COPR PCP UPDATED TEST ANSWERS AND
QUESTIONS SET A+
✔✔R on T phenomenon - ✔✔a situation in which the QRS complex of a premature
ventricular complex falls on the T wave of the previous beat; may lead to ventricular
tachycardia or ventricular fibrillation.
✔✔Asthma - ✔✔A chronic allergic disorder characterized by episodes of severe
breathing difficulty, coughing, and wheezing. Someone with asthma has an increased
number of mast cells in their body and when an antigen is introduced into the body it
creates an "overreaction" causing bronchoconstriction and excess mucus production.
✔✔Asthma treatment - ✔✔Mild: O2, bronchodilators Ventolin (stimulates Beta 2
receptors), Atrovent (blocks parasympathetic nerve fibers) prevents further mucus
formation and a smooth muscle relaxant.
Moderate + Severe: All of above + Epi (helps reverse bronchoconstriction) used in
asthmatic silent chest, CPAP
✔✔Status Asthmaticus - ✔✔a severe, life-threatening asthma attack that is refractory to
usual treatment and places the patient at risk for developing respiratory failure. Chest
will be hyperinflated, breath sounds may be inaudible, pt is exhausted, severely acidotic
and dehydrated.
✔✔Sensitization - ✔✔Developing a sensitivity to a substance that initially caused no
allergic reaction. Body will produce antibodies against a substance after first contact,
the second time you come in contact with substance antibodies are released causing
anaphylaxis
✔✔Mediators - ✔✔Mediators that are stored include histamine, heparin and
chemotactic factors, others are formed during degranulation such as prostaglandin,
leukotrienes, bradykinins and interleukins
✔✔COPD (chronic obstructive pulmonary disease) - ✔✔A group of lung diseases that
block airflow and make it difficult to breathe.
,-airflow obstruction (problem getting air out)
-bronchospasm/bronchoconstriction
-increased mucus production
-impaired elasticity of airways
✔✔pulmonary emphysema "pink puffer" - ✔✔Destruction of alveoli walls, weakening
and destruction of bronchioles, decreased alveoli surface area and air exchange.
S/S:
-Pts have a permanent enlarged air space (barrel chest)
-Usually have a non productive cough
-leaning forward position of comfort
-distended neck veins
-tachypnea
-pursed lips breathing
-acc. muscle use
✔✔Chronic Bronchitis "blue bloaters" - ✔✔inflammation and swelling with excessive
mucus production in the bronchial tree. Minimal alveoli involvement. Decreased
ventilation of alveoli due to airflow obstruction.
S/S:
-thick mucus with coughing
-edema
-cyanosis-->skin appears blue
-distended neck veins
-tachypnea
-pursed lips
-high-pitched wheezing or low-pitched snoring during inhalation and exhalation
-acc. muscle use
-fever
✔✔Chronic Bronchitis Treatment - ✔✔O2, Atrovent to prevent further mucus production,
and Ventolin for the wheezing.
CPAP if severe, it increases alveoli size giving it more surface for gas exchange.
*CHRONIC if occurs for 2 months of the year for more than 2yrs*
✔✔what happens in pleural effusion? - ✔✔fluid accumulates in the pleural space due to
many reasons: infections, tumors, CHF, trauma. It impairs breathing by limiting space
for lung expansion and can cause complete lung collapse.
s/s:
-silent lung sounds
-hypoxia
✔✔Pneumonia - ✔✔inflammation of the lungs affecting primarily the alveoli
s/s:
-high fever and chills
-diaphoretic
, -muscle fatigue, aches, joint pain
-headache, loss of appetite
-n/v
-low BP
-high HR
-SOB, cough w/ phlegm (green/yellow)
✔✔Pulmonary Embolism (PE) - ✔✔Blocking of a pulmonary artery due to a blood clot
Risk factors include:
-estrogen containing hormonal contraceptives
-cancer (due to secretion of pre-coagulants)
-alterations in blood flow: immobilization after surgery, pregnancy, obesity, smokers
✔✔Pulmonary Embolism S/S - ✔✔-dyspnea
-tachypnea
-pinpoint chest pain on inspiration
-decrease O2 sat
-cyanosis
-hemoptysis
-clear lungs sounds
treat symptomatically, high flow O2, left lateral decubitus position and Trendelenburg to
prevent embolism from travelling to heart
✔✔V/Q mismatch - ✔✔Ventilation-perfusion (V/Q) mismatch occurs when either the
ventilation (airflow) or perfusion (blood flow) in the lungs is impaired, preventing the
lungs from optimally delivering oxygen to the blood.
✔✔Acute Respiratory Failure - ✔✔Type 1 Respiratory failure: hypoxia without
hypercapnia (no increased CO2 levels in blood), caused by a V:Q mismatch the volume
of air flowing in and out of lungs doesn't match with flow of blood to the lungs. It is
oxygenation failure (e.g PE)
Type 2 Ventilation failure: caused by inadequate ventilation, built up of CO2 levels due
to increased airway resistance e.g COPD, asthma, suffocation, or reduced breathing
effort e.g drug effects, brain stem lesion, extreme obesity. Failure to compensate.
✔✔ARDS (acute respiratory distress syndrome) - ✔✔Inflammation of the lung leading to
impaired gas exchange with release of inflammatory mediators causing hypoxemia and
multi-organ failure.
✔✔Hyperventilation - ✔✔An anxiety attack, pt has normal oxygenation in the arterial
blood and little CO2 making them alkalotic which in turn can cause
S/S:
-palpitations
-chest pain
-paresthesia of hands and muscles (pins and needles)
-weakness
QUESTIONS SET A+
✔✔R on T phenomenon - ✔✔a situation in which the QRS complex of a premature
ventricular complex falls on the T wave of the previous beat; may lead to ventricular
tachycardia or ventricular fibrillation.
✔✔Asthma - ✔✔A chronic allergic disorder characterized by episodes of severe
breathing difficulty, coughing, and wheezing. Someone with asthma has an increased
number of mast cells in their body and when an antigen is introduced into the body it
creates an "overreaction" causing bronchoconstriction and excess mucus production.
✔✔Asthma treatment - ✔✔Mild: O2, bronchodilators Ventolin (stimulates Beta 2
receptors), Atrovent (blocks parasympathetic nerve fibers) prevents further mucus
formation and a smooth muscle relaxant.
Moderate + Severe: All of above + Epi (helps reverse bronchoconstriction) used in
asthmatic silent chest, CPAP
✔✔Status Asthmaticus - ✔✔a severe, life-threatening asthma attack that is refractory to
usual treatment and places the patient at risk for developing respiratory failure. Chest
will be hyperinflated, breath sounds may be inaudible, pt is exhausted, severely acidotic
and dehydrated.
✔✔Sensitization - ✔✔Developing a sensitivity to a substance that initially caused no
allergic reaction. Body will produce antibodies against a substance after first contact,
the second time you come in contact with substance antibodies are released causing
anaphylaxis
✔✔Mediators - ✔✔Mediators that are stored include histamine, heparin and
chemotactic factors, others are formed during degranulation such as prostaglandin,
leukotrienes, bradykinins and interleukins
✔✔COPD (chronic obstructive pulmonary disease) - ✔✔A group of lung diseases that
block airflow and make it difficult to breathe.
,-airflow obstruction (problem getting air out)
-bronchospasm/bronchoconstriction
-increased mucus production
-impaired elasticity of airways
✔✔pulmonary emphysema "pink puffer" - ✔✔Destruction of alveoli walls, weakening
and destruction of bronchioles, decreased alveoli surface area and air exchange.
S/S:
-Pts have a permanent enlarged air space (barrel chest)
-Usually have a non productive cough
-leaning forward position of comfort
-distended neck veins
-tachypnea
-pursed lips breathing
-acc. muscle use
✔✔Chronic Bronchitis "blue bloaters" - ✔✔inflammation and swelling with excessive
mucus production in the bronchial tree. Minimal alveoli involvement. Decreased
ventilation of alveoli due to airflow obstruction.
S/S:
-thick mucus with coughing
-edema
-cyanosis-->skin appears blue
-distended neck veins
-tachypnea
-pursed lips
-high-pitched wheezing or low-pitched snoring during inhalation and exhalation
-acc. muscle use
-fever
✔✔Chronic Bronchitis Treatment - ✔✔O2, Atrovent to prevent further mucus production,
and Ventolin for the wheezing.
CPAP if severe, it increases alveoli size giving it more surface for gas exchange.
*CHRONIC if occurs for 2 months of the year for more than 2yrs*
✔✔what happens in pleural effusion? - ✔✔fluid accumulates in the pleural space due to
many reasons: infections, tumors, CHF, trauma. It impairs breathing by limiting space
for lung expansion and can cause complete lung collapse.
s/s:
-silent lung sounds
-hypoxia
✔✔Pneumonia - ✔✔inflammation of the lungs affecting primarily the alveoli
s/s:
-high fever and chills
-diaphoretic
, -muscle fatigue, aches, joint pain
-headache, loss of appetite
-n/v
-low BP
-high HR
-SOB, cough w/ phlegm (green/yellow)
✔✔Pulmonary Embolism (PE) - ✔✔Blocking of a pulmonary artery due to a blood clot
Risk factors include:
-estrogen containing hormonal contraceptives
-cancer (due to secretion of pre-coagulants)
-alterations in blood flow: immobilization after surgery, pregnancy, obesity, smokers
✔✔Pulmonary Embolism S/S - ✔✔-dyspnea
-tachypnea
-pinpoint chest pain on inspiration
-decrease O2 sat
-cyanosis
-hemoptysis
-clear lungs sounds
treat symptomatically, high flow O2, left lateral decubitus position and Trendelenburg to
prevent embolism from travelling to heart
✔✔V/Q mismatch - ✔✔Ventilation-perfusion (V/Q) mismatch occurs when either the
ventilation (airflow) or perfusion (blood flow) in the lungs is impaired, preventing the
lungs from optimally delivering oxygen to the blood.
✔✔Acute Respiratory Failure - ✔✔Type 1 Respiratory failure: hypoxia without
hypercapnia (no increased CO2 levels in blood), caused by a V:Q mismatch the volume
of air flowing in and out of lungs doesn't match with flow of blood to the lungs. It is
oxygenation failure (e.g PE)
Type 2 Ventilation failure: caused by inadequate ventilation, built up of CO2 levels due
to increased airway resistance e.g COPD, asthma, suffocation, or reduced breathing
effort e.g drug effects, brain stem lesion, extreme obesity. Failure to compensate.
✔✔ARDS (acute respiratory distress syndrome) - ✔✔Inflammation of the lung leading to
impaired gas exchange with release of inflammatory mediators causing hypoxemia and
multi-organ failure.
✔✔Hyperventilation - ✔✔An anxiety attack, pt has normal oxygenation in the arterial
blood and little CO2 making them alkalotic which in turn can cause
S/S:
-palpitations
-chest pain
-paresthesia of hands and muscles (pins and needles)
-weakness
