respiratory disorder (diseases) Flashcards
what is COPD (chronic obstructive pulmonary disease)
(emphysema and chronic bronchitis) - co existing diseases that narrow airways
- progressive development of airflow limitation, not fully reversible and the destruction of lung parenchyma (alveoli, alveolar ducts and respiratory bronchioles)
- associated with an inflammatory response to noxious particles
causes of copd: (3)
- smoking (primary0
- indoor pollution
- occupational dusts and chemicals
signs and symptoms of COPD
- wheezing; comes from turbulent flow due to mucus plugs etc
- dyspnea
COPD is a progressive disease what is the pathophysiology of early disease?
small airways have mucus plugging, inflammation, fibrosis (scarring), narrowing
True or false:
COPD is not curable but progression can be slowed and symptoms controlled with treatments
true
What are 3 clinical manifestation of COPD
- increased work of breathing
- ventilation - perfusion mismatching
- decreased FEV1
what is the pathopysiology of emphysema? (4 things)
- a decrease of elastic recall
- destruction of the alveolar walls produce dilated air spaces and therefore less surface area for gas exchange
- unsupported airways tend to collapse on expiration = air trapping
- obstruction of small bronchioles (eg mucus plugs)
clinical manifestations of emphysema (6)
- exertional dyspnea
- weightloss
- tachypnea with prolonged expiration use of accessory muscles to breath, pursed lips
- little coughing/ sputum
- increase anterioposterior ration (barrel chest)
- leans forward with arms braced on knees to increase lung capacity.
what is chronic bronchitis?
a recurrent of chronic productive cough for a minimum of 3 months for 2 consecutive years (eg smokers cough)
pathophysiology of chronic bronchitis (7)
- chronic inflammation
- bronchoconstriction
- episodic dyspnea
- hypertrophy of bronchial glands that secrete mucus leading to mucus plugs
- hypoventilation and CO2 retention
- hypoxemia
- accessory muscle use with increased work of breathing
What are 5 clinical manifestations of chronic bronchitis?
- decreased exercise tolerance
- wheezing and dyspnea
- productive (wet) cough becomes copious (dry)
- polycythemia ( high rbc count)
- decreased FEV1
what does Alpha 1 - antitrypsin do and what happens in its abscence?
- it inhibits vairety of proteases and protects tissues from neutrophil elastase.
- if absent neutrophil elastase is free to break down elastin which contributes to elasticity of lungs and results in respiartory complication such as emphysema.
what will the FEV1 value be if a person has mild COPD and what are some signs/ symptoms
- approx 60-80%
- sob on moderate exertion
- recurrent chest infections
has little impact on adls
what will the FEV1 value be if a person has moderate COPD and what are some signs/ symptoms
- 40 - 59%
- increased dyspnea
- increased limitation of dls
- cough and sputum production
- exacerbations require corticosteriods/ antibiotics
what will the FEV1 value be if a person has severe COPD and what are some signs/ symptoms
- less than 40%
- dyspnea follow minimale exertion
- adls severly impacted
- chronic cough
- regular sputum production
what are 5 non pharmaceutical COPD management methods
- nutrition intervention - increase calorie intake due to increase work of breathing
- o2 therapy or concentrator
- smoking cessation
- breathing techniques
- psychosocial support
COPD Pharmacotherapy what are the 3 types of drugs used commonly for treatment
- bronchodialators (short or long acting ) (beta agonists)
- inhaled corticosteriods
- oral corticosteriods
An acute exarcerbation of COPD is a common reason for hospitilisation and mechanical ventilation, what is this and what is the common cause behind it ?-
- (AECOPD) = clinical diagnosis made when a patient with COPD experiences sustained (eg 24hrs) increase in cough, sputum production and/or dyspnea
- most common cause = bacterial or viral infections
Cor Pulmonale and right heart failure is a complication of COPD what is the clinical manifestations and treatment for this?
- Clinical manifestation = heart appears normal at rest and with exercise co is decreased and chest pain is present
- treatment = decrease workload of right ventricle by lowering pulmonary artery pressure
what is asthma
- chronic inflammatory disorder of the airways characterised by reversible airflow obstruction resulting in a cough, wheeze, chest tightness and SOB
- bronchial hyper responsiveness
cause for asthama?
- not completely understood but potentially a combination of geentic predisposition with enviromental exposure to inhaled substances and particles that may provoke allergic reactions of irritate airways
Triggers of asthma?
- may include: cold air, extreme emotional arousal, physical exercise, certain meds (eg NSAIDS and betablockers), respiratory infections (eg cold)
What is asthma pathopysiology (early and late response)
early = bronchoconstriction late = inflammation (occurs up to 6 hrs after exposure)
during an asthma attack immunoglobulin E cause the mast cells to degranualte releasing a large number of inflammatory mediators. what are these?
- vasodialation
- increase capillary permeability
- mucosal oedema
- bronchospasm ( bronchial smooth muscle contraction)
- tenacious mucus secretion
4 prevention methods of asthma
- reduce exposure to allergens
- reduce air pollution
- smoking cessation
- flu immunisation
Pharmaceutical management of the different severities of asthma
mild = SABA inhalers moderate= anti inflammatory meds and ICS severe = LABA and oral NSAIDS
what is some ways on non pharmalogical treatment of asthma
- o2 therapy
- monitoring gas exchange and airway obstruction in response to therapy
- education of triggers
- skin prick testing for allergies
