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STEP 2 Pulmonary > Pulmo. DLCO lent. + bronchiectasis 03-11 (2) > Flashcards

Pulmo. DLCO lent. + bronchiectasis 03-11 (2) Flashcards

pirmu kartu 100 proc.

1
Q

Obstructive pattern: FEV1/FVC < 70 proc predicted.

A

.

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2
Q

Restrictive pattern: FEV1/FVC > 70 proc predicted, FVC < 80 proc. predicted.

A

.

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3
Q

Obstructive pattern + low DLCO? 1

A

Emphysema

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4
Q

Obstructive pattern + normal DLCO? 2

A

Chronic bronchitis, asthma

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5
Q

Obstructive pattern + increased DLCO? 1

A

asthma

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6
Q

Restrictive pattern + low DLCO? 4

A

ILD
Sarcoidosis
Asbestosis
HF

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7
Q

Restrictive pattern + normal DLCO? 2

A

musculoskeletal deformity
neuromuscular disease

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8
Q

Restrictive pattern + high DLCO? 1

A

morbid obesity

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9
Q

Normal spirometry + low DLCO? 3

A

anemia
PE
PH

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10
Q

Normal spirometry + high DLCO? 2

A

pulmonary hemorrhage
polycythemia

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11
Q

bronchiectasis. symptoms? 3

A

cought with daily mucopurulent sputum production
Rhinosinusitis, dyspnea, hemoptysis
Crackles, wheezing

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12
Q

bronchiectasis. pathophysiology?

A

Infectious insult with impaired clearance

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13
Q

bronchiectasis. etiologies? 5

A

Airway obstruction (eg cancer)
Rheumatic disease (RA, sjogren), toxic inhalation
Chronic or prior infection (eg aspergilosis, mycobacteria)
Immunodeficiency (eg hypogammaglobulinemia)
Congenital (eg CF, A1AT)

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14
Q

bronchiectasis. evaluation 4

A

HRCT of chest (needed for initial diagnosis)
Immunoglobulin quantification
CF testing, sputum culture (bacteria, fungi, mycobacteria)
PFT

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15
Q

bronchiectasis. CP?

A

C/P: large amounts of mucopurulent sputum (>100ml/day).

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16
Q

bronchiectasis. exacerbation causes?

A

Exacerbations are typically bacterial and required antibiotics.

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17
Q

bronchiectasis. relation to smoking?

A

No causal relationship between smoking and bronchiectasis.

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18
Q

bronchiectasis. in case of CF, what part of lung?

A

CF –> upper lobe bronchiectasis.

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19
Q

bronchiectasis. diagnosis. PFT?

A

obstructive patter

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20
Q

bronchiectasis. diagnosis. xray?

A

CXR: airway thickening (tram-track or ring sign).

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21
Q

bronchiectasis. diagnosis. CT?

A

CT: bronchial dilation, lack of airway tapering, and bronchial wall thickening.

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22
Q

bronchiectasis. pathogenesis scheme. initial?

A

Infectious insult PLUS impaired bacterial clearance

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23
Q

bronchiectasis. initial insult –> ?

A

leads to bacterial overgrowth

24
Q

bronchiectasis. initial insult –> bacterial overgrowth -> ?

A

neutrophil infiltration (excessive release of elastase = bronchial wall damage)

25
Q

bronchiectasis. initial insult –> bacterial overgrowth -> neutrophil infiltration -> ?

A

inflammation

26
Q

bronchiectasis. initial insult –> bacterial overgrowth -> neutrophil infiltration -> inflammation ->?

A

Tissue damage and structural airway changes

27
Q

bronchiectasis. initial insult –> bacterial overgrowth -> neutrophil infiltration -> inflammation ->issue damage and structural airway changes –> closes circle and arrow goes again to bacterial overgrowth.

28
Q

PFT in chronic lung disease. asthma TLC?

A

normal/increased

29
Q

PFT in chronic lung disease. asthma FEV1/FVC?

A

decr (with positive bronchodilator response)

30
Q

PFT in chronic lung disease. asthma DLCO?

A

normal/increased

31
Q

PFT in chronic lung disease. COPD TLC?

32
Q

PFT in chronic lung disease. COPD. DLCO?

A

decr (normal in early COPD)

33
Q

PFT in chronic lung disease. COPD FEV1/FVC?

34
Q

PFT in chronic lung disease. ILD TLC?

35
Q

PFT in chronic lung disease. ILD FEV1/FVC?

36
Q

PFT in chronic lung disease. ILD DLCO?

37
Q

PFT in chronic lung disease. PH TLC?

38
Q

PFT in chronic lung disease. PH FEV1/FVC?

39
Q

PFT in chronic lung disease. PH DLCO?

40
Q

PFT in chronic lung disease. restrictive chest wall disease TLC?

41
Q

PFT in chronic lung disease. restrictive chest wall disease FEV1/FVC?

42
Q

PFT in chronic lung disease. restrictive chest wall disease DLCO?

43
Q

PFT -> obstr. –> DLCO normal/incr –>?

44
Q

PFT -> obstr. –> DLCO decr –>?

45
Q

PFT -> restr. –> DLCO normal –>?

A

chest wall weakness

46
Q

PFT -> restr. –> DLCO decr –>?

A

ILD, granulomatous disease

47
Q

Bronchiectasis kinda due to recurrent cycle of infection

48
Q

Bronchiectasis. development requires infectious insult in combination with impaired bacterial clearance

49
Q

Bronchiectasis. exacerbations why and what symptoms?

A

Patients may have frequent exacerbations (due to bacterial infections) characterized by:
a. Fever
b. Increased dyspnea
c. Increased sputum production

50
Q

Bronchiectasis. Best diagnostic?

A

CT
i. Bronchial dilation
ii. Lack of airway tapering
iii. Bronchial wall thickening

xray is not diagnostic, but may show linear atelectasis, dilated and thickened airways

51
Q

bronchiectasis differential?

A

a. Chronic Bronchitis:
i. Sputum production is less prominent than bronchiectasis
ii. Exacerbations are usually viral in chronic bronchitis
iii. It is associated with smoking, while bronchiectasis is not

52
Q

bronchiectasis due to CF.

A

In young patients, because CF is usually in young people.

53
Q

bronchiectasis due to CF. pathophysiology?

A

a. Defective sodium and chloride transport leads to thick secretions and impaired mucociliary clearance

b. Chronic bacterial infection ensues, leading to enhanced neutrophil recruitment and excessive release of Elastase (which contributes to bronchial airway damage)

54
Q

bronchiectasis due to CF. causative mo?

A

pseudomonas aeruginosa

55
Q

bronchiectasis due to CF. what lung part involvement?

A

Upper lung lobe involvement is characteristic of bronchiectasis due to CF, and helps differentiate it from bronchiectasis due to other causes

STEP 2 Pulmonary (30 decks)

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