Test #3 Flashcards
What are the signs of COPD?
Wheezing
Decreased breath sounds
Cyanosis in the absence of polycythemia (late sign)
Signs of lung hyperinflation
Decreased measurements of airflow on spirometry
A disease state characterized by airflow limitation that’s not fully reversible
COPD
What is the single most important risk factor for COPD?
Cigarette smoking
What is the ddx for COPD?
Asthma
Bronchiectasis
Pulmonary Tuberculosis
How do you test for COPD?
Spirometry
What imaging method should you use for COPD?
Chest x-rays - may show features of COPD & may rule out alternative diagnoses
This measure indicates the presence of hypoxia or hypercapnia (in COPD)
Arterial blood gas
What stage of COPD shows forced expiratory volume/forced vital capacity is decreased; usually but not always, chronic cough & sputum production; pt may not be aware that lung function is abnormal
Stage 2 - moderate
What are the management goals for COPD?
Educate pt about disease
Prevent progression
Work to improve ADLs by decreasing symptoms
Reduce the number of exacerbations & superimposed infections
Support smoking cessation
Reduce mortality
Reverse hypoxia & maintain adequate oxygenation
What are the xray findings assoc w/ chronic bronchitis?
Pulmonary overinflation
Flattened diaphragm
Increased retrosternal airspace
Increased bronchial marking
What is the main cause of emphysema?
Smoking
What are the cardinal features of asthma?
Episodic or chronic wheezing
Dyspnea
Cough
Feeling of tightness in chest
What are precipitants for asthma?
Exercise Cold weather Infection Drugs Allergens
What is the ddx for asthma?
COPD Congestive heart disease Pneumothorax Pulmonary Embolism Large airway obstruction Vocal cord dysfunction
How is moderate, persistent asthma treated?
Daily medication is recommended
Low to medium dose inhaled steroid
This is abnormal & permanent dilation of cartilage bearing pulmonary bronchi w/ copious sputum production
Bronchiectasis
What are the tx’s for bronchiectasis?
Antibiotics
PT
Surgery for localized disease
Lifestyle modifications
The most characteristic physical finding is “velcro” quality bibasilar crackles that don’t clear w/ cough & are heard over posterolateral chest in mid to late inspiration
Occupational Lung Disease
Refers to parenchymal lung disease resulting from inhalant of silicon dioxide or silica, in crystalline form
Silicosis
Type of silicosis that occurs rarely but is usually fatal
Acute silicosis
This refers to an infection of the parenchyma of lung & may occur in tandem w/ distal bronchial infection
Pneumonia
Type of pneumonia that is more mild in healthy population?
Viral pneumonia
What is the ddx for viral pneumonia?
Bronchitis Bronchiolitis (on test) Leukocytosis COPD Asthma ARDS
This can be a pulmonary disease or extrapulmonary disease or both that is spread from person to person via inhalant droplets.
TB
What are 2 ways TB is diagnosed?
Isolating the organism from a clinical specimen or biopsy
Infection (not disease) is diagnosed by (+) skin test to tuberculin antigen
How are pts w/ TB treated?
Active TB - Isoniazid w/ rifampin
This disease can effect multiple organs but has a propensity to involve the respiratory tract initially. Cause is unknown
Sarcoidosis
What is the tx for sarcoidosis?
Spontaneous regression of the pulmonary process is frequent
What are some causes of pleural disease?
Transudates
Exudates
Empyema
Cirrhosis
What is the ddx for pleural disease?
CHF
What is the primary etiologic agent that promotes the development of lung cancer?
Tobacco
Smoking contributes to the development of what % of all lung cancers?
90%
What are characteristics of solitary pulmonary nodules that are generally benign?
Present in the past
Haven’t changed size for more than 2 years
What size of pulmonary nodules are almost always malignant?
3cm
The presence of what in a pulmonary nodule has a high predictive value for malignancy?
Corona radiata sign (fine linear strands extending outward from the nodule)
What are characteristics of low risk nodules?
Stable in size (>2 yrs) Benign type calcifications Younger pt (<35yrs) w/ no history of exposures
What are characteristics of high risk nodules?
Nodules larger than 3 cm
Abnormal calcification patterns (corona radiata, eccentric/stippled)
Older pts who are smokers
What category of nodules do most pts have?
Indeterminate risk nodules
