Chronic Lung Disease

Question 1

what is bronchial asthma

Answer 1

chronic inflammation of airway - bronchial constriction

allergy c airway hyperrresponsiveness

reversible limiation

Question 2

usual characteristics of asthma

Answer 2

wheezing

breathlessness

chest tightness

inc mucus - cold go to chest

coughing

relief p bronchodilator

Question 3

discuss inflammatory response in asthma

Answer 3

response from interleukins and eosinophils to allergens

causes vasoconstriction and airway hyper responsiveness

beta agonists like salbutamol - combats this

Question 4

usual triggers of asthma

Answer 4

allergens

respi infections

exercise and hyperventilation

sulfur dioxide

stress and emotions

cigarette

food, additives, drugs, chemical

Question 5

common allergens of asthma

Answer 5

dust and mites

cockroach

fur, saliva, urine

mold

pollen

chemical irritants and scented products

Question 6

risk factors of asthma

Answer 6

host - strongly genetic

environmental factors

Question 7

discuss the process of asthma

Answer 7

from allergens mag bronchoconstrict tapos inc mucus kasi hyperactive

dyspnea or hypoxic na d/t dec airflow

kaya may wheeze or breathlessness

Question 8

dx of asthma

Answer 8

clinical dx

hx and pattern

PE

lung function

airway response

allergic status

Question 9

acute ssx of asthma

Answer 9

dyspnea

wheezing to absent

alar flaring

interrupted talking

agitation

chronic or recurring cough

Question 10

goals of PT in asthma

Answer 10

minimal or no chronic sx

minimal exacerbation

no emergency visits

minimal use of beta 2 agonist

no limit on activity

< 20% circadian variation

normal PEF

min adverse effects of medicine

Question 11

what lung function is measured in asthma

Answer 11

PEF

Question 12

what are the meds for asthma

Answer 12

long-term: regularly control chronic attacks; inhalers and tablets

quick relief: rapid short term during attack; inhalers

allergy control: dec sensitivity to allergens

reliever: short acting

controllers: long acting

Question 13

primary cause of COPD

Answer 13

cigarette smoking

Question 14

what is COPD

Answer 14

irreversible airflow limitation and structural changes

inflamm response to noxious particles or gases

Question 15

what are the 2 classes of COPD

Answer 15

emphysema and chronic bronchitis

Question 16

discuss chronic bronchitis

Answer 16

too much mucus kase hyper active response

cough and sputum for at least 3 mo in 2 consecutive yrs

Question 17

discuss emphysema

Answer 17

prob c surfactant

destruction and dilation of alveoli - malaki sila so di nag iinflate

Question 18

ssx of chronic bronchitis

Answer 18

inflamed small airways

swelling

hypertrophy

mucus more in morning

blue bloater - stocky and cyanotic

copious cough na 2 yrs

Question 19

ssx of emphysema

Answer 19

aleveolar destrcution

airflow narrowing na permanent

pink puffer - thin and emaciated

non-prod cough

hypertrophy of SCM, traps and scalenes

barrel chest

Question 20

characteristics of a person c COPD

Answer 20

tripod sign and pursed lip

wheezing

prolonged inhalation and easy fatigue

frequent respi infections

cor pulmonale

barrel chest

clubbing

accessory muscles

Question 21

host factors of COPD

Answer 21

alpha1-antitrypsin deficiency - born preterm

hyperresponsiveness

lung growth

Question 22

exposure factors of COPD

Answer 22

tobacco smoke

occupational dust and chemicals

infections

socioeconomic status

Question 23

pathogenesis of COPD

Answer 23

noxious agent + susceptible host = COPD

mag kaka lung inflammation that causes fibrosis so permanent na

inflammation of small airway and parenchymal destruction

RLD = ariflow limitation

Question 24

usual lung function measured in COPD

Answer 24

FEV1 and FVC

Question 25

goals of PT in COPD

Answer 25

prevent progression relieve sx improve ex tolerance and health prevent exacerbations and complications reduce mortality min side effects of meds

Question 26

what is restrictive lung disease

Answer 26

reduced lung compliance - more pressure to expand kase stiff dec TLC, FEV1, FVC

Question 27

mechanism of disease of RLD

Answer 27

injury to endothelial and epithelial cells lead to fibrosis = stiff lung

Question 28

discuss chest wall abnormality

Answer 28

RLD but not primarily lung from deformities or kyphoscolio MG, ALS, MS, dystrophy and myopathy

Question 29

acute primary lung disease

Answer 29

RLD - ARDS

Question 30

chronic primary lung disease

Answer 30

occupational: asbestos, coal, silicosis interstitial lung disease and fibrosis sarcoid, SLE, RA, wegener radiation or chemo

Question 31

what are chronic RLD

Answer 31

group of diseases nag kaka honeycomb lung from fibrosis poor prog usually

Question 32

idiopathic pulmonary fibrosis

Answer 32

80% idiopathic and 20% collagen vascular disease random pattern ng inflamm and fibrosis severe hypoxemia and cyanosis - vent cant help M>F and 60 yo dx of exclusion

Question 33

pathogenesis of idiopathic pulmonary fibrosis

Answer 33

alveolitis fibrosis immune prob macrophages

Question 34

clinical pres of idiopathic pulmonary fibrosis

Answer 34

gradual non prod cough dyspnea and cyanosis inspi crackles clubbbing poor response to PT bad prog: 2-4 yrs

Question 35

sarcoidosis

Answer 35

multisystem and unknown cause non-caseating granuloma dx of exclusion benign and self-limiting

Question 36

salient features of sarcoidosis

Answer 36

B hilar lymphadenopathy lung and nodules skin, eye or any tissue < 40 yo and US blacks higher in non-smokers

Question 37

ssx of sarcoidosis

Answer 37

asymptomatic in many lymphadenopathy, skin and eye lesions dyspnea, dry cough low grade fever, fatigue and weight loss undpredictable and can be progressive or relapsing-remitting 10% have fibrosis

Question 38

pathogensis of sarcoidosis

Answer 38

CD4 t cells and fibroblasts non-caseating granulom schumann bodies asteroid bodies

Question 39

hypersensitivity pneumonitis

Answer 39

immune mediated - type 3-4 hypersensitivity not common in PH inflamm, occupatoinal and restrictive

Question 40

presentation of hypersensitivity pneumonitis

Answer 40

acute: 4-6 hrs p exposure - fever, cough and dyspnea chronic: cough, dyspnea, hypoxemia and weight loss

Question 41

causes of hypersensitivity pneumonitis

Answer 41

fungal or bacterial - cheese animal product - pigeon chemicals

Question 42

collagen vascular diases

Answer 42

assoc c interstitial pneumonia similiar to IPF favorable prog c tx

Question 43

causes of collagen vascular disease

Answer 43

scleroderma polymyositis or dermamyosistis SLE RA ankylosing spondylitis

Question 44

what is wegener granuloma

Answer 44

necrotizing vasculitis URT: sinusitis, epistaxis, nasal perforation LRT: cough, hemoptysis, chest pain