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Pulm > Pathophysiology: Restrictive Disease > Flashcards

Pathophysiology: Restrictive Disease Flashcards

1
Q

Main concept based on the chart

A
  • Everything decreases in Restrictive but remains proportional
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2
Q

ILD

A

Interstitial Lung Disease

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3
Q
A
  • Decreased Lung volume
  • Harder to breath in because working against resistance, compensating with muscles
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4
Q

UIP

A

Usual Interstitial pneumonia
- Significant collagen deposition
- Thickening alveolar walls and septa
- Little inflammation
- Fibrosing in the interstitial area leads to stiffening of the lung or decreased compliance

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5
Q

Antihypertensives for Pulm HTN (UIP)

A
  • Flolan
  • Bosantin
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6
Q

NSIP

A

Nonspecific Interstitial Pneumonia
- Inflammation
- Thickening alveolar walls and septa
- leads to decreased compliance of the lung

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7
Q

Anti-inflammatory medications (NSIP)

A
  • Cellcept
  • Prednisone
  • Azathioprine
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8
Q

DIP

A

Desquamative Interstitial Pneumonia
- Primarily inflammatory

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9
Q

Fick’s Law

A

Rate of gas transfer is proportional to tissue area and differences in gas partial pressure between 2 sides, but inversely proportional to tissue thickness

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10
Q

ILD Prognosis

A
  • Poor
  • 3 to 6 years from time of diagnosis
  • Early diagnosis and treatment are critical in impacting survival
  • NSIP much better survival than UIP
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11
Q

Pulmonary Sarcoidosis

A
  • 20 to 40 yo
  • Females more than males
  • Disease due to inflammation
  • Characterized by the presence of granulomas
  • can cause abnormal lung stiffness and loss of lung volume
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12
Q

Pulmonary Sarcoidosis: Clinical Findings

A
  • Symptoms: Dry couch, Dyspnea, Mild chest pain, fever, fatigue, weight loss
  • Breath sounds: RR increased, Chest expansion decreased, wheezes from bronchial obstruction
  • Decreased TLC and lung volumes
  • Lung Compliance decreased
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13
Q

Pulmonary Sarcoidosis: Intervention

A
  • May resolve spontaneously
  • Corticosteroids
  • Supplemental oxygen as indicated
  • Pulmonary Rehabilitation
  • Lung transplant in advanced disease
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14
Q

ILD: Clinical Findings

A
  • Dyspea - Progressive and insidious onset
  • Untreated Hypoxemia can lead to decreased BP, dizziness, arrythmias
  • Weight loss
  • Digital clubbing
  • Pulmonary HTN, R heart failure
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15
Q

ILD: Clinical Findings

A
  • Decreased
  • Positive
  • Rapid, Shallow
    • exertion, dry
  • Rales
  • Decreased volume, honeycombing
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16
Q

ILD: Clinical Findings

A
  • Positive
  • Positive only at end stage
  • down
  • down
  • equal
  • down
  • down
  • down
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17
Q
A
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18
Q
A
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19
Q

Acute Pulmonary Embolism

A
  • Blood clot in the lung
  • Blood stasis
  • Coagulopathy
  • Changes in vessel wall permeability
  • Symptoms: Dyspnea, decreased SpO2
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20
Q

Pulmonary Hypertension value

A
  • Normal mean pressure: 15mmHg
  • Hypertension: rest greater than 25mmHg, exercise greater than 30mmHg
21
Q

Primary Pulmonary Hypertension (PPH)

A
  • Females in mid 30s
    Causes:
  • Genetic
  • Appetite suppressant medications
  • Illegal Drugs
  • Infections
  • Reaction to hormonal changes during pregnancy
22
Q

Secondary Pulmonary Hypertension

A
  • Occurs after congenital heart defect, lung disease with hypoxia, collagen vascular disease, thromboembolic disease, left heart failure
23
Q

Physiology of Primary Pulmonary Hypertension

A
  • Dilation of small arteries that are distal to obstructed large arteries
  • Small arteries fill with abnormal endothelium lining
24
Q

Clinical Findings of Pulmonary Hypertension

A
  • SOB
  • Chest Pain
  • Fatigue
  • Peripheral edema
  • S4 or atrial gallop, split S2
25
Q

Pulmonary Edema

A
  • Accumulation of fluid within the lungs
  • Engorgement or perivascular (interstitial) space and progression to alveolar edema
  • Results from breakdown to protective barrier of lungs
26
Q

Pulmonary Edema- Risk Factors

A
  • Inhaled Toxins (Chlorine, sulfur dioxide)
  • High altitude
27
Q

Clinical Findings of Pulmonary Edema

A
  • Increased RR & BP
  • Decreased SpO2
  • Pulmonary Vascular congestion
28
Q

Symptoms of Pulmonary Edema

A
  • Respiratory distress (dyspnea)
29
Q

Chest Assessment of Pulmonary Edema

A
  • Decreased to absent BS / Rales (Fluid in lungs)
  • Decreased chest wall motion
30
Q

Treatment of Pulmonary Edema

A
  • Treat underlying cause
  • Support with diuretics and oxygen therapy
31
Q

Diseases of the Pleura

A
  • Pleural effusion
  • Pneumothorax
  • Hemothorax
  • Empyema ( Pockets of pus enclosed in fibrous adhesions)
32
Q

Pleural Effusion

A
  • Fluid accumulation in the pleural space
  • Separates the air filled lung from chest wall
  • Blocks transmission of sound
  • Results in change in the hydrostatic osmotic pressure
  • Dyspnea and fatigue
  • Small effusion will reabsorb, large must be drained
33
Q

Pleural Effusion: Causes

A
  • Congestive heart failure
  • Edematous (bloating) state
  • Change in pressure
  • Malignancies and infections
34
Q

Pleural Effusion Clinical findings

A
35
Q

Pneumothorax

A
  • Leakage of air into the pleural space through blebs, resulting partial or complete collapse of the lung
  • Blebs may rupture under increased pressure
36
Q

Open vs. Tension Pneumothorax

A

– Describing Mediastinal shift
- Open will see collapse and ipsilateral shift
- Tension will see collapse and contralateral shift ( one way ‘valve’ causes air to collect in thoracic cavity)

37
Q

Pneumothorax: Clinical Findings

A
38
Q

Hemothorax

A
  • Penetrating and crush wounds
  • Fatigue, dyspnea
  • SpO2 will remain normal
  • Excessive bleeding, clot formation and decreased HCT
  • Decreased chest excursion with inhalation
39
Q

Empyema

A
  • Presence of gross pus into the pleural cavity
  • consists of an effusion containing polymorphonuclear leukocytes and fibrin
  • Localized infection following pulmonary process or post op complications
  • Increased RR, HR, temperature
40
Q

Sleep Apnea

A
  • Temporary cessation of ventilation during sleep
  • Occlusion in upper airway
  • Severe when apnea periods occur greater than 30 times / minute
  • Long term can lead to pulmonary HTN
41
Q

Pregnancy

A
  • 50% increase CO and O2 consumption by end gestation
  • Decrease PVR 2nd to dilation of pulm arteries and capillaries
  • Decreased chest wall compliance, Increased work of breathing
42
Q

Atelectasis

A
  • Decrease functional residual capacity
  • Decrease lung compliance
  • Surface tension holds collapsed alveoli shut → Higher pressure to reinflate lungs - Overinflation of unaffected lung areas
  • Increased work of breathing → respiratory failure
43
Q

Atelectasis clinical findings

A
44
Q

Subcutaneous Emphysema

A
  • Develops secondary to air leakage from a disrupted airway
  • Air migrates along the great vessels to the mediastinum and then into the soft tissues of the neck and chest
  • Can be just cosmetic or represent underlying problem
45
Q

Pneumonia

A
  • Acute inflammation of lung parenchyma from the respiratory bronchioles to the alveoli from an infecting agent
  • Protective system of airways are impaired
46
Q

Adult Respiratory Distress Syndrome (ARDS)

A
  • Noncardiogenic pulmonary edema / shock lung
  • Hypoxemic respiratory failure from damage to the alveolar capillary membrane
  • Increased pulmonary vascular permeability and leads to pulmonary edema
  • Ultimately serious damage to alveolar capillary membrane
  • Occurs with multiple organ system failure
  • Treatment may include prone positioning
47
Q

What are the 4 stages of ARDS

A
  • Edema (Interstitial to alveolar)
  • Hemorrhagic derby fills alveoli
  • Hyperplasia ( Cells organize and line alveoli)
  • IPF develops

Clinical Findings
- Severe respiratory distress with compromised oxygenation

48
Q
A

Pulm (7 decks)

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