Week 6: COPD

Question 1

In emphysema we are having issues at the a____ ____ junction, so we are going to have an issue with _____

Answer 1

Alveolar- capillary

Diffusion

Question 2

_____ of the gas exchange airways and difficulty with ____ due to decreased airway patency. There can also be an ____ issue which is why it’s classified under c__ ___ ___ ____

Answer 2

Enlargement
Expiration
Obstruction
Chronic obstructive pulmonary disorders

Question 3

The _____ have become ____ in emphysema and fibrotic so they don’t release ___

Answer 3

CAPILLARIES
Thickened
Co2

Question 4

____ is the number one reason people get emphysema

Answer 4

Smoking

Question 5

A genetic deficiency of a___ _ _______ can lead to an early form of emphysema that is not ___ related

Answer 5

Alpha 1 antitrypsin

Smoking

Question 6

A__ ___ occurs with emphysema. We are getting ___ in but are having trouble getting ___ out

Answer 6

Air trapping
O2
Co2

Question 7

The breakdown of the ___ ___ leads to a loss of surface area for ___ ___. This will lead to a loss of ____ capillaries and mess up the ____ _____ ratio

Answer 7

Alveolar wall
Gas exchange
Pulmonary
Ventilation: perfusion

Question 8

The ____ of some capillaries can lead to ___ airways, weakened walls, and interfere with the p___ ___ airflow

Answer 8

Fibrosis
Narrowed
Passive expiratory

Question 9

As condition progresses person will start to trap air in the ____ and eventually increase their t____ ___ ___, leading to inflation and altered chest anatomy

Answer 9

Alveoli

Total residual volume

Question 10

Barrel chest ap:t ratio

Answer 10

Is 1:1

Question 11

Normal chest ap: t ratio

Answer 11

1:2

Question 12

Person with emphysema may have f___ of ___ in respiratory position, b___ ___, and f___ ____

Answer 12

Fixation of ribs
Barrel chest
Flattened diaphragm

Question 13

_____ occurs when the damaged walls of the aveoli collapse and join together forming large air spaces and then rupture

Answer 13

Pneumothorax

Question 14

In advanced emphysema there is h___ and there is an increase in that h___ drive. The chronic levels of __ are going to shut off those chemoreceptors looking at ___ as our respiratory drive and turn on our ___ ___ receptors

Answer 14

Hypercapnea
Hypoxic drive
Co2 
Co2 
Peripheral o2 receptors

Question 15

Patients with advanced emphysema are more prone to i___ due to compromised immune function

Answer 15

Infection

Question 16

emphysema: Issues with p___ and v___ and lack of ___ can result in ___ ____. Leading to ___ ___ ____ and eventually ___ ___ ___ ___

Answer 16

Perfusion 
Ventilation 
O2 
Pulmonary HTN 
Right ventricular hypertrophy
Right sided heart failure

Question 17

Cor pulmonary

Answer 17

R ventricular hypertrophy due to work against pulmonary HTN

Question 18

In emphysema ___will begin to occur on _____. Eventually this will occur __ ___

Answer 18

Dyspnea
Exertion
At rest

Question 19

emphysema: have ______ with prolonged ____ phase because they are trying to ____ off that ____

Answer 19

Hyperventilation
Expiratory
Blow
Co2

Question 20

emphysema: called ___ ____ because they are _____. It is not necessarily an ___ issue so they will be more _____

Answer 20

Pink puffers
Hyperventilating
O2
Pink

Question 21

Patient with emphysema will have ____ _____, and possibly ____ in late stages

Answer 21

Anorexia
Fatigue
Cynosis

Question 22

A ___ and _____ will help determine the cause of emphysema if they are a smoker

Answer 22

History

Physical

Question 23

For a non smoker, test ____ _ ____ enzyme levels. If its ___ - ___% lower than the expected value, they likely have an a___ ____ disorder leading to the enzyme deficiency.

Answer 23

Alpha 1 antitrypsin
10-15%
Autosomal recessive

Question 24

Alpha 1 antitrypsin enzyme gets rid of the _____ enzymes that can be around the ______. If those enzymes remain they may degrade the _____ themselves

Answer 24

Proteolytic
Alveoli
Alveoli

Question 25

emphysema: if FEV is less than ___% expected of their w___, h___, a___, and g___

Answer 25

``` 30% Weight Height Age Gender ```

Question 26

emphysema treatment: use the ______ to determine the ___ of the disease or ______

Answer 26

Spirometer Progression Exhasturbation

Question 27

emphysema: in a _____ __-___ you can see h____

Answer 27

Chest x Ray | Hyperinflation

Question 28

emphysema: An ABG will detect any h_____ or h_____

Answer 28

Hypercapnea | Hypoxemia

Question 29

emphysema is ______, but we want to prevent further degreasing of the _____ and worsening of clinical manifestations

Answer 29

Irreversible | Alveoli

Question 30

emphysema: avoid respiratory irritants such as ____

Answer 30

Smoking

Question 31

Immunization against _____ and ____ is to prevent the patient with emphysema from getting an ____ and ___ respiratory tract infection, which will ___ their. emphysema

Answer 31

``` Flu Pneumonia Upper Lower Exhasturbate ```

Question 32

Pulmonary rehab is structured ___ and ___ to optimize function. ____ ___ breathing and ____ position will help patient with emphysema expel ____

Answer 32

``` Diet Exercise Pursed lip Tripod Co2 ```

Question 33

Patient with emphysema may need b____ and s_____ just like a person with asthma. ______ will be given if infection is present. ____ therapy is provided as condition progresses

Answer 33

Bronchodilators Steroids Antibiotics Oxygen

Question 34

For emphysema patient with _____ of lung tissue some tissue might need to be removed to get rid of i___ and r____ v___

Answer 34

Hyperinflation Inflation Residual Volume

Question 35

Chronic bronchitis occurs with repeated ____ with ____ ____ that lasts for _ months or longer _ times in a _ year span

Answer 35

Infection Chronic Cough 3 months 2 times in a 2 year span

Question 36

Chronic bronchitis is an _____ disorder that leads to ___ and difficulties getting __ our of the body and __ into the body

Answer 36

Inflammatory Obstruction Co2 O2

Question 37

Primary etiology of Chronic bronchitis is ___

Answer 37

Smoking

Question 38

___ areas where coming into contact with air pollutants may also lead to Chronic bronchitis

Answer 38

Urban

Question 39

In Chronic bronchitis the ___ of the airways becomes ____ and the mucous glands are going to ______. there is going to _____ of them so there's is going to be more ___ production

Answer 39

``` Mucosa Inflamed Hypertrophy Hyperplasia Mucous ```

Question 40

Chronic inflammation can lead to f___ and thickening of the B__ wall so those large __ glands and large wall are going to start to close off the airway. This leads to low ___ levels, d___, and ____.

Answer 40

``` Fibrosis Bronchial Mucous O2 Dyspnea Fatigue ```

Question 41

Chronic bronchitis: As result of low oxygen levels, we are going to increase the amount of blood getting to the lungs to get more oxygen to. ___ ____ and eventually __ ____, and finally ___ ___ ___ ____

Answer 41

Pulmonary HTN Cor pulmonale Right sided heart failure

Question 42

Emphysema is destruction to ____ ____ leading to reduced airway patency. Chronic bronchitis is no damage to ___ ___ but ___ of the ____ ____

Answer 42

Alveolar wall Alveolar wall Inflammation Bronchial tree

Question 43

The airway blockage in Chronic bronchitis is a result of ___ and ___ of the ___ membranes. Patient can have barrel chest due to ____ ____

Answer 43

Hypertrophy Hyperplasia Mucous Air trapping

Question 44

Patient with Chronic bronchitis will have a ___ ___ and ____ so they are constantly coughing up thick ____ sputum

Answer 44

Chronic cough Infection Purulent

Question 45

On auscultation ___ and ____ might be heard in patient with Chronic bronchitis

Answer 45

Rhonci | Wheezing

Question 46

Patient with Chronic bronchitis has __ ___ ___, t___, h___,h___ and ______

Answer 46

``` Shortness of breath Tachypnea Hypoxia/ Hypoxemia Hypercapnia Cyanosis ```

Question 47

Chronic bronchitis patient is a "____ ____"

Answer 47

Blue bloated

Question 48

Chronic bronchitis: due to poor oxygenation they are going to ___ the production of __ ____ ___ leading to p_____

Answer 48

Increase Red blood cells Polycythemia

Question 49

Chronic bronchitis patient may have weight ___, c_____ ____, and c___ due to ___ and increase tissue in the fingers

Answer 49

Loss Cor pulmonale Clubbing

Question 50

Chronic bronchitis: | ____ and ____ needed for dx. ABG will test for ____ or ____ and changes in __ and ___ see how body is compensating.

Answer 50

``` History Physical Hypercapnea Hypoxia Co2 Bicarbonate ```

Question 51

To diagnose Chronic bronchitis ___ and ___ pulmonary function tests can be done to determine progression. ____ ____ should also be tested

Answer 51

Fev1 Spirometery Pulse oximetry

Question 52

Treatment Chronic bronchitis: Supplemental ____, ___ ___, chest _____, _____ rehab, ______ therapy can be used

Answer 52

``` O2 Smoking cessation Chest physiotherapy Pulmonary rehab Pharm therapy ```

Question 53

If we give the patient with Chronic bronchitis too much oxygen to they body might think that they ___ have to ___. This might slow down their ___ and further exacerbate their symptoms. Prevent infections with ___ and ___ vaccines

Answer 53

``` Don't Breathe Respirations Influenza Pneumococcal ```

Question 54

Emphysema is an abnormal ____ of the ___ ___ airways that is accompanied by the ___ of alveolar walls without any necessary ____

Answer 54

Enlargement Gas exchange Destruction Fibrosis