Intro to Pulmonology

Question 1

What is the difference between restrictive and obstructive lung disease?

Answer 1

-Obstructive: “air trapping,” air cannot get out. Ex. COPD, emphysema, chronic bronchitis

• Restrictive: lungs cannot fill up
  ex. too stiff from scarring, spinal abnormalities in which the lungs cannot expand.

Question 2

Lung disease can be classified into which three categories?

Answer 2

• airway: obstructive (COPD, cystic fibrosis, asthma)
• interstitium: Restrictive (asbestosis, pulm fibrosis)
• vasculature (PE, pulmonary HTN)

Question 3

Risk factor for pulmonary disease

• non modifiable
• modifiable

Answer 3

• NON modifiable:
• -genetics (alpha-1 anntitrypsin deficiency, Wegeners, Asthma)
• -socioeconomic status
• -environment
• Modifiable:
• -immunizations
• -smoking cessation
• -reduction in secondhand smoke exposure
• -protection from environmental toxins

Question 4

Common sx of pulmonary disease

Answer 4

• dyspnea
• chest tightness
• exercise intolerance
• chest pain
• cough
• hemoptysis
• sputum production
• stridor

Question 5

chronic dyspnea of unclear etiology is like one of the following…

Answer 5

• asthma
• COPD
• Interstitial Lung disease
• Myocardial dysfunction
• Obesity/deconditioning

Question 6

What is orthopnea?

why is orthopnea important to know about?

Answer 6

• SOB why lying down

- helps determine the etiology of their dyspnea.

Question 7

Cough lasts how long if it is:

• acute
• subacute
• chronic

Answer 7

Acute-less than 3wks
Subacute- 3-8wks
Chronic: greater than 8 weeks

Question 8

Common causes of cough (their anatomical locations)

Answer 8

• nose and sinus
• pharynx
• larynx
• trachea and bronchi
• pulmonary parenchyma
• esophagus
• Heart and blood vessels
• Mediastinum
• pleura
• External ear canal and TM
• psychogenic
• drug induced

Question 9

Normal and abnormal breath sounds

Answer 9

• Normal: vesicular over periphery, bronchial centrally

- Abnormal: pleural rub, stridor, crackles, wheezes

Question 10

What are the major respiratory distress accessory muscles

Answer 10

SCM, scalenes, serratus anterior

Question 11

what is ROWL?

Answer 11

• tells us how “sick” a patient is.
• R: Resp rate
• O: O2 sat.
• W: words per sentence
• L: Labor, (look at lungs and see how well they are breathing)

Question 12

What is the grading for the severity of disease? restrictive/obstructive

Answer 12

mild- greater than 70% FEV1
moderate- 60-69%
moderately severe- 50-59%
severe- 35-49%
very severe- less than 35%