Determine common triggers and risk factors of an asthma attack. (SIGS 6.4a)
RF: family hx, allergy hx, young age; Trigger: Allergic (environmental, etc); Non-allergic (cold air, exercise, infection, Aspirin, stress)
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15
Explain how CO2, pH, Temp., and 2,3 diphosphoglycerate (DPG) or biphosphoglycerate (BPG) would shift the hemoglobin saturation curve and how this affects tissue oxygenation.(Sigs Case 6.5a)
Right shift: tissue oxygenation increased; Left shift: holds onto oxygen
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15
What is included in the GOLD assessment and what is it used for?- (Sigs Case 6.6a)
Classification of COPD based on FEV1% of predicted value; determine severity of expiratory airflow obstruction for classification/prognosis/interventions
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15
Explain the relationship of pulmonary perfusion to ventilation. How is this altered in a PE?(SIGS 6.4b)
PP: measurement of how much blood is pumped through lungs to alveoli for gas exchange; PE blocks/reduces supply; air movement still occurs--> VQ mismatch
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15
What are the risks and benefits of LABAs and LAMAs for treating COPD? (Sigs Case 6.6a)
LABA-deathly asthma attack when used w/out steroid = B2-adrenoceptor decrease; LAMA-arrhythmia; increased CV risk
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15
Explain how pulmonary hypertension increases the pressure/afterload on the right side of the heart. (SIGS 6.4b)
normally very low pressure/resistance; emboli blocks flow from RV--> resistance increases--> inc. afterload on RV (needs more work to contract against resist)
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15
What is the role of glucocorticoids in managing COPD? (Sigs Case 6.6a)
Steroid must be used with LABA; decrease inflammation in flare-ups (swelling, mucus production, breathlessness)
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15
Describe how cor pulmonale can result in right-sided heart failure. (SIGS 6.4b)
cor pul.->RV work harder->enlargement & thickening of RV (remodeling)-> contraction decreased-> conduction path stretched-> V. arrhythmia-> Vfib-> RHF
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15
Identify confirmatory biochemical reactions for bacterial respiratory pathogens. (SIGS 6.5b)
