Pulmonary Diseases

Question 1

FEV1 (decrease)/FVC (unchanged): problem with getting the air out due to narrowing of the airways (tubular issue)

Emphysema, COPD, asthma, cystic fibrosis

Answer 1

Obstructive pulmonary disease

Question 2

FEV1 (decrease)/FVC (decrease) = ratio unchanged: problem with getting the air in due to restriction on how much can be inhaled/expandability of the lungs (decreased compliance)

Pulmonary fibrosis, sarcoidosis, granulomas, ARDs

Answer 2

Restrictive pulmonary disease

Question 3

Cough, wheezing, SOB
Measure FEV1/FVC ratio
Albuterol, corticosteroids, leukotriene modifiers, mast cell inhibitors

Answer 3

Asthma

Question 4

Chronic wet cough, edema (cor pulmonale), SOB, O2 dependent, cyanosis, increased sputum, cardiovascular system affected

Answer 4

Chronic bronchitis (blue bloater)

Question 5

Minimal/absent cough, use of accessory muscles, pursed-lip breathing, barrel chest, air-trapping, nail clubbing,

Answer 5

Emphysema (pink puffer)

Question 6

Cellular debris/microbes deposited as “waste” in weak spots of the walls > can lead to infection

Answer 6

Bronchiectasis

Question 7

Recurrent infections, wet cough (increased mucus), malabsorption (pancreatic insufficiency, malnutrition), diabetes

Answer 7

Clinical manifestations of Cystic Fibrosis

Question 8

Chloride movement across the cell membranes affects sodium > improper movement of water

Answer 8

Thicker mucus - CF

Question 9

Wheezing, dyspnea/tachypnea, low-grade fever
Inflammation in the lower airways
< 2 y.o. (smaller airways, size changes resistance)
RSV - respiratory syncytial virus

Answer 9

Broncholitis

Question 10

Swollen/red throat, drooling, dysphagia, fever, stridor (high pitch)
Swelling of epiglottis
H. flu vaccine, H. flu, S. pnuemo

Answer 10

Epiglottitis

Question 11

Inspiratory stridor, expiratory barking cough, low-grade fever
6 m.o. - 3 y.o.
RSV, influenza, M. Pneumo

Answer 11

Croup

Question 12

Inflammatory response destroys Type 1 pneumocytes, hypertrophy/hyperplasia of Type 2 pneumocytes affects surfactant production
Lung tissue becomes scarred and tough

Answer 12

Idopathic pulmonary fibrosis

Question 13

Non-caseating granulomas (no necrosis in WBC inflammatory response cells)
Common in the lymph nodes and lungs
Affect skin, eyes, spleen, liver, kidneys
Prevalent in African Americans

Answer 13

Sarcoidosis

Question 14

Type III hypersensitivity (B-cell mediated)
Dusts enter respiratory system and cause immune response

Answer 14

Hypersensitivity Pneumonitis

Question 15

Asymptomatic
Inorganic dust exposure (silicates, asbestos)

Answer 15

Pneumoconiosis

Question 16

Type 2 pneumocytes affected
Refractory hypoxemia, non-cardiogenic pulmonary edema, leaky capillaries, vasodilation
Aspiration, shock, sepsis, trauma

Answer 16

ARDs

Question 17

Type 2 pneumocytes affected
Refractory hypoxemia, non-cardiogenic pulmonary edema, leaky capillaries, vasodilation
Aspiration, shock, sepsis, trauma

Answer 17

ARDs

Question 18

Type 2 pneumocytes affected
Resp. distress, intercostal retractions, nasal flaring
Immature lungs/lack of surfactant
Decreased compliance

Answer 18

IRDS (Hyaline membrane disease)

Question 19

Build up of air in the pleural space (outside lung, in chest cavity)
Decreased ability of lungs to expand

Answer 19

Pneumothorax

Question 20

Tension/trauma cause collapse of pleural space/lungs
Trapped air causes increased pressure
Midline lungs, restricted blood flow, JVD

Answer 20

Tension pneumothorax

Question 21

Collection of fluid in the pleural space

Answer 21

Pleural effusion

Question 22

Sinusitis (inflammation of nasal passages)
Usually viral, sometimes bacterial

Answer 22

Upper respiratory tract infection

Question 23

Bronchitis (viral)
Pneumonia (bacterial, more common than bronchitis)

Answer 23

Lower respiratory tract infection

Question 24

Bacterial: fever, chills, wet cough
Viral: URI, dry cough
Atypical: high fever, muscle pain, GI symptoms
Community acquired - viral, nosocomial - bacterial
Inhalation of infectious agents, aspiration, systemic disease

Answer 24

Pneumonia