Clinical Approach to Pulmonary Diseases Flashcards Preview

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Flashcards in Clinical Approach to Pulmonary Diseases Deck (36):
1

What are the 3 categories of pulmonary causes of dyspnea?

- Obstruction
- Restriction
- Pulmonary HTN

2

What are the main obstructive lung diseases?

Asthma
COPD
Bronchiectasis

3

What are the main restrictive lung diseases?

Interstitial Lung Disease
Chest Wall
Neuromuscular

4

What are the signs and symptoms of obstructive lung diseases?

SOB, DOE, Cough, Tightness, Poor Air Movement, Wheezing and Hyperinflation in CXR

5

Is asthma a reversible disease?

Yes

6

What are the relievers of asthma and how are they used?

Bronchodilators
All asthmatics get a puffer - inhaler as a beta agonist that should be used as needed

7

What are the controllers of asthma and how are they used?

Controllers
They are anti-inflammatory medications that must be regularly used

8

What are first line controllers?

Corticosteroids

9

What are the second line controllers?

Long Acting beta􏰄-Agonists
􏰀Anti-Leukotrienes

10

What are some SE of inhaled corticosteroids?

Can cause inflammation or infection in the throat - this can be managed with teeth brushing after use or a spacer that only allows small particles through

11

What are SE of long acting beta agonists?

Long acting beta agonists on their own will increase
the risk of dying

12

What is the 2nd most common cause of chronic cough?

Cough Variant of Asthma

13

How does exercise induced asthma occur?

- Increased minute ventilation results in mucosal ‘dehydration’ and mast cell degranulation
- Worse in cold, dry air

14

What is occupational asthma?

Due to inhalational trigger in work environment

15

What is reactive airway dysfunction syndrome?

Reactive Airway Dysfunction Syndrome - patient
who was normal until one day in their life when
there asthma is triggered and they will have asthma
everyday since that exposure

16

What is Samter's Triad and what does it relate to?

- Asthma
- Nasal Polyposis
- ASA Sensitivity

It relates to aspirin induced asthma

17

What is ABPA?

Allergic Bronchopulmonary Aspergillosis - hyperreactivity to aspergillus via IgE - treated with steroids

18

What are the 2 main classifications of COPD and what are their symptoms?

􏰀- Emphysema: Permanent distention of the distal air spaces with destruction of alveolar septa
-􏰀 Chronic Bronchitis: Excessive sputum production

19

What are the characteristics of emphysema?

Pink Puffer
􏰀- Maintains a normal pCO2
􏰀 ‘Huffs and Puffs’
􏰀 ‘Burns calories’
􏰀- Therefore, maintains a normal pO2
􏰀- Appears ‘pink’

20

What are the characteristics of chronic bronchitis?

Blue Bloater
􏰀- “Accepts” Hypercapnea
􏰀- Less tachypneic
􏰀 Doesn’t burn calories
􏰀 Results in Hypoxia (Cyanosis)
􏰀 Hypoxic Pulmonary
- Vasoconstriction 􏰀 Edematous
􏰀 Lots of Mucous

21

What are some of the medications for COPD?

1. Anti-cholinergics (ipratropium)
2. 􏰄Beta-agonists (albuterol,pirbuerol,levalbuterol)

22

What is the recommendation for O2 use?

O2 proved to be beneficial for most COPD patient groups

23

What is bronchiectasis?

A suppurative lung disease characterized by permanent abnormal dilation of the bronchi

24

What is a major characteristic of bronchiecctasis?

Daily copious sputum production

25

“Signet Ring Sign”

The internal diameter of the bronchus is larger than that of its accompanying vessel

26

􏰀 “Tram Tracking”

The bronchus fails to taper in the periphery of the chest.

27

What is the cycle of bronchiectasis?

It is the cycle of mucus stasis, infection, inflammation, and airway destruction

28

What is the main cause of restrictive lung diseases?

Interstitial Lung Diseases

29

Interstitial Lung Disease

Chronic, non-malignant, non-infectious inflammation and/or derangement of the alveolar walls - increased elastic recoil

30

What are some examples of interstitial lung diseases?

􏰀Sarcoid
􏰀Hypersensitivity Pneumonitis
􏰀Idiopathic Pulmonary Fibrosis/ “IIP’s” 􏰀
Tuberculosis
Fungal
Aspiration / Asbestosis
􏰀Connective Tissue Diseases / (Cancer)
􏰀Eosinophilic Granuloma 􏰀
Drugs - Amiodarone,Nitrofurantoin, Bleomycin

31

What are the signs of ILD?

- Reduced TLC
- 􏰀 “Interstitial Markings”

32

What is sarcoid?

􏰀Non-Specific Tissue Reaction 􏰀
Non-Caseating Granulomata

33

Who is the typical patient of sarcoid?

Young African American Female

34

Who is the typical patient of idiopathic pulmonary fibrosis?

Middle Aged/Elderly Male

35

What are some symptoms of IPF?

􏰀 Insidious DOE
􏰀 Cough

36

What are the treatments for IPF now?

- Previously there were no known treatments
- Now use:􏰀 Pirfenidone and Nintedanib

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