Exam 2 - Obstructive Airway Conditions Flashcards
1
Q
what does air trapping result in
A
- hypoventilation
- hypercapnia
2
Q
what is present in all obstructive diseases
A
- dyspnea
- wheezing
3
Q
asthma
A
- chronic inflammation of the bronchial airways
- chronic disease state with acute exacerbations
4
Q
risk factors for asthma
A
- childhood, highly associated with allergies
- familial link
- level of allergen exposure
- urban residency
- exposure to indoor and outdoor air pollution
- tobacco exposure/smoke
- recurrent respiratory tract viral infections
- GERD
5
Q
early asthmatic response
A
- cellular responses are activated immediately and the cascade of release of inflammatory mediators occurs within minutes
- vasodilation, increased capillary permeability, mucosal edema, bronchial smooth muscle contraction and mucus secretion
6
Q
late asthmatic response
A
- 4-8 hours after early response
- recruitment of eosinophils, neutrophils, and lymphocytes during acute response, causes another release of inflammatory mediators inciting same process
7
Q
what is airway remodeling
A
- untreated inflammation can lead to long-term airway damage that is irreversible
8
Q
bronchoconstriction
A
1 symptom of asthma attack
9
Q
inflammation
A
the biggest problem and causes the seriousness of the disease
10
Q
how do we diagnose asthma
A
- history
- pulmonary function tests (PFTs)
- FEV1
11
Q
classic symptoms of asthma
A
- wheezing
- shortness of air
- cough
- chest tightness
12
Q
severe asthma attacks
A
- use of accessory muscles
- distant breath sounds
- diaphoresis
- inability to speak one or two words before taking a breath
- respiratory failure (patient decline)
13
Q
asthma management
A
- avoidance of asthma/irritants
- use of peak flow meter
- medication
- immunotherapy
14
Q
status asthmaticus
A
- severe symptoms
- unrelenting asthma attack
- life threatening emergency
15
Q
simple (acute) bronchitis
A
- inflammation of the bronchi and bronchioles
- bacterial or viral with NO AIRFLOW OBSTRUCTION
- usually mild and self-limited
- requires supportive care
- prognosis is good and usually better in 3-4 weeks
16
Q
chronic bronchitis
A
- bronchitis for 3 months out of the year for at least 2 years
- cigarettes
- AIRFLOW OBSTRUCTION
- may have acute exacerbation of chronic bronchitis = AECB
- prognosis is premature morbidity and mortality
17
Q
clinical manifestations of chronic bronchitis
A
- persistent productive cough
- purulent if superimposed respiratory infection
18
Q
chronic bronchitis diagnosis
A
- history, physical exam, chest imaging, pulmonary function tests
- by the time people seek treatment, disease is in a progressive state and the pathological changes that have occurred are IRREVERSIBLE
19
Q
chronic bronchitis pathogenesis
A
- thick, tenacious secretions are produced and cannot be cleared
- damaged cilia bronchial walls become inflamed/thickened secondary to edema
- accumulation of inflammatory cells
- thickened smooth muscle
- INITIALLY ONLY AFFECTS LARGER BRONCHI
20
Q
late clinical manifestations of chronic bronchitis
A
pulmonary hypertension
21
Q
treatment for chronic bronchitis
A
- prevention
- bronchodilators
- expectorants
- chest physiotherapy
- steroids
- home O2 therapy
22
Q
emphysema
A
- abnormal, permanent enlargement of gas exchange airways, accompanied by destruction of alveolar walls
- destruction results from tissue changes and not mucus production
23
Q
clinical manifestations for emphysema
A
- increase in breathlessness
- SOA at rest
- wheezing
- malnourished
- decrease muscle mass
- barrel chest
- pursed lip breathing
- decreased breath sounds
24
Q
diagnosis of emphysema
A
- PFTs (FEV1 decreased)
- CXR (hyperinflation)
- ABGs (respiratory acidosis)
- alpha1-antitrypsin
25
Q
emphysema treatment
A
- smoking cessation
- bronchodilators and anti-inflammatory agents
- O2 supplementation
- breathing retraining
- relaxation techniques
- antibiotics for acute infections
