoenzymes (+ troponin in bloodstream = tissue damage)
***T WAVE WILL BE HIGH IN EKG***
Common if you have DVT
Treatment
- Analgesics
- Anticoagulants (prevent blood clot from getting bigger)
- Thrombolytic agents may be used (takes a long time)
Endocarditis
- Caused by infection of heart valves - common in people w/ artificial heart valves
Acute - sudden onset, high variant + caused by STAPH
Subacute - insidious onset, low variant + caused by STREP
***Similar Symptoms as HF → Low grade fever, anorexia, splenomegaly***
Angina Pectoris
- Lack of O2 to meet metabolic needs
Variant - vasospasm at rest
Classic - chest pain when heart does not get enough oxygen w/ activity
Unstable - chest pain for very long time - is not relieved by rest → may precede MI
***If chest pain does not cease, take a 3rd Nitroglycerin. If that doesn’t work, call 911.***
Rheumatic Fever
-
Untreated strep in children (aged 5-15 yrs)
v
Rheumatic Heart Disease
Myocarditis
-
Inflammation of heart itself
Congestive Heart Failure (CHF)
-
Heart is unable to pump out sufficient blood to meet metabolic demands of the
body.
Right Sided HF
-
Right ventricle leads to lungs → BACKS UP ENTIRE SYSTEM
-
Back up effects in body
- Edema in feet, legs, + abdomen (acidis)
- Distended jugular veins
- Weight gain
- Hepato + Splenomegaly
Left Sided HF
-
Left ventricle leads to body + COMES FROM LUNGS
Back up effects in lungs
- Cough
-
Hemoptysis (blood sputum) + rales → can lead to pneumonia
Cardiac Dysrhythmias (Arrhythmias) - caused by hyper or hypokalemia (K+)
Cardiac Arrest
Cessation of all heart activity
- No conduction of impulses
- Flat ECG
Hypertension
-
Effects brain, eyes, heart, + kidneys
Atherosclerosis
-
Atheromas or Thrombus forms and causes due to plaques blockage
Arteriosclerosis
-
Hardening of artery wall → loss of elasticity
Atrial Stenosis
-
Thickening and narrowing of valves in aorta
Varicose Veins
-
Irregular, dilated, and tortuous areas of the superficial veins
- Leaky valves in veins
Caused by long periods of standing
Elevate legs + don’t cross legs
Thrombophlebitis
-
Thrombus development in inflamed vein (Ex. IV site)
Phlebothrombosis
-
Thrombus forms spontaneously without prior inflammation; attached loosely
Shock
Hypovolemic shock - (bleeding out)
- Loss of circulating blood volume
- Hemorrhage or burns
Cardiogenic shock - MI
- Inability of heart to maintain cardiac output to circulation
Distributive, vasogenic, neurogenic, anaphylactic shock
- Changes in peripheral resistance leading to pooling of blood in the periphery
- Spinal cord injury, hypoglycemia (insulin shock)
Septic
- Virulent organisms
Blood and Lymph
Anemia
-
O2 deficit
- Decreased regeneration of epithelial cells
Common symptoms
- Fatigue
- Pallor
- ^ RR + ^HR
- Peripheral vasoconstriction
- v BP
-
Digestive tract becomes inflamed and ulcerated → stomatitis
-
Inflamed and cracked lips
Dysphasia
Hair and skin may show degenerative changes
Iron Deficiency Anemia
-
LOW Iron in blood → v hemoglobin
Causes
- Low dietary intake OR
- Malabsorption
- Chronic bleeding (hemorrhoids, cancer, ulcer, etc…)
- Heavy periods
- Severe liver disease
Symptoms
- Stomatitis + Glossitis
Pernicious Anemia
-
LOW Vitamin B12 in blood bc of lack of intrinsic factor → v hemoglobin
-
Very large, immature, nucleated erythrocytes → shorter lifespan
Causes
- Genetic factor has been implicated
- Often accompanies chronic gastritis
- May be outcome of gastric surgery
***Vitamin B12 Needed for: RBC formation, neurological function, + DNA synthesis***
Symptoms
- Enlarged, red sore, + shiny tongue
- Digestive discomfort (nausea/diarrhea)
- Tingling limbs (nerves)
Aplastic Anemia
- Impairment of BONE MARROW
Causes
- Hep C
-
Genetic abnormalities → myelodysplastic syndrome
Hemolytic Anemia
- Excessive destruction of RBCs
Causes
- Immune reactions (antigen-antibody reactions)
- Infections (malaria)
- Genetic defects
Sickle Cell Anemia
-
BROKEN hemoglobin changes shape of RBC
- Sickle-shaped cells are too large to pass through circulation
- Causes multiple infections
- Genetic condition - homozygous recessive
- 1/10 African Americans have heterozygous trait
Symptoms
- Hyperbilirubinemia, jaundice, gallstones bc of hemolysis
- Splenomegaly
- Smaller blood vessels (hands + feet)
- CHF
- Symptoms do not appear until 12 mo old
Thalassemia
-
LOW hemoglobin
Genetic condition - one or more genes for hemoglobin are missing or variant
Polycythemia
- INCREASED erythrocytes, granulocytes and thrombocytes
PRIMARY - Polycythemia vera - Neoplastic, LOW serum erythropoietin, ^ production of
erythrocytes
SECONDARY - Erythrocytosis - Hypoxia causes ^ RBCs, HIGH serum erythropoietin
Symptoms
- Distended blood vessels, sluggish blood flow (THINK HEAVY BLOOD = SLUGGISH)
- Hepato + Splenomegaly
-
Dyspnea
Headaches
Hypertrophied heart (enlarged)
Visual disturbances
Thromboses and infarctions
Blood Clotting Disorders
-
Gum bleeding
Epistaxis (nose bleeds)
Petechiae (flat red spots on skin + mucous membranes)
Purpura and ecchymosis (bruising)
^ bleeding
Hemoptysis
Hematemesis
Blood in feces
Anemia
LOW BP, ^ HR, rapid pulse
Feeling faint + anxious
Hemophilia A
-
DEFICIT of clotting factor VII
- Body cannot clot properly
INCREASED PTT, aPPT, + COAGULATION TIME
BLEEDING TIME AND PT ARE NORMAL
Disseminated Intravascular Coagulation
-
Body clotting TOO MUCH → DEFICIT of clotting factors bc it’s all used up
-
You can bleed out from this
Myelodysplastic Syndrome
-
Inadequate production of cells by BONE MARROW
Leukemia
Symptoms
- Frequent or uncontrolled infections - sepsis, CHF, renal/liver failure, CNS depression
- Weight loss + fatigue
- Severe + steady BONE PAIN
- Headache, visual disturbances, nausea/vomiting
- Hepato + Splenomegaly, + enlarged lymph nodes
Acute - LOTS OF immature + nonfunctional cells in bone
- B lymphocytes
- Young CHILDREN
Acute Myelogenous (AML) - Granulocytic stem cells + ADULTS
Chronic Lymphocytic - LOTS OF mature cells (better prognosis)
- B lymphocytes
- ADULTS > 50 yrs
Chronic Myelogenous (CML) - Granulocytic stem cells + ADULTS 30-50 yrs
Diagnostic tests - v RBCs + Platelets, ^ WBCs
Treatment - Chemo + biological therapy (interferon to STIMULATE IMMUNE SYSTEM)
Lymphomas
- lymphocyte PROLIFERATION in lymph nodes
Hodgkin lymphoma - ONE lymph node
Non-Hodgkin lymphoma - MULTIPLE nodes, non-organized, + widespread metastases
- ^ due to HIV INFECTION
Symptoms
-
First → painless enlarged lymph node
-
Later → Splenomegaly + enlarged nodes
- General signs of cancer
Treatment - Radiation, Chemo, surgery
Multiple Myeloma
-
-
INCREASED production of plasma cells in BONE MARROW
- Loss of bone
- Severe bone pain
OLDER ADULTS
Respiratory Disorders
Upper Respiratory Tract Infections
-
Common cold (infectious rhinitis)
Viral
Secondary bacterial infections may occur (Strep)
-
Purulent exudate → systemic effects like fever
Sinusitis (bacterial)
Laryngotracheobronchitis (croup) (viral)
- children
Influenza/Flu (can lead to pneumonia - lower resp. tract)
- Sudden acute onset
- Achy, fatigue, fever
- Type A (most prevalent)
- Teens
- High mortality rate if acute resp. syndrome (pulmonary edema + pneumonia)
- Also Types B + C
Lower Respiratory Tract Infections
Bronchitis
- Necrosis + inflammation in small bronchi and bronchioles
- Caused by respiratory syncytial virus (RSV)
- ORAL DROPLET TRANSMISSION
Symptoms
- Wheezing + dyspnea
- Cough + rales
- Chest retractions
- Fever + malaise
Pneumonia
- Viral, bacterial, or fungal
- Changes in interstitial tissue, alveolar septae, or alveoli
Symptoms
- Fever, chills, + cough
Lobar
Bronchopneumonia
-
1 or 2 lobes
-
-
Strep
-
-
Inflammation of alveolar wall
Leakage of cells, fibrin, + fluid
into alveoli
Inflamed pleura
Sudden acute onset
RUSTY sputum
-
RALES → absent breath sounds
-
Scattered small patches
(BOTH LUNGS)
Bacteria
Inflammation + purulent
exudate
Insidious onset
YELLOW-GREEN sputum
DYSPNEA
Interstitial Pneumonia (Primary
Atypical Pneumonia - PAP)
- Scattered small patches
- Legionnaires’ disease
- Influenza
- Interstitial inflammation
AROUND alveoli
- Necrosis of bronchial
epithelium
- Variable onset
- NO sputum
- Unproductive cough,
hoarseness, sore throat
Tuberculosis
- Inflammation + destruction of lung tissue
Symptoms
- Cough + rusty sputum
- ORAL DROPLET TRANSMISSION
- Can survive in dried sputum for WEEKS
- Destroyed by UV light, heat, alcohol, glutaraldehyde, + formaldehyde
Primary/Latent - exposed + infected but asymptomatic + NOT CONTAGIOUS
Secondary/Reinfection TB - cell-mediated immunity is impaired bc of stress, malnutrition, HIV,age
- CONTAGIOUS
Miliary/Extrapulmonary TB - children <5 yrs → weight loss + measles
- lesions NOT in lung = NOT CONTAGIOUS
Aspiration
-
Obstructive Lung Disease - foreign material in lungs
-
Inflammation + swelling → resp. Distress syndrome
-
Can lead to pneumonia
Symptomes
- Coughing + choking w/ dyspnea
- Stridor
- Wheezing
- Nasal flaring, chest retractions, + hypoxia
***HEIMLICH MANEUVER***
Asthma
- Bronchial Obstruction
- Bronchoconstriction (contraction of smooth muscle)
- Coughing + Wheezing
- Respiratory Alkalosis - hyperventilation
- Respiratory Acidosis - air trapping
Extrinsic - acute episodes (TYPE 1 HYPERSENSITIVITY)
Intrinsic - onset in early childhood
- Thick or sticky mucus build-up or Inflammation
Treatment - bronchodilators (v inflammation) or cromolyn sodium (prophylactic med)
Chronic Obstructive Pulmonary Disease (COPD)
- Irreversible damage to lungs
Emphysema - Destruction of alveolar walls and septae + Fibrosis
→ large, permanently inflated alveolar air spaces
-
Some infections
Pink Puffer
Barrel-chested
Dyspnea
Prolonged expiration
Hunched over
PURSED LIPS BREATHING
Anorexia + Fatigue - (patient is so tired from breathing that they just
lose their appetite)
Chronic Bronchitis - Mucus secretion, inflammation/obstruction of bronchi
- FIBROSIS OF BRONCHIAL WALL
- Frequent infections
- Coughing twice for 3 mo or > 2 yrs
***History of Smoking***
- Blue Bloater
- Hypoxia, cyanosis, hypercapnia
- Cough and rhonchi more severe in MORNING
Pulmonary Edema
-
Fluid in alveoli and interstitial area → Crackles
-
Cough + Rales
-
Orthopnea → feel like choking when lying down
Pulmonary Embolus
- Blood clot or mass obstructs pulmonary artery
- 90% come from DVT
Symptoms
- Later: Hemoptysis (bc of inflammation) + fever
- Hypoxia: causes anxiety, restlessness, pallor, ^ HR
Atelectasis
-
Air in pleural cavity
Causes partial or full collapse of lung
Pneumothorax
- Partial (usually lower right lobe) or Full Collapse of lung due to atelectasis
Closed - Air enters pleural cavity through internal airways
- Asymmetrical chest movements
Open - Opening in chest wall (stab wound)
- “Sucking wound”
- Mediastinal flutter, impairing venous return
***Tension Pneumothorax is most severe → tear in lung surface***
Treatment
- Cover open wound
- Do not remove protruding objects
- If possible tension pneumothorax should be converted to open
pneumothorax by removing loose tissue or enlarging opening
Pleural Effusion
-
Excess fluid in pleural cavity → prevents lung from expanding fully
-
Often result of SURGERY
Acute Respiratory Distress Syndrome
→ Ex. COVID-19
-
Injury to the alveolar wall and capillary membrane
-
Release of chemical mediators
Acute Respiratory Failure
-
May result from acute or chronic disorders
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