Clinical Obstructive Lung Disease: COPD/Asthma/CF Flashcards
What are two major causes of obstructive airway disease?
Intrinsic airway narrowing (bronchospasm, edema, inflammation, or plugging) and “floppy” airways (decreased radial tethering)
Airway resistance is inversely proportional to the __________.
fourth power of the radius of the airway
Hyperinflation (as found in obstructive lung disease) increases __________ and decreases ___________.
FRC and RV; IRV and TV
A flat diaphragm generates ____________ than a curved diaphragm.
less pressure at the same level of muscle tension
In basic terms, asthma is _____________.
a chronic inflammatory disorder of the airways
Differentiate extrinsic and intrinsic asthma.
Extrinsic asthma is IgE-mediated and caused by allergens, while intrinsic asthma is non-allergic and caused by epithelial injury or altered arachidonic acid metabolites.
Asthma can be aggravated by ______ air.
cold
Which kind of wheezing comes first, in an asthma attack?
Expiratory
Stridor is __________.
inspiratory wheezing
There are four grades of asthma severity. What are they?
(1) Intermittent
(2) Mild persistent
(3) Moderate persistent
(4) Severe persistent
Vocal cord dysfunction is not an _________ process. As such, it is treated with _________.
inflammatory; speech therapy, botox, and anxiolytics
COPD is defined as FEV/FVC
70%
After 50 years of smoking, what percentage of people will have COPD?
20%
Chronic bronchitis is defined as ______________.
a productive cough of at least three months’ duration over the past two years without other cause
In emphysema, compliance increases because ________ decreases.
elastic tissue (which is the cause of alpha-1 anti-trypsin deficiency)
On physical exam, those with chronic bronchitis will often have ________.
cough, rhonchi, and wheezing
On physical exam, those with emphysema will often have _________.
decreased breath sounds on auscultation and hyper-resonance on percussion
Those with emphysema and chronic bronchitis will often have ________ on physical exam.
tripodding, prolonged expiratory phase, and purse-lip breathing
Exacerbations of COPD are treated with ___________.
steroids, antibiotics, and bronchodilators
Unlike asthma, chronic bronchitis has minimal ___________.
reversibility
Resistance = _____________
(8 x n x l) / (pi x r^4)
Those with extreme asthma exacerbations can have ___________.
epithelial desquamation, mucous plugging, smooth-muscle hypertrophy, and inflammatory cell infiltration
What is the clinical criteria for intermittent asthma?
What is the clinical criteria for mild persistent asthma?
> 2x per week - 2 nightly attacks per month
Moderate persistent asthma is characterized by __________.
daily symptoms with greater than one nightly attack per month
Severe persistent asthma is characterized by ___________.
constant limitations of daily activity with frequent nightly symptoms
“Blue bloaters” were historically called _________ and are characterized by ________ breathing.
chronic bronchitis; hypoventilatory
“Pink puffers” were historically called ____________ and are characterized by __________ breathing.
emphysema; hyperventilatory
Histologically, chronic bronchitis typically displays __________.
expanded cartilage layer
Give the GOLD criteria.
All COPD patients have FEV/FVC 80%
2) 50% - 80%
3) 30% - 50%
4)
What are five common mechanisms of death for those with COPD?
- Pulmonary embolism
- RV failure
- Pneumonia
- Spontaneous pneumothorax
- Respiratory failure
Of the obstructive diseases, _________ has the most hyperinflation.
emphysema
Bronchiectasis is ____________.
abnormal dilation of the proximal airways
