Quiz 4 Study Guide: Lungs Flashcards by Dane Goodwin

What is Atelectasis?

Inadequate expansion of airspaces.

Some cause of aspiration, pneumothorax, and pleural fibrosis.

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What is caused by trauma to the lung resulting in inflammation resulting in generalized fluid accumulation? (Progression of acute injury and damage from activated neutrophils)

***High Rate of Fatalities

Acute Respiratory Distress Syndrome (ARDS)

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What are three components of COPD?

Emphysema, Asthma, and Bronchiectasis

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What is Emphysema and what causes it?

Destruction of Alveolar walls and permanent enlargement of airspaces.

Smoking, Alpha-1 antitrypsin deficiency, air pollution

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What is Chronic Bronchitis and what are its causes?

Persistent cough of 3 or more months in 2 consecutive years.

Smoking and air pollution

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What is Bronchiectasis and what are its causes?

Obstruction of bronchi and persistent necrotizing infections.

Destruction of elastin and muscles in bronchial walls.

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What is Asthma and what is it caused by?

Reactive airway disease and narrowing of airways (hyperactivity)

Hyperinflated lungs, thick mucus plugs in airways, smooth muscle hypertrophy.

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What is Fibrosing Lung Disease?

Associated with collagen vascular diseases such as rheumatoid arthritis.

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What is Occupational Lung Disease?

Restrictive

E.g. Mineral dust induced, silicosis, asbestosis (mesothelioma)

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What is Sarcoidosis?

Restrictive disease (abnormal connective tissue and reduced elastic properties)

*** Multi-organ involvement

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What are the two vascular diseases of the lung?

Pulmonary Embolus

Pulmonary Hypertension

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What is a Pulmonary Embolus?

A vascular disease of the lung that can cause sudden death if in the pulmonary artery. It originates from deep veins in the legs.

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What is Pulmonary Hypertension?

Causes Heart Disease and recurrent Thromboemboli.

Cor Pulmonale

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What is Cor Pulmonale?

Right Ventricular Failure

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What are the 3 types of lung disease?

Restrictive
Vascular
Obstruction

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What are characteristics of a Restrictive Lung Disease?

Caused by fibrosis or chest wall abnormalities
Gas exchange is impaired
Difficulty inhaling and expanding lungs

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What are characteristics of a Vascular Lung Disease?

Gas exchange impaired by obstruction or hemmorage

May be abrupt or insidious

What are characteristics of a Obstructive Lung disease?

Blocked airways
Gas exchange through septal walls not impaired
Unable to exhale

What is the cause of Tuberculosis?

Mycobacterium Tuberculosis

What are characteristics of Tuberculosis?

Usually in the Lungs but can affect other organs
Flourishes in crowded impoverished areas
Non-Contagious during long periods of dormancy
Problems with multi drug antibiotic resistance
Froms Necrotizing Granulomas

95% of Lung tumors are…

Carcinomas

adeno and squamous cell types most common

What population is 55X more likely to develop Lung tumors?

Smokers

In what populations is Asthma the most prevalent?

Children and females

What are the seven different types of asthma medication?

Relievers
Controllers
Add-on Controllers
Antimuscarinics
Leukotriene Modifiers
Cromolyn
Omalizumab

What are characteristics of Relievers?

- Short Acting - Less Severe Cases - Typically Beta 2 agonist

What two Beta 2 agonists are used as Relievers for asthma?

Albuterol: 4-6 Hour effect; Rapid onset Salmetrol: 12 Hour effect; Slower onset

What is the Mechanism of Action of Relievers?

Directly relax airway smooth muscle.

What are the characteristics of controllers

Need to be taken long term for stable control (more side effects) Normally inhaled (Corticosteroids, etc for moderate to severe asthma. * **Often combine with B2 agonist * **Chronic Management, not rescue * ** e.g. Fluticasone

What are side effects of controllers?

Nose bleeds | Sores that don't heal on the nose, tongue and mouth

What are add on controllers?

Methyxanthine drugs | Theophylline (tablet or inhaler)

What is the Mechanism of Action of add-on controllers?

Phosphodiesterase inhibitor along with the ability to increase cAMP and relax airway smooth muscle. ***These are combined with corticosteroids to reduce steroid doses and side effects.

What is an example of a Antimuscarinic?

Ipatropium - Reverses contraction of smooth muscle from vagal activity -usually a backup for beta 2 agonists

Example of a Leukotriene modifier

Montelukast (Singulair) ***Used for prophylaxis in patients who have trouble with inhaled therapies. (Nasal bleeding, etc...)

What does the anti-asthma drug Cromolyn do?

Inhibits release of inflammatory mediators such as histamine.

What does the anti-asthma drug Omalizumab do?

Inhibits IgE binding to mast cells. ***Very Expensive and only used for severe non-responsive asthma.

What is the dental relevance of asthma?

``` Mouth Breathers (dry mouth) Inhalers irritate mucosa, especially back roof of mouth ``` ***Make sure patients bring inhalers to appts.

What does COPD stand for?

Congestive Obstructive Pulmonary Disease

COPD is caused by...

- Long smoking history, or exposure to environmental irritants. - Airway limitations from progressive irreversible airway remodeling.

What are Treatments for COPD?

1. Tiotropium Bromide (Spireva) - Longer acting Bronchodilators 2. Salmeterol - Longer acting B2 agonist 3. Theopyline with glucocorticoids ***These responses typically aren't as good as seen with asthma.

What are three Antismoking treatments?

Nicotine Replacement Therapy Bupropion-Wellbutrin or Zyban (antidepressants) Varenicline (Chantix)

How does Varenicline (Chantix) work?

Partial nicotine agonist that relieves the cravings to smoke.