respiratory > Obstructive lung disease > Flashcards

Obstructive lung disease Flashcards

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1
Q

Obstructive lung disease - types

A
  1. Chronic bronchitis
  2. Emphysema
  3. Asthma
  4. Bronchiectasis
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2
Q

obstruction of air flow results in

A

air trapping in lungs

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3
Q

at high lung volumes, airways …

A

close prematurely

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4
Q

Obstructive lung disease - volumes

A
  1. increased RV
  2. decreased FVC
  3. increased TLC
  4. increased FRC
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5
Q

PFT

A

pulmonary function test

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6
Q

Obstructive lung disease - pulmonary function test

A
  1. largely decreased FEV1
  2. decreased FVC
  3. decreased FEV1/FVC ratio
  4. V/Q mismatch
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7
Q

Obstructive lung disease - hallmark

A

decreased FEV1/FVC ratio

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8
Q

Obstructive lung disease - affect heart? (mechanism)

A

Chronic, hypoxic pulmonary vasoconstriction can lead to cor pulmonale

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9
Q

chronic bronchitis - appearance

A

blue bloaters

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10
Q

Obstructive lung disease - mechanism of increased RV and decreased FVC

A

airways close prematurely at high lung volumes

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11
Q

Obstructive lung disease - characteristics

A
  1. airway obstruction

2. trapped air

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12
Q

chronic bronchitis - pathology

A

hyperplasia of mucus-secreting glands –> Reid index >50%

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13
Q

Reid index (pathology)

A

thickness of gland layer/total thickness of bronchial wall

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14
Q

chronic bronchitis - definition

A

productive cough for >3 months PER YEAR (not necessarily consecutive) for >2 years

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15
Q

chronic bronchitis - findings/symptoms

A
  1. wheezing 2. crackles 3. cyanosis 4. late onset dyspnea 5. hypercapnia 6. secondary polycythemia
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16
Q

chronic bronchitis - polycethemia

A

secondary to hypoxia

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17
Q

chronic bronchitis - cyanosis (mechansim)

A

early onset of hypoxia due to shunting

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18
Q

chronic bronchitis - hypercapnia (mechansim)

A

mucus plugs trap CO2

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19
Q

bronchiectasia

A

permanent dilation of bronchioles and bronchi

loss of airway tone results in air trapping

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20
Q

bronchiectasia is due to

A

chronic necrotizing infection

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21
Q

bronchiectasia symptoms

A
  1. purulent sputum
  2. recurrent infections
  3. hemoptysis
  4. digital clubbing
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22
Q

bronchiectasia is associated with (like predisposition)

A
  1. bronchial obstruction
  2. poor ciliary motility (SMOKING, kartegener syndrome)
  3. cystic fibrosis
  4. allergic bronchopulmonary aspergillosis
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23
Q

causes of poor ciliary motility

A
  1. smoking

2. kartegener syndrome

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24
Q

asthma mechanism

A

bronchial hyperresponsiveness causes reversible bronchoconstriction

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25
asthma can be triggered by
1. viral URI 2. allergens 3. stress
26
test asthma with
metacholine challenge
27
asthma symptoms and clinical findings
1. cough 2. wheezing 3. tachypnea 4. dyspnea 5. hypoxemia 6. decreased inspiratory/expiratory ratio 7. puslus paradoxous 8. mucus plugging
28
pulsus paradoxus - seen in
1. cardiac teponade 2. asthma 3. obstructive sleep apnea | 4. pericarditis 5. croup
29
pulsus paradoxus - definition
decreased in amplitude of systolic BP by >10 during inspiration
30
inspiratory/expiratory ratio in asthma | and why
decreased | expiration is prolonged
31
normal inspiratory/expiratory ratio
1:2, 1:3 or 1:4
32
asthma - histology
1. smooth muscle hypertrophy 2. Curschmann spirals 3. Charcot - Leyden crystals
33
Curschmann spirals
shed epithelium forms whorled mucus plugs (IN ASTHMA)
34
Charcot - Leyden crystals
eosinophilic, hexagonal, double-pointed, needle-like crystal from breakdown of eosinophils in sputum (IN ASTHMA)
35
asthma bronchoconstriction is mediated by
1. inflammatory process | 2. parasympathetic tone
36
asthma drugs
1. β2 agonists (albuterol, salmeterol, formoterol) 2. corticosteroids (fluticasone, budesonide) 3. Muscarinic antagonists (ipratropium) 4. Antileukotrienes (montelukast, zafirlukast, zileuton) 5. omalizumab 6. Methylxanthines (theophylline) 7. Metacholine
37
emphysema - patient appearance
pink puffer
38
emphysema - chest
barrel - shaped chest
39
emphysema types
1. centriacinar | 2. Panacinar
40
centriacinar emphysema - associations and area
associated with smoking --> upper lobes
41
panacinar emphysema - associations and area
associated with α1 - antitrypsin --> lower lobes
42
emphysema - diffusion capacity of CO test (and mechanism)
decreased diffusing capacity for CO resulting from destruction of alveolar walls
43
emphysema properties
1. enlargement of air spaces 2. decreased recoil 3. increased compliance
44
emphysema - recoil
decreased
45
emphysema - compliance
increased
46
α1 - antitrypsin role
neutralizes proteases
47
emphysema pathophysiology
increased elastase activity (imbalance of protease anti protease) --> loss of elastic fibers --> increased lung compliance
48
emphysema - role of smoking
excessive inflammation and protease mediated damage
49
centriacinar emphysema is most severe in (area)
upper lobes
50
emphysema - pursed lips
expiration through pursed lips to increase airway pressure and prevent airway collapse during respiration
51
emphysema - sputum?
minimal
52
blue bloaters
chronic bronchitis
53
pink puffer
emphysema
54
diseases associated with a1 antitrypsin
1. panacinar emphysema | 2. cirrhosis
55
chronic bronchitis is highly associated with
smoking
56
chronic bronchitis - increased risk of
1. infections (blocking) | 2. cor pulmonale
57
obstructive lung disease with weight loss
emphysema
58
emphysema - chest appearance (and mechansim)
Barrel - shaped | increased anterioposterior diameter
59
emphysema - late complications
cor pulmoale | hypoxemia
60
nonallergic causes of asthma
1. aspirin 2. exercise 3. occupational 4. viral
61
bronchiectasis - complications
1. hypoxemia 2. cor pulmonale 3. SECONDARY AMYLOIDOSIS
62
obstructive lung disease with amyloidosis
bronchiectasis
63
obstructive lung disease with polycythemia
chronic bronchitis
64
obstructive lung disease with hemoptysis
bronchiectasis
65
Crackles are caused by ... (and characteristics)
explosive opening of small airways and are discontinuous, nonmusical, and brief
66
Asthma - CXR
peribronchial cuffing (thickening)
67
emphysema - CXR
1. increased anteriopostosterior diameter 2. flattened diaphragm 3. high lung field lucency
68
chronic bonchitis vs emphysema according to PCO2
chronic bronchitis --> hypercapnia (retention) | emphysema --> normocapnia (maintain alveolar ventilation)
69
chronic bonchitis vs emphysema according to PO2
chronic bronchitis --> severe hypoxemia (cyanosis) | emphysema --> mild hypoxemia
70
chronic bonchitis vs emphysema according to PO2 and PCO2
chronic bronchitis --> severe hypoxemia, hypercapnia | emphysema --> mild hypoxemia, normocapnia
respiratory
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