Chronic Lung Disease Flashcards
what is bronchial asthma
chronic inflammation of airway - bronchial constriction
allergy c airway hyperrresponsiveness
reversible limiation
usual characteristics of asthma
wheezing
breathlessness
chest tightness
inc mucus - cold go to chest
coughing
relief p bronchodilator
discuss inflammatory response in asthma
response from interleukins and eosinophils to allergens
causes vasoconstriction and airway hyper responsiveness
beta agonists like salbutamol - combats this
usual triggers of asthma
allergens
respi infections
exercise and hyperventilation
sulfur dioxide
stress and emotions
cigarette
food, additives, drugs, chemical
common allergens of asthma
dust and mites
cockroach
fur, saliva, urine
mold
pollen
chemical irritants and scented products
risk factors of asthma
host - strongly genetic
environmental factors
discuss the process of asthma
from allergens mag bronchoconstrict tapos inc mucus kasi hyperactive
dyspnea or hypoxic na d/t dec airflow
kaya may wheeze or breathlessness
dx of asthma
clinical dx
hx and pattern
PE
lung function
airway response
allergic status
acute ssx of asthma
dyspnea
wheezing to absent
alar flaring
interrupted talking
agitation
chronic or recurring cough
goals of PT in asthma
minimal or no chronic sx
minimal exacerbation
no emergency visits
minimal use of beta 2 agonist
no limit on activity
< 20% circadian variation
normal PEF
min adverse effects of medicine
what lung function is measured in asthma
PEF
what are the meds for asthma
long-term: regularly control chronic attacks; inhalers and tablets
quick relief: rapid short term during attack; inhalers
allergy control: dec sensitivity to allergens
reliever: short acting
controllers: long acting
primary cause of COPD
cigarette smoking
what is COPD
irreversible airflow limitation and structural changes
inflamm response to noxious particles or gases
what are the 2 classes of COPD
emphysema and chronic bronchitis
discuss chronic bronchitis
too much mucus kase hyper active response
cough and sputum for at least 3 mo in 2 consecutive yrs
discuss emphysema
prob c surfactant
destruction and dilation of alveoli - malaki sila so di nag iinflate
ssx of chronic bronchitis
inflamed small airways
swelling
hypertrophy
mucus more in morning
blue bloater - stocky and cyanotic
copious cough na 2 yrs
ssx of emphysema
aleveolar destrcution
airflow narrowing na permanent
pink puffer - thin and emaciated
non-prod cough
hypertrophy of SCM, traps and scalenes
barrel chest
characteristics of a person c COPD
tripod sign and pursed lip
wheezing
prolonged inhalation and easy fatigue
frequent respi infections
cor pulmonale
barrel chest
clubbing
accessory muscles
host factors of COPD
alpha1-antitrypsin deficiency - born preterm
hyperresponsiveness
lung growth
exposure factors of COPD
tobacco smoke
occupational dust and chemicals
infections
socioeconomic status
pathogenesis of COPD
noxious agent + susceptible host = COPD
mag kaka lung inflammation that causes fibrosis so permanent na
inflammation of small airway and parenchymal destruction
RLD = ariflow limitation
usual lung function measured in COPD
FEV1 and FVC
goals of PT in COPD
prevent progression
relieve sx
improve ex tolerance and health
prevent exacerbations and complications
reduce mortality
min side effects of meds
what is restrictive lung disease
reduced lung compliance - more pressure to expand kase stiff
dec TLC, FEV1, FVC
mechanism of disease of RLD
injury to endothelial and epithelial cells
lead to fibrosis = stiff lung
discuss chest wall abnormality
RLD but not primarily lung
from deformities or kyphoscolio
MG, ALS, MS, dystrophy and myopathy
acute primary lung disease
RLD - ARDS
chronic primary lung disease
occupational: asbestos, coal, silicosis
interstitial lung disease and fibrosis
sarcoid, SLE, RA, wegener
radiation or chemo
what are chronic RLD
group of diseases
nag kaka honeycomb lung from fibrosis
poor prog usually
idiopathic pulmonary fibrosis
80% idiopathic and 20% collagen vascular disease
random pattern ng inflamm and fibrosis
severe hypoxemia and cyanosis - vent cant help
M>F and 60 yo
dx of exclusion
pathogenesis of idiopathic pulmonary fibrosis
alveolitis
fibrosis
immune prob
macrophages
clinical pres of idiopathic pulmonary fibrosis
gradual non prod cough
dyspnea and cyanosis
inspi crackles
clubbbing
poor response to PT
bad prog: 2-4 yrs
sarcoidosis
multisystem and unknown cause
non-caseating granuloma
dx of exclusion
benign and self-limiting
salient features of sarcoidosis
B hilar lymphadenopathy
lung and nodules
skin, eye or any tissue
< 40 yo and US blacks
higher in non-smokers
ssx of sarcoidosis
asymptomatic in many
lymphadenopathy, skin and eye lesions
dyspnea, dry cough
low grade fever, fatigue and weight loss
undpredictable and can be progressive or relapsing-remitting
10% have fibrosis
pathogensis of sarcoidosis
CD4 t cells and fibroblasts
non-caseating granulom
schumann bodies
asteroid bodies
hypersensitivity pneumonitis
immune mediated - type 3-4 hypersensitivity
not common in PH
inflamm, occupatoinal and restrictive
presentation of hypersensitivity pneumonitis
acute: 4-6 hrs p exposure
- fever, cough and dyspnea
chronic: cough, dyspnea, hypoxemia and weight loss
causes of hypersensitivity pneumonitis
fungal or bacterial - cheese
animal product - pigeon
chemicals
collagen vascular diases
assoc c interstitial pneumonia
similiar to IPF
favorable prog c tx
causes of collagen vascular disease
scleroderma
polymyositis or dermamyosistis
SLE
RA
ankylosing spondylitis
what is wegener granuloma
necrotizing vasculitis
URT: sinusitis, epistaxis, nasal perforation
LRT: cough, hemoptysis, chest pain
