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Pathophysiology > Obstructive Pulmonary > Flashcards

Obstructive Pulmonary Flashcards

1
Q

How are obstructive lung diseases diagnosed?

A

by outcomes on static PFTs

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2
Q

What are the risk factors for COPD?

A

secondhand smoke and smoking
hereditary and hx of respiratory infectios
environmental factors

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3
Q

Emphysema is a disease of:

A

exhalation

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4
Q

Emphysema will cause an increase in:

A

TLC and Residual volume

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5
Q

emphysema will cause a decrease in:

A

FVC1/ FVC ratio

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6
Q

What enzyme is thought to be a genetic cause of emphysema?

A

A-1AT

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7
Q

A-1AT deficiencies can not only cause emphysema but:

A

liver disease

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8
Q

If a pt has an FEV1/FEV <.5, is this good or bad for emphysema?

A

it is very bad

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9
Q

What is the first complaint of someone w emphysema?

A

Shortness of breath

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10
Q

A - 1AT deficiency and cigarette smoking are associated with:

A
  • destruction of individual alveoli
  • development of super alveoli
  • destruction of connective tissue supports for the very smallest airways allowing them to collapse during expiration.
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11
Q

What are the characteristics of someone with emphysema?

A

anxious, addicted to O2
thin
deformed chest
absent cough

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12
Q

What typical cardiac problem accompanies emphysema?

A

cor pulmonale!

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13
Q

with disease progression of emphysema, what 3 things will occur?

A
  • structural damage to the lungs increases
  • hypoxemia worsens
  • CO2 is retaine
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14
Q

What are 7 frequent complications of emphysema?

A
  • pneumonia
  • pneumothorax
  • chronic atelectasis
  • cor pulmonale
  • pulmonary interstitial emphysema
  • recurrent respiratory tract infections
  • respiratory acidosis
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15
Q

What are the 4 gold level criteria we have for emphysema?

A

Mild = FEV1 is 80 or above
Moderate = FEV1 is between 50 - 79
Severe = FEV1 is 30 - 50
Very severe = FEV1 is below 30

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16
Q

How do we treat emphysema?

A
  1. Reducing airway edema
  2. Facilitating the elimination of bronchial secretions
  3. Prevent & treat respiratory infection
  4. Increase exercise tolerance
  5. avoid airway irritants
  6. relieve airway anxiety
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17
Q

What medication thins and loosens mucus?

A

expectorants and mucolytics

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18
Q

what medication will manage respiratory tract infections?

A

antibiotics

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19
Q

What medication will result in the dilation of bronchial smooth muscles?

A

anticholinergics and B2 Agonists

20
Q

What medications will limit the occurrence of an inflammatory reaction?

A

mast cell membrane stabilizers, glucocorticoids, and antihistamines

21
Q

What pt would get long-term oxygen therapy?

A
  • PaO2 of 55 or less
  • resting oxygen saturation of 88% or less
22
Q

What are the implications for the PT?

A
  • pulse oximeter
  • monitor HR and BP
  • take first heart distal sternal area
  • can modulate the nasal cannula O2
  • monitor respiratory rate and O2 saturation
23
Q

What is used to deliver drugs to lungs for emphysema?

A

a metered dose inhaler

24
Q

what are the diagnostic criteria for being diagnosed with chronic bronchitis?

A
  • productive cough lasting at least 3 months per year for 2 consecutive years
  • FEV/FEV1 < 75% (suggests obstruction) plus chronic cough suggests bronchitis
25
Q

What is the cause of chronic bronchitis?

A

Usually caused by long-term exposure to irritants that damage your lungs.

26
Q

What is chronic bronchitis characterized by:

A

inflammation
excessive mucous production
scarring of the bronchial lining
obstructed airflow caused by increased mucous production

27
Q

Chronic bronchitis destroys the:

A

the ciliary lining of the cells

28
Q

What are the symptoms of chronic bronchitis?

A
  • recurring morning cough
  • increased production of phlegm and chronic coughing secondary to inflammation
  • wheezing
  • shortness of breath
  • tight chest
  • Feeling tired
29
Q

What is chronic bronchitis caused by?

A
  • upper/lower airway infections
  • exposure to irritants
  • have pts avoid exposure to these irritants
30
Q

Pts w/ chronic bronchitis tend to be/have:

A

polycythemic (blood cancer)
cyanotic
peripheral edema

31
Q

what are trx for chronic bronchitis?

A

bronchodilators
anti inflammatory drugs
o2 therapy

32
Q

Why are those with chronic bronchitis called blue bloaters?

A
  • decreased ventilation
  • increased RV
  • Dreadful V/Q mismatch, much shunting
  • Hypoxemia, hypercapnia, cyanosis, polycythemia
  • Cor pulmonale, 2 chronic pulmonary HTN
33
Q

What are the PT implications for chronic bronchitis?

A
  • reduce irritants
  • bronchodilators
  • mucolytics
  • NSAIDS
34
Q

What is asthma characterized as?

A
  • episodic, reversible, an obstructive lung disease characterized by bronchospasms resulting from an exaggerated inflammatory response to airway smooth muscles
  • bronchial hyperactivity
  • Clinically manifested by: episodic dyspnea, coughing, and wheezing
35
Q

What is an extrinsic cause of asthma?

A

result of an allergic reaction to specific triggers such as pollen, dust, molds, smoke

36
Q

What is an intrinsic cause of asthma?

A

has no known allergic cause or trigger

37
Q

What are 5 other types of recognized categories asthma?

A

adult onset
exercise-induced
aspirin-sensitive
aspergillus - hypersensitive to the aspergillus fungus
occupational asthma

38
Q

What are 5 other types of recognized categories of asthma?

A

adult onset
exercise-induced
aspirin-sensitive
aspergillus - hypersensitive to the aspergillus fungus
occupational asthma

39
Q

What is the pathogenesis of asthma?

A

an inflammatory response consisting of cellular infiltration, epithelial disruption, mucosal edema, inflammatory mediator release
- inflammatory mediators produce bronchial smooth muscle spasm

40
Q

What drug is administered for the bronchial provocation test?

A

methacholine - a cholinergic stimulant that will cause smooth muscle contraction.

41
Q

What is a positive bronchial provocation test?

A

20% decrease FEV1

42
Q

Chronic Asthma will cause:

A

airway remodeling
chronic air trapping
the proliferation of submucosal glands
hypertrophied smooth muscle

43
Q

How do you treat asthma?

A
  • identify/avoid triggers or allergens
  • bronchodilators
  • low dose corticosteroids
44
Q

What do people with exercise-induced asthma take?

A

corticosteroids

44
Q
A

Pathophysiology (11 decks)

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