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Practical Cases in Medicine > Case in Review 2 > Flashcards

Case in Review 2 Flashcards

1
Q

Main causes of COPD

A
  • Smoking
  • toxic chemicals
  • Alpha-1 antitrypsin deficiency
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2
Q

Pathophysiology of COPD

A
  • Persistent narrowing of small airways when pt has emphysema, chronic obstructive bronchitis
  • Leads to a decrease in the rate of exhaled air (OBSTRUCTIVE)
  • Most common cause is cig smoking
  • Irreversible
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3
Q

COPD age affected

A

Adult 40-50, takes years to develop

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4
Q

How do you evaluate airflow?

A

Spirometry
- the ratio of forced expired volume in 1 second (FEV1) to the forced vital capacity (FVC) is <0.70 after administration of a bronchodilator, airway obstruction is indicated

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5
Q

COPD symptoms

A

mild cough with clear sputum -> SOB during exertion -> weight loss -> barrel chest

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6
Q

Pathophysiology of Asthma

A

-Airways narrow in response to certain stimuli
- Reversible
- Chronic inflammatory disease of airways
Bronchi receptors sense the presence of a substance and stimulate bronchi muscles to contract or relax (altering airflow)
- Difficulty exhaling (OBSTRUCTIVE)

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7
Q

Early phase reaction of asthma

A

(Minutes)
Antigen exposure causes it to cross-link IgE mast cells causing the release of preformed mediation.
Results in bronchoconstriction, excess mucus, and edema.
Inflammatory cell recruitment

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8
Q

Late phase reaction of asthma

A

(hours)
Recruited immune cells cause long-term inflammation.
Airway remodeling.

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9
Q

Main causes of asthma

A
  • Allergens/irritants (tobacco smoke)
  • Exercise
  • Infections: bronchitis, pneumonia, colds
  • Aspirin
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10
Q

Main causes of pneumonia

A
  • Bacteria, viruses
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11
Q

Symptoms of asthma

A

Sudden onset when exposed to trigger
- wheezing
- SOB
- Cough

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12
Q

Symptoms of pneumonia and age

A

Develop over several days
Adults 65+ and young kids
-Productive cough (sputum)
- Angina
- Chills
- Fever
- SOB

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13
Q

Pathophysiology of pneumonia

A
  • Pathogen colonizes nasopharynx and reaches alveoli via microaspiration
    -Infection of alveoli and surrounding tissues
  • Fluid/pus in alveoli
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14
Q

Changes in lung/airways with restrictive lung disease

A
  • Lungs become stiff, and more effort is needed to expand when inhaling
  • Decrease in the volume of air that lungs can hold,
  • Lose elasticity
  • Harder to INHALE
  • Does NOT cause wheezing
    Ex: sarcoidosis (granulomas in lungs)
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15
Q

Changes in lung/airways with obstructive lung disease

A
  • Airway is narrowed, with high resistance of airflow
  • Airways widen during inhalation and air can be pulled in, airways narrow during exhalation and air cant be exhaled from lungs quickly (wheezing)
  • Dyspnea occurs when too much air is left in the lungs after inhaling
  • Hard to EXHALE
    Ex: asthma, COPD
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16
Q

How can pulmonary hypertension from COPD cause pitting edema, elevated jugular venous pressure, and hyperinflated lungs?

A
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17
Q

How can cor pulmonae from COPD cause pitting edema, elevated jugular venous pressure, and hyperinflated lungs?

A
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18
Q

What are some of the environmental factors that can cause COPD?

A
  • Smoking
  • Pollution
  • Dust/ fume exposure in the workplace
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19
Q

How do we know that there are genetic factors that predispose an individual to COPD?

A

-B/c a non-smoker can develop COPD
- There are clusters in families

20
Q

What genetic factors have been linked to COPD?

A

-Alpha-antitrypsin deficiency (AATD)
There are other parts of the genome that have been associated with COPD

21
Q

Epidemiology of COPD; why is it important for a HCP to learn about COPD?

A
  • Common worldwide
  • Prevalence is correlated with increasing age, lower socioeconomic status, and smiling
  • Prevalent in M and F
  • Annual death rates are steadily rising in US
  • Economic burden
  • 4th leading COD worldwide
22
Q

What type of disease is COPD?

A

Complex disorder; environmental and genetic factors involved

23
Q

What is emphysema?

A
  • Permanent enlargement of air spaces distal to the terminal bronchioles
  • Destruction of lung tissues, limiting gas exchange
24
Q

What is the connection b/t inflammation and emphysema?

A

Cause emphysema and proteolytic destruction of the lung connective tissue:
- imbalance b/t protease and anti-protease systems in the lungs
- Macrophages MMP
- Neutrophil elastase and destruction of elastin
- cig smoking -> induced infl. -> trigger cycle of protease release and lung destruction

25
Q

Why did Elisa with COPD have a high RBC and WBC count?

A

WBC: infection fighters
RBC: Carry O2 throughout the body

RBC- when there’s damage to the lungs, they cant get enough air, so the body reacts by making more RBC to increase the amount of O2 in the blood

WBC- inflammation, high neutrophils and lymphocytes
toxins recruit macrophages recruits neutrophils which release elastase and MMP that causes Lung damage

26
Q

What is Cardiothoracic ratio (CTR) and how does it indicate an increased expansion of the lung?

A
27
Q

AATD has been linked to COPD, what is the definition of AAT deficiency?

A
28
Q

What are the different alleles of AAT? What is the phenotype associated with each genotype?

A
29
Q

What would be the genotype associated with high risk for COPD?

A
30
Q

What are the different barriers to the dx of AATD?

A
31
Q

What are the major causes of congenital malformation?

A
32
Q

What is the correlation between the exposure of teratogen and the stage of development?

A
33
Q

What is the 4 digit parity system?

A
34
Q

How do you calculate the EDD and gestation age?

A
35
Q

What was the main cause of Boyka’s children’s illness?

A
36
Q

What is FAS? What population is more at risk? What does the severity depend on?

A
37
Q

What is maternal PKU?

A
38
Q

How can maternal PKU cause developmental abnormalities?

A
39
Q

Why are individuals with PKU on a protein-free diet but kids with maternal PKU are not?

A
40
Q

What is the JVP?

A
41
Q

Excessive mucus in large airways causes what symptom?

A

cough

42
Q

Excessive mucus in small airways causes what symptom?

A

wheezing

43
Q

3 most common symptoms of lung disorders

A

1.) Cough
2.) SOB
3.) Wheezing

44
Q

What is the mechanism of coughing?

A
  • Clear material out of the airway
  • Protect lungs from particles that were inhaled
45
Q

What is wheezing?

A

Happens when airways are partially blocked/narrowing

Practical Cases in Medicine (1 decks)

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