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Pharmo Drugs Kim > Chapter 14 Patho > Flashcards

Chapter 14 Patho Flashcards

1
Q
  1. What is the definition of Bronchiectasis?
  2. The abnormal dilation of the bronchi.
  3. Hyerinflation.
A
  1. The abnormal dilation of the bronchi.
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2
Q
  1. What are the 3 forms of Bronchiectasis?
A
  1. Varicose Bronchiectasis (Fusiform), Cylindrical Bronchiectasis (Tubular), Cystic Bronchiectasis (Saccular)
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3
Q
  1. Bronchiectasis effects which portion/(lobes) of the lung?
A

The lower lobes.

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4
Q
  1. Varicose (Fusiform) Bronchiectasis has what type of characteristics?
A

The bronchial walls have large, irregular shaped distortions. Resembles varicose veins that are dilated and constricted.

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5
Q
  1. Cylindrical (Tubular) Bronchiectasis has what type of characteristics?
A

The bronchial walls are dilated. The bronchi do not taper and end abruptly.

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6
Q
  1. What form of Bronchiectasis is the least severe?
A

Varicose (Fusiform), Cylindrical (Tubular) or Cystic (Saccular)
Cylindrical Bronchiectasis.

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7
Q
  1. Cystic (Saccular) Bronchiectasis has what type of characteristics?
A

Complete destruction of bronchial walls. Normal tissue is replaced by fibrous tissue. Bronchi end in large, cyst-like sacs. Trapped secretions change the airway which leads to the greatest damage to the tracheobronchial tree.

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8
Q
  1. What form of Bronchiectasis is the most severe?
A

Varicose (Fusiform), Cylindrical (Tubular) or Cystic (Saccular)
Cystic Bronchiectasis.

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9
Q
  1. What form of bronchiectasis is this?
A

Varicose (Fusiform), Cylindrical (Tubular), or Cystic (Saccular)
Cystic (Saccular) Bronchiectasis
(Trapped secretions)

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10
Q
  1. What are the anatomical alterations of the lungs that are associated with Bronchiectasis?
A

Chronic dilation and distortion of bronchial airways.
Excessive production of often foul-smelling sputum.
(Anaerobic organisms)
Bronchospasm
Hyperinflation of alveoli (air-trapping).
Atelectasis (to a degree of mucus plugging).
Consolidation and parenchymal fibrosis.
Hemorrhage secondary to bronchial arterial erosion.

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11
Q
  1. True/False. Most all causes of bronchiectasis include some combination of bronchial obstruction and infection.
A

True.

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12
Q
  1. True/False. In the United States, the incidence of non-cystic fibrosis bronchiectasis is about 4.2 per 100,000 young adults.
A

True.

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13
Q

True/False. There are higher incidences of non-cystic fibrosis bronchiectasis in under-developed countries.

A

True.

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14
Q
  1. What is the #1 cause of Bronchiectasis?
A

Cystic Fibrosis.

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15
Q
  1. The causes of Bronchiectasis are classified as:
A 
Acquired bronchial obstruction.
Congenital anatomic defects.
Immunodeficiency states.
Abnormal secretion clearance.
Miscellaneous disorders.
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16
Q
  1. What are the “acquired” causes of Bronchiectasis?
A 
Foreign body aspiration.
Tumors.
Hilar adenopathy.
COPD.
Rheumatic disease.
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17
Q
  1. What are the “congenital” (born with) causes of
A

Bronchiectasis?
Tracheobronchial abnormalities.
Vascular abnormalities.
Lymphatic abnormalities.

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18
Q
  1. What are the Immunologic States of Bronchiectasis?
A

Low levels of immunoglobulin IgG, IgA, and IgM.

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19
Q
  1. What are the Abnormal Secretion Clearance causes of Bronchiectasis?
A

Ciliary defects of airway mucosa.
(Kartagener’s syndrome -situs inversus).
(Ciliary dyskinesis).
Cystic Fibrosis.

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20
Q
  1. What are the Miscellaneous Disorders causes of Bronchiectasis?
A 
Alpha1-antitrypsin deficiency.
Recurrent aspiration pneumonia.
Inflammatory bowel diseases.
Inhalation of toxic fumes.
Chronic organ rejection following transplantation.
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21
Q

What is the “gold standard” to confirm Non-Cystic Fibrosis Bronchiectasis?

A

HR-CT scan.

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22
Q
  1. The HR-CT scan used to diagnose Non-Cystic Fibrosis Bronchiectasis replaced what method?
A

The bronchography. (Bronchogram)

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23
Q
  1. The primary diagnosis of Bronchiectasis includes:
A

An internal diameter of a bronchus that is wider than its adjacent pulmonary artery.
A failure of the bronchi to taper.
The visualization of bronchi in the outer 1-2 cm of the lung fields.

24
Q
  1. Spirometry testing can be used to determine if the bronchiectasis is primarly an _______ or _______ lung pathophysiology.
A

obstructive, restrictive.

25
Q
  1. What is the “gold standard” to confirm Non-Cystic Fibrosis Bronchiectasis?
A

HR-CT scan.

26
Q
  1. The HR-CT scan used to diagnose Non-Cystic Fibrosis Bronchiectasis replaced what method?
A

The bronchography. (Bronchogram)

27
Q
  1. In the diagnosis of Bronchiectasis, an ABG can confirm if the patient has _______, _________, or ________ bronchiectasis.
A

mild, moderate, severe.

28
Q
  1. Bronchiectasis manifestations from pathophysiologic mechanisms are caused or activated by:
A

Excessive bronchial secretions.
Bronchospasm.
Consolidation.
Increased aveolar-capillary membrane thickness.

29
Q
  1. Depending on the amount of bronchial secretions and the degree of bronchial destruction and fibrosis/atelectasis associated with bronchiectasis, the disease may create an _______ or a ________ lung disorder or a ___________ of both.
A

obstructive, restrictive, combination.

30
Q
  1. If the majority of the bronchial airways are only partially obstructed, the bronchiectasis manifests primarily as an ______ lung disorder.
A

obstructive.

31
Q
  1. If the majority of the bronchial airways are completely obstructed, the distal alveoli collapse, atelectasis results, and the bronchiectasis manifests primarily as a _____ disorder.
A

restrictive.

32
Q

True/False. If the disease is limited to a relatively small portion of the lung- as it often is- the patient may not have any of the following typical clinical manifestations of bronchiectasis.

A

True.

33
Q
  1. What are the physical signs of Bronchiectasis?
A

Increased HR, RR, BP.
Use of accessory muscles on inspiration and expiration.
Pursed-lip breathing (when obstructive).
Increased anteroposterior chest diameter (barrel chest) (when obstructive).
Cyansis.
Digital clubbing.
Peripheral edema and venous distention.
Distended neck veins, pitting edema, and enlarged and tender liver.
Cough, sputum, and hemoptysis

34
Q
  1. What is the hallmark of Bronchiectasis?
A

Chronic cough with production of large quantities of foul-smelling sputum.

35
Q
  1. In Bronchiectasis, the sputum tends to settle in layers. What are the layers?
A

Foam, Liquid, then Pus Sediment.

36
Q
  1. What are the chest findings in Bronchiectasis when the disease is Obstructive in nature?
A 
Decreased tactile and vocal fremitus.
Hyperresonant percussion note.
Diminished breath sounds.
Wheezing.
Crackles.
37
Q
  1. What are the chest findings in Bronchiectasis when the disease is Restrictive in nature?
A 
Increased tactile and vocal fremitus.
Bronchial breath sounds.
Crackles.
Whispered pectoriloquy. (99-muffled)
Dull percussion note.
38
Q
  1. Bronchiectasis pulmonary function is best described as:
A

decreased flows. (FEV1/FVC ratio is decreased)

39
Q
  1. In Bronchiectasis, pulmonary function with Obstructive Disease is described as:
A

air trapping. (FRc and RV are increased)

40
Q
  1. In Bronchiectasis, the pulmonary function with Restrictive Disease is described as:
    normal flows. (Volumes/Capacities are decreased)
A

normal flows. (Volumes/Capacities are decreased)

41
Q
  1. In Bronchiectasis, the ABG reads:
A

Increased pH.

Decreased PaCO2, HCO3, PaO2, and SaO2.

42
Q
  1. In Bronchiectasis, what are the abnormal lab tests associated with this disorder?
A

Increased hematocrit and hemoglobin.
Elevated WBC count, if infection.
Sputum examination.

43
Q
  1. In Bronchiectasis, what is the sputum examined for?
A

Streptococcus pneumoniae.
Haemophilus influenzae.
Pseudomonas aeruginosa.
Anaerobic organisms.

44
Q
  1. In Bronchiectasis, when Obstructive in nature, what do the chest findings appear as?
A

Translucent (dark) lung fields.
Depressed or flattened diaphragm.
Long or narrow heart.
Enlarged heart (in heart failure).
Areas of consolidation and/or atelectasis may or may not be seen.
Tram tracks (cylindrical bronchiectasis).
Areas of consolidation and/or atelectasis.

45
Q
  1. Tram tracks are associated with which form of Bronchiectasis?
    Varicose (Fusiform), Cylindrical (Tubular), or Cystic (Saccular).
A

Cylindrical (Tubular) Bronchiectasis.

46
Q
  1. In Bronchiectasis, when Restrictive in nature, what do the chest findings appear as?
A

Atelectasis and consolidation.
Infiltrates (suggesting pneumonia).
Increased opacity.

47
Q
  1. What is the name of this syndrome?
A

Kartagener’s syndrome; situs inversus.

48
Q
  1. What form of bronchiectasis is this?

Varicose (Fusiform), Cylindrical (Tubular), or Cystic (Saccular)

A

Cylindrical (Tubular) Bronchiectasis.

49
Q
  1. What form of bronchiectasis is this?

Varicose (Fusiform), Cylindrical (Tubular), or Cystic (Saccular)

A

Varicose (Fusiform) Bronchiectasis.

50
Q
  1. What are the circle-like structures called in this CT scan for Bronchiectasis?
A

Signet ring sacs.

51
Q
  1. What is the definition of Lung Mapping?
A

The ability to map out and determine precisely where chest physical therapy would be delivered.

52
Q
  1. True/False. Bronchiectasis is treatable, NOT curable.

.

A

True

53
Q
  1. What are the general treatments for Bronchiectasis?
A

Controlling pulmonary infections.
Controlling airway secretions.
Preventing complications.
(Vaccinations, Quit Smoking, and Avoid Pollutants)

54
Q
  1. What are the Respiratory Therapy Protocols for the general management of Bronchiectasis?
A 
Oxygen Therapy Protocol.
Bronchopulmonary Hygiene Therapy Protocol.
Lung Expansion Therapy Protocol.
Aerosolized Medication Therapy Protocol.
Mechanical Ventilation Protocol.
55
Q
  1. What are the medications commonly prescribed by a physician in the general management of Bronchiectasis?
A

Expectorants (Mucinex)
Antibiotics
NO COUGH SUPPRESSANTS!

56
Q
  1. A patient who has Bronchiectasis and is prescribed a mucolytic, what is a potential side effect?
A

Bronchospasm

Pharmo Drugs Kim (23 decks)

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