Chronic Obstructive Pulmonary Disease Flashcards

1
Q

Define bronchitis

A

Inflammation of large airways

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2
Q

What is the difference between asthma and bronchitis?

A

Asthma affects the small airways while bronchitis inflames the large airways

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3
Q

What are some causes of bronchitis?

A

Air pollution, Allergies, Occupational hazards

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4
Q

What are some symptoms of bronchitis?

A
Cough
Mucus production
Shortness of breath
Wheezing
Cyanosis in severe cases
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5
Q

What are some treatment options for bronchitis?

A

Short-term steroid therapy
Bronchodilators
Hydration
Antibiotics

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6
Q

Emphysema is associated with inhalation or exhalation?

A

Emphysema is the impaired ability to exhale

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7
Q

What is the most common cause of emphysema?

A

Smoking

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8
Q

Emphysema effects what part of the airways?

A

Terminal

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9
Q

What are some of the treatment options for emphysema?

A
Short-acting bronchodilators
Long-acting anti-cholinergic bronchodilators
Inhaled corticosteroids
Oral steroids
Antibiotics
Oxygen in endstage
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10
Q

What type of lung infection is associated with swelling and mucus buildup in the bronchioles due to a viral infection and is commonly seen in children under two years of age?

A

Bronchiolitis

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11
Q

What are some of the symptoms of bronchiolitis?

A

Shortness of breath
Cough
Wheezing

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12
Q

What are some treatment options for bronchiolitis?

A
Antibiotics
Hydration
Chest physical therapy
Steroid therapy
Bronchodilators
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13
Q

Bronchiolitis infects primarily the larger or smaller airways?

A

Larger

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14
Q

What is bronchiectasis?

A

Loss of airway wall integrity

–Destruction and widening of large airways

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15
Q

What is a common cause of bronchiectasis

A

Cystic fibrosis causes about half of the cases

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16
Q

What are some symptoms of bronchiectasis?

A
Shortness of breath
Cyanosis
Halitosis (bad breath)
Chronic cough with sputum
Finger clubbing
17
Q

What are some of the treatment options for bronchiectasis?

A

Hydration
Antibiotics
Antiviral drugs
Humidified oxygen and IV fluids

18
Q

Which disease has the nickname “pink puffer?”

A

Pulmonary emphysema

Think about taking a puff from a cigarette

19
Q

Which pulmonary disease has the nickname “blue bloater?”

A

Chronic bronchitis

20
Q

Which divisions of the airway are conducting and which are responsible for gas exchange?

A

1-16: conducting

17-23: gas exchange

21
Q

What type of cell produces surfactant?

A

Type II alveolar cell

22
Q

What are the six risk factors that predispose patients to post operative pulmonary dysfunction?

A
  1. Pre-existing pulmonary disease***
  2. Thoracic or upper abdominal surgery
  3. Smoking (major factor for developing COPD)
  4. Obesity
  5. Age > 60
  6. Prolonged general anesthesia
23
Q

How will a pulmonary function test differ in a normal patient versus one with chronic constructive pulmonary disease?

A

COPD patient will have:

decreased ERV
Increased FRC and RV
Increased TLC

24
Q

Bronchospasm effects inspiration or expiration?

A

Inspiration

Remember the “shark fin” capnogram

25
FEV/FVC <____% = COPD
70
26
When there is an increased difficulty on expiration because of the airflow resistance what happens in COPD patients?
Increased air trapping | --RV and TLC increase
27
How long before surgery should the patient discontinue smoking?
They shouldn't have started But since they did 6-8 weeks
28
What effect does cigarette smoking have on mucus production and clearance?
Increases mucus production and decreases clearance
29
What are some important factors to assess preoperatively?
SpO2 on room air Listen to breath sounds History Medications
30
What is an important factor to be mindful of before extubating a patient with COPD?
Full reversal from NMBs
31
What type of ventilation will optimize lung function in COPD patients?
Controlled mechanical ventilation -May not tolerate spontaneous ventilation without assistance
32
What type of respiratory rate is most efficient for COPD patients?
Slow respiratory rate provide sufficient time for complete exhalation
33
Make sure you look at pictures of the flow volume loops
Obstructive lung diseases will be more to the left and restrictive's will be to the right
34
What type of extubation may be beneficial for a patient with a reactive airway?
Deep
35
Patients with emphysema would best tolerate what type of extubation?
Awake
36
Why is it important to keep COPD patients close to their normal limits with ventilation?
Parameters outside their norm may decrease ventilatory drive