Week 5 Pulmonary Pathophysiology Part 1

Question 1

chronic lower respiratory diseases are the ___ leading cause of death in the US

Answer 1

third

Question 2

what are some forces that affect the work of breathing

Answer 2

airway compliance and elastic recoil of the lungs and chest wall, also airway resistance (mucus, bronchoconstriction and airway thickening)

Question 3

what is compliance, and how does it affect work of breathing

Answer 3

compliance is the ability the lungs to change volume for a given pressure. the amount it can stretch. it is the change in volume over the change in pressure

Question 4

what is the compliance like in a COPD patients vs a RLD patient

Answer 4

COPD: increased compliance, which can lead to air trapping. RLD: decreased compliance.

Question 5

what are some ways we can asses lung function

Answer 5

lung volume/ capacity (PFT)
gas exchange (ABG and DLCO)
imaging (X-ray, ST scan, perfusion scan)
Function (6MWT, ETT)

Question 6

what is the DLCO

Answer 6

it is the diffusion capacity of the carbon monoxide in the body. Give CO, then max inhale, hold for 10 seconds, then max exhale. look at the initial and final alveolar concentrations of CO.

Question 7

what is the DLCO in normal or pathology conditions

Answer 7

normal: 80-100%

pulmonary pathology: less than 80%

Question 8

DLCO is dependent on what 5 factors

Answer 8

1. volume inspired
2. pulmonary blood flow
3. AC surface area
4. hemoglobin
   5 . thickness of AC membrane.

Question 9

what are the common sequelae of chronic lung disease

Answer 9

right HF
pulmonary hypertension
a-fib
obstructive sleep apnea.

Question 10

digital clubbing is most commonly caused by

Answer 10

lung cancer

Question 11

TF: digital clubbing is always present

Answer 11

false

Question 12

COPD is a problem with getting air ___

Answer 12

out

Question 13

what is the FEV1/FVC ratio and the FEV1 values for COPD

Answer 13

FEV1/FVC: less than .7

FEV1: less than 80% predicted.

Question 14

COPD is accompanied with increased or decreased compliance

Answer 14

increase

Question 15

COPD is characterized by

Answer 15

persistence progressive airflow limitation with an enhanced chronic inflammatory response to noxious particles or gases.

Question 16

most common risk factor for COPD is

Answer 16

tobacco smoking

Question 17

what are the types of COPD

Answer 17

chronic bronchitis
emphysema
alpha 1 antitrypsin deficiency
asthma

Question 18

what is chronic bronchitis

Answer 18

cough and sputum production in the winter, for most days of 3 months for 2 consecutive years.

Question 19

what is emphysema

Answer 19

loss of alveolar walls, increased size of acinar airways in the upper lobe segments

Question 20

what kind of pattern does emphysema create

Answer 20

centrilobular or centriacinar patters.

Question 21

what is alpha 1 antitrypsin deficiency

Answer 21

genetic deficiency that gives you pacing emphysema and the lower regions of the lungs are affected first.

Question 22

what is asthma

Answer 22

reversible bronchospasm with wheezing, short lived bouts. from plane or allergies.

Question 23

what is some of the pathophysiology of emphysema

Answer 23

fibrotic and thin membranes
mucus hyper-secretion
alveolar walls destroyed
macrophages overtaxed and ruptured.

Question 24

how is air trapped in COPD

Answer 24

there are collapse or narrowing in some of the airways, which makes it hard for air to leave, so you get trapped air.