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Obstructive Lung Disease Flashcards

1
Q

Patient with Obstructive Pulmonary Disease will have difficulty inhaling or exhaling?

A

Exhaling

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2
Q

What are the 2 most common S/S of Obstructive Lung Disease?

A

Dyspnea upon exertion and a productive cough

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3
Q

What is the 3rd most deadliest disease?

A

COPD

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4
Q

What are the 2 primary causes of Obstructive Lung Disease

A

Inhalation(smoking)

Genetics(affects surfactant and integrity of alveolar sac).. inherited a1-antitrypsin deficiency

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5
Q

T/F: All persons, smoking or non, will experiences a decrease in FEV1?

A

True

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6
Q

T/F a patient with COPD who quits smoking can experience a FEV1 decline that parallels a non-smoking, age matched person

A

True

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7
Q

Place the following terms in order based off the process of obstructive airway diseases:

  1. obstruction
  2. irritant
  3. inflammation
  4. infection
  5. elastic recoil destroyed
A

Irritant->inhalation leads to airway and alveolar inflammatory response, continues as long as irritant is present, long exposure will cause irreversible damage
Infection->speeds process
Inflammation->starts in small airways of lungs, breaks down elastin and connective tisssue, leads to hyperplasia and mucus secretion
Obstruction->hypersecretion of mucus, mucus plugging, edema, increased reactivity and eventual bronchial fibrosis and destruction of terminal airways
Elastic recoil destroyed

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8
Q

Obstructive lung disease will cause lung hypoinflation or hyperinflation?

A

Hyperinflation

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9
Q

What is the gold standard of hyperinflation of the lungs and its gas exchanging capabilities?

A

ABG

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10
Q

Decreased bucket handle action at the ribs would indicate _____ angled ribs ____degrees

  • horizontal or vertical
  • <90 degrees or >90 degrees
A

horizontal ribs >90 degrees

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11
Q

Elevation of the shoulder girdle that occurs with lung hyperinflation is caused by?

A

Accessory muscles being used for ventilation instead of the diaphragm

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12
Q

During hyperinflation the diaphragm will take on what shape?

A

Low, flattened shape

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13
Q

Common s/s of lung hyperinflation include:

A

elevation of the shoulder girdle
horizontal ribs
barrel shaped thorax
low flattened diaphragm

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14
Q

Name that dyfunction:
Expiration: mucous plugs and narrowed airways cause air trapping and hyperinflation on expiration, decreased elastic recoil of bronchial walls results in collapse of airways and prevents normal expiatory airflow

Inspiration: airways pulled open, allowing gas to flow past the obstruction

A

COPD

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15
Q

What posture does a COPD patient take on?

A

Forward leaning posture

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16
Q

COPD patients would have cyanosis or flushin?

A

Cynosis and clubbing

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17
Q

COPD patients would have increased or decreased breath sounds and increased or decreased CO2?

A

Decreased breath sounds, increased CO2, decreased O2

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18
Q

What long volumes(2) and ratio would prominently be affected by COPD?

A

FEV1, FVC, FEV1/FVC ratio

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19
Q

How could a flatted diaphragm from lung hyperinflation cause pelvic and/or bladder issues

A

Increased pressure causes incontinence

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20
Q

Muscle composition for COPD patients would change to what type of fiber?

A

Type II fast twitch

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21
Q

How many stages of COPD are there?

A

4

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22
Q

Chronic respiratory failure is considered anything less than what percent of the FEV1/FEVC?

A

50%

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23
Q

The stages of COPD look at what ratio to define respiratory failure and what lung volume?

A

FEV1/FVC

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24
Q

FEV1/FVC must be less than what to be considered mild, moderate or severe?

A
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25
The degree of severity of COPD is dependent of FEV1/FVC or the lung volume FEV1?
FEV1
26
A patient has an FEV1 of 83%, what stage would she fall under?
Stage 1: mild, with or without chronic symptoms. Cough and sputum FEV1>80%
27
A patient has a FEV1 of 65%, what stage does he fall under?
Stage 2: moderate, SOB with exertion, chronic cough, sputum | FEV1: 50-80%
28
A patient has a FEV1 of 35%, what stage does she fall under?
Stage 3: severe, decreases exercises capacity, chronic cough, sputum, SOB FEV1: 30-50%
29
A patient has a FEV1 of 25%, what stage does he fall under?
Stage 4: very severe, decreased QOL, life threatening, right heart failure, weight loss FEV1<30 OR <50% with chronic respiratory failure
30
What is the gold standard for diagnosing COPD?
Spirometry
31
T/F: Obstructive disease: delayed and incomplete emptying of lung during exhalation
True
32
Define FEV1
forced expiratory volume in 1 sec
33
What is a normal FEV1/FVC ration?
>75%
34
What is a normal FEV1?
90%
35
What lung volume will be decreased with COPD?
FEV1
36
What two lung volumes will be increased with COPD?
TLC and RV
37
What ratio will be decreased with COPD concerning lung volumes?
FEV1/FVC
38
Destruction of alveolar walls and enlargement of airspaces distal to terminal bronchioles
Emphysema
39
What is a major cause of emphysema?
Smoking
40
Presence of chronic productive cough for 3 mo in 2 successive years Hypersecretion of mucus begins in large airways and progress to smaller airways
Chronic bronchitis
41
Emphysema vs chronic bronchitis: excessive body fluids
bronchitis
42
Emphysema vs chronic bronchitis: chronic cough
bronchitis
43
Emphysema vs chronic bronchitis: cyanosis
bronchitis
44
Emphysema vs chronic bronchitis: pursed lip breathing
emphysema
45
Emphysema vs chronic bronchitis: minimal cough
emphysema
46
Emphysema vs chronic bronchitis: forward leaning
emphysema
47
Emphysema vs chronic bronchitis: blue bloater
bronchitis
48
Emphysema vs chronic bronchitis: pink puffer
emphysema
49
Emphysema vs chronic bronchitis: use accessory muscles
emphysema
50
Exhalation >___ seconds in abnormal
4
51
Emphysema: pink puffer or blue bloater?
Pink puffer: skinny, use acessory muscles to breath with pursed lips while forward leaning, minimal cough, SOB later
52
Chronic bronchitis: pink puffer or blue bloater
Blue bloater: fat, excess body fluids causing productive cough and SOB, cynosis
53
On the Body mass Obstruction Dyspnea Exercises Index what is a score associated with high mortality?
7-10
54
End stage COPD is commonly found in conjunction with left or right heart failure?
Right, increased pressure causing pulmonary hypertension
55
What is the single most effective intervention for COPD?
Cessation of smoking
56
Abnormal dilation of bronchi and excessive sputum production
bronchiestasis: Dilation: irreversible with chronic inflammation and infection S/S: productive mucopurulent secretions greatest in morning , recurrent lung infections Cause: bronchial wall injury, traction from lung fibrosis, tumor
57
Thickening of secretions of all exocrine glands
Cystic Fibrosis
58
Name that syndrome! Meconium ileus (bowel obstruction of baby’s 1st stool)  Frequent respiratory infections (staph, pseudomonas aeruginosa)  Inability to gain weight  90% have pancreatic insufficiency
Cystic fibrosis
59
What is the gold standard of diagnosing cystic fibrosis?
Electrolyte test from sweat
60
What are common reasons patients with cystic fibrosis die?
- Pulmonary complications | - Right heart failure
61
``` Name that syndrome:  Chronic pneumonia  Recurrent wheezing  Fatigue  Chronic productive cough  Chronic hypoxia • Clubbing, barrel chest  Decreased absorption of vitamins and enzymes  Chronic URI(upper respiratory infection) ```
Cystic fibrosis
62
Is cystic fibrosis obstructive or restrictive?
Can be either!
63
Name that syndrome! Increased reaction to stimuli within the trachea and bronchi  Narrowing of airways due to inflammation, constriction, secretions
Asthma
64
What is the most common drug type for asthma?
Bronchodilator

Cardiopulmonary (8 decks)

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