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Pulmonary > Obstructive lung disease > Flashcards

Obstructive lung disease Flashcards

1
Q

How does radius affect airway resistance?

A

resistance is inversely proportional to the r^4

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2
Q

How does radius affect airway resistance?

A

resistance is inversely proportional to the r^4

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3
Q

how does airflow obstruction lead to increased lung volumes?

A

incomplete emptying of alveoli (breath stacking and gas trapping)

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4
Q

What is a key word for airway hyper responsiveness?

A

asthma

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5
Q

What are the 2 types of asthma and what causes them?

A 
Extrinsic = allergic IgE mediated
Intrinsic = non-seasonal, non-allergenic, chronic and persistent
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6
Q

Is asthma a Th2 or Th1 mediated disease?

A

Th2

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7
Q

what is the DLCO in asthma?

A

nl to increased

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8
Q

What is inspiratory wheeze indicative of?

A

vocal cord dysfunction

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9
Q

what phase is wheezing heard in asthma?

A

expiratory

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10
Q

what is the pathophysiology of asthma?

A

airway inflammation, edema, and mucous plugging leading to gas trapping and airflow obstruction

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11
Q

what would the PV curve of asthma show?

A

increased volumes but normal slope because elastic recoil is normal

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12
Q

why are there increased lung volumes in asthma?

A

because there is air trapping

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13
Q

what is the long term treatment of vocal cord dysfunction?

A

speech therapy

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14
Q

on a methacholine challenge on vocal cord dysfunction what will be seen?

A

no change in FEV1 or PC20

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15
Q

What must the FEV1/FVC be in COPD?

A
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16
Q

if you have a 50 year smoking history what chance do you have to develop COPD?

A

20% chance

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17
Q

what are the characteristics of a blue bloater and what disease is this associated with?

A 
hypoventilator
hypoxic
hypercapnic
cor pulmonale
CHRONIC BRONCHITIS
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18
Q

What are the characteristic of a pink puffer and what disease is this associated with?

A

hyperventilator
less hypoxic/hypercapnic than blue bloater
EMPHYSEMA

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19
Q

What is the pathogenesis of chronic bronchitis

A

glandular hypertrophy and over excretion of fluid mucous leading to impaired ventilation

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20
Q

What is the pathogenesis of chronic bronchitis

A

glandular hypertrophy and over excretion of fluid mucous leading to impaired ventilation

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21
Q

how does airflow obstruction lead to increased lung volumes?

A

incomplete emptying of alveoli (breath stacking and gas trapping)

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22
Q

What is a key word for airway hyper responsiveness?

A

asthma

How well did you know this?
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4
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23
Q

What are the 2 types of asthma and what causes them?

A 
Extrinsic = allergic IgE mediated
Intrinsic = non-seasonal, non-allergenic, chronic and persistent
24
Q

Is asthma a Th2 or Th1 mediated disease?

A

Th2

25
Q

what is the DLCO in asthma?

A

nl to increased

26
Q

What is inspiratory wheeze indicative of?

A

vocal cord dysfunction

27
Q

what phase is wheezing heard in asthma?

A

expiratory

28
Q

what is the pathophysiology of asthma?

A

airway inflammation, edema, and mucous plugging leading to gas trapping and airflow obstruction

29
Q

what would the PV curve of asthma show?

A

increased volumes but normal slope because elastic recoil is normal

30
Q

why are there increased lung volumes in asthma?

A

because there is air trapping

31
Q

what is the long term treatment of vocal cord dysfunction?

A

speech therapy

32
Q

on a methacholine challenge on vocal cord dysfunction what will be seen?

A

no change in FEV1 or PC20

33
Q

What must the FEV1/FVC be in COPD?

A
34
Q

if you have a 50 year smoking history what chance do you have to develop COPD?

A

20% chance

35
Q

what are the characteristics of a blue bloater and what disease is this associated with?

A 
hypoventilator
hypoxic
hypercapnic
cor pulmonale
CHRONIC BRONCHITIS
36
Q

What are the characteristic of a pink puffer and what disease is this associated with?

A

hyperventilator
less hypoxic/hypercapnic than blue bloater
EMPHYSEMA

37
Q

what are the historical requirements for diagnosis of chronic bronchitis?

A

cough > 3 months over the past 2 years without specific cause

38
Q

What is the pathogenesis of chronic bronchitis

A

glandular hypertrophy and over excretion of fluid mucous leading to impaired ventilation

39
Q

What is the pathogenesis of emphysema?

A

loss of normal alveolar space with enlargement of distal airspaces

40
Q

what happens to compliance in emphysema?

A

it increases. The lungs are like a big floppy bag because of loss of elastic tissue and increased apoptosis of alveolar cells

41
Q

What are the 2 types of emphysema?

A

Panacinar

Centriacinar

42
Q

What location is panacinar emphysema located and which patients are more likely to have this type of emphysema?

A

involves the entire acinus

usually present in older patients or those with alpha 1 antitrypsin deficiency

43
Q

What location is centriacinar emphysema located and which patients are more likely to have this type of emphysema?

A

involves the respiratory bronchiole

usually present in smokers

44
Q

what is the PV curve of emphysema?

A

leftward shift and increased slope

45
Q

what is the physical exam findings for chronic bronchitis?

A

cough
rhonchi
wheezing

46
Q

what is the physical exam findings for emphysema?

A

diminished breath sounds

hyperresonant

47
Q

What are common physical exam findings for both chronic bronchitis and emphysema?

A

prolonged expiratory phase
pursed lip breathing
tri-pod positionig

48
Q

what is the best predictor for survival of COPD?

A

FEV1

49
Q

what is the grading system for COPD?

A

GOLD 1-4 with 4 being the worst

50
Q

what are the most common causes of death in COPD?

A 
respiratory failure
RV failure
pneumonia
spontaneous ptx
PE
51
Q

What are the distinguishable features of asthma compared to emphysema and bronchitis?

A

reversible, episodic
exacerbation with methacholine
normal and increased DLCO

52
Q

what are the distinguishable features of chronic bronchitis compared to asthma and emphysema?

A 
minimal reversibility (under stable conditions)
normal to slightly increased DLCO
53
Q

what are the distinguishable features of emphysema compared to asthma and emphysema?

A

marked hyperinflation
no reversibility to bronchodilation
decreased DLCO
shift in PV curve

54
Q

What is key feature of bronchiectasis?

A

abnormal dilation of proximal bronchi

55
Q

what is the physical exam finding of bronchiolitis?

A

inspiratory squeaks on exam

Pulmonary (32 decks)

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