pulm dzs pt 1

Question 1

chronic obstructive pulmonary disease

Answer 1

chronic airflow limitation that is not fully reversible

Question 2

what can COPD manifest as

Answer 2

chronic bronchitis

emphysema

asthma can also progress to COPD

Question 3

COPD

Answer 3

second only to heart disease as a cause for disability in adults under 65

4th leading cause of death in US

deficiency of alpha1-antitrypsin (anti-inflammatory protein) develop COPD earlier and disease is accelerated

Question 4

common presenting signs of COPD

Answer 4

dyspnea

sputum production

chronic cough

Question 5

diagnosis COPD

Answer 5

spirometry

to measure how much air the lungs can hold and how well the respiratory system is able to move air into and out of the lungs

blood gas measurement

blood pH

Question 6

treatment COPD

Answer 6

goals are to improve oxygenation and decrease CO2 retention

long term O2 treatment

Question 7

prognosis COPD

Answer 7

poor b/c these are chronic, progressive, debilitating diseases

COPD is largely preventable

death rate has increased 22% in last decade

Question 8

COPD risk factors (chronic bronchitis)

Answer 8

irritants (smoking)

long-term dust inhalation

air pollution

Question 9

COPD pathogenesis (chronic bronchitis)

Answer 9

inflammation and scarring of the bronchial lining caused by mucus hypersecretion and hypertrophy of mucus producing glands

Question 10

COPD clinical manifestations (chronic bronchitis)

Answer 10

persistent cough and sputum production result in shortness of breath, prolonged expiration and recurrent infection

Question 11

COPD medical management (Chronic bronchitis)

Answer 11

reducing irritants and using combination of bronchodilators

Question 12

2 types of COPD

Answer 12

chronic bronchitis

emphysema

Question 13

COPD –> chronic bronchitis

Answer 13

productive cough lasting for at least 3 months per year for 2 years

Question 14

COPD –> emphysema

Answer 14

pathologic accumulation of air in tissues

occurs as a results of prolonged respiratory difficulties

Question 15

3 types of emphysema

Answer 15

centrilobular

panlobular

paraseptal

Question 16

centrilobular emphysema

Answer 16

destruction in the bronchioles, usually in the upper lung

Question 17

panlobular emphysema

Answer 17

destroys the air spaces of the entire acinus (lower lung)

Question 18

paraseptal (paracinar) emphysema

Answer 18

destroys the alveoli in the lower lobes of the lungs

resulting in isolated blebs along the lung periphery

Question 19

COPD emphysema pathogenesis

Answer 19

destruction of elastin in the lung that normally maintains the strength of the alveolar walls leads to permanent enlargement

Question 20

COPD emphysema clinical manifestations

Answer 20

exertional dyspnea progresses to dyspnea at rest

cough is uncommon with little sputum production

pt is often thin, has tachypnea w/ prolonged expiration

must use accessory muscles for ventilation

Question 21

COPD emphysema treatment

Answer 21

most important is cessation of smoking, pursed lip breathing, diaphragmatic breathing, pulmonary rehab and supplemental oxygen

lung transplantation

LVRS

AATD replacement

Question 22

asthma

Answer 22

reversible obstructive lung disease characterized by inflammation and increased smooth muscle reaction of the airways to various stimuli

irreversible = COPD

Question 23

asthma is an…

Answer 23

inflammatory response

produces bronchial smooth muscle spasm, vascular congestion, increases vascular permeability, edema formation, production of thick tenacious mucus and impaired mucocilary function