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CABS2: Pulm > obstructive lung disease > Flashcards

obstructive lung disease Flashcards

1
Q

what is the gas exchange unit within the lungs

A

alveloi

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2
Q

what is atelectasis

A

alveolar collapse
very common in patients who are immobilized

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3
Q

what is atelectasis associated with

A

compression: external force
Obstruction: hypoventilation
decreased surfactant: may be reduction of production or alternation in makeup of surfactant

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4
Q

what creates surfactant

A

type 2 alvelolar epithelial cells
mix of phospholipids, proteins, ions

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5
Q

what does surfactant do to the surface tension

A

keeps surface tension lower
creates water tension for recoil

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6
Q

what is the presentation of atelectasis

A

typically asymptomatic
may have SOB, cough, fever, elevated WBC

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7
Q

what are obstructive lung diseases

A

disease state in which it is difficult for the patient to get air OUT of the lung

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8
Q

what can cause obstructive lung disease

A

mechanical obstruction: FB, tumor, mucus plug
increased resistance: thickening associated with inflam changes, chronic bronchitis
airway closure : asthma/emphysema

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9
Q

what is lowered with obstructive patterns

A

Decreased FEV1
FEV1/FVC ratio

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10
Q

what is FEV1

A

forced expiratory volume in 1 second

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11
Q

what is restrictive lung disease

A

disease state in which it is difficult for the patient to get air IN to the lung

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12
Q

what can restrictive lung disease be associated with

A

stiffening of the lungs
stiff chest wall
muscular weakness of respiratory musculature

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13
Q

What is emphysema

A

progressive destruction of alveolar membranes and dilation of the distal airways

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14
Q

what is emphysema associated with

A

most commonly associated with smoking (inhaled pollutant)
less commonly associated with alpha-1 antitrypsin deficiency

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15
Q

what occurs with emphysema

A

macrophages try to protect alveoli and engulf foreign substance (pollutant)
inflammatory activation with cytokine release
increased WBC recruitment
WBC release proteases
break down the connective tissue surrounding alveoli

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16
Q

what are the layers of the cronchioles

A

epithelial lining: contains goblet-cells and cilia
smooth muscle layer
connective tissue

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17
Q

what presents with a honeycombing appearance

A

emphysema - large airspace

18
Q

is emphysema reversible or irreversible

A

irreversible damage

19
Q

what are complications of emphysema

A

hypoxemia, hypercapnia
pneumothorax

20
Q

what is the presentation of emphysema

A

dyspnea
prolonged expiratory phase
accessory breathing
wheezing
barrel shaped chest
dyspnea
decreased FEV1/FVC ratio

21
Q

what is a bleb vs bulla

A

bleb- small
bulla - large

22
Q

what is chronic bronchitis

A

obstructive airflow secondary to thick mucus - not as much structural, more mucus plugging
associated with smoking

23
Q

what occurs during chronic bronchitis

A

exposure (smoking) will cause irritation/inflammation
cellular damage, ciliary damage
over production of mucus
goblet cells will unregulated/increase the number and size, thickening in the airway

24
Q

what is air trapping

A

decreased air out during expiration compared to air in during inspiration

25
Q

what is a mucus plug

A

increased mucus with chronic bronchitis can lead to a mucus plug which further reduces the passage of air

26
Q

what is the presentation of chronic bronchitis

A

dyspnea - worse with exertion
decreased FEV1/FVC ratio
flare will lead to decreased alveolar lumen

27
Q

what are complications of chronic bronchitis

A

pneumonia distal to obstruction
hypoxemia
hypercapnia
VQ mismatch

28
Q

What is bronchiectasis

A

considered a chronic obstructive pulmonary disease but not COPD
abnormal dilation of the bronchi
dilated airways more readily collapse
chronic inflammatory state will cause increased mucus production/stasis

29
Q

what is the most common cause of bronchiectasis

A

cystic fibrosis
aspiration
immunodeficiencies
connective tissue diseases

30
Q

what is the presentation of bronchiectasis

A

productive cough - foul smelling sputum, purulent
hemoptysis

31
Q

what is the atopic triad

A

atopic dermatitis (eczema)
allergic rhinitis (Hay fever)
asthma

32
Q

what are common triggers for asthma

A

allergens
cold
exercise
illness
pets
increased emotional stress/anxiety

33
Q

what is the process of asthma

A

trigger - leads to activation of dendritic cells
activated T cells
releases interleukins
activated B cells and eosinophils
activation of mast cells
degranulation -> histamine production

34
Q

what occurs during asthma exacerbation

A

patient will have increased lung volumes (like emphysema)
muscular fatigue
respiratory failure
intrathoracic pressure can increase to the point patient has pulsus paradoxus

35
Q

what are complications of asthma

A

chronic complications associated with repetitive cellular damage - fibrosis

36
Q

what is cystic fibrosis

A

autosomal recessive abnormality resulting in mutation of CF transmembrane conductance regulator (CFTR protein)

37
Q

what is CFTR

A

chronic transportation protein on the exocrine glands
found in epithelial cells of the airways, bile ducts, pancreas, sweat glands, sinuses, vas deferens

38
Q

what is the pulmonary manifestations of CF

A

mucus plugs
inflammatory reaction
increased risk of infection
recurrent infections - chronic inflammatory changes - COPD/Bronchiectasis

39
Q

what are complications of CF

A

peripheral bullae
pneumothorax
hemoptysis
cor pulmonale

40
Q

what is the presentation of CF

A

neonatal difficulty with passage of meconium
foul smelling stool
failure to thrive
cough
infections
SOB

41
Q

what is the typical cause of death in patient with CF

A

respiratory failure

42
Q

what occurs with CF alternation

A

change in water concentration/movement
thickening of secretions (dehydration)

CABS2: Pulm (7 decks)

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