Clinical Approach to Pulmonary Diseases Flashcards

1
Q

What are the 3 categories of pulmonary causes of dyspnea?

A
  • Obstruction
  • Restriction
  • Pulmonary HTN
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2
Q

What are the main obstructive lung diseases?

A

Asthma
COPD
Bronchiectasis

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3
Q

What are the main restrictive lung diseases?

A

Interstitial Lung Disease
Chest Wall
Neuromuscular

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4
Q

What are the signs and symptoms of obstructive lung diseases?

A

SOB, DOE, Cough, Tightness, Poor Air Movement, Wheezing and Hyperinflation in CXR

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5
Q

Is asthma a reversible disease?

A

Yes

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6
Q

What are the relievers of asthma and how are they used?

A

Bronchodilators

All asthmatics get a puffer - inhaler as a beta agonist that should be used as needed

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7
Q

What are the controllers of asthma and how are they used?

A

Controllers

They are anti-inflammatory medications that must be regularly used

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8
Q

What are first line controllers?

A

Corticosteroids

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9
Q

What are the second line controllers?

A

Long Acting beta􏰄-Agonists

􏰀Anti-Leukotrienes

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10
Q

What are some SE of inhaled corticosteroids?

A

Can cause inflammation or infection in the throat - this can be managed with teeth brushing after use or a spacer that only allows small particles through

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11
Q

What are SE of long acting beta agonists?

A

Long acting beta agonists on their own will increase

the risk of dying

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12
Q

What is the 2nd most common cause of chronic cough?

A

Cough Variant of Asthma

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13
Q

How does exercise induced asthma occur?

A
  • Increased minute ventilation results in mucosal ‘dehydration’ and mast cell degranulation
  • Worse in cold, dry air
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14
Q

What is occupational asthma?

A

Due to inhalational trigger in work environment

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15
Q

What is reactive airway dysfunction syndrome?

A

Reactive Airway Dysfunction Syndrome - patient
who was normal until one day in their life when
there asthma is triggered and they will have asthma
everyday since that exposure

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16
Q

What is Samter’s Triad and what does it relate to?

A
  • Asthma
  • Nasal Polyposis
  • ASA Sensitivity

It relates to aspirin induced asthma

17
Q

What is ABPA?

A

Allergic Bronchopulmonary Aspergillosis - hyperreactivity to aspergillus via IgE - treated with steroids

18
Q

What are the 2 main classifications of COPD and what are their symptoms?

A

􏰀- Emphysema: Permanent distention of the distal air spaces with destruction of alveolar septa
-􏰀 Chronic Bronchitis: Excessive sputum production

19
Q

What are the characteristics of emphysema?

A
Pink Puffer
􏰀- Maintains a normal pCO2
􏰀 ‘Huffs and Puffs’
􏰀 ‘Burns calories’
􏰀- Therefore, maintains a normal pO2
􏰀- Appears ‘pink’
20
Q

What are the characteristics of chronic bronchitis?

A
Blue Bloater
􏰀- “Accepts” Hypercapnea
􏰀- Less tachypneic
􏰀 Doesn’t burn calories
􏰀 Results in Hypoxia (Cyanosis)
􏰀 Hypoxic Pulmonary
- Vasoconstriction 􏰀 Edematous
􏰀 Lots of Mucous
21
Q

What are some of the medications for COPD?

A
  1. Anti-cholinergics (ipratropium)

2. 􏰄Beta-agonists (albuterol,pirbuerol,levalbuterol)

22
Q

What is the recommendation for O2 use?

A

O2 proved to be beneficial for most COPD patient groups

23
Q

What is bronchiectasis?

A

A suppurative lung disease characterized by permanent abnormal dilation of the bronchi

24
Q

What is a major characteristic of bronchiecctasis?

A

Daily copious sputum production

25
Q

“Signet Ring Sign”

A

The internal diameter of the bronchus is larger than that of its accompanying vessel

26
Q

􏰀 “Tram Tracking”

A

The bronchus fails to taper in the periphery of the chest.

27
Q

What is the cycle of bronchiectasis?

A

It is the cycle of mucus stasis, infection, inflammation, and airway destruction

28
Q

What is the main cause of restrictive lung diseases?

A

Interstitial Lung Diseases

29
Q

Interstitial Lung Disease

A

Chronic, non-malignant, non-infectious inflammation and/or derangement of the alveolar walls - increased elastic recoil

30
Q

What are some examples of interstitial lung diseases?

A
􏰀Sarcoid
􏰀Hypersensitivity Pneumonitis
􏰀Idiopathic Pulmonary Fibrosis/ “IIP’s” 􏰀 
Tuberculosis
Fungal
Aspiration / Asbestosis
􏰀Connective Tissue Diseases / (Cancer)
􏰀Eosinophilic Granuloma 􏰀 
Drugs - Amiodarone,Nitrofurantoin, Bleomycin
31
Q

What are the signs of ILD?

A
  • Reduced TLC

- 􏰀 “Interstitial Markings”

32
Q

What is sarcoid?

A

􏰀Non-Specific Tissue Reaction 􏰀

Non-Caseating Granulomata

33
Q

Who is the typical patient of sarcoid?

A

Young African American Female

34
Q

Who is the typical patient of idiopathic pulmonary fibrosis?

A

Middle Aged/Elderly Male

35
Q

What are some symptoms of IPF?

A

􏰀 Insidious DOE

􏰀 Cough

36
Q

What are the treatments for IPF now?

A
  • Previously there were no known treatments

- Now use:􏰀 Pirfenidone and Nintedanib