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Pharmo Drugs Kim > Chapter 12 Phatho > Flashcards

Chapter 12 Phatho Flashcards

1
Q
  1. What are the 5 Obstructive Lung Diseases? (CBABE)

A. Cystic Fibrosis, Bronchitis, Asthma, Bronchiectasis, Emphysema.

B. Asthma, Influenza, TB, Fungal disease, Coccidioidomycosis.

A

A. Cystic Fibrosis, Bronchitis, Asthma, Bronchiectasis, Emphysema.

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2
Q
  1. What is the definition for Chronic Obstructive Lung Disease (COPD)?

A. Asthma, Influenza, TB, Fungal disease, Coccidioidomycosis.

B. A preventable and treatable disease state characterized by airflow limitation that is not fully reversible.

A

B. A preventable and treatable disease state characterized by airflow limitation that is not fully reversible.

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3
Q
  1. What is the primary cause of COPD?

A. Alcohol
B. Shisha
C. Cigarette smoking.

A

C. Cigarette smoking.

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4
Q
  1. Describe the airflow limitation with COPD.

A. A productive cough for 3 months in each of 2 successive years in a patient whom other causes of productive couch have been excluded.

B. Defined pathologically as the presence of permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.

C. The airflow limitation is progressive and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases.
Although COPD affects the lungs, what are the other consequences?

A

C. The airflow limitation is progressive and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases.
Although COPD affects the lungs, what are the other consequences?

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5
Q
  1. What is the definition for Chronic Bronchitis?

A. A productive cough for 3 months in each of 2 successive years in a patient whom other causes of productive couch have been excluded.

B. Mild case of pneumonia, patient remains ambulatory
CAP

C. Cigarette smoking.

A

A. A productive cough for 3 months in each of 2 successive years in a patient whom other causes of productive couch have been excluded.

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6
Q
  1. Although COPD affects the lungs, what are the other consequences?

A. Asthma, Influenza, TB, Fungal disease, Coccidioidomycosis.

B. It produces significant systemic consequences.

A

It produces significant systemic consequences.

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7
Q
  1. What is the definition of Emphysema?

A. Defined pathologically as the presence of permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.

B. It produces significant systemic consequences.

C. Asthma, Influenza, TB, Fungal disease, Coccidioidomycosis.

A

A. Defined pathologically as the presence of permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.

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8
Q
  1. Patients with COPD usually have what?
  2. Both chronic bronchitis and emphysema.
  3. Emphysema only
  4. Chronic bronchitis
A
  1. Both chronic bronchitis and emphysema.
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9
Q
  1. According to the (ATS) American Thoracic Society, what is the definition for Chronic Bronchitis?
  2. Both chronic bronchitis and emphysema.
  3. Emphysema only
  4. It produces significant systemic consequences.
  5. Chronic Bronchitis is based on the major “clinical manifestations” associated with the disease.
A
  1. Chronic Bronchitis is based on the major “clinical manifestations” associated with the disease.
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10
Q
  1. What other important PFT values associate with COPD include the following:
  2. Increase (Inspiratory capacity) IC
  3. Incrase Vital capacity (VC)
  4. Decrease (Inspiratory capacity) IC
  5. Decrease ital capacity (VC)
  6. Increase TLC, FRC, RV, and RV/TLC ratio
  7. Decrease TLC, FRC, RV, and RV/TLC ratio

a) 3, 4, 5
b) 1, 2
c) 1, 4, 5
d) 1, 3, 4, 5

A

a) 3, 4, 5

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11
Q
  1. According to the (ATS) American Thoracic Society, what is the definition for Emphysema?
  2. It produces significant systemic consequences.
  3. Chronic Bronchitis is based on the major “clinical manifestations” associated with the disease.
  4. Emphysema is based on the pathology, or the “anatomical alterations of the lung,” associated with the disorder.
A
  1. Emphysema is based on the pathology, or the “anatomical alterations of the lung,” associated with the disorder.
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12
Q
  1. E-cigarettes contain what chemical also found in antifreeze and fog machines?
  2. It produces significant systemic consequences.
  3. Proplyene glycol.
A
  1. Proplyene glycol.
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13
Q
  1. E-cigarettes cause what type of lung disease?
  2. Popcorn lung.
  3. COPD
  4. Emphysema
A
  1. Popcorn lung.
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14
Q
  1. What are the anatomical alternations of the lungs associated with Chronic Bronchitis?
  2. Chronic inflammation and thickening of the wall of the peripheral airways. Excessive mucus production and accumulation. Partial and total mucus plugging of the airways. Smooth muscle constriction of bronchial airways (bronchospasm). Air trapping and hyperinflation of alveoli.
  3. Chronic Bronchitis is based on the major “clinical manifestations” associated with the disease.
  4. Emphysema is based on the pathology, or the “anatomical alterations of the lung,” associated with the disorder.
A
  1. Chronic inflammation and thickening of the wall of the peripheral airways. Excessive mucus production and accumulation. Partial and total mucus plugging of the airways. Smooth muscle constriction of bronchial airways (bronchospasm). Air trapping and hyperinflation of alveoli.
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15
Q
  1. What are the anatomical alterations of the lungs associated with Emphysema?
  2. Chronic inflammation and thickening of the wall of the peripheral airways. Excessive mucus production and accumulation. Partial and total mucus plugging of the airways. Smooth muscle constriction of bronchial airways (bronchospasm). Air trapping and hyperinflation of alveoli.
  3. Chronic Bronchitis is based on the major “clinical manifestations” associated with the disease.
  4. Emphysema is based on the pathology, or the “anatomical alterations of the lung,” associated with the disorder.
  5. Permanent enlargement and destruction of the air spaces distal to the terminal bronchioles. Destruction of alveolar-capillary membrane. Weakening of the distal airways, primarily the respiratory bronchioles. Air trapping and hyperinflation.
A
  1. Permanent enlargement and destruction of the air spaces distal to the terminal bronchioles. Destruction of alveolar-capillary membrane. Weakening of the distal airways, primarily the respiratory bronchioles. Air trapping and hyperinflation.
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16
Q
  1. Panlobular Emphysema is associated with which parts of the acinus?
  2. Popcorn lung.
  3. COPD
  4. Distal parts.
  5. Emphysema
A
  1. Distal parts.
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17
Q
  1. Panlobular Emphysema is associated with what deficiency?
  2. Popcorn lung.
  3. COPD
  4. Distal parts.
  5. Alpha 1- antitrypsin deficiency.
A
  1. Alpha 1- antitrypsin deficiency.
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18
Q
  1. Centrilobular Emphysema is associated with which parts of the acinus?
  2. Popcorn lung.
  3. Proximal parts.
  4. Distal parts.
  5. Alpha 1- antitrypsin deficiency.
A
  1. Proximal parts.
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19
Q
  1. Centrilobular Emphysema is associated with what lung disease?
  2. Popcorn lung.
  3. COPD
  4. Distal parts.
  5. Chronic Bronchitis.
A
  1. Chronic Bronchitis.
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20
Q
  1. What is a side effect of Alpha-1 antitrypsin deficiency?
  2. Blistering skin
  3. Popcorn lung.
A
  1. Blistering skin
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21
Q
  1. Alpha 1-antitrypsin deficiency is also known as?
  2. Popcorn lung.
  3. COPD
  4. Genetic Emphysema.
  5. Distal parts.
A
  1. Genetic Emphysema.
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22
Q
  1. A normal patient testing for Alpha 1- antitrypsin deficiency is what % and what phenotype?
  2. 25%, MM
  3. 50%, MZ
  4. 25%, ZZ
A
  1. 25%, MM
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23
Q
  1. A carrier of Alpha 1- antitrypsin deficiency is what % and what phenotype?
  2. 25%, MM
  3. 50%, MZ
  4. 25%, ZZ
A
  1. 50%, MZ
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24
Q
  1. An individual who has Alpha-1 antitrypsin deficiency is what % and what phenotype?
  2. 25%, MM
  3. 50%, MZ
  4. 25%, ZZ
A
  1. 25%, ZZ
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25
Q

How can you rule out Alpha-1 antitrypsin deficiency?

  1. Blood test
  2. PFT.
  3. Inspiratory
A
  1. Blood test
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26
Q
  1. What is the therapy associated with Alpha 1- antitrypsin deficiency?
  2. Blood test
  3. PFT.
  4. Weekly protein replacement.
A
  1. Weekly protein replacement.
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27
Q
  1. What are the primary indicators for considering COPD in patients over the age of 40?

. Popcorn lung.

  1. COPD
  2. Genetic Emphysema.
  3. Dyspnea, chronic cough, chronic sputum, history of exposure, and family history.
A
  1. Dyspnea, chronic cough, chronic sputum, history of exposure, and family history.
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28
Q
  1. What are the 3 spirometry tests for COPD?
  2. FEV1, FVC, FEV1/FVC ratio.
  3. Blood test
A
  1. FEV1, FVC, FEV1/FVC ratio.
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29
Q
  1. How can you tell after a spirometry test for COPD that a patient has an obstruction?
  2. The FEV1/FVC ratio will be under 70%.
  3. The FEV1/FVC ratio will be above 70%.
A
  1. The FEV1/FVC ratio will be under 70%.
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30
Q
  1. According to the lung volumes chart, which are increased and decreased due to COPD?
  2. Increase in TLC, RV, FRC. Decrease in IC and VC.
  3. Decrease in TLC, RV, FRC. Increase in IC and VC.
A
  1. Increase in TLC, RV, FRC. Decrease in IC and VC.
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31
Q
  1. On a (CAT) COPD Assessment Test, what score would a patient have to have in order to be considered likely to have COPD?
  2. 10 or higher.
  3. 10 or lower.
A
  1. 10 or higher.
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32
Q
  1. On a (mMRC) Modified British Medical Research Council Breathlessness Scale, what test score would a patient have to have in order to be considered likely to have COPD?
  2. 2 or higher.
  3. 2 or lower.
A
  1. 2 or higher.
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33
Q
  1. What is a normal FEV1?
  2. 80-100 %
  3. 70-100%
A
  1. 80-100 %
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34
Q
  1. A patient who is considered a “Pink Puffer” is?
  2. A patient with emphysema.
  3. A patient with COPD.
  4. A patient with chronic.
A
  1. A patient with emphysema.
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35
Q
  1. A patient who is considered a “Blue Bloater” is?
  2. A patient with chronic bronchitis.
  3. A patient with emphysema.
  4. A patient with COPD.
A
  1. A patient with chronic bronchitis.
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36
Q
  1. What is the body type of a patient with emphysema?
  2. Large.
  3. Thin.
  4. Fat
A
  1. Thin.
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37
Q
  1. What is the body type of a patient with chronic bronchitis?
  2. Stocky and overweight.
  3. Thin.
  4. Fat
A
  1. Stocky and overweight.
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38
Q
  1. A patient with a barrel chest: Emphysema or Chronic Bronchitis?
  2. A patient with emphysema.
  3. A patient with COPD.
  4. Emphysema.
A
  1. Emphysema.
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39
Q
  1. Emphysema: A “Pink Puffer” is also know as?
  2. Type B
  3. Type A
  4. Type C
A
  1. Type A
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40
Q
  1. Chronic Bronchitis: A “Blue Bloater” is also known as?
  2. Type B
  3. Type A
  4. Type C
A
  1. Type B
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41
Q
  1. What is the respiratory pattern with Emphysema?
  2. Hyperventilation.
  3. Hypoventilation.
A
  1. Hyperventilation.
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42
Q
  1. What is the respiratory pattern with Chronic Bronchitis?
  2. Hyerventilation.
  3. Hypoventilation.
A
  1. Hypoventilation.
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43
Q
  1. Pursed lip breathing: Emphysema or Chronic Bronchitis?
  2. A patient with COPD.
  3. Emphysema.
A
  1. Emphysema.
44
Q
  1. Cough:

1. Emphysema or Chronic Bronchitis?

A

Chronic Bronchitis.

45
Q
  1. Sputum:

1. Emphysema or Chronic Bronchitis?

A

Chronic Bronchitis.

46
Q
  1. Cyanosis:

Emphysema or Chronic Bronchitis?

A

Chronic Bronchitis.

47
Q
  1. Peripheral Edema:

1. Emphysema or Chronic Bronchitis?

A

Chronic Bronchitis.

48
Q
  1. Reddish skin:

Emphysema or Chronic Bronchitis?

A

Emphysema.

49
Q
  1. Neck vein distention:

Emphysema or Chronic Bronchitis?

A

Chronic Bronchitis.

50
Q
  1. Cor pulmonale:

1. Emphysema or Chronic Bronchitis?

A

Chronic Bronchitis.

51
Q
  1. Use of accessory muscles: Emphysema or Chronic Bronchitis?
A

Emphysema.

52
Q
  1. What heart sounds would you expect to hear in a patient with Emphysema?
  2. Decreased heart sounds.
  3. Increased heart sounds.
A
  1. Decreased heart sounds.
53
Q
  1. What breath sounds would you expect to hear in a patient with Emphysema?
  2. Prolonged expiration.
  3. Prolonged inspiratory
A
  1. Prolonged expiration.
54
Q

What breath sounds would you expect to hear in a patient with Chronic Bronchitis?

  1. Prolonged expiration.
  2. Wheezes, crackles, or ronchi.
  3. Increased heart sounds.
A
  1. Wheezes, crackles, or ronchi.
55
Q
  1. Hyperresonance:

1. Emphysema or Chronic Bronchitis?

A

Emphysema.

56
Q
  1. Hyperinflation:

1. Emphysema or Chronic Bronchitis?

A

Emphysema.

57
Q
  1. Long, vertical heart:

1. Emphysema or Chronic Bronchitis?

A

Emphysema.

58
Q
  1. Enlarged, horizontal heart:

Emphysema or Chronic Bronchitis?

A

Chronic Bronchitis.

59
Q
  1. Polycythemia:

1. Emphysema or Chronic Bronchitis?

A

Chronic Bronchitis.

60
Q
  1. Which patient gets more infections?

1. Emphysema or Chronic Bronchitis?

A

Chronic Bronchitis.

61
Q
  1. Decreased diffusion:

1. Emphysema or Chronic Bronchitis?

A

Emphysema.

62
Q
  1. Pulmonary hypertension:

Emphysema or Chronic Bronchitis?

A

Chronic Bronchitis?

63
Q
  1. What is another name for right heart failure?
  2. COPD
  3. Cor pulmonale.
  4. Left heart failure
A
  1. Cor pulmonale.
64
Q
  1. What are the 3 clinical manifestations associated with Chronic Bronchitis and Emphysema?
  2. Dyspnea, chronic cough, chronic sputum, history of exposure, and family history.
  3. Excessive bronchial secretions, bronchospasm, and distal airway and alveolar weakening.
A
  1. Excessive bronchial secretions, bronchospasm, and distal airway and alveolar weakening.
65
Q
  1. Digital clubbing: Emphysema or Chronic Bronchitis?
    Chronic Bronchitis.
  2. Chronic Bronchitis.
  3. Emphysema.
  4. COPD
A
  1. Chronic Bronchitis.
66
Q
  1. Enlarged liver:

Emphysema or Chronic Bronchitis?

A

Chronic Bronchitis.

67
Q
  1. Hoover’s Sign:

Emphysema or Chronic Bronchitis?

A

Emphysema

68
Q
  1. When RV AND FRC are increased with COPD, what does this mean?
  2. Air trapping.
  3. Atelectasis
A
  1. Air trapping.
69
Q
  1. On an (ABG) Arterial Blood Gas, what does it mean when the PaCo2 is decreased?
  2. The patient is hyperventilating.
  3. The patient is hypoventilating.
A
  1. The patient is hyperventilating.
70
Q
  1. “V/Q” and “Qs/Qt” are related to what condition?
  2. Shunting.
  3. Air trapping
A
  1. Shunting.
71
Q
  1. A flattened diaphragm can be seen in patients with?
  2. Emphysema and Chronic Bronchitis.
  3. Asthma and COPD
A
  1. Emphysema and Chronic Bronchitis.
72
Q
  1. Bullae on CXR:

1. Emphysema or Chronic Bronchitis?

A

Emphysema.

73
Q
  1. A bullae signifies what?
  2. Air trapping. No gas exchange occuring.
  3. Shunting
A
  1. Air trapping. No gas exchange occuring.
74
Q
  1. Hyperlucent means what?
  2. Dark.
  3. Blue
  4. Red
A
  1. Dark.
75
Q
  1. What is the % of patient’s who will die within 3 months of admission for COPD?
  2. 10-20%.
  3. 15-25%.
  4. 30-40%
A
  1. 10-20%.
76
Q
  1. What is the % of patient’s who will die within 1 year if COPD is present with Co2 retention?
  2. 20%
  3. 40%.
  4. 25%.
A
  1. 40%.
77
Q
  1. What is the most common cause of exacerbations?
  2. Respiratory infection. (Viral or Bacterial)
  3. Air trapping. No gas exchange occuring.
A
  1. Respiratory infection. (Viral or Bacterial)
78
Q

What is the % of COPD deaths caused by smoking?

  1. 10-20%.
  2. 15-25%.
  3. 85-90%.
A
  1. 85-90%.
79
Q

True/False: A female smoker is 13x more likely to die from COPD vs. a non-smoker.

  1. True.
  2. False.
A
  1. True.
80
Q

True/False: A male smoker is 12x more likely to die from COPD vs. a non-smoker.

  1. False
  2. True.
A

2.True.

81
Q
  1. What is the single most important etiologic factor in emphysema?
  2. Alpha - antitrypsin deficiency
  3. Cigarette smoking
  4. Sulfur dioxide
  5. Infection
A
  1. Cigarette smoking
82
Q
  1. The DLCO diffusion of patients with severe emphysema is:
  2. Increased
  3. Decreased
  4. Normal
  5. The DLCO test is not to assess emphysema patient.
A
  1. Decreased
83
Q
  1. COPD includes which conditions?
A

Emphysema and Chronic bronchitis

84
Q
  1. What is Bronchiectasis ?
  2. Chronic dilation & distortion of one or more bronchi that is usually limited to a lobe or segment & frequently found in the lower lobes.
  3. The DLCO test is not to assess emphysema patient.
A
  1. Chronic dilation & distortion of one or more bronchi that is usually limited to a lobe or segment & frequently found in the lower lobes.
85
Q
  1. What is Chronic Bronchitis ?
    1. Chronic dilation & distortion of one or more bronchi that is usually limited to a lobe or segment & frequently found in the lower lobes.
  3. Is defined as having a chronic “productive” cough for 3 months in each of 2 successive years.
    “clinical manifestations”
A
  1. Is defined as having a chronic “productive” cough for 3 months in each of 2 successive years.
    “clinical manifestations”
86
Q
  1. What is Emphysema ?
  2. Is defined as the presence of permanent “enlargement” of the alveoli, accompanied by destruction of their walls without obvious fibrosis. “anatomical alterations of the lung”
  3. Is defined as having a chronic “productive” cough for 3 months in each of 2 successive years.
    “clinical manifestations”
A
  1. Is defined as the presence of permanent “enlargement” of the alveoli, accompanied by destruction of their walls without obvious fibrosis. “anatomical alterations of the lung”
87
Q
  1. What is the primary difference between Chronic Bronchitis & Asthma ?
A

In Chronic Bronchitis there is no narrowing of the smooth muscle due to constriction like there is in Asthma.

88
Q
  1. What anatomic alterations of the lungs are seen with Chronic Bronchitis ?
A
  • Chronic inflammation and swelling of the peripheral airways
  • Excessive mucus production
  • Partial or total mucus plugging
  • Bronchospasm
  • Air trapping
89
Q
  1. What anatomic alterations of the lungs are seen with Emphysema ?
    - Permanent Enlargement & deterioration of alveoli
    - Destruction of pulmonary capillaries
    - Air trapping
    - Weakening of distal airways
A
  • Permanent Enlargement & deterioration of alveoli
  • Destruction of pulmonary capillaries
  • Air trapping
  • Weakening of distal airways
90
Q
  1. What are the risk factors associated with COPD ?
A
  • Tobacco smoke (#1)
  • Occupational dusts and chemicals
  • Indoor and outdoor air pollution
  • Alpha 1 - antitrypsin deficiency
91
Q
  1. What are the signs and symptoms associated with COPD?
A
  • Dyspnea
  • Chronic Cough
  • Chronic Sputum production (Chronic Bronchitis pt)
  • History of exposure to risk factors
92
Q
  1. What are the stages of COPD?
A

Stage I: Mild (pt doesn’t notice symptoms)
Stage II: Moderate (SOB w/exertion) pt usually seek medical attention at this stage
Stage III: Severe (Quality of life impacted)
Stage IV: Very Severe (Quality of life very impaired and could be life threatening)

93
Q
  1. In Chronic Bronchitis:
  2. The bronchial glands are enlarged.
  3. The bronchial walls are narrowed because of vasoconstriction.
  4. The number of cilia lining the tracheobronchial tree is increased.
A
  1. The bronchial glands are enlarged.
94
Q
  1. Which of the following bacteria are commonly found in the tracheobronchial tree of patients with chronic bronchitis?
  2. Haemophilus influenza and Streptococcus pneumonia
  3. Staphylococcus and Klebsiella
A
  1. Haemophilus influenza and Streptococcus pneumonia
95
Q
  1. In Chronic Bronchitis, the patient commonly demonstrates which of the following?
  2. Increased FVC
  3. Decreased FEV1 and FEV1/FVC ratio.
  4. Increase VC.
A
  1. Decreased FEV1 and FEV1/FVC ratio.
96
Q
  1. The patient with severe chronic bronchitis (late stage) commonly has which of the following arterial blood gas values?
  2. Normal pH and increased PaCO2.
  3. Decreased HC03.
  4. Increased PaCO2.
  5. Normal
A
  1. Normal pH and increased PaCO2.
97
Q
  1. Patients with severe chronic bronchitis may demonstrate which of the following?
  2. Peripheral edema, distended neck veins, an elevated hemoglobin concentration and an enlarged liver.
  3. Decreased HC03.
  4. Increased PaCO2.
  5. Normal
A
  1. Peripheral edema, distended neck veins, an elevated hemoglobin concentration and an enlarged liver.
98
Q
  1. What type of emphysema creates an abnormal enlargement of all structures distal to the terminal bronchioles?
  2. Panlobular emphysema.
  3. ZZ phenotype emphysema.
  4. Centrilobular emphysema.
A
  1. Panlobular emphysema.
99
Q
  1. What is the normal range of Alpha1- antitrypsin?
  2. 0-150 mg/dL
  3. 150-350 mg/dL
  4. 350-340 mg/dL
A
  1. 150-350 mg/dL
100
Q
  1. Patients with severe emphysema commonly 100. demonstrate which of the following oxygenation indices?
  2. Increased SvO2 and DO2 as well as decreased O2ER.
  3. Decreased SvO2 and DO2 as well as increased O2ER.
A
  1. Decreased SvO2 and DO2 as well as increased O2ER.
101
Q
  1. Which phenotype is associated with the lowest serum concentration of Aplha 1-antitrypsin?
  2. Phenotype ZZ.
  3. Phenotype MM.
  4. Phenotype M.
  5. Phenotype MZ.
A
  1. Phenotype ZZ.
102
Q
  1. Which of the following pulmonary function study findings are associated with severe emphysema?
  2. Decreased FRC and RV and increased PEFR and FVC.
  3. Increased FRC and RV and decreased PEFR and FVC.
A
  1. Increased FRC and RV and decreased PEFR and FVC.
103
Q
  1. The patient with severe COPD commonly demonstrates which of the following hemodynamic indices?
  2. Decreased CVP
  3. Increased PA and PVR.
A
  1. Increased PA and PVR.
104
Q
  1. Because acute ventilatory changes are often seen in patients with chronic ventilatory failure (compensated respiratory acidosis), the respiratory therapist must be alert for this problem in patients with severe COPD. Which of the following arterial blood gas values represent(s) acute alveolar hyperventilation superimposed on chronic ventilatory failure?
  2. Increased PaO2
  3. Increased pH, PaCO2 and HCO3.
A
  1. Increased pH, PaCO2 and HCO3.
105
Q
  1. The lung parenchyma in the chest radiograph of a patient with emphysema appears:
  2. Opaque
  3. White
  4. More translucent then normal as well as dark.
A
  1. More translucent then normal as well as dark.
106
Q

What is the single most common etiologic factor in emphysema?

  1. Cigarette smoking.
  2. Drugs
A
  1. Cigarette smoking.

Pharmo Drugs Kim (23 decks)

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