Quiz 4 Study Guide: Lungs Flashcards
What is Atelectasis?
Inadequate expansion of airspaces.
Some cause of aspiration, pneumothorax, and pleural fibrosis.
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)
What are three components of COPD?
Emphysema, Asthma, and Bronchiectasis
What is Emphysema and what causes it?
Destruction of Alveolar walls and permanent enlargement of airspaces.
Smoking, Alpha-1 antitrypsin deficiency, air pollution
What is Chronic Bronchitis and what are its causes?
Persistent cough of 3 or more months in 2 consecutive years.
Smoking and air pollution
What is Bronchiectasis and what are its causes?
Obstruction of bronchi and persistent necrotizing infections.
Destruction of elastin and muscles in bronchial walls.
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.
What is Fibrosing Lung Disease?
Associated with collagen vascular diseases such as rheumatoid arthritis.
What is Occupational Lung Disease?
Restrictive
E.g. Mineral dust induced, silicosis, asbestosis (mesothelioma)
What is Sarcoidosis?
Restrictive disease (abnormal connective tissue and reduced elastic properties)
*** Multi-organ involvement
What are the two vascular diseases of the lung?
Pulmonary Embolus
Pulmonary Hypertension
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.
What is Pulmonary Hypertension?
Causes Heart Disease and recurrent Thromboemboli.
Cor Pulmonale
What is Cor Pulmonale?
Right Ventricular Failure
What are the 3 types of lung disease?
Restrictive
Vascular
Obstruction
What are characteristics of a Restrictive Lung Disease?
Caused by fibrosis or chest wall abnormalities
Gas exchange is impaired
Difficulty inhaling and expanding lungs
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?
- Tiotropium Bromide (Spireva) - Longer acting Bronchodilators
- Salmeterol - Longer acting B2 agonist
- 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.
