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RET 2934 > Chapter 12 > Flashcards

Chapter 12 Flashcards

1
Q

What is emphysema?

A

A permanent abnormal enlargement of the air
spaces distal to the terminal bronchioles
associated with destructive changes of the

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2
Q

What is panilobar emphysema?

A

The acinus is the involved and is the anatomic
unit of gas exchange for the lung. It involves the
respiratory bronchioles, alveolar ducts, alveolar

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3
Q

What is centrilobar emphysema?

A

The lesion is the center of the lobules and, which
results in enlargement of the and destruction of
the respiratory bronchioles. It involves the upper

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4
Q

What is Bollous emphysema?

A

Emphysematous changes are isolated and
accompanied by the development of bullae,
which are weak air spaces and susceptible to

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5
Q

What are bullae?

A

air spaces in their distended state, more than 1
cm in diameter

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6
Q

What are blebs?

A

air spaces adjacent to the pleura, usually less
than 1 cm in diameter in their distended state.

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7
Q

What is the cause of emphysema?

A

Smoking
a1-Antitrypsin deficiency (hereditary)

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8
Q

In emphysema air-trapping leads to chronic
hyperinflation of the lungs and an ______?

A

Increased FRC

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9
Q

_______ is increased as a result of the destruction
of elastic lung tissue?

A

Lung compliance

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10
Q

What are the signs and symptoms of
emphysema?

A

Elevated hemoglobin, hematocrit, and red
blood cell count.
chronic CO2 retention and

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11
Q

What will you see on a CXR for emphysema?

A

Hyperinflation
Reduced vascular markings

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12
Q

What PFTs will be seen with emphysema?

A

Decreased forced expiratory volume in 1

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13
Q

What is the treatment for emphysema?

A

Bronchodilators
Methylxanthines

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14
Q

What are some examples of a smoking
cessation program?

A

Group counseling
Nicotine replacement therapy

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15
Q

What are some examples of a SABA and what
patients are the used for?

A

Albuterol
Xopenex
Used for COPD patients

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16
Q

What is a short acting anticholinergic?

A

Atrovent

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17
Q

What are some examples of a LABA?

A

Serevent
Spiriva

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18
Q

What is an example of an ICS and what can it be
combined with to reduce acute exacerbations?

A

Inhaled Flonase
A LABA

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19
Q

What is an example of an methylxanthine?

A

Theophylline

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20
Q

What are some examples of breathing
exercises?

A

Diaphragmatic breathing
Pursed lip breathing
O2 therapy

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21
Q

PaCO2 begins increasing after a patient with
severe COPD starts receiving O2, what does that

A

The respiratory drive has been suppressed

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22
Q

Remain the PaO2 between what?

A

50-65 mmHG

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23
Q

What is chronic bronchitis?

A

chronic excessive mucus production, resulting
from an increase in the number and size of
mucus glands and goblet cells. Symptoms are a
cough and increased mucus production for at
least 3 months of the year for more than 2

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24
Q

Who is most commonly affected with chronic
bronchitis?

A

Males

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25
Q

What is the cause of chronic bronchitis?

A

Smoking

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26
Q

What is the pathophysiology of chronic
bronchitis?

A

Mucus plugs in peripheral airways
Loss of cilia
Emphysematous changes in advanced
stages of disease

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27
Q

What are the signs and symptoms of chronic
bronchitis?

A

CO2 retention and hypoxemia in advanced
stages
Increased pulmonary vascular resistance
(PVR) in advanced stages

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28
Q

What will you see on a CXR for chronic
bronchitis?

A

Not significant in early disease
Hyperinflation (in advanced stages)

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29
Q

What are some PFTs seen with chronic

A

Increased RV

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30
Q

bronchitis?

A

Decreased FEV1

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31
Q

What is the treatment for chronic bronchitis?

A

Smoking cessation program

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32
Q

An FEV1/FVC < 70% indicates what?

A

Obstruction

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33
Q

What is GOLD standard 1 Mild?

A

FEV1 > 80% predicted

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34
Q

What is GOLD standard 2 Moderate?

A

FEV1 50-79% of predicted

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35
Q

What is GOLD standard 3 Severe?

A

FEV1 30-49% of predicted

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36
Q

What is GOLD Standard 4 Very Severe?

A

FEV1 < 29% of predicted

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37
Q

What are the GOLD standard guidelines for drug therapy?

A

Inhaled ICS

38
Q

therapy?

A

Phosphodiesterase-4 inhibitorS

39
Q

Inhaled ICS will be beneficial for COPD patients
with an FEV1 of what?

A

< 60% predicted

40
Q

Combining long-acting bronchodilators and
inhaled corticosteroids will be more effective
than using either drug individually but may

A

pneumonia

41
Q

Roflumilast can be helpful with what patients?

A

GOLD 3 and GOLD 4 patients who have a history
of acute exacerbations and chronic bronchitis

42
Q

Roflumilast can be combined with what?

A

LABAs

43
Q

Theophylline added to ______ has been shown to
increase FEV1 more than with _____ by itself.

A

Salmeterol

44
Q

What methylxanthine is not recommended for
chronic bronchitis?

A

Theophylline

45
Q

What is asthma?

A

A clinical syndrome characterized by airway
obstruction, which is partially or completely
reversible either spontaneously or with

46
Q

What are the characteristics of asthma?

A

airway hyperresponsiveness to various
stimuli

47
Q

What are some causes of asthma?

A

Environmental factors
Infection

48
Q

What is intermittent asthma?

A

the least severe of the four classifications

49
Q

What are the symptoms of intermittent asthma?

A

wheezing or coughing are experienced no more
than twice per week.

50
Q

What are the PFT characteristics of intermittent
asthma?

A

The patients in this category generally have
FEV1 and peak expiratory flow (PEF) values of
at least 80% of predicted.

51
Q

What medications are used for intermittent
asthma?

A

Routine management generally consists of beta-
2 agonists (SABAs), as needed.

52
Q

What is the treatment for intermittent asthma?

A

emergency department treatment or
hospitalization

53
Q

What are the symptoms for mild asthma?

A

Symptoms of coughing or wheezing are
experienced more than twice per week but less

54
Q

How often do the symptoms for mild asthma

A

Symptoms affect the patient’s daily activity and
sleep during the night; nocturnal coughing,

55
Q

occur?

A

wheezing, or dyspnea is experienced more than

56
Q

What are the PFT characteristics for mild
asthma?

A

The patients in this category generally have
FEV1 and PEF values of at least 80% of
predicted.

57
Q

What drugs are used for mild asthma?

A

Routine management generally consists of ICS
therapy to control symptoms and the use of a

58
Q

What is the treatment for mild asthma?

A

Emergency department treatment for
exacerbations occurs periodically and may

59
Q

What are the symptoms for moderate asthma?

A

Symptoms of coughing or wheezing are
experienced almost daily in this category.

60
Q

How often do exacerbations occur for moderate
asthma?

A

Exacerbation of symptoms are experienced at
least twice per week and may persist for several
days.

61
Q

How often do symptoms occur for moderate
asthma?

A

Symptoms affect the patient’s daily activity and
sleep during the night; nocturnal coughing,
wheezing, or dyspnea is experienced more than

62
Q

What are the PFT characteristics for moderate
asthma?

A

The patients in this category generally have
FEV1 and PEF values of 60% to 80% of
predicted.

63
Q

What are the medications for moderate asthma?

A

A SABA as needed for symptoms and not to
exceed 3 to 4 times per day; LABA for nocturnal

64
Q

What is the treatment for moderate asthma?

A

Patients in this category routinely require
emergency department treatment or require

65
Q

What is severe asthma?

A

This is the worst category of the four.

66
Q

What are the symptoms for asthma?

A

Symptoms of coughing or wheezing are
experienced almost continually.

67
Q

How often do exacerbations occur for sever
asthma?

A

Exacerbations are frequent and may last for
weeks.

68
Q

How often do symptoms occur for severe
asthma?

A

Symptoms affect the patient’s daily activity and
sleep during the night; nocturnal coughing,
wheezing, or dyspnea is experienced almost

69
Q

What are the PFT characteristics for sever
asthma?

A

The patients in this category generally have
FEV1 and PEF values of 60% or less of
predicted.

70
Q

What medications are used for sever asthma?

A

3 to 4 times per day; LABA and oral
corticosteroids for nocturnal symptoms and

71
Q

What is the treatment for severe asthma?

A

Patients in this category routinely require
emergency department treatment or require

72
Q

What is the pathophysiology for asthma?

A

When the asthmatic inhales an allergen that he
or she is sensitive to, mast cells located in the
bronchial mucosa and submucosa and will

73
Q

What are the chemical mediators for asthma?

A

Leukotrienes
Platelet-activating factor

74
Q

What substances will the chemical mediators
release:

A

Increased mucus production
Accumulation of eosinophils in the blood
and

75
Q

Measuring FeNO can help determine what?

A

airway inflammation

76
Q

What is normal FeNO for adults?

A

25 ppb

77
Q

What is normal FeNO for children?

A

20 ppb

78
Q

FeNO levels greater than 50 ppb indicate what?

A

patient needs to increase his or her normal
medication

79
Q

FeNO levels are usually increased with what?

A

patient’s noncompliance with corticosteroid use.

80
Q

What are the signs and symptoms for asthma?

A

Paradoxical pulse
Tachycardia and tachypnea

81
Q

What are the characteristics of a chest x-ray for
asthma?

A

Hyperinflation (hyperlucency of lung fields)
Atelectasis
Infiltrates

82
Q

What are some characteristics of PFTs for

A

Decreased FVC

83
Q

asthma?

A

Decreased FEV1/FVC

84
Q

What are some asthma preventative drugs?

A

Cromolyn sodium (Intal): mast cell
stabilizer referred to as a noncorticosteroid
anti-inflammatory drug

85
Q

What is the treatment for asthma during an
attack?

A

Xopenex
IV fluids
O2 therapy

86
Q

What is status asthmaticus?

A

a severe asthmatic attack that responds poorly
to bronchodilator therapy and is associated with

87
Q

What is the treatment for status asthmaticus?

A

Close monitoring of ABG levels and SpO2
Bronchodilating agents

88
Q

What is nocturnal asthma?

A

Nocturnal (nighttime) symptoms are seen in up
to 75% of all patients with asthma and even in
those who have mild intermittent or mild

89
Q

What are some causes uses of nocturnal
asthma?

A

b2-receptor function during sleep
aspiration
sleep apnea,

90
Q

What is the treatment for nocturnal asthma?

A

First line management is ICS. May also be
managed by LABA.

RET 2934 (13 decks)

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