10. Small Group Smoker w SOB Flashcards Preview

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Flashcards in 10. Small Group Smoker w SOB Deck (13):
1

when determining if something is obstructive or restrictive, what to look at first?

FEV1/FVC ratio.
if obstructive, then FEV1 to see how significant the obstruction is

2

in obstructive disease, hyperresonance and diminished breath sounds argue for CB, emphysema, or asthma?

emphysema

3

could emphysema, CB, and asthma all produce an obstructive pattern with incr RV?

yes

4

in obstructive disease, airflow obstruction and diminished diffusion capacity argue for CB, emphysema, or asthma?

emphysema

5

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.

6

in emphysema, will you see VQ mismatch?

no, because both the alveoli and capillaries are destroyed at the same time.

7

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.

8

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.

9

why would patients with COPD breathe with pursed-lips?

because the added pressure on the airway helps reduce dynamic compression - keeps airways open longer

10

should emphysema respond to bronchodilator therapy?

not really - problem is with alveoli, which bronchodilators don't affect.

11

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

12

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.

13

in emphysema, how are the areas of high V/Q (ie dead space) compensated for?

by increasing ventilatory rate