Pulmonology Flashcards
Indications for PFTs
- Dx and classify severity of pulm dysfxn
- Distinguish btn; obstructive, restrictive or mixed pulm dz
- Monitor response to therapeutic interventions
- Determine pulmonary risk prior to surgery
Basic PFTs
- Air flow spirometry
- Lung volumes
- DLCO
Considerations for PFTs
Age Height Weight Gender Ethnicity Smoking
How many times must spirometry testing be done
three times
FEV-1/FVC ratio for obstructive pattern
below seventy percent
Why is bronchodilator testing done
To test reversibility
How long after nebulizer or inhaler is PFT done again
15 min
What is the indication for reversibility
Increase in FEV1 by twelve percent or t200ml
DLCO
Measures ability of lungs to transfer CO and saturate Hgb
DLCO for healthy lung
Little CO collected after expiration (mostly absorbed)
Gold std diagnostic for COPD
Reversibility below twelve precent on spirometry
How often do you do asthma follow up
one to three months initially then three to twelve months depending on severity
In what age is spirometry not beneficial
Five and under
How long after an acute asthma exacerbation does an individual need to follow up
one week
What is the 3rd leading cause of death in the US
COPD
Chronic bronchitis
cough for three months during two consecutive yrs
structural changes w/ chronic bronchitis
Mucous gland enlargement; hyper secretion
Bronchial squamous metaplasia
Loss of ciliary transport
What cells are predominant in the inflammation associated with chronic bronchitis
Neutrophils
What cells are predominant in the inflammation associated with asthma
Eosinophils
Is the airflow obstruction in chronic bronchitis inspiratory or expiratory
Both
Which causes more parenchymal damage; Emphysema or COPD
Emphysema
Is the airflow obstruction in emphysema inspiratory or expiratory
Expiratory
What DLCO is associated with emphysema
Reduced (destruction of capillary bed)
What is the role of antitrypsin
Inhibit elastase
What is the role of elastase
Break down elastin which reduces the elasticity of the lung alveoli
How does smoking affect the lungs
It activates elastase which causes degeneration of alveolar elastin
How is pursed breathing an adaptation in COPD
it increases the intrabronchial pressure to keep the bronchi open and more air can be expelle
Causative agent of pneumonia in younger pple
Chlamydophila
Causative agent of pneumonia associated w/ diarrhea and in elderly
Legionella
Causative agent of pneumonia in CHF
Pseudomonas
Post influenza causative agent of pneumonia
Staph aureus
