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Renal/Resp > COPD > Flashcards

COPD Flashcards

1
Q

____ respiratory disease:

decreased total lung capacity, O2, diffusing capacity, and compliance

A

restrictive

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2
Q

paraseptal emphysema =

A

sub-pleural involvement

spontaneous pneumothorax

no COPD

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2
Q

irregular emphysema =

A

localized, scar associated

no copd

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2
Q

emphysema vs chronic bronchitis

pt appearance

A

blue bloater - CB
E - pink puffer

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4
Q

cover 95% of alveolar surface

A

type I pneumocytes

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4
Q

4 types of COPD

A

(obstruction to airflow out)

emphysema

chronic bronchitis

asthma

bronchiectasis

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5
Q

emphysema vs chronic bronchitis

infections

A

CB common

E- occasional

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6
Q

physical exam findings chronic bronchitis

A

productive cough

cyanosis

blue bloaters

dypsnea

expiratory wheezing and ronchi

cor pulmonae

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6
Q

causes, bronchiectasis

A

cystic fibrosis

infections (TB adenovirus, H ifluenzae, Staph A.)

bronchial obstruction

primary ciliary dyskinesia

allergic bronchopulmonary aspergillosis

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6
Q

gros findings bronchiectasis

A

bilateral lover lobes, distal bronchi, broncioles

dilated airways out to plueral surface

cut surface - bronchi = cystlike with mucopurlent scretions

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8
Q

tissue distal to termial bronchiole

A

acinus

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8
Q

CXR chronic bronchitis

A

enlarged, horizontal heart

increased bronchial markings

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9
Q

physical exam findings, emphysema

A

severe, early onsset dyspnea

pink puffers

chronic bronchitis

cor pulmonae

diminished breath sounds (hyper inflation)

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9
Q

gross morphology chronic bronchitis

A

hyperemia, swelling, and edema of mucous membranes

mucinous and mucopurulent secretions

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9
Q

emphysema vs chronic bronchitis

age

A

CB - 40-56

E 50-75

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9
Q

CXR bronciectasis

A

bronchial markings extending to periphery of lungs

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10
Q

microscopic findings bronchiectasis

A

acute inflam exudate in bronchial walls

necrotizing ulceration

squamous metaplasia of bronchial epi

lung abcess

fibrosis > brochiolitis obliterans

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11
Q

most common cause of bronchiectatsis

genetics?

A

cystic fibrosis

AR

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11
Q

pathogenesis cystic fibrosis

A

chr7 deletion (Phe) >

CFTR transporter for Cl >

increased Na and water reab from luminal secretions, decreased Cl secretion >

>dehydration due to lack of NaCl

12
Q

emphysema vs chronic bronchitis

cor pulmonae

A

CB - common

E - rare, terminal

13
Q

3 causes emphysema

A

smoking

pollution

a1 antitrypsin deficiency

14
Q

chronic bronchitis =

A

productive cough for at least 3months for 2 consecutive years

15
Q

FEV1/FVC ratio obstructive vs restrictive

A

obstructive = reduced FEV1/FVC ratio

restrictive = increased

16
Q

FEV1 =

A

forced expiratory volume in one second

18
Q

pathogenesis emphysema

A

increased macrophages, CD8 Tcells, PMNs >

> activated by tissue damage >

>elastase and free radicals from PMNs and macrophages >

>destruction of elastic tissue >

increased compliance and decreased elasticity

20
Q

a1-antitrypsin defiency emphysmea (proteas-antiprotease imbalance) impacts lower lung becasue

A

perfusion and neutrophil numbers greatest

22
Q

permanent enlargement of all or part of the repiratory unit acompanied by wall destruction without obvious fibrosis

A

emphysema

22
Q

Panacinar emphysema=

areas affected

A

a1-antirypsin deficiency

genetic (AD) or cigarette smoking

lower lobes, all parts of respiratory unit

24
Q

repair alveolar epithelium

A

type II pneumocytes

26
Q

2 types of emphysema

A

cantriacinar (95%)

panacinar

27
Q

____ smokers emphysema area of lung impact

A

centriacinar emphysema > apical segments of upper lobes

28
Q

clinical presentation bronchiectasis

A

copoius sputum

hemoptysis

clubbing

cor pulmonale

30
Q

reid index

A

rate of the thickeness of mucous gland later to thickness of epithelium and cartilage

increased in chronic bronchitis

32
Q

measured as lungs forcibly emptied at maximal speed from full inspiration

A

forced vital capacity FCV

33
Q

destroyed in bronchiectasis

A

permanent destruction of cartilage and elastic tissue

34
Q

pathogenesis chronic bronchitis

A

irratant > mucus hypersecretion > obstruction (more proximal than emphysema) > irreversible fibrosis

or

infection

bronchospasm

35
Q

most common causes of death in cystic fibrosis

A

resp failure

liver failure

36
Q

oxidative injury from smoke inactive native anti-proteases, bring on a functional ____

A

a1-antitrypsin deficiency

37
Q

location of disorders, obstructive and restrictive disease

A

obstructive - airway, trachea to terminal bronchiole

restrictive - parenchymal - respiratoy bronchiole, alveoli and alveolar ducts

39
Q

____ respiratory disease:
increased resistance to air flow and limited expiratory rates on forced expiration

A

obstructive

40
Q

trapped air in airways in emphysema leads to

A

dilation and destruction of alveolie, alveolar ducts (also distal/terminal bronchioles)

42
Q

tissue morphology proximal t bronchioles

A

pseudostratified ciliated columnar epithelium

43
Q

clinical presentation cystic fibrosis

A

nasal polyps

resp infxn>failure (psuedomonas aeruginosa, Staph A, H influenzae, Cor pulmonae)

Malabsorption

DM I

Vas deferens atresia (infertility)

meconium ileus (small bowel obstruction in newborns)

secondary billiary cirrhosis (bile duct obstrction by secretions)

44
Q

CXR empysema

A

increased AP diameter

hyerlucent lung fields

verticle heart

depressed diaphram

45
Q

emphysema vs chronic bronchitis

cxr

A

CB prominent vessels, large heart

E - hyperinflation, small heart

Renal/Resp (43 decks)

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