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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

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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?

25
what is the DLCO in asthma?
nl to increased
26
What is inspiratory wheeze indicative of?
vocal cord dysfunction
27
what phase is wheezing heard in asthma?
expiratory
28
what is the pathophysiology of asthma?
airway inflammation, edema, and mucous plugging leading to gas trapping and airflow obstruction
29
what would the PV curve of asthma show?
increased volumes but normal slope because elastic recoil is normal
30
why are there increased lung volumes in asthma?
because there is air trapping
31
what is the long term treatment of vocal cord dysfunction?
speech therapy
32
on a methacholine challenge on vocal cord dysfunction what will be seen?
no change in FEV1 or PC20
33
What must the FEV1/FVC be in COPD?
34
if you have a 50 year smoking history what chance do you have to develop COPD?
20% chance
35
what are the characteristics of a blue bloater and what disease is this associated with?
``` hypoventilator hypoxic hypercapnic cor pulmonale CHRONIC BRONCHITIS ```
36
What are the characteristic of a pink puffer and what disease is this associated with?
hyperventilator less hypoxic/hypercapnic than blue bloater EMPHYSEMA
37
what are the historical requirements for diagnosis of chronic bronchitis?
cough > 3 months over the past 2 years without specific cause
38
What is the pathogenesis of chronic bronchitis
glandular hypertrophy and over excretion of fluid mucous leading to impaired ventilation
39
What is the pathogenesis of emphysema?
loss of normal alveolar space with enlargement of distal airspaces
40
what happens to compliance in emphysema?
it increases. The lungs are like a big floppy bag because of loss of elastic tissue and increased apoptosis of alveolar cells
41
What are the 2 types of emphysema?
Panacinar | Centriacinar
42
What location is panacinar emphysema located and which patients are more likely to have this type of emphysema?
involves the entire acinus | usually present in older patients or those with alpha 1 antitrypsin deficiency
43
What location is centriacinar emphysema located and which patients are more likely to have this type of emphysema?
involves the respiratory bronchiole | usually present in smokers
44
what is the PV curve of emphysema?
leftward shift and increased slope
45
what is the physical exam findings for chronic bronchitis?
cough rhonchi wheezing
46
what is the physical exam findings for emphysema?
diminished breath sounds | hyperresonant
47
What are common physical exam findings for both chronic bronchitis and emphysema?
prolonged expiratory phase pursed lip breathing tri-pod positionig
48
what is the best predictor for survival of COPD?
FEV1
49
what is the grading system for COPD?
GOLD 1-4 with 4 being the worst
50
what are the most common causes of death in COPD?
``` respiratory failure RV failure pneumonia spontaneous ptx PE ```
51
What are the distinguishable features of asthma compared to emphysema and bronchitis?
reversible, episodic exacerbation with methacholine normal and increased DLCO
52
what are the distinguishable features of chronic bronchitis compared to asthma and emphysema?
``` minimal reversibility (under stable conditions) normal to slightly increased DLCO ```
53
what are the distinguishable features of emphysema compared to asthma and emphysema?
marked hyperinflation no reversibility to bronchodilation decreased DLCO shift in PV curve
54
What is key feature of bronchiectasis?
abnormal dilation of proximal bronchi
55
what is the physical exam finding of bronchiolitis?
inspiratory squeaks on exam

Pulmonary (32 decks)

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