Obstructive Pulmonary diseases

Question 1

define obstructive pulmonary disease

Answer 1

conditions characterized by increasing airflow resistance as a result of airway obstruction or narrowing

Question 2

discuss asthma KNOW THIS

Answer 2

airway inflammation and airway hyper-responsiveness

Question 3

what does degree bronchoconstriction in asthma related to ?

Answer 3

1) degree of airway inflammation

2) airway hyper-responsiveness

3) exposure to triggers (ex: infection, allergens)

Question 4

discuss path of asthma in the early phase

Answer 4

allergen or irritant attaches to IgE receptors on mast cells which then release chemical inflammatory mediators like histamine
- epithelial damage
- intense inflammation
-increase vasodilation and permeability
- bronchial smooth muscle constriction

• peaks within 30-90 minutes after exposure to the trigger
• subsides in another 30-90 minutes

Question 5

discuss asthma in the late phase response patho

Answer 5

inflammatory cells involved in asthma (eosinophils and neutrophils) infiltrate the airway, release mediators that induce further inflammation causing mast cells to degranulate basically histamine and other mediators released = self-sustaining cycle

• peaks 5-12 hours after exposure
• lasts from several hours to days
• primary characteristic is inflammation as opposed to bronchial smooth muscle contraction

Question 6

discuss asthma key take aways

Answer 6

• reduction in airway diameter
• increase in airway resistance
• hypertrophy

Question 7

what is an unpredictable sign of asthma?

Answer 7

Wheezing is an unpredictable
sign for gauging severity of attack

also note changes in vital signs

Question 8

what is asthma status asthmaticus

Answer 8

life threatening medical emergency

• its basically an extreme form of acute asthma attack that doesnt respond to the medications

you get hypoxia, hypercapnia and acute respiratory failure all at once
NOTE: the first 2 happens because pt will hyperventilate to control to maintain oxygen but they will sooner or later become fatigued and CO2 will start to be retained

• happens bc of viral illness or pollution or poor management of asthma

Question 9

what are 2 types of reliever medications for asthma?

Answer 9

1) bronchodilators: short acting inhaled beta adrenergic agnosists example: salbutamol, ventolin

used for fast relief of attack. not intended to be used for daily treatment.

2) anticholinergics/short-acting muscarinic antagonists: ipratropium, atrovent. THIS IS USED WHEN THE PT CANT HANDLE BETA AGONIST SO THEY USE THIS INSTEAD

Question 10

what are 2 types of controller medications for asthma?

Answer 10

1) anti-inflammatory medications: corticosteroids

2) bronchodilators: long acting, methylxanthines

Question 11

what is the primary cause of acute asthma attack?

Answer 11

viral respiratory infections

Question 12

What do you call asthma where the only symptom is a cough?

Answer 12

cough variant asthma

Question 13

discuss COPD

Answer 13

• it’s preventable
• characterized by persistent airflow limitation inflammation in the lung parenchyma (bronchioles and alveoli)

basically inflammation of bronchioles and excess sputum

Question 14

how does COPD happen?

Answer 14

1) airflow limitations during forced exhalation that are caused by loss of elastic recoil and are not fully reversible - emphysema

2) airflow obstruction caused by mucus hyper secretion, mucosal edema and bronchospasm - chronic bronchitis

Question 15

what does the inflammation from COPD cause?

Answer 15

destroys the tissues and hinders the normal defence mechanism and repair of the lungs

the inflammation also attracts inflammatory cells leukotrienes and interleukins for structural chnage

Question 16

what is the shape of the chest with COPD?

Answer 16

Because air occurs due to the inability to expire, the chest hyper-expands creating a barrel chest as respiratory muscles cannot function properly

Question 17

what is the ultra combination of COPD in someone?

Answer 17

suspect COPD in pt who
1) has cough
2) sputum production
3) dyspnea and history of smoking

Question 18

what are the 2 types of COPD?

Answer 18

1) emphysema: destruction of alveoli which decreases gas exchange

2) chronic bronchitis : airway inflammation + excess sputum + cough

Question 19

what are 4 complications of COPD?

Answer 19

1) Cor pulmonate - hypertrophy of right side of heart with or without heart failure as a result of pulmonary hypertension

2) Acute exacerbation of COPD: sustained worsening of COPD symptoms
- many exacerbations caused by bacterial infection

3) Acute respiratory failure: overall decline in lung function, deterioration in health status, risk of death

4) depression and anxiety

Question 20

how is COPD treated?

Answer 20

bronchodilators and corticosteroids

usually pt education route so stop smoking, active lifestyle, short acting bronchodilators PRN. spirometry and prevention

if it gets really bad then its ling transplant or end of life care

Question 21

what is the difference between asthma and COPD?

Answer 21

Asthma
- < 40 yrs old
- triggered
- stable with exacerbation
- spirometry normalizez condition

COPD
- > 40 yrs
- smoker
- sputum
- progressively worsens
- spirometry may improve but never normalize

Question 22

What is the normal range for copd oxygen?

Answer 22

88-93