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This document, "NSG 3850 Patho Exam 2," covers specific topics in pathology, including respiratory
conditions such as hypoventilation, hyperventilation, and hypoxia, as well as cardiovascular conditions
such as right-side heart failure and deep vein thrombosis. Each question includes the correct answer,
providing a comprehensive review of key concepts and pathophysiology. This resource can be used by
students to study, review, and deepen their understanding of these concepts, making it an effective tool
for exam preparation.
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EXAM QUESTIONS
QUESTION 1
hypoventilation
CORRECT ANSWER
results in ^ high PACO2 (greater than >45) and hypoxemia
- Drugs like morphine and barbiturates depress the CNS which leads to hypoventilation
- obesity, myasthenia gravis, obstructive sleep apnea, chest wall damage, paralysis of respiratory muscles,
surgery of the thorax or abdomen can cause hypoventilation
QUESTION 2
Hyperventilation
CORRECT ANSWER
- Increase of air entering the alveoli leads to hypocapnia (decrease in CO2 levels) (PACO2 <35 mm Hg)
Etiology
- Pain, fever, anxiety, obstructive and restrictive lung diseases, sepsis, high altitude (lower air pressure),
and brainstem injury
QUESTION 3
Hypoxia
CORRECT ANSWER
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, - Decrease in tissue oxygenation.
- Hypoxic hypoxia (high altitude, hypoventilation, obstruction)
- Anemic hypoxia (low hemoglobin)
- Circulatory hypoxia (low cardiac output; shock)- normal O2 carrying RBC, problem in blood flow. Ex: pt in
cardiac arrest
- Histotoxic hypoxia (decreased O2 carrying capacity from a toxic substance; cyanide poisoning)
QUESTION 4
acute bronchitis
CORRECT ANSWER
- Acute inflammation of the trachea and bronchi
- Viral (most) or non-viral, Inhalation of smoke or chemicals,
- Allergic reactions
Clinical Manifestations
· Usually mild and self-limiting
· Cough (productive or nonproductive)
· Low-grade fever
· Substernal chest discomfort
· Sore throat
· Postnasal drip
· Fatigue
- Increased mucus production
- Loss of ciliary function
- Loss of portions of the ciliated epithelium
Diagnostic Tests
- Distinct hallmark of disease: recent onset of cough
- Chest x-ray to distinguish acute bronchitis from pneumonia- would be placed on antibiotic.
- *Highest incidences are noted in smokers, young children (see a lot of asthmatic bronchitis with
wheezing and soa), and the elderly.
QUESTION 5
chronic bronchitis
CORRECT ANSWER
- Cigarette smoking (90%)
- Repeated airway infections
- Genetic predisposition
- Inhalation of physical or chemical irritants
- Chronic or recurrent productive cough greater than >3 months >2+ successive years
- Type B COPD, “blue bloater”: cyanotic lips and nail beds, overweight, soa, chronic cough
- Hypersecretion of bronchial mucus
- Persistent, irreversible when paired with emphysema.
- 1:2 male to female ratio
>30 to 40 years.
Diagnostic tests:
- Chest x-ray
- Pulmonary function tests
- Arterial blood gas (ABG)- increase in CO2 due to impaired respiration, harder to respiratory- ABG would
show increase ^ CO2 and low O2
- ECG
- Secondary polycythemia- increase in RBC, because the hypoxemia leads to increased production of RBC
in attempt to carry more Oxygen to the body tissues.
Clinical Manifestations
- Typical patient is overweight.
- Commonly associated with emphysema
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, - SOB on exertion
- Excessive sputum
- Chronic cough (more severe in mornings)
- Evidence of excess body fluids (edema, hypervolemia)
- Cyanosis (late sign), blue around the lips is called circumoral
**RIGHT SIDED HEART FAILURE EFFECTING THE BODY**
Left side HF: effects lungs
Right side HF: effects body ex: edema, distended beck veins
QUESTION 6
Left sided HF & Right sided HF
CORRECT ANSWER
- **left sided heart failure effects lungs, right sided heart failure effects the body.
At the end stages of chronic bronchitis, the patient presents with signs of right sided heart failure
(distended neck veins, peripheral edema)
QUESTION 7
Emphysema
CORRECT ANSWER
Etiology
- Type A COPD: Pink Puffer
- Damage is irreversible
- Smoking more than 70 packs a year
- Certain occupations: mining, welding, working with or near asbestos
- Antitrypsin deficiency
Patho:
- smoking causes alveolar damage
- reduction in pulmonary capillary bed
- Loss of elastic tissue in lungs
-air becomes trapped in distal alveoli creating Barrel Chest
Clinical Manifestations:
- use of accessory muscles, exertional dyspnea, use of accessory muscles
- cough (minimal or absent)
- Thing, wasted appearance, underweight individuals
- Decreased breath sounds
- Chronic morning cough
- Digital clubbing
- Barrel chest
-Hyperresonance, pursed- lip breathing, Wheezing.
- O2 sat high 80%s- patient baseline
Diagnostic tests
- Chest x-ray
- Hx and physical
- ABGS
- Pulmonary function test
- electrocardiogram
QUESTION 8
Sarcoidosis
CORRECT ANSWER
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