Managing the Pulmonary Patient

Question 1

What disease can be commonly caused by smoking? Exacerbated by smoking?

Answer 1

Smoking causes: chronic cough, COPD (emphysema, chronic bronchitis), and pulmonary malignancies

Smoking exacerbates: asthma & everything else!

Question 2

What is COPD? What are its subtypes?

Answer 2

COPD = chronic obstructive pulmonary disorder = progressive airflow limitation, enhanced chronic inflammatory response in airways/lungs to particles/gases

3 subtypes = chronic bronchitis, emphysema, and chronic obstructive asmthma

Question 3

How are acute, subacute, and chronic cough defined?

Answer 3

Acute: <3 weeks

Subacute: 3-8 weeks

Chronic: >8 weeks

Question 4

What are the common causes of acute cough in adults?

Answer 4

Viral respiratory tract infaction (common cod)

Acute bacterial sinusitis

Pertussis

Acute exacerbation of COPD

Allergic rhinits

Environmental irritant rhinitis

Question 5

What are common causes of subacute cough in adults?

Answer 5

Bacterial sinusitis

Asthma

Post-infectious cough = post-bronchitic tussive syndrome, following a upper respiratory infection or lower respiratory tract infection (not pneumonia)

Question 6

What are common causes of a chronic cough in adults?

Answer 6

Post-nasal drip (upper airway cough syndrome)
Due to allergic rhinitis, vasomotor rhinitis (nonallergic cause i.e. cold, spicy food, etc.) or chronic bacterial sinusitis

Asthma

GERD

Chronic bronchitis

Eosinophilic bronchitis

Drug side effects- ACEI

Question 7

What are the major categoris of potential causes of hemoptysis?

Answer 7

Source other than lower respiratory tract

Lower respiratory tract sources:

Tracheobronchial

Pulmonary parenchyma

Primary vascular source

Misc/rare causes

Question 8

What are the most common causes of acute dyspnea?

Answer 8

Cardiac/pulmonary!!

Cardiac ischemia, CHF, COPD, pneumonia, bronchospasm/asthma, pulmonary embolism, pneumothorax

Other organs: neurologic, neuromuscular, hematologic (anemia), endocrin/metabolic (severe acidosis), psychiatric

Question 9

What are the most common causes of chronic dyspnea?

Answer 9

CHF, cardiac ischemia, asthma, COPD, diffuse parenchymal lung dz, deconditioning/obseity

Other organ systems: neuromuscular, hematologic, GI, psych