S1 L3.2: Chronic Lung Diseases Flashcards
A chronic inflammatory disorder of the airway mucosa associated with airway hyperresponsiveness
“Big form of allergy”
Bronchial Asthma
Sx of Bronchial Asthma
○ Recurrent episodes of wheezing
○ Breathlessness d/t narrowed airway
○ Chest tightness
○ Mucus production d/t inflammation
○ Coughing d/t irritation of the airways eliciting asthmatic s/sxs
Risk Factors for Asthma
Influence susceptibility to development of asthma in predisposed individuals, precipitate asthma exacerbations, and/or cause symptoms to persist
Environmental Factors
Risk Factors of Asthma
Predisposed individuals to, or protect them from, developing asthma; could be genetic
Host Factors
Inflammation makes the airway hyperresponsive → [?]
Develop sx
Statement 1: Allergens, sensitizers, viruses, or air pollutants come in contact with our airways
Statement 2: Our immune system (+ eosinophils, inflammatory cells) is poised to react to these triggers, their interaction results to inflammation
a. TF
b. FT
c. TT
d. FF
c. TT
With triggers, the normal airway’s muscular portion contracts (bronchoconstriction) → [?] → result to [?]
With triggers, the normal airway’s muscular portion contracts (bronchoconstriction) → will narrow down airways → result to limited airflow
Statement 1: Asthmatic people, whenever they have attacks, become dyspneic or hypoxemic d/t bronchodilation
Statement 2: Wheezes are low-pitched sounds caused by narrowed airways
a. TF
b. FT
c. TT
d. FF
d. FF
1. Bronchoconstriction; 2: High-pitched
Acute Signs and Sx of Asthma
- Dyspnea
- Wheezing (especially upon expiration)
- Flaring of Nostrils
- Interrupted Talking
- Agitation
- Chronic/recurrent cough
Heart is not functioning well (not pumping well), therefore blood fluid that should move forward goes back and returns to the lungs.
Cardiac Wheeze
Severity of Asthma Attack
Alert: Agitated
Breathlessness: Even at rest
Talks in: Words
Wheeze: Loud
Accessory Muscle: Used
RR: Often >30
PR: >120
PaO2: <60, possible cyanosis
PCO2: >45
Severe
Severity of Asthma Attack
Alert: May show agitation
Breathlessness: On walking
Talks in: Sentences
Wheeze: Moderate
Accessory Muscle: Usually not Used
RR: Inc
PR: 100
PaO2: Normal
PCO2: <45
Mild
Severity of Asthma Attack
Alert: Confused
Breathlessness: -
Talks in: -
Wheeze: Absent
Accessory Muscle: -
RR: -
PR: <60 (bradycardia)
PaO2: -
PCO2: -
Pending Arrest
Severity of Asthma Attack
Alert: Agitated
Breathlessness: On walking
Talks in: Phrases
Wheeze: Loud
Accessory Muscle: Used
RR: Inc
PR: 100-120
PaO2: >60
PCO2: <45
Moderate
Chronic Asthma Severity while on Treatment
Daytime Symptoms: Monthly
Nocturnal Awakenings: Less than monthly
Rescue Beta 2 Use: Less than weekly
PEF/FEV1: >80% of predicted
Tx needed: Occasional prn Beta 2 only
Intermittent
Chronic Asthma Severity while on Treatment
Daytime Symptoms: Weekly
Nocturnal Awakenings: Monthly-Weekly
Rescue Beta 2 Use: Weekly-Daily
PEF/FEV1: 60-80% of predicted
Tx needed: Reg ICS + LABA combination
Persistent Mild/Moderate
Chronic Asthma Severity while on Treatment
Daytime Symptoms: Daily
Nocturnal Awakenings: Nightly
Rescue Beta 2 Use: Several times/day
PEF/FEV1: <60% of predicted
Tx needed: Combination of ICS + LABA + OCS
Persistent Severe
Medications
Used regularly to control chronic symptoms and prevent asthma attacks
Long-term-control medications
Medications
Used as needed for rapid, short-term relief of symptoms during an asthma attack
Quick relief medications
Medications
Decrease sensitivity to allergens
Allergy Control
Modified T/F
Facts about COPD
A. In 2010, the WHO estimated 2.74 million deaths worldwide from COPD
B. COPD is the 2nd leading cause of death in the US
FF
A. WHO estimated this in 2000
B. 4th leading cause of death in the US
What is the primary cause of COPD?
Cigarette smoking
T/F
Vape is safer in terms of cardiac & lung problems
False. Vape may be safer in terms of cardiac problems, but in the lungs it is not.
Modified T/F
Facts about COPD
A.Characterized by airflow limitation that is fully reversible
B. Usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gasses
FT
A. Characterized by airflow limitation that is not fully reversible. You can alleviate worsening only.
What are the 3 classifications of COPD?
CHRONIC BRONCHITIS
EMPHYSEMA
SMALL AIRWAYS DISEASE
Matching type
- Destruction and enlargement of the alveoli, Anatomically defined
- Cough and sputum production for at least 3 months in a row of 2 of consecutive years, Clinically defined
- A condition in which small bronchioles are narrowed but pathology is same
A. CHRONIC BRONCHITIS
B. EMPHYSEMA
C. SMALL AIRWAYS DISEASE
- B
- A
- C
Matching type
MANIFESTATIONS
- Inflamed small airways; bronchioles are destroyed
- Airflow narrowing is structural and permanent
- “Pink puffer”
- Alveolar destruction
- Blue bloaters
A. CHRONIC BRONCHITIS
B. EMPHYSEMA
- A
- B
- B
- B
- A
Matching type
RISK FACTORS OF COPD
- Genes
- Lung growth
- Tobacco smoke
- Hyperresponsiveness
- Education
A. HOST FACTORS
B. EXPOSURE
- A
- A
- B
- A
- B
Modified T/F
COPD PATHOGENESIS
A. You are predisposed to COPD because of your genes and you have the environment to culture it
B. Disease particles in gasses promote lung inflammation
TF
B. Noxious particles in gasses promote lung inflammation
COPD PATHOGENESIS
Depending on how the body reacts to inflammation, excessive reaction can lead to _______
Fibrosis
- scars / dead tissues
Matching type
COPD PATHOGENESIS
- Loss of alveolar attachments
- Airway inflammation
- Airway remodeling
- Decrease of elastic recoil
A. Small airway disease
B. Parenchymal destruction
- B
- A
- A
- B
Modified T/F
COPD
A. Irreversible causes of airflow limitation include accumulation of inflammatory cells, mucus, and plasma exudate in bronchi
B. Reversible causes of airflow limitation include fibrosis and narrowing of the airways, loss of elastic recoil due to alveolar destruction, & destruction of alveolar support that maintains patency of small airways
FF
A. Accumulation of inflammatory cells, mucus, and plasma exudate in bronchi - REVERSIBLE
B. Fibrosis and narrowing of the airways, loss of elastic recoil due to alveolar destruction, & destruction of alveolar support that maintains patency of small airways - IRREVERSIBLE
Matching type
COPD PATHOGENESIS
- Smooth muscle construction in peripheral and central airways
- Loss of elastic recoil due to alveolar destruction
- Destruction of alveolar support that maintains patency of small airways
- Fibrosis and narrowing of the airways
A. REVERSIBLE
B. IRREVERSIBLE
- A
- B
- B
- B
T/F
Common symptoms to aid in the diagnosis of COPD are cough, sputum, & fever.
FALSE.
Cough, sputum, & DYSPNEA.
Modified T/F
Diagnosis of COPD
A. Symptoms (cough, sputum, dyspnea) are the only thing to look out for when doing a patient’s subjective examination.
B. Diagnosis of COPD is similar to asthma
FT
A. Symptoms (cough, sputum, dyspnea) and history of exposure to risk factors (tobacco, occupation, indoor & outdoor pollution)
T/F
Diagnosis of COPD
The patient cannot be subjected to spirometry without the s/sx.
FALSE
The patient can be subjected to spirometry even without the s/sx.