Test 3: Wk11: 2.3 Mechanisms of Ventilation - Dasgupta Flashcards

2
Q

5 Obstructive diseases

A

emphysema

asthma

bronchitis

CF

COPD

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3
Q

5 Restrictive Diseases

A

Pulmonary fibrosis

sarcoidosis

silicosis

asbestosis

Wegener’s Granulomatosis

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3
Q

Restrictive diseases characterized by

A

low lung compliance or increased stiffness of the lung and increased recoil

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4
Q

Obstructive Dz characterized by

A

high airway resistance

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5
Q

Asthma

A

chronic inflammatory disorder of airways characterized by airflow obstruction

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6
Q

Bronchitis

A

inflammation of mucous membranes of bronchi

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7
Q

Cystic Fibrosis

A

causes thick, sticky mucus build up in the lungs and GI

caused by mutation on CFTR gene

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8
Q

COPD

A

coexisting emphysema and chronic bronchitis

narrowing of airways and shortness of breath

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9
Q

pulmonary fibrosis

A

chronic dz that causes swelling and scarring of alveoli and interstitial tissue

scar tissue replaces healthy tissue and causes inflammation

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10
Q

Sarcoidosis

A

dz in which abnormal collections of chronic inflammatory cells form as nodules in the lungs or lymph nodes.

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11
Q

silicosis/ asbestosis

A

pulmonary fibrosis due to long term exposure to silica and asbestos

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12
Q

Wegener’s Granulamatosis

A

presence of pulmonary nodules

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13
Q

coin lesions

A

Wegener’s Granulamatosis

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14
Q

normal FEV1

A

80% FVC

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15
Q

FEV1 is an estimate of

A

airway resistance because it depends largely on flow rate

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16
Q

FEV 75% to 25% is

A

the slope between 75% and 25% on the FEV graph

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17
Q

Low FEV 1 and FEF 25-75% are diagnostic of

A

obstructive pulmonary disease

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18
Q

FEV1 / FVC normalizes FEV1 to

A

body size

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19
Q

in obstructive disease FVC is

A

lower

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20
Q

in obstructive disease FEV1 is

A

lower

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21
Q

FEV1 / FVC in obstructive

A

decrease

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22
Q

FEV1 / FVC in restrictive

A

normal to increased

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23
Q

why is FEV1 higher in restrictive disease than obstructive

A

in restrictive a small volume of air is expired quickly because of low compliance

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24
Q

FEV1/FVC ratio is lower than 70%, then that suggests

A

obstructive lung

disease

25
Q

FEV1/FVC ratio is higher than 70%, then that suggests

A

restrictive lung disease.

26
Q

normal FEV1/FVC

A

80%

27
Q

Flow volume loop obstructive disease shifts

A

to the left towards larger volumes as a result of high compliance

28
Q

Flow volume loop restrictive disease shifts

A

right towards smaller volumes as result of decreased compliance

29
Q

Obstructive disease expiratory rates are much smaller than normal from

A

collapse of airways

30
Q

Peak Expiratory Flow Loop Obstructive Disease

A

shift left

expiration is prolonged because of high compliance and dynamic collapse

31
Q

Peak Expiratory Flow loop Restrictive Disease

A

Shift right

Lungs are stiffer only small volume inhaled and expired quickly

32
Q

Restrictive Disease flow volume curve

A

witches hat shape

33
Q

Obstructive Disease flow volume loop

A

low and concave

34
Q

Pneumothorax

A

air enters the pleural cavity leading to partial or total collapse of lung

35
Q

Tension Pneumothorax

A

more and more air accumulates in pleural space with each breath

36
Q

non-tension Pneumothorax

A

air in pleural space does not accumulate with each breath

37
Q

why is tension Pneumothorax an emergency

A

accumulating air puts pressure on the organs of chest

38
Q

Atelectasis

A

partial or total collapse of the lung

39
Q

Complete Atelectasis collapse of lung with shift of mediastinum to

A

the side of the collapse

40
Q

what direction does the mediastinum go in Pneumothorax

A

elevated pressure shifts mediastinum to opposite direction

41
Q

SPONTANEOUS PNEUMOTHORAX

A

Without any blunt force trauma

or medical procedure

42
Q

NON-SPONTANEOUS

PNEUMOTHORAX

A

Arising due to blunt force

trauma or medical procedure

43
Q

PRIMARY SPONTANEOUS

PNEUMOTHORAX

A

Without any existing lung

pathology

44
Q

SECONDARY SPONTANEOUS

PNEUMOTHORAX

A

Arising due to lung disease

e.g. COPD

45
Q

TRAUMATIC PNEUMOTHORAX

A

Blunt-force trauma, gun shot
wound, knife wound, car
accident

46
Q

IATROGENIC PNEUMOTHORAX

A

Trauma due to a medical
procedure e.g. pacemaker
insertion

47
Q

treatment of pneumothorax includes

A

needle aspiration or insertion of a one-way chest

tube to allow the air to escape. Occasionally, surgical measures are required

48
Q

Methacholine test used for

A

detection of hyperreactive airways

49
Q

when is Methacholine test started

A

when baseline spirogram is relatively normal

50
Q

Methacholine test is sensitive for

A

asthma

51
Q

Methacholine is a

A

bronchoconstrictor

52
Q

how does Methacholine test work

A

5 stage test with increasing dose of Methacholine until FEV1 drops to 20% of original value

53
Q

if FEV1 is less than 20% after 5 stages

A

the test is negative

54
Q

a PC20FEV1 of less than 8mg/mL suggests

A

hyperactive airway - asthma

55
Q

PC20FEV1 8-16

A

no asthma

56
Q

do all pts testing positve for Methacholine test have asthma

A

no, Patients with COPD, who smoke or patients with allergic rhinitis will test positive in
the methacholine test

57
Q

asthma patients taking anti-inflammatory drugs

may test

A

negative

58
Q

Patients whose asthma is triggered by specific agents like cold or allergens may also test

A

negative

59
Q

what direction does the mediastinum shift in a pneumothorax

A

increased pressure shifts mediastinum in the opposite direction