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Spr24 Assess Ex1&2 - Cornelius > Restrictive Lung Disease (Exam IV) > Flashcards

Restrictive Lung Disease (Exam IV) Flashcards

1
Q

TLC is ________ % of normal in mild restrictive lung disease.

A

65 - 80%

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2
Q

TLC is ________ % of normal in moderate restrictive lung disease.

A

50 - 65 %

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3
Q

TLC is ________ % of normal in severe restrictive lung disease.

A

< 50 %

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4
Q

The two chest x-rays below would likely be indicative of what?

A

Pulmonary Edema

Bilateral symmetrical butterfly appearing opacities.

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5
Q

What occurs at the cellular level with pulmonary aspiration?

A
  • Surfactant producing cells are destroyed
  • Capillary endothelium is destroyed
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6
Q

Where is aspiration most often seen on a CXR?

A

Superior Segment of the RLL

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7
Q

How would acute respiratory failure be defined?

A
  • Inability to provide O₂ and eliminate CO₂
  • PaO₂ < 60 mmHg despite O₂ administration
  • Uncompensated metabolic alkalosis w/ PaCO₂ > 50 mmHg
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8
Q

Differentiate acute vs chronic respiratory failure.

A

Acute: ↑ PaCO₂ and ↓ pH
Chronic: ↑ PaCO₂ and compensated pH (from renal HCO₃⁻)

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9
Q

How is ARDS classified?

A

By its PaO₂ / FiO₂ ratio

P/F Ratio

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10
Q

What would be classified as mild ARDS?

A

PaO₂ / FiO₂ = 201 - 300 mmHg

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11
Q

What would be classified as moderate ARDS?

A

PaO₂ / FiO₂ of 101 - 200 mmHg

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12
Q

What would be classified as severe ARDS?

A

PaO₂ / FiO₂ of ≤ 100 mmHg

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13
Q

How could ARDS be diagnosed via CXR?

A

Bilateral findings in at least 3 lung quadrants not explained by pleural effusion or atelectasis.

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14
Q

Why might neuromuscular blockers be useful for ARDs?

A
  • Less ventilator barotrauma
  • Less inflammatory mediators
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15
Q

Why might prone positioning be useful for ARDS?

A
  • Recruits Alveoli
  • Improves V/Q mismatch
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16
Q

What is Sarcoidosis?

A

Systemic granulomatous disorder primarily involving lymph nodes and the lungs

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17
Q

What signs and symptoms might initially be seen with sarcoidosis?

A

Usually no symptoms at time of presentation

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18
Q

What signs and symptoms might be seen later in sarcoidosis?

A
  • Wheezing, dyspnea, cough
  • Cor pulmonale
  • Hypercalcemia
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19
Q

What places can sarcoidosis affect other than the lungs and lymph nodes?

A
  • Ocular (uveitis)
  • Myocardial (conduction problems)
  • Laryngeal
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20
Q

How is sarcoidosis diagnosed?

A
  • Mediastinoscopy
  • ↑ACE activity
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21
Q

What drug class is used to treat sarcoidosis?

A

Corticosteroids

22
Q

What is kyphosis?

A

Anterior flexion of the spinal vertebral column

23
Q

What is the most serious spinal abnormality affecting the pulmonary system?

A

Kyphoscoliosis

24
Q

Kyphoscoliosis exhibits a raised hemidiaphragm on the ______ side of the concavity.

A

same

25
Q

How is the severity of kyphoscoliosis measured?

A

Cobb Angle

26
Q

What Cobb angle would indicated mild-moderate kyphoscoliosis severity?

A

< 60°

27
Q

What Cobb angle would indicated severe kyphoscoliosis?

A

> 100°

28
Q

At what Cobb angle would you expect to see an increased risk of respiratory dysfunction?

A

> 70°

29
Q

What would occur with a Cobb Angle of > 100° ?

A
  • Chronic hypoventilation
  • pHTN
  • Hypoxemia
  • Erythrocytosis
  • Cor Pulmonale
30
Q

What vital capacity would be expected of someone with a Cobb Angle of > 100° ?

A

VC < 45% of normal

31
Q

What CXR signs are seen with pleural effusion?

A
  • Costophrenic angle blunting
  • Homogenous opacity
  • Concave meniscus of the chest wall
32
Q

What test has a better sensitivity and specificity for pleural effusion than chest x-rays?

A

Ultrasound

33
Q

What characterizes secondary pneumothorax?

A

Known parenchymal lung pathology

34
Q

What characterizes spontaneous pneumothorax?

A

Gas originating from the lung

35
Q

What characterizes idiopathic spontaneous pneumothorax?

A

Rupture of apical subpleural blebs

36
Q

With tension pneumothoraces the trachea is deviated _____ the pneumothorax.

A

away from

37
Q

Where is a needle decompression of a tension pneumothorax performed?

A

Second anterior intercostal space

38
Q

What pathology is depicted below?

A

Tension Pneumothorax

39
Q

What types of masses are seen in the anterior mediastinum?

A
  • Thymomas
  • Germ Cell tumors
  • Lymphomas
  • Thyroid and Parathyroid masses
40
Q

What types of masses are seen in the middle mediastinum?

A
  • Tracheal masses
  • Bronchogenic
  • Pericardial cysts
  • Enlarged lymph nodes
  • Proximal aortic disease
41
Q

What types of masses are seen in the posterior mediastinum?

A
  • Neurogenic cysts and tumors
  • Meningocele
  • Lymphoma
  • Descending aortic problems
  • Esophageal disorders
42
Q

How would mediastinal masses be evaluated pre-operatively?

A
  • Flow-volume loop studies
  • Imaging studies
  • Check for tracheobronchial compression
43
Q

What lung volumes are decreased with obese patients?

A

FEV₁
FVC
FRC
ERV

RV and TLC as well if BMI > 40 kg/m²

44
Q

Is VT or respiratory rate generally elevated in obese patients?

A

respiratory rate

45
Q

Central obesity is associated with ______ lung function.

A

worse

46
Q

How does pregnancy affect the subcostal angle?

A

Pregnancy will widen the subcostal angle from 63° to 103°

47
Q

What happens to the circumference of the lower chest wall in pregnancy?

A

Chest wall circumference increases

48
Q

Increased levels of what hormone are responsible for a lot of the musculoskeletal changes seen in pregnancy?

A

Relaxin

49
Q

How long does it take for chest wall configuration to normalize post-pregnancy?

A

6 months

Subcostal angle will remain 20° wider.

50
Q

What Cobb angle would indicated mild-moderate kyphoscoliosis severity?

A

< 60°

Spr24 Assess Ex1&2 - Cornelius (26 decks)

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