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respiratory > Obstructive lung disease > Flashcards

Obstructive lung disease Flashcards

1
Q

Obstructive lung disease - types

A
  1. Chronic bronchitis
  2. Emphysema
  3. Asthma
  4. Bronchiectasis
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2
Q

obstruction of air flow results in

A

air trapping in lungs

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3
Q

at high lung volumes, airways …

A

close prematurely

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4
Q

Obstructive lung disease - volumes

A
  1. increased RV
  2. decreased FVC
  3. increased TLC
  4. increased FRC
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5
Q

PFT

A

pulmonary function test

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6
Q

Obstructive lung disease - pulmonary function test

A
  1. largely decreased FEV1
  2. decreased FVC
  3. decreased FEV1/FVC ratio
  4. V/Q mismatch
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7
Q

Obstructive lung disease - hallmark

A

decreased FEV1/FVC ratio

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8
Q

Obstructive lung disease - affect heart? (mechanism)

A

Chronic, hypoxic pulmonary vasoconstriction can lead to cor pulmonale

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9
Q

chronic bronchitis - appearance

A

blue bloaters

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10
Q

Obstructive lung disease - mechanism of increased RV and decreased FVC

A

airways close prematurely at high lung volumes

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11
Q

Obstructive lung disease - characteristics

A
  1. airway obstruction

2. trapped air

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12
Q

chronic bronchitis - pathology

A

hyperplasia of mucus-secreting glands –> Reid index >50%

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13
Q

Reid index (pathology)

A

thickness of gland layer/total thickness of bronchial wall

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14
Q

chronic bronchitis - definition

A

productive cough for >3 months PER YEAR (not necessarily consecutive) for >2 years

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15
Q

chronic bronchitis - findings/symptoms

A
  1. wheezing 2. crackles 3. cyanosis 4. late onset dyspnea 5. hypercapnia 6. secondary polycythemia
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16
Q

chronic bronchitis - polycethemia

A

secondary to hypoxia

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17
Q

chronic bronchitis - cyanosis (mechansim)

A

early onset of hypoxia due to shunting

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18
Q

chronic bronchitis - hypercapnia (mechansim)

A

mucus plugs trap CO2

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19
Q

bronchiectasia

A

permanent dilation of bronchioles and bronchi

loss of airway tone results in air trapping

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20
Q

bronchiectasia is due to

A

chronic necrotizing infection

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21
Q

bronchiectasia symptoms

A
  1. purulent sputum
  2. recurrent infections
  3. hemoptysis
  4. digital clubbing
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22
Q

bronchiectasia is associated with (like predisposition)

A
  1. bronchial obstruction
  2. poor ciliary motility (SMOKING, kartegener syndrome)
  3. cystic fibrosis
  4. allergic bronchopulmonary aspergillosis
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23
Q

causes of poor ciliary motility

A
  1. smoking

2. kartegener syndrome

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24
Q

asthma mechanism

A

bronchial hyperresponsiveness causes reversible bronchoconstriction

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25
Q

asthma can be triggered by

A
  1. viral URI
  2. allergens
  3. stress
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26
Q

test asthma with

A

metacholine challenge

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27
Q

asthma symptoms and clinical findings

A
  1. cough 2. wheezing 3. tachypnea 4. dyspnea
  2. hypoxemia 6. decreased inspiratory/expiratory ratio
  3. puslus paradoxous 8. mucus plugging
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28
Q

pulsus paradoxus - seen in

A
  1. cardiac teponade 2. asthma 3. obstructive sleep apnea

4. pericarditis 5. croup

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29
Q

pulsus paradoxus - definition

A

decreased in amplitude of systolic BP by >10 during inspiration

30
Q

inspiratory/expiratory ratio in asthma

and why

A

decreased

expiration is prolonged

31
Q

normal inspiratory/expiratory ratio

A

1:2, 1:3 or 1:4

32
Q

asthma - histology

A
  1. smooth muscle hypertrophy
  2. Curschmann spirals
  3. Charcot - Leyden crystals
33
Q

Curschmann spirals

A

shed epithelium forms whorled mucus plugs (IN ASTHMA)

34
Q

Charcot - Leyden crystals

A

eosinophilic, hexagonal, double-pointed, needle-like crystal from breakdown of eosinophils in sputum (IN ASTHMA)

35
Q

asthma bronchoconstriction is mediated by

A
  1. inflammatory process

2. parasympathetic tone

36
Q

asthma drugs

A
  1. β2 agonists (albuterol, salmeterol, formoterol)
  2. corticosteroids (fluticasone, budesonide)
  3. Muscarinic antagonists (ipratropium)
  4. Antileukotrienes (montelukast, zafirlukast, zileuton)
  5. omalizumab
  6. Methylxanthines (theophylline)
  7. Metacholine
37
Q

emphysema - patient appearance

A

pink puffer

38
Q

emphysema - chest

A

barrel - shaped chest

39
Q

emphysema types

A
  1. centriacinar

2. Panacinar

40
Q

centriacinar emphysema - associations and area

A

associated with smoking –> upper lobes

41
Q

panacinar emphysema - associations and area

A

associated with α1 - antitrypsin –> lower lobes

42
Q

emphysema - diffusion capacity of CO test (and mechanism)

A

decreased diffusing capacity for CO resulting from destruction of alveolar walls

43
Q

emphysema properties

A
  1. enlargement of air spaces
  2. decreased recoil
  3. increased compliance
44
Q

emphysema - recoil

A

decreased

45
Q

emphysema - compliance

A

increased

46
Q

α1 - antitrypsin role

A

neutralizes proteases

47
Q

emphysema pathophysiology

A

increased elastase activity (imbalance of protease anti protease) –> loss of elastic fibers –> increased lung compliance

48
Q

emphysema - role of smoking

A

excessive inflammation and protease mediated damage

49
Q

centriacinar emphysema is most severe in (area)

A

upper lobes

50
Q

emphysema - pursed lips

A

expiration through pursed lips to increase airway pressure and prevent airway collapse during respiration

51
Q

emphysema - sputum?

A

minimal

52
Q

blue bloaters

A

chronic bronchitis

53
Q

pink puffer

A

emphysema

54
Q

diseases associated with a1 antitrypsin

A
  1. panacinar emphysema

2. cirrhosis

55
Q

chronic bronchitis is highly associated with

A

smoking

56
Q

chronic bronchitis - increased risk of

A
  1. infections (blocking)

2. cor pulmonale

57
Q

obstructive lung disease with weight loss

A

emphysema

58
Q

emphysema - chest appearance (and mechansim)

A

Barrel - shaped

increased anterioposterior diameter

59
Q

emphysema - late complications

A

cor pulmoale

hypoxemia

60
Q

nonallergic causes of asthma

A
  1. aspirin
  2. exercise
  3. occupational
  4. viral
61
Q

bronchiectasis - complications

A
  1. hypoxemia
  2. cor pulmonale
  3. SECONDARY AMYLOIDOSIS
62
Q

obstructive lung disease with amyloidosis

A

bronchiectasis

63
Q

obstructive lung disease with polycythemia

A

chronic bronchitis

64
Q

obstructive lung disease with hemoptysis

A

bronchiectasis

65
Q

Crackles are caused by … (and characteristics)

A

explosive opening of small airways and are discontinuous, nonmusical, and brief

66
Q

Asthma - CXR

A

peribronchial cuffing (thickening)

67
Q

emphysema - CXR

A
  1. increased anteriopostosterior diameter
  2. flattened diaphragm
  3. high lung field lucency
68
Q

chronic bonchitis vs emphysema according to PCO2

A

chronic bronchitis –> hypercapnia (retention)

emphysema –> normocapnia (maintain alveolar ventilation)

69
Q

chronic bonchitis vs emphysema according to PO2

A

chronic bronchitis –> severe hypoxemia (cyanosis)

emphysema –> mild hypoxemia

70
Q

chronic bonchitis vs emphysema according to PO2 and PCO2

A

chronic bronchitis –> severe hypoxemia, hypercapnia

emphysema –> mild hypoxemia, normocapnia

respiratory (27 decks)

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