Obstructive Lung Diseases

Question 1

4 groups fo Obstructive diseases

Answer 1

Acute upper resp infection
Asthma
COPD
Miscellaneous resp disorders

Question 2

What accounts for 95% of URIs

Answer 2

Infections Nasopharyngitis

Question 3

Most URI’s involve what type of pt

Answer 3

pedatric pt

Question 4

Children with URI are at higher risk for what

Answer 4

hypoxemia, laryngospasmn, breath holding, coughing

Question 5

A stable URI in someone is ok for what

Answer 5

surgery

Question 6

If surgery is cancelled due to URI it should not be rescheduled for how long

Answer 6

6 weeks

Question 7

Use of what in someone with an acute URI may reduce risk of laryngospasam

Answer 7

LMA

Question 8

What may allow for a smoother emergence

Answer 8

deep extubation

Question 9

What resp events in pts with acute URI can occur

Answer 9

laryngospasam, airway obstruction, post intubation croup, desaturation, atelectasis

Question 10

Asthma

Answer 10

Chronic inflmmation of mucosa of lower airways

Question 11

Astha results in edema in what part of the airway

Answer 11

bronchi

Question 12

Main inflammatory mediators in asthma

Answer 12

histamine, prostglandin d2, leukotrienes

Question 13

Asthma is episodic dz with _____ exacerbations and _____ periods

Answer 13

acute
asymptomatic

Question 14

Diagnosis of asthma is based on PFTs that show

Answer 14

airway obstruction that responds to treatment with bronchodilators

Question 15

What is the typical FEV1 in a symptomatic asthmatic

Answer 15

< 35%

Question 16

During a severe asthmatic attack what may increase

Answer 16

FRC

Question 17

Would TLC increase or change in a severe asmatic attack

Answer 17

NO

Question 18

Can a pt have asthma with a normal PFT test?

Answer 18

Yes: asmatha is an episodic illness

Question 19

Durin and asthma attack tachynea and hyperventilation is c/b _________ reflexes of the lungs

Answer 19

Neural

Question 20

Two most common findings on ABG in someone with symptomatic asthma

Answer 20

Hyocarbia, respiratory alkolosis

Question 21

When does PCO2 increase based of the FEV1

Answer 21

<25%

Question 22

First line treatment for mild asthma

Answer 22

Short acting inhaled B2 agonist

Question 23

Following a short acting b2 agonist, what medication would be given next that reduce exacerbations and decrease hospitlization

Answer 23

Inhaled corticosteroids

Question 24

Systemic coricosteroids are reserved for _______ asthma

Answer 24

severe

Question 25

what can be given SQ to decrease use of long term medications

Answer 25

Immunotherapy

Question 26

Nonpharmalogic asthma treatment done by a pulmonologist

Answer 26

Bronchial Thermoplasty: performed over 3 sessions which inovolves ablation of smooth airway muscle

Question 27

Following bronchial thermoplasty when the FEV1 improves to ____ pts usually have no symptoms

Answer 27

50% of normal

Question 28

Bronchospasam doesnt resovle in acute severe asthma despite____

Answer 28

noraml treatment

Question 29

Emergency treatment for severe acute asthma

Answer 29

high dose, short acting b2 agonist, systemic corticosteroids

Question 30

How often can inhaled b2 agoinst can be given in severe acute asthma

Answer 30

Every 15-20 minutes for several doses

Question 31

Most common IV corticosteroids used for acute asthma

Answer 31

Hydrocortisone, methylprednisone

Question 32

What other two drugs can be given in addition to steroids in acute severe asthma

Answer 32

magnesium, leukotriene inhibitors

Question 33

Bronchospasam has been reported in ______ of asthmatics undergoing GA

Answer 33

0.2%-4.2%

Question 34

Risk of bronchospasam is correlated more with specific types of surgery

Answer 34

upper abdominal and oncologic surgery

Question 35

What blood cell count often mirrors the degree of airway inflammation

Answer 35

Eosinophil

Question 36

During astha pre op assement, a reduction in FEV1or FVC less than ____ of predicited and or FEV1 ratio less than ___ of predicited is a risk of periop resp complications

Answer 36

<70%, <65%

Question 37

If asthma pt has been on systemic corticosteroids within the past 6 months a ______ dose of ______ or ______ is indicated

Answer 37

stress: hydrocortisone: methylprednisone

Question 38

Pts should have a PEFR of _______ their predicted or their personal best value before surgery

Answer 38

>80%

Question 39

What is emphysema characterized by

Answer 39

Lung parenchymal destruction

Question 40

What is lost in COPD

Answer 40

Elastic recoil

Question 41

COPD diagnosis PFT shows a decrease in the FEF between

Answer 41

25-75% of vital capacity

Question 42

Will a COPD pt have an increased FRC and TLC

Answer 42

yes

Question 43

How will the diffusing lung capacity be affected by COPD

Answer 43

Reduced

Question 44

An increase in RV in COPD is caused by what

Answer 44

slow expiratory flow and gas trapping due to airway closure

Question 45

What on an xray represents COPD

Answer 45

Hyperlucency

Question 46

Most sensitve test at diagnosing COPD

Answer 46

CT

Question 47

What phenotype of COPD causes alveolar destruction, loss of bone, muscle, fat, and carries a higher rate of lung cancer

Answer 47

Multiorgan loss of tissue (MLOT)

Question 48

What phenotype of COPD is associated with bronchiolar narrowing and wall thickening and accompanied by metablolic syndrome and cardiac disease

Answer 48

Bronchitic

Question 49

What dificiency is inherited and associated with COPD

Answer 49

low a1-antitrypsin ssss