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EXB 117 FINAL > 13-14. Pulmonary Disease > Flashcards

13-14. Pulmonary Disease Flashcards

1
Q

Does exercise develop a large lung? Does lack of exercise create pulmonary disease?

A

No

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2
Q

What is the primary cause of pulmonary disease in the U.S.?

A

Smoking

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3
Q

List at least 3 smoking-related diseases.

A
  • CAD / Atherosclerosis
  • Lung cancer
  • COPD
  • Bladder cancer
  • Premature skin aging
  • Erectile dysfunction
  • Oral pharyngeal cancer
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4
Q

Compare the frequencies of the 3 main smoking-related diseases.

A
  • Lung cancer = 15/10K
  • Atherosclerosis = 150/10K
  • COPD = 2.5-5K / 10K
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5
Q

What are the primary physiologic functions of the lungs?

A
  • Ventilation (air pumping)

- Diffusion of gases

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6
Q

How would a physiologist broadly divide the diseases of the lung? What is the primary deficit in each of these conditions?

A
  • COPD: impaired ventilation

- Emphysema: impaired diffusion of gases

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7
Q

What are the 2 conditions that impair ventilatory function? Which is more common?

A
  • Airway obstruction (COPD) = more common

- Volume restriction = more uncommon

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8
Q

Using FVC and FEV1 as measurements, how would you distinguish the 2 patterns of ventilatory impairment?

A
  • Airway obstruction: FEV1 / FVC greater than 90%

- Volume restriction: FEV1 / FVC less than 70%

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9
Q

What diseases are grouped in COPD?

A
  • Emphysema
  • Chronic bronchitis
  • Asthma
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10
Q

What distinguishes asthma from other COPDs?

A

Asthma is rapidly precipitated (minutes) and reversible

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11
Q

How can one measure impairments of diffusional function in the lung?

A
  • Pulmonary function tests

- D(Lco)

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12
Q

How does a patient w/ significant diffusional impairment differ from a normal person in terms of oxygen hemoglobin saturation during exercise?

A

No difference b/c arterial oxygen saturation never drops

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13
Q

What is the normal value for FEV1?

A

80%

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14
Q

At max exercise, what % of the max ventilatory volume is used?

A

70-80%

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15
Q

What 2 basic morphological changes in alveolar septal structure are diffusional disease derived from? How does each affect ventilation?

A
  • Thickened lungs –> impaired diffusion

- Stiff lungs –> impaired ventilation

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16
Q

What are the general steps in treating pulmonary disease in adults?

A
  • Remove damaging agents (smoking, allergens, cold air)
  • Suppress active inflammation or infection (antibiotics, steroids)
  • Avoid future damage and infections
  • Manage fixed residual airway obstruction (bronchodilators, steroids)
  • Supplemental oxygen
  • Exercise rehab
17
Q

What is generally the fatal complication of COPD? What interventions help avoid this?

A

LOOKUP

18
Q

What has been added to bronchodilator therapy in the last 20 years that significantly improves control and slows disease progression?

A

LOOKUP

19
Q

Can the improvements created by pulmonary rehab (exercise training) in COPD be recreated by some combo of pharmaceutical therapy?

A

No

20
Q

What is D(Lco)?

A
  • Rate of disappearance of a small breath of carbon monoxide into the bloodstream
  • Desaturation of arterial blood below 95% during exercise
21
Q

What are the most provocative causes of exercise-induced asthma?

A
  • Intense exercise w/ no warm up

- Cold, unfiltered air

22
Q

How do you treat exercise-induced asthma?

A

Combo of bronchodilators and anti-inflammatories

23
Q

What CAN’T exercise training do for pulmonary patients? Why not?

A

Improve ventilatory of diffusional impairments b/c damage usually permanent

24
Q

What CAN exercise training do for pulmonary patients?

A
  • Increased peak inspiratory pressures
  • Decreased ventilatory muscle fatigue
  • Habituation to high ventilatory muscle tensions
  • Less demand for ventilation for any given task
25
Q

What special preparations must be made to allow pulmonary patients to exercise?

A
  • Pre-exercise meds (inhaler)
  • Avoid allergens or cold air
  • Extended warm up
  • Carry medications during exercise
26
Q

What is the gold standard of asthma diagnosis?

A

Methacholine challenge

27
Q

Explain the methacholine challenge.

A

Pt breathes in MCh –> bronchiole constricts –> asthmatics will react to lower dosages of MCh

28
Q

What is the modern pharmaceutical treatment for asthma?

A
  • Bronchodilators

- Anti inflammatories

29
Q

Why bother to treat “a little asthma”?

A
  • Short term: better sleep, better exercise, quicker return after illness
  • Long term: all stuff downstream of inflammation are being damanged
30
Q

Explain the concept of “tight control”.

A

Trying to return quantitative variables that cause disease back to normal

31
Q

What aspects of COPD do no respond to bronchodilators?

A

Pure bronchitis or emphysema

EXB 117 FINAL (4 decks)

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