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Pulmonology > 3 - Overview of Obstructive & Restrictive Disease > Flashcards

3 - Overview of Obstructive & Restrictive Disease Flashcards

1
Q

What type of lung disease does turbulence on physical exam suggest?

A

Obstructive

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2
Q

A(n) [increase/decrease] in smooth muscle tone of large/medium airways will decrease the radius, [increasing/decreasing] the resistance.

A

increased tone –> smaller radius –> increased resistance

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3
Q

Parasympathetic stimulation of smooth muscle will result in a(n) [increased/decreased] airway radius.

A

more tone –> decreased radius

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4
Q

Low PaCO2 levels will affect airway smooth muscle to result in a(n) [increased/decreased] airway radius.

A

decreased radius (hypocapnic bronchoconstriction)

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5
Q

High PaCO2 levels will affect airway smooth muscle to result in a(n) [increased/decreased] airway radius.

A

increased radius

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6
Q

Sympathetic stimulation of smooth muscle will result in a(n) [increased/decreased] airway radius.

A

decreased tone –> increased radius

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7
Q

What are some factors that affect airway resistance in disease?

A
  • smooth muscle (hypertrophy and contraction)
  • mucus (hypersecreted, gland hypertrophy)
  • airway wall infiltrated
  • epithelium desquamated
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8
Q

What is the major driving force of expiration?

A

Elastic recoil (from elastic fibers and surface tension)

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9
Q

Why does emphysema lead to hyperinflation?

A

Decreased alveolar pressure because of lost elasticity and surface tension –> not enough pressure gradient to get air out before hitting equal pressure point (EPP) –> EPP happens at compressible part of respiratory system –> airway collapse –> trapped air

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10
Q

What are the two stages of forced expiration in regards to effort?

A

Early phase: flow is effort dependent

Late phase: flow is effort independent

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11
Q

Why is there increased expiration resistance in emphysema?

A

The lung lacks enough alveoli to pull on the bronchiole to keep it open –> narrowed/collapsed airway = increased resistance

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12
Q

What two things limit expiratory flow in emphysema?

A
  • loss of radial traction from surrounding alveoli –> airway collapse
  • loss of elastic recoil –> decreased alveolar driving pressure
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13
Q

Reduced compliance is seen in [obstructive/restrictive] lung disease.

A

restrictive

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14
Q

In restrictive disease, resistance is [decreased/normal/elevated] because of [no/some] airway involvement.

A

normal resistance because of no airway involvement

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15
Q

Wheezing [is/is not] seen with restrictive lung disease.

A

is not (because there is no turbulent flow)

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16
Q

What four factors contribute to FEV1 and FVC values?

A
  • age
  • sex
  • height
  • race / racial health disparities
17
Q

What FEV1/FVC ratio is diagnostic of obstructive lung disease?

A

FEV1/FVC < 0.7

18
Q

In a flow volume loop, obstructive disease shows [increased/decreased] TLC, [increased/decreased RV], and ___. Why do you see this increase/decrease?

A

increased TLC, increased RV, expiratory scooping

Lung cannot expire all of the air –> hyperinflation –> increased TLC and RV over time

19
Q

In a flow volume loop, restrictive disease shows [increased/decreased] TLC and [increased/decreased RV]. Why do you see this increase/decrease?

A

decreased TLC, decreased RV

Problem with compliance –> need more effort to breathe in the same amount –> reduced volume over time

20
Q

What determines the diffusion of a gas?

A
  • ventilation
  • perfusion
  • hemoglobin
  • surface area, solubility, pressure gradient, thickness of interstitium (all part of diffusion equation)
21
Q

What is the equation for diffusion?

A

D = [area * gas *(pressure 1 - pressure 2)]/Thickness

gas = solubility / MW

22
Q

What three lung disease categories have reduced diffusion? Which is the only obstructive disease?

A
  • emphysema (obstructive)
  • alveolar filling
  • interstitial
23
Q

Asthma results in [normal/reduced] diffusion.

A

normal

24
Q

Chronic bronchitis results in [normal/reduced] diffusion.

A

normal

25
Q

Upper airway obstruction results in [normal/reduced] diffusion.

A

normal

26
Q

Small airways disease results in [normal/reduced] diffusion.

A

normal

27
Q

Pleural disease results in [normal/reduced] diffusion.

A

normal

28
Q

Neuromuscular disease results in [normal/reduced] diffusion.

A

normal

29
Q

Chest wall abnormalities result in [normal/reduced] diffusion.

A

normal

30
Q

Emphysema results in [normal/reduced] diffusion.

A

reduced

31
Q

Alveolar filling disease results in [normal/reduced] diffusion.

A

reduced

32
Q

Interstitial lung disease results in [normal/reduced] diffusion.

A

reduced

33
Q

What factors affect diffusion?

A
  • surface area
  • thickness of interstitium
  • hemoglobin content
  • perfusion
34
Q

What factors cause expiratory flow limitation?

A
  • increased resistance
  • decreased radial traction
  • decreased elastic recoil
35
Q

What factors affect diffusion?

A
  • surface area
  • thickness of interstitium
  • hemoglobin content
  • perfusion
  • pressure gradient

Pulmonology (25 decks)

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