Pulmonary Flashcards
Decreased FEV1 and low FEV1/FEV below 56%
Obstructive
A reduced (<70%) FEV1/FVC ratio
Obstructive
FEV1/FVC ratio above 70%
Restrictive
FEV1, FVC and TLC are all reduced
Restrictive lung disease
Asthma
Obstructive
Intrinsic Asthma
Trigged by anxiety, GERD, Obesity, chemicals like ASA
more common in adults
Extrinsic Astham
outside environment triggers, elevated IgE,
more common in kids
Treatment of mild Asthma
SABA inhaler
Mild -persistent asthma characteristics
night symptoms 3-4 days a month
Chronic airway inflammation, bronchial hyperreactivity and smooth muscle spasm.
Asthma
Hygiene hypothesis
overstimulation of immune cells due to decreased illness due to vaccines, limited exposure, natural exposures to infections agents, more sterile environment
GERD related to Asthma
vagal stimulation due to acid – acetylcholine release = bronchoconstriction
air passing through narrowed bronchioles and mucus during exhalation causes
Wheezing
Common spirometry in asthma
there is a scooping nature to the flow volume loop.
FEV1 decreased progressive and unresponsive to bronchodilator
COPD
2 diagnoses under COPD
Emphysema and chronic bronchitis
GOLD 1
FVE1 > 80 predicted
GOLD 2
50 % FVE1 < 80
GOLD 3
30 % FVE1 < 50
GOLD 4
FEV1 < 30% predicted
When damage occurs in the Alveoli
Emphysema
Barrel chest, air trapping, pursed lip breathing, increased AP diameter,
Emphysema
CXR findings with emphysema
lateral view with flattened diaphragm and increased AP diameter
When damage occurs in the airway and not alveoli
Chronic Bronchitis
by bronchial hyperinflation, hypersecretion of mucus, and chronic productive cough; irreversible
COPD
V/Q mismatch in COPD
high CO2 = not good for gas exchange/ right to left shunting
Hyperresonance is the characteristic lung percussion finding
COPD
Cor pulmonale
due to high pressure in right heart - causes fluid to back up into the body organs from the right side of the heart, causing splenomegaly or an enlarged spleen.
A normal FEV1/FVC points to
Restrictive disease
any disease affecting the pulmonary interstitium and typically excludes infectious and neoplastic diseases.
ILD
Drugs most commonly associated with ILD
- Methotrexate
- Amiodarone
- Nitrofurantoin
The most diagnosed interstitial lung diseases
Radiation pneumonitis
characteristic finding of on a chest x-ray of an individual with ILD
a honey-comb pattern
gold standard for diagnosing asthma
Methacholine Challenge Test
