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PT Pulmonary Pathology, Diagnosis and Management > Restrictive and Obstructive Lung Dysfucntion > Flashcards

Restrictive and Obstructive Lung Dysfucntion Flashcards

1
Q
A

bronchitis

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2
Q

Severe hypoxemia

A

<75% SaO2

<40 mmHg PaO2

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3
Q

Tuberculosis S & S

A

if symptomatic,

  • usually cough (unproductive)
  • and fever,
  • night sweats,
  • weight loss;
  • poss dyspnea;
  • crackles w/poss bronchial BS is consolidation
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4
Q

Abnormal permanent dilation of bronchi and bronchioles. Destruction of elastic & muscular bronchiole walls:

A

Bronchiectasis

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5
Q

Hypocapnia:

A

Low PaCO2 = hyperventilation

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6
Q

Blood clot lodges in pulmonary artery

A

Pulmonary Embolism

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7
Q

Mild hypoxemia:

A

90 - 94% SaO2

60-79 mmHg PaO2

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8
Q

Symptoms of COPD:

A
  • Dyspnea on exertion (DOE)
  • Chronic cough
  • Expectoration of mucus
  • Wheezing
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9
Q

types of bronchiectasis

A

● Cylindrical (longitudinal)
● Varicose
● Saccular (cystic)

(chronic condition where the walls of the bronchi are thickened from inflammation and infection)

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10
Q

In restrictive diseases, what are the most marked lung volumes decreases?

A

IRV and ERV

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11
Q

true or false: both restrictive and obstructive pulmonary diseases may present with cor pulmonale.

A

true

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12
Q

Hypercapnia S & S:

A
  • Increased HR and BP
  • Dizziness
  • Headache
  • Confusion or loss of consciousness
  • Muscle twitching and tremor
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13
Q

Altered expiratory flow rate, increased RV, increased airflow resistance, loss of elastic recoil, increased work of breathing (WOB):

A

result of the COPD’s inflammatory response

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14
Q

Moderate hypoxemia:

A

75 -89% SaO2

40 - 59 mmHg PaO2

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15
Q

Signs of hyperinflation can be seen in which three COPD diseases?

A

emphysema, chronic bronchitis and asthma.

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16
Q

True or false. V/Q mismatch can be a cause of impaired oxygenation

A

true

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17
Q

An increase in CO2 in the body will:
● ____________ pH
● ____________ ventilation

A
  • decrease PH (acidosis)
  • increases ventilation (to get rid if CO2)
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18
Q

Hypocapnia S & S

A
  • Lightheadedness
  • Fatigue
  • Irritability
  • Inability to concentrate
  • Tingling
  • Impaired conciousness
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19
Q

Describe the characteristic pathologic changes in emphysema.

A
  1. Destruction of septal walls of alveoli
  2. Loss of elastic recoil
  3. Destruction of vascular bed
  4. Fusion of adjacent alveoli producing large abnormal airspaces (blebs or bullae)
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20
Q
A

emphysema

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21
Q

Normal persons use ___VO to support work breathing

A

<5%

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22
Q

In tuberculosis, the immune system usually surrounds the TB to form a____

A

granuloma

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23
Q

Decrease in the size of the bronchial lumen
causes increased resistance to airflow resulting in hyperinflated lungs – air gets trapped behind
collapsed bronchial walls

A

COPD

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24
Q

Nomal hypoxemia range :

A

>95%

80-100 mmHG PaO2

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25
Q
A

emphysema radiograph:

flatten diaphragm
enlarged R side of heart (cor pulmonale)
hyper-lucent lungs (darker)

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26
Q

Patient has 80% SaO2 in the blood. This is considered…

A

moderate hypoxemia

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27
Q

A look at obstructive and normal lung volumes:

A
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28
Q

Hypercapnia:

A

Increased PaCO2 = hypoventilation

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29
Q

occurs when air leaks into the space between your lung and chest wall (pleural cavity)

A

pneumothorax

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30
Q

Bronchityis S & S:

A
  • Inflammation of the bronchi
  • Blue bloater
  • Barrel chest
  • Morning expectoration
  • Chronic cough, productive sputum
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31
Q

Trasnmition of tuberculosis is by

A

inhalation of droplets that become airborne, usually with cough or sneeze

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32
Q

Hypocapnia is PaCO2 of less than

A

35 mmHg

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33
Q

hypoxemia

A

low PaO2 in the blood

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34
Q

Abnormal, irreversible enlargement of airways distal to terminal bronchioles

A

Emphysema

  • Centriacinar/lobar, panacinar, paraseptal →based on location of anatomic disruption
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35
Q

Hypercapnia is a PaCO2 of more than_____

A

45 mmHg

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36
Q

Inflammatory process of alveolar wall. Scarring leads to stiffness (decreased compliance)

A

Pulmonary Fibrosis

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37
Q

Signs of restrictive pulmonary diseases:

A
  • Tachypnea
  • Hypoxemia
  • Diminished BS
  • Adventitious BS
  • Decreased lung volumes
  • Decreased diffusion capacity
  • Cor Pulmonale (Right hearth failure): hearth overloads
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38
Q

oxygen toxicity (high concentrations) can cause

A
  • interstitial lung disease
  • alveolar edema and hemorrhage with atelectasis
  • Need to keep Fraction of Inspired Oxygen (FiO2) <40%.
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39
Q

Global Initiative for Obstructive Lung Disease
(GOLD)

A

to increase awareness of COPD

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40
Q

an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands

A

sarcoidosis

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41
Q

in Cystic Fibrosis what is the key to its treatment?

A

Bronchial hygiene is key!!!!

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42
Q

In COPD, obstruction affects mechanical function or does it affect gas exchange?

A

both

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43
Q

Cor pulmonale

A
  • abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels.
  • Sign of both COPD and restrictive
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44
Q

______________of the lung is simply a “solidification” of the lung tissue due to accumulation of solid and liquid material in the air spaces that would have normally been filled by gas. The most common cause of ___________is pneumonia – inflammation of the lung – as cellular debris, blood cells and exudate collects in the alveoli (air sacs) of the lung.

A

Consolidation

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45
Q

Pulmonary artery vasoconstriction is a S & S of what?

A

impaired oxygenation from:

  • Respiratory: reduced inspired O
    hypoventilation, impairment of diffusion, V/Q
    mismatch
  • Other systems: decreased blood volume,
    anemia, carbon monoxide poisoning,
    hypothermia
46
Q

Some people with emphysema develop empty spaces in the lungs called ____

A

bullae. Giant bullae can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can increase your risk of pneumothorax.

47
Q

Patient has 98% SaO2 in the blood. This is considered…

A

normal hypoxemia

48
Q

Inflammation of the airway is associated with alveolar
wall destruction & rupture of attachments b/t outer airways & alveoli ➔ loss of elastic recoil in the lung tissue (leads to airway obstruction and hyperinflation of lungs)

A

bronchitis

49
Q

Patient has 68% SaO2 in the blood. This is considered…

A

severe hypoxemia

50
Q

Incomplete expansion (or collapse) of lung that can result from secretion retention or compression of the lung

A

Atelectasis

51
Q

Signs of COPD:

A
  • Hypoxemia
  • Hypercapnia
  • Increased production of mucous/impaired mucous clearance
  • Pulmonary hypertension
  • Polycythemia
  • Cor pulmonale
  • Often see productive cough
  • Decreased expiratory flow rates (FEV1)
  • Increased residual volume
52
Q

Bronchiectasis auscultation:

A

crackles, wheezes, pleural rub, decreased BS

53
Q

May be idiopathic (IPF), immune response, genetic, occupational hazards (coal dust, asbestosis → inflammatory process of alveolar wall. Scarring leads to stiffness (decreased compliance)

A

Pulmonary Fibrosis

(Restrictive disease)

54
Q

Another look at lung volumes

A
55
Q

inflammation of the bronchi, obstruction of the airway:

A

bronchitis

56
Q

In children, is caused by RSV (respiratory syncytial virus)

A

Bronchiolitis Obliterans (BO)

Adults: by toxic fumes, or other infections

57
Q

Abnormal reduction in pulmonary ventilation
often due to diminished lung expansion resulting in a decreased volume of gas moving in and out

A

restrictive disease

58
Q

Drop in CO2 will:
● ____________ pH
● ____________ ventilation

A
  • increase PH
  • decrease ventilation (to keep CO2)
  • Alkalosis
59
Q

in genereal, with COPD, how does mucus pluggins affect breath sounds?

A

decreased breath sounds

60
Q

Symptoms of restrictive pulmonary diseases:

A
  • Dyspnea
  • Cough
  • Emaciation
61
Q

reduced inspired O2, hypoventilation, impairment of diffusion, V/Q mismatch, decreased blood volume, anemia, carbon monoxide poisoning, hypothermia will cause

A

hypoxemia

62
Q

Sudden respiratory failure due to fluid leaking from smallest blood vessels in lungs into the alveoli. Often seen in critically ill patients. Develop severe SOB w/in hours → days of initial injury/disease

A

Acute Respiratory Distress Syndrome (ARDS)

63
Q

Chronic inflammatory disease of the airways characterized by reversible obstruction to airflow with increased mucosal edema

A

Asthma

64
Q

Inflammatory process of the lung. Often begins from a lower respiratory tract infection

A

Pneumonia

65
Q

What is the difference between a pleural effusion and a pneumothorax?

A
  • Pleural effusion: fluid in the pleural space
  • Pneumothorax: air the pleural cavity
66
Q

Hypersecretion of mucus in response to a chronic
irritation (smoking)

A

bronchitis

67
Q
A

Cystic Fibrosis X-ray

68
Q

Patient has 92% SaO2 in the blood. This is considered…

A

mild hypoxemia

69
Q

In restrictive lung disease → work of breathing increases or decreases?

A

increases

70
Q

COPD disease that used to be deadly characterized by thick, excessive secretions and poor ciliary function

A

Cystic fibrosis

71
Q
A

Cystic Fibrosis X-ray

72
Q

One of the most common chronic lung diseases in
children (along with asthma and CF)

A

Bronchpulmonary dysplasia (BPD)

more common in pre-term children

73
Q

PaO2 bet 40- 60?

A

moderate hypoxemic

74
Q

Inflammatory immune response in the lungs
usually in response to noxious stimuli (ex: cigarette smoke)

A

COPD pathogenesis

75
Q

So, with increased CO2 production, chemoreceptors will _______ ventilation to express the CO2 and
_______ the H+ concentration

A

increase ventilation

decrease the H+ concentration

76
Q

_______________________ sends inhibitory impulses to the inspiratory area→shortening inhalation

A

pneumotaxic area in the pons

77
Q

how would percussion be in emphysema?

A

hyper-resonant, because is so air filled

78
Q

Blood Gas looks at what aspect of impaired oxygenation disease?

A

PaO2

Amount of O2 in the blood: HYPOXEMIA

Blood for an ABG test is taken from an artery.

79
Q

Emphysema Signs and Sx

A
  • pink puffer
  • Often thin
  • Increased accessory mm use
  • lung hyperinflated (decreased BS)
80
Q

leading cause of cancer deaths:

A

carcinoma

81
Q

This COPD disease is characterized by exocrine gland dysfunction:

  • GI: pancreatic enzyme deficiency
  • Integumentary: increased sweat production
A

Cystic Fibrosis

82
Q

Hemothorax

A

blood in the pleural cavity

83
Q

PaO2 bet 80 and 100

A

normal oxygen level

84
Q

Increased fluid in the lung (alveoli), often due to
left ventricular failure (CHF). Can be a medical emergency

A

Pulmonary Edema

85
Q

True or false.
In bronchitis, the cilia in airways remain intact

A

false

86
Q

Incubation time of tuberculosis

A

2-12 weeks (PPD + ~6-8 wks)

87
Q

in Bronchiectasis think of…

A

disgusting horrible muscus that you have to help pt clear

88
Q
A

asthma

89
Q

Air trapping in the lungs due to premature closure of the airways

A

COPD

90
Q

Anoxia

A

absence of oxygen

91
Q

Types of COPD:

(COPD diseases)

A
  • Bronchitis (blue boater)
  • Asthma
  • Emphysema (pink puffer)
  • Bronchiectasis: chronic condition where the walls of the bronchi are thickened from inflammation and infection
  • Cystic Fibrosis
92
Q

PaO2 of less than 40

A

severely hypoxemic

93
Q

increased CO2 would cause ________in H+ (___ in pH)

A

increase H+

decreases PH (Acidosis)

94
Q

hypoxia

A

low oxygen in the tissues

95
Q

Oxygentation status values:

A
96
Q

Disease of respiratory tract which produces an obstruction to airflow

A

obstructive disease (COPD)

97
Q

Manifestations of respiratoty diseases:

A
  • Impaired Oxygenation
  • Impaired CO2 removal
98
Q

PaO2 bet 60 and 80

A

mild hypoxemic

99
Q

Causes of impaired oxygenation:

A
  • Respiratory:
    • reduced inspired O2
    • alveolar hypoventilation
    • impairment of diffusion
    • V/Q mismatch
  • Other systems:
    • decreased blood volume
    • anemia (not enough RBC)
    • carbon monoxide poisoning
    • hypothermia
100
Q
A

asthma

101
Q

Lung diseases that result in air trapping in the lungs

A

COPD

  • Increased lung compliance with larger lung volumes
102
Q

Signs and symptoms of impaired oxygenation:

A
  • Cyanosis
  • Tachycardia, tachypnea
  • Cerebral hypoxia (disoriented)
  • Cardiac arrhythmia
  • Pulmonary artery vasoconstriction
103
Q

Patients with COPD usually present with:

A
  1. hyperinflation,
  2. barrel chest, and
  3. increased accessory respiratory muscle use
104
Q

Types of asthma:

A
  • Exercise induced asthma
  • Asthma attack
  • Status asthmaticus: attack that persists for hours and is unresponsive to medical management → medical emergency
105
Q

Diagnosis of COPD is made by

A
  • pulmonary function test,
  • symptoms
  • history
106
Q

This disease can be extrinsic – begins in childhood, triggered by allergens (allergic) or Intrinsic – begins as adult (usu after age 35), more severe (non-allergic)

A

Asthma

107
Q

Pleural Effusion

A
  • Fluid in the pleural space (from an infection like pneumonia)
108
Q

Occurs in infants by RSV (respiratory syncytial virus)or dults by toxic fumes, or other infections. Fibrotic lung dx of smaller airways with necrosis of the respiratory epithelium from inflammatory injury that causes destruction of bronchioles

A

Bronchiolitis Obliterans (BO) / with Organizing Pneumonia (BOOP)

109
Q

Productive cough on MOST days for 3 months during 2 consecutive years

A

Bronchitis

110
Q

With restrictive lung disease, % of O2 expediture utilized in the work of breathing can go up to ____

A

25%

Can develop respiratory mm fatigue, overuse, and failure

111
Q

What are the universal precaustions in tuberculosis?

A
  • mask
  • respiratory isolation

PT Pulmonary Pathology, Diagnosis and Management (10 decks)

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