Obstructive Pulmonary Disease

Question 1

What are the two main causes for obstructive pulmonary disease?

Answer 1

inhalation factors (cigarette smoke), genetics (deficiency that leads to early onset emphysema)

Question 2

What are characteristics of obstructive pulmonary disease?

Answer 2

lung hyperinflation (elevation of shoulder girdle, horizontal ribs), barrel-shaped thorax, low and flattened diaphragm

Question 3

Obstructive diseases have ___ and ___ emptying of the lungs during ___

Answer 3

delayed, incomplete, exhalation

Question 4

A normal FEV1/FVC is > _____%

Answer 4

75

Question 5

Those with obstructive disease show ____ than normal total lung capacities and residual volumes

Answer 5

larger (due to air trapping and hyperinflation)

Question 6

What are the 5 specific obstructive lung conditions?

Answer 6

chronic bronchitis, emphysema, asthma, cystic fibrosis, bronchiectasis

Question 7

Which obstructive disease is due to a permanent enlargement of the bronchioles and destructive changes in the alveoli?

Answer 7

emphysema

Question 8

Which obstructive disease is diagnosed on symptoms and is based on having a chronic or productive cough on most days for minimum of 3mo/yr for more than 2 consecutive years?

Answer 8

chronic bronchitis

Question 9

auscultation of the lungs in copd will show a prolonged _____ phase

Answer 9

expiratory (greater than 4 sec is indicative of significant obstruction)

Question 10

You have a pt come in with clubbed fingers, cyanosis and you notice their breath sounds are diminished during auscultation, what do you think they might have?

Answer 10

COPD

Question 11

Which tests are considered the gold standard for diagnosing COPD and monitoring its progress?

Answer 11

pulmonary function tests

Question 12

What will be different in a pt with asthma vs COPD after they are given a bronchodilator before doing spirometry?

Answer 12

test measurement will return to normal (test will improve as it was abnormal on the first try without the bronchodilator) but COPD the measurement will only partially improve (if it improves at all)

Question 13

What index is used to predict survival in COPD and what are its components?

Answer 13

BODE- body mass, obstruction, dyspnea, exercise

Question 14

end stage COPD results in ______

Answer 14

cor pulmonale

Question 15

What are characteristics of cystic fibrosis?

Answer 15

pancreatic insufficiency, persistent cough, malabsorption of nutrients in intestinal tract, recurrent lung infiltrates

Question 16

What are the diagnostic tests for cystic fibrosis?

Answer 16

newborn screen-CFTR mutation
sweat test- elevated chloride levels (>60mEq/L)

Question 17

Which obstructive disease is due to airway resistance caused by constriction of the bronchial smooth mm cells and mucus production within the airway?

Answer 17

asthma

Question 18

t/f, asthma can be caused by viral or allergen exposure

Answer 18

true, as well as by exercise and inhalation of cold air

Question 19

Which obstruction disease is due to dilation of the bronchials- irreversible with chronic inflammation and infection, distortion of conducting airways, thickening, herniation, or dilation?

Answer 19

bronchiectasis

Question 20

You have a pt that says that they produce most of their sputum in the morning, with large amounts and have recurrent lung infections. You take a sample of their sputum and notice it has layers, what condition do you think they might have?

Answer 20

bronchiectasis