Week 6: COPD

Question 1

In emphysema we are having issues at the a____ ____ junction, so we are going to have an issue with _____

Answer 1

Alveolar- capillary

Diffusion

Question 2

_____ of the gas exchange airways and difficulty with ____ due to decreased airway patency. There can also be an ____ issue which is why it’s classified under c__ ___ ___ ____

Answer 2

Enlargement
Expiration
Obstruction
Chronic obstructive pulmonary disorders

Question 3

The _____ have become ____ in emphysema and fibrotic so they don’t release ___

Answer 3

CAPILLARIES
Thickened
Co2

Question 4

____ is the number one reason people get emphysema

Answer 4

Smoking

Question 5

A genetic deficiency of a___ _ _______ can lead to an early form of emphysema that is not ___ related

Answer 5

Alpha 1 antitrypsin

Smoking

Question 6

A__ ___ occurs with emphysema. We are getting ___ in but are having trouble getting ___ out

Answer 6

Air trapping
O2
Co2

Question 7

The breakdown of the ___ ___ leads to a loss of surface area for ___ ___. This will lead to a loss of ____ capillaries and mess up the ____ _____ ratio

Answer 7

Alveolar wall
Gas exchange
Pulmonary
Ventilation: perfusion

Question 8

The ____ of some capillaries can lead to ___ airways, weakened walls, and interfere with the p___ ___ airflow

Answer 8

Fibrosis
Narrowed
Passive expiratory

Question 9

As condition progresses person will start to trap air in the ____ and eventually increase their t____ ___ ___, leading to inflation and altered chest anatomy

Answer 9

Alveoli

Total residual volume

Question 10

Barrel chest ap:t ratio

Answer 10

Is 1:1

Question 11

Normal chest ap: t ratio

Answer 11

1:2

Question 12

Person with emphysema may have f___ of ___ in respiratory position, b___ ___, and f___ ____

Answer 12

Fixation of ribs
Barrel chest
Flattened diaphragm

Question 13

_____ occurs when the damaged walls of the aveoli collapse and join together forming large air spaces and then rupture

Answer 13

Pneumothorax

Question 14

In advanced emphysema there is h___ and there is an increase in that h___ drive. The chronic levels of __ are going to shut off those chemoreceptors looking at ___ as our respiratory drive and turn on our ___ ___ receptors

Answer 14

Hypercapnea
Hypoxic drive
Co2 
Co2 
Peripheral o2 receptors

Question 15

Patients with advanced emphysema are more prone to i___ due to compromised immune function

Answer 15

Infection

Question 16

emphysema: Issues with p___ and v___ and lack of ___ can result in ___ ____. Leading to ___ ___ ____ and eventually ___ ___ ___ ___

Answer 16

Perfusion 
Ventilation 
O2 
Pulmonary HTN 
Right ventricular hypertrophy
Right sided heart failure

Question 17

Cor pulmonary

Answer 17

R ventricular hypertrophy due to work against pulmonary HTN

Question 18

In emphysema ___will begin to occur on _____. Eventually this will occur __ ___

Answer 18

Dyspnea
Exertion
At rest

Question 19

emphysema: have ______ with prolonged ____ phase because they are trying to ____ off that ____

Answer 19

Hyperventilation
Expiratory
Blow
Co2

Question 20

emphysema: called ___ ____ because they are _____. It is not necessarily an ___ issue so they will be more _____

Answer 20

Pink puffers
Hyperventilating
O2
Pink

Question 21

Patient with emphysema will have ____ _____, and possibly ____ in late stages

Answer 21

Anorexia
Fatigue
Cynosis

Question 22

A ___ and _____ will help determine the cause of emphysema if they are a smoker

Answer 22

History

Physical

Question 23

For a non smoker, test ____ _ ____ enzyme levels. If its ___ - ___% lower than the expected value, they likely have an a___ ____ disorder leading to the enzyme deficiency.

Answer 23

Alpha 1 antitrypsin
10-15%
Autosomal recessive

Question 24

Alpha 1 antitrypsin enzyme gets rid of the _____ enzymes that can be around the ______. If those enzymes remain they may degrade the _____ themselves

Answer 24

Proteolytic
Alveoli
Alveoli

Question 25

emphysema: if FEV is less than ___% expected of their w___, h___, a___, and g___

Answer 25

30% 
Weight 
Height 
Age 
Gender

Question 26

emphysema treatment: use the ______ to determine the ___ of the disease or ______

Answer 26

Spirometer
Progression
Exhasturbation

Question 27

emphysema: in a _____ __-___ you can see h____

Answer 27

Chest x Ray

Hyperinflation

Question 28

emphysema: An ABG will detect any h_____ or h_____

Answer 28

Hypercapnea

Hypoxemia

Question 29

emphysema is ______, but we want to prevent further degreasing of the _____ and worsening of clinical manifestations

Answer 29

Irreversible

Alveoli

Question 30

emphysema: avoid respiratory irritants such as ____

Answer 30

Smoking

Question 31

Immunization against _____ and ____ is to prevent the patient with emphysema from getting an ____ and ___ respiratory tract infection, which will ___ their. emphysema

Answer 31

Flu
Pneumonia 
Upper 
Lower 
Exhasturbate

Question 32

Pulmonary rehab is structured ___ and ___ to optimize function. ____ ___ breathing and ____ position will help patient with emphysema expel ____

Answer 32

Diet 
Exercise 
Pursed lip
Tripod 
Co2

Question 33

Patient with emphysema may need b____ and s_____ just like a person with asthma. ______ will be given if infection is present. ____ therapy is provided as condition progresses

Answer 33

Bronchodilators
Steroids
Antibiotics
Oxygen

Question 34

For emphysema patient with _____ of lung tissue some tissue might need to be removed to get rid of i___ and r____ v___

Answer 34

Hyperinflation
Inflation
Residual
Volume

Question 35

Chronic bronchitis occurs with repeated ____ with ____ ____ that lasts for _ months or longer _ times in a _ year span

Answer 35

Infection
Chronic
Cough
3 months 2 times in a 2 year span

Question 36

Chronic bronchitis is an _____ disorder that leads to ___ and difficulties getting __ our of the body and __ into the body

Answer 36

Inflammatory
Obstruction
Co2
O2

Question 37

Primary etiology of Chronic bronchitis is ___

Answer 37

Smoking

Question 38

___ areas where coming into contact with air pollutants may also lead to Chronic bronchitis

Answer 38

Urban

Question 39

In Chronic bronchitis the ___ of the airways becomes ____ and the mucous glands are going to ______. there is going to _____ of them so there’s is going to be more ___ production

Answer 39

Mucosa 
Inflamed 
Hypertrophy 
Hyperplasia 
Mucous

Question 40

Chronic inflammation can lead to f___ and thickening of the B__ wall so those large __ glands and large wall are going to start to close off the airway. This leads to low ___ levels, d___, and ____.

Answer 40

Fibrosis 
Bronchial 
Mucous
O2 
Dyspnea 
Fatigue

Question 41

Chronic bronchitis:
As result of low oxygen levels, we are going to increase the amount of blood getting to the lungs to get more oxygen to. ___ ____ and eventually __ ____, and finally ___ ___ ___ ____

Answer 41

Pulmonary HTN
Cor pulmonale
Right sided heart failure

Question 42

Emphysema is destruction to ____ ____ leading to reduced airway patency. Chronic bronchitis is no damage to ___ ___ but ___ of the ____ ____

Answer 42

Alveolar wall
Alveolar wall
Inflammation
Bronchial tree

Question 43

The airway blockage in Chronic bronchitis is a result of ___ and ___ of the ___ membranes. Patient can have barrel chest due to ____ ____

Answer 43

Hypertrophy
Hyperplasia
Mucous
Air trapping

Question 44

Patient with Chronic bronchitis will have a ___ ___ and ____ so they are constantly coughing up thick ____ sputum

Answer 44

Chronic cough
Infection
Purulent

Question 45

On auscultation ___ and ____ might be heard in patient with Chronic bronchitis

Answer 45

Rhonci

Wheezing

Question 46

Patient with Chronic bronchitis has __ ___ ___, t___, h___,h___ and ______

Answer 46

Shortness of breath
Tachypnea 
Hypoxia/ Hypoxemia 
Hypercapnia 
Cyanosis

Question 47

Chronic bronchitis patient is a “____ ____”

Answer 47

Blue bloated

Question 48

Chronic bronchitis: due to poor oxygenation they are going to ___ the production of __ ____ ___ leading to p_____

Answer 48

Increase
Red blood cells
Polycythemia

Question 49

Chronic bronchitis patient may have weight ___, c_____ ____, and c___ due to ___ and increase tissue in the fingers

Answer 49

Loss
Cor pulmonale
Clubbing

Question 50

Chronic bronchitis:

____ and ____ needed for dx. ABG will test for ____ or ____ and changes in __ and ___ see how body is compensating.

Answer 50

History 
Physical 
Hypercapnea 
Hypoxia
Co2 
Bicarbonate

Question 51

To diagnose Chronic bronchitis ___ and ___ pulmonary function tests can be done to determine progression. ____ ____ should also be tested

Answer 51

Fev1
Spirometery
Pulse oximetry

Question 52

Treatment Chronic bronchitis:

Supplemental ____, ___ ___, chest _____, _____ rehab, ______ therapy can be used

Answer 52

O2
Smoking cessation 
Chest physiotherapy 
Pulmonary rehab
Pharm therapy

Question 53

If we give the patient with Chronic bronchitis too much oxygen to they body might think that they ___ have to ___. This might slow down their ___ and further exacerbate their symptoms. Prevent infections with ___ and ___ vaccines

Answer 53

Don't 
Breathe 
Respirations 
Influenza 
Pneumococcal

Question 54

Emphysema is an abnormal ____ of the ___ ___ airways that is accompanied by the ___ of alveolar walls without any necessary ____

Answer 54

Enlargement
Gas exchange
Destruction
Fibrosis