Flashcards in 10. Small Group Smoker w SOB Deck (13):
when determining if something is obstructive or restrictive, what to look at first?
if obstructive, then FEV1 to see how significant the obstruction is
in obstructive disease, hyperresonance and diminished breath sounds argue for CB, emphysema, or asthma?
could emphysema, CB, and asthma all produce an obstructive pattern with incr RV?
in obstructive disease, airflow obstruction and diminished diffusion capacity argue for CB, emphysema, or asthma?
with emphysema, why might you palpate a liver edge? why would the diaphragm be flat?
due to the incr weight of the lungs (which have lost elastic recoil) on the abdominal contents.
in emphysema, will you see VQ mismatch?
no, because both the alveoli and capillaries are destroyed at the same time.
hyperinflation: why does it occur? benefits/problems?
adaptive because with a flow limitation (ie obstructive pattern) the only way to incr flow rate is to breathe at a higher lung volume. problem is that the resp system becomes less compliant as lung vol increases, and strength/mech advantage of inspiratory muscles are lost.
what can account for dyspnea at a relatively low level of hypoxia?
if you are breathing at a high lung volume constantly, the incr work of the resp muscles sends a signal that you are dyspneic.
why would patients with COPD breathe with pursed-lips?
because the added pressure on the airway helps reduce dynamic compression - keeps airways open longer
should emphysema respond to bronchodilator therapy?
not really - problem is with alveoli, which bronchodilators don't affect.
what are treatment options with emphysema?
not many options: bronchodilators rarely help (though they help with asthma, and somewhat with chronic bronchitis). lung reduction surgery to keep the hyperinflation problems down might help
why can you see a patient with COPD, with very minimal blood gas abnormalities?
this situation tends to occur more in emphysema than CB. there are actually very few low V/Q (shunt) areas so oxygenation tends to be preserved.