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STEP 2 Pulmonary > Pulmo. DLCO lent. + bronchiectasis 03-11 (2) > Flashcards

Pulmo. DLCO lent. + bronchiectasis 03-11 (2) Flashcards

pirmu kartu 100 proc. (55 cards)

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1
Q

Obstructive pattern: FEV1/FVC < 70 proc predicted.

A

.

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2
Q

Restrictive pattern: FEV1/FVC > 70 proc predicted, FVC < 80 proc. predicted.

A

.

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3
Q

Obstructive pattern + low DLCO? 1

A

Emphysema

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4
Q

Obstructive pattern + normal DLCO? 2

A

Chronic bronchitis, asthma

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5
Q

Obstructive pattern + increased DLCO? 1

A

asthma

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6
Q

Restrictive pattern + low DLCO? 4

A

ILD
Sarcoidosis
Asbestosis
HF

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7
Q

Restrictive pattern + normal DLCO? 2

A

musculoskeletal deformity
neuromuscular disease

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8
Q

Restrictive pattern + high DLCO? 1

A

morbid obesity

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9
Q

Normal spirometry + low DLCO? 3

A

anemia
PE
PH

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10
Q

Normal spirometry + high DLCO? 2

A

pulmonary hemorrhage
polycythemia

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11
Q

bronchiectasis. symptoms? 3

A

cought with daily mucopurulent sputum production
Rhinosinusitis, dyspnea, hemoptysis
Crackles, wheezing

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12
Q

bronchiectasis. pathophysiology?

A

Infectious insult with impaired clearance

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13
Q

bronchiectasis. etiologies? 5

A

Airway obstruction (eg cancer)
Rheumatic disease (RA, sjogren), toxic inhalation
Chronic or prior infection (eg aspergilosis, mycobacteria)
Immunodeficiency (eg hypogammaglobulinemia)
Congenital (eg CF, A1AT)

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14
Q

bronchiectasis. evaluation 4

A

HRCT of chest (needed for initial diagnosis)
Immunoglobulin quantification
CF testing, sputum culture (bacteria, fungi, mycobacteria)
PFT

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15
Q

bronchiectasis. CP?

A

C/P: large amounts of mucopurulent sputum (>100ml/day).

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16
Q

bronchiectasis. exacerbation causes?

A

Exacerbations are typically bacterial and required antibiotics.

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17
Q

bronchiectasis. relation to smoking?

A

No causal relationship between smoking and bronchiectasis.

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18
Q

bronchiectasis. in case of CF, what part of lung?

A

CF –> upper lobe bronchiectasis.

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19
Q

bronchiectasis. diagnosis. PFT?

A

obstructive patter

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20
Q

bronchiectasis. diagnosis. xray?

A

CXR: airway thickening (tram-track or ring sign).

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21
Q

bronchiectasis. diagnosis. CT?

A

CT: bronchial dilation, lack of airway tapering, and bronchial wall thickening.

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22
Q

bronchiectasis. pathogenesis scheme. initial?

A

Infectious insult PLUS impaired bacterial clearance

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23
Q

bronchiectasis. initial insult –> ?

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A

leads to bacterial overgrowth

24
Q

bronchiectasis. initial insult –> bacterial overgrowth -> ?

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A

neutrophil infiltration (excessive release of elastase = bronchial wall damage)

25
bronchiectasis. initial insult --> bacterial overgrowth -> neutrophil infiltration -> ?
inflammation
26
bronchiectasis. initial insult --> bacterial overgrowth -> neutrophil infiltration -> inflammation ->?
Tissue damage and structural airway changes
27
bronchiectasis. initial insult --> bacterial overgrowth -> neutrophil infiltration -> inflammation ->issue damage and structural airway changes --> closes circle and arrow goes again to bacterial overgrowth.
.
28
PFT in chronic lung disease. asthma TLC?
normal/increased
29
PFT in chronic lung disease. asthma FEV1/FVC?
decr (with positive bronchodilator response)
30
PFT in chronic lung disease. asthma DLCO?
normal/increased
31
PFT in chronic lung disease. COPD TLC?
increased
32
PFT in chronic lung disease. COPD. DLCO?
decr (normal in early COPD)
33
PFT in chronic lung disease. COPD FEV1/FVC?
decreased
34
PFT in chronic lung disease. ILD TLC?
decr
35
PFT in chronic lung disease. ILD FEV1/FVC?
normal
36
PFT in chronic lung disease. ILD DLCO?
decr.
37
PFT in chronic lung disease. PH TLC?
normal
38
PFT in chronic lung disease. PH FEV1/FVC?
normal
39
PFT in chronic lung disease. PH DLCO?
decr.
40
PFT in chronic lung disease. restrictive chest wall disease TLC?
decr
41
PFT in chronic lung disease. restrictive chest wall disease FEV1/FVC?
normal
42
PFT in chronic lung disease. restrictive chest wall disease DLCO?
normal
43
PFT -> obstr. --> DLCO normal/incr -->?
asthma
44
PFT -> obstr. --> DLCO decr -->?
COPD
45
PFT -> restr. --> DLCO normal -->?
chest wall weakness
46
PFT -> restr. --> DLCO decr -->?
ILD, granulomatous disease
47
Bronchiectasis kinda due to recurrent cycle of infection
.
48
Bronchiectasis. development requires infectious insult in combination with impaired bacterial clearance
.
49
Bronchiectasis. exacerbations why and what symptoms?
Patients may have frequent exacerbations (due to bacterial infections) characterized by: a. Fever b. Increased dyspnea c. Increased sputum production
50
Bronchiectasis. Best diagnostic?
CT i. Bronchial dilation ii. Lack of airway tapering iii. Bronchial wall thickening xray is not diagnostic, but may show linear atelectasis, dilated and thickened airways
51
bronchiectasis differential?
a. Chronic Bronchitis: i. Sputum production is less prominent than bronchiectasis ii. Exacerbations are usually viral in chronic bronchitis iii. It is associated with smoking, while bronchiectasis is not
52
bronchiectasis due to CF.
In young patients, because CF is usually in young people.
53
bronchiectasis due to CF. pathophysiology?
a. Defective sodium and chloride transport leads to thick secretions and impaired mucociliary clearance b. Chronic bacterial infection ensues, leading to enhanced neutrophil recruitment and excessive release of Elastase (which contributes to bronchial airway damage)
54
bronchiectasis due to CF. causative mo?
pseudomonas aeruginosa
55
bronchiectasis due to CF. what lung part involvement?
Upper lung lobe involvement is characteristic of bronchiectasis due to CF, and helps differentiate it from bronchiectasis due to other causes

STEP 2 Pulmonary (30 decks)

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