Reviewer #5 Flashcards
A disease state characterized by airflow limitation that is not fully reversible
Chronic Obstructive Pulmonary Disease (COPD)
What is the rank of Chronic Respiratory Diseases in the leading causes of death in the PH according to the DOH?
7th place
The airflow limitation of COPD is both progressive and abnormal inflammatory response of lungs to noxious particles or gas, explain.
COPD worsens over time and structural changes happen in the airway in response to noxious particles and gas
People with COPD commonly become symptomatic during the middle adult years, and the incidence of COPD increases with age, why?
Since COPD is a disease that worsens over time, one may look unaffected but will reveal itself as time goes by
Since the symptoms of COPD starts of as mild people tend to associate them with?
Getting old
Its calling card is a nagging cough with plenty of mucus (phlegm). Inside the lungs, the small airways have swollen walls, constant oozing of mucus, and scarring.
Chronic Bronchitis
Typically, it is a sign of chronic bronchitis due to the body’s response to the build-up of phlegm
Smokers cough
Air sacs can’t expand and contract properly. In time, the damage destroys the air sacs, leaving large holes in the lungs, which trap stale air. This tend to cause great trouble exhaling.
Emphysema
The main test for COPD?
Spirometry
X-ray is not used to diagnose COPD but can be used to?
Help rule out conditions that cause similar symptoms, such as pneumonia.
In advanced COPD, a chest X-ray might show?
Lungs that are much larger than normal
Medications that relax the muscles of the airways to help keep them open and make it easier to breathe.
Bronchodilators
Work by blocking muscarinic receptors in airway smooth muscle. Medicine of choice for COPD
Anticholinergic
If bronchodilators don’t provide enough relief, people with COPD may take
Corticosteroids to reduce inflammation in the airways
Severe COPD lowers oxygen in your blood so
Extra oxygen might be needed for the body
Surgical removal of a bulla, which is a dilated air space in the lung parenchyma measuring more than 1 cm.
Bullectomy
Reduction surgery remove the diseased parts of the lung, allowing the healthy tissue to perform better and making it easier.
Bullectomy and Lung Volume Reduction Surgery
Difference of Bullectomy to Lung Volume Reduction surgery
They both involve removing non-working air sacs. However, unlike the bullectomy, LVRS sometimes removes some good air sacs as well.
May help some people with the most severe COPD who have lung failure, but it can have serious complications.
Lung transplant
One of the best thing you can do if you have COPD
Walking
If 90% of people with COPD are current or former smokers and their disease usually appears after age 40, what are the remaining 10?
The remaining 10% are either second-hand smokers of people with Alpha-1 Antitrypsin (AAT) deficiency
What is Alpha-1 Antitrypsin (AAT) deficiency
It is a condition where the body does not produce enough AAT, a protein that protects the lungs and liver from damage.
Tobacco smoke destroys
Tiny hair-like cilia that normally repair and clean the airways and harms the lungs in other ways
Simply the most important step you can take for COPD
Quitting
A healthy diet is important for people with COPD
Overweight = Harder to breathe
Underweight = Makes you weak
Many people with COPD also develop?
Lung cancer
A disease of the airways, is defined as the presence of cough and sputum production for at least 3 months in each 2 consecutive years.
Chronic Bronchitis
In many cases, smoke or other environmental pollutants irritate the airways, resulting in
Hypersecretion of mucus and inflammation
This constant irritation causes the mucus-secreting glands and goblet cells to increase in number resulting in
Ciliary function is reduced, and more mucus is produced.
The bronchial walls become thickened
the bronchial lumen is narrowed, and mucus may plug the airway.
Pathognomonic sign of Chronic Bronchitis
Dyspnea at exertion
Prolonged expiratory grunt in Chronic Bronchitis
Air Trapping: The airflow limitation leads to incomplete exhalation, causing air to remain trapped in the lungs. This can result in a grunt or forced expiration as the person struggles to expel trapped air.
Scattered rales, rhonchi in Chronic Bronchitis
Rales are often caused by airway collapse or mucus plugging, especially in the smaller airways. Rhonchi are often present due to the excessive mucus production and airway narrowing.
Anorexia in Chronic Bronchitis
COPD patients expend more energy on breathing due to airway obstruction and decreased lung function. This increased energy demand may lead to early satiety (feeling full quickly) and reduced appetite.
Emphysema is an impaired gas exchange (oxygen, carbon dioxide) resulting from
Destruction of the walls of overdistented alveoli.
A pathological term that describes an abnormal distention of the air space beyond the terminal bronchioles, with destruction of the walls of the alveoli.
Emphysema
- As the walls of the alveoli are destroyed (a process accelerated by recurrent infections), the alveolar surface are in direct contact with pulmonary capillaries continually decreases, causing an increase in dead space (lung area where no gas exchange can occur) and impaired oxygen diffusion, which leads to
Hypoxemia
Suggests the development of cardiac failure in emphysema
Congestion, dependent edema, distended neck veins, or pain in the region of the liver
There are main two types of emphysema, based on the changes taking place in the lung:
- Panlobular (Pancinar)
- Centrilobular (Centroacinar)
There is destruction of the respiratory bronchiole, alveolar duct, and the alveoli
Panlobular (Pancinar)
Pathognomonic sign of emphysema
Barrel Chest
To move air into and out of the lungs what is needed to do?
Negative pressure is required during inspiration, and an adequate level of positive pressure must be attained and maintained during expiration.
Instead of being an involuntary passive act,
Expiration becomes active and requires muscular effort.
Pathologic changes take place mainly in the center of the secondary lobule, preserving the peripheral portions of the acinus
Centrilobular (Centroacinar)
Smoking depresses the activity of scavenger cells and affects the respiratory tract’s ciliary cleansing mechanisms, which
Keeps breathing passages free of inhaled irritants, bacteria and other foreign matter.
Smoking also irritates the goblet cells and mucus glands, causing
Increased accumulation of mucus which in turn produces more irritation, infection, and damage to the lung.
Carbon Monoxide (a byproduct of smoking) combines with hemoglobin that forms
Carboxyhemoglobin which are incapacitated to carry oxygen.
COPD is characterized by three primary symptoms
Cough, sputum production, and dyspnea on exertion which may worsen over time.
Often precede the development of airflow limitation
Chronic cough and sputum production
Complications of COPD include
Pneumonia, atelectasis, pneumothorax, and cor pulmonale.
The single most effective intervention to prevent COPD or slow its progression.
Smoking Cessation
Diet for COPD patients
High Calorie, High Protein (CHON), Low Carbohydrates (CHO).
LPM for COPD patients
1-3 LPM but 2 is the safest
Giving high concetration of oxygen may result in
Absence of hypoxic drive to breathe
In COPD, the carbon dioxide level in the blood is consistently high. This causes
Damage of the central chemoreceptors in the carotid and aortic bodies take up the work of breathing.
Refer to patients with emphysema.
Pink Puffers
Generalized edema
Anasarca
Suppresses cough
Antitussive
What do you call people with Chronic Bronchitis
Blue Bloaters
In patients with emphysema, what typically appears in xray?
Hyperinflated lung and Flat diaphragm
What is injected to people that the cause of COPD is due to AAT deficiency
Alpha protease
High carbon dioxide in blood
Hypercapnia
