Obstructive lung disease Flashcards
A 78-year-old patient presents with severe COPD (FEV1, 25%), a former smoker, with three hospitalizations for exacerbation of COPD during the last year. He is admitted to the emergency department because of severe dyspnea and fever. Vesicular murmur is not auscultated, and the sputum is greenish and abundant. Arterial gasometry (FIO2, 21%) shows PaO2, 36 mm Hg; PaCO2, 63 mm Hg; pH 7.28; CO3H-, 31; EB-6; thorax plate without infiltrates. Recommend a therapeutic regimen.
Include two long-acting bronchodilators (beta2-agonist and anticholinergic) during the first hours of observation.
Transfer to the ICU for tracheal intubation, sedation, mechanical ventilation, systemic glucocorticoids, and a third-generation cephalosporin plus macrolide IV.
Include nebulized or systemic glucocorticoids during the first hours of observation.
Use reduced flow oxygen therapy (using nasal contact lenses) during the first hours of observation.
Include nebulized or systemic glucocorticoids during the first hours of observation.
Identify a complication of COPD in the elderly.
Hormonal changes
Blood clotting
Sepsis and septic shock
Cognitive impairment and pneumonia
Cognitive impairment and pneumonia
Analyze and select the statement that is true about bronchiectasis.
Symptoms include back pain, excessive sweating, light-headed feeling, and fainting.
Bronchiectasis causes a group of symptoms called Horner syndrome—drooping or weakness of one upper eyelid, a smaller pupil, and little or no sweating on the same side of the face.
The most frequent cause of this inflammation is infection. Adenovirus, which causes the common cold and other conditions, and the influenza virus are the main agents that produce it.
The most common medications used to treat bronchiectasis include isoniazid, rifampin (Rifadin, Rimactane), ethambutol (Myambutol), and pyrazinamide.
The most frequent cause of this inflammation is infection. Adenovirus, which causes the common cold and other conditions, and the influenza virus are the main agents that produce it.
In a patient with COPD, it is necessary to differentiate if the emphysematous component predominates over the bronchitic. Identify the characteristic that defines the emphysematous component.
There is an increase in lung marks in X-rays.
There is abundant purulent expectoration.
There is hypercapnia.
The main symptom of emphysema is shortness of breath.
The main symptom of emphysema is shortness of breath.
Analyze and select the most accurate statement about COPD.
Alveolar emphysema is the collapse of alveoli because of compression of the lung tissue or absorption of gas from obstructed alveoli.
COPD is a group of respiratory diseases characterized by an irreversible limitation of airflow. Smoking is the leading cause of COPD.
Emphysema is the abnormal dilation of the bronchi, secondary to another pulmonary disorder, usually infection or inflammation.
COPD is a group of respiratory diseases characterized by an irreversible limitation of airflow. Smoking is the leading cause of COPD.
A 60-year-old female with a 25-year history of smoking is diagnosed with emphysema. She has an increased anterior–posterior chest diameter. Propose to what the provider should attribute this finding.
There are increased flow rates.
There are decreased inspiratory reserve volumes.
There is the presence of fibrosis.
Many patients with COPD usually breathe with the upper portion.
Many patients with COPD usually breathe with the upper portion.
There are generally accepted clinical practice guidelines for the indication of chronic home oxygen therapy for patients with chronic obstructive pulmonary disease (COPD). Identify a good candidate for that type of intervention.
Partial arterial oxygen pressure (PaO2) = 52 mm Hg in a stable clinical situation
Partial arterial oxygen pressure (PaO2) = 54 mm Hg in acute clinical condition
Partial arterial oxygen pressure (PaO2) greater than 60 mm Hg in a stable clinical situation, but with a hematocrit value greater than 55%
Partial arterial oxygen pressure (PaO2) between 55 and 60 mm Hg in acute clinical condition, but with a history of more severe aggravations below 55 mm Hg
Partial arterial oxygen pressure (PaO2) = 52 mm Hg in a stable clinical situation
A 63-year-old male with a 20-year history of smoking is diagnosed with emphysema. When the provider is asked what causes this, recommend a response.
Changes in the lungs are caused by an association with alpha-1-antitrypsin deficiency; it is not caused by viral infections.
Changes in the lungs are caused by fibrotic lung disease.
Changes in the lungs are caused by bacterial infections.
Changes in the lungs are caused by a viral infection.
Changes in the lungs are caused by an association with alpha-1-antitrypsin deficiency; it is not caused by viral infections.
Preventive treatment is the fundamental one regarding bronchiectasis, eliminating or correcting factors capable of producing the disease. Determine the treatment of bronchiectasis.
Provide palliative care.
Remove the scarring tissue.
Use permanent oxygen therapy.
Improve the elimination of bronchial secretions by mucolytic and bronchodilator medications.
Improve the elimination of bronchial secretions by mucolytic and bronchodilator medications.
In a patient with COPD, it is necessary to differentiate if the emphysematous component predominates over the bronchitic. Identify the characteristic that defines the emphysematous component.
There is hypercapnia.
The main symptom of emphysema is shortness of breath.
There is an increase in lung marks in X-rays.
There is increased venous pressure.
The main symptom of emphysema is shortness of breath.
Analyze and select the most accurate statement about COPD in the elderly.
When a person is over 65, the immune system is not as strong as it used to be. Therefore, it is more susceptible to COPD.
Age raises the chances of serious flu complications, such as pneumonia and sepsis(bacterial infection in blood).
In elderly patients, the hemodynamic status is the most important prognostic criterion.
There are some pulmonary changes caused by aging, which make complications more common in older people. Sarcopenia(fragility) in an elderly person with COPD is an element of poor prognosis.
There are some pulmonary changes caused by aging, which make complications more common in older people. Sarcopenia(fragility) in an elderly person with COPD is an element of poor prognosis.
Identify a complication of COPD in the elderly.
Hormonal changes
Blood clotting
Arrhythmias and cor pulmonale
Sepsis and septic shock
Arrhythmias and cor pulmonale
Determine the cause of airflow limitation that characterizes stable COPD.
Increase in the CO
Alveolar hypoventilation
Prolonged time constant for lung emptying caused by increased resistance of the small conducting airways and increased compliance of the lung
Chronic obstruction of lung airflow that interferes with normal breathing
Chronic obstruction of lung airflow that interferes with normal breathing
Determine a common presenting factor that individuals with a recent diagnosis of emphysema should be assessed.
Cor pulmonale is the most common presenting factor of emphysema.
Cyanosis is the most common presenting factor of emphysema.
Dyspnea, not cor pulmonale, is the most common presenting factor of emphysema.
Productive cough is the most common presenting factor of emphysema.
Dyspnea, not cor pulmonale, is the most common presenting factor of emphysema.
A 70-year-old female with emphysema is having difficulty expiring a given volume of air. When giving a report, the provider will relay that the patient is most likely experiencing pulmonary disease. Identify the characteristics.
Emphysema is a form of pleuritic pulmonary disease, not obstructive.
Emphysema is a form of atelectatic pulmonary disease, not obstructive.
Emphysema is a form of bronchitic pulmonary disease, not obstructive.
Emphysema is a form of obstructive pulmonary disease, not pleuritic.
Emphysema is a form of obstructive pulmonary disease, not pleuritic.
