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Resp DRX > 01b: COPD > Flashcards

01b: COPD Flashcards

1
Q

Emphysema is pathologically characterized by (increase/decrease) in (X) and an abnormal (increase/decrease) in size of (Y).

A

Decrease;
X = total gas-exchanging airspaces
Increase;
Y = remaining airspaces

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2
Q

Which portion of respiratory airspaces are destroyed in emphysema?

A

Resp bronchioles and beyond (alv duct, alv sac, or alveolus)

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3
Q

T/F: Breath sounds are diminished in emphysema.

A

True - diaphragm doesn’t move with respiration

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4
Q

(X) is an alteration in structure/function of (R/L) (atrium/ventricle) caused by primary disorder of the respiratory symptom. This can occur in advanced emphysema.

A

X = cor pulmonale

RV

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5
Q

Dyspnea of extreme severity occurring with normal ADLs is typically seen at FEV1 less than:

A

750 mL

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6
Q

Emphysema patients usually die as a result of which diseases/complications?

A
  1. HF
  2. PE
  3. Infection
  4. Resp insufficiency
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7
Q

What’s a downside to utilization of inhaled corticosteroids in COPD patients?

A

Increased risk of pneumonia

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8
Q

T/F: If emphysema patient doesn’t exhibit improvement in flow rate after bronchodilator use in pulmonary lab, a bronchodilator should not be prescribed; patient may rely on it too heavily.

A

False - should be tried in those patients

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9
Q

Chronic bronchitis and (emphysema/bronchiectasis/asthma) patients always produce sputum.

A

Bronchiectasis

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10
Q

(Bronchitis/bronchiectasis) directly involves destruction of the gas exchanging structures in lung.

A

Neither! Destruction is of the airway wall components

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11
Q

List some etiologies of bronchiectasis.

A
  1. CF
  2. Kartagener’s syndrome (“immotile ciliary syndrome”)
  3. Post-infectious (rare)
  4. Allergic aspergillosis
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12
Q

T/F: Chronic bronchitis/bronchiectasis patients will have diminished breath sounds and hyper-aeration (like emphysema)

A

False - no hyper-aeration

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13
Q

Secondary erythrocytosis aka polycythemia is an (increase/decrease) in (X). It’s seen in (emphysema/bronchitis) and occurs in response to (Y).

A

Increase;
X = RBCs

Bronchitis/bronchiectasis
Y = Chronic hypoxia (leads to increased EPO production)

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14
Q

T/F: Diffusing capacity is usually within normal limits in chronic bronchitis/bronchiectasis patients.

A

True

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15
Q

Why might diuretics be important in medical therapy for (emphysema/bronchitic) patients?

A

Bronchitic;

Help mobilize fluid and improve cardiac performance

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16
Q

Normally, (X)% of forced vital capacity is exhaled in the first second.

A

X = over 70%

Hence: FEV1/FVC ratio should be over 70%

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17
Q

T/F: Seeing low FEV1 and FVC, but normal ratio is diagnostic of restrictive lung disease.

A

False! Can’t diagnose based on spirometry alone - ALWAYS need lung volumes!

18
Q

Which lung volume would confirm restrictive lung disease?

A

Low TLC

19
Q

You suspect restrictive lung disease, based on spirometry. But TLC is normal. Which value do you check next? If reduced, this indicates (X).

A

RV;

X = air-trapping

20
Q

FEF25-75 is said to represent (X) and is measured with which units?

A

X = airflow through small airways

L/s

21
Q

FV Loop: early portion characterized by (high/low) flows from (small/large) airways. And latter portion?

A

High; large airways

Low; small airways

22
Q

“Hamburger” sign in FV Loop is indicative of:

A

Fixed Upper Airway destruction (ex: tracheal stenosis or goiter)

23
Q

FV Loop: a truncated expiratory limb (with inspiratory loop preserved) is indicative of (X) condition.

A

X = variable intra-thoracic upper airways obstruction

24
Q

FV Loop: a truncated inspiratory limb (with expiratory loop preserved) is indicative of (X) condition.

A

X = variable extra-thoracic upper airways obstruction

25
Q

Vocal cord abnormalities would likely result in which FV Loop?

A

Truncated inspiratory limb (variable extra-thoracic upper airway obstruction)

26
Q

Tracheal mass (above/below) vocal cords would likely result in FV Loop with truncated expiratory limb.

A

Below (variable intra-thoracic upper airway obstruction)

27
Q

Helium dilution technique is used to measure (X) volume.

A

X = FRC

28
Q

Measuring diffusion capacity involves inhalation and measurement of (X) gas

A

X = CO

29
Q

Most important variables that affect diffusion capacity:

A
  1. Area
  2. Thickness
  3. Oxygen-carrying capacity of blood
30
Q

How might smoking affect oxygen-carrying capacity of blood?

A

Increased (abnormal) CO levels bind Hb

31
Q

Pulmonary edema decreases diffusion capacity of lungs by:

A

Increasing membrane thickness

32
Q

Interstitial lung disease decreases diffusion capacity of lungs by:

A

Decreasing area for diffusion

33
Q

T/F: Pulmonary hemorrhage increases diffusion capacity.

A

True - increase blood volume

34
Q

T/F: Pulmonary hypertension increases diffusion capacity.

A

False - decreases it (probably due to abnormal structure of vasculature)

35
Q

Asthma (increases/decreases) diffusion capacity of lungs, likely as a result of:

A

Increases;

more uniform distribution of blood flow (increase V/Q matching)

36
Q

MIP, aka (X) pressure, is measured to assess strength of (Y) muscles.

A 
X = Max inspiratory;
Y = diaphragm (mainly) and other inspiratory muscles
37
Q

MEP, aka (X) pressure, is measured to assess strength of (Y) muscles.

A 
X = Max expiratory;
Y = abdominals (mainly) and other expiratory muscles
38
Q

Which equation represents the lung’s “stretchiness” or (X).

A

X = compliance;

deltaV/deltaP
change in volume per change in distending P

39
Q

At (X) volume, the alveolar pressure is 0. This means that which forces are balanced?

A

X = FRC

Outward recoil of chest wall balances inward recoil of lungs

40
Q

In emphysema, the lung compliance is (increased/decreased), so a (small/large) change in P produces (small/large) change in V.

A

Increased (loss of elastic recoil);

small; large

41
Q

In restrictive lung disease, the lung compliance is (increased/decreased).

A

Decreased

42
Q

(Increased/decreased/normal) chest resonance seen in Emphysema.

A

Increased (due to hyperinflation)

Resp DRX (9 decks)

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