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CABS pulmonology > obstructive lung disease > Flashcards

obstructive lung disease Flashcards

1
Q

What allows for the passage of air between the alveoli to share to air

A

pores of Kohn

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2
Q

What is atelectasis

A

alveolar collapse

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3
Q

What is atelectasis associated with

A

compression
decreased surfactant
obstruction

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4
Q

What can cause compression of the alveoli

A

external force from pneumo, plural effusion, abdominal distention

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5
Q

What is occurring in obstruction of the alveoli

A

hypoventilation of the alveoli

-absorption of air that is left in alveoli with no new air coming in b/c of obstruction

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6
Q

Why does decreased surfactant cause atelectasis

A

the reduction or production / alteration in the makeup causes the tension to not be maintained

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7
Q

What is decreased surfactant associated with

A

premature births
aspiration
ARDS
anesthesia
ventilation

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8
Q

Which cells create surfactant

A

type 2 alveolar epithelial cells

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9
Q

What makes up surfactant

A

phospholipids, proteins, ions

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10
Q

What allows water retention for recoil in the alveoli

A

layer of fluid

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11
Q

What is obstructive lung disease

A

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

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12
Q

What may cause obstructions for the lungs

A

mechanical
increased resistance
airway closure

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13
Q

What can cause mechanical obstruction of airways

A

FB
Tumor

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14
Q

What causes increased resistance in the lungs

A

thickening associated with inflammatory changes

chronic bronchitis

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15
Q

What can cause airway closure in obstructive lung disease

A

asthma
emphysema

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16
Q

What is the biggest difference between asthma and COPD

A

COPD is irreversible

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17
Q

What is FEV1 and FVC in obstructive lung disease

A

decreased FEV1

lowered FEV1/FVC ratio

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18
Q

What is restrictive lug disease

A

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

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19
Q

What may cause restrictive lung disease

A

stiffening of the lungs
stiff chest wall
Muscular weakness or resp. muscle

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20
Q

What can cause the stiffening of the lungs

A

interstitial lung disease

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21
Q

What can cause a stiff chest wall

A

kyphosis
ankylosing spondylitits
obesity

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22
Q

What can cause muscular weakness of respiratory muscle

A

neurologic / neuromuscular disease

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23
Q

What type of lung disease Is COPD

A

chronic obstructive

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24
Q

What is often included with COPD

A

Emphysema and chronic bronchitis

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25
Q

What is emphysema

A

progressive destruction of alveolar membranes and dilatation of distal airways

*bronchioles collapse more readily

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26
Q

What is emphysema m/c associated with

A

smoking

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27
Q

What is occurring in the body during emphysema

A

macrophages try to protect alveoli and engulf forge in substance

inflammatory activation with cytokine release

increase WBC recruitment -> WBC release protease

Causes breakdown of CT surrounding alveoli

28
Q

What helps maintain alveolar shape

A

elastin

29
Q

What occurs when there is elastin breakdown in the alveoli

A

Airway will collapse and will trap inhaled air

Decrease alveolar surface area & decreased gas exchange

30
Q

What tissue layers make up bronchioles

A

epithelial (goblet cells & cilia)
Smooth muscle layer
Connective tissue layer

31
Q

What appearance will alveoli have in emphysema

A

honeycomb appearance

32
Q

What is the progression of emphysema

A

inflammation & exposure to toxins = growth factor activation = fibrous tissue deposition = irreversible damage

33
Q

What is a bleb

A

a small coalition of alveoli with loss of elastin because of a pneumo on the outer edge of the lung

**generally in upper lobe

34
Q

What is a Bulla

A

Air filled space of 1cm of diameter that has developed because of emphysematous destruction of lung parenchyma

35
Q

What are some complications of emphysema

A

hypoxemia
hypercapnia
pneumothorax

36
Q

What are some of the presentations of emphysema

A

Prolonged expiratory phase
accessory breathing
barrel shaped chest
decreased FEV1/FVC ration

37
Q

What causes chronic bronchitis

A

obstructive airflow secondary to thick mucus

38
Q

What is chronic bronchitis often associated with

A

smoking

39
Q

What is the job of goblet cells

A

modified epithelial cells to produce mucin to lubricate airways

40
Q

What occurs in the body with chronic bronchitis

A

irritation (smoking) will cause irritation = ciliary damage = over production of mucus = goblet cells will up regulate in size

41
Q

What occurs in the airway when glandular cells (goblet) become unregulated and increase in size

A

thickening of the airway

42
Q

What is the major problem with having damaged cilia

A

unable to get rid of excess mucus

43
Q

What are complications of chronic bronchitis

A

pneumonia distal to obstruction
hypoxemia
hypercapnia
VQ mismatch

44
Q

What are the types of COPD

A

Chronic bronchitis
emphysema

45
Q

What is bronchiectasis

A

Abnormal dilatation of bronchi which makes airways more readily collapsable

46
Q

what is bronchiectasis most commonly due to

A

cystic fibrosis
aspiration
immunodeficiency
connective tissue disease

47
Q

How does bronchiectasis present

A

productive cough with purulent, foul smelling sputum

hemoptysis

48
Q

What is asthma

A

Obstructive disease pattern associated with airways being hyperactive

reversible

49
Q

When do airways constrict with asthma

A

airways constrict secondary to inhalation of noxious stimuli

50
Q

What are common triggers for asthma

A

allergens
cold
exercise
illness
pets
increased emotional stress/anxiety

51
Q

What is the process during asthma attack

A

Trigger= dendritic cell activation= activate T cells = release interleukins = activate B cells & eosinophils = activate mast cells= degranulation = histamine production

52
Q

What do eosinophils release

A

protease which causes cellular destruction

53
Q

What occurs after the immediate asthma response

A

ciliary damage, decreased mucus expulsion = mucus plugging

54
Q

If asthma is left untreated, what can occur

A

irreversible airway remodeling associated with fibrosis and smooth muscle hypertrophy

55
Q

What can happen to intrathoracic pressure in asthmatics

A

can increase to the point they have pulsus paradoxus

56
Q

What occurs during an asthma exacerbation

A

increased lung volumes
muscular fatigue
respiratory failure

57
Q

How do asthmatics present during exacerbations

A

wheezing
tight chest
hyper expansion
cough
VQ mismatch
prolonged expiration

58
Q

What is cystic fibrosis

A

autosomal recessive resulting in mutation of cystic fibrosis transmembrane conductance regulator (CFTR)

59
Q

What chromosome does CF effect

A

7

60
Q

When is CF diagnosed

A

generally before 6 months old

61
Q

Where is CF found

A

epithelial cells of airways
bile ducts
pancrease
sweat glands
sinuses
vas defrens

62
Q

What are pulmonary manifestations in cystic fibrosis

A

mucus plugs
inflammatory reaction
increased risk of infection
recurrent infections

63
Q

What are complications of cystic fibrosis

A

peripheral bullae
pneumothorax
hemoptysis
cor pulmonale

64
Q

What are the common presentations of cystic fibrosis

A

neonate difficulty passing meconium

Foul smelling stool
failure to thrive
cough
infection
SOB

65
Q

What is the typical cause of death in CF patients

A

respiratory failure

CABS pulmonology (8 decks)

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