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Flashcards in Pulmonary disorders Deck (51):
1

Obstructive diseases are manifested by what?

increased resistance to airflow

2

What are the three types of obstructive pulmonary diseases?

1. Obstruction from conditions in the wall of the lumen

2. Obstruction related to loss of lung parenchyma

3. Obstruction of the airway lumen

3

What type of disease is asthma?

Obstruction from conditions in the wall of the lumen

4

What is the level of alveolar damage going from asthma, chronic bronchitis, to COPD?

Increases steadily

5

What is the level of reversibility going from asthma, chronic bronchitis, to COPD?

Decreases steadily

6

What is the level of sputum production going from asthma, chronic bronchitis, to COPD?

High in chronic bronchitis

Low for asthma and COPD

7

What is asthma?

Increased airway responsiveness to stimuli that partially or completely reversible bronchoconstriction

8

Allergic asthma presents when? Non allergic?

Allergic = peds
Non-allergic = adulthood

9

What is the main difference between allergic and nonallergic asthma?

Can have allergen specific immunotherapy if know allergen

10

Allergen binding to the bronchial epithelium in allergic asthma activates what? What does this lead to (2)?

Inflammatory mediators,

leading to vasodilation, increased mucus production and loss of epithelium

11

What type of disease is Acute bronchitis?

Obstruction from conditions in the wall of the lumen

12

What type of disease is Chronic bronchitis?

Obstruction from conditions in the wall of the lumen

13

What type of obstructive disease is COPD?

Loss of lung parenchyma

14

What type of obstructive disease is bronchiectasis?

Obstruction of the airway lumen

15

What type of obstructive disease is Bronchiolitis?

Obstruction of the airway lumen

16

What type of obstructive disease is Cystic fibrosis?

Obstruction of the airway lumen

17

What type of obstructive disease is Acute tracheobronchial obstruction?

Obstruction of the airway lumen

18

What type of obstructive disease is epiglottitis?

Obstruction of the airway lumen

19

What type of obstructive disease is croup?

Obstruction of the airway lumen

20

Do you have a family or personal h/o allergies in allergic asthma? Nonallergic asthma?

Yes for allergic, no for nonallergic

21

What leads to the increase in mucus secretion/narrower bronchiolar diameter seen in asthma? (3)

1. Loss of epithelial cells and their cilia
2. Vasodilation/angiogenesis
3. Bronchoconstriction

22

What happens to the submucosal layer of the bronchi in asthma? Smooth muscle?

Thickening and edema

Hyperplasia and hypertrophy

23

What is the HPI like in asthma?

SOB d/t temp changes, allergen exposure, exercise,

24

What are the vital like in asthma attack? (3)

1. Tachypnea
2. Tachycardia
3. Pulsus paradoxus

25

What is pulsus paradoxus?

Inspiration produces a drop in the plus pressure (this is opposite of normal)

26

What causes pulsus paradoxus?

Increased afterload of the right heart, lowering stroke volume, and lowering left ventricular SV d/t pressure from the right side of the heart

27

What are the four major exam findings in asthma?

1. Accessory musle use
2. expiration > inspiration
3. hyperinflated chest
4. Wheezing

28

When, typically, is wheezing longer/louder in asthma, the inspiratory or expiratory phase?

Expiratory phase

29

What are the peak flow rates like in an asthma attack?

A decrease in airflow rates throughout the vital capacity is the cardinal pulmonary function
abnormality during an asthmatic episode.

30

What happens to the volumes of the lung in asthma?

lung volume measurements
demonstrate an increase in both total lung capacity and residual volume;

31

What are the therapeutic goals of treating asthma?

1. ADLs w/o SOB
2. Sleep w/o awakening
3. Minimize rescue inhaler use
4. Minimize care

32

When are bronchodilators used in asthma?

Acutely

33

What is the MOA of controller treatments for asthma?

block the effects or prevent the production of inflammatory mediators that are released by
inflammatory cells in the airway

34

What are the two receptors that we utilize to effect bronchodilation?

Beta 2 (excite)

M3 (inhibit)

35

What are restrictive lung diseases?

Decreased expansion of the lungs d/t alteration in thelung parenchyma

36

What are the four types of restrictive lung disorders?

1. Lung parenchyma disorders
2. Pleural space disorders
3. Neuromuscular/chest wall abnormalities
4. Infection/inflammation of the lungs

37

What are the two types of lung parenchyma disorders?

1. Fibrotic interstitial lung disease
2. Atelectasis disorders (ARDS, IRDS)

38

What are the two types of pleural space disorders?

Pneumothorax
Pleural effusion

39

What is Adult Respiratory distress syndrome (ARDS)?

A severe respiratory distress condition characterized by damage to the alveolar-capillary
membrane

40

What are the three key pathological features of ARDS?

1. noncardiogenic pulmonary edema
2. Atelectasis d/t lack of surfactant
3. Fibrosis

41

What are the two most common causes of ARDS?

1. Sepsis
2. Aspiration of gastric acid

42

How do you diagnose ARDS?

Decrease in PaO2 that is refractory to supplemental O2 therapy

43

What causes noncardiogenic pulmonary edema?

Damage to the alveolar capillaries

44

What causes the severe hypoxemia seen in ARDS?

intrapulmonary shunting of blood

45

What causes the decreased lung compliance seen in ARDS?

Deposition of plasma protein

46

What are the findings seen on a CXR in ARDS?

White out

47

What is the treatment for ARDS?

Supportive
Cure cause of disease
PEEP

48

How does PEEP help ARDS?

Increases FRV
Forces edema out

49

How does atelectasis occur during high [c] oxygen administration?

Use of oxygen by body

50

What is High Frequency Jet Ventilation (HFJV??

small Vt is given at a high frequency, reducing
lung injury caused by ventilator

51

Why is inhaled NO given to ARDS patients?

Relaxation of the bronchioles