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Cardiopulm > Restrictive Lung diseases > Flashcards

Restrictive Lung diseases Flashcards

1
Q

what is the chief problem of all restrictive lung diseases?

A

can’t get air in, but have normal exhale (but of course exhale is small too bc the amount of air u got in in the first place in order to exhale it is small)

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2
Q

how are restrictive lung diseases classified?

A

reduced lung volumes with normal expiratory flow rates

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3
Q

what is the usual ultimate pathological condition that most ppl with RLDs end up with?

A

diffuse fibrosis

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4
Q

Restrictive lung dysfunction. (RLD)

A

side effect of reduced compliance of lungs or of chest wall for a number of different reasons.

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5
Q

is RLD a disease process?

A

no, its a side effect

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6
Q

what are the values for RLD?

A

transpulmonary pressure is kept relatively constant due to lack of elasticity, this causes dec. of volume that can get in
inc. in RR to try to help but then that gives up and u are left with dec. RR, dec. FVC, dec. TLC, dec. VC, dec. ERV dec. IRV, dec. FRC (ERV+RV)

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7
Q

what is work of breathing in RLD? what is normal?

A

greater than or equal to 25%, norm is 5%

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8
Q

might these ppl need o2 during therapy?

A

yes, maybe up to 1-6L with exercise

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9
Q

what might be reasons for RLD?

A

pollutants causing injury to lung–>scarring and fibrosis

injury to chest wall: paralysis, torn mm, broken rib, obesity

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10
Q

classic signs of RLD?

A 
Tachypenea (inc. RR)
hypoxemia
dec. breath sounds- with rales 
non productive dry, irritating cough (#1 symp. that brings ppl in to doctor) 
emaciated appearance
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11
Q

what do ppl with RLD usually die from?

A

cor pulmonale

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12
Q

why do ppl with RLD get cor pulmonale?

A

hypoxemia and fibrosis of capillaries leads to pulm. HTN and creates inc. pressure for the R ventricle to pump against until it gives out.

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13
Q

ppl with chronic bronchitis have a _______ cough, but ppl with RLD have a ___________ cough!

A 
bronchitis= productive! 
RLD= non productive
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14
Q

PULMONARY FIBROSIS- types

A 
sarcoidosis
lupus
IPF
scleroderma
rheumatic disease
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15
Q

sarcoidosis

A

granulomatous disease of unknown etiology

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16
Q

what is it that causes granulomas at the site injection if u have sarcoidosis?

A

kviem antigen

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17
Q

what does fibrosis alveolitis look like on an X ray?

A

honeycomb, scarring

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18
Q

S&S of sarcoidosis

A

dry, irritating cough, general weakness, fatigue, weight loss, malaise, fever

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19
Q

tx for sarcoidosis

A

corticosteroids and immunosuppressive drugs

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20
Q

Lupus

A

systemic autoimmune disease with varied clinical manifestations

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21
Q

who does lupus affect most often?

A

women ages 15-45

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22
Q

what lung sounds do ppl with lupus have?

A

dec. souds, friction rub, rales,

23
Q

what do ppl with lupus present like?

A

butterfly rash, cyanotic, may have raynauds

24
Q

rheumatoid disease

A

dec. chest wall compliance secondary to systemic and pulmonary rheumatoid disease.

25
Q

who is affected by rheumatoid disease?

A

females more than males, 50-60 years old

26
Q

Scleroderma

A

an autoimmune disease that affects the endothelial cells of blood vessels and connective tissues causing fibrosis in organs. non-reversible damage.

27
Q

who is affected by scleroderma?

A

F >M x5

28
Q

Idiopathic pulmonary fibrosis (IPF)

A

chronic lung disease that causes fibrosis of alveoli and capillary network, differentiated only by lack of any causative factor or environmental agent.

29
Q

chief sign of IPF

A

slow, progressive dyspnea

30
Q

Who gets IPF?

A

Middle aged men>women

31
Q

life expectancy of someone diagnosed with IPF?

A

50% live 5 years, R sided heart failure, or lack of O2

32
Q

values for IPF

A

dec. TLC, VC, FRC (ERV+RV), inc. venilation-perfusion mismatch

33
Q

when in doubt, how do u treat all restrictive lung diseases?

A

immunosuppressors and corticosteroids

34
Q

4 categories of restrictive environmental lung diseases

A

infectious agents
organic dusts
inorganic dusts
gases

35
Q

pneumoconioses

A

inhalation of inorganic dust- COAL WORKERS

36
Q

silicosis

A

inhaling silicas (crystalline silicone dioxide)- mining, grinding, polishing rock, ship building,

37
Q

asbestos

A

inhaling silicates- sheet metal, ships, asbestos mines

38
Q

what sound do u here both with asbestos and coal workers pneumonia?

A

rales

39
Q

irritant gasses that are inhaled

A 
ammonia
sulfur dioxide
chlorine
nitrogen dioxide
ozone
phosgene
40
Q

what happens when irritant gasses are inhaled?

A

epithelial injury, hyperemia, edema, mucosal sloughing, coughing, dyspnea, cyanosis-pulmonary fibrosis from significant exposure

41
Q

restrictive lung diseases caused by spine and chest wall pathology

A 
kyphosis
scoliosis
kyphoscoleosis (lateral and posterior curvature) 
lordosis
pectus excavatum- scoop chest
pectus carinatum- pigeon chest
42
Q

S&S of restrictive diseases caused by spine and chest wall

A

dyspnea, frequent pneumonia, respiratory insufficiency, hypoxia, hypercapnia, risk of cardiac failure

43
Q

restrictive lung diseases caused by the neuromuscular system

A

myasthenia gravis
guillan barre
ALS
quadriplegia

44
Q

myasthenia gravis

A

autoimmune disease,
body destroys its own ACH receptors= not enough ACH= weak mm, including resp. mm
treat with anticholinesterase drugs and steriods

45
Q

Guillan Barre syndrome

A

acute inflammatory polyneuritis, idiopathic
demyelination of peripheral nerves, ascending paralysis, need to get to a hospital before it paralyzes your diaphragm, after that scary time (1-3 weeks) (as long as u don’t get pneumonia) you should start to heal up in 2-4 weeks.

46
Q

ALS

A

inflammatory or neoplastic disease of the spinal cord

47
Q

quadriplegia- what level of injury affects the diaphragm?

A

C3,C4,C5

48
Q

what level of injury affects the scalenes?

A

C5-6

49
Q

what level affects the intercostals?

A

T1-T11

50
Q

what level effects the abdominals

A

T8-T12

51
Q

what is defined as an acute inflammatory process that affects the gas exchange units of the lungs?

A

pneumonia!

52
Q

in pneumonia, what happens in response to inflammation?

A

fluid and RBCs pour into the alveoli, phagocytes also pour into the infected area to engulf and kill bacteria, then the alveoli undergo “consolidation” and become filled with fulid, looking milky.

53
Q

what happens if the adjacent lining of the pleural cavity gets involved in pneumonia?

A

pleural effusion

54
Q

S&S of pneumonia

A

malaise, chills, fever, cough, chest pain, dyspnea

Cardiopulm (10 decks)

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