Exam 2 WTF I Do Not Know About RLD

Question 1

what happens to FEV1 FVC and FEV1/FVC in restricted Lund disease (RLD)

Answer 1

FEV1 reduced
FVC reduced
ratio: can RTS or increase

Question 2

what happens to TLC in RLL

Answer 2

decreases

Question 3

DLCO in RLL

Answer 3

reduced

Question 4

intrinsic vs extrinsic RLL

Answer 4

intrinsic: decreased airway compliance, like the thickening or scarring of the inner tubes
extrinsic: reduced chest wall compliance, like obesity, deformities, scoliosis, trauma, burns

Question 5

do occupational causes like asbestos, silicosis, coal minors have intrinsic or extrinsic RLD

Answer 5

intrinsic

Question 6

what are the two idiopathic intrinsic RLDs

Answer 6

pulmonary fibrosis and sarcoidosis

Question 7

do you have a dry or wet cough with intrinsic RLD

Answer 7

dry

Question 8

what does a honeycomb on a CT mean

Answer 8

that there is probably fibrosis in the lungs

Question 9

what does a 6MWT of less than 212 mean for prognosis

Answer 9

not great

Question 10

what do you have if you have RLD with no known cause, destruction of alveoli and loss of capillaries, and less compliance.

Answer 10

Idiopathic pulmonary fibrosis

Question 11

what is a multi-system autoimmune disease that can cause interstitial fibrosis

Answer 11

Sarcoidosis

Question 12

in what disease does it look like your upper lobes have nodules and egg shaped calcifications of the hilarity nodes

Answer 12

silicosis

Question 13

what affects alveolar septa

Answer 13

hypersensitive pneumonitis

Question 14

what are some things that came extrinsic RLD

Answer 14

SCI, burns, smoke, inhalation, facial burn and fires

Question 15

how do post polio patients breath

Answer 15

the upper thorax will rise, and the abdominals with suck in

Question 16

what do you have when BMI is over 30 and you have PaCO2 of less than 45 mmHg, and you have fat deposits over the chest wall that make it very hard to excursion, and therefore more work to breathe

Answer 16

obesity-hypoventilation syndrome (Pickwickian)

Question 17

what are the three big signs in obesity-hypoventilation or Pickwickian disease

Answer 17

BMI over 30
PaCO2 less than 45
sleep related apneas.

Question 18

how does obesity change TLC, VC, FEV1, and FEV1/FVC

Answer 18

the TLC, VC and FEV1 are reduced,

the FEV1/FVC is usually spared

Question 19

what happens when you have pharyngeal muscles that do not maintain potency and you have a fall is SaO2 levels

Answer 19

obstructive sleep apnea.

Question 20

what do you have when you have narrowed airways with fatty deposits in the neck

Answer 20

you have obesity related asthma

Question 21

how do your Diagnose Pulmonary HTN

Answer 21

pressure over 25 mmHg at rest, and over 30 mmHg during exercise.

Question 22

what are the five groups of PHTN and what are the 3 most common

Answer 22

pulmonary arterial HTN (PAH)
PHTN due to L ventricular dysfunction 
PHTN de to lung disease 
PHTN due to chronic blood clots 
and PHTN due to other diseases

Question 23

what might you have if you have dyspnea with exertion at rest, dull rostrosternal chest pain, narrowS2 splitting with loud P2 and right heart failure.

Answer 23

pulmonary HTN

Question 24

what is it when you have a rare, idiopathic dyspnea, with chest pain and syncope

Answer 24

PAH

Question 25

what might you have when you are tachycardia, tachypnea, scattered rales, post surgery and on bedrest, and overweight, and decreased breathe sounds

Answer 25

atelectasis

Question 26

when is atelectasis a problem in terms of developing pneumonia

Answer 26

over 72 hours.

Question 27

how can you prevent atelectasis

Answer 27

10 breaths per hour, early mobilization, chasing position and coughing

Question 28

what are the 4 phases of bacterial pneumonia

Answer 28

1. congestion
2. red hospitalization (fibrin and RBCs fill alveolar spaces, and looks reddish then neutrophils
3. grey hospitalization (no new RBCs, and most are degraded.)
4. resolution (al debris is cleared by neutrophils.

Question 29

what kind of pneumonia might you have with abrupt onset, fever, chills, nausea, apprehension, flaring and grunting, and pain

Answer 29

bacterial

Question 30

what type of pneumonia might you have with gradual onset, coughing without much mucus, malaise, wheeling, rales, nasal flaring

Answer 30

viral

Question 31

what is the difference between type I and type II acute respiratory failure

Answer 31

type 1: hypoxia without hypercapnia

type 2: hypoxia and hypercapnia

Question 32

what ribs are fractured with a high energy fracture

Answer 32

ribs 1-3

Question 33

what happens with a flail chest

Answer 33

this is when 3+ ribs breaks, or 1 ribs breaks in 2+ places, and you have the chest falling in with inspiration and falling out with expiration. there is unequal chest expansion

Question 34

what is a sucking chest

Answer 34

a pneumothorax

Question 35

in what way does the mediastinum shift when you have a pneumothorax

Answer 35

towards the contralateral side

Question 36

if you are spitting up blood, what are you likely to have

Answer 36

a PE