Obstructive Lung Disease Flashcards

1
Q

what is the most common worldwide risk factor for COPD?

A

smoking

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2
Q

what % of FEV1 is lost within each year of smoking?

A

25%

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3
Q

how do cigarattes lead to COPD?

A

cigs destroy cilia in lungs –> difficulty moving secretions –> mucus plugs up –> obstructive

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4
Q

what are the two types of OLD?

A

non-septic and septic

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5
Q

what is non-septic OLD?

A

no sputum production
emphysema
asthma

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6
Q

what is septic OLD?

A

large volume purulent sputum production
chronic bronchitis
CF

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7
Q

what are the pathologic changes in OLD?

A
  • hyperplasia of mucus-secreting cells (excess mucus production)
  • reactive airways w/ terminal airway destruction
  • alveolar sac destruction
    — all lead to reduction of airflow, lung hyperinflatation, and impaired gas exchange
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8
Q

what is emphysema triggered by?

A

body’s inflammatory response

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9
Q

what is chronic bronchitis

A

presence of chronic productive cough for 3 months in 2 successive years in absence of other pathologies

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10
Q

in chronic bronchitis, what is the airway obstruction from?

A
  • loss of elastic recoil
  • inflammation of respiratory bronchioles
  • hypertrophy of smooth muscle
  • mucus plugging
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11
Q

what changes in lung function do we see in OLD?

A
  • lung hyperinflatation
  • impaired gas exchange (hypoxemia or hypercapnia/excessive CO2 in blood)
  • impaired mucociliary function
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12
Q

what signs of hyperinflation are present on xray?

A
  • elevation of shoulder girdle
  • horizontal ribs
  • barrel shaped thorax
  • flattened diaphragm
  • increased subcostal angle
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13
Q

clinical presentations of chronic bronchitis?

A
  • cough
    • minimal production
    • sputum is thin unless infected
  • dyspnea (persistent/progressive esp. w/ BUE movement)
  • acute exacerbations
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14
Q

what is the V/Q ratio?

A

relationship between alveolar ventilation and pulmonary perfusion
V = alveolar ventilation (Va)
Q = pulmonary perfusion

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15
Q

what is the optimum V/Q ratio?

A

0.8 (4/5)

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16
Q

what is shunt perfusion?

A

perfusion without ventilation

17
Q

what is dead space ventilation?

A

alveolar gas without perfusion

18
Q

how much oxygen binds to hemoglobin in RBCs?

A

98%, 2% dissolves in plasma

19
Q

how much oxygen can a hemoglobin hold?

A

four O2 molecules

20
Q

characteristics of asthma?

A
  • widespread and variable airway obstruction
  • reversible spontaneously or w/ meds
  • episodic - periods of obstruction w/ otherwise normal lung function
21
Q

what is cystic fibrosis

A

multisystem disorder affecting children and young adults - affects epithelial cells

22
Q

what does cystic fibrosis manifest as?

A
  • recurrent and chronic cough
  • recurrent infections
  • salty skin
  • wheezing / SOB
  • poor growth + slow weight gain
  • frequent greasy, bulky stools or difficult BMs
23
Q

training pulmonary patients at what intensity results in substantial increases max. exercise capacity

A

60-85%

24
Q

what exercise routine might be better tolerated in pulmonary patients?

A

HIIT - 3-4x/week, intervals, 80% of max work rate for 15-20min progress to 100%, 5-6 RPE / 3-4 DOE