In each blank, try to type in the
word that is missing. If you've
typed in the correct word, the
blank will turn green.
If your not sure what answer should be entered, press the space bar and the next missing letter will be displayed. When you are all done, you should look back over all your answers and review the ones in red. These ones in red are the ones which you needed help on. Question: what are breath sounds?Answer: high pitched, loud intensity sounds heard over the Question: what are breath sounds?Answer: moderate pitch, moderate sound, around upper half of sternum and between the scapulae. Question: what are the vesicular breath ?Answer: low pitch, soft intensity and heard in the peripheral lung Question: what is ?Answer: loud, high pitched that can sometimes be heard w/o at stethoscope. it is a sign of obstruction and heard mostly on inspiration. Question: what are discontinuous sounds?Answer: breath sounds that are intermittent, , or bubbling on short duration. Question: In a diagram of normal breath sounds, what does the of the stroke represent?Answer: the Question: in a of normal breath sounds, what does the angle represent?Answer: the Question: when one crackles, what is going on in the airways?Answer: excessive secretions or fluid in the OR collapse airways that are popping open during inspiration Question: in what disease processes can you hear wheezing?Answer: anytime multiple airways are obstructed eg , bronchitis and CHF Question: what is friction rub?Answer: creaking or grating sound (sounds ) that occurs when the pleural surfaces become inflamed and the roughened edges rub together during breathing. usually localized to a certain site of the chest wall. Question: what is ?Answer: an increase in the intensity and clarity of resonance produced by enhanced transmission of vocal vibrations. Question: what does bronchophony ?Answer: inc lung density (eg consolidation in pneumonia) Question: what is the possible lung behind fine crackles?Answer: sudden of peripheral airways Question: when are fine crackles usually ?Answer: late Question: what disease processes are fine associated with?Answer: atelectasis, , pulmo edema Question: what is biot's breathing like and what disease process does it ?Answer: with periods of apnea. (increased ICP) Question: what is kussmaul breathing and what disease process does it ?Answer: deep and fast, like panting. (metabolic ) Question: what is asthmatic breathing like and what process does it indicate?Answer: prolonged expiratory phase. (obstructive disease) Question: what is cheyne'stokes breathing and what disease process does it ?Answer: shallow increases depth and rate followed by a period of apnea. Regular. (CNS problem, CHF) Question: what is breathing and what disease process does it indicate?Answer: long inspiration, like a sigh. (brain stem ) Question: what is paradoxical and what does it indicate?Answer: chest wall collapses or moves in while abdomen moves out. associated with muscle fatigue. Question: what is and what can cause it?Answer: no breathing. (Arrest, airway obstruction) Question: where is the PMI (point of max -of heart)?Answer: mid-clavicular line 5th space Question: PMI towards/away from lobal collapse?Answer: Question: PMI towards/away from pneumothorax?Answer: Question: what is a quiet SI or S2 indicative of?Answer: , poor CO Question: what is especially associated with?Answer: liver cancer, cirrohsis, and other cancers Question: can be sign of what?Answer: sided heart failure Question: what is associated with?Answer: Clubbing-chronic long standing , lung cancers, infiltrative/interstitial lung disease, CHD, liver disease, inflammatory bowel disease Question: what is pedal ?Answer: of lower extremities due to inc in the hydrostatic pressure of the venous system. Question: what disease process is pedal edema with?Answer: left and heart failure. Question: what is ?Answer: skin that is white with spots of Question: what does of skin indicate?Answer: inadequate perfusion, lack of arterial blood flow Question: what is ?Answer: of soft tissue in the extremity Question: what disease process is associated with?Answer: heart failure or or lung disease Question: what are the four of the treatment plan and evaluation?Answer: oxygenation, ventilation, management and secretion management Question: what is hemoptysis?Answer: more than 300 ml in a 24 hour Question: how long is a normal PR on an ECG?Answer: .12 to .20 or 3-5 small boxes Question: what is on in the heart during the P wave?Answer: Atrial Question: what is going on in the during the QRS complex?Answer: Conduction Question: what is going on in the heart during the ST ?Answer: Time between left ventricular depolarization and Question: what is on in the heart during the T wave?Answer: Repolarization Question: on the ECG grid, what does the axis mean?Answer: mV (volts) Question: on the ECG grid, what does the axis mean?Answer: seconds Question: on the ECG grid, what does one vertical box mean?Answer: 5 mm or .5 Question: on the ECG grid, what does one horizontal box mean?Answer: .2 sec (.04 per each box) Question: what is the normal length of a QRS ?Answer: less than 0.12 sec (3 blocks) Question: what is the six rule in counting heart rate on the ECG?Answer: Measure the of R waves or beats in a six second period then multiply by 10 Question: what is the rule in counting heart rate on the ECG?Answer: the number of large (0.2 sec) blocks between R waves Question: what is the of heart rate in counting the heart rate for block rule?Answer: 300 (1 =.2), 150 (2 blocks), 100,75,60,50 Question: what happens during tachy?Answer: ectopic focus above the ventricles,HR around 150, electrical pulses from av node have gone a bit , can deteriorate into v tach or v fib. Question: what would you give lidocaine for an arrhythmia?Answer: to dec mycocardia Question: what you give nitroglycerine for during an arrhythmia?Answer: vasodilator Question: what are ?Answer: consist of large molecules that attract and hold Question: what does mean?Answer: describes how much osmotic pressure is exerted by a Question: what is the tonicity of average body cell ?Answer: .9%, is to .9% NaCL solution Question: what does mean?Answer: more than .9% Question: what does a CBC lab test mean?Answer: blood count test-provides detailed description of WBCs, RBCs and platelets Question: what is ?Answer: elevation of the WBC Question: what is ?Answer: WBC below normal Question: what are common causes of ?Answer: bone marrow , chemo and radiation therapy for cancer Question: What is WBC count?Answer: 4500 to 11,500 Question: what is the percentage of in the WBC count?Answer: 40% to 75% Question: what is the absolute count of ?Answer: 1800 to Question: what are the causes for an abnormality in neutrophil ?Answer: increases due to bacteria infection and trauma, w bone marrow diseases Question: what is the percentage of eosinophils in the WBC ?Answer: 0 to 6% Question: what is the count of eosinophils?Answer: 0 to Question: what are the for an abnormality in eosinophils count?Answer: increased w allergic reactions and parasitic Question: what is the of basophils in the WBC count?Answer: 0 to 1% Question: what is the absolute count of ?Answer: 0 to Question: what are the causes for an in basophils count?Answer: increased w reactions Question: what is the percentage of monocytes in the WBC ?Answer: 2% to 10% Question: what is the count of monocytes?Answer: 90-1000 Question: what are the causes for an in monocytes count?Answer: inc w of foreign material Question: what is the of lymphocytes in the WBC count?Answer: 20 to 45% Question: what is the absolute count of ?Answer: 900 to Question: what are the causes for an abnormality in count?Answer: inc w viral infections, count w immunodeficiency probs Question: what is ?Answer: elevation of the absolute value of Question: what are neutrophils referred to as?Answer: bands (due to shape of nucleus) Question: what are mature neutrophils as?Answer: segs Question: when both and segs are elevated in the CBC, what does this mean?Answer: body is fighting a more severe bacterial infection. severe infection causes the bone to release both mature and immature neutrophils Question: what is ?Answer: reduced number of circulating Question: what can mean?Answer: RBC production is inadequate or excessive loss of blood has Question: what is ?Answer: significant in the platelet count Question: what hazards come with ?Answer: pt will bruise easily and at risk for Question: What is the normal value for ?Answer: 137-147 mEq/L Question: what is the value for potassium?Answer: 3.5 to 4.8 mEq/L Question: what is the value for chloride?Answer: 98 to Question: what is the value for co2?Answer: 25-33 Question: what is the value for BUN?Answer: 7-20 Question: what is the normal value for ?Answer: 150-220 mg/l Question: what is the value for glucose?Answer: 70-105 Question: What does the total co2 mean in of hco3?Answer: co2 reps the level of hco3 in venous Question: how does hco3 mean for co2?Answer: means elevated Question: what does hco3 mean for co2?Answer: means abnormally low total Question: what are the chloride in CF patients?Answer: they are elevated (more than 60-80) bc of their inability to it Question: how do you the anion gap?Answer: adding hco3 and cl together and subtracting them from Na Question: what does anion gap ?Answer: the balance between anions and cations in the Question: what is the normal range of gap?Answer: 8-16 mEq/l Question: what does of the anion gap suggest?Answer: a metabolic is present (esp if over 16) Question: what are the two most common tests to evaluate function?Answer: BUN and Question: what will the BUN look like renal disease?Answer: can be over 20 mg/dl Question: what are levels of creatinine?Answer: .7-1.3 mg/l Question: what is range for mild ?Answer: 60-80 Question: what is for moderate hypoxemia?Answer: 40- 60 Question: what is for severe hypoxemia?Answer: 40 or less Question: for adequate oxygenation, there are five :Answer: transfer of oxygen across the alveolarcapillary membrane,presence of hemoglobin to the O2,cardiac output to deliver O2 to the tissue bed,release of O2 from the hemoglobin molecule,ability of the cells to utilize O2. Question: what is the effect of , fever, and increased concentrations of 2,3-diphosphoglycerate (2,3-DPG) on the oxy-hb dissociation curve? Answer: shifts it to the right-making oxygen more readily available for to tissues.dec affinity Question: what is the effect of Alkalosis and decreased 2,3-DPG concentrations on oxy-hb curve?Answer: shifts to the left- increasing oxygen binding to Hgb and potentially oxygen delivery to tissues. inc affinity Question: what are two examples of that inhibit the cells from using O2?Answer: Lactic acidosis and poisoning Question: Case study
A 47 year old man is seen in the ED are : ph 7.47, PaCO2 33, HCO3 20,
PaO2 122mmhg.
Can this PaO2 be correct?
Answer: Using Dalton’s Law and Alveolar air :
(Pb-H2O) X FIO2 - (PaCO2 X RQ)
(760- 47) X .21 - (33 X 1.25)
149.73 – 41.25= 108.48 Alveolar
Question: Case study
A 47 year old man is seen in the ED are : ph 7.47, PaCO2 33, HCO3 20,
PaO2 122mmhg.
Can this PaO2 be correct?
Answer: 108.48 Alveolar
122 arterial
Aging – about 3mm loss
AC Membrane thickness- 10 mm loss
122 – (3+10) = 109 arterial
Question: what is a way to hyperkalemia?Answer: give up to 10 mg/hr Question: what is the impact of Primary Respiratory Disturbances-Acidosis on dead ?Answer: Increased dead space- ventilation where no gas exchange place. Question: Respiratory Disturbances-AcidosisAnswer: bad alveolar ventilation- the lung's to excrete CO2,Increased production of CO2-Changes in metabolic rate like fever.,Increased dead space- ventilation where no gas exchange takes place Question: Primary Respiratory - AlkalosisAnswer: Hyperventilation- excessive alveolar production of CO2-Changes in metabolic rate like fever.,Increased dead space- ventilation where no gas exchange takes . Question: Hypoventilation is seen withAnswer: muscle weakness/ , CNS malfunction, and mechanical disadvantage. Question: Increased production of carbon is frequently seen inAnswer: burn patients, septic , fever, and malnutrition. Question: Increased dead space ventilation is frequently Answer: in rapid shallow breathing, anatomical. Disorders, which are characteristic of ventilation like PE. Or V/Q imbalances. Question: Primary Metabolic - AcidosisAnswer: Loss of plasma HCO3.,Increase in nonvolitile acids. ,Evident by plasma HCO3 less than 22 Meq/l. Anion gap is useful in acidosis due to a or b. Question: Loss of plasma HCO3 is seen inAnswer: diarrhea, decreased renal tubular function disease, hyperalimentation nutrition. Normal anion gap. Question: Increased production of fixed acids is seen in like Answer: diabetic ketosis, lactic acid, ingestion of acids aspirin, methanol, ethylene . High anion gap. Question: Metabolic Disturbance- AlkalosisAnswer: Increased levels of plasma HCO3.,Loss of fixed acids.,Evident by plasma HCO3 greater than 26 Meq/l and pH greater than 7.45.,Be aware of compensatory , especially in chronic hypoventilation situations Question: what are examples seen that lead to alkalosis?Answer: Bicarbonate replacement in cardiac arrest. Excessive gastric suctioning or vomiting. hypochloremia and hypokalemia. These are common side effects in the COPD taking meds for cor pulmonale, and CHF Question: what type of acid base is cardiac arrest?Answer: Combined respiratory and metabolic acidosis. Apnea results in anaerobic metabolism that in an increase in fixed acids. Question: What happens to pH a cardiac arrest?Answer: pH drops quickly below 7.35 with PaCO2 and decreased HCO3. Question: How do you correct arrest?Answer: with artificial ventilation and bicarbonate administration. Question: what is the frequency of Combined and metabolic alkalosis?Answer: it is very rare. Question: what is the threshold?Answer: between 26 and 30 Question: hypoxiaAnswer: refers to the condition in which is inadequate oxygen at the tissue cells caused by low arterial O2 tension Question: hypoxiaAnswer: -the tension in the arterial blood is normal but the O2 carrying capacity of the blood is inadequate. Question: Circulatory hypoxia (aka or hypoperfusion)Answer: blood that reaches the tissue cells may have a normal O2 tension and content, but the amt of blood and therefore the amt of O2- is not adequate to meet tissue needs. Question: hypoxiaAnswer: develops in any condition that the ability of tissue cells to utilize oxygen. |
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