CSE Pathology nbrc Questions With Complete Solutions

Emphysema definition correct answer: Permanent enlargement of air spaces, accompanied by destruction of bronchial walls w/o obvious fibrosis Chronic bronchitis definition correct answer: Chronic productive cough for 3 months Emphysema primary assessment (info gathering) correct answer: Pink puffer, underweight, barrel chest, Hoover's sign, reddish skin, clubbing in late stage, dyspnea, pursed-lip breathing, accessory muscle use, hyperresonant/tympanic, diminished BS Chronic bronchitis primary assessment (info gathering) correct answer: Blue bloater, overweight, productive cough, purulent secretions, occasional barrel chest, cyanotic, clubbing is common, normal chest percussion, rhonchi, crackles, wheezes Emphysema secondary assessment (info gathering) correct answer: CXR - long, narrow heart, possibly hypertrophy of right ventricle ABG - mild/moderate stage: actue alv hyperventilation w/ hypoxemia. Severe stage: chronic ventilatory failure w/ hypoxemia PFT - decreased flow rates and DLCO CBC - increased RBC/Hb/Hct in LATE stages Sputum - normal Chronic bronchitis secondary assessment (info gathering) correct answer: CXR - possibly hypertrophy of right ventricle ABG - mild/moderate stage: actue alv hyperventilation w/ hypoxemia. Severe stage: chronic ventilatory failure w/ hypoxemia PFT - decreased flow rates, normal DLCO CBC - increased RBC/Hb/Hct in EARLY and LATE stages Sputum - streptococcus pneumoniae, haemophilus influenzae, moraxella catarrhalis Emphysema and Chronic bronchitis Tx. (decision making) correct answer: Low flow O2 therapy (NC 1 - 2 LPM) Bronchodilators (SABA, LABA, anticholinergics) ICS ABX if indicated by sputum culture Bronchial hygiene as indicated NPPV for acute exacerbations of ventilatory failure Pulm rehab Chest trauma/Flail chest/Rib fractures definition correct answer: Trauma - any trauma to chest wall Flail chest - result of double fractures or 3 or more adjacent ribs causing thoracic cage to become unstable