COPD Flashcards
1
Q
involves airflow limitation due to obstructed airways, which leads to difficulty in exhaling air
A
Chronic Obstructive Pulmonary Disease (COPD)
2
Q
involves reduced lung expansion or decreased lung compliance, leading to restricted lung volumes
and difficulty in fully expanding the lungs during inhalation.
A
Chronic Restrictive Pulmonary Disease (CRPD)
3
Q
former name for COPD
A
Chronic Obstructive Lung Disease (COLD)
4
Q
Leading cause of morbidity and mortality among smokers, 4th leading cause of death in the world
A
COPD
5
Q
Main RF for COPD
A
Tobacco smoking
6
Q
Other RF for COPD
A
Air pollution
Accelerated aging
Infection
Allergies
7
Q
Pathophysiology of COPD
A
Airway inflammation
Increased mucus production
Fibrosis and alveolar wall destruction
Narrowing airway
Resulting in air trapping
8
Q
Cells present in bronchioles
A
Pseudostratified columnar epithelium often ciliated
9
Q
Cell lining in alveoli
A
Simple squamous epithelium
10
Q
FEV1 is
A
the forced expiratory volume in 1 min
11
Q
Clinical indicators for COPD
A
Progressive dyspnea
Recurrent wheezes
Chronic coughing
12
Q
Mild COPD FEV1
A
> 80%
13
Q
Moderate COPD FEV1
A
50% < 80%
14
Q
Severe COPD FEV1
A
30% < 50%
15
Q
Very Severe COPD FEV1
A
< 30%
16
Q
Breathlessness only on strenuous exercise
A
mMRC Grade 0
17
Q
Breathless when hurrying on the level or walking up a slight hill
A
mMRC Grade 1
18
Q
Walks slower than other people of same age on the level due to shortness of breath or
need to stop for breath when walking at own pace
A
mMRC Grade 2
19
Q
Short of breath after walking few minutes on the level or about 100 yards (90m)
A
mMRC Grade 3
20
Q
Too breathless to leave the house, or breathless when dressing or undressing
A
mMRC Grade 4
21
Q
COPD conditions
A
Bronchitis
Emphysema
Bronchiectasis
Asthma
Cystic Fibrosis
Pneumonia
PTB
22
Q
Area affected in bronchitis
A
Membrane lining the bronchial tubes
23
Q
Area affected in Bronchiectasis
A
Bronchia tubes
24
Q
Area affected in Pneumonia
A
Alveoli
25
Area affected in Emphysema
Air spaces beyond terminal bronchioles
26
Area affected in Asthma
Bronchioles
27
Area affected in Cystic Fibrosis
Bronchioles
28
Inflammation of the tracheobronchial tree
Acute bronchitis
29
Characteristics of acute bronchitis
Self-limiting
Short-duration
30
Chemical irritations that may cause acute bronchitis
Influenza
Chicken pox
Measles
Whooping cough
31
Clinical S/Sx of Acute bronchitis
Mild fever (1-3 days)
Malaise
Back and muscle pain
Cough c sputum
Sore throat
32
Difference of Bacterial and Viral sore throat
Bacterial - presence of pus
Viral - irritation, redness, swelling
33
Criteria for chronic bronchitis
Coughing for at least 3 months per year for 2 consecutive years
34
Cause of chronic bornchitis
Prolonged exposure to non-specific bronchial irritants
35
m/c cause of chronic bronchitis
Cigarette smoking
36
What happens to the bronchi in chronic bronchitis?
Hypertrophy of mucus-producing cells
37
Pathophysiology of Chronic bronchitis
Inflammation of bronchial lining
Hypertrophy of bronchial walls
Mucus hypersecretion
38
Clinical S/Sx of Chronic bronchitis
Persistent cough c sputum
Reduced chest expansion
Wheezing
Fever
Dyspnea
Cyanosis
39
Progressive and chronic pulmonary disease occurring after infections such as pneumonia, measles,
pertussis, TB or cystic fibrosis
Bronchiectasis
40
Bronchiectasis is characterized by
Abnormal and permanent dilatation of medium-sized bronchi
41
Primary prevention for bronchiectasis
Smoking cessation
42
Pathophysiology of bronchiectasis
Infection leads to inflammation
Destruction of bronchial walls caused by bronchial dilatation and impaired mucociliary drainage
Resulting in pulmonary HTN and R-side heart failure
43
S/Sx of Bronchiectasis
Hemoptysis
Dyspnea
Anemia
Malaise
Fatigue
44
Obstructed air passages due to alveolar wall destruction from a long
history of chronic bronchitis
Emphysema
45
Pathophysiology of Emphysema
Permanent overdistention of the air spaces and loss of normal elastic recoil tension in the lung tissue
46
Difference between Bronchiectasis and Emphysema
Bronchiectasis - affects bronchi
Emphysema - Affects the bronchioles
47
m/c type of emphysema affecting the upper lung regions
Centrilobular Emphysema
48
A type of emphysema where alveolar sacs remain intact
Centrilobular Emphysema
49
A type of emphysema that destroys more distal alveolar walls and commonly involves the lower lung fields
Panlobular
50
Cause of Panlobular Emphysema
May occur secondary to infection of exposure to the irritants
51
Characteristics of an emphysematous patient
Thin and tachypneic
Increased respiratory effort
Leaning forward with knees for support
Barrel-chested
52
S/Sx of Emphysema
Dyspnea
Chronic cough
Barrel chest
Wt. loss
Malaise
53
Blue bloaters S/Sx (Chronic Bronchitis)
Chronic productive cough
Purulent sputum
Hemoptysis
Cyanosis
Cor Pulmonale
Obese
54
Pink Puffer S/Sx (Emphysema)
Dyspnea
Minimal cough
Increased minute ventilation
Cachexia
Tachypnea
Barrel chest
55
Autosomal recessive disorder that affects the excretory glands of the body
Cystic Fibrosis
56
Gene found in Cystic Fibrosis
CFTR in Gene 7 (long arm)
57
Test for Cystic Fibrosis
Chloride sweat test
58
(+) sign of Chloride Sweat Test
Chloride ion concentration of > 60 mEq/L
59
Pathophysiology of Cystic Fibrosis
Defective CFTR results in defective transport of sodium, potassium, and water
Partial or complete obstruction of the lumen
V/P mismatch
Fibrotic changes in lung parenchyma
60
Life span of people with Cystic Fibrosis
Rarely survive beyond 30 yrs old
61
Early S/Sx of Cystic Fibrosis
Recurrent pneumonia
Excessive appetite but poor wt. gain
Salty skin
Bulky, foul-smelling stool
62
Pulmonary S/Sx of Cystic Fibrosis
Tachypnea
Barrel-chest
Cyanosis and digital clubbing
Sustained chronic cough with mucus
63
Complications of Asthma
Pneumothorax
Hemoptysis
R-side HF 2 to Pulmonary HTN
64
Asthma is a heteroenous disease characterized by
Airway hyperresponsiveness
Chronic airway inflammation
Expiratory airflow limitation
65
Most easily recognizable phenotype of asthma. It is associated with a personal or familial Hx of atopy
Allergic Asthma
66
A phenotype of asthma that responds well to inhaled corticosteroids
Allergic asthma
67
A phenotype of asthma that shows neutrophilic or paucinogranulocytic airway inflammation.
Non-allergic asthma
68
A type of asthma that is less responsive to inhaled corticosteroids
Non-allergic asthma
69
A type of asthma common in women presenting with symptoms in adulthood
Adult-onset/late-onset asthma
70
A type of asthma that requires higher doses of inhaled corticosteroids
Adult-onset/late-onset asthma
71
Seen inpatients with long-standing asthma who develop fixed airflow limitation due to
airway wall remodeling
Asthma with persistent airflow limitation
72
Seen in obese patients with asthma who present with little eosinophilic inflammation
but with prominent respiratory symptoms
Asthma with obesity
73
Genetic predisposition characterized by heightened reactivity to allergens
Atopy
74
Common manifestations of Atopy
Allergic Rhinitis
Atopic dermatitis
Asthma
75
Pathophysiology of asthma
Inflammation of the airway due to airway hyperresponsiveness upon exposure to allergens/triggers/stimuli
Bronchoconstriction
Hypertrophy
and hyperplasia of airway smooth muscle
76
Clinical S/Sx of Asthma
Wheezing
Cough
Dyspnea
77
Severe life-threatening complication of asthma
Status Asthmaticus
78
Triggers of Asthma
Dust
Stress
Stroke
Insects
Anger
Air pollution
Pets
Colds
Pollen
Tobacco
79
Things to look for in a patient with asthma
Skin retraction
Hunched-over posture
Pursed-lip breathing
Nostrils flaring
Unusual pallor or unexplained sweatin
80
Criteria for Asthma
Night-time awakening
Need for rescue meds
Daytime Sx
Limitation of ADLs
81
Asthma is characterized by
Airway hyperresponsiveness
Chronic airway inflammation
Expiratory airflow limitation
Reversible c bronchodilators
82
S/Sx present in status asthmaticus
Acute Cor Pulmonale
Respiratory Acidosis
83
What happens to the blood pressure during Status Asthmaticus
10 mmHg drop in blood pressure during inhalation
84
Classifications of control for asthma
Well-controlled
Partially-controlled
Poorly-controlled
85
Difference of COPD and Asthma in terms of onset
COPD: Mid-life (40 and above)
Asthma: Early childhood
86
Difference of COPD and Asthma in terms of symptoms
COPD: Progressive and persistent
Asthma: Varying day-to-day
87
Difference of Asthma and COPD in terms of cause
COPD: Smoking Hx
Asthma: Atopy Family Hx
88
Causes of Pneumonia include
Aspiration of food, fluids, or vomitus
Inhalation of toxic or caustic chemicals, smoke, dust, or grasses
Bacterial, viral, or mycoplasmal infection
89
Primary treatment for Pneumonia caused by bacterial infection
Antibiotics
90
Common population affected by Aspiration Pneumonia
Children
Stroke pts
Senior citizens
Pts c poor diaphragm function (no phrenic n.)
91
A vomitus gastric acid can lead to lung inflammation in this disease
Gastroesophageal Reflux Disease
92
Types of Pneumonia
Community-Acquired Pneumonia (CAP)
Hospital-Acquired Pneumonia (HAP)
Ventilator-Acquired Pneumonia (VAP)
93
Most common form of Pneumonia
CAP
94
Mode of transmission of Community-Acquired Pneumonia
Droplets
95
Is Pneumonia self-limiting?
NO
96
Another name for HAP
Nosocomial Pneumonia
97
Pneumonia that occurs 48 hours or more after hospital admission
HAP
98
HAP develops in a mechanically ventilated patient after endotracheal intubation
VAP
99
A protozoan organism that rarely causes pneumonia in healthy individuals
Pneumocystis-carinii
100
most common life-threatening opportunistic
infection in persons with acquired immunodeficiency syndrome (AIDS)
Pneumocystis-carinii Pneumonia
101
Pneumonia that involves the lobes of the lungs
Lobar Pneumonia
102
Pneumonia that involves the distal terminal bronchioles and alveoli
Bronchopneumonia
103
Why are elderly and bed-ridden pts at risk for Pneumonia?
Physical inactivity and immobility leads to pooling of secretions
104
Phases of Pneumonia
Edema
Red Hepatization
Gray Hepatization
Resolution
105
Pneumonia phase wherein initial phase with the presence of a proteinaceous exudate, and often with bacteria in the alveoli
Edema phase
106
Pneumonia phase wherein the presence of erythrocytes in the cellular intra-alveolar exudate
Neutrophil influx is more important.
Red Hepatization phase
107
Pneumonia phase wherein no new erythrocytes are extravasating; those already present have been degraded.
Neutrophil is the predominant cell.
Gray Hepatization phase
108
Pneumonia phase wherein macrophage reappears as the dominant cell type in the alveolar space
Inflammatory response and cellular debris have been cleared
Resolution phase
109
RF for Pneumonia
Age
Smoking
Air Pollution
URI
Alcoholism
110
S/Sx of Pneumonia
Tachypnea
Tachycardia
Dyspnea
Non-productive cough
Hypoxemia
111
(+) sign for Lower respiratory tract infection
Crackles
112
A bacterial infectious disease transmitted by the gram-positive, acid-fast bacilli that causes PTB
Mycobacterium tuberculosis
113
A disease that is highly infectious and contagious, especially in 3rd world countries
Pulmonary Tuberculosis
113
PTB is the most common cause of ____ in the Philippines
Hemoptysis
114
PTB mode of transmission
Person-to-person through droplet
115
Examples of droplet transmission
Sneezing, coughing, speaking
116
RF of PTB
Drug-resistance strains of TB develop if the duration of the treatment is not followed
117
Duration of Tx for PTB
6 mos
118
Medication for PTB
HRZE medication
119
most infectious pts with TB
Cavitary Pulmonary TB
Laryngeal TB
120
Role of Macrophages during PTB
Engulf the bacteria
121
The route of the spread of infection in PTB
Entry in the lungs
Lymphatics in the mediastinum
Entire parts of the body
122
Clinical S/Sx of PTB
Fatigue
Malaise
Anorexia
Frequent productive cough
Wt. loss
Dyspnea
123
A classification of TB that occurs shortly after exposure. It can be symptomatic or mild c non-specific symptoms
Primary TB
124
It occurs when the immune system contains the infection, but the bacteria remain
dormant in the body. It is typically asymptomatic
Latent TB
125
TB of the Spine
Pott's disease
126
Extrapulmonary TB
Pott's dse
TB meningitis
Gastrointestinal TB
Milliary TB
TB of the bone
127
Most common structures affected in bone TB
Long bones
128
A distinct feature of Milliary TB
Small-white millet seed-like granulomas
Bilateral affectation
129
Diagnosis of PTB
Chest XRay
Sputum Analysis
Gene Xpert
Skin testing
130
Medication Tx for PTB
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
Streptomyocin
131
How long is PTB infectious?
2 weeks
132
A drug that has eye problems as its side effect
Ethambutol
133
Used to prevent severe forms of extrapulmonary tuberculosis, such as TB meningitis and military TB.
Bacillus Calmette-Guerin (BCG Vaccine)
134
(+) sign for Mantoux test (Tuberculin Skin Testing)
Induration of 10 mm or more
