medical respiratory conditions Flashcards

1
Q

describe COPD and its characteristics

A

COPD= chronic obstructive pulmonary disease
-it is a common, preventable and treatable disease that is characters tided by persistent respiratory symptoms and airflow limitation

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2
Q

in relation to COPD, what does a limitation of airflow mean?

A

it means that is is difficult to exhale fully
-spirpmetry shows a reduced ratio of FEV1:FVC - key for diagnosis

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3
Q

what structural changes can chronic inflammation lead to?

A

narrowing of the small airways, decreased elastic recoil, parenchyma destruction (sites of exchange)
-this leads to a diminished ability of the lungs to stay open during expiration

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4
Q

what 2 conditions is COPD associated with?

A

1.chronic bronchitis - inflammation and narrowing of the airways and mucous production
2. emphysema - break down of the alveolar membranes

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5
Q

what are examples of factors that can influence the development and progression of COPD?

A

-smoking
-exposure to pollutants
-age
-sex - women tend to have more severe disease
-infections
-lung growth and development

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6
Q

what is an alpha antitrypsin deficiency (AATD)?

A

a deficiency that affects the production of alpha 1 antitrypsin - which plays a crucial role in protecting the lung from damage caused by enzymes released by WBC’s
-these enzymes can destroy alveolar walls if not properly regulated by AAT

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6
Q

what are the most common symptoms of COPD?

A

-shortness of breath
-cough - intermittent or chronic cough
-sputum prediction - not present in all patients
-wheezing and chest tightness
-fatigue, weight loss and muscle loss

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7
Q

what is hyperinflation in COPD?

A

refers to the abnormal increase in the volume of air remaining in the lungs at the end of normal exhalation - this occurs because people with COPD have narrowed or obstructed airways making it difficult to exhale

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7
Q

what are the 2 types of hyperinflation in COPD?

A

-static
-dynamic

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8
Q

define static hyperinflation

A

-refers to the increase in lung volume that remains constant over time - ie there is an abnormal increase in the amount of air left in the lungs after exhalation which doesnt change much with activity

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9
Q

define dynamic hyperinflation

A

the increase in lung volume that happens during physical activity eg exercise
- eg if a person with COPD exercises, their airways might become more obstructed, leading to more air being trapped in the lungs during each breath

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10
Q

what are morbidities?

A

morbidities refer to the presence of one of more diseases or health conditions in a person

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11
Q

what morbidities is COPD associated with?

A
  • cardiovascular disease
  • skeletal muscle dysfunction
    -metabolic syndrome
    -osteoporosis
    -lung cancer
    -depression and anxiety
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12
Q

what are COPD exacerbations?

A

-episodes where the symptoms of COPD worsen significantly compared to the usual state
- eg increased breathlessness, coughing, changes in sputum , wheezing etc

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13
Q

what important test is required to diagnose COPD?

A

lung spirometry - the presence of a FEV1/FVC less than 0.7 confirms the presence of airflow limitation

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14
Q

what is FVC?

A

the amount of air that can be forcibly exhaled from your lungs after taking the deepest breath possible, as measured by spirometry

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15
Q

what is FEV1?

A

forced expiratory volume in 1 second
-measures the volume of expired air over the first second of an FVC measure
-healthy lungs will exhale more than 80% of the FVC in the first second

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16
Q

describe GOLD stage 1, stage 2, stage 3 and stage 4 values in relation to FEV1/FVC values

A

-GOLD stage 1 (mild) - FEV1 will be less than 80%
-GOLD stage 2 (moderate) - FEV1 between 50 and 80% predicted
-GOLD stage 3 (severe)- FEV1 between 30-50% predicted
-GOLD stage 4 - very severe - FEV1 less than 30%

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17
Q

what is the modified MRC dyspnea scale?

A

it is a tool used to assess the level of breathlessness or dyspnea experienced by people, particularly those w/ chronic respiratory conditions eg COPD etc

18
Q

what is the BORG breathlessness scale?

A

a subjetive tool used to measure the intensity of breathlessness experienced by people - using a scale range 0-10what

19
Q

what is the ACBD tool?

A

a structured assessment tool to evaluate and manage patients with COPD- stands for A (assess exacerbation freq), C (comorbidities), B (breathlessness), D (daily functioning)

20
Q

what does the pharmacological treatment of COPD involve?

A

-bronchodilators
-antiinflammatories
-oxygen therapy
-mucolytics (meds to help break down mucous)
-corticosteroids

21
Q

what does non-pharmacological treatment of COPD involve?

A

-pulmonary rehab
-smoking cessation
-nutrition
-airway clearance techniques
-surgery - lung volume reduction surgery, lung transplant etc

22
Q

what are endobronchial valves?

A

they are one way valves that restrict airflow to a particular lung segment

23
Q

what are the goals of management of COPD?

A

-relieve symptoms
-improve exercise tolerance
-improve health status
-prevent disease progression
-reduce mortality

24
Q

what is the strongest predictor of mortality for people with COPD?

A

physical activity
-people with COPD who are more active experience fewer hospitalisations and exaceberations

25
Q

what is asthma?

A

-asthma is usually characterised by chronic airflow limitation
-defined by the history of respiratory symptoms such as wheeze, SOB, chest tightness and cough
-both symptoms and airflow limitation vary over time and intensity and they can be triggered by exercise, allergens etc

26
Q

compare COPD vs asthma

A

-COPD- onset in mid line, symptoms slow and progressive, long smoking history, largely irreversible airflow limitation
-asthma - early onset in life, symptoms vary from day to day, may have associated allergic disease, largely reversible airflow limitation

27
Q

what is the treatment for asthma?

A

-inhaled corticosteroid inhaler
- preferred reliever - long active beta agonist

28
Q

define bronchiectasis

A

the term used for the permanent dilation of 1 or more bronchi

29
Q

what is non CF bronchiectasis?

A

refers to a broad set of conditions that give rise to airway injury that result in inflammation, increased mucus secretions and infections that produce airway dilatation

30
Q

what are the key features if non CF bronchiectasis?

A

-bronchial dilation
-mucus accumulation
-recurrent infections
-chronic cough & sputum production

31
Q

what are examples of some causes of non CF bronchiectasis?

A

-lung infection eg TB, pneumonia, whooping cough
-immunodeficiency
-local airway obstruction eg tumour, COPD, foreign body
-environmental exposures

32
Q

what are the main symptoms of non CF bronchiectasis?

A

-sputum - sometimes blood stained
-chronic cough
-SOB
-fatigue

33
Q

what does the pharmacological management of non CF bronchiectasis involve?

A

-mucolytic
-antibiotic
-corticosteroids
-bronchodilators
-oxygen therapy

34
Q

what is cystic fibrosis?

A

a genetically inherited disease that primarily affects the lungs and digestive system

35
Q

what is the genetic cause of CF?

A

-genetic mutation causes abnormalities in the production & function of a protein called the cystic fibrosis transmembrane conductance regulator
-CTFR acts as a chloride channel and a regulator of sodium chloride and bicarbonate transport

36
Q

what does inactive or compromised functioning of CTFR lead to?

A

impaired chloride transport and increased sodium absorption across airway epithelial cells
-dehydrates the airway surfaces and more viscid mucus
-cilia become impaired due to very sticky mucus, resulting in a build up of secretions

37
Q

how do you diagnose CF?

A

genetic testing
-sweat test - high conc of electrolytes in the sweat are a hallmark of CF - sweat chloride levels

38
Q

how is CF managed pharmacologically ?

A

-antibiotics
-bronchodilators
-hydrator therapy
-mucolytics
-CFTR modulators

39
Q

how is CF managed non pharmacologically?

A

-nutrition support
-airway clearance techniques - physio
-exercise
-surgery - lung transplant

40
Q

what is interstitial lung disease?

A

it is an umbrella term for a large group of disorders that cause scarring of the lungs
-the scarring causes stiffness in the lungs which makes it difficult to breathe

41
Q

what are examples of interstitial lung diseases?

A

-idiopathic pulmonary fibrosis
-hypersensitivity pneumonitis

42
Q

what is idiopathic pulmonary fibrosis?

A

chronic and progressive lung disease characterized by the thickening and scarring (fibrosis) of the lung tissue
-cause is not known

43
Q

what are the symptoms of IPF?

A

-SOB
-non productive cough
-fine crackles on auscultation

44
Q

compare the pharmacological vs non pharmacological management of IPF

A
  1. pharma =. corticosteroids, immunosuppressive agents, o2 therapy, anti-fibrotic agents
  2. pulmonary rehab, surgery, management of breathlessness etc