Respiratory diseases

Question 1

asthma

Answer 1

a disease of chronic airway inflammation

Question 2

airflow w asthma

Answer 2

variable expiratory airflow limitation

Question 3

4 symptoms of asthma

Answer 3

wheezes, sob, chest tightness, cough

Question 4

airways w asthma

Answer 4

overresponsiveness (hyperresponsiveness) to stimuli (allergens)

Question 5

how is hyperresponsiveness to stimuli w asthma happening

Answer 5

by narrowing airways and producing mucus

Question 6

3 main abnormalities caused by asthma

Answer 6

inflammation of airways;
bronchial hyperresponsiveness;
airway remodeling

Question 7

inflammation of airways w asthma

Answer 7

an overreaction to normal stimuli/allergens

Question 8

airway inflammation w asthma (steps)

Answer 8

1. antibodies develop after exposure to a stimulus
2. these stimuli trigger an overresponse
3. mast cells, once triggered, degranulate and produce an inflammatory response

Question 9

bronchial hyperresponsiveness w asthma

Answer 9

smooth muscles contract in an overreaction to normal stimuli

Question 10

airway remodeling w asthma

Answer 10

permanent changes to the structure of airways that result in irreversible obstruction in at least some patients

Question 11

airway remodeling w asthma (steps)

Answer 11

1. increase in goblet cells (increasing mucus production)
2. thickening of the bronchial walls
3. change in smooth muscle function/structure resulting in air-trapping (dynamic hyperinflation)

Question 12

5 risk factors of asthma

Answer 12

allergic, non-allergic, adult-onset asthma; asthma w obesity; asthma w persistent airwflow limitation

Question 13

allergic asthma

Answer 13

often starts in childhood; often a genetic component

Question 14

adult-onset asthma

Answer 14

usually non-allergic, esp. in women (endometriosis..)

Question 15

asthma w persistent airwflow limitation

Answer 15

more chronic; likely due to airway remodeling, persistent sympts of airwlow limit-n (not compltly reversible)

Question 16

atelectasis

Answer 16

a loss of lung volume as a result of colapse of lung tissue

Question 17

what can atelectasis affect

Answer 17

part or all of the lungs

Question 18

what does atelectasis result in

Answer 18

impaired gas exchange

Question 19

7 sings of atelectasis seen w physical exam

Answer 19

• tracheal shift (toward the affected side);
• decresed chest expansion
• dyspnea
• increased WOB
• chest pain
• refractory hypoxemia (leads to tachypnea, tachycardia, decreased SpO2);
• fever

Question 20

5 possible auscultation findings w atelectasis

Answer 20

• fine crackles;
• diminished (w obstruction);
• bronchial (if aw is patent - open & allows for adequate af);
• increased fremitus (aka tactile fremitus, occurs as a result of increased density within the lung tissue (lung consolidation, which refers to the replacement of the air within healthy lung tissue with another substance: blood, pus..)
• dull percussion note

Question 21

(5) chest imaging w atelectasis

Answer 21

• opacifications (less aeraeted tissue);
• air bronchograms;
• narrowing of rib spaces;
• elevation of diaphragm (on affected side);
• tracheal/cardiac/mediastinal shift

Question 22

4 treatment strategies w atelectasis

Answer 22

• lung expansion therapies (deep breathing, IS - incentive spirometry (taught before surgery if it is possible to prevent atelectasis), PEP - positive exp. pressure..);
• aw clearance w secretions (IPV - intrapulmonary percussive ventilation);
• CPAP (noninvasive = do not need artificial aw) or optimal PEEP (positive end-exp. pressure; invasive) to reinflate;
• bronchoscopy (= tube goes thru nose/mouth to lungs with a camera) if obstructive (secretions..)