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Z Clinical Medicine - Midterm > Respiratory Disorders > Flashcards

Respiratory Disorders Flashcards

1
Q

Respiratory Disorders

  • major categories (3)
  • cardinal symptoms (2)
A

Obstructive (e.g. asthma)
Restrictive (e.g. sarcoidosis)
Vascular abnormalities

Dyspnea
Cough

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2
Q

Asthma

  • define
  • prevalence
A

Condn in which a person’s airways become inflamed, narrow, swell, and produce excess mucus - difficult to breathe

One of the most common chronic diseases globally

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3
Q

Asthma

  • peak incidence
  • severity
A

~3 years old

Varies greatly, but not significantly within a given pt

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4
Q

Asthma

  • risk factors vs triggers
  • major risk factor
A

RF: may cause development of disease

T: may exacerbate the disease

Atopy

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5
Q

As Asthma
-pathophysiology
—assoc w/ __
—leading to (6)

A

Specific chronic inflammation of the mucosa of the lower airways leading to:

Infiltration (inflamm cells)
Fibrosis (remodeling)
Edema
Mucus hypersecretion
Smooth muscle hypertrophy/hyperplasia
Airway hyper-responsiveness** -> bronchoconstriction (inflamm cascade)
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6
Q

Asthma
-pathophysiology
—foci
—fatal asthma

A

Down deep in lungs - at level of alveoli (gas exchange site)

Mucus plug is common finding

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7
Q

Asthma

-clinical features

A

Characteristic symptoms: wheezing, dyspnea, coughing

Prodromal may proceed

May be (-)abnormal when under control

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8
Q

Asthma

-diagnosis

A

Usually apparent from symptoms
Must be confirmed by objective measurements of lung function
-spirometry

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9
Q

Asthma
-treatment
—bronchodilators
—controllers

A

Bronchodilators

  • rapid relief
  • usually beta-2 agonist (albuterol) PRN via inhaler

Controllers

  • inhibit underlying inflamm process
  • usually low-dose inhaled corticosteroid BID
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10
Q

Asthma

-OD implications (3)

A

Glaucoma meds interaction
-bottom line, avoid tx glaucoma with Timolol for asthmatics on albuterol

Steroids

Activate emergency response system

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11
Q

Chronic Obstructive Pulmonary Disease (COPD)

  • define
  • prevalence
A

Group of lung diseases characterized by persistent respiratory symptoms and airflow limitations that’s not fully reversible

> 10 million
3rd leading cause of death USA

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12
Q

Chronic Obstructive Pulmonary Disease (COPD)

-subcategories and definitions (3)

A

Emphysema

  • anatomically defined
  • desctruction of alveoli/loss of septae with air space enlargment

Chronic bronchitis

  • clinically defined
  • chronic cough and phlegm

Small airway disease
-small bronchioles are narrowed and reduced in number

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13
Q 
Chronic Obstructive Pulmonary Disease (COPD)
-pathophysiology
—when airway limitations occur
—triggers
—chronic inflammation leads to (3)
A

In setting of noxious environmental exposures in those genetically susceptible

Ciagrette smoke&raquo_space;> occupational exposures

ECM destruction
Cell death
Ineffective repair

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14
Q

Chronic Obstructive Pulmonary Disease (COPD)

-signs/symptoms

A

Cough, sputum production, exertional dyspnea

May eventually develop resting hypoxemia -> need supplemental O2

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15
Q

Chronic Obstructive Pulmonary Disease (COPD)

-diagnosis (3)

A

Pulmonary function tests

Arterial blood gases/oximetry - may demonstrate hypoxemia

Radiographic studies - classify type of COPD

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16
Q

Chronic Obstructive Pulmonary Disease (COPD)

-hypoxia vs hypoxemia

A

Hypoxia: An absence of enough oxygen in the tissues to sustain bodily functions

Hypoxemia: A low level of oxygen in the blood

17
Q

Chronic Obstructive Pulmonary Disease (COPD)
-treatment
—goals
—only 3 that have proven to increase survival rate

A

Symptomatic relief and reduce further risk

Smoking cessation, supplemental O2, lung volume reduction surgery

18
Q

Chronic Obstructive Pulmonary Disease (COPD)

-OD implications (4)

A

Dry eye from supplemental O2

Medications (same as asthma)

Susceptible to infections/prone to airborne pathogens

Thinning of RNFL in pts with hypoxia/chronic inflammation

19
Q

Sleep Apnea

  • define
  • apnea vs hypopnea
  • types (2)
A

Cessation or reduction in airflow for at least 10 sec during sleep

A: cessatoin
H: reduction

Types

  • obstructive (OSAHS)
  • central (CSA) - less common
20
Q 
Obstructive Sleep Apnea
- pathophysiology
—in general
—vs asthma/COPD
—anatomy
—waking
A

Neuromuscular output to pharyngeal dilator muscles decreases during sleep

Mechanical problem in upper airway (asthma/COPD = lower)

Pharynx collapse (apnea) or near collapse (hypopnea)

Ventilatory reflexes activated, cause arousal

21
Q

Obstructive Sleep Apnea

  • main risk factors (2)
  • prevalence
A 
Obesity (4x)
Male gender (2-4x) - esp due to fat distribution near neck/airway

Peak 3-8 in children
2-15% mid-age, >20% elderly
Esp high for HTN, DM
Undiagnosed in majority of adults

22
Q

Obstructive Sleep Apnea

  • symptoms (2)
  • physical findings (2)
A

Snoring
Excessive daytime sleepiness

Central obesity
Oropharynx - small orifice with crowding by enlarged tongue, low soft palate, bulky uvula, large tonsils, etc.

23
Q

Obstructive Sleep Apnea

-diagnosis

A

Gold standard = polysomnogram

24
Q

Obstructive Sleep Apnea

-management (4)

A

Lifestyle/behavioral changes

CPAP - continuous positve airway pressure

Oral appliances

Upper airway surgery

25
Q

Obstructive Sleep Apnea

-OD implications (4)

A

Virtually any ischemic ocular disorder may be exacerbated

  • diabetic ret
  • glaucoma
  • NAION

Floppy eyelid

CSCR

Dry eye

Z Clinical Medicine - Midterm (9 decks)

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