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Pulmonary > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

A decrease in lung capacities and volumes

A

Restrictive Lung disease

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2
Q

Difficulty getting air in, inability to fill the alveoli

A

Restrictive Lung disease

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3
Q

Is FEV1/FVC normal or abnormal with restrictive dz

A

normal

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4
Q

Is FEV1/FVC normal or abnormal with obstructive dz

A

abnormal

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5
Q

Increased airway resitance =

A

Obstructive lung disease

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6
Q

Is inspriation or expiration the issue with restrictive dz

A

inspriation

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7
Q

Is inspiration or expiration the issue with obstructive dz

A

expiration

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8
Q

Are flow rates abnormal with obstructive or restrictive dz

A

Obstructive

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9
Q

Are volumes/capacities abnormal with restrictve or obstructive dz

A

Restrictive

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10
Q

Treatment for permanent restrictive lung dz

A

Exercise, supplemental O2, (supportive measures)

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11
Q

Treatment for reversible restrictive lung dz

A

Corrective measures (chest tube or mechanical ventilation)

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12
Q

a disorder characterized by airflow obstruction

A

COPD

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13
Q

Describe the check valve effect (COPD)

A

During inspriation the airways open to allow air entry
But during expiration they prematruely close and air becomes trapped in the alveoli

This leads to an incr in TLC

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14
Q

What are 2 conditions included in COPD

A
  1. ) Chronic Bronchitis

2. ) Emphysema

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15
Q

True or false: COPD results in air trapping, alveolar hyperinflation and destruction, and weakened bronchiolar walls

A

True

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16
Q

Clinical presentation for COPD

A 
Digital clubbing
Barrel chest
Decr FEV1 
Dyspnea
Incr in RV
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17
Q

What is used to diagnose the prescence and severity of COPD?

A

Pulmonary Function Testing (PFT)

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18
Q

What is normal tidal volume

A

500 mL

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19
Q

What is normal TLC

A

6L

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20
Q

A FEV1/FVC below ____ is considered abnormal

A

70%

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21
Q

What is a prognostic indicator of COPD

A

FEV1

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22
Q

COPD often leads to what

A

Cor Pulmonale (right sided heart failure)

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23
Q

Pursed lip breathing helps those with COPD

A

true

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24
Q

Cough and excpectoration of at least 3 months duration, occuring for at least 2 consecutive years =

A

Chronic bronchitis

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25
Q

What usually leads to chronic bronchitis

A

smoking

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26
Q

Blue bloater =

A

chronic bronchitis

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27
Q

Pink puffer =

A

emphysema

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28
Q

Why is there an incr in hematocrit in those with Chronic Bronchitis

A

the body is fighting chronic hypoxia so the kidneys are incr their production of EPO

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29
Q

Abnormal enlargement of the respiratory unit accompanied by destructive changes to the alveolar walls

A

Emphysema

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30
Q

What is caused by alpha-1 antitrpsin deficiciency or cigarettte smoking

A

Emphysema

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31
Q

Which has a better long term prognosis chronic bronchitis or emphysema

A

Emphysema

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32
Q

Incr in the reactivity of tracheobronchial tree

A

Asthma

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33
Q

characterized by a permanent dilation and inflammation of one or more bronchi resulting from destruction of elastic and muscular components of the bronchial wall

A

Bronchietasis

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34
Q

What is the BODE index

A

Prognostic tool used to categorize and predict outcomes in individuals with COPD

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35
Q

What is included in the BODE Index

A 
B = BMI
O = degree of obstruction
D= Dyspena
E = Exercise capacity
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36
Q

Is high or low BMI worse for those with COPD

A

Low

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37
Q

Most common way pulmonary meds are administered

A

Inhalation

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38
Q

Drugs that stimulate the Sympathetic NS or inhibit the Parasympathetic NS

A

Bronchodilators

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39
Q

Type of Bronchodilator that mimics the effects of SNS by increasing cAMP levels thru stimulation of beta receptors

A

Sympathomimetics

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40
Q

Are Sympathomimetics fast or slow acting

A

fast

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41
Q

Example of Sympathomimetics

A

Albuterol

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42
Q

Slow acting bronchodilators

A

Methylzathines

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43
Q

Example of Methylzathines

A

Theophylline

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44
Q

Type of bronchodilator that blocks muscarinic cholinergic receprots, therby decreasing parasympathetic tone

A

Anticholinergics

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45
Q

Example of Anticholinergic

A

Sprivia

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46
Q

Are anticholinergics fast acting

A

No

47
Q

What is a side effect of anticholinergics

A

drying out

48
Q

potent anti-inflammatory drugs, help to maintain/increase airway diameter

A

corticosteroids

49
Q

Name a corticosterioid

A

Prednisone

50
Q

The side effects of corticosteroids (HTN, Gi irritation, moon face, skin breakdown, etc) are assocaited with which mode of ingestion

A

oral

51
Q

Name a combination drug

A

Advair

52
Q

Are combination drugs good for controlling acute events

A

no

53
Q

what are leukotrienes

A

inflammatory agents that cause smooth muscle hypertrophy and increased mucus secretion

54
Q

What is an example of a Leukotriene Inhibitor

A

Singulair

55
Q

used prophylactically to prevent bronchial inflammation and constriction. Used to prevent allergy induced asthma, blocks the effects of histamine

A

Cromolyn Sodium

56
Q

Used to prevent and treat pulmonary infections

A

antibiotics

57
Q

How do mutant CFTR Channels lead to CF?

A

The channels do not move chloride ions well which leads to a build up of sticky mucous on the outside of the cell

58
Q

Clinical Presenation of someone with CF?

A
  • chronic productive cough
  • barrel chest
  • dyspnea with accessory muscle use
  • inspiratory crackles and wheezing
  • clubbing of nail beds
  • pancreatic insufficiney
  • weight loss
  • decr activity tolerance
  • hemoptysis - coughing up blood
59
Q

What type of precautions should be used when entering room with someone who has CF

A

Contact Precautions

60
Q

CPT Contraindications

A
  1. ) Head and/or neck injury that has not been stabilized

2. ) Active hemorrhage with hemodynamic instability

61
Q

Inhaled Medications used for CF

A
  1. ) Meter Dose Inhaler (MDI)

2. ) Handheld Nebulizer (HHN)

62
Q

3-7% Hypertonic Saline (NaCl) helps those with CF how?

A

helps restore the liquid layer that lines the lungs

63
Q

Flattened diaphragm on chest radiography =

A

COPD

64
Q

What is the gold standard for diagnosis of a pulmonary embolism

A

CT Scan

65
Q

What is best identified using an MRI

A

Tumors

66
Q

Allows the bronchial tree to be visualized and a biopsy can be taken

A

Bronchoscopy

67
Q

What imaging technique in commonly done in those with CF

A

Bronchoscopy

68
Q

Measures lung volumes, capacities, and flow rates. Diagnostic and prognostic tool for a variety of pulmonary conditions including COPD

A

Pulmonary Function Testing (PFTs)

69
Q

A concavity will be seen on PFT graph with which kind of disease

A

obstructive disease (flow issue)

70
Q

FEV1/FVC ratio under _____% suggests underlying obstructive pathology

A

70%

71
Q

Most common dx in pulmonary rehab

A

COPD

72
Q

How frequent should Pulmonary rehab programs be

A

3-5 days/wk

73
Q

How intense should Pulmonary rehab programs be

A

40-50% of VO2 Max as minimal threshold level OR RPE of 11-14

74
Q

Is it ok to continue if someone has 3/4 dyspnea

A

Yes

75
Q

How long should a pulmonary rehab program last for

A

20-30 min of physical activity

76
Q

What is the mode that most pulmonary rehab should be

A

Aerobic activity (involving the LE)…..walking is great

77
Q

Supplemental O2 should be given when below what level

A

Below 90%

78
Q

What can an incentive spirometer help do

A

Strengthen ventilatory muscles

79
Q

Incentive spirometer is contraindicated in what types of people

A

Those with evidence of hyperinflation on chest x ray

80
Q

When during an exercise program are thoracic mobility exercises to be included

A

Cool down

81
Q

How many inspirations per hour with the incentive spirometer

A

10

82
Q

Often used to help with breathing after thoracic surgery

A

Incentive Spirometer

83
Q

P flex device is used for what

A

Increasing strength of inspiratory muscles

84
Q

Breathing technique taught to those who may complain of dyspnea and display a rapid and ineffective breathing pattern.

A

Pursed lip breathing

85
Q

Progressions with teaching diaphragmatic breathing

A
  1. ) Therapist hands in supine
  2. ) Patient’s hands in supine
  3. ) Patient’s hands in sitting
  4. ) Patient’s hands in standing and walking
86
Q

soft rustling during inhalation with a quiet or inaudible expiratory phase

A

Vesicular breath sound

87
Q

Often heard in patients with pulmonary edema, pneumonia, chronic bronchitis, bronchiectasis or other conditions that lead to secretion production.

A

Crackles (rales)

88
Q

Heard as previously closed/collapsed small airways pop open during inhalation

A

Crackles (rales)

89
Q

Commonly noted on expiration in individuals experiencing an acute asthmatic episode, as well as in individuals with concomitant asthma and COPD.

A

Wheezes (ronchi)

90
Q

Heard as air moves thru constricted airways

A

Wheezes (ronchi)

91
Q

Can be heard without stethoscope

A

Stridor

92
Q

Signifies an upper airway obstruction, thus it is best ausultated at the trachea. Common causes include croup, epiglottitis, bronchitis, foreign body obstruction.

A

Stridor

93
Q

Intense continuous wheezes heard mainly during inspiration

A

Stridor

94
Q

6 sites (2 on each side) to ausculatate on anterior side

A
  1. ) 1st IC space, medial 1/3 of clavicle
  2. ) 5th IC space, mid-clavicular
  3. ) 6 IC space, anterior axiallary
95
Q

8 sites (2 on each side) to auscultate on posterior side

A
  1. ) Above spine of scapula (T3)
  2. ) Mid scapula (T6)
  3. ) Tip of medial scapula (T9)
  4. ) Tip of lateral scapula (T9)
96
Q

separates the upper and middle lobes anteriorly on the right lung

A

horizontal fissure

97
Q

separates the upper and lower lobes posteriorly on the right lung

A

oblique fissure

98
Q

separates the upper and lower lobes of the left lung

A

oblique fissure

99
Q

Which mainstem bronchi is shorter, wider, and less angular which leads to aspiration

A

R mainstem bronchi

100
Q

Process of moving air in and out of the lungs

A

Ventilation

101
Q

Actual gas exchange at the level of the lung or the level of the tissue

A

Respiration

102
Q

Changes in lung volumes and capacities related to aging:

A
  1. ) Incr in Residual Volume
  2. ) Decrease in Inspiratory reserve volume
  3. ) Decrease in vital capacity
103
Q

Refers to the amount of gas moved per unit of time, and is related to resistance to airflow and elasticity of the lung parenchyma

A

Flow rate

104
Q

True or false: There is an incr in TLC with obstructive disease (COPD)

A

True (due to incr in RV)

105
Q

Pulmonary artery pressure =

A

25/10

106
Q

What doe hypoxia/hypercapnia lead to in the lungs

A

Vasoconstriction in an effort to shunt blood to better ventilated portions of the lungs

107
Q

Normal Ventilation-Perfusion Ratio (V/Q)

A

4/5 (.80)

108
Q

Sympathetic stimulation does what to rate and depth of breathing

A

increases it

109
Q

Does sympathetic stimulation lead to bronchodilation or constriction

A

bronchodilation

110
Q

Central response to ______appears to be most important in terms of driving ventilation

A

CO2

111
Q

Receptors respond to stretch in the lungs and limit inhalation

A

Hering Breuer reflex

112
Q

If BP is high then what happens do ventilation

A

The depth and rate of ventilation is slowed down

113
Q

Where are the respiratory centers

A

Medulla and Pons

114
Q

PaO2 of 95-100 mHg =

A

normal

Pulmonary (1 decks)

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