COPD

Question 1

primary function of resp system:

Answer 1

gas exchange

Question 2

structures involved in the generation of rhythmic resp mvmts and reflexes

Answer 2

medulla, pons (resp centre)

Question 3

electrical impulses generated by resp centre carried by ___ nerves to _____

Answer 3

phrenic; diaphragm

Question 4

contraction of diaphragm and other muscles increase _____ pressure and allow air to be sucked in, reaching ___

Answer 4

intrathoracic; alveoli

Question 5

large pulmonary BV and conducting airways located in _____

Answer 5

pleural cavity

Question 6

what are cilia?

Answer 6

hair like structures that move superficial liquid lining layer from deep within lungs toward the pharynx to enter GI tract (lung defense mechanism)

Question 7

alveolar cells secrete _____ that maintain stability of pulmonary tissue by reducing surface tension

Answer 7

surfactant

Question 8

fx of lungs?

Answer 8

regulate pH, make arachidonic acid–>prostaglandins and leukotrienes, convert angiotensin 1–>2,

Question 9

how does malnutrition affect pulmonary system?

Answer 9

adverse affect on lung structure, elasticity, function, muscle mass/strength/endurance, lung immunity, control of breathing

Question 10

pulmonary system disorders categorized as primary:

Answer 10

TB, bronchial asthma, cancer of lung

Question 11

pulmonary system disorders categorized as secondary:

Answer 11

associated with cardiovascular disease, obesity, HIV, sickle cell disease, scoliosis

Question 12

chronic conditions of pulm system?

Answer 12

cystic fibrosis and COPD

Question 13

symptoms and signs of pulmonary disease:

Answer 13

cough, dyspnea, fatigue, early satiety, anorexia, wt loss

Question 14

____ tests used to diagnose/monitor status of lung disease by measuring ability of resp system to exchange O2 and CO2

Answer 14

pulmonary function

Question 15

this device uses light waves to measure oxygen saturation of arterial blood, placed on end of finger

Answer 15

pulse oximeter

Question 16

third most common cause of death in the world

Answer 16

COPD

Question 17

risk factors for COPD?

Answer 17

smoke from cigarettes, biomass fuel for cooking and heating in developing countries, air pollution, occupational smoke/dust, genetic factors

Question 18

COPD encompasses :

Answer 18

chronic bronchitis, emphysema

Question 19

pt with primary emphysema suffer from greater ____

Answer 19

dyspnea and cachexia

Question 20

pt with bronchitis have ____

Answer 20

hypoxia, hypercapnia, pulmonary hypertension, right heart failure

Question 21

condition characterized by destruction of lung parenchyma with lack of elastic recoil

Answer 21

emphysema

Question 22

_____deficiency present in 1-2% of COPD pt

Answer 22

alpha 1 antitrypsin

Question 23

allergies, smoking, congestive heart failure, pulmonary embolism, pneumonia, systemic infections are reason for _____% of COPD exacerbation

Answer 23

20-40

Question 24

how does osteoporosis make COPD worse?

Answer 24

altering configuration of chest wall

Question 25

mainstay of treatment for COPD pt

Answer 25

inhaled bronchodilators given by metered dose inhalers (in severe dyspnea, administered in nebulized form)

Question 26

if resp failure, need ___

Answer 26

mechanical ventilation

Question 27

breathing with normal lungs expends 36 to 72 kcals/day, but increases ____ x in COPD

Answer 27

10

Question 28

two main goals in managing hypermetabolism seen in stable COPD:

Answer 28

prevention of wt loss and prevention of loss of LBM

Question 29

inverse relationship between dietary ______ and COPD risk

Answer 29

iron and calcium

Question 30

increased BP which leads to enlargement and failure of right ventricle of heart, can mask wasting cuz fluid retention

Answer 30

cor pulmonale

Question 31

these have opposite effect, important indicators

Answer 31

leptin (satiety) vs. adiponectin (enhance appetite)

Question 32

promotes inflammation and insulin resistance by production of IL6 and TNF-alpha

Answer 32

resistin

Question 33

diet supplementation of _____ shown delay and reduce risk of upper resp infections and asthma, lowering incidence of bronchiolitis during first year of life

Answer 33

DHA, Arachidonic Acid

Question 34

___ and ___ help with inflammation

Answer 34

PUFAs, aspirin

Question 35

protein requirements:

Answer 35

1.2-1.7g/kg

Question 36

fluid requirements:

Answer 36

35ml/kg up to 60 years, then 30ml/kg

Question 37

ppl in advanced COPD are in state of ____

Answer 37

pulmonary cachexia (myostatin influence)

Question 38

energy requirements during healing;

Answer 38

30kcal/kg

Question 39

risk increases over age of ____

Answer 39

40

Question 40

inflammatory cells and mediators involved in asthma vs COPD:

Answer 40

eosinophilic vs. neutrophilic

Question 41

pathophysiological changes in COPD lead to

Answer 41

airflow limitation, gas trapping, gas exchange abnormalities, mucus hypersecretion, pulmonary hypertension, exacerbations, systemic features

Question 42

max volume of air exhaled in first second of forced expiration

Answer 42

FEV1 (forced expiratory volume in first second)

Question 43

what is max amount of air which can be exhaled from lungs on rapid complete exhalation?

Answer 43

FVC (forced vital capacity)

Question 44

consequence of air trapping during expiration:

Answer 44

hyperinflation

Question 45

signs of hypoxemia:

Answer 45

cyanosis, clubbing, polycythemia

Question 46

if not treat hypoxemia what happens?

Answer 46

pulmonary artery hypertension, right sided heart failure

Question 47

treatments for COPD:

Answer 47

pulmonary rehab programs, oxygen therapy, meds (bronchodilators, glucocorticosteroids, mucolytic agents, antibiotics), surgery

Question 48

protein ____% energy, fat ___%, and CHO ___%

Answer 48

15-20; 30-45; 40-55

Question 49

smokers need ___ supplement

Answer 49

Vit C (16-32 mg/day)

Question 50

why early satiety?

Answer 50

hyperinflation of lungs cause flattening of diaphragm and pressure on abdominal cavity while eating; drinking too much fluids before meals

Question 51

malnutrition classified as:

Answer 51

<20 BMI or <90% IBW

Question 52

chronic bronchitis more common in ____ pt, emphysema more common in ____ pt

Answer 52

overweight; malnourished