Patho Exam 3

Early Hypoxemia

Chronic Bronchitis - Yes
Emphysema - No

Early CO2 retention

Chronic Bronchitis - Yes
Emphysema - No

Productive Cough

Chronic Bronchitis - Yes
Emphysema - No

Increased anteroposterior chest diameter

Chronic Bronchitis - No
Emphysema - Yes

Cor pulmonale

Chronic Bronchitis - Yes
Emphysema - No

Bronchiolitis, commonly seen in infants due to respiratory syncytial virus, is characterized by

Airway inflammation and mucus formation

Which of the following statements regarding cystic fibrosis is correct

It is associated with genetic defect in chloride ion transport

Signs or symptoms of tracheobronchial obstruction include all of the following

-Stridor
-Wheezing
-Sternal retractions
-Except: Crackles

A classic clinical finding when a patient has epiglottitis is

Pain and Difficulty swallowing

Group is a syndrome, a collection of signs and symptoms that may be due to several etiologic factors. the most characteristic finding in croup is

Barking cough with respiratory stridor

Extrinsic/allergic asthma

Is due to an antigen-antibody reaction on the IgE-bearing mast cells

Air trapping associated with chronic obstructive diseases results in an increase in which of the following components of pulmonary function testing

Residual Volume

Acute and chronic bronchitis differ in which of the following ways

Chronic bronchitis resultes in airway changes that are irreversible

Which of the following assessment findings is indicative of an asthma attack

Wheezing

Pathophysiologic differences between emphysema and chronic bronchitis include the fact that

Chronic bronchitis commonly results in polycythemia to compensate for persistant hypoxemia

Arterial blood gases for a patient with mild to moderate emphysema would reflect

Increased PaCO2

Pursed-lip breathing is commonly used by patients with emphysema because it

Decreases small airway collapse due to expiration

Clincal findings of prolonged hypoxemia in long-standing cystic fibrosis include

Clubbing of the fingers

Decreased airway radius occurs in chronic bronchitis due to all of the following

-Excessive amounts of sputum
-Airway scarring
-Inflammation
-Except: increased elastic recoil

Regardless of the trigger for an asthma attack, all forms are characterized by airway _____ which causes mucosal edema, bronchoconstriction, and hyper secretion of mucus

Inflammation

The increased work of breathing during an asthma attack is attributed to increased airway ______

Resistance

The peak expiratory flow rate is characteristically _______ in obstructive lung disorders, but normal or ____ in restrictive disorders

Decreased, Increased

A patient with a significant smoking history, chronically elevated PaCO2, and hypoxemia most likely has a respiratory disease diagnosis of _________

Chronic Bronchitis

Emphysema is a chronic obstructive disorder associated with loss of lung parenchymal tissue. Obstruction occurs because lung parenchyma is responsible for maintaining _______ ____ on the small airways

Radial Traction

A low, flat diaphragm; narrow mediastinum; and decreased lung density on chest x-ray are characteristic finding in ________

Emphysema

Interventions for the patient with asthma are often based on the assessment of ____ ___

Peak Flow

Acute airway obstruction with a foreign object may be relieved by ____ _____ or the ___ _____

Back Blows, Hemlic Manuver

During pulmonary function testing, bronchospasm may be pharmacologically induced. This is known as

Bronchial Provocation

A Common Complication of Bronchiolitis is ____ _____

Otitis Media

The larynx is anatomically part of the lower airway but performs functions characteristic of the upper airway

True

Cilia are located throughout the airway and are responsible for the production of mucus

False

Aspiration of food into the airway is prevented by closure of the trachea with swallowing

False

The carina is the anatomic end of the trachea, where two main stem bronchi originate

True

Aspirated materials tend to go into the right main stem bronchus because it is shorter, wider and at less of an angle from the trachea

True

The right lung has two lobes, where as the left lung has three lobes

False

Surfactant is produced by the columnar epithelial cells lining the airways

False

Stimulation of the sympathetic branch of the ANS results in the release of acetylcholine, which causes constriction of smooth muscle in the bronchi and bronchioles

False

Cough Reflex receptors are located at the epiglottis and carina

True

Gas exchange occurs between the alveoli and capillaries (alveolar unit) by the physical process of diffusion

True

A reduction in the number of alveoli is to be expected as a part of the aging process

True

Blood is delivered to the lungs by the pulmonary vein, and oxygenated blood leaves the lungs via the pulmonary artery

False

Expiration is a passive process, primarily due to the elastic recoil of the lung tissue

True

An increase in lung compliance is associated with aging

True

The chemoreceptor center in the medulla is stimulated primarily by an increase in arterial CO2

True

A significant increase in the resistance of the pulmonary vasculature results in pulmonary ________

Hypertension

The three risk factors for thrombus formation commonly called Virchow's triad are

Statsis, Hypercoaguability, Injury to the vessel

Lung cancers are rarely diagnosed before they ___ and therefore have a very low long-term survival rate

Metastasized

The great majority of lung cancers occur in individuals who ______

Smoke

Diseases that cause global pulmonary hypoxemia usually are associated with pulmonary hypertension because hypoxemia causes ______ of pulmonary vessels

Vasoconstriction

An abnormal opening between the esophagus and trachea is called a ________

Fistula

The areas of the lung that are not involved in gas exchange are referred to as ____ _____ _____

Atomic Dead Space

Collapsed alveoli are the etiology of the condition known as _____

Atelectasis

As the radius of the airway is reduced, as is the case with asthma attacks or bacterial pneumonia, the ______ to air flow increases

Resistance

Pulmonary compliance is a reflection of airway ________ and lung ______

Resistance, Elasticity

The respiratory centers of the brain are located in the ______ and _______

Medulla, Pons

Activation of the intrinsic pathway of coagulation is initiated by

Blood contact with injured vascular endothelium

Fibrinolysis is characterized by

Conversion of plasminogen to plasmin

Deficient production of clotting factors would occur if which of the following organs were functioning abnormally

Liver

The proper function of the extrinsic pathway of coagulation is best measured by which of the following lab tests

Prothrombin Time (PT)/INR (International Normalized Ratio)

A common over the counter medication that can alter hemostasis is

Ibuprofen

Vitamin K deficiency in the adult may be associated with

Liver Disease

Pathologic activation of the clotting cascade producing widespread coagulation and subsequent bleeding from a deficiency of clotting factors occurs in

Disseminated Intravascular Coagulation (DIC)

All of the following are true regarding primary hemostasis

-Vasoconstriction reduces blood loss
-Platelets adhere to injured endothelial surfaces
-Initial vasoconstriction increases with increased trauma
-Except: Fibrin clots retract and solidify

The two most dangerous bleeding sites are the brain and

Oropharynx

Clotting factors are essential for successful hemostasis. which of the following statements regarding clotting factors is true

Most clotting factors circulate in inactive form

Idiopathic thrombocytopenic purpura

Platelet count - Decreased
PT/INR - Normal
aPTT - Normal
Bleeding time - Elevated

Hemophilia A or B

Platelet Count - Normal
PT/INR - Elevated
aPTT - Elevated
Bleeding Time - Elevated or Normal

Liver Disease

Platelet Count - Normal or Decreased
PT/INR - Elevated
aPTT - Normal or Elevated
Bleeding Time - Elevated

Aspirin use

Platelet Count - Normal
PT/INR - Normal
aPTT - Normal
Bleeding Time - Elevated

DIC

Platelet Count - Decreased
PT/INR - Elevated
aPTT - Elevated
Bleeding time - Elevated

Platelets aggriate together by binding to fibrinogen with their ___________

Glycoprotein IIb/IIIa

Aspirin and other Non-Steroidal Anti-Inflammatory Drugs (NSAID) inhibit platelet function by inhibiting the enzyme _________ which decreases the production of prostaglandins and thromboxanes

Cyclooxygenase

The ________ pathway is activated by external traumatic injury of blood vessel walls, while the _____ pathway is activated by damaged endothelial walls

Extrinsic, Entrinsic

________ is the medical term for a bruise, and ________ means blood in the urine

Ecchymosis, Hematuria