Chapter 33: Medical Nutrition Therapy for Pulmonary Disease

Question 1

cilia

Answer 1

“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

Question 2

surfactant

Answer 2

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

Question 3

tachypnea

Answer 3

Rapid breathing

Question 4

dyspnea

Answer 4

Shortness of breath

Question 5

pulmonary function tests

Answer 5

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

Question 6

pulse oximetry

Answer 6

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%

Question 7

spirometry

Answer 7

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

Question 8

cystic fibrosis (CF)

Answer 8

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

Question 9

bronchioectasis

Answer 9

A chronic condition of dilation of the bronchi that develops as a result of recurrent long infections

Question 10

clubbing

Answer 10

Physical sign characterized by bulbous enlargement of the ends of one or more fingers or toes

Question 11

pancreatic insufficiency (PI)

Answer 11

The pancreas fails to make adequate enzymes to digest food in the small intestine, is the most common gastrointestinal complication of CF

Question 12

steatorrhea

Answer 12

Characterized by foul smelling, bulky, oily stools and failure to thrive or poor weight gain

Question 13

cystic fibrosis related diabetes (CFRD)

Answer 13

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

Question 14

kyphosis

Answer 14

An increased curvature of the upper back

Question 15

pancreatic enzyme replacement therapy (PERT)

Answer 15

An important component of the management of CF patients to adequately absorb carbohydrates, protein, and fat

Question 16

pancreatic acinus

Answer 16

The secretory unit of exocrine pancreas, where pancreatic juice is produced

Question 17

acinar destruction

Answer 17

Results in impaired secretion of pancreatic juice, which results in loose, oily, frequent stools and malabsorption

Question 18

elastase

Answer 18

Protein-digesting enzyme secreted by the pancreas and involved in hydrolysis of peptide bonds

Question 19

distal intestinal obstruction syndrome (DIOS)

Answer 19

The blockage of intestines resulting from stool and intussusceptions (obstructions)

Question 20

asthma

Answer 20

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

Question 21

osteopenia

Answer 21

Precursor to osteoporosis. A condition in which there is a lower-than-normal bone mass or bone mineral density

Question 22

chronic obstructive pulmonary disease (COPD)

Answer 22

Refers to a group of diseases that cause airflow blockage and breathing-related problems. It includes emphysema and chronic bronchitis

Question 23

chronic bronchitis

Answer 23

Enflamed bronchi lead to mucus, cough, and difficulty breathing

Question 24

emphysema

Answer 24

A form of long-term lung disease characterized by the destruction of lung parenchyma with lack of elastic recoil

Question 25

hypercapnia

Answer 25

Increased amount of CO2

Question 26

cor pulmonale

Answer 26

Increased blood pressure that leads to enlargement and failure of the right ventricle of the heart

Question 27

leptin

Answer 27

Satiety hormone. Is secreted in response to food intake and plays a role in suppressing appetite and enhancing energy expenditure

Question 28

adiponectin

Answer 28

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

Question 29

resistin

Answer 29

An adipokine. Induces inflammation and insulin resistance

Question 30

ghrelin

Answer 30

Appetite stimulant. Also stimulates growth hormone secretion, with antagonistic effects to leptin

Question 31

resolvin

Answer 31

Resolves or turns off the inflammation in underlying destructive conditions such as inflammatory lung diseases

Question 32

pulmonary cachexia

Answer 32

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

Question 33

pulmonary hypertension (PH)

Answer 33

An elevated pressure within the pulmonary circulation that includes the pulmonary artery, capillaries, and pulmonary veins

Question 34

cyanosis

Answer 34

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

Question 35

interstitial pulmonary fibrosis

Answer 35

Scar tissue in the lungs

Question 36

interstitial lung disease (ILD)

Answer 36

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

Question 37

idiopathic pulmonary fibrosis (IPF)

Answer 37

Most common ILD and is associated with worst prognosis. Typical symptoms are chronic shortness of breath that progresses and nonproductive cough

Question 38

tuberculosis (TB)

Answer 38

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

Question 39

bronchogenic carcinomas

Answer 39

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

Question 40

cancer cachexia syndrome (CCS)

Answer 40

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

Question 41

obesity hypoventilation syndrome (OHS)

Answer 41

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

Question 42

obstructive sleep apnea (OSA)

Answer 42

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

Question 43

hypopnea

Answer 43

Overly shallow breathing

Question 44

continuous positive airway pressure (CPAP)

Answer 44

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

Question 45

pleural effusion

Answer 45

Accumulation of the fluid in the pleural space

Question 46

chylothorax

Answer 46

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

Question 47

acute respiratory distress syndrome (ARDS)

Answer 47

A clinical state in which patients develop diffuse pulmonary infiltrates, severe hypoxia, and respiratory failure

Question 48

pneumonia

Answer 48

An inflammatory condition of the lungs that causes chest pain, fever, cough, and dyspnea

Question 49

aspiration pneumonia

Answer 49

When aspiration results in pulmonary infection

Question 50

bronchopulmonary dysplasia (BPD)

Answer 50

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