Fouty: pathophys of chronic bronchitis and emphysema

Question 1

chronic bronchitis + emphysema

Answer 1

COPD

Question 2

at the end of normal expiration (most effort independent out of all PFTs)

Answer 2

functional residual capacity (FRC)

Question 3

when you blow up a balloon, what is the pressure needing to overcome

Answer 3

elastic recoil

Question 4

when the lung is not present, what does the chest wall do

Answer 4

springs outwards

Question 5

___ and ___ are held at equilibrium at FRC

Answer 5

the lung and chest wall

Question 6

at ____ volume, still some air in lungs requiring some pressure to keep it there

Answer 6

residual volume

Question 7

what sets the residual volume

Answer 7

characteristics of chest wall (can’t go lower than a certain point)

Question 8

when the springs are equal tension on both sides

Answer 8

FRC

Question 9

Inward recoil of the lung=outward recoil of chest wall

Answer 9

FRC

Question 10

takes____ to move respiratory system away from functional residual capacity

Answer 10

work

Question 11

work being done to inflate the lungs is required to overcome what 2 things

Answer 11

elastic recoil of lungs and chest wall and airflow resistance

Question 12

low at high volumes
higher at low volumes

Answer 12

resistive work (airflow resistance)

Question 13

high at higher volumes (takes more work to keep lungs expanded)
low at lower lung volumes

Answer 13

elastic work

Question 14

spot of least resistance when breathing

Answer 14

RR of 12-18
volume of 400 mL

Question 15

pressure of elastic recoil of chest wall and lungs + pressure to overcome resistance to airflow

Answer 15

total pressure (work of breathing)

Question 16

lung is less stiff and easier to distend (high compliance)—lost its elastic recoil; takes very little pressure to move air in

Answer 16

emphysema

Question 17

lung is much stiffer, (harder to put air in)—takes more work to distend lung

Answer 17

fibrosis

Question 18

neonate with no surfactant has to generate what to try and distend lung

Answer 18

generate a lot of negative pressure

Question 19

is based on the compliance of the chest wall and the lung (effort independent)

Answer 19

FRC

Question 20

FRC goes down

Answer 20

restrictive disease

Question 21

FRC goes up

Answer 21

obstructive disease

Question 22

Provides a reservoir of air in the lung during breathing

Answer 22

FRC

Question 23

Increases The Resistance To Airflow And Thus Increases The Work Required To Overcome Airway Resistance

Answer 23

obstructive disease

Question 24

airway resistance is greatest in what airways

Answer 24

large (like river opening up into delta (small airways–more of them)

Question 25

anything that’s being carried such as tobacco smoke in the lungs gets deposited in the area around the _____

Answer 25

terminal bronchioles

Question 26

centrilobar/centriacinar emphysema means..

Answer 26

where the respiratory bronchioles transition off the terminal bronchioles

Question 27

Answer 27

airflow obstruction (

Question 28

increases Lung Volumes And Impairs Airflow

Answer 28

emphysema

Question 29

flattening of _____ decreases ability to generate pressure

Answer 29

diaphragm

Question 30

Pressure you can generate is _____ related to radius

Answer 30

inversely (smaller radius, can generate more pressure)

Question 31

how would this person breathe effectively since they have flattened diaphragm

Answer 31

accessory muscles (external intercostals, sternocleidomastoid, scalenes)

Question 32

RV higher than normal, FRC higher

Answer 32

obstructive lung disease

Question 33

TLC is higher in this obstructive lung disease

Answer 33

emphysema

Question 34

TLC stays the same in this obstructive lung disease

Answer 34

asthma

Question 35

bronchi filled with mucus and causes luminal narrowing

Answer 35

chronic bronchitis

Question 36

destruction of elastin; dilated airspaces (bronchioles easily compressible)

Answer 36

emphysema

Question 37

airflow obstruction that is not fully reversible; emphysema and chronic bronchitis

Answer 37

COPD

Question 38

Tobacco, work exposures to fumes, secondhand smoke, air pollution, vaping

Answer 38

can lead to COPD

Question 39

major cause of COPD worldwide

Answer 39

smoking, air pollution, indoor cooking w/ wood

Question 40

smoker's cough present for atleast 3 months; excessive sputum production

Answer 40

chronic bronchitis

Question 41

Narrowing of lumen due to mucous glands and smooth muscle cell hyperplasia

Answer 41

chronic bronchitis

Question 42

more mucous is being secreted into the airways which impairs airflow obstruction (due to mucous gland hyperplasia)

Answer 42

chronic bronchitis

Question 43

marked increase in mucous glands

Answer 43

chronic bronchitis

Question 44

alveolar wall destruction w/ irreversible enlargement of the air spaces distal to terminal bronchioles

Answer 44

emphysema

Question 45

can cause permanent enlargement of the acinus

Answer 45

emphysema

Question 46

pan-acinar emphysema (in lower lobes)

Answer 46

A1AT deficiency

Question 47

centri-acinar emphysema

Answer 47

smokers

Question 48

Loss of elastic recoil; airways and alveoli lost elasticity that allows them to stay open (easy to collapse); gas trapping

Answer 48

emphysema

Question 49

destruction of elastic fibers air trapping

Answer 49

emphysema

Question 50

"moth eaten"

Answer 50

emphysema

Question 51

destroys alveolar-capillary bed

Answer 51

emphysema

Question 52

DLCO decreased in this

Answer 52

emphysema

Question 53

purse lip breathing

Answer 53

emphysema

Question 54

Answer 54

emphysema

Question 55

Answer 55

chronic bronchitis

Question 56

minimal reversibility normal to slightly decreased DLCO

Answer 56

chronic bronchitis

Question 57

marked hyperinflation no reversibility decreased DLCO

Answer 57

emphysema

Question 58

dyspnea mucus production wheezing cough

Answer 58

COPD

Question 59

Pursed lip breathing Wheezing Decreased lung sounds Barrel chest Cyanosis

Answer 59

physical exam for COPD

Question 60

Answer 60

Hb desaturated (hypoxemia) R heart failure (peripheral edema)

Question 61

GOLD normal (based on FEV1)

Answer 61

stage 0 COPD

Question 62

GOLD (based on FEV1) >/= 80%

Answer 62

stage I COPD

Question 63

GOLD (based on FEV1) 50-79%

Answer 63

stage II COPD

Question 64

GOLD (based on FEV1) 30-49%

Answer 64

stage III COPD

Question 65

GOLD (based on FEV1) <30%

Answer 65

stage IV COPD

Question 66

BMI obstruction dyspnea exercise capacity

Answer 66

BODE index for COPD

Question 67

treatment of COPD

Answer 67

stop smoking, vaccines

Question 68

peak age for FEV1

Answer 68

25

Question 69

worst MMRC stage

Answer 69

D (high risk and high symptoms)

Question 70

bronchodilators steroids O2 PDE4 inhibitors

Answer 70

Rx COPD

Question 71

decreased exacerbations of COPD by 27%

Answer 71

Azithromycin

Question 72

Increased dyspnea above baseline Increased sputum production Deterioration in arterial blood gas Increased requirements of bronchodilators Visits to ER/hospitalization

Answer 72

acute exacerbations of COPD (marker for more severe disease)

Question 73

most common cause of COPD exacerbations

Answer 73

infection

Question 74

main 3 bacterial infections for smokers with COPD exacerbation

Answer 74

Haemophilus influenzae Streptococcus pneumoniae Moraxella catarrhalis

Question 75

main virus for COPD exacerbation

Answer 75

rhinovirus

Question 76

causes of death from COPD

Answer 76

resp. failure R ventricular failure (cor pulmonale) pneumonia spontaneous pneumothorax

Question 77

must have airway obstruction w/ emphysema and/or chronic bronchitis

Answer 77

COPD