Pulmonary Diseases

Question 1

Describe Emphysema. Does Total surface area increase or decrease when compared to normal?

Answer 1

1. Emphysema is caused when macrophages don’t secrete _____ that normally inhibit the Elastace made by Neutrophils from destroying ELASTIN fibers in the alveolar walls. Reduced elastic recoil needed for expiration.
2. Due to this Total SA for effective gas exchange DECREASES, because during expiration the alveoli expand beyond function. Although individual alveoli SA increases, most function is abolished from bursting. (Slide 89)

Question 2

Describe Obstructive Lung Disease.

2. What parameters change in the spirometry charts.
3. Explain the associated ABG disorders.

Answer 2

1. This type of lung disease affects the ability to get the AIR OUT (loss of recoil) ~ Total SA DECREASES
2. Increased: RV, FRC, TLC (no problems with amount of air in system)
   Decreased: ERV, VC (issue with ventilation or less expiration)
3. Symptoms include Barrel chest, chronic Respiratory Acidosis and metabolic alkalosis.

Question 3

Describe Restrictive Lung Disease.

2. What are the expected spirometry results compared to normal?
3. Name the associated ABG disorders and other features.

Answer 3

1. This disease is associated with a non-compliant lung. The lungs struggle to BREATHE IN AIR, “Like Blowing INTO a basketball!”
2. Spirometry values ALL DECREASE: TLC, TV, RV, VC, ERV (lungs still have good recoil though: no trouble exhaling).
3. Respiratory acidosis and Metabolic alkalosis

Question 4

Describe the changes in the Flow-Volume Loop of someone with Obstructive Lung Disease.

Answer 4

1. Severely Reduced FEV1 and FEV1/FVC (expiration is impaired compared to VC)
2. RV increases, TLC shifts up (barrel chest)
3. Less steep slope (slower expiration; laborious sign of respiratory disease)

Question 5

Describe the changes in the Flow-Volume Loop of someone with Restrictive Lung Disease.

Answer 5

1. FEV1 is Reduced BUT FEV1/FVC is normal or INCREASES (VC decreases, preventing much air from getting in at first; little volume to blow out anyways)
2. TLC decreases - less lung volume ACROSS the board to fill
3. Shorter duration for exhalation (downward slope is quick ~ liKL0-ttle air to blow out in the first place).55

Question 6

Name a way to treat Obstructive Lung Disease.

Answer 6

1. Albuterol - used as a bronchodilator that widens the airways to improve FEV1 and FEV1/FVC

Question 7

Lay out the pathway for respiratory inflammation by an allergen.

Answer 7

1. Dendritic cells find allergen and present it to lymph nodes.
2. B and T lymphocytes make IgE (antibody) that bind CD 23 on a sleeping mast cell.
3. Bound CD 23 in a mast cell would activate degranulation.
4. Degranulation recruits eusinophils that secrete factors.
5. Factors cause inflammation, mucous build-up and bronchospasm.

Question 8

Name at least 3 causes of hypoxemia.

Answer 8

• Intrapulmonary Shunt
• little ability for O2 to reach circulation
  1. Pneumothorax
  2. Airway Occlusion
  3. Tetralogy of Fallot

Question 9

Describe what occurs in Kartagener’s Syndrome

Answer 9

Immotile Cilia inherited disorder in which lack of dynein leads to impaired function of microtubules assembly in cilia and flagella. Symptoms manifest as sterile males and inability to clear nasal passages.

Question 10

Describe Respiratory Distress Syndrome.

Answer 10

This may be seen in premature infants where Type II Pneumocytes are not fully developed. There is insufficient amount of surfactant necessary for adequate respiratory function.

Question 11

Describe Obstructive Sleep Apnea Syndrome.

Answer 11

OSA is the occurrence of repetitive episodes of upper airway collapse in sleep followed by arousals.
Mild 5-15 apnea’s/hour. Severe >30 apnea’s/hour
Causes may be large tonsils or adenoids in children
Symptoms include loud irregular snoring and possible hyperactivity for school-aged children