kettering pathology Questions With Complete Solutions

asthma correct answer: chronic, inflammatory, obstructive disease, characterized by wheezing and coughing triggered by dust, smoke, etc. asthma pt assessment and definition of pulsus paradoxus correct answer: SOB - pursed lip breathing, tight chest Appearance of chest: increased A-P diameter Resp. Pattern: use of accessory muscles Diagnostic chest percussion: hyperresonant/tympanic Breath sounds: Diffuse wheezing, diminished breath sounds Physical appearance: diaphoresis Vital signs: tachycardia, tachypnea, pulsus paradoxus in severe episodes. Definition: pulsus paradoxus-abnormally large decrease in systolic BP during inspiration. norm is less than 10mmhg asthma (diagnostic testing) correct answer: Chest X-ray: increased A-P, translucent lungs, depressed or flattened diaphragms ABG: Initiallly acute alveolar hyperventilation with hypoxemia and may develop hypercarbia(CO2 retention) in status asthmaticus (asthma attack with no pause) Pulm. Function: spirometry shows reduced flowrates (peak flow, FEV1, FEV1/FVC) Post bronchodilator: significant improvement in FEV1 it increases at least 12% and 200ml asthma (treatment) correct answer: *O2 therapy *aerosol therapy with a SABA(short acting beta agonists) & anticholinergic (consider continuous aerosol therapy) *corticosteroids (oral or IV) *Close monitoring *Intubation and MV if ventilator failure or respiratory arrest continues *Consider adjunct therapies: heliox therapy, magnesium sulfate, subcutaneous epinephrine asthma (long term control of asthma) correct answer: *Eliminate triggers *Control meds: LABA, inhaled corticosteroids, mast cell stabilizers, leukotriene inhibitors *Asthma action plan based on peak flow monitoring COPD correct answer: Weakening and perm. enlargement of the air spaces distal to terminal bronchioles, often accompanied by hypertrophy(increase in volume of organ or tissue due to enlargement of cells) of the goblet cells and mucus glands. Characterized by dyspnea on exertion with significant hypercapnea COPD (terminology describing pt) correct answer: Chronic vent failure, chronic hypercapnea, increased lung compliance, loss of elastic recoil, chronic CO2 retention COPD (pt appearance) correct answer: -General appearance:barrel chest, clubbing, cyanosis -Resp. pattern: dyspnea, accessory muscle -Breath sounds: bilateral expiratory wheeze -Diagnostic Chest percussion: tympanic or hyperresonant COPD (Diagnostic testing) correct answer: -Chest X-ray: hyperlucency, hyperinflation, barrel chest, flattened diaphragm -ABG: comp. resp. acidosis with hypoxemia and hypercapnea -Pulm. function testing: decreased flows (FEV1, FEV1/FVC) COPD (Treatments) correct answer: -low flow O2 -Aerosolized bronchodilators (Beta2 agonist+anticholinergic) -bronchial hygiene as indicated -Inhaled corticosteroids -Antibiotics if indicated by sputum sample -Smoking cessation -Pulm rehab for proper nutrition and fluid intake -Consider NPPV for acute exacerbations of vent failure -Education on nutrition, avoiding infections (include signs & symptoms), exercise, methods for secretion clearance, home O2 and aerosol treatment, meds. Congestive heart failure/pulm. edema correct answer: -