Pulm Restrictive Disorders Flashcards
What is the FEV1/FVC ratio? Components?
-can’t inhale norm amount, but no challenge exhale
-FEV1: forced expiratory volume in 1 sec
-FVC: forced vital capacity, amount of air forcefully and quickly exhaled after full insp
3 hallmark symptoms of restrictive pulmonary disease
-dyspnea
-cough (irritating, dry, non-productive)
-potentially wasted appearance
3 types of interstitial lung disease
Idiopathic, exposure related, autoimmune related
Idiopathic pulmonary fibrosis - what is it, cause, risk factors, prevalence and clinical present
-inflam of alveolar walls -> scarring
-etiology unknown
-RF: 50-70, air pollution, smoking, viral infections, genetic, GERD
-prevalence: men > women
-clinical: persistent dry cough, weight loss, fatigue, digital clubbing, LE edema
List 5-ish autoimmune disorders
-sarcoidosis
-RA
-scleroderma
-systemic lupus erythematosus (lupus)
-polymyositis and dermatomyoitis
Sarcoidosis - what is it, clinical present, pulm staging
-inflam autoimmune disease, granulomas (inflam cells that cause fibrosis)
-clinical: YA, unexplained persistent cough, SOB, tight chest, women >, 30-55 yo
-1) lymph, 2) lymph and lungs, 3)lungs, 4) irreversible lung scarring
RA - what is it, risk factors for ILD, clinical present
-chronic inflam of peripheral joints
-risk: 8x higher risk, males >, smokers, severity of RA, age >60 at higher risk
-clinical: progressive dyspnea, non-productive cough, cyanosis, warm/swollen joints, diminished breath sounds (rales)
Systemic lupus erythematosus - what is it, cause, clinical present
-chronic inflam CT disorder, multi-system
-cause: unknown
-clinical: joint pain and swelling, dyspnea, fatigue, non/productive cough, OA, weight loss, eye disease, photosensitivity, mouth ulcers, dry mouth, fever, chest pain, hair loss, anemia (increased risk for blood clots)
Scleroderma - what is it, cause, prevalence, tx
-progressive fibrosis disorder (degeneration of small blood vessels)
-prevalence: women > men, 30-50
-tx: no effective drugs, tx symps, supportive care
Scleroderma clinical present (11)
-skin thick, swell, tight
-enlg blood vessels on hands and face
-HTN from kidney dysfxn
-heart burn
-GI involvement
-weight loss
-exertional dyspnea
-decreased lung volume
-nonproductive cough
-joint pain
-Raynaud’s (a spasm -> decreased BF)
Polymyositis and dermatomyoitis - what are they, pulm characteristics
-inflam conditions w/ progressive mus weakness and skin changes
-aspiration pneumonia (d/t weakness), weak neck flexors/laryngeal/pharyngeal, increased respiratory mus weakness, diaphragm elevated (decreased lung volume), ILD at bases, SOB, non productive cough
SCI - signs (pulm, CXR, breath sounds), symps
-signs: decreased TLC, VC, IC, peak insp/exp pressures; increased RV, RR; cxr norm, infections, ribs become more horizontal; breath sounds decreased
-symps: fatigue, SOB, inability to cough, poor voice volume, morning headaches, restless/irritable w/ increased PaCO2
Diaphragm paralysis or paresis - what is it, cause, tx
-loss/impairment of diaphragm motor fxn due to lesion
-cause: phrenic n/ injury
-tx: uni - no tx; bi - mechanical ventilation
Diaphragm paralysis or paresis - pulm signs, cxr, blood gases, breath sounds, symps
-pulm: decreased all lung capacities and volumes
-cxr: elevated hemi-diaphragm (classic sign), collapsed lung (atelectasis) may be present
-blood: decreased PaO2
-breath: decreased sound on paralysis/paresis at base
-symps: dyspnea, orthopnea, difficult inspiration, anxiety, insomnia, morning headaches
Amyotrophic lateral sclerosis (ALS) - symps (pulm, breath sounds)
-decreased pulm fxn, RR w/ weak ventilatory mus
Poliomyelitis - what is it, pulm symps (5ish)
Viral diseases, affects CNS (may cause paralysis)
-decreased lung volumes and sounds (rhonchi)
-weak cough, poor airway clearance
-dyspnea
-easily fatigue, poor activity endurance
Guillain-Barré syndrome - what is it, pulm symps (5ish)
Autoimmune condition where PNS attacked
-decreased lung volumes and sounds (rhonchi and crackles)
-B LE weak, poor activity endurance
-dyspnea, poor cough and airway clearance
Myasthenia Gravis - what is it, pulm symps (7ish)
Autoimmune chronic neuroms, progressive mus weakness on exertion
-all lung vol decreased
-breath sounds decreased
-poor air way clearance -> crackles and rhonchi
-weak, fatigue, dyspnea
-weak and ineffective cough
Ankylosing spondylitis - what is it, tx
-chronic inflam of spine
-no cure; maintain good alignment and thoracic mobility
Ankylosing spondylitis - signs and symps
-signs: decreased VC and IC, same or increased RV and FRC
-symps: dyspnea on exertion, pleuritic chest pain, possible productive cough, weight loss, LBP
Kyphosis and scoliosis - degrees of pulm dysfxn
< 70 degrees = no pulm dysfxn
70-120 degrees = some pulm dysfxn
> 120 degrees = severe RLD and respiratory failure
Kyphosis and scoliosis - pulm, cxr, blood gases, CV
-pulm: all dynamic lung vol decreased, RV is normal, flow rates decreased
-cxr: abnormal
-blood gases: decreased PaO2 and increased PaCO2
-CV: pulm HTN, thick arterial walls
Kyphosis and scoliosis - symps
Dyspnea on exertion, decreased exercise tolerance, mus spasms, overuse of respiratory accessory mus
What is pectus excavatum and carinatum?
Excavatum: funnel chest, eternal dep, decreased A/P diameter, severe deformity restrict lung volumes
Carinatum: pigeon breast, sternum protruding ant, associated w/ childhood asthma
