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Pathophysiology and Pharmacology > Restrictive Respiratory Disorders > Flashcards

Restrictive Respiratory Disorders Flashcards

1
Q

Restrictive Respiratory Disorders

A

Characterized by a restriction in lung volume, caused by decreased compliance of the lungs or
chest wall

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2
Q

Extrapulmonary disorders

A

involve the central nervous system, neuromuscular system, and chest wall; lung tissue is NORMAL

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3
Q

Intrapulmonary disorders

A

involve the pleura or the lung tissue.

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4
Q

Pleural Effusion

A

Not a disease rather a symptom of disease

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5
Q

Types of Pleural Effusion

A

Transudative

Exudative

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6
Q

Transudative Pleural Effusion

A

non-inflammatory: HF d/t increased hydrostatic pressure (most common cause); chronic liver or renal disease d/t decreased oncotic pressure

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7
Q

Exudative Pleural Effusion

A

inflammatory: d/t increase capillary permeability – pulmonary malignancy/infection/embolism; GI disease - pancreatitis

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8
Q

Type of effusion can be determined from a sample of

pleural fluid obtained via thoracentesis

A
  • Transudative –> low protein concentration; fluid clear
    or pale yellow
  • Exudative –> high protein concentration; fluid dark yellow/amber
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9
Q

What else is fluid from a thoracentesis analyzed for?

A

for RBC, WBC, malignant cells, bacteria, glucose

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10
Q

Empyema

A

Pleural effusion that contains pus

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11
Q

Causes of Empyema

A

Pneumonia, TB, lung abscess, infected surgical wounds

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12
Q

Treatment of Empyema

A

chest tube drainage, antibiotic therapy

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13
Q

Manifestations of empyema include:

A

those of pleural effusion as well as fever, night sweats, cough, and weight loss.

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14
Q

Clinical Manifestation of pleural effusion

A

Progressive dyspnea; decreased movement of the
chest wall on the affected side; pleuritic pain from
the underlying disease; dullness to percussion and
absent or decreased breath sounds over the
affected area during physical examination

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15
Q

Collaborative Care of Pleural Effusion

A
  • Treat the underlying cause – HF (diuretics, Na restriction)
  • Treatment of pleural effusions secondary to malignant disease is difficult.
  • Chemical pleurodesis to sclerose pleural space
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16
Q

Pleurisy

A

Inflammation of the pleura

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17
Q

Pleurisy Clinical Manifestation

A

Abrupt onset of pain, esp. with inspiration, shallow

breathing, tachypnea

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18
Q

Causes of pleurisy

A

pneumonia, TB, chest trauma, pulmonary infarction, neoplasm

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19
Q

Classifications of Pleurisy

A

fibrous (dry) or wet (effusion)

20
Q

Treatment of Pleurisy

A
  • Treatment of primary disease causes symptoms resolution

- Analgesics, lying or splinting the affected side

21
Q

Atelectasis

A

Condition of the lungs characterized by collapsed,

airless alveoli

22
Q

Most common cause Atelectasis

A

retained exudates and secretions

23
Q

Atelectasis is common in what type of patients?

A

Common in post operative patients

24
Q

Prevention of Atelectasis

A

deep breathing and coughing

25
Q

Interstitial Lung Disease

A

Many acute and chronic lung disorders with
variable degrees of pulmonary inflammation and
fibrosis are collectively referred to as interstitial
lung diseases (ILDs) or diffuse parenchymal lung
diseases.

26
Q

Causes of Interstitial Lung Disease

A
  • Many causes - difficult to classify – 200+ causes as
    primary conditions of the lung or parts of
    multiorgan processes (SLE, RA)
  • Most common causes – occupational and
    environmental exposures – dust, fumes, gases
27
Q

Idiopathic Pulmonary Fibrosis (IPF)

A

Characterized by scar tissue in the connective tissue of the lungs as a sequel to inflammation or irritation

28
Q

Idiopathic Pulmonary Fibrosis (IPF) risk factors

A

occupational/environmental exposures, smoking, chronic aspiration

29
Q

Idiopathic Pulmonary Fibrosis (IPF) Clinical Manifestations

A

Exertional dyspnea, nonproductive cough, and inspirational crackles with or without clubbing

30
Q

Idiopathic Pulmonary Fibrosis (IPF) Clinical course

A

Variable. 5 year survival rate 30-50%

31
Q

Idiopathic Pulmonary Fibrosis (IPF) Treatment

A

Corticosteroids, cytotoxic agents, antifibrotic agents, lung transplant

32
Q

Sarcoidosis

A
  • Chronic, multisystem granulomatous disease of
    unknown cause that affects primarily the lungs (also
    skin, eyes, liver, kidney, heart, lymph nodes)
  • Often acute and self limiting, but can also be
    chronic with remissions and exacerbations
  • Severe restrictive lung disease
33
Q

Sarcoidosis Treatment

A

corticosteroids, cytotoxic agents

34
Q

Pulmonary Edema

A

An abnormal accumulation of fluid in the alveoli and the interstitial spaces of the lungs

35
Q

Most common complication of Pulmonary Edema

A

left sided heart failure

36
Q

Is Pulmonary Edema a Medical Emergency?

A

YES!

37
Q

Pulmonary Edema is caused by what?

A

Increased hydrostatic pressure or decreased oncotic pressure in pulmonary capillaries that outpaces lymphatic drainage; interferes with gas exchange

38
Q

Pulmonary Edema Clinical Manifestations:

A

tachypnea, tachycardia, hypoxia, crackles, dyspnea

39
Q

Pulmonary Edema Treatment:

A

correct underlying cause; diuretics, Na restriction, oxygen, morphine, nitro

40
Q

Pulmonary Embolism

A

Blockage of pulmonary arteries by a thrombus, fat or air embolus, or tumour tissue

41
Q

Pulmonary Embolism Causes:

A

Most arise from DVT (legs), also from atrial fibrillation, long bone # (fat emboli), IV therapy errors (air emboli), tumors

42
Q

Pulmonary Embolism Risk Factors:

A

immobility, surgery, pregnancy, obesity, heavy smoking HTN

43
Q

Pulmonary Embolism Clinical manifestations:

A

slow or sudden onset; varied and non-specific; classic triad - dyspnea, chest pain, hemoptysis; crackles, fever, change in mental status d/t hypoxia,

44
Q

Pulmonary Embolism Complications:

A

pleural effusion; pulmonary infarction

45
Q

Pulmonary Embolism Diagnostic studies:

A

spiral CT scan with contrast injection is visualize blood vessels; V/Q (ventilation/perfusion) scan

46
Q

Pulmonary Embolism Collaborative Care:

A

prevention (early ambulation, SCDs, prophylactic anticoagulants); oxygen, analgesics, turning, DB & C to prevent atelectasis; low molecular weight heparin (to prevent further clots) x 3-6/12; severe cases may require ventilator support, surgery

47
Q

Vascular Lung Disorders:

A
  • Pulmonary Edema

- Pulmonary Embolism

Pathophysiology and Pharmacology (17 decks)

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