Emphysema

Question 1

ephysema

Answer 1

an obstructive disease disease characterize by destruction of lung tissue

Question 2

panlobular

Answer 2

destruction of parenchyma distal to the terminal bronchioles
typically a lower lobe disease or pattern
alpha one antitrypsin defiency

Question 3

centrilobular

Answer 3

usually an upper lobe disease

usually characterize by destruction of central respiratory bronchioles sparing the distal portion

Question 4

smoke increase protease activity and it does what?

Answer 4

an enzyme which destroys the terminal bronchioles and alveolar walls
which decreases mucocillary transport
paralyzes cilia
thickens mucous increase mucous production from irruption

Question 5

smokers are most likely to develop in?

Answer 5

centrilobular emphysema of upper lobes

Question 6

alpha 1 protease inhibitor

Answer 6

responsible for the inactivation of elastase

breaks down elastin during an inflammatory response

Question 7

if enzyme alpha 1PI is missing then

Answer 7

lung tissue is lost due to action of elastic

Question 8

inhierated emphysma

Answer 8

approximately 1% of cases

most people with genetic problem of deficiency alpha 1PL due well if they don’t smoke

Question 9

PFT lung volumes decrease in

Answer 9

FVC
FEV1
IC
ERV

Question 10

pft lung volume increase in

`

Answer 10

tidal volume
TLC
FRC
RV
RV/TLC%

Question 11

what is decrease in flow

Answer 11

FEF25-75%

decrease DLCO

Question 12

lung pathology affects on oxygenation and ventilation

Answer 12

decrease surface area
v/q mismatch
affects hypoxemia and hypercapnea

Question 13

symptoms of chronic emphysema

Answer 13

often symptoms occur with chronic bronchitis
dyspnea during exertion
typically worse following or during upper respiratory illness

Question 14

chest expectation

Answer 14

tachypnea
use of accessory muscle
increase AP diameter
pursed lip breathing

Question 15

in palpation you should feel

Answer 15

decrease tactile and vocal fremitous

Question 16

percussion and auscultation

Answer 16

hyperresonance and flat lower diaphragm

diminished breath sounds

Question 17

x-ray

Answer 17

flattend diaphragm
hyperinflation
compress heart
increased retrosternal airspace

Question 18

ABG we expect

and ekg

Answer 18

compensated respiratory acidosis with hypoxemia

right shift of p and QRS in frontal plane

Question 19

support oxygenation and ventilation

Answer 19

low flow oxygen

cpt breathing retraining

Question 20

decrease work of breathing

Answer 20

symoathomimetics
methylxanthines
cortisteriod

Question 21

respiratory rehab is very important

Answer 21

improvement in exercise tolerance knowledge of disease state
improvement in self-care
smoking cessation is important

Question 22

supplemental oxygen

Answer 22

administer if resting pa02<55 mm Hg
usually low flow system are adequate
v/q mismatching is the pathology

Question 23

prolastin replacement

Answer 23

must be done fairly early in life prior to lung loss

very expensive