RESPIRATORY DISEASES

Question 1

what is the main function of the lungs?

Answer 1

gas exchange - inhaling oxygen that we need to oxidize macromolecules and removing carbon dioxide from our systems

Question 2

where is gas exchange done?

Answer 2

alveoli

Question 3

describe the roles of type 1 and type 2 alveoli cells

Answer 3

type 1: responsible for gas exchange
type 2: alveoli cells produce surfactant decrease surface tension to avoid the alveoli to collapse after exhalation

Question 4

what is pleural effusion

Answer 4

accumulation of fluids in the pleura (layer that allows the lungs to expand) - causing shortness of breath

Question 5

what is atelectasis

Answer 5

when lungs collapse

Question 6

describe how nutrition impacts pulmonary function

Answer 6

• strength and endurance of respiratory muscles
• lung parenchyma –> increased incidence of pulmonary infection
• antioxidant protection - inadequate intake of antioxidants could lead to increased oxidative injury of the lung tissues

Question 7

how do pulmonary functions impact nutrition>

Answer 7

• energy expenditure
• dietary intake (early satiety, anorexia)

Question 8

what is cystic fibrosis?

Answer 8

autosomal recessive disease
- disease caused by genetic mutation which will impair the function of the CFTR (cystic fibrosis transmembrane conductance)
- CTFR is the sodium and chloride transport and so there will be abnormal transport leading to viscous/thick mucus secretion from epithelial surfaces

Question 9

what is progressive lung disease?

Answer 9

inability to clear mucus from the lungs - mucus prevents entrance of different particles which will increase the change that we are exposed to possible infections
- chronic inflammation can lead to losing the functions of our lungs
- increased risk of infection

Question 10

what is pancreatic insufficiency

Answer 10

malabsorption of fats
- steatorrhea (excessive amounts of fat in poops) –> poor growth pattern
- main causes of malnutrition in patients with CF

Question 11

how are cystic fibrosis and diabetes related

Answer 11

(10-15% of adults)
- inflammation and accumulation of fibrous tissues in the pancreas - interferes with normal insulin production

Question 12

what are the CF diagnosis

Answer 12

• all newborns are screened with serum testing
• fecal elastase test (elastase is a digestive enzyme) - may have pancreatic insufficiency if cannot find elastase in stools or lower values
• sweat chloride test (considered gold standard)

Question 13

what are CF nutrition implications

Answer 13

• pancreatic insufficiency - malabsorption of dietary fat, fat soluble vitamins, and other nutrients
• increased energy requirements
• malnutrition –> stunted growth and inadequate weight gain in children
• osteoporosis –> from fat malabsorption (unabsorbed FA can form soaps and increase secretion of calcium, zinc, and magnesium
• hyponatremia - loss of sodium in sweat

Question 14

what are you looking for in the assessment portion of CF?

Answer 14

• anthropometric measurements
• labs: glucose, albumin, electrolytes, serum vit A, D, E, K, and calcium

Question 15

intervention for individuals with CF?

Answer 15

• high energy, high protein
• no need to restrict on fat
• liberalize high salt diet
• routine supplementation of fat soluble vitamins A, D, E, K
• breast milk recommended for first year of life

Question 16

describe asthma

Answer 16

chronic inflammatory disorder of the airway –> airflow obstruction often reversible either spontaneously or with treatment
- restricts airflow to the lungs

Question 17

what is the association between obesity and asthma

Answer 17

both inflammatory conditions

Question 18

what are nutrition therapies for asthma

Answer 18

• mediterranean dietary pattern (anti-inflammatory diet)
• olive oil, omega 3’s, intake of fruit and vegetables (increase antioxidants)
• long term use of corticosteroids –> increased glycemia and Na retention - watch out

Question 19

what is COPD

Answer 19

chronic obstructive pulmonary disease
- generalized inflammatory response to pollutants repeated exposure to cigarette smoke and other pollutants
- progressive disease that limits airflow through inflammation of bronchial tubes (bronchitis) or destruction of alveoli (emphysema)

Question 20

what is chronic bronchitis

Answer 20

• thickened airways
• decreased cilia function (inability to clean mucus from the airways)
• thickened mucus provides an environment prime for bacteria growth

Question 21

what is cor puolmonale

Answer 21

complication of COPD
- right sided heart failure (helps remove CO2 - will overwork the right side of the heart)

Question 22

what is emphysema

Answer 22

• destruction of lung tissue
• loss of connective tissue –> loss of surface area –> decreased surfactant
• bronchioles collapse during exhalation and cause hyperinflation of the lungs

Question 23

a noticeable clinical manifestation of emphysema

Answer 23

barrel chest

Question 24

COPD Treatment

Answer 24

• lifestyle changes (smoking, avoidance of other pollutants, exercise as tolerated)
• pharmacologic treatment
• pulmonary rehabilitation
• lung transplant

Question 25

COPD Nutrition Implications

Answer 25

- increased REE secondary to the work of breathing - reduced nutrient intake from: - hyperinflation of the lungs with flattening of the diaphragm --> early satiety - chronic mouth breathing --> taste perceptions and xerostomia - change of breathing patterns and reduced oxygen uptake --> chewing and swallowing difficulties - fatigue and reduced functional status - weight loss and losses of lean body mass - osteoporosis in advanced COPD

Question 26

COPD Nutrition Therapy:

Answer 26

- SFM - alleviate the fullness and bloating - nutrient and energy dense foods - high kcal and high protein

Question 27

what is respiratory failure

Answer 27

occurs when the respiratory system is no longer able to perform its normal functions - can be caused by low oxygen or excess CO2 or both

Question 28

what is pneumonia

Answer 28

infection of the lungs, usually caused by bacteria, viruses, or fungi

Question 29

3 diff ways to acquire pneumonia

Answer 29

- community - hospital - ventilator

Question 30

what is aspiration pneumonia

Answer 30

- aspirate material causes an inflammatory response in the lung

Question 31

some risk factors of aspiration pneumonia

Answer 31

- head injuries, neurological impairments - use of paralyzing agents - improper positioning of a feeding tube - placement of the head of the patient's bed at a shallow angle - hyperglycemia, gastroparesis

Question 32

ways to prevent aspiration pneumonia

Answer 32

- patient's head to be elevated higher than his or her stomach or at an angle of >30 degrees during feeding

Question 33

what are tracheostomies

Answer 33

surgical opening made in the trachea to assist breathing

Question 34

nutrition implications of tracheostomies

Answer 34

- risk of aspiration - patients may require a feeding tube - viscosity of food makes a difference once the patient is able to eat orally - SLP should determine whether the patient can safely swallow food without aspiration