COPD/Asthma

Question 1

Drugs for the treatment of bronchospasms?

Answer 1

bronchodilators (to treat bronchospasm, albuterol), steroids (to tx inflammation), antihistamines, antileukotrienes, anticholinergic (helps decrease broncho spasm), magnesium sulfate, terbutaline, epinephrine

Question 2

Signs of respiratory distress

Answer 2

wheezing, retractions, tracheal tugging, low O2 sat on O2

Question 3

Bronchiolitis/Reactive airway disease

Answer 3

Children w/ RSV

Question 4

Obstructive Lung Disease

Answer 4

obstruction on exhalation, air-trapping

Question 5

RSV is very concerning in

Answer 5

premature infants, infants < 3mo

Question 6

What is the initial cause of asthma?

Answer 6

airway inflammation (NOT narrowing)

Question 7

SM has beta___ receptors

Answer 7

beta-2

Question 8

Cholinergic stimulation causes

Answer 8

bronchoconstriction

Question 9

Adrenergic stimulation causes

Answer 9

bronchodilation

Question 10

Spiral shaped mucus plugs in sputum/desquamated epithelium from mucus plugs indicates

Answer 10

Asthma

Question 11

Asthma wheezing timeline

Answer 11

1. End expiratory wheezing
2. Full expiratory wheezing
3. Shortened expiratory phase
4. Inspiratory wheezing

Question 12

Diagnosis of asthma

Answer 12

Pulmonary Function Test: decreased FEV1 that improves w/ bronchodilator
Airway Reactivity: less bronchodilation w/ cholinergics

Question 13

Asthma Findings

Answer 13

wheezing, chefs pain, tightness, dyspnea, cough, sputum, hypoxemia, pulses paradoxus

Question 14

Severe Asthma Findings

Answer 14

Conversational dyspnea, diaphoresis, accessory muscle use, fatigue, hypoxia

Question 15

First ABG finding in early asthma

Answer 15

Respiratory alkalosis -> Normal -> Respiratory acidosis (late asthma finding)

Question 16

Asthma is a Type __ HSN

Answer 16

type I

Question 17

Croup

Answer 17

URI, laryngospasm, steeple sign, seal-like barking cough, narrowed laryngeal space

Question 18

Tripod stance

Answer 18

severe asthma

Question 19

Asthma Tx

Answer 19

albuterol (beta-2 agonist), corticosteroids, anticholinergic (Atrovent), cromolyn

Question 20

Main stay treatment for asthma

Answer 20

Inhaled Corticosteroids

Question 21

Albuterol is used in asthma for

Answer 21

attacks to dilate airway (beta-2 agonist)

Question 22

SE of albuterol

Answer 22

tachycardia

Question 23

Atrovent is used in asthma for

Answer 23

anti-cholinergic (prevents bronchoconstriction)

Question 24

Cromolyn

Answer 24

prophylaxis, stabilizes mast cell membrane, must be compliant

Question 25

Real-life Tx for asthma attack

Answer 25

Oxygen Albuterol + Atrovent Prednisone/Solumedrol (steroid)

Question 26

Real-life Tx for asthma attack for severe attack

Answer 26

In addition, give Magnesium or Terbutaline, if really bad condition use BIPAP or intubate

Question 27

Greatest risk factor for COPD

Answer 27

smoking

Question 28

First Sx of COPD

Answer 28

Dyspnea on exertion

Question 29

COPD CXR

Answer 29

hyperinflation (dark lung fields), flattened diaphragm (can see 8-11 ribs), long narrow mediastinum

Question 30

<40y/o w/ emphysema

Answer 30

alpha-1-antitrypsin deficiency

Question 31

Emphysema pathology

Answer 31

destruction of alveoli wall, enlarged air spaces, loss of elasticity, air trapping

Question 32

Panacinar

Answer 32

entire acinar - alpha-1-antitrypsin deficiency

Question 33

Centrilobular emphysema

Answer 33

proximal acinar - smoker

Question 34

Emphysema CXR

Answer 34

hyperinflation, decreased vasculature, bullous disease

Question 35

Emphysema S/S

Answer 35

thin, pursed lips, pink puffer, barrel chest

Question 36

CO2 retainer

Answer 36

Normal pH, High CO2, High HCO3

Question 37

Be careful giving _______ to a CO2 retainer

Answer 37

O2 (may decrease their drive to breath), but do not withhold O2 is pt needs it

Question 38

What may happen if you give them O2?

Answer 38

CO2 narcosis

Question 39

Chronic Bronchitis Pathology

Answer 39

mucosal gland hyperplasia, destruction of epithelium + loss of mucociliary escalator

Question 40

Chronic Bronchitis leads to secondary bacterial infection d/t

Answer 40

mucus plugs

Question 41

COPD Tx

Answer 41

Albuterol, Atrovent, Prednisone, Solumedrol