Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory- Cecil > Chapter 17- Obstructive Lung Disease > Flashcards

Chapter 17- Obstructive Lung Disease Flashcards

1
Q

What are the clinical features of COPD?

A

Chronic progressive dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the laboratory findings of COPD?

A

Decreased expiratory flow rates, hypoxia and hypercapnia in end-stage disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the clinical features of emphysema?

A

Little or no sputum, end stage cachexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the laboratory findings of emphysema?

A

Hyperinflation, increased compliance, low DLCO, rarely alpha1-antitrypsin deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the clinical features of chronic bronchitis?

A

Sputum, history of smoking, industrial exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the laboratory findings of chronic bronchitis?

A

Nonspecific- rarely occurs in isolation without varying degree of emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the clinical features of asthma?

A

Episodic dyspnea, cough, wheezing, with or without environmental triggers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the laboratory findings of asthma?

A

Airway hyperreactivity, response to bronchodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the clinical features of bronchiectasis?

A

Usually large volume of sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the laboratory findings of bronchiectasis?

A

Chest radiograph; dilated bronchi, thick walled, tram track shadows, obstruction with or without restriction on pulmonary function tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the clinical features of immotile cilia syndrome?

A

Situs inversus, dextrocardia, sinusitis, infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the laboratory findings of immotile cilia syndrome?

A

Abnormal dynein in ciliated cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the laboratory findings with hypogammaglobulinemia?

A

Decrease in one or more immunoglobulins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the clinical features of cystic fibrosis?

A

Sinusitis, bronchiectasis, meconium ileus, malabsorption, infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the laboratory findings in cystic fibrosis?

A

Increased sweat chloride, mutation in CFTR chloride channel, elevated fecal fat, abnormal nasal mucosal potentail difference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the three obstructive lung disorders that can make up COPD?

A

Chronic bronchitis
Emphysema
Chronic broncholitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the algorithm for emergency department treatment of acute bronchospasm? What should you do if there is an inadequate response to this treatment?

A

Oxygen, inhaled B2 agonist, consider inhaled anticholinergic and oral or IV corticosteroids

If inadequate response- inhaled anticholinergics if not given already. If bronchospams persists admit to hopsital. If respiratory failure consider aminophylline, Heliox (hellium=oxygen), IV magnesium, endotracheal intubation and mechanical ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the algorithm for emergency department treatment of acute bronchospasm? What should you do if there is a good response to this treatment?

A

Oxygen, inhaled B2 agonist, consider inhaled anticholinergic and oral or IV corticosteroids

Good response- discharge on inhaled B2 agonist +/- inhaled anticholinergic, corticosteroids x 5 days, arrange outpatient follow-up within 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the algorithm for outpatient treatment of the chronic/stable bronchospasm in asthma?

A

Inhaled PRN short acting B2-Agonist
If continued sx add ICS
If continued sx increase dose of ICS add long-acting b2-agonist
If continued sx add leukotriene antagonist
if sx continued add oral corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the algorithm for outpatient treatment of the chronic/stable bronchospasm in COPD?

A

Inhaled short acting b2-agonist and inhaled anticholinergic
If continued sx add trial of ICS
If continued sx add oral abx if chronic bronchitis is predominent component, and consider trial of theophylline
If continued sx trial of oral corticosteroids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the organ systems involved in cystic fibrosis?

A

Pulmonary
Pancrease
Genitourinary
Gastrointestinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the pulmonary involvement in cystic fibrosis?

A 
Cough and sputum production
Recurrent pneumonias
Bronchial hyperreactivity
Hemoptysis
Pneumothorax
Significant digital clubbing
Cor pulmonale
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the upper respiratory tract involvement in cystic fibrosis?

A

Nasal polyps

Chronic sinusitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the gastrointestinal involvement in cystic fibrosis?

A 
Meconium ileus in the neonate
Distal intestinal obstruction
Rectal prolapse
Hernias
Exocrine pancreatic dysfunction causing steatorrhea, malnutrition, and vitamin deficiency
Acute pancreatitis (rare)
Diabetes mellitus
Cirrhosis and portal HTN
Salivary gland inflammation
Cholelithiasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the genitourinary involvement in cystic fibrosis?

A

Azoospermia
Decreased fertility rate in women
Nephrolithiasis

26
Q

What are the diagnostic studies used in asthma?

A 
Routine pulmonary function test 
Special pulmonary function test
Methacholine or cold-air challenge
Challenge with specific agents: occupational, drugs
Chest radiograph
Skin tests
Blood tests
27
Q

What does routine pulmonary function test result in asthma?

A

Decreased FEV1; hyperinflation; improvement with bronchodilator

28
Q

What does the methacholine challenge or cold-air challenge result in asthma?

A

Indicates the presence of nonspecific bronchial hyperreactivity; bronchoconstriction occurs at lower doses in asthma

29
Q

When is the challenge with specific agents: occupational and drugs done for asthma?

A

Occasionally performed

30
Q

What does the chest radiograph result in asthma?

A

Fleeting infiltrates and central bronchiectasis in ABPA (allergic bronchopulmonary aspergillosis)

31
Q

What do skin tests result in asthma?

A

Demonstrate atopy; little value except prick test to Aspergillus fumigatus positive in ABPA (allergic bronchopulmonary aspergillosis)

32
Q

What do blood tests result in asthma?

A

Eosinophils and IgE are usually increased in atopy; levels may be very high in ABPA (allergic bronchopulmonary aspergillosis); Aspergillus preciptins increased in many but not all patients with ABPA

33
Q

Slowly progressive dyspnea characterized by abnormalities of airway and lung structure occuring in response to noxious inhaled substances

A

COPD

34
Q

What is the hallmark of COPD?

A

irreversible airflow inflammation

35
Q

Is there a genetic component to COPD?

A

Yes, less than 1% of COPD cases are linked to alpha-antitrypsin deficiency, a genetic disorder

36
Q

Permanent enlargement of the air spaces distal to the terminal bronchiole due to destruction of lung parenchyma in the absence of significant fibrosis

A

Emphysema

37
Q

Persistent cough resulting in sputum production for more than 3 months in each of the past 2 years

A

Chronic Bronchitis

38
Q

Is chronic bronchitis a disease of small or large airways?

A

Large airways and not lung parenchyma

39
Q

Slow progressive dyspnea first noted during exertion that progresses over years until it is evident at rest. Exercise intolerance and fatigue, weight loss, depression, anxiety, chronic cough

A

small airways disease

40
Q

What are the late stages of small airways disease?

A

Skeletal muscle wasting, accessory muscle use, pursed-lip breathing, weight loss, flattened diaphragm, TV decreases while RR increases

41
Q

What are PE findings of small airways disease?

A

hyperresonant to percussion, diminished breath sounds with rhonchi, wheezes, or faint crackles, barrel chest

42
Q

Caused by a virus that is common in infants during winter. Caused typically by RSV. Typical symptoms are wheezing and dyspnea that resolve without treatment

A

Acute bronchiolitis

43
Q

Common in Japan. Cough with purulent sputum, sinusitis, dyspnea

A

Diffuse panbronchiolitis

44
Q

Seen with connective tissue disease. Azithromycin increases FEV1

A

Bronchiolitis obliterans

45
Q

Abnormal dilation of the bronchi resulting from inflammation and permanent destructive changes in the elastic and muscular layers of the bronchial walls. Frequent in middle aged to older

A

Bronchiectasis

46
Q

Is Bronchiectasis localized or diffuse?

A

both

47
Q

S/S of bronchiectasis

A

chronic cough, FOUL SMELLING SPUTUM, SOB, abnormal chest sounds, fatigue

Can see blood streaked sputum or clubbing

48
Q

What is the classic finding of bronchiectasis on radiograph?

A

tram tracks (parallel lines in peripheral lung fields)_

49
Q

How should you treat bronchiectasis?

A 
Treat underlying problem
Bacteria: broad spectrum ABX
Allergic: corticosteroids
Bronchodilators for symptoms
Hemoptysis: angiography with embolization
50
Q

An autosomal recessive disorder that affects lungs, pancreas, reproductive organs

A

Cystic Fibrosis

51
Q

What is the most common lethal genetic disorder in white population?

A

Cystic Fibrosis

52
Q

What is the mutation in for CF?

A

gene that encodes for CFTR

53
Q

What are the common symptoms of CF in infants?

A

Meconium ileus or FTT with steatorrhea

Salty tasting skin

54
Q

Symptoms of CF

A

chronic cough with thick sputum, wheezing, dyspnea, pancreatic insufficiency, diabetes, azoospermia, nasal polyps, clubbing

55
Q

What does PFT show with CF?

A

hyperinflation, bronchial wall thickening, bronchiectasis

56
Q

How do you diagnose CF?

A

sweat test and genotyping

57
Q

What is the treatment of CF?

A

aggressive airway hygiene, nutritional support, ABX, bronchodilators, inhaled hypertonic saline, TOBI, anti-inflammatory agents

58
Q

Characterized by airway inflammation, hyper-reactivity, reversible airflow obstruction

A

Asthma

59
Q

What is the asthma triad?

A

wheezing, chronic episodic dyspnea, chronic cough

60
Q

What is included in the evaluation of asthma?

A

Bronchoprovocation challenge
Blood tests that may reveal eosinophilia and increased IgE levels
Documentation of hyperactivity and reversible airway obstruction to flow

Respiratory- Cecil (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions