RESPIRATORY - obstructive lung disorders: asthma & COPD Flashcards

EXAM 2 content

1
Q

what is the definition of obstructive lung disorder?

A

airways that are narrowed –> allows alveoli to inflate but can not deflate –> increase overall lung volume + can not bring more air in because of the air trapped already –> impaired gas exchange + acid base imbalance

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2
Q

what are the two disorders under obstructive lung dsorders?

A
  • asthma
  • COPD (chronic obstructive pulmonary disease)
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3
Q

what is asthma?

A

inflammation disorder to the bronchial mucosa

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4
Q

what is the asthma’s pathophysiology?

A

airway exposed to antigen/irritant
–> degranulation mast cells
–> histamine release
–> bronchoconstriction + vasodilation
–> cytokines + leukotrienes
–> vasodilation, incr. capillary membrane, smooth muscle constriction & mucus secretion
–> obstructs airway
–> air trapped into alveoli
–> air can not escape
–> impaired gas exchange + hypoxemia
–> hyperventilation
–> respiratory acidosis –> respiratory alkalosis
–> respiratory failure

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5
Q

what are asthma’s risk factors?

A

hypersensitivities (type 1) + environmental exposure!!
- genetics
- recurrent respiratory infections
- exercise
- GERD

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6
Q

what are the biggest asthma manifestations?

A
  • wheezes
  • non productive cough
  • use of accessory muscles to breathe
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7
Q

what are the other asthma manifestations?

A
  • neuro: altered LOC, dizziness, anxiety
  • CV: tachycardia & hypotension
  • resp: tachypnea, dyspnea & diminished breath sound
  • GI: n/v
  • GU: oliguria
  • integ/musc: cyanosis & delayed capillary refill
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8
Q

what labs and lab diagnostics would we use for asthma?

A

ABGs & PFTs (pulmonary function tests)

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9
Q

what types of drugs do we use for asthma?

A
  • ventilatory support: O2 & mech vent
  • opening airways
  • reduce allergic reactions
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10
Q

what are the asthma’s complications

A
  • status asthmaticus
  • acid base imbalance –> respiratory failure –> cardiac arrest –> death
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11
Q

what is status asthmaticus?

A

a continuous state of asthma attack –> can get hypoxic –> respiratory/cardiac arrest

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12
Q

what is COPD? does it have a cure?

A

a progressive disease characterized by airflow limits

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13
Q

what are the two major divisions of COPD and what are they? what do they both lead to?

A
  • chronic bronchitis: overproduction of mucus & productive cough
  • emphysema: destruction of alveolar walls –> breakdown elasticity of alveoli –> enlarges gas exchange airways

BOTH LEAD TO TRAPPING OF AIR –> chronic hypercapnia + hypoxia

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14
Q

what is the the pathophysiology of COPD’s chronic bronchitis?

A
  1. inflammation –> incr. in cells + mucus production –> air able to get into alveoli during inhalation –> air gets trapped bc of mucus during exhalation –> decr. gas exchange –> v/q mismatch
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15
Q

what is the the pathophysiology of COPD’s emphysema?

A

neutrophils release an incr. of elastase & protease –> breaks down alveoli & bronchioles –> they lose elasticity –> air trapped –> v/q mismatch

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16
Q

what is the haldane effect? is that part of chronic bronchitis or emphysema?

A

where oxygenated blood cant carry CO2 well –> if we give more O2 –> it kicks CO2 in the serum –> pt naturally breathes faster –> but w/COPD you can NOT –> pt becomes hypercapnic, hypoxic, & vasoconstriction in lungs

17
Q

what are COPD’s risk factors?

A
  • genetics
  • smoking!
  • exposure to chemicals/pollution
  • repeated respiratory infections
18
Q

what are COPDs manifestations?

A
  • neuro: altered LOC, dizzy & anxiety
  • CV: tachycardia & hypotension
  • resp: tachypnea, dyspnea, diminished breath sounds
  • GI: n/v
  • GU: oliguria
  • integ/musc: cyanosis, delayed capillary refill, using accessory muscles, weight loss, barrel chest, tripod breathing & clubbing
  • repeated respiratory infections
19
Q

what are the biggest differences to know if its more chronic bronchitis or emphysema?

A
  • chronic bronchitis: wheezing & productive cough
  • emphysema: non productive cough
20
Q

what labs & diagnostics are we using for COPD?

A

-ABGs: 60-60 club
- PFTs & Xray

21
Q

what does the 60-60 club mean?

A

when the pt is hypoxic & hypercapnic
- PO2 = 60 (norm 80-100)
- CO2 = 60 (norm 35-45)

22
Q

what are COPD’s complications?

A
  • infection
  • spesis
  • hypercapnia!: haldane effect & v/q mismatch
  • hypoxemia!
  • respiratory acidosis
  • acute respiratory failure
  • renal failure
  • cor pulmonale
  • death