Chapter 33: Medical Nutrition Therapy for Pulmonary Disease Flashcards
cilia
“Hair-like” structures that move the superficial liquid lining layer from deep within the lungs toward the pharynx to enter the gastrointestinal tract, thereby playing an important role as a lung defense mechanism by clearing bacteria and other foreign bodies
surfactant
Secreted by alveolar cells. A compound synthesized from proteins and phospholipids that maintains the stability of pulmonary tissue by reducing the surface tension of fluids that coat the lung
tachypnea
Rapid breathing
dyspnea
Shortness of breath
pulmonary function tests
Used to diagnose or monitor the status of lung disease; they are designed to measure the ability of the respiratory system to exchange O2 and CO2
pulse oximetry
A pulmonary function test. A small device called a pulse oximeter, which uses light waves to measure the O2 saturation of arterial blood, is placed on the end of the finger. Normal for a young, healthy person is 95% to 99%
spirometry
A common pulmonary function test. This involves breathing into a spirometer that gives information on lung volume and the rate at which air can be inhaled or exhaled
cystic fibrosis (CF)
A life-threatening autosomal recessive inherited disorder. CF is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) protein, a complex chloride channel and regulatory protein found in all exocrine tissue. Most of the clinical manifestations are related to the thick, viscous secretions. Lung disease and malnutrition are predominant consequences of the disease
bronchioectasis
A chronic condition of dilation of the bronchi that develops as a result of recurrent long infections
clubbing
Physical sign characterized by bulbous enlargement of the ends of one or more fingers or toes
pancreatic insufficiency (PI)
The pancreas fails to make adequate enzymes to digest food in the small intestine, is the most common gastrointestinal complication of CF
steatorrhea
Characterized by foul smelling, bulky, oily stools and failure to thrive or poor weight gain
cystic fibrosis related diabetes (CFRD)
Most common comorbidity in the CF population. CFRD is associated with poor growth, clinical and nutritional deterioration, and early death. The use of hemoglobin A1C is not recommended for screening because it has low sensitivity in CFRD
kyphosis
An increased curvature of the upper back
pancreatic enzyme replacement therapy (PERT)
An important component of the management of CF patients to adequately absorb carbohydrates, protein, and fat
pancreatic acinus
The secretory unit of exocrine pancreas, where pancreatic juice is produced
acinar destruction
Results in impaired secretion of pancreatic juice, which results in loose, oily, frequent stools and malabsorption
elastase
Protein-digesting enzyme secreted by the pancreas and involved in hydrolysis of peptide bonds
distal intestinal obstruction syndrome (DIOS)
The blockage of intestines resulting from stool and intussusceptions (obstructions)
asthma
A chronic disorder that affects the airways and is characterized by bronchial hyper-reactivity, reversible airflow obstruction, and airway remodeling. Asthmatic symptoms include periodic episodes of chest tightness, breathlessness, and wheezing
osteopenia
Precursor to osteoporosis. A condition in which there is a lower-than-normal bone mass or bone mineral density
chronic obstructive pulmonary disease (COPD)
Refers to a group of diseases that cause airflow blockage and breathing-related problems. It includes emphysema and chronic bronchitis
chronic bronchitis
Enflamed bronchi lead to mucus, cough, and difficulty breathing
emphysema
A form of long-term lung disease characterized by the destruction of lung parenchyma with lack of elastic recoil
hypercapnia
Increased amount of CO2
cor pulmonale
Increased blood pressure that leads to enlargement and failure of the right ventricle of the heart
leptin
Satiety hormone. Is secreted in response to food intake and plays a role in suppressing appetite and enhancing energy expenditure
adiponectin
A protein involved in fatty acid breakdown and glucose regulation. Secreted from adipocytes. Enhances appetite and has an antiinflammatory, antidiabetic, and antiatherosclerotic effect and is considered beneficial
resistin
An adipokine. Induces inflammation and insulin resistance
ghrelin
Appetite stimulant. Also stimulates growth hormone secretion, with antagonistic effects to leptin
resolvin
Resolves or turns off the inflammation in underlying destructive conditions such as inflammatory lung diseases
pulmonary cachexia
Defined as a BMI of less than 17 in men and less than 14 in women. Patients with advanced COPD are undernourished and in a state of pulmonary cachexia
pulmonary hypertension (PH)
An elevated pressure within the pulmonary circulation that includes the pulmonary artery, capillaries, and pulmonary veins
cyanosis
Occurs when hemoglobin is inadequately saturated with oxygen, and it is characterized by a bluish discoloration of the skin, nails, lips, or around the eyes
interstitial pulmonary fibrosis
Scar tissue in the lungs
interstitial lung disease (ILD)
AKA diffuse parenchymal lung disease (DPLD). Comprises a long list of diseases and can be primary or secondary due to other systemic disorders or medications. Patients typically complain of chronic shortness of breath, nonproductive cough, and fatigue
idiopathic pulmonary fibrosis (IPF)
Most common ILD and is associated with worst prognosis. Typical symptoms are chronic shortness of breath that progresses and nonproductive cough
tuberculosis (TB)
Caused by mycobacterium tuberculosis an intracellular bacterial parasite, has a slow rate of growth, is an obligate aerobe, and induces a granulomatous response in the tissues of a normal host
bronchogenic carcinomas
Comprises squamous cell carcinoma, adenocarcinoma, small cell undifferentiated carcinoma, and large cell undifferentiated carcinoma and account fo 90% of all the neoplasms of the lower respiratory tract
cancer cachexia syndrome (CCS)
The presence of a metabolic state that leads to energy and muscle store depletion in lung cancer patients. When patients experience CCS, they lose adipose and skeletal muscle mass
obesity hypoventilation syndrome (OHS)
Defined as a BMI of more than 30 kg/m2 and alveolar hypoventilation defined by arterial CO2 level of more than 45 mm Hg during wakefulness, which occurs in the absence of other conditions that cause hypoventilation
obstructive sleep apnea (OSA)
A common chronic disorder, which is characterized by loud snoring, excessive daytime sleepiness, and witnessed breathing interruptions or awakenings because of gasping or choking. OSA is graded as mild, moderate, or severe
hypopnea
Overly shallow breathing
continuous positive airway pressure (CPAP)
A machine used to treat patients with OSA. Includes a mask worn over the nose, or nose and mouth that provides oxygen under pressure to aid in breathing
pleural effusion
Accumulation of the fluid in the pleural space
chylothorax
A rare cause of pleural effusion. Caused by the disruption or obstruction of the thoracic duct, which results in the leakage of chyle into the pleural space
acute respiratory distress syndrome (ARDS)
A clinical state in which patients develop diffuse pulmonary infiltrates, severe hypoxia, and respiratory failure
pneumonia
An inflammatory condition of the lungs that causes chest pain, fever, cough, and dyspnea
aspiration pneumonia
When aspiration results in pulmonary infection
bronchopulmonary dysplasia (BPD)
Chronic lung disease most commonly seen in premature infants who require mechanical ventilation and oxygen therapy for acute respiratory distress. BPD is a lung development disorder characterized by impairment of alveolarization. This leads to pulmonary and vascular hypoplasia with less interstitial cellularity and fibrosis
