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BOARDS: Pulmonary > Acute and chronic obstructive diseases > Flashcards

Acute and chronic obstructive diseases Flashcards

1
Q

What is the most common type of gram-positive pneumonia that is usually acquired in the community?

A

pneumococcal (streptococcal)

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2
Q

What’s the difference between gram positive and gram negative bacteria?

A 
positive = acquired in community
negative = develop in a host with underlying, chronic, debilitating conditions
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3
Q

T/F: A dry cough indicates viral pneumonia.

A

true, productive with blood-streaked sputum is bacterial pneumonia

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4
Q

What are some indicators of pneumonia?

A

fever, chills, tachypnea (bacterial), headaches (viral), hypoxemia/hypercapnea, cough, decreased breath sounds and/or crackles

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5
Q

What lung sounds might you hear with your patient that has pneumonia?

A

crackles, decreased breath sounds

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6
Q

What type of pneumonia is usually found in patients with dysphagia?

A

aspiration pneumonia: causes acute inflammatory reaction within lungs

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7
Q

Increased incidence of TB occurs with what population?

A

those with HIV

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8
Q

What precautions must be taken for those patients with TB?

A

droplet, since that’s how it’s spread

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9
Q

How long is a person that’s been infected with TB considered incubatory?

A

2-10 wks

  • primary disease = 10days to 2 weeks
  • postprimary can occur years after initial infection
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10
Q

What is Pott’s disease?

A

tuberculous spondylitis

  • form of TB that affects the thoracic and upper lumbar vertebrae
  • aka kyphosis from arthritic change: PT to decrease pain, improve ROM/strength
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11
Q

What type of pneumonia is often found in patients following transplantation, or in neonates?

A

pneumocystis pneumonia (PCP)

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12
Q

What is pneumonia, in general terms?

A

infection/inflammation of the lung’s air sacs (grapes), which can fill with fluid

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13
Q

What is sarcoidosis? Symptoms?

A

multisystem inflammatory disease consisting of granulomas in multiple organs, more often lungs, skin, lymph nodes, eyes, and liver

  • symptoms: fever, cough, fatigue, chest pain, SOB
  • granuloma = mass of granulation tissue in response to inflammation or infection
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14
Q

What outcome measures are used to monitor sarcoidosis?

A

PFTs and 6MWT

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15
Q

Is COPD considered progressive?

A

yes; not completely reversible is a characteristic

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16
Q

How many stages are there in COPD?

A

4: mild, moderate, severe, very severe

17
Q

What does FEV1/FVC have to be to be considered COPD?

A

<70%

18
Q

What is COPD?

A

obstructive lung disease = aka air isnt getting in

  • can be d/t retaining secretions, inflammation of airway, airsac destruction or overinflation (with break down of surfactant)
  • aka can be from emphysema (air sacs blend together), asthma (constriction/spasm of airway)
19
Q

How do lungs get overinflated in COPD?

A

chronic inflammation of airways -> don’t allow them to stay open with exhalation

  • air trapping occurs b/c can’t breathe out all the air, overinflation occurs
  • hyperinflation causes decreased lung recoil
20
Q

What pathological process is occurs with emphysema?

A

air sacs blend together into one big sac, decreasing surface area
- limits ability to gas exchange, so air gets trapped

21
Q

What pathological process occurs in chronic bronchitis?

A

grapes are okay, but muscous and bronchoconstriction doesn’t let you get to them
- gas exchange is fine at the grapes, but air doesn’t get there b/c of airways

22
Q

What happens to the diaphragm in COPD?

A

gets flattened - poor ability to help with inhalation

  • angles of pull are now flattened, so the contraction isn’t as efficient
  • end up using accessory muscles more
23
Q

What is FEV?

A

forced expiratory volume = amount of air forcibly exhaled in one breath

24
Q

What is the difference between FEV1/FVC ratios for obstructive disease vs restrictive?

A 
<75% = obstructive
>75% = restrictive
25
Q

What value of PaCO2 indicates respiratory failure?

A

> 50mmHg (normal is 35-45)

26
Q

What can be some symptoms of increased CO2 retention?

A

drowsy, lethargic, headache, tachy, diaphoretic

27
Q

T/F: there is a decreased expiration phase for those with COPD.

A

false, it’s increased (cause they have trouble getting air out, so it takes longer)

  • usually longer than 4s
28
Q

T/F: You want pts with COPD to tripod during your session.

A

yes!! teach it to them as a means to increase function

- do 2 min intervals of tripod, one minute standing on treadmill walks

29
Q

You read a chart of patient you’re going to see later today with COPD. What are symptoms you’ll see in your patient with COPD?

A 
cough/sputum production
dyspnea upon exertion
adventitious breath sounds
increased RR
weight loss
increased AP diameter
postures to elevate shoulder girdle***
30
Q

What is asthma?

A

increased reactivity of the trachea and bronchi to various stimuli
- reversible in nature

31
Q

When do you hear wheezes, inspiration or expiration?

A

expiration - musical sound

32
Q

What pathology occurs in cystic fibrosis?

A

thickening of secretions of all exocrine glands, leading to obstruction
- can be obstructive, restrictive, or mixed

33
Q

Frequent respiratory infections are commonly present in what type of chronic lung disease?

A

CF

34
Q

What causes cystic fibrosis?

A

genetically inherited

35
Q

What clinical findings might you find with patients that have bronchiectasis?

A

bronchiectasis = chronic disease that has abnormal dilation of bronchi and excessive sputum production

Symptoms:
large amounts of mucopurulent secretions
frequent secondary infections
dyspnea
crackles, decreased breath sounds
36
Q

What is RDS?

A

respiratory distress syndrome

- alveolar collapse in premature infant from lung immaturity, inadequate surfactant

37
Q

What disease is often a sequela of premature infants with RDS?

A

bronchopulmonary dysplasia

- d/t high pressures of mechanical ventilation, high fractions of inspired O2, and/or infection

BOARDS: Pulmonary (7 decks)

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