NSG 3850 EXAM 2 PT 2 REVIEW QUESTIONS AND
ANSWERS
Increase of air entering the alveoli leads to hypocapnia (PaCO2 <35 mm Hg) - Answers
- Hyperventilation
Cause of hyperventilation - Answers - Pain
fever
anxiety
obstructive and restrictive lung diseases
sepsis
high altitude
brainstem injury
PaO2 is low despite normal O2-carrying capacity
Causes include high altitude, hypoventilation, obstruction - Answers - Hypoxic hypoxia
A decrease in O2 carrying capacity
Low Hgb - Answers - Anemic hypoxia
Low cardiac output; SHOCK, cardiac arrest, severe blood loss, CHF, thyrotoxicosis
O2-carrying capacity is normal but blood flow is reduced - Answers - Circulatory hypoxia
Decreased O2 carrying capacity from a toxic substance; cyanide poisoning - Answers -
Histotoxic hypoxia
Manifestations of acute bronchitis - Answers - Usually mild and self-limiting
Cough (productive or non-productive)
Recent onset
Low-grade fever
Substernal chest discomfort
Sore throat
Postnasal drip
Fatigue
Cause of chronic bronchitis - Answers - Cigarette smoking (90%)
Repeated airway infections
Overweight
Genetic predisposition
Inhalation of physical or chemical irritants
Chronic or recurrent productive cough >3months and >2+ successive years
Testing for chronic bronchitis - Answers - Chest x-ray
PFTs
ABGs
, ECG
Secondary polycythemia
Typical patient is overweight
Commonly associated with emphysema
SOB on exertion
Excessive sputum
Chronic cough (more severe in mornings)
Evidence of excess body fluids (edema, hypervolemia)
Cyanosis (late sign)
Crackles, rhonchi, and wheezes; use of accessory muscles to breathe; JVD; clubbing;
and pedal/ankle edema - Answers - Manifestations of chronic bronchitis
Pathogenesis of emphysema - Answers - (1) Release of proteolytic enzymes from
neutrophils and macrophages leading to alveolar damage
(2) α1-Antitrypsin deficiency
(3) Smoking causes alveolar damage
(4) Inflammation leads to release of proteolytic enzymes
(5) Inactivates α1-antitrypsin (normally protects lung parenchyma)
(6) Reduction in pulmonary capillary bed
(7) Loss of elastic tissue in lung
(8) Air becomes trapped in distal alveoli
(9) Loss of alveolar wall and air trapping leads to bullae (large, thin-walled cysts in the
lung) formation
A common feature of sarcoidosis is the presence of CD4+ T cells.
Commonly effects lungs and lymph nodes (and multiple organ systems)
Immunologic basis is most likely cause
Activation of alveolar macrophage to unknown trigger
First degree relative increases risk 5-fold - Answers - Cause of sarcoidosis
Manifestation of sarcoidosis - Answers - Malaise, fatigue
Weight loss
Fever
Dyspnea of insidious onset
Dry, nonproductive cough
Erythema nodosum
Macules, papules, hyperpigmentation, and subcutaneous nodules
Hepatosplenomegaly, lymphadenopathy
Liver enzymes tested
Swollen lymph nodes
Known as extrinsic allergic alveolitis
Restrictive and occupational disease
Inhaled organic agents are responsible for the inflammatory process
ANSWERS
Increase of air entering the alveoli leads to hypocapnia (PaCO2 <35 mm Hg) - Answers
- Hyperventilation
Cause of hyperventilation - Answers - Pain
fever
anxiety
obstructive and restrictive lung diseases
sepsis
high altitude
brainstem injury
PaO2 is low despite normal O2-carrying capacity
Causes include high altitude, hypoventilation, obstruction - Answers - Hypoxic hypoxia
A decrease in O2 carrying capacity
Low Hgb - Answers - Anemic hypoxia
Low cardiac output; SHOCK, cardiac arrest, severe blood loss, CHF, thyrotoxicosis
O2-carrying capacity is normal but blood flow is reduced - Answers - Circulatory hypoxia
Decreased O2 carrying capacity from a toxic substance; cyanide poisoning - Answers -
Histotoxic hypoxia
Manifestations of acute bronchitis - Answers - Usually mild and self-limiting
Cough (productive or non-productive)
Recent onset
Low-grade fever
Substernal chest discomfort
Sore throat
Postnasal drip
Fatigue
Cause of chronic bronchitis - Answers - Cigarette smoking (90%)
Repeated airway infections
Overweight
Genetic predisposition
Inhalation of physical or chemical irritants
Chronic or recurrent productive cough >3months and >2+ successive years
Testing for chronic bronchitis - Answers - Chest x-ray
PFTs
ABGs
, ECG
Secondary polycythemia
Typical patient is overweight
Commonly associated with emphysema
SOB on exertion
Excessive sputum
Chronic cough (more severe in mornings)
Evidence of excess body fluids (edema, hypervolemia)
Cyanosis (late sign)
Crackles, rhonchi, and wheezes; use of accessory muscles to breathe; JVD; clubbing;
and pedal/ankle edema - Answers - Manifestations of chronic bronchitis
Pathogenesis of emphysema - Answers - (1) Release of proteolytic enzymes from
neutrophils and macrophages leading to alveolar damage
(2) α1-Antitrypsin deficiency
(3) Smoking causes alveolar damage
(4) Inflammation leads to release of proteolytic enzymes
(5) Inactivates α1-antitrypsin (normally protects lung parenchyma)
(6) Reduction in pulmonary capillary bed
(7) Loss of elastic tissue in lung
(8) Air becomes trapped in distal alveoli
(9) Loss of alveolar wall and air trapping leads to bullae (large, thin-walled cysts in the
lung) formation
A common feature of sarcoidosis is the presence of CD4+ T cells.
Commonly effects lungs and lymph nodes (and multiple organ systems)
Immunologic basis is most likely cause
Activation of alveolar macrophage to unknown trigger
First degree relative increases risk 5-fold - Answers - Cause of sarcoidosis
Manifestation of sarcoidosis - Answers - Malaise, fatigue
Weight loss
Fever
Dyspnea of insidious onset
Dry, nonproductive cough
Erythema nodosum
Macules, papules, hyperpigmentation, and subcutaneous nodules
Hepatosplenomegaly, lymphadenopathy
Liver enzymes tested
Swollen lymph nodes
Known as extrinsic allergic alveolitis
Restrictive and occupational disease
Inhaled organic agents are responsible for the inflammatory process
