Obstructive Lung Disease CIS II Flashcards Preview

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Flashcards in Obstructive Lung Disease CIS II Deck (50)
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1

asthma components

1 recurrent obstruction - resolves with Tx

2 airway hyperresponsiveness

3 airway inflammation

2

asthma population

8% adults

boys and women

15 million outpatient visits and 2 million hospitalizations

3

mild asthma

edema and hyperemia of mucosa and infiltration of mucosa with mast cells, eosinos, lymphocytes

4

moderate asthma

chemokines eotaxin, RANTES, macro inflammatory protein I, IL8

lead to inflammation and smooth m constriction

5

severe asthma

hypertrophy and hyperplasia of airway glands and smooth m lead to severe airway thickening

6

airway obstruction in asthma

constriction of airway smooth m

thickened airway epithelium

liquids in airway

7

ACh

M3 - smooth m constriction in asthma

8

histamine

minor role in asthma
-mast cells

9

leukotrienes and lipoxins

lipoxygenation of arachidonic acid release from target cell membrane phospholipids during cell activation

10

nitric oxide

produced by airway epithelial cells and by inflammatory cells found asthmatic lung
-high levels found during asthma attacks

11

asthma Hx

dyspnea, cough, wheezing, anxiety

exercise induced, aspirin ingestion, allergens

cough, hoarseness, inability to sleep

rapid change in temp or humidity may lead to an attack

12

pulsus paradoxus

10mmHg systolic difference during inspiration

in asthmatics

13

ABG in asthma

mild hypocapnea

normalized - indicated resp failure

14

asthma PFT

obstructive

15

CBC asthma

eosinophilia
IgE elevation

16

CXR asthma

hyperinflation

17

EKG asthma

RBBB, P pulmonale, ST-T changes

18

P pulmonale

right atrial enlargement

19

omalizumab

monoclonal Ab for IgE

alternate Tx for hypersensitivity asthma

20

60yo M, cough, productive purulent sputum, dyspnea, hemoptysis, pleuritic chest pain, wheezing and rales, dilated airways

bronchiectasis

21

atelectasis

collapse of lung

22

ARDS

acute resp distress syndrome

-white out of lung on CXR

23

churg strauss syndrome

elevated eosinos

24

bronchiectasis

abnormal permanent dilation of bronchi and bronchioles

due to repeated cycles of airway infection and inflammation

abnormal cilia, mucous clearance, rainage, and host defenses

25

mycobacterium avium intracellulare

right middle lobe and lingula of lung

-may lead to bronchiectasis

26

etiology of bronchiectasis

1/2 CF

1/3 infection
-pertussis, TB, MAI
-CF, primary ciliary dyskinesia, alpha1 antitrypsin
-esophageal dysfunction and aspiration, COPD, aspergillosis, tumor, foreign body
-sjogrens, rheumatoid arthritis, HIV, IgG deficiency

27

chronic cough, purulent sputum, hemoptysis, pleuritic chest pain, weight loss, fatigue, wheezing and crackles

bronchiectasis

28

Dx of bronchiectasis

high res CT
-bronchi visible in peripheral 1cm of lung

-internal bronchial diameter greater than diameter of accompanying bronchial artery

29

CF bronchiectasis

upper lobe predominance

30

aspiration bronchiectasis

lower lobes