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RET 2934 > Chapter 12 > Flashcards

Chapter 12 Flashcards

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1
Q

What is emphysema?

A

A permanent abnormal enlargement of the air
spaces distal to the terminal bronchioles
associated with destructive changes of the

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2
Q

What is panilobar emphysema?

A

The acinus is the involved and is the anatomic
unit of gas exchange for the lung. It involves the
respiratory bronchioles, alveolar ducts, alveolar

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3
Q

What is centrilobar emphysema?

A

The lesion is the center of the lobules and, which
results in enlargement of the and destruction of
the respiratory bronchioles. It involves the upper

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4
Q

What is Bollous emphysema?

A

Emphysematous changes are isolated and
accompanied by the development of bullae,
which are weak air spaces and susceptible to

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5
Q

What are bullae?

A

air spaces in their distended state, more than 1
cm in diameter

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6
Q

What are blebs?

A

air spaces adjacent to the pleura, usually less
than 1 cm in diameter in their distended state.

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7
Q

What is the cause of emphysema?

A

Smoking
a1-Antitrypsin deficiency (hereditary)

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8
Q

In emphysema air-trapping leads to chronic
hyperinflation of the lungs and an ______?

A

Increased FRC

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9
Q

_______ is increased as a result of the destruction
of elastic lung tissue?

A

Lung compliance

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10
Q

What are the signs and symptoms of
emphysema?

A

Elevated hemoglobin, hematocrit, and red
blood cell count.
chronic CO2 retention and

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11
Q

What will you see on a CXR for emphysema?

A

Hyperinflation
Reduced vascular markings

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12
Q

What PFTs will be seen with emphysema?

A

Decreased forced expiratory volume in 1

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13
Q

What is the treatment for emphysema?

A

Bronchodilators
Methylxanthines

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14
Q

What are some examples of a smoking
cessation program?

A

Group counseling
Nicotine replacement therapy

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15
Q

What are some examples of a SABA and what
patients are the used for?

A

Albuterol
Xopenex
Used for COPD patients

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16
Q

What is a short acting anticholinergic?

A

Atrovent

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17
Q

What are some examples of a LABA?

A

Serevent
Spiriva

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18
Q

What is an example of an ICS and what can it be
combined with to reduce acute exacerbations?

A

Inhaled Flonase
A LABA

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19
Q

What is an example of an methylxanthine?

A

Theophylline

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20
Q

What are some examples of breathing
exercises?

A

Diaphragmatic breathing
Pursed lip breathing
O2 therapy

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21
Q

PaCO2 begins increasing after a patient with
severe COPD starts receiving O2, what does that

A

The respiratory drive has been suppressed

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22
Q

Remain the PaO2 between what?

A

50-65 mmHG

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23
Q

What is chronic bronchitis?

A

chronic excessive mucus production, resulting
from an increase in the number and size of
mucus glands and goblet cells. Symptoms are a
cough and increased mucus production for at
least 3 months of the year for more than 2

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24
Q

Who is most commonly affected with chronic
bronchitis?

A

Males

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25
What is the cause of chronic bronchitis?
Smoking
26
What is the pathophysiology of chronic bronchitis?
Mucus plugs in peripheral airways Loss of cilia Emphysematous changes in advanced stages of disease
27
What are the signs and symptoms of chronic bronchitis?
CO2 retention and hypoxemia in advanced stages Increased pulmonary vascular resistance (PVR) in advanced stages
28
What will you see on a CXR for chronic bronchitis?
Not significant in early disease Hyperinflation (in advanced stages)
29
What are some PFTs seen with chronic
Increased RV
30
bronchitis?
Decreased FEV1
31
What is the treatment for chronic bronchitis?
Smoking cessation program
32
An FEV1/FVC < 70% indicates what?
Obstruction
33
What is GOLD standard 1 Mild?
FEV1 > 80% predicted
34
What is GOLD standard 2 Moderate?
FEV1 50-79% of predicted
35
What is GOLD standard 3 Severe?
FEV1 30-49% of predicted
36
What is GOLD Standard 4 Very Severe?
FEV1 < 29% of predicted
37
What are the GOLD standard guidelines for drug therapy?
Inhaled ICS
38
therapy?
Phosphodiesterase-4 inhibitorS
39
Inhaled ICS will be beneficial for COPD patients with an FEV1 of what?
< 60% predicted
40
Combining long-acting bronchodilators and inhaled corticosteroids will be more effective than using either drug individually but may
pneumonia
41
Roflumilast can be helpful with what patients?
GOLD 3 and GOLD 4 patients who have a history of acute exacerbations and chronic bronchitis
42
Roflumilast can be combined with what?
LABAs
43
Theophylline added to ______ has been shown to increase FEV1 more than with _____ by itself.
Salmeterol
44
What methylxanthine is not recommended for chronic bronchitis?
Theophylline
45
What is asthma?
A clinical syndrome characterized by airway obstruction, which is partially or completely reversible either spontaneously or with
46
What are the characteristics of asthma?
airway hyperresponsiveness to various stimuli
47
What are some causes of asthma?
Environmental factors Infection
48
What is intermittent asthma?
the least severe of the four classifications
49
What are the symptoms of intermittent asthma?
wheezing or coughing are experienced no more than twice per week.
50
What are the PFT characteristics of intermittent asthma?
The patients in this category generally have FEV1 and peak expiratory flow (PEF) values of at least 80% of predicted.
51
What medications are used for intermittent asthma?
Routine management generally consists of beta- 2 agonists (SABAs), as needed.
52
What is the treatment for intermittent asthma?
emergency department treatment or hospitalization
53
What are the symptoms for mild asthma?
Symptoms of coughing or wheezing are experienced more than twice per week but less
54
How often do the symptoms for mild asthma
Symptoms affect the patient’s daily activity and sleep during the night; nocturnal coughing,
55
occur?
wheezing, or dyspnea is experienced more than
56
What are the PFT characteristics for mild asthma?
The patients in this category generally have FEV1 and PEF values of at least 80% of predicted.
57
What drugs are used for mild asthma?
Routine management generally consists of ICS therapy to control symptoms and the use of a
58
What is the treatment for mild asthma?
Emergency department treatment for exacerbations occurs periodically and may
59
What are the symptoms for moderate asthma?
Symptoms of coughing or wheezing are experienced almost daily in this category.
60
How often do exacerbations occur for moderate asthma?
Exacerbation of symptoms are experienced at least twice per week and may persist for several days.
61
How often do symptoms occur for moderate asthma?
Symptoms affect the patient’s daily activity and sleep during the night; nocturnal coughing, wheezing, or dyspnea is experienced more than
62
What are the PFT characteristics for moderate asthma?
The patients in this category generally have FEV1 and PEF values of 60% to 80% of predicted.
63
What are the medications for moderate asthma?
A SABA as needed for symptoms and not to exceed 3 to 4 times per day; LABA for nocturnal
64
What is the treatment for moderate asthma?
Patients in this category routinely require emergency department treatment or require
65
What is severe asthma?
This is the worst category of the four.
66
What are the symptoms for asthma?
Symptoms of coughing or wheezing are experienced almost continually.
67
How often do exacerbations occur for sever asthma?
Exacerbations are frequent and may last for weeks.
68
How often do symptoms occur for severe asthma?
Symptoms affect the patient’s daily activity and sleep during the night; nocturnal coughing, wheezing, or dyspnea is experienced almost
69
What are the PFT characteristics for sever asthma?
The patients in this category generally have FEV1 and PEF values of 60% or less of predicted.
70
What medications are used for sever asthma?
3 to 4 times per day; LABA and oral corticosteroids for nocturnal symptoms and
71
What is the treatment for severe asthma?
Patients in this category routinely require emergency department treatment or require
72
What is the pathophysiology for asthma?
When the asthmatic inhales an allergen that he or she is sensitive to, mast cells located in the bronchial mucosa and submucosa and will
73
What are the chemical mediators for asthma?
Leukotrienes Platelet-activating factor
74
What substances will the chemical mediators release:
Increased mucus production Accumulation of eosinophils in the blood and
75
Measuring FeNO can help determine what?
airway inflammation
76
What is normal FeNO for adults?
25 ppb
77
What is normal FeNO for children?
20 ppb
78
FeNO levels greater than 50 ppb indicate what?
patient needs to increase his or her normal medication
79
FeNO levels are usually increased with what?
patient’s noncompliance with corticosteroid use.
80
What are the signs and symptoms for asthma?
Paradoxical pulse Tachycardia and tachypnea
81
What are the characteristics of a chest x-ray for asthma?
Hyperinflation (hyperlucency of lung fields) Atelectasis Infiltrates
82
What are some characteristics of PFTs for
Decreased FVC
83
asthma?
Decreased FEV1/FVC
84
What are some asthma preventative drugs?
Cromolyn sodium (Intal): mast cell stabilizer referred to as a noncorticosteroid anti-inflammatory drug
85
What is the treatment for asthma during an attack?
Xopenex IV fluids O2 therapy
86
What is status asthmaticus?
a severe asthmatic attack that responds poorly to bronchodilator therapy and is associated with
87
What is the treatment for status asthmaticus?
Close monitoring of ABG levels and SpO2 Bronchodilating agents
88
What is nocturnal asthma?
Nocturnal (nighttime) symptoms are seen in up to 75% of all patients with asthma and even in those who have mild intermittent or mild
89
What are some causes uses of nocturnal asthma?
b2-receptor function during sleep aspiration sleep apnea,
90
What is the treatment for nocturnal asthma?
First line management is ICS. May also be managed by LABA.

RET 2934 (13 decks)

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