COPD

Question 1

What is COPD

Answer 1

chronic disease that cause obstruction of the airways

Question 2

How prevalent if COPD

Answer 2

4th cause of death in US, 6th in the world

Question 3

What is Emphysema

Answer 3

permenant damage to alveolar walls
enlargement of the air spaces distal to the terminal bronchioles
loss of lung elasticity

Question 4

What are the two major causes

Answer 4

smoking

inherited deficiency of alpha1-antitrypsin

Question 5

What is the pathology of emphysema

Answer 5

because leukocytes in the lung produce elastase (which breaks down the alveolar cell wall) and because smoking causes excessive amounts of leukocytes to come to the lung, an excess amount of elastase is produced that cant be neutralized anymore by antiproteases like alpha1-antitrypsin so destruction of the alveolar cell walls occur

Question 6

What are the two types of emphysema and explain

Answer 6

Centriacinar- affects the terminal bronchioles first then later effects the alveoli
Panacinar- affects the alveoli fist then affects the terminal bronchioles

Question 7

What happens to your air volume in emphysema

Answer 7

your total lung capacity increasing the amount of air trapped in the lungs (causing barrel chest)

Question 8

What happens to the amount of surface area for gas exchange in emphysema

Answer 8

it decreases

Question 9

Because of your loss of elasticity and gas exchange in emphysema, what happens to your CO2 levels

Answer 9

you retain a larger amount of CO2

Question 10

What causes Chronic Bronchitis

Answer 10

obstruction of major and small airways from smoking or recurrent infection

Question 11

What is the pathophysiology of Bronchitis

Answer 11

Infiltration of neutrophils, macrophages and lymphocytes in bronchial wall that leads to edema and increases size of mucous glands and goblet cells
Thick mucous impairs ciliary function
Has

Question 12

What are Chronic B’s manifestations

Answer 12

Productive cough secondary to increased mucus production
Prolonged expiration
Dyspnea on exertion due to air trapping
“Blue bloater”, cyanosis
Chronic hypoventilation
Cor pulmonale (R sided heart failure)

Question 13

What is required to diagnose someone with Chronic B

Answer 13

Hypersecretion of mucus, chronic productive cough for more than 3 months for at least 2 years consecutively

Question 14

What type of VQ mismatch is Bronchitis

Answer 14

V/Q mismatches- poor vent good perf

Question 15

What type of VQ mismatch is Emphysema

Answer 15

Good vent poor perf

Question 16

Why are people with emphysema called pink puffers

Answer 16

They have too much CO2 in they bodies

Question 17

Why are people with Bronchitis called blue bloaters

Answer 17

they don’t have enough oxygen in there bodies

Question 18

What is a risk the people with COPD have when given oxygen

Answer 18

If you give to much oxygen to someone with COPD it can cause them to lose their ventilation drive

Question 19

What causes pulmonary edema

Answer 19

left sided heart failure
inflammation
pneumonia infection

Question 20

what are the manifestations of pulmonary edema

Answer 20

pink frothy secretions Dyspnea, hypoxemia, increased work of breathing, crackles

Question 21

How is pulmonary edema treated

Answer 21

supplemental O2

positive press mechanical ventilation

Question 22

What is aspirations

Answer 22

Passage of fluid or solid particles into the lung.

Question 23

What are the big risk factors for aspirations

Answer 23

periods of altered LOC like substance abuse, sedation, seizure disorders, stroke, elderly

Question 24

What is the pathology of aspirations

Answer 24

Particles obstructing bronchi cause inflammation and airway collapse

Question 25

What are the manifestations of aspirations

Answer 25

sudden choking, dyspnea, and wheezing

Question 26

What happens to the lungs after aspirations

Answer 26

they become noncompliant

Question 27

What are people with aspirations at a higher risk of

Answer 27

pneumonia

Question 28

What is respiratory distress syndrome

Answer 28

hyaline membrane disease of premature infants that causes decreased surfactant production

Question 29

Why is the lack of surfactant in premature infants problematic

Answer 29

its causes the alveolar to collapse, and a V/Q inbalance

Question 30

What is the pathogenesis of RDS

Answer 30

the premature infant has a lack of surfactant and immature lung structures causing decreased compliance leading to atelectasis and hypoxia

Question 31

What are the manifestations of RDS

Answer 31

increased WOB, tachypnea, retractions of the chest wall, diminished breath sounds, nasal flaring, cyanosis

Question 32

What is RDS characterized by

Answer 32

hemorrhagic pulmonary edema, patchy atelectasis, increased work of breathing

Question 33

How is RDS treated

Answer 33

supp O2 | positive pressure ventilation

Question 34

What are pulmonary emboli's

Answer 34

a thrombus, air, fat, tumor that lodges in a pulmonary vessel

Question 35

What is the patho of a pulmonary emboli

Answer 35

the obstruction causes perfusion to decrease (high V/Q) causing hypoxemia

Question 36

What are the manifestations of pulmonary emboli

Answer 36

``` Unexplained anxiety Restlessness Dyspnea Tachycardia Tachypnea Pleuretic chest pain Pulmonary artery is most common place ```

Question 37

Where are pulmonary emboli's usually found

Answer 37

Pulmonary artery

Question 38

What is cor pulmonale

Answer 38

peripheral edema from right sided heart failure or pulmonary hypertension

Question 39

What are the manifestations of cor pulm

Answer 39

``` decreased vent decreased O2 Pulmonary vasoconstriction increased WOB productive cough altered LOC ```

Question 40

How is cor pulm treated

Answer 40

treating lung disease or heart failure

Question 41

What are the manifestations of emphysema

Answer 41

``` Dyspnea Prolonged expiration Barrel chest Wheezing Tachypnea Use of accessory muscles Decreased breath sounds Pink puffer-because lose of elasticity- causes shorteness of breath- lack cyanosis ```