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Clin Med III > 5C: OLD > Flashcards

5C: OLD Flashcards

1
Q

What does the obstruction of air flow result in?

A

Impairments of mechanical function (primarily reduce FEV1) and gas exchange

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2
Q

According to GOLD, what should the FEV1/FVC ratio be?

A

> .75

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3
Q

What is GOLD Stage 1?

A

Mild - FEV1 is 80% or greater than predicted

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4
Q

What is GOLD Stage 2?

A

Moderate - FEV1 between 50-80% of predicted

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5
Q

What is GOLD Stage 3?

A

Severe - FEV1 between 30-50% of predicted

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6
Q

What is GOLD Stage 4?

A

Very severe - FEV1 < 30% of predicted

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7
Q

What are the two types of COPD?

A

Emphysema and bronchitis

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8
Q

What is a pack year?

A

pack year = ppd x yrs

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9
Q

What does smoking inhibit with Emphysema that leads to destruction of alveolar walls?

A

Alpha 1-antitrypsin

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10
Q

Why are WBC’s released with emphysema COPD and what is the effect?

A

To try and get rid of smoking vapor particles, but they end up destroying the alveolar walls because of the lack of alpha 1-antitrypsin

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11
Q

What is the result of early airways closure with COPD?

A

Overinflation of the alveoli that causes air to get trapped and ventilation/perfusion mismatch

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12
Q

What are permanent effects of COPD?

A

Enlargement of alveoli, loss of elastic recoil of alveoli, lungs, and thoracic cage

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13
Q

What is the result of overinflation of the alveoli?

A

Increased RV and increased compliance of the lungs and increased resting size

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14
Q

What happens to rib orientation over time with COPD?

A

Barrel chested - Increased A-P diameter, and diaphragm flattens

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15
Q

What can happen if hypoxemia persists in a COPD patient?

A

Pulmonary HTN

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16
Q

In advanced cases, what can the change in diaphragm position result in?

A

Paradoxial breathing

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17
Q

What are some common symptoms of COPD?

A

SOB, DOE, orthopnea, wheezing, decreased breath sounds, increased RR, chronic cough, malaise, weight loss

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18
Q

What are observable signs of COPD?

A

Digital clubbing, peripheral cyanosis, barrel chest, elbow roughness from UE support

19
Q

What happens to accessory muscles with COPD?

A

Hypertrophy

20
Q

What happens to FEV1 with COPD?

A

Decreases

21
Q

What is bronchitis?

A

Productive cough for 3+ more months for at least 2 years

22
Q

Why is there excess mucous secretions with bronchitis?

A

Hyperplasia at goblet cells and mucous glands

23
Q

What happens at the lungs secondary to decreased ventilation?

A

Vasoconstriction

24
Q

What can cause a patient with Bronchitis to appear bloated?

A

Vasoconstriction leads to increased pulmonary pressures and ultimately R sided CHF

25
Q

What are the four key symptoms of bronchitis?

A
  1. Productive cough
  2. Bloated
  3. Peripheral cyanosis
  4. SOB
26
Q

What is CF and the four effects?

A

Genetic condition that causes
1. Increased mucous production
2. Thick secretions that block airways
3. Chronic inflammation
4. High susceptibility to infection

27
Q

What does hyperinflation with CF result in?

A

Decreased gas exchange and hypoxemia

28
Q

What are the 5 signs of CF?

A
  1. Hyperinflation on x-ray
  2. Increased RR
  3. Rales and wheezes
  4. Productive cough and thick secretions
  5. Decreased endurance
29
Q

What is the definition of Asthma?

A

Reversible OLD characterized by inflammation and increased reactivity of smooth airway muscles to stimuli

30
Q

What is the response to stimuli with asthma?

A

Chronic inflammation and then bronchospasm and bronchoconstriction related to the stimuli

31
Q

What are the four types of asthma?

A
  1. Extrinsic
  2. Intrinsic
  3. Exercise induced
  4. Occupational
32
Q

What is extrinsic asthma?

A

Reaction to allergens

33
Q

What is intrinsic asthma?

A

Unknown, but triggered by pulmonary infections

34
Q

What is exercise induced asthma?

A

Related to increased RR demand, airway temp and humidity

35
Q

What is occupational asthma?

A

Similar to extrinsic, but directly items at place of work

36
Q

What is Bronchiectasis?

A

Progressive with permanent airway damage that is similar to emphysema

37
Q

What is the specific cause of Bronchiectasis?

A

Chronic inflammation after pulmonary infection

38
Q

What conditions can then lead to Bronchiectasis?

A
  1. CF - half of all cases
  2. RA
  3. Sinusitis
39
Q

What is the Stage 1 of Bronchiectasis?

A

Chronic infection

40
Q

What is Stage 2 of Bronchiectasis?

A

Chronic inflammatory response to infection

41
Q

What is Stage 3 of Bronchiectasis?

A

Impaired immune defense and decreased mucociliary ability

42
Q

What is Stage 4 of Bronchiectasis?

A

Permanent dilation of airways

43
Q

What are 4 signs of Bronchiectasis?

A
  1. Persistent cough with large amounts of sputum
  2. Dyspnea
  3. Some chest pain
  4. Fatigue, weight loss, decreased endurance

Clin Med III (18 decks)

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