Exam #1 Ms 2 Part 2

Front 1

chronic airflow limitation (CAL) includes:

Back 1

asthma, chronic bronchitis and emphysema

Front 2

chronic bronchitis and emphysema are categorized as:

Back 2

COPD

Front 3

abnormal permanent enlargement of gas exchange airways, accompanied by alveolar destruction

Back 3

emphysema

Front 4

chronic bronchitis, emphysema, and asthma - which is reversible?

Back 4

asthma

Front 5

clinical manifestations:
productive cough, late in course dyspnea, intermittent wheezing, common hisroty of smoking, occasional barrel chest, prolonged expiration, cyanosis, chronic hypoventilation, polycythemia (excess RBCs), cor pulmonale (R.HF)

Back 5

chronic bronchitis

Front 6

clinical manifestations:
productive cough late in process, dyspnea, minimal wheezing, history of smoking, classic barrel chest, prolonged expiration

Back 6

emphysema

Front 7

best lab test for O2 perfusion

Back 7

ABGs

Front 8

treatment for COPD

Back 8

1. treat infection
2. bronchodilator
3. theophylline
4. steroids
5. CPT
6. postural drainage
7. breathing exercises
8. hydration

Front 9

emphysema can be due to a deficiency of (in non-smokers):

Back 9

alpha-antitrypsin - an enzyme that inhibits proteolysis in the lungs

Front 10

alpha antitrypsin replacement

Back 10

Prolastin

Front 11

more common: centrlobular or panlobular emphysema?

Back 11

cenrilobular, also associated with chronic bronchitis.

Front 12

associated with AAT deficiency - centrlobular or panlobular emphysema?

Back 12

panlobular

Front 13

most common organism causing acute bronchitis is:

Back 13

H influenza and staph pneumonia

Front 14

most common evetns leading to acute respiratory failure are:

Back 14

acute respiratory trat infection or acute bornchitis

Front 15

prevents bronchial collapse and air trapping

Back 15

purse lipped breathing

Front 16

in purse lipped breathing, exhalation should be ___ times as long as inspiration

Back 16

3x. Can practice by exhaling through a straw into a glass of water.

Front 17

Teaching for COPD pts

Back 17

rest befor eeating (wears them out)
use bronchodialtor b4 meals
five to six small meals daily
high calorie/protein
use O2 while eating
intake 3L/d
restrict sodium

Front 18

_______ are chronically elevated in COPD

Back 18

eosinophils

Front 19

ABG range:

pH

Back 19

7.35-7.45

Front 20

ABG range:

PaO2

Back 20

80-100

Front 21

ABG range:

PaCO2

Back 21

35-45

Front 22

ABG range:

HCO3

Back 22

21-28

Front 23

first line drugs for asthma?

Back 23

corticosteroids - improvement seen within 2 weeks.

Front 24

the incidence of TB among recent immigrants is nearly ____ times native born americans

Back 24

10x

Front 25

alveolar space that contains liquid instead of gas.

Back 25

lung consolidation

Front 26

induration of greater than ____mm is indicative of exposure to TB

Back 26

10mm. 5mm if HIV positive

Front 27

fluid in the pleural space

Back 27

pleural effusion

Front 28

TB meds leach:

Back 28

iron. Encourage foods rich in iron, protein, vit c and b

Front 29

purulent pleural fluid

Back 29

empyema

Front 30

A risk facotr for CAD that can be decreased by folic acid:

Back 30

homocysteine levels

Front 31

narrowing or obstruction of vessels in CAD occurs at the _____ of an artery

Back 31

bifurcations

Front 32

Anastamoses are also called

Back 32

colateral circulation

Front 33

two factors for colateral circulation growth:

Back 33

inherited predisposition and presence of chronic ischemia

Front 34

typical exertional angina should not last longer than ___ minutes after admin of ____

Back 34

20; NTG

Front 35

the myocardium extracts ______% of available oxygen at rest

Back 35

60-85%

Front 36

for ischemia secondary to atherosclerosis, the artery is usually ____% or more stenosed

Back 36

75%

Front 37

approximately 80% of patients with myocardial ischemia are ____

Back 37

asymptomatic

Front 38

Silent ischemia is associated with _____ and _____

Back 38

DM and HTN

Front 39

_____% of patients admitted to r/o MI have an actual MI

Back 39

25%

Front 40

three most serious causes of chest pain:

Back 40

acute MI, PE and aortic dissection

Front 41

why do circadian rhythms precipitate angina?

Back 41

catecholamines are released in the early morning and lead to vasoconstriction

Front 42

CP occuring intermittently over a long period w/ the same pattern of onset, duration and intensity

Back 42

stable angina.

usually exercised induced and shows ST depression

Front 43

unpredictable CP, easily provoked or during sleep/rest,

Back 43

unstable angina.

Front 44

treatment for unstable angina

Back 44

ASA and systemic anticoagulants, also antianginals, nitrates, BBs and CCBs

Front 45

Unstabe angina (USA) can progress to

Back 45

AMI.

theory is that plaque has ruptured and now platelets accumulate with vasoconstriction and thrombus formation

Front 46

type of angina that can be cuased by hypokalemia

Back 46

prinzmetal

Front 47

strong contraction of snooth muscle in coronary artery caused by an increase in intracellular calcium ions

Back 47

prinzmetal angina

Front 48

myocardial protein released into blood with injury to myocardial muscle. Not found in healthy patients.

Back 48

Troponin T and I. Results available within 15 minutes.

Front 49

The appearance of this enzyme in the blood indicates tissue necrosis or injury. Shows a predictable rise and flal during 3 days. . Most specific marker but peaks at 24 hours after onset of CP

Back 49

CK-MB

Front 50

stays elevated longer than CK-MB

Back 50

troponin. Good for pts that present late after AMI

Front 51

Enzyme that carries a worse prognosis

Back 51

troponin

Front 52

NTG can only be given max ____ times over ____ minutes

Back 52

3 x over 15 min

Front 53

thrombolysis meds for MI

Back 53

TPA - tissue plasminogen activator, streptokinase

Front 54

all thrombolytic agents work by converting __________ to _________

Back 54

plasminogen to plasmin

Front 55

hospital goal for thombolysis is :

Back 55

30 minutes

Front 56

gold standard antiarrythmic

Back 56

amiodarone

Front 57

Beat blockers are good for this type of patient:

Back 57

early presentation, tachycardic, HTN, anterior wall MI

Front 58

Atropine will be given for bradycardia related to AMI, but is short term adn is followed by:

Back 58

transvernous pacemaker

Front 59

large interior wall MI within 24 hrs, or MIs associated with CHF (ejection fraction <40%) should get these:

Back 59

ACEi

Front 60

normal ejection fraction

Back 60

>60%

Front 61

occlusions greater than 75% get:

Back 61

CABG

Front 62

occlusions less than 75% may get:

Back 62

PTCA (angiography)

Front 63

balloon pumps are for :

Back 63

cardiogenic shock

Front 64

to circumvent valves in harvested veins used for CABG:

Back 64

they are turned inside out

Front 65

this is given for AMI but is stopped in 4-6 weeks if LV function is preserved and no CHF

Back 65

ACEi

Front 66

This drug will be used indefinitely for AF, but only three months for large anterior AMI

Back 66

coumadin

Front 67

Strong associated factor with Buerger's disease

Back 67

smoking

Front 68

Sign of Buerger's disease

Back 68

claudication: muscle pain cuased by inadequate blood supply