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Cardio Pulm > Pulmonary Pathology: Restrictive Lung Disease > Flashcards

Pulmonary Pathology: Restrictive Lung Disease Flashcards

1
Q

cardiovascular causes of restrictive lung dysfunction

A
  • pulmonary edema

- pulmonary emboli

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2
Q

Neuromuscular Causes of restrictive lung dysfunction

A
  • SCI
  • ALS
  • Polio
  • Guillain-Barre Syndrome
  • Myasthenia Gravis
  • Tetanus
  • Duchenne’s Muscular Dystrophy
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3
Q

Connective Tissue Causes of restrictive lung dysfunction

A
  • RA
  • SLE
  • Polio
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4
Q

Nutritional and Metabolic Causes of restrictive lung dysfunction

A
  • Obesity

- DM

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5
Q

Traumatic Causes of restrictive lung dysfunction

A
  • crush injuries
  • penetrating wounds
  • thermal trauma
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6
Q

Immunologic Causes of restrictive lung dysfunction

A
  • Goodpasture’s syndrome

- Wegener’s Granulomatosis

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7
Q

Therapeutic Causes of restrictive lung dysfunction

A
  • surgical therapy
  • lung transplant
  • drug therapy
  • radiation therapy
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8
Q

Hospital-Acquired Pneumonia

A
  • infection of lower respiratory tract beginning 72 hours + after hospitalization
  • most common cause: pseudomonas aeruginosa
  • Risk factors: tubes in throat, dysphagia, lung injury, diabetes, chronic cardiopulm disease, infection, smoker
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9
Q

Thoracic Cage Changes Due to:

A
  • kyphoscoliosis

- ankylosing spondylitis

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10
Q

Common restrictive primary problems

A
  • decreased compliance
  • decreased lung volume & capacity
  • increased WOB
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11
Q

Cor Pulmonale

A

R ventricular hypertrophy

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12
Q

Limited diaphragm displacement due to:

A
  • obesity

- ascites

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13
Q

Alveolar compression caused by

A

-pleural effusion

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14
Q

Decreased compliance due to:

A
  • stiffening of lung parenchyma
  • alveolar compression
  • thoracic changes
  • limited diaphragm displacement
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15
Q

Restrictive

A

-trouble getting air in

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16
Q

Lung parenchyma stiffening from:

A
  • interstitial fibrosis
  • sarcoidosis
  • scleroderma
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17
Q

Common restrictive symptoms

A
  • dyspnea
  • dry, nonproductive cough
  • wasted, emaciated appearance
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18
Q

Common Restrictive Signs

A
  • tachypnea
  • vent-perf mismatching
  • decr breath sounds
  • decr lung volume and capacity
  • cor pulmonale
19
Q

Common restrictive diseases

A
  • RDS
  • BOOP
  • Pneumonia
  • ARDS
  • Idiopathic Pulmonary Fibrosis
20
Q

ARDS

Pathophysiology

A

-exact mechanism unknown

-damage to capillary & alveolar endothelial cells–>
-incr permeability–>
-fluid & protein leave capillaries to interstitial fluid & alveoli–>
-decr lung vol & capacity & compliance–>
-Incr PVR–>
-R to L shunt–>
decr vent-perf matching–>
-alveolar fibrosis and los of capillaries

21
Q

ARDS

Etiology

A
  • trauma
  • shock
  • blood transfusion
  • pneumonia
  • metabolic
  • drugs
  • inhaled toxins
  • aspiration
22
Q

ARDS

Prognosis

A

80% survival rate

23
Q

ARDS

Treatment

A
  • treat cause
  • maintain gas exchange (vent)
  • supportive (nutrition, electrolytes, fluid)
  • Prevent complications
  • positioning
  • prone
24
Q

BOOP

A

Bronchiolitis obliterans w/ organizing pneumonia

aka. bronchiolitis fibrosa obliterans, follicular bronchiolitis, bronchiolitis w/ diffuse interstitial pneumonia

25
Q

BOOP

Pathophysiology

A
  • necrosis of epithelium in affected bronchioles–>
  • accum fluid/debri–>
  • pulm edema with obstruction of small airways–>
  • atelectasis from collapsed airways–>
  • inflamation–>
  • fibrosis of bronchial tree and alveoli
26
Q

BOOP

Etiology

A
  • result of having something else
  • fibrotic lung disease of smaller airways
  • can cause restrictive or obstructive lung diseases
  • children: viral infection
  • adults: viral, bacterial, mycobacterial infections, toxic fumes, connective tissue diseases (RA), graft vs host reactions
27
Q

BOOP

Treatment

A
  • Kids: supportive (O2, hydration, postural drainage, suctioning)
  • Adults: supportive (O2, hydration, corticosteroids
28
Q

IPF

A

Idiopathic Pulmonary Fibrosis

29
Q

Idiopathic Pulmonary Fibrosis

Pathophysiology

A
  • localized inflammatory changes (alveolitis) progressing to scarring and fibrosis
  • alveoli irregular in size/shape
  • capillaries destroyed
30
Q

Idiopathic Pulmonary Fibrosis

Etiology

A
  • unknown

- immunnologically mediated response to acute injury or infection

31
Q

Idiopathic Pulmonary Fibrosis

Treatment

A
  • corticosteroids
  • cytotoxic meds
  • supportive (O2, vent)
  • lung transplant
32
Q

Types of Pneumonia

A
  • community-acquired

- hospital acquired (nosocomial)

33
Q

Community Acquired Pneumonia

A
  • most can be tracked to cause (bacterial mostly)

- streptococcus pneumoniae (pneumococcus) most common

34
Q

Pneumonia

Pathophysiology

A
  • agent enters through inhalation/aspiration

- bacterial/viral

35
Q

Pneumonia

Etiology

A
  • 5th leading cause of death in US
  • inflm of lung parenchyma from exposure to microbes

-(bacteria, mycoplasms, viruses, protozoa, psittacosis agents)

36
Q

Bacterial Pneumonia

A

–1st response to infection is edema then polymorphonuclear leukocytes (phagocytosis) and deposits of fibrin

37
Q

Bacterial Pneumonia

Treatment

A
  • antibiotics
  • supplemental O2 as needed
  • pulm hygiene
  • hydration
  • nutrition
38
Q

Viral Pneumonia

A
  • 1st localizes in epithelial cells and destroys cilia and mucosal surfaces
  • may proceed to alveoli–>edema, hemorrhage, hyaline membrane formation or ARDS
39
Q

Viral Pneumonia

Treatment

A
  • supportive

- few antivirals available

40
Q

RDS

Pathophysiology

A
  • absence/inadequate surfactant
  • abnormal alveolar and epithelial & endothelial permeability
  • pulmonary HTN
41
Q

RDS

Etiology

A

(hyaline membrane disease)

  • gestation <36 weeks (no surfactant)
  • more in males
  • delivered by c-section
  • mother has diabetes (insulin delays surfactant production)
  • born with PDA
42
Q

RDS

Prognosis

A
  • progressively worse for 2-4 days then improves

- potential for BPD

43
Q

RDS

Treatment

A
  • mechanical vent (–>BPD)
  • supplemental O2
  • CPAP
  • Surfactant replacement
  • medications (sedation, pain relief)

Cardio Pulm (27 decks)

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