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RES Biweekly 1 > Fouty: pathophys of chronic bronchitis and emphysema > Flashcards

Fouty: pathophys of chronic bronchitis and emphysema Flashcards

1
Q

chronic bronchitis + emphysema

A

COPD

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2
Q

at the end of normal expiration (most effort independent out of all PFTs)

A

functional residual capacity (FRC)

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3
Q

when you blow up a balloon, what is the pressure needing to overcome

A

elastic recoil

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4
Q

when the lung is not present, what does the chest wall do

A

springs outwards

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5
Q

___ and ___ are held at equilibrium at FRC

A

the lung and chest wall

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6
Q

at ____ volume, still some air in lungs requiring some pressure to keep it there

A

residual volume

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7
Q

what sets the residual volume

A

characteristics of chest wall (can’t go lower than a certain point)

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8
Q

when the springs are equal tension on both sides

A

FRC

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9
Q

Inward recoil of the lung=outward recoil of chest wall

A

FRC

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10
Q

takes____ to move respiratory system away from functional residual capacity

A

work

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11
Q

work being done to inflate the lungs is required to overcome what 2 things

A

elastic recoil of lungs and chest wall and airflow resistance

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12
Q

low at high volumes
higher at low volumes

A

resistive work (airflow resistance)

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13
Q

high at higher volumes (takes more work to keep lungs expanded)
low at lower lung volumes

A

elastic work

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14
Q

spot of least resistance when breathing

A

RR of 12-18
volume of 400 mL

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15
Q

pressure of elastic recoil of chest wall and lungs + pressure to overcome resistance to airflow

A

total pressure (work of breathing)

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16
Q

lung is less stiff and easier to distend (high compliance)—lost its elastic recoil; takes very little pressure to move air in

A

emphysema

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17
Q

lung is much stiffer, (harder to put air in)—takes more work to distend lung

A

fibrosis

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18
Q

neonate with no surfactant has to generate what to try and distend lung

A

generate a lot of negative pressure

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19
Q

is based on the compliance of the chest wall and the lung (effort independent)

A

FRC

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20
Q

FRC goes down

A

restrictive disease

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21
Q

FRC goes up

A

obstructive disease

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22
Q

Provides a reservoir of air in the lung during breathing

A

FRC

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23
Q

Increases The Resistance To Airflow And Thus Increases The Work Required To Overcome Airway Resistance

A

obstructive disease

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24
Q

airway resistance is greatest in what airways

A

large (like river opening up into delta (small airways–more of them)

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25
Q

anything that’s being carried such as tobacco smoke in the lungs gets deposited in the area around the _____

A

terminal bronchioles

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26
Q

centrilobar/centriacinar emphysema means..

A

where the respiratory bronchioles transition off the terminal bronchioles

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27
Q
A

airflow obstruction (<LLN)

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28
Q

increases Lung Volumes And Impairs Airflow

A

emphysema

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29
Q

flattening of _____ decreases ability to generate pressure

A

diaphragm

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30
Q

Pressure you can generate is _____ related to radius

A

inversely (smaller radius, can generate more pressure)

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31
Q

how would this person breathe effectively since they have flattened diaphragm

A

accessory muscles (external intercostals, sternocleidomastoid, scalenes)

32
Q

RV higher than normal, FRC higher

A

obstructive lung disease

33
Q

TLC is higher in this obstructive lung disease

34
Q

TLC stays the same in this obstructive lung disease

35
Q

bronchi filled with mucus and causes luminal narrowing

A

chronic bronchitis

36
Q

destruction of elastin; dilated airspaces (bronchioles easily compressible)

37
Q

airflow obstruction that is not fully reversible; emphysema and chronic bronchitis

38
Q

Tobacco, work exposures to fumes, secondhand smoke, air pollution, vaping

A

can lead to COPD

39
Q

major cause of COPD worldwide

A

smoking, air pollution, indoor cooking w/ wood

40
Q

smoker’s cough present for atleast 3 months; excessive sputum production

A

chronic bronchitis

41
Q

Narrowing of lumen due to mucous glands and smooth muscle cell hyperplasia

A

chronic bronchitis

42
Q

more mucous is being secreted into the airways which impairs airflow obstruction (due to mucous gland hyperplasia)

A

chronic bronchitis

43
Q

marked increase in mucous glands

A

chronic bronchitis

44
Q

alveolar wall destruction w/ irreversible enlargement of the air spaces distal to terminal bronchioles

45
Q

can cause permanent enlargement of the acinus

46
Q

pan-acinar emphysema (in lower lobes)

A

A1AT deficiency

47
Q

centri-acinar emphysema

48
Q

Loss of elastic recoil; airways and alveoli lost elasticity that allows them to stay open (easy to collapse); gas trapping

49
Q

destruction of elastic fibers
air trapping

50
Q

“moth eaten”

51
Q

destroys alveolar-capillary bed

52
Q

DLCO decreased in this

53
Q

purse lip breathing

54
Q
55
Q
A

chronic bronchitis

56
Q

minimal reversibility
normal to slightly decreased DLCO

A

chronic bronchitis

57
Q

marked hyperinflation
no reversibility
decreased DLCO

58
Q

dyspnea
mucus production
wheezing
cough

59
Q

Pursed lip breathing
Wheezing
Decreased lung sounds
Barrel chest
Cyanosis

A

physical exam for COPD

60
Q
A

Hb desaturated (hypoxemia)
R heart failure (peripheral edema)

61
Q

GOLD normal (based on FEV1)

A

stage 0 COPD

62
Q

GOLD (based on FEV1) >/= 80%

A

stage I COPD

63
Q

GOLD (based on FEV1) 50-79%

A

stage II COPD

64
Q

GOLD (based on FEV1) 30-49%

A

stage III COPD

65
Q

GOLD (based on FEV1) <30%

A

stage IV COPD

66
Q

BMI
obstruction
dyspnea
exercise capacity

A

BODE index for COPD

67
Q

treatment of COPD

A

stop smoking, vaccines

68
Q

peak age for FEV1

69
Q

worst MMRC stage

A

D (high risk and high symptoms)

70
Q

bronchodilators
steroids
O2
PDE4 inhibitors

71
Q

decreased exacerbations of COPD by 27%

A

Azithromycin

72
Q

Increased dyspnea above baseline
Increased sputum production
Deterioration in arterial blood gas
Increased requirements of bronchodilators
Visits to ER/hospitalization

A

acute exacerbations of COPD (marker for more severe disease)

73
Q

most common cause of COPD exacerbations

74
Q

main 3 bacterial infections for smokers with COPD exacerbation

A

Haemophilus influenzae
Streptococcus pneumoniae
Moraxella catarrhalis

75
Q

main virus for COPD exacerbation

A

rhinovirus

76
Q

causes of death from COPD

A

resp. failure
R ventricular failure (cor pulmonale)
pneumonia
spontaneous pneumothorax

77
Q

must have airway obstruction w/ emphysema and/or chronic bronchitis

RES Biweekly 1 (11 decks)

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