obstructive lung disease

Question 1

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

Answer 1

pores of Kohn

Question 2

What is atelectasis

Answer 2

alveolar collapse

Question 3

What is atelectasis associated with

Answer 3

compression
decreased surfactant
obstruction

Question 4

What can cause compression of the alveoli

Answer 4

external force from pneumo, plural effusion, abdominal distention

Question 5

What is occurring in obstruction of the alveoli

Answer 5

hypoventilation of the alveoli

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

Question 6

Why does decreased surfactant cause atelectasis

Answer 6

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

Question 7

What is decreased surfactant associated with

Answer 7

premature births
aspiration
ARDS
anesthesia
ventilation

Question 8

Which cells create surfactant

Answer 8

type 2 alveolar epithelial cells

Question 9

What makes up surfactant

Answer 9

phospholipids, proteins, ions

Question 10

What allows water retention for recoil in the alveoli

Answer 10

layer of fluid

Question 11

What is obstructive lung disease

Answer 11

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

Question 12

What may cause obstructions for the lungs

Answer 12

mechanical
increased resistance
airway closure

Question 13

What can cause mechanical obstruction of airways

Answer 13

FB
Tumor

Question 14

What causes increased resistance in the lungs

Answer 14

thickening associated with inflammatory changes

chronic bronchitis

Question 15

What can cause airway closure in obstructive lung disease

Answer 15

asthma
emphysema

Question 16

What is the biggest difference between asthma and COPD

Answer 16

COPD is irreversible

Question 17

What is FEV1 and FVC in obstructive lung disease

Answer 17

decreased FEV1

lowered FEV1/FVC ratio

Question 18

What is restrictive lug disease

Answer 18

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

Question 19

What may cause restrictive lung disease

Answer 19

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

Question 20

What can cause the stiffening of the lungs

Answer 20

interstitial lung disease

Question 21

What can cause a stiff chest wall

Answer 21

kyphosis
ankylosing spondylitits
obesity

Question 22

What can cause muscular weakness of respiratory muscle

Answer 22

neurologic / neuromuscular disease

Question 23

What type of lung disease Is COPD

Answer 23

chronic obstructive

Question 24

What is often included with COPD

Answer 24

Emphysema and chronic bronchitis

Question 25

What is emphysema

Answer 25

progressive destruction of alveolar membranes and dilatation of distal airways *bronchioles collapse more readily

Question 26

What is emphysema m/c associated with

Answer 26

smoking

Question 27

What is occurring in the body during emphysema

Answer 27

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

Question 28

What helps maintain alveolar shape

Answer 28

elastin

Question 29

What occurs when there is elastin breakdown in the alveoli

Answer 29

Airway will collapse and will trap inhaled air Decrease alveolar surface area & decreased gas exchange

Question 30

What tissue layers make up bronchioles

Answer 30

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

Question 31

What appearance will alveoli have in emphysema

Answer 31

honeycomb appearance

Question 32

What is the progression of emphysema

Answer 32

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

Question 33

What is a bleb

Answer 33

a small coalition of alveoli with loss of elastin because of a pneumo on the outer edge of the lung **generally in upper lobe

Question 34

What is a Bulla

Answer 34

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

Question 35

What are some complications of emphysema

Answer 35

hypoxemia hypercapnia pneumothorax

Question 36

What are some of the presentations of emphysema

Answer 36

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

Question 37

What causes chronic bronchitis

Answer 37

obstructive airflow secondary to thick mucus

Question 38

What is chronic bronchitis often associated with

Answer 38

smoking

Question 39

What is the job of goblet cells

Answer 39

modified epithelial cells to produce mucin to lubricate airways

Question 40

What occurs in the body with chronic bronchitis

Answer 40

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

Question 41

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

Answer 41

thickening of the airway

Question 42

What is the major problem with having damaged cilia

Answer 42

unable to get rid of excess mucus

Question 43

What are complications of chronic bronchitis

Answer 43

pneumonia distal to obstruction hypoxemia hypercapnia VQ mismatch

Question 44

What are the types of COPD

Answer 44

Chronic bronchitis emphysema

Question 45

What is bronchiectasis

Answer 45

Abnormal dilatation of bronchi which makes airways more readily collapsable

Question 46

what is bronchiectasis most commonly due to

Answer 46

cystic fibrosis aspiration immunodeficiency connective tissue disease

Question 47

How does bronchiectasis present

Answer 47

productive cough with purulent, foul smelling sputum hemoptysis

Question 48

What is asthma

Answer 48

Obstructive disease pattern associated with airways being hyperactive reversible

Question 49

When do airways constrict with asthma

Answer 49

airways constrict secondary to inhalation of noxious stimuli

Question 50

What are common triggers for asthma

Answer 50

allergens cold exercise illness pets increased emotional stress/anxiety

Question 51

What is the process during asthma attack

Answer 51

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

Question 52

What do eosinophils release

Answer 52

protease which causes cellular destruction

Question 53

What occurs after the immediate asthma response

Answer 53

ciliary damage, decreased mucus expulsion = mucus plugging

Question 54

If asthma is left untreated, what can occur

Answer 54

irreversible airway remodeling associated with fibrosis and smooth muscle hypertrophy

Question 55

What can happen to intrathoracic pressure in asthmatics

Answer 55

can increase to the point they have pulsus paradoxus

Question 56

What occurs during an asthma exacerbation

Answer 56

increased lung volumes muscular fatigue respiratory failure

Question 57

How do asthmatics present during exacerbations

Answer 57

wheezing tight chest hyper expansion cough VQ mismatch prolonged expiration

Question 58

What is cystic fibrosis

Answer 58

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

Question 59

What chromosome does CF effect

Answer 59

7

Question 60

When is CF diagnosed

Answer 60

generally before 6 months old

Question 61

Where is CF found

Answer 61

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

Question 62

What are pulmonary manifestations in cystic fibrosis

Answer 62

mucus plugs inflammatory reaction increased risk of infection recurrent infections

Question 63

What are complications of cystic fibrosis

Answer 63

peripheral bullae pneumothorax hemoptysis cor pulmonale

Question 64

What are the common presentations of cystic fibrosis

Answer 64

neonate difficulty passing meconium Foul smelling stool failure to thrive cough infection SOB

Question 65

What is the typical cause of death in CF patients

Answer 65

respiratory failure