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Health Assessment > Unit 4 - Obstructive Lung Disease > Flashcards

Unit 4 - Obstructive Lung Disease Flashcards

https://txwes-my.sharepoint.com/personal/deschneider_txwes_edu/Documents/Obstructive%20Lung%20Disease%20%2724%201.pdf?login_hint=deschneider%40txwes.edu

1
Q

4 groups of obstructive respirtory disease?

A
  1. Acute Upper Respiratory Tract Infection (URI)
  2. Asthma
  3. Chronic obstructive pulmonary disease (COPD)
  4. Miscellaneous respiratory disorders

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2
Q

URI

What rate do ages 25-44 experience the “common cold”? Ages 45-65?

A

25-44yo: 19% per year
45-65yo: 16% per year

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3
Q

URI

What accounts for about 95% of all URIs?

A

Infectious nasopharyngitis

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4
Q

URI

What are the most common associated viral pathogens for URIs?

A
  • rhinovirus
  • coronavirus
  • influenza
  • parainfluenza
  • respiratory syncytial virus (RSV)

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5
Q

URI

What are the two causes on noninfectious nasopharyngitis?

A

allergic and vasomotor

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6
Q

URI

What perioperative resp. events are children with URIs at higher risk for?

A
  • transient hypoxemia
  • laryngospasm
  • breath holding
  • coughing

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7
Q

URI

Adverse respiratory events in pts with URI?

All pts. Not just kids.

A
  • bronchospasm
  • laryngospasm
  • airway obstruction
  • postintubation croup
  • desaturation
  • atelectasis

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8
Q

URI

When is is safe to proceed with surgery on a patient with an URI? If you had to reschedule surgery, how far out should you reschedule?

A

A patient that has had their URI for weeks and is stable can proceed with surgery.

Reschedule for 6 weeks out to avoid airway hyperreactivity period.

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9
Q

URI

COLDS scoring system:

What does it determine and what does it stand for?

A

Determines risk of proceeding with surgery.

C: current symptoms
O: onset of symptoms (higher risk within 2 weeks)
L: lung disease (comorbidities)
D: device for airway (ETT = higher risk)
S: surgery (major airway surgery = higher risk)

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10
Q

URI

Anesthesia mgmt for pts with URI?

A
  • adequate hydration
  • reducing secretions
  • limiting airway manipulation
  • neb or topical LA on vocal cords to dec. sensitivity

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11
Q

URI

What airway considerations would we do for URIs?

A

LMA over ETT to reduce laryngospasm. Deep extubation (if no contraindication) to allow for smoother emergence.

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12
Q

Asthma

Asthma definition:

A

chonic inflammation of the mucosa of the lower airways

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13
Q

Asthma

Inflammatory process:

A

inflammatory cascade leads to infiltration of the airway mucosa with eosinophils, neutrophils, mast cells, T cells, B cells, and leukotrienes.

Results in airway edema (esp. in the bronchi) and airway remodeling causing thickening to basement membrane and smooth muscle mass.

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14
Q

Asthma

3 main inflammatory mediators implicated in asthma?

A
  1. histamine
  2. prostaglandin D2
  3. leukotrienes

Release of these are caused by:

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15
Q

Asthma

Symptoms of exacerbations?

A
  • expiratory wheezing
  • productive or nonproductive cough
  • dyspnea
  • chest tightness that may lead to air hunger
  • eosinophilia

most attacks are short lived (minutes to hours) and m

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16
Q

Asthma

What is status asthmaticus?

A

dangerous, life threatening cronchospasm that persists despite treatment

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17
Q

Asthma

What should pre-op history questions be focused on?

A
  • previous intubations
  • ICU admissions
  • 2+ hospitalizations for asthma within the past year
  • presence of coexisting disease

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18
Q

Asthma

What symptoms lead to a **diagnosis **of asthma?

A
  • wheezing
  • chest tightness
  • SOB
    **AND ** a demonstrated airflow obstruction on PFT that is at least partially reversible with bronchodilators

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19
Q

Asthma

Table of most clinically useful Spirometric Tests of lung function:

A

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20
Q

Asthma

What is the FEV1 of the typical asthmatic patient that comes to the hospital?

A

< 35%

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21
Q

Asthma

Which three PFTs are direct measurements of the severity of expiratory obstruction?

A

FEV1, FEF, and midexpiratory phase flow

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22
Q

Asthma

What changes to FRC and TLC might we see during moderate or severe asthma attacks?

A

FRC: increase substantially
TLC: usually remains normal

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23
Q

Asthma

What causes tachypnea and hyperventilation during asthma attacks?

A

neural reflexes
NOT hypoxemia

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24
Q

Asthma

What are the two most common findings of asthma on an ABG?

A

hypocarbia
respiratory alkalosis

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25
Q

Asthma

When do we see a decrease in PaO2?

A

When the severity of expiratory obstruction increases and we have worsening of ventilation/perfusion mismatching leading to a PaO2 < 60 mmHg

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26
Q

Asthma

At what point do we see an increase in PaCO2 during an asthma attack?

A

When the FEV1 is < 25% of predicted

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27
Q

Asthma

What does an EKG tell us during an asthma attack?

A

Might show signs of right ventricular strain or ventricular irritability

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28
Q

Asthma

What chest xray findings would we see with an asthma attack?

A

hyperinflationa and hilar vascular congestion due to mucus plugging and pulmonary hypertension

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29
Q

Asthma

What is 1st line treatment for mild asthmatics?

A

PRN short acting inhaled B2 agonist

only recommended for patients with < 2 exacerbations per month

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30
Q

Asthma

What other type of inhaler can we use to reduce exacerbations and decrease risk of hospitalizations? What do we give if symptoms persist?

A

daily inhaled corticosteroids

If symptoms persist, we can do a daily inhaled B2 agonist.

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31
Q

Asthma

What are last ditch effort treatment for severe asthma that is uncontrolled with inhalation medications?

A

systemic corticosteroids

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32
Q
A
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33
Q

Asthma

What other therapies can we try besides SABA and inhaled corticosteroids?

A
  • inhaled muscarinic antagonists
  • leukotriene modifiers
  • mast cell stabilizers

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34
Q

Asthma

What is bronchial thermoplasty (BT)?

A

Uses bronchoscopy to deliver radiofrequency ablation of airway smooth muscles to all lung fields except the right middle lobe

Procedure is performed in 3 sessions and uses intense heat and the loss of airway smooth muscle mass is thought to reduce bronchoconstriction.

Only non-pharmacologic treatment for refractory asthma.

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35
Q

Asthma

What are the two most common IV corticosteroids used in acute severe asthma?
When should we admnister them?

A

hydrocortisone and methylprednisone

Administer early because onset takes several hours.

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36
Q

Asthma

How often can we administer inhaled B2 agonists? What adverse effects might we see from them?

A

Q15-30 min

minimal adverse hemodynamic effects, but pts may have unpleasant sensations from adrenergic overstimulation.

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37
Q

Asthma

Table: Treatment for acute severe asthma.

A

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38
Q

Asthma

What types of surgeries increase risk of bronchospasm?

A

upper abdominal surgeries and oncologic surgeries

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39
Q

Asthma

What GA mechanisms increase airway resistance?

A
  • depression of cough reflex
  • impairment of mucociliary function
  • increased fluid in the airway wall
  • airway stimulation by intubation
  • PNS activation
  • release of neurotransmitters such as Substance P and neurokinins

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40
Q

Asthma

What lab value often mirrors the degree of airway inflammation?

A

eosinophil count

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41
Q

Asthma

When do we give a stress dose of hydrocortisone or methylprednisone prior to surgery?

A

If the patient has been taking systemic corticosteroids within the past 6 months.

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42
Q

Asthma

What are two requirements for pts to go to surgery?

A
  1. free of wheezing
  2. PEFR > 80% of predicted or the pt’s personal best

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43
Q

COPD

What are the symptoms of COPD?

A
  • emphysema characterized by lung parynchemal destruction
  • chronic bronchitis
  • productive cough
  • small airway disease
  • dyspnea at rest or exertion
  • chronic sputum production
  • decreased breath sounds
  • expiratory wheezes

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44
Q

COPD

Risk factors for COPD?

A
  • cigarette smoking
  • occupational exposure to dust and chemicals, asbestos, gold mining, biomass fuel, air pollution
  • genetic factors
  • age
  • female gender
  • poor lung development during gestation
  • low birth weight
  • recurrent childhood respiratory infections
  • low socioeconomic class
  • asthma

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45
Q

COPD

COPD leads to:

A
  1. deterioration in elastic recoil
  2. decrease bronchial wall structure allowing collapse during expiration
  3. inc. velocity through the narrowed bronchioli which lowers intrabronchial pressure
  4. active bronchospasm and obstruction from inc. secretions
  5. destruction of lung parynchema enlarged air sacs, and development of emphysema

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46
Q

COPD

What is a COPD exacerbation?

A

acute worsening in airflow

as expiratory obstruction increases, tachypnea and prolonged expiratory times become evident

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47
Q

COPD

What PFT changes are associated with COPD?

A
  • decrease in FEV1:FVC ratio (<70%)
  • FEF between 25% and 75% of vital capacity
  • increased RV, FRC, and TLC (think higher lung volumes with loss of reserve)
  • decreased DLCO (diffusing lung capacity for carbon monoxide)

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48
Q

COPD stages

Mild COPD

A

FEV1 ≥ 80% predicted

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49
Q

COPD stages

Moderate COPD

A

50% ≤ FEV1 < 80%

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50
Q

COPD stages

Severe COPD

A

30% ≤ FEV1 < 50% predicted

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51
Q

COPD stages

Very severe COPD

A

FEV1 < 30% predicted

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52
Q

COPD

Lung volume changes in COPD?

VC, TLC, RV and FRC, RV:TLC ratio - increased or decreased?

A

VC: normal to decreased
TLC: normal to increased
RV and FRC: increased
RV:TLC ratio: increased

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53
Q

COPD

What CXR finding suggests and confirms emphysema?

A

suggests: hyperlucency
confirms: bullae

only small % of pts have bullae

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54
Q

COPD

What is MOLT?

A

multi-organ loss of tissue
a phenotype of COPD associated with airspace enlargement, alcveolar destruction, loss of bone, muscle, and fat tissues, and carries higher rates of lung cancer

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55
Q

COPD

What is Bronchitic?

A

phenotype of COPD associated with bronchilar narrowing and wall thickening and is usually accompanied by metabolic syndrome and cardiac disease

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56
Q

COPD

What is the BODE index? What does a higher BODE mean?

A

Grading system that looks at BMI, degree of obstruction, level of dyspnea, and exercise tolerance to assess prognosis.

Higher BODE indicates greater risk of exacerbations, hospitalizations, and pulmonary death

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57
Q

COPD

What is a1-antitrypsin deficiency?

A

An inherited disorder associated with COPD. Low levels require lifelong replacement therapy.

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58
Q

COPD

When do we measure eosinophils in COPD pts and what does that measurement tell us?

A

measured with uncontrolled disease despite bronchodilators

High: indicate need for inhaled glucocorticoids
Low: associated with increased risk of pneumonia

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59
Q

COPD

When does PaO2 decrease in COPD patients? When does PaCO2 increase?

A

PaO2: decreases when FEV1 is < 50% of predicted (severe and very severe stages)

PaCO2: increases when FEV1 is even lower (think very severe stage)

Slode 31

60
Q

COPD

What is the 1st step in treatment for COPD?

A

reduce exacerbations!! reduce exposure to smoke and environmental pollutants

*smoking cessation can decrease disease progression and lower mortality rates by up to 18%

slide 32

61
Q

COPD

In what order are inhaled medications prescribed to COPD patients?

A
  1. long-acting inhaled muscarinic antagonists
  2. long-acting B2 agonists
  3. inhaled glucocorticoids

slide 32

62
Q

COPD

When are inhaled glucocorticoids most effective in COPD patients?

A

When they have associated asthma, rhinitis, elevated eosinophils, and history of exacerbations

slide 32

63
Q

COPD

When do we give COPD patients diuretics?

A

If right heart failure or congestive heart failure has developed

Slide 33

64
Q

COPD

When is long-term home O2 recommended for COPD patients?

A

When PaO2 is < 55 mmHg, the HCT >55% or if there is evidence of cor pulmonale

slide 34

65
Q

COPD

What is the goal for supplemental O2 and how much O2 is usually required to reach this goal?

A

goal is PaO2 > 60mmHg
2 L NC

Slide 34

66
Q

COPD

Table:
Treatment of Patients with COPD
Treatments of Patients with COPD exacerbations

A

Slide 35

67
Q

COPD

Who is a candidate for lung volume reduction surgery?

A

pts with severe refractory COPD and overdistended lung tissue

Slide 36

68
Q

COPD

What is lung volume reduction surgery?

A

removal of overdistended areas allowing more areas of normal lung to expand and improve lung function

*Most commonly performed via a median sternotomy or VATS

Slide 36

69
Q

COPD

3 things for anesthesia management for lung-volume reduction surgery?

A
  1. double lumen ETT
  2. avoidance of N2O
  3. minimizing excessive airway pressure

Slide 36

70
Q

COPD

Why might CVP be an unreliable guide for fluid management in lung-volume reduction surgery patients?

A

because surgical alterations affect intrathoracic pressures

Slide 36

71
Q

COPD

Indications for pre-op pulmonary evaluation:

A

Slide 38

72
Q

COPD

Table:
Major Risk Factors for Development of Postoperative Pulmonary Complications

A

Slide 41

73
Q

COPD

Table:
Strategies to reduce post-op complications

A
74
Q

COPD

What percentage of smokers undergo general anesthesia annually?

A

5-10%

*This is an opportunity for us to teach about smoking cessation. *

Slide 43

75
Q

COPD

What is the single most important risk factor for developing COPD and death caused by lung disease?

A

smoking

Slide 43

76
Q

COPD

The maximum benefit of smoking cessation is not usually seen unless smoking is stopped at least ——- prior to surgery.

A

8 weeks

slide 43

77
Q

COPD

How long do the sympathomimetic effects of nicotine last on the heart?

A

20-30 minutes

slide 44

78
Q

COPD

What is the elimination half-life of carbon monoxide?

A

4-6 hours

slide 44

79
Q

COPD

Within 12 hours of quitting smoking, what changes will you see in P50 value and plasma levels of carboxyhemoglobin?

A

P50 increases from 22.9 to 26.4 mmHg
HbCO decreases from 6.5% to 1%

Remember P50 is the PaO2 required to saturate 50% of Hb with oxygen.

Slide 44

80
Q

COPD

How long after quitting smoking until we see return of normal immune function?

A

6 weeks

Slide 45

81
Q

COPD

How long after quitting smoking until hepatic enzyme function returns to normal?

A

6 weeks or longer

82
Q

COPD

What are the disadvantages to stopping smoking in the immediate pre-op period?

A
  • increase in sputum production
  • inability to handle stress
  • nicotine withdrawal
  • irritability
  • restlesness
  • sleep disturbances
  • depression

slide 46

83
Q

COPD

What interventions can we provide to assist with smoking cessation?

A

Behavioral support and pharmacotherapy:
* nicotine replacement (patches, inhalers, nasal sprays, lozenges, gum
* sustained release bupropion (Wellbutrin)

Slide 46

84
Q

Bronchiectasis

What is bronchiectasis?

A

irreversible airway dilaiton, inflammation and chronic bacterial infection

slide47

85
Q

Bronchiectasis

Symptoms of bronchiectasis?

A
  • chronic productive cough
  • purlent sputum
  • hemoptysis
  • clubbing
  • poor mucocilliary activity (leading to recurrent infections)

slide 47

86
Q

Bronchiectasis

What is seen on CT that is the gold standard diagnosis for bronchiectasis?

A

dilated bronchi

slide 48

87
Q

Bronchiectasis

What are the key treatments?

A
  • antibiotics based on sputum culture
  • bronchodilators
  • systemic corticosteroids
  • O2 therapy
  • surgery (rare)

slide 48

88
Q

Cystic FIbrosis

What is CF?

A

autosomal recessive disorder of the chloride channels leading to abnormal production and clearance of secretions

slide 49

89
Q

CF

What gene mutation causes CF?

A

mutation on chromosome 7

encodes the cystic fibrosis transmembrane conductance regulator (CFTR)

slide 49

90
Q

CF

What does CFTR do?

A

produces a protein that aids in salt and water movement in and out of cells.

In CF, the mutated gene results in the production of abnormally thick mucus outside of epithelial cells.

slide 49

91
Q

CF

What is the primary cause of morbidity and mortality in CF patients?

A

chronic pulmonary infection

slide 49

92
Q

CF

How does chloride transport disrupt lung function?

A

decreased chloride transport is accompanied by decreased transport of sodium and water, which leads to:
* dehydrated viscous secretions
* luminal obstruction
* destruction and scarring of various glands and tissues

slide 49

93
Q

CF

What is the diagnostic criteria?

A

sweat chloride conc. > 60mEq/L AND clinical symptoms such as:
* cough
* purulent sputum
* exertional dyspnea
* family history of CF

slide 50

94
Q

CF

What is evidence of pancreatic exocrine insufficiency associated with CF?

A

malabsorption with a response to pancreatic enzyme treatment

slide 50

95
Q

CF

What reproductive test is an indicator of CF?

A

obstructive azoospermia confirmed by testicular biopsy

slide 50

96
Q

CF

What comorbidity is present in virtually all adult CF patients?

A

COPD

slide 50

97
Q

CF

What is the treatment for CF?

A
  • symptom management
  • pancreatic enzyme replacement
  • O2 therapy
  • nutrition
  • prevention of intestinal obstruction
  • gene therapy currently being investigated

slide 50

98
Q

CF

What is the main non-pharmacologic approach to enhancing clearance of secretions?

A

chest physiotherapy with postural drainage

high-frequency chest compression with an inflatable vest and airway oscillation devices are also good for this

slide 51

99
Q

CF

When are bronchodilators used for CF patients?

A

When they are “beneficial” lol duh.

Beneficial response = an increase of 10% or more in FEV1 after administration of bronchodilator

slide 51

100
Q

CF

What is present in secretions that makes it super viscous?

A

neutrophils and degredation products (DNA released from neutrophils that form long fibrils)

slide 52

101
Q

CF

What treatment can cleave the DNA fibrils and increase the clearance of sputum?

A

recombinant human deoxyribonuclease

slide 52

102
Q
A
103
Q

CF

When do we give antibiotics to CF patients?

A

Only if they have a confirmed infection from bacteria isolated from sputum.

slide 52

104
Q

CF

What do we do if the sputum culture shows no pathogens?

A

Bronchoscopy to remove lower airway secretions

slide 52

105
Q

CF

When do we give Vitamin K?

A

if hepatic function is poor or exocrine pancreatic function is impaired

slide 53

106
Q

CF

What are ways we can maintain less-viscous secretions?

A
  • humidification of gases
  • hydration
  • avoidance of anticholinergic drugs

Slide 53

107
Q

CF

What are requirements prior to extubation?

aside from the normal shizzz

A
  • regain full airway reflexes
  • and obvi have adequate TV and RR

slide 53

108
Q

CF

Why is post-op pain control important for CF patients?

A

Bc they gotsta be able to cough, deep breathe, and ambulate to prevent pulmonary complications.

slide 53

109
Q

Primary Ciliary Dyskinesia (PCD)

What is PCD?

A

congenital impairment of ciliary activity in respiratory tract, epithelial celss, and sperm tails/ciliated ovary ducts.

this leads to chronic sinusitis, recurrent respiratory infections, bronchiectasis, and infertility

slide 54

110
Q

PCD

What is Kartagener Syndrome?

A

triad of
1. chronic sinusitis
2. bronchiectasis
3. situs inversus (chest organ position is inversed)

slide 54

111
Q

PCD

What percentage of patient with congenitally nonfunctioning cilia exhibit situs inversus?

A

about half

slide 54

112
Q

PCD

Isolated dextrocardia is almost always associated with what?

A

congenital heart disease

*This is when the heart is located on the opposite side of the body but there are no other thoracic abnormalities. *

slide 54

113
Q

PCD

Do we prefer RA or GA for these patients?

A

RA to help decrease postop pulmonary complications

Slide 55

114
Q

PCD

What does dextrocardia mean for our monitors?

A

EKG equipment should be reversed for accurate interpretation

slide 55

115
Q

PCD

What vein is preferred for CVC placement?

A

L IJ since the great vessels are inverted

Normally we do RIJ since it goes straight to SVC.

slide 55

116
Q

PCD

Which way do we displace the uterus in pregnant women with PCD to prevent vena cava syndrome

A

right.

Normal mommas get displaced to the left.

slide 55

117
Q

Bronchiolitis Obliterans (BO)

What causes BO?

A

results from epithelial and subepithelial inflammation leading to bronchiolar destruction and narrowing

slide 56

118
Q

BO

Risk factors?

A
  • viral respiratory infections
  • environmental exposures
  • lung transplant
  • stem cell transplant

slide 56

119
Q

BO

PFT results with BO?

A

usually show obstructive lung disease
* reduced FEV1
* reduced FEV1:FVC ratio

slide 56

120
Q

BO

What do we see on CT for these pts?

A

air trapping and bronchiectasis in severe cases

slide 56

121
Q

Central Airway Obstruction (CAO)

What percentage of lung cancer patient can be affected by airflow obstruction?

A

20-30%

slide 57

122
Q

CAO

Which airways are included in CAO?

A

obstruction of airflow in the trachea and mainstem bronchi

slide 57

123
Q

CAO

What causes obstruction?

think disease processes, not foreign body

A
  • tumors
  • granulation from chronic infection
  • airway thinning from cartilage destruction

slide 57

124
Q

CAO

How can we cause tracheal stenosis?

A

with prolonged intubation either with an ETT or a tracheostomy tube

125
Q

CAO

How do we prevent tracheal stenosis from artificial airways?

A

high volume low pressure cuffs

slide 57

126
Q

CAO

What does tracheal mucosal ischemia progression cause?

A
  • destruction of cartilaginous rings
  • subsequent circumferential scar formation

slide 57

127
Q

CAO

At what point does tracheal stenosis become symptomatic?

A

When the lumen is decreased to < 5 mm in diameter

Slide 58

128
Q

CAO

Tracheal stenosis symptoms?

A
  • dyspnea (even at rest)
  • accessory muscle use though all phase of respiratory cycle
  • audible stridor
  • tracheal narrowing on CT
  • flattened flow volume loops characteristic of fixed obstruction

may not develop for several weeks after extubation

slide 58

129
Q

CAO

What procedure can temporarily fix tracheal stenosis?

A

tracheal dilation via bronchoscopy with balloon dilators, surgical dilators, or laser resection of the tissue

slide 59

130
Q

CAO

Is tracheobronchial stent short or long term solution for tracheal stenosis?

A

trick question bitches, it can be both.

slide 59

131
Q

CAO

What is the most successful surgical treatment for tracheal stenosis and what kind of airway does it require?

A

surgical resection and reconstruction with primary re-anastomosis.

Requires a translaryngeal intubation

slide 59

132
Q

CAO

What anesthetic considerations are there for tracheal resection and reconstruction?

A
  • use volatiles to ensure maximal FiO2
  • may use high frequency ventilation
  • may add helium gas to facilitate anesthetics

slide 59

133
Q

CAO

How does helium gas facilitate anesthetic gasses?

A

Helium decreases the density of the gas mixture and may improve flow through the area of tracheal narrowing

slide 59

134
Q

Kahoot:

What pathology is responsible for themajority of URIs?
A. Infectious laryngitis
B. Infectious brinchitis
C. Infectious nasopharyngitis
D. Infectious cystic fibrosis

A

C. Infectious Nasopharyngitis

135
Q

Kahoot:

Which interventions can minimize the risk of laryngospasm in URI patient?
A. LMA
B. Nebulized local anesthetics
C. bronchodilators
D. oropharyngeal suctioning

A

A, B, and D

LMA, neb locals, and oropharyngeal suctioning

136
Q

Kahoot:

The main inflammaotry mediators in asthma?
A. Histamine
B. Leukotrienes
C. Free radicals
D. Prostaglandin D2

A

A, B, and D

histamine
leukotrienes
prostaglandin d2

137
Q

Kahoot:

Which spirometric value refers to the volume of air exhaled with mex effort after deep inhalation?
A. FEV1
B. FRC
C. FVC
D. TLC

A

C. FVC

138
Q

Kahoot:

Which spirometric valure remains unchanged during an asthma attack?
A. DLCO
B. FEV1
C. FVC
D. FEF

A

A. DLCO

139
Q

Kahoot:

What is the mechanism stimulated tachypnea and hyperventilation during an asthma attack?

A. hypoxemia
B. hypercarbia
C. pulmonary neural reflexes
D. metabolic acidosis

A

C. pulmonary neural reflexes

140
Q

Kahoot:

At what level of FEV1 does the PaCO2 increase?

A. < 30%
B. < 25%
C. < 40%
D. < 50%

A

B. < 25%

141
Q

Kahoot

Select two types of surgery that are associated with a higher risk of bronchospasm.

A. oncologic surgery
B. laparoscopic surgery
C. upper abdominal surgery
D. neurosurgery

A

A and C

oncologic surgery
upper abdominal surgery

142
Q

Kahoot

Which lung volume may be decreased in COPD?

A. TLC
B. VC
C. FRC
D. RV

A

B. vital capacity

143
Q

Kahoot

Which radiologic finding confirms a diagnosis of COPD?
A. bullae
B. hyperlucency
C. kerly lines
D. blebs

A

A. Bullae

144
Q

Kahoot

Which disorder is associated with irreversible airway dilation, inflammation, and chronic bacterial infection?
A. cystic fibrosis
B. bronchiectasis
C. primary ciliary dyskinesia
D. bronchiolitis obliterans

A

B. Bronchiectasis

145
Q

Kahoot

Which respiratory disorder is commonly associated with situs inversus?
A. cystic fibrosis
B. bronchiectasis
C. primary ciliary dyskinesia
D. bronchiolitis obliterans

A

C. Primary ciliary dyskinesia

Health Assessment (8 decks)

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