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Flashcards in Respiratory II Deck (43):
1

What percentage of people in USA under 65 have COPD?

50%

2

What is a key feature of COPD?

1. Chronic cough
2. Dyspnea
3. Rhonci
4. Airflow on PFT NOT REVERSIBLE with bronchodilator
5. Hx of cigarette smoking

3

What is Rhonci?

A course rattling sound caused by secretion in bronchial airways, lower pitch than wheezing.

4

Chronic Bronchitis key symptom is:
1. Wheezing
2. Dry Cough
3. Cough with sputum
4. All of the above

3. Cough with sputum on most days for at least 3 months for at least 2 successive years.

5

How does cigarette smoking affect the airways?

Toxins in smoke cause increased production of mucus.

6

Chronic Bronchitis involves chronic inflammation of:
1. Pharynx, Trachea, Bronchi
2. Bronchi, Bronchioles, Aveolis
3. Trachea, Bronchi, Bronchioles

3. Trachea, Bronchi, Bronchioles

7

As a result of Chronic Bronchitis there is:
1. Hypersecretion of Mucus
2. Thickening of the walls of respiratory tree
3. Irritation of the airways
4. Thickening of epithelium
4. All of the above

4. All of the above

8

Which does sub mucosal gland hypertrophy NOT involve:
1. Thickening of the airway walls
2. Increased volume of mucus that plugs the airways
3. Hyperventilation
4. Hyperplasia
5. Decreased efficacy of gas exchange

3. Hyperventilation

9

Sub mucosal gland hypertrophy is a symptom of what?

Chronic Bronchitis

10

What does hyperplasia do?

Thickens epithelium, by increasing activity of glands. Can be due to smoking or pollution.

11

The single most important risk factor for COPD?

Smoking: smoking is the single most important risk factor for COPD.

12

These are all signs of what condition?
- Dyspnea
- Hypoxemia, hypercapnia,
- Hyperventilation
- pink puffers
- Decreased breath sounds
- Pursed Lips

Emphysema

13

How does submucosal gland hypertrophy affect O2 and CO2?

It decreases the efficiency in gas exchange.

14

Chronic inflammation, as in Chronic Bronchitis, leads to a thickening of what lining?

Epithelium.

15

Thickening of epithelium results in a loss of what?

Cilia.

16

What is the function of Cilia in the lungs?

To clear bacteria.

17

What do leukocytes and neutrophils do to the airways in the case of inflammation caused by smoking?

They cause a thickening of the airways.. Nicotine is a paralytic.

18

True or False: Dyspnea is a symptom of chronic inflammation of the lungs.

True

19

What are characteristics of Blue Bloater?

- Lack of oxygen
- Chronic productive cough
- Hypercapnia (high levels CO2)
- Cyanosis of nail beds
- Clubbing

20

"Blue Bloater" appearance is indicative of what disease?

Answer: Chronic Bronchitis.
Unlike emphysema, the pulmonary capillary bed is undamaged. Instead, the body responds to the increased obstruction by decreasing ventilation and increasing cardiac output.

21

Which of these do Blue Bloaters NOT have?
1. Cardiac Enlargement
2. Clubbed Nails
3. Thin Appearance
4. Lg, Accessory Muscles
5. Dyspnea
6. Air Trapping

3. Thin appearance

22

Bronchietasis is:
1. Inflamed Airways
2. Flabby Airways
3. Dilated Airways
4. All of the above

4. All of the above

23

True or False Bronchiectasis is a complication of Chronic Bronchitis?

True. Flabby airways can't clear mucus and become vulnerable to bacterial infection.

24

What happens to the lungs in Atelectasis?

Collapse (A Complication of Chronic Bronchitis)

25

True or False Atelectasis is temporary?

False

26

Broncheitasis requires what two components?

1. Obstruction
2. Inflammation (d/t infection)

27

Pulmonary Hypertension usually affects which side of the heart?

Right. It's an increase in blood pressure.

28

What are four options for treating or managing Chronic Inflammation of the lungs?

1. Oxygen
2. Medication
3. Antibiotics
4. Prevention/Stop smoking

29

Is physical activity a recommended treatment for Chronic Inflammation of the lungs?

Yes. Also Breathing techniques.

30

True or False: Emphysema is a temporary enlargement of the air spaces distal to the terminal bronchiole?

False: It is a PERMANENT enlargement

31

True or False: In emphysema, there is a decreased gas exchange due to a loss of surface area in the alveolar space.

True, resulting in a DECREASE IN OXYGEN.

32

True or False: In emphysema the wall s of the terminal bronchiole are destroyed?

True

33

What is Hypercapnia in Emphysema?

Excess CO2 in blood

34

What does the term Pink Puffer refer to?

Hyperventilation in patients with Emphysema. Also thin, pursed lips, tripod position, clubbed nails.

35

True or False: In progressive Emphysema Pink Puffers show great improvement with the use of bronchodilators?

False

36

True or False: Pink Puffers rely on the accessory muscles (SCMs) to hep breathe?

True

37

What is the Tx for Emphysema?

1. Lung Volume Reduction Surgery
2. Lung Transplantation

38

Chronic cough and upper respiratory infection might suggest what disease?

Emphysema

39

A middle aged smoker who has bronchial disease showing progressive airway obstruction that produces dyspnea on exertion may have what?

Emphysema

40

Patient 50 years old with excess cough, sputum, SOB and slight dyspnea may have?

Emphysema

41

What test is essential in establishing a diagnosis of COPD?

PFT (Pulmonary Function Test)

42

The typical abnormality in COPD is a reduced...?
1. IRV
2. FEV
3. ERV

2. FEV

43

1. Bronchodilators: relax muscles (Short term)

2. Beta 2s Agonists: (Albuterol – Short Term & Long Term- Ventolin for COPD)

3. Anticholinergic agents: Ipratropium (Atrovent)

4. Theophylline preparations: Theophylline

5. Corticosteroids: Beclomethasone (Long term - Beclovent)

1. Relaxes Muscles:
- Albutero / Ventolin for COPD
- Short term

2. Relaxes Muscles:
- ProAir / Ventolin for COPD
- Short & Long Term

3. Enlarges Airways:
- Anticholinergic agents:
Ipratropium / Atrovent
- Long term ?

4. Relxes Muscles:
- Theophylline for Asthma / COPDs
- Long term

5. Reduce Inflammation:
- Beclomethasone
- Long term