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CPP > CPP - COPD > Flashcards

CPP - COPD Flashcards

1
Q

Chronic excessive mucus production, resulting from an increase in the number and size of mucus glands and goblet cells. Symptoms are a cough and increased mucus production for at least 3 months of the year for more than 2 consecutive years. Males are most commonly affected.

A

Chronic Bronchitis

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2
Q

It is derived form the cyanosis, and is commonly seen in the patient with Chronic Bronchitis

A

Blue Bloater (Type B COPD)

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3
Q

Cyanosis or Bluish Complexion is CAUSED by the following:

A
  • Chronic bronchitis responds to the increased airway obstruction by decreasing ventilation and increasing cardiac output.
  • The persistent low V/Q ratio and depressed respiratory drive both contribute to a chronically reduced arterial oxygenation level and polycythemia that turn in causes CYANOSIS.
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4
Q

Major pathologic or structural changes are associated with Chronic Bronchitis.

A

a. Chronic inflammation and thickening of the walls of the peripheral airways.
b. Excessive mucous production and accumulation.
c. Partial or total mucous plugging of the airways.
d. Smooth muscle constriction of bronchial airways (Bronchospasm) - a variable finding.
e. Air trapping and hyperventilation pf alveoli may occur in late stages.

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5
Q

Pathophysiology of Chronic Bronchitis

A

a. Increase in the size of mucus glands
b. Increase in the number of goblet cells
c. Inflammation of bronchial walls
d. Mucus plugs in peripheral airways
e. Loss of cilia
f. Emphysematous changes in advanced stages of
disease
g. Narrowing airways, leading to airflow limitation

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6
Q

Clinical signs and symptoms of Chronic Bronchitis

A

a. Cough with sputum production
b. Dyspnea on exertion progressing to dyspnea
with less effort
c. CO2 retention and hypoxemia in advanced
stages
d. Increased pulmonary vascular resistance (PVR)
in advanced stages
e. Increased Hb level, Hct, and RBC count in
advanced stages
f. Cor pulmonale in advanced stages
g. Breath sounds: coarse crackles and wheezes

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7
Q

Characteristics of pulmonary function studies of Chronic Bronchitis

A

a. None in early disease
b. Increased RV
c. Decreased FEV1
d. Decreased expiratory flow rates

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8
Q

Two most common risk factors affecting COPD

A

a. Smoking

b. Al[ha-1 antitrypsin (AAT) deficiency

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9
Q

Risk factors (High-risk of developing COPD )

A
  1. gene
  2. Age
  3. Lung Growth & development
  4. Exposure to particles
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10
Q

Abnormalities of Chronic Bronchitis (X-ray)

A
  • Flattened Diaphragm
  • Hyperlucent, Darkening (Represents air)
  • Enlarge Heart
  • Tear-shaped heart
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11
Q

Auscultative for COPD

A
  • Diminish breath sound
  • crackles, discontinuous sound
  • Rhonchi
  • Wheezes
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12
Q

An abnormal, irreversible dilation of
the bronchi caused by destructive and inflammatory
changes in the walls of the airway

A

Bronchiectasis

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13
Q

Causes of Bronchiectasis

A
  1. Chronic respiratory infections
  2. TB lesion
  3. Secondary to cystic fibrosis
  4. Bronchial obstruction
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14
Q

a permanent abnormal enlargement
of the air spaces distal to the terminal bronchioles,
associated with destructive changes of the alveolar
walls

A

Emphysema

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15
Q

(1) The acinus is the anatomic gas exchange
unit of the lung, made up of the respiratory
bronchiole, alveolar duct, alveolar sacs, and
the alveoli.
(2) The entire acinus is involved.
(3) There is significant loss of lung parenchyma.
(4) Alveoli are destroyed.
(5) Bullae are present.
(6) Usually is associated with emphysema resulting from a1-antitrypsin deficiency.

  • MOST SEVERE
A

Panlobular (Panacinar) type

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16
Q

(1) Lesion is in the center of the lobules, which
results in enlargement and destruction of
the respiratory bronchioles.
(2) Usually involves the upper lung fields and
is most commonly associated with chronic
bronchitis

A

Centrilobular (centriacinar)

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17
Q

(1) Emphysematous changes are isolated and
accompanied by the development of bullae,
which are weak air spaces and susceptible
to rupture

A

Bullous emphysema

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18
Q
  • defined as air spaces in their distended state, more than 1 cm in diameter.
  • is air pockets greater than one centimeter in the lung
    parenchyma. .
A

Bullae

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19
Q
  • defined as air spaces adjacent to
    the pleura, usually less than 1 cm in diameter
    in their distended state.
  • is the accumulations of air within the layers of the visceral pleura. This is usually smaller than bulla
A

Blebs

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20
Q

Alpha-1 Antitrypsin normal value

A

150 - 350 mg/dl or 1.5 - 3.5 g/L

21
Q

If neutrophil is present in the lungs what will happen?

A
  • It breakdown connective tissue of our lungs
22
Q

What type of Emphysema is more common?

A

Centrilobular (Centroacinar)

23
Q

What parts of the lungs does panlobular emphysema

affect?

A

Respiratory bronchioles,
Alveolar ducts, and
Alveolar sacs which are destroyed by ELASTASE.

24
Q

What parts of the lungs does centrilobular emphysema

affect?

A

Respiratory bronchioles and upper lobes.

25
Q

What can be observed in pulmonary function test on

patients with emphysema?

A 
Decreased forced expiratory flow, 
increased total lung capacity, 
residual volume, and 
functional residual capacity, 
increased residual capacity over total lung volume and low diffusion.
26
Q

How is emphysema similar to chronic bronchitis?

A

It is very similar, except the airways have obstruction due to the reduced elastic recoil of the lungs. The inspiratory flowrates are normal if the patient has pure emphysema. The patient has dyspnea initially only on exertion with it intensifying at variable rates until shortness of breath at rest.

27
Q

What happens to alveolar walls in emphysema?

A

It enlarges and then degenerates.

28
Q

What kind of damage of the alveoli does emphysema

cause?

A

Permanent and irreversible.

29
Q

What position is best for clients with emphysema

under normal circumstances?

A

Semi-fowlers or higher.

30
Q

What is the rare inherited deficiency of the protein that

protects the elastic function of lungs?

A

Alpha-1 antitrypsin deficiency; seen in emphysema.

31
Q

What is the breath sounds associated with a severe

state of bronchiectasis?

A

Rales and rhonchi.

32
Q

How does the pulmonary function test of a patient with

bronchiectasis show?

A

It can show obstructive patterns. Remember “CBABE”.
Bronchiectasis is a part of CBABE.

C - CYSTIC FIBROSIS
B - BRONCHIRCTASIS
A - ASTHMA
B - CHRONIC BRONCHITIS
E - EMPHYSEMA
33
Q

What does the ABG show on a patient with mild to

moderate bronchiectasis?

A

The ABG will show respiratory alkalosis with hypoxemia

34
Q

What are some common infections associated with

bronchiectasis?

A

Haemophilus influenzae, streptococcus, staphylococcus, pneumonia, moraxella catarrhalis, and pseudomonas in cystic fibrosis patients.

35
Q

How do you diagnose bronchiectasis?

A

CT scan and a history of a chronic cough with sputum.

36
Q

What will the spirometry results show for patients with

bronchiectasis?

A

Decreased Flow Rates (FEV1, FEV1/FVC, FEF25-75).

37
Q

What pattern might spirometry show in a patient with

bronchiectasis?

A

Obstructive

38
Q

What are the main symptoms associated with

bronchiectasis?

A

A persistent cough with purulent sputum, hemoptysis (may be

massive), fever, and weight loss

39
Q

What is panlobular/pancinar emphysema?

A

Panlobular/Panacinar is an abnormal weakening and
enlargement of all air spaces distal to the terminal bronchioles.
It is related to alpha1-antitrypsin deficiency.

40
Q

What is centrilobular/centriacinar emphysema?

A

Centrilobar/Centriacinar is the abnormal weakening and enlargement of the respiratory bronchioles and alveoli in the proximal portion of the acinus. It is related to inflammation. Most common.

41
Q

Common factor of Centrilobular emphysema

A

Cigarrete smoking and Chronic Bronchiitis

42
Q

What are pink puffers?

A
  • Reddish complexion
  • commonly seen in patient with Emphysema
  • Weight loss
43
Q

What happens when the lungs do not recoil properly?

A

Increased compliance (floppy airways), premature airway closure leading to air trapping, hyperinflation, and increased residual volume, functional residual capacity, and total lung capacity.

44
Q

What are the shapes of the destroyed bronchial walls?

A

Varicose, fusiform, saccular, cystic and cylindrical.

45
Q

What are the key anatomic alterations of rigid and

dilated bronchi?

A

Cylindrical bronchiectasis

46
Q

What are the key anatomic alterations of irregularly

dilated and constricted bronchi?

A

Varicose bronchiectasis.

47
Q

What is the other name for cystic bronchiectasis?

A

Saccular

48
Q

The alpha 1 antitrypsin deficiency can lead to focal
bronchiectasis. How will the left lung pocket looks like
after a patient with alpha 1 antitrypsin deficiency 1 and 2 undergoes a CT scan?

A

The left lung’s pocket will show an abnormally large bronchi branch

49
Q

Tuberculosis causes bronchiectasis as it damages the

airways. How will the CT scan look like for a patient post-tuberculosis bronchiectasis

A

The lower left lung will show evidence of a very local damage.
It is important to note that it is just a coincidence that all of these occurrences happen in the lower left lung.

CPP (2 decks)

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