Test #1 Flashcards
What are obstructive diseases?
Asthma, COPD,chronic bronchitis and emphysema, bronchiectasis,CF
What is obstructive disorder?
Gas will enter during inspiration but is prevented from leaving. Hard to get the air out
What is restrictive disorder?
Increase in lung rigidity whichwill decrease lung compliance, decreases the volumes held and limit ability to expand during inhalation.
Is asthma reversible?
TRUE
Is COPD reversible or irreversible?
irreversible
What is the disease that is only of the bronchioles and NOT the alveoli?
Asthma
What are the symptoms of an obstructive disease?
- airway narrowing
- bronchospasms
- inflammation
- WHITE, watery to thick mucus
when is air flow especially decreased ?
During exhalation
What are the Anatomic Alterations of the Lungs?
Smooth muscle - constriction of bronchial airways (bronchospasm)
- Bronchial wall inflammation
- Excessive production of thick, whitish, bronchial secretions
- Mucus plugging
- Hyperinflation of alveoli (air-trapping)
- In severe cases, atelectasis caused by mucus plugging
- Increased airway responsiveness
What are the extrinsic risk factors?
house dust, mites, furred animals, cockroaches, fungi, mold, yeast, grasses, trees etc
What is the definition of an extrinsic factor?
Who does it normally appear in and when does it disappear?
- an immediate hypersensitivity reaction.
- children and adults younger than 30. Often disappears after puberty.
What is the definition of intrinsic factor?
can NOT be directly linked to a specific antigen or extrinsic factor, Occurs after the age of 40, its not hypersensitive
What is the diagnosis of asthma?
- cough worsens at night
- recurrent wheeze
- recurrent difficult breathing/SOB
- recurrent tight chest
- symptoms occur or worsen in a seasonal pattern
- pt. Has eczema, hay fever, or a family history of asthma or atopic disease
T or F
You have to have a wheeze in order to have asthma?
FALSE
What factors can trigger asthma?
- cold air
- chemical fumes
- fire smoke
- infection
- exercise
- emotional stress
- tobacco use
- ## drugs
what can intrinsic asthma respond to and be mistaken for?
Symptoms respond to appropriate anti-asthma therapy
Patient’s colds “go to the chest” or take more than 10days to clear up
Maybe mistaken for vocal dysfunction, GERD, CHF
What do we assess when treating asthma?
- Control over a 4-week period:
Daytime and nighttime symptoms
Unable to sleep due to symptoms
Relievers needed more than 2x/week
Medication technique and adherence
Comorbidities
Medication side effects
How much should the FEV1 increase after giving a bronchodilator And/or 4 weeks of anti-inflammatory treatment?
> 12% or 200mL
how much should the peak expiratory flow increase after a bronchodilator?
> 20%
What are the normal FENO results for an adult and a child?
Adult
- normal:25
- >50; start ICS
Child
- normal:20
- >35; start ICS
What is intermittent severity of asthma?
- symptoms <2 days/week
- nighttime awakening <2x/month
- no interference l with normal activity
- exacerbations requiring oral systemic steroids.
-saba <2days/week - lung function PEF > 80% FEV1/FVC normal, PEF or FEV1 <20%
What is the severity of mild persistent asthma?
- symptoms > 2 days/week but NO daily
- minor limitations to normal activity
- night time symptoms 3-4x/month
- SABA > 2x/week but not daily and NOT more than 1x daily
- Exacerbation >2/year
Wha is the severity of moderate persistent asthma?
- symptoms daily
- exacerbations may affect activity and slee
- some limitation with everyday living
- night time symptoms >1/week not nightly
- daily use of inhaled SABA
- exacerbations >2/year
What is the severity of severe persistent asthma?
- daily symptoms
- frequent night symptoms and awakening, often or every night
- extremely limited with normal activity
- SABA several times per day
- limitation of physical activity
Exacerbations >2/year
