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Respiratory > COPD > Flashcards

COPD Flashcards

1
Q

What is the mainstay treatment for acute asthma exacerbation?

A

Albuterol

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2
Q

Which of the following is a current therapy for acute asthma exacerbations?

A
  1. Magnesium
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3
Q

Which of the following is a complication to worry for the most if you intubate a child during an asthma attack?

A
  1. Pneumothorax
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4
Q

What percentage of response to the methacholine is considered relevant to asthma’s diagnosis?

A
  1. 20%
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5
Q

What is intermittent asthma?

A
  1. exacerbations every now and then
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6
Q

What does LABA stand for?

A
  1. Long acting beta agonist
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7
Q

What does SABA stand for

A
  1. Short Acting Beta Agonist
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8
Q

A 7 year old uses albuterol three times a week and has night-time coughing that wakes him up twice a week. He takes his low-dose fluticasone, two puffs twice a day and is compliant. What’s the best thing to do

A

Increase his inhaler to moderate dose fluticasone.

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9
Q

What is COPD?

A

COPD characterized by progressive airflow limitations, gas exchange abnormalities and hypersecretion of mucous usually induced by significant exposure to noxious particles or gases.

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10
Q

Permanent abnormal enlargement or destruction of air spaces distal to the terminal bronchioles, including alveolar ducts, alveolar sacs and alveoli

A

Emphysema

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11
Q

Clinically defined as a chronic productive cough for 3 consecutive months each year for 2 consecutive years with other causes excluded?

A

Chronic bronchitis

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12
Q

Forced expiratory volume

A

Forced Expiratory Volume

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13
Q

The measure of how much air a person can exhale during a forced breath?

A

FEV Forced Expiratory Volume

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14
Q

FVC

A

Forced vital capacity

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15
Q

The total amount of air exhaled during the FEV1 test

A

Forced vital capacity

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16
Q

lung function value depends on the patient’s?

A
  1. Age
  2. sex
  3. height
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17
Q

What does Peak flow measure?

A

A hand held meter used to measure how air flows from your lungs in one fast blast.

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18
Q

FEV1/FVC > 80% means?

A
  1. normal or restrictive disorder
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19
Q

FEV1/FVC ratio <80 means?

A
  1. obstructive disorder
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20
Q

If the FEV1 improves after a bronchodilator what does that mean?

A
  1. The lung disease is reversible
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21
Q

Concerning the sensitivity and specificity of diagnostic tests, which of the following statements is accurate?

A

Sensitivity is the proportion of people who have the disease and test positive for it.

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22
Q

The following parameters can physiologically alter spirometry results, except

A
  1. Abdominal circumference
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23
Q

Regarding spirometry results, which of the following can be interpreted from a FEV1/FVC ratio < 70%?

A
  1. An obstructive disorder is taking place
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24
Q

What is PFT?

A

PFT can measure lung mechanics or the gas exchange/diffusion function of the respiratory system.

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25
Q

On spirometry, restrictive lung disease has a what?

A
  1. Reduced volume low FVC
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26
Q

On spirometry obstructive lung disease has a reduced what?

A
  1. Flow, Low FEV1
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27
Q

What are contraindications of a PFT

A
  1. Recent eye surgery
  2. abdominal aneurysms
  3. hemoptysis
  4. pneumothorax
  5. MI
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28
Q

Volume of inhaled or exhaled air during regular respiration at rest. The normal value is 500 ml?

A
  1. Tidal volume
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29
Q

The maximum volume of air that can be inhaled above the normal tidal inspiration the normal value is 3000 ml?

A
  1. Inspiratory reserve volume
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30
Q

The maximum volume of air that can be exhaled after a normal tidal expiration; the normal value is 1,500 ml

A
  1. Expiratory reserve volume
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31
Q

the volume of air present in lungs after maximum deep inspiration; the sum of all volumes: TLC = IRV + TV + ERV + RV; the normal value is 5,000–6,000 ml

A
  1. Total lung capacity
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32
Q

the maximum volume of air exhaled after a maximum deep inspiration: VC = IRV + TV + ERV or VC = TLC – RV; the normal value is 4,500–5,000 ml

A
  1. Vital Capacity
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33
Q

the maximum volume of air inspired after a normal tidal expiration: IC = TV + IRV; the normal value is 2,400–3,600 ml

A

Inspiratory capacity

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34
Q

the maximum volume of air expired after normal tidal inspiration: EC = TV+ ERV; the normal value is 1,800–2,300 ml

A

Expiratory capacity

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35
Q

the volume of air remaining in the lungs after normal tidal expiration: FRC = ERV + RV. FRC is an important component that maintains a continuous exchange of oxygen and carbon dioxide at the alveolar-capillary membrane. Collapse or atelectasis of the lungs leads to a reduction in FRC, causing hypoxemia and hypercarbia. The normal value is 2,500 ml.

A

Functional residual capacity

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36
Q

What is the normal value of the FEV1/FVC ratio?

A
  1. The normal value is >75%
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37
Q

In obstructive lung disease the value of the FEV1/FVC ratio is?

A

Decreased values of less than50% suggest a severe obstruction

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38
Q

What does FEF stand for?

A
  1. Forced mid expiratory flow
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39
Q

he maximum flow rate during the mid-expiratory part of the FVC maneuver. Expressed in L/min, it represents the status of small airways. The normal value is 300 L/min

A
  1. Forced mid expiratory flow
40
Q

the maximal flow rate during the FVC maneuver occurs in the initial 0.1 seconds. It gives a crude estimate of larger airway function. The normal value is 400–700 L/min

A
  1. Peak expiratory flow rate
41
Q

With COPD VC can be reduced in what two scenarios?

A
  1. The patient has superimposed restrictive lung disease

2. The patient has significant hyper-inflation

42
Q

What is a fixed airway obstruction?

A
  1. Constant limitation of flow during inspiration and expiration such as stricture, goiter or stenosis
43
Q

Reduced flow during inspiration (airways tend to collapse during inspiration due to negative transmural pressure). Positive pressure in the airway during expiration decreases obstruction, such as vocal cord palsy, obstructive sleep apnea

A
  1. Variable extrathoracic obstruction
44
Q

Reduction inflow is greater during expiration (high pleural pressure decreases airway diameter). During inspiration, lower pleural pressure around the airway tends to decrease obstruction, such as tracheomalacia or bronchial tumors

A
  1. Variable intrathoracic obstruction
45
Q

N2 washout:

A

The patient breathes 100% oxygen so that all nitrogen in the lungs is washed out. The difference in nitrogen volume at initial exhaled concentration and final concentration gives the value of FRC.

46
Q

He dilution

A

The patient breathes from a reservoir containing a known volume of gas with a trace of helium. The inhaled helium gets diluted in the gas present in the lungs. The concentration of helium in the exhaled gas is expressed as a percentage, giving the lung volume. For example, if the patient breathes 50 mL of helium, and its concentration in the exhaled gas is 1%, the volume of the lung is 5 L.

47
Q

Salmeterol and formoterol are what type of beta agonist?

A

Long acting

48
Q

Albuterol, terbutaline, levalbuterol are what type of agonist

A

Short acting

49
Q

Theophylline is what type of drug?

A

Methyl xanthine

50
Q

what type of Muscarinic is ipratropium?

A

short acting muscarinic antagonist

51
Q

What type of antagonist is toitropium?

A

long acting muscarinic antagonist

52
Q

Cromolyn and nedocromil are what type of anti inflammatory agents?

A

Mast cell degranulation inhibitors

53
Q

Taken regularly to control chronic symptoms and prevent asthma attacks — the most important type of treatment for most people with asthma

A

Long-term asthma control medications

54
Q

Taken as needed for rapid, short-term relief of symptoms — used to prevent or treat an asthma attack

A

Quick-relief medications (rescue medications)

55
Q

Taken regularly or as needed to reduce your body’s sensitivity to a particular allergy-causing substance (allergen)

A

Medications for allergy-induced asthma

56
Q
  1. fluticasone
  2. Budesonide
  3. Mometasone
  4. Beclamethasone
  5. Ciclesonide
    Are what type of medications
A
  1. Inhaled corticosteroids
57
Q
  1. Montelukast
  2. Zafirlukast
  3. Zileuton

Are what type of medications

A

These medications block the effects of leukotrienes, immune system chemicals that cause asthma symptoms. Leukotriene modifiers can help prevent symptoms for up to 24 hours.

58
Q

Why are long acting beta agonist only taken in combination with an inhaled corticosteroid?

A
  1. Long acting beta agonist have been linked to server asthma attacks
59
Q
  1. Fluticasone and salmeterol
  2. Budesonide and formoterol
  3. Mometasone and formoterl
  4. Fluticasone and vilanterol
    are what types of medications?
A
  1. Combination inhaler Corticosteroids and long acting beta agonist
60
Q

These asthma medications open the lungs by relaxing airway muscles. Often called rescue medications, they can ease worsening symptoms or stop an asthma attack in progress. They begin working within minutes and are effective for four to six hours. They’re not for daily use.

A

Albuterol (ProAir HFA, Ventolin HFA, others)

Levalbuterol (Xopenex HFA)

61
Q

A short acting bronchodilator that is usually prescribed for emphysema or short chronic bronchitis, but is sometimes used to treat asthma attacks . May be used either with or as an alternative to short acting beta agonist.

A
  1. Ipratropium
62
Q

These medications may be taken to treat severe asthma attacks. They can cause bothersome short-term side effects and more-serious side effects if they’re taken for a long period. Examples include:
Long-term use of these medications can cause side effects including cataracts, thinning bones (osteoporosis), muscle weakness, decreased resistance to infection, high blood pressure and reduced growth in children.

A

Prednisone

Methylprednisolone

63
Q

sometimes used to treat asthma triggered by airborne allergens. If you have allergies, your immune system produces allergy-causing antibodies to attack substances that generally cause no harm, such as pollen, dust mites and pet dander: blocks the action of these antibodies, reducing the immune system reaction that causes allergy and asthma symptoms.

A

Omalizumab

64
Q

Mepolizumab (Nucala)
Benralizumab (Fasenra)
Reslizumab (Cinqair)

Are what type of medication

A

A newer class of biologic drugs has been developed to target specific substances secreted by certain immune system cells. For some people, certain white blood cells, called eosinophils, build up within body tissues. Eosinophils secrete substances, called cytokines, which cause inflammation. These biological drugs target eosinophils and cytokines, reducing their numbers within the body and lowering inflammation. Taken together with other asthma medications, biologics help people with more severe forms of asthma achieve greater symptom control. These medications include

65
Q

FEV/FVC 80%?

A
  1. Mild
66
Q

FEV1/FVC 50%< FEV<80%

A
  1. Moderate
67
Q

30%

A
  1. Severe
68
Q

FEV1<30%predicted

A
  1. very severe
69
Q

What happens to the lungs with pulmonary fibrosis?

A
  1. The lungs shrink
70
Q

Measure of oxygen dissolved in the blood?

A
  1. Blood gases
71
Q

Blood gasses are used to determine what types of respiratory failure?

A
  1. hypoxic

2. Hypercapnic

72
Q

Which of the following sums of volumes equals total lung capacity (TLC)?

A

Forced vital capacity and residual volume

73
Q

Regarding pulmonary function tests, which of the following changes would be expected in patients with COPD?

A

An increased residual volume (RV)

74
Q

Which of the following flow volume loop patterns would be expected in a patient with a tracheal obstruction?

A

Squared off pattern

75
Q

What are the main indications for bronchoscopy?

A
  1. New lung shadow
  2. Lobar collapse
  3. Hemoptysis
  4. Suspected airway obstruction
76
Q

Which of the following statements about lung volumes is TRUE?

A
  1. Total lung capacity increases in COPD
77
Q

Which of the blood gas results would be indicative o type 2 respiratory failure. hypoxia due to underventilation

A

Pa02 7.5 PaC02 8.4- ph 7.15

78
Q

On x ray the lungs should appear what color?

A
  1. Black
79
Q

A cyst or pneumothorax will show what color on x ray

A
  1. black
80
Q

Common indications for a CT thorax are?

A
  1. Possible lung tumors
  2. Possible interstitial lung disease
  3. Potential mediastinal, hilar and pleural abnormalities
  4. Lobar collapse
  5. Hemoptysis
81
Q

is defined as obstructive lung disease and represents a chronic inflammation of the respiratory tract. The inflammation results in bronchial obstruction, which causes paroxysmal dyspnea. In asthmatics, the bronchial obstruction can be provoked with a methacholine challenge test and controlled with sympathomimetic drugs, bronchodilators, and corticosteroids.

A

Bronchial asthma

82
Q

What divides the left lung into superior and inferior?

A
  1. The oblique fissure
83
Q

Where does the low airway start?

A
  1. Trachea
84
Q

the accumulation of air between the visceral and the parietal pleura.

A

Pneumothorax

85
Q

an acute or chronic inflammation of the alveolar space and/or the interstitial lung tissue. It is one of the most frequent deadly infectious diseases in industrialized countries

A

PNA

86
Q

According to Boyle’s Law, what is the relationship between the pressure of a gas and the volume of its container?

A

inversely proportional

87
Q

What occurs to the diaphragm when it contracts

A

It flattens

88
Q

Which of the following processes occurs during exhalation?

A

Elastic recoil of the lungs causes them to retract

89
Q

What is Ficks law?

A

1.Amount of gas transferred through a sheet of tissue (V) is proportional to:
1. The tissue area
2. A diffusion constant
3. The difference in partial pressures.
and indirectly proportional to the tissue thickness

90
Q

What does PaCO2 mean?

A

PaCO2 = measured the partial pressure of carbon dioxide in arterial blood.

91
Q

What is a normal Pa02?

A

Partial pressure of oxygen (PaO2) - 75 - 100 mmHg

92
Q

What is a normal PaC02?

A

Partial pressure of carbon dioxide (PaCO2) - 38 - 42 mmHg.

93
Q

What is a normal arterial blood gas?

A

Arterial blood pH of 7.38 - 7.42

94
Q

What is the partial pressure of oxygen (PaO2) in deoxygenated blood?

A

40 mm Hg

95
Q

What is the partial pressure of oxygen (PaO2) in oxygenated blood

A

100 mm hg

96
Q

How much does the partial pressure of carbon dioxide (PaCO2) change after going through the pulmonary capillary bed?

A

it decreases by 5 mm hg

97
Q

How many barriers in the normal alveolar membrane must gaseous molecules cross during diffusion?

A

Six: the surfactant layer, the alveolar epithelium, the interstitial space, the capillary endothelium, blood in the capillary (liquid interface), and the erythrocyte membrane.

Respiratory (3 decks)

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