Respiratory therapists play a critical role in the medical field, providing specialized care to patients with a wide range of respiratory disorders.
To become a registered respiratory therapist (RRT), students must pass the Clinical Simulation Exam (CSE), which evaluates their knowledge and skills in the diagnosis and treatment of respiratory conditions.
This exam covers a comprehensive list of various cardiopulmonary disorders that students must fully understand, including asthma, COPD, pneumonia, and many others.
In this article, we’ll explore each of the essential respiratory diseases so that you’ll know exactly what to prepare for when you take the real thing.
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What Diseases Will Be On the Clinical Simulation Exam (CSE)?
The CSE encompasses a wide range of respiratory disorders, focusing on adult chronic airway diseases, adult trauma, cardiovascular issues, neurological and neuromuscular conditions, and various medical/surgical situations. It also covers various neonatal and pediatric conditions.
This comprehensive exam helps ensure that respiratory therapists are well-prepared to provide specialized care across a broad spectrum of patients.
Clinical Simulation Exam (CSE) Diseases:
Here is a comprehensive list of cardiopulmonary diseases to learn when preparing for the CSE:
Adult Chronic Airway Diseases
- Chronic Obstructive Pulmonary Disease (COPD): A progressive lung disease that makes it difficult to breathe. COPD is typically caused by long-term exposure to irritants such as cigarette smoke, air pollution, and chemical fumes. The two main types of COPD are emphysema and chronic bronchitis.
- Emphysema: A type of COPD characterized by increased lung expansion due to air trapping. It causes irreversible damage to the alveolar walls, which results in permanent enlargement of the air spaces distal to the terminal bronchioles.
- Chronic Bronchitis: A type of COPD that is characterized by increased mucus production in the trachea and bronchi that results in a productive cough that occurs for at least three months of the year for more than two consecutive years.
- Bronchiectasis: An obstructive condition that causes irreversible destruction of the bronchial walls of the airways, which results in the accumulation of copious amounts of bronchial secretions.
- Asthma: A chronic, obstructive, and inflammatory lung condition characterized by recurring episodes of dyspnea, wheezing, and chest tightness. Asthma episodes are triggered by a variety of factors, including allergens, exercise, and stress, and can range in severity from mild to life-threatening.
Adult Trauma
- Chest Trauma: Any physical injury or trauma to the chest, which can include the ribcage, lungs, heart, and other vital organs. Chest trauma can range in severity from minor bruises and contusions to life-threatening injuries such as punctured lungs, broken ribs, or damage to the heart or major blood vessels.
- Pneumothorax: A condition that occurs when air leaks into the pleural space, causing a collapsed lung.
- Hemothorax: The accumulation of blood in the pleural space that results from a traumatic thoracic injury.
- Head Trauma: Any physical injury, trauma, or surgical procedure to the head, brain, or skull.
- Spinal Cord Injuries: Refers to an injury to the neck or spinal cord, which is a bundle of nerves that runs from the brain down through the spine.
- Burns/Smoke Inhalation: Burns and smoke inhalation injuries are two related medical conditions that can occur together as a result of exposure to fire or other sources of intense heat or smoke.
- Hypothermia: A medical condition that occurs when the body loses heat faster than it can produce it, causing a drop in core body temperature.
Adult Cardiovascular
- Congestive Heart Failure: A chronic condition that affects the ability of the heart to pump blood adequately, often resulting in pulmonary edema. This can occur due to damage or weakness of the heart muscle or as a result of other underlying health conditions such as high blood pressure, coronary artery disease, or diabetes.
- Pulmonary Edema: A medical condition characterized by the accumulation of fluid in the alveoli of the lungs, leading to impaired gas exchange and breathing difficulties.
- Myocardial Infarction: A serious medical condition that occurs when blood flow to a part of the heart muscle is blocked, causing damage or death of the heart tissue. The blockage is typically caused by a buildup of plaque in the arteries that supply blood to the heart.
- Shock: A condition that occurs when the body’s vital organs are not receiving enough oxygen and nutrients to function properly. This can happen due to a variety of causes, such as severe bleeding, infection, heart attack, allergic reaction, or trauma.
- Cor Pulmonale: A condition that occurs as a result of damage to the right side of the heart, often resulting from pulmonary hypertension.
- Coronary Artery Disease: A condition that occurs when the arteries that supply blood to the heart become narrowed or blocked, which can restrict blood flow and oxygen to the heart muscle. This is usually caused by atherosclerosis, a process in which fatty deposits (plaque) build up in the inner walls of the arteries, reducing their diameter and impeding blood flow.
- Pulmonary Embolism: A condition that occurs when a blood clot travels to the lungs and blocks one of the pulmonary arteries. This can lead to reduced blood flow and oxygen supply to the lungs, which can be life-threatening.
Adult Neurological or Neuromuscular
- Myasthenia Gravis: A chronic neuromuscular disease that leads to descending paralysis and muscular weakness in the face, throat, and respiratory system.
- Guillain-Barré Syndrome: A rapid-onset disease characterized by ascending paralysis in which the patient’s autoimmune system attacks and causes inflammation and deterioration of the peripheral nervous system.
- Drug Overdose: A medical emergency that occurs when a person takes more than the recommended or prescribed dose of a substance or when they take multiple drugs that interact with each other. Overdose can also occur when drugs are contaminated or adulterated with other substances.
- Muscular Dystrophy: A group of genetic disorders that cause progressive weakness and degeneration of the muscles that control movement.
- Stroke: A condition that occurs when there is a lack of blood supply to the brain, which can cause damage to the brain tissue and lead to a wide range of symptoms.
- Tetanus: A bacterial infection that affects the nervous system and causes muscle stiffness and spasms, especially in the jaw and neck muscles.
Adult Medical or Surgical
- Acute Respiratory Distress Syndrome (ARDS): A respiratory disorder characterized by fluid in the alveoli that causes refractory hypoxemia, decreased lung compliance, and severe oxygen insufficiency.
- Pneumonia: An infection that causes inflammation in the lungs and results in fluid build-up, fever, cough, and difficulty breathing.
- Acquired Immunodeficiency Syndrome (AIDS): A condition caused by the human immunodeficiency virus (HIV), which attacks the immune system, gradually weakening it over time and making it difficult for the body to fight off infections and diseases.
- Thoracic Surgery: Involves surgical procedures to diagnose, treat, and manage conditions that affect the thoracic cavity, including the chest, lungs, esophagus, diaphragm, and mediastinum.
- Sleep Disorders: Medical conditions that affect the quality, timing, or duration of sleep. This includes central and obstructive sleep apnea.
- Hypothermia: A medical condition that occurs when the body’s core temperature drops below the normal range 95°F (35°C).
- Renal Failure (Diabetes): A condition in which the kidneys are unable to function properly and effectively filter waste products and excess fluid from the blood. Renal failure can be caused by a variety of factors, including diabetes.
- Pleural Effusion: A medical condition characterized by the accumulation of excess fluid between the layers of the pleura, the membrane lining the chest cavity and surrounding the lungs.
- Tuberculosis: A contagious bacterial infection caused by Mycobacterium tuberculosis, primarily affecting the lungs but potentially spreading to other parts of the body.
- Obesity: A chronic medical condition where excess body fat accumulates to the extent that it may have a negative effect on health. It is commonly measured by body mass index (BMI), and higher values are associated with increased risks of heart disease, diabetes, sleep apnea, certain types of cancer, and other complications.
- Heart Surgery: A broad range of surgical procedures performed on the heart or its vessels to treat complications of ischemic heart disease (such as coronary artery bypass grafting), correct congenital heart disease, or treat valvular heart disease from various causes, including endocarditis, rheumatic heart disease, and atherosclerosis.
- Abdominal Surgery: Refers to any surgical operation on abdominal organs, including the stomach, liver, gallbladder, pancreas, small and large intestines, spleen, and appendix. These surgeries can be performed for various reasons, including but not limited to the treatment of diseases, trauma repair, and organ transplantation.
- Laryngectomy: A surgical procedure involving the partial or total removal of the larynx, usually as a treatment for cancer of the larynx. It can result in loss of voice or necessitate breathing through a stoma in the neck.
Pediatric
- Croup: A viral infection of the upper airway that results in subglottic swelling and an obstruction below the vocal cords. It most commonly occurs in infants and children and results in inspiratory stridor.
- Epiglottitis: An acute upper airway infection that causes severe supraglottic swelling and, in severe cases, can results in respiratory failure and life-threatening complication.
- Bronchiolitis: A viral infection characterized by inflammation of the bronchioles that results in wheezing and difficulty breathing in children.
- Cystic Fibrosis: A genetic disorder characterized by abnormally large amounts of thick secretions and pancreatic insufficiency that causes lung infections and difficulty breathing over time.
- Foreign Body Aspiration: A condition in which an object becomes lodged in the airway and obstructs breathing, which can occur at any age, but is more common in children.
Neonatal
- Delivery Room Management: The medical care and support provided to both the mother and the newborn during the process of childbirth. The goal of delivery room management is to ensure a safe and healthy delivery.
- Meconium Aspiration: A condition in newborns that causes respiratory distress when meconium is aspirated into the lungs.
- Apnea of Prematurity: A disorder characterized by frequent periods of apnea that occurs in preterm infants. It is caused by a physiologically underdeveloped respiratory control center in the brain.
- Congenital Diaphragmatic Hernia: A developmental birth defect characterized by a hole in the diaphragm of a fetus that results in severe respiratory distress.
- Infant Respiratory Distress Syndrome (IRDS): A disorder in premature infants with underdeveloped lungs that is associated with decreased surfactant production and severe hypoxemia.
- Bronchopulmonary Dysplasia: A chronic respiratory disorder in premature and low birth weight infants characterized by a reduction in the overall surface area for gas exchange.
- Congenital Heart Defects: A group of structural abnormalities in the heart that are present at birth. They can vary in severity and may affect the heart’s function, circulation, or oxygen delivery to the body.
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Final Thoughts
The Clinical Simulation Exam (CSE) covers a broad subset of respiratory disorders, ranging from adult chronic airway diseases to neonatal and pediatric disorders.
As a respiratory therapist, it’s essential to have a thorough understanding of each of these conditions to provide the best possible care for your patients.
This article has provided a comprehensive list of the essential respiratory disorders that you must learn for the exam.
By studying this list and understanding the intricacies of each condition, you can prepare for the CSE and then become a skilled respiratory therapist.
Written by:
John Landry, BS, RRT
John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.
References
- Egan’s Fundamentals of Respiratory Care. 12th ed., Mosby, 2020.
- Clinical Manifestations and Assessment of Respiratory Disease. 8th ed., Mosby, 2019.
- Pant P, Joshi A, Shrestha BM, Basnet B, Bam N, Das SK. Pattern of Respiratory Diseases, Morbidities and Outcome in Patients Admitted in Respiratory Ward of a Tertiary Care Hospital: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2020.