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Flashcards in COPD PP 21 on Deck (104)
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1
Q

Type B COPD, “blue bloater” associated with ________

A

chronic bronchitis

2
Q

Hypersecretion of bronchial mucus

A

chronic bronchitis

3
Q

1) Chronic or recurrent productive cough >3 months >2+ successive years 2) Persistent, irreversible when paired with emphysema 3) 1:2 male to female ratio 4) >30 to 40 years

A

chronic bronchitis

4
Q

Chronic inflammation and swelling of the bronchial mucosa resulting in scarring leads to ______

A

chronic bronchitis

5
Q

Elevated IL8 levels recruit neutrophil activation Elevated CD8 T-lymphocytes Extend into surrounding alveoli prevents proper oxygenation and potentiates airway obstruction

A

chronic bronchitis

6
Q

Hyperplasia of bronchial mucous gland/goblet cells Formation of mucus plugs

A

chronic bronchitis

7
Q

Increased bronchial wall thickness associated with _____

A

chronic bronchitis

8
Q

Pulmonary hypertension associated with _____

A

chronic bronchitis

9
Q

Pulmonary hypertension in chronic bronchitis caused by _______ and ______

A

cor pulmonale; r/s heart failure

10
Q

Results in dilation of airway sacs: bronchiectasis Dilated sacs contain pools of infected secretion that do not clear themselves; can cause further infection that can spread to adjacent lung fields by the lymphatics or venous drainage to other areas of the body, commonly the brain

A

chronic bronchitis

11
Q

Typical patient is overweight Commonly associated with emphysema SOB on exertion associated with _______

A

chronic bronchitis

12
Q

Excessive sputum Chronic cough (more severe in mornings) associated with _______

A

chronic bronchitis

13
Q

Evidence of excess body fluids (edema, hypervolemia) Cyanosis (late sign) associated with _______

A

chronic bronchitis

14
Q

You diagnose chronic bronchitis using a ________ and _______ function tests

A

chest x ray; pulmonary

15
Q

_____ total lung capacity (TLC) _____ residual volume (RV) _____FEV1 are pulmonary function tests used to diagnose chronic bronchitis

A

normal; increased; decreased

16
Q

Increased bronchial vascular markings Congested lung fields used to diagnose ________

A

chronic bronchitis

17
Q

Enlarged horizontal cardiac silhouette Evidence of previous pulmonary infection used to diagnose _______

A

chronic bronchitis

18
Q

______ PaCO2 ______ PO2 used to diagnose chronic bronchitis

A

elevated; decreased

19
Q

Atrial arrhythmias Evidence of right ventricular hypertrophy used to diagnose ________

A

chronic bronchitis

20
Q

Secondary polycythemia used to diagnose _______

A

chronic bronchitis

21
Q

Block the progression of the disease Return to optimal respiratory function Return to usual activities of daily living are just some goals of _______

A

chronic bronchitis

22
Q

Inhaled short-acting B2 agonists is medication for ______

A

chronic bronchitis

23
Q

Inhaled anticholinergic bronchodilators Cough suppressants Antimicrobial agents (bacterial infections) meds for _______

A

chronic bronchitis

24
Q

Inhaled/oral corticosteroids Theophylline products meds for ______

A

chronic bronchitis

25
Q

Low-dose _____therapy Mechanical ventilation may be necessary for ______

A

O2; chronic bronchitis

26
Q

Smoking cessation Bronchodilator therapy Reduction to exposure of irritants done to manage ______

A

chronic bronchitis

27
Q

Rest, hydration, and physical reconditioning used to manage _____

A

chronic bronchitis

28
Q

Influenza and pneumococcal vaccines used to manage _______-

A

chronic bronchitis

29
Q

Type A COPD “Pink puffer associated with _______

A

emphysema

30
Q

Destructive changes of the alveolar walls WITHOUT fibrosis Abnormal enlargement of the distal air sacs

A

emphysema

31
Q

Damage is irreversible Associated with chronic bronchitis

A

emphysema

32
Q

Smoking >70 packs/year Air pollution Certain occupations (mining, welding, working with or near asbestos) are just some causes of _______

A

emphysema

33
Q

α1-Antitrypsin deficiency notable for causing_______

A

emphysema

34
Q

Pathogenesis of _______ includes release of proteolytic enzymes from neutrophils and macrophages leading to alveolar damage

A

emphysema

35
Q

Smoking causes alveolar damage, leading to Inflammation in ______-

A

emphysema

36
Q

Release of proteolytic enzymes and Inactivated α1-antitrypsin in ______

A

emphysema

37
Q

Reduction in pulmonary capillary bed and loss of elastic tissue in lung leads to _______

A

emphysema

38
Q

Loss of alveolar wall and air trapping leads to bullae formation in _______

A

emphysema

39
Q

Progressive, exertional dyspnea a symptom of ______

A

emphysema

40
Q

Thin R/t increased respiratory effect, increased caloric expenditure, and decreased ability to consume adequate calories manifestation of _______

A

emphysema

41
Q

Use of accessory muscles manifestation of ______

A

emphysema

42
Q

Pursed-lip breathing manifestation of _____

A

emphysema

43
Q

Cough (minimal or absent) Digital clubbing manifestations of ______

A

emphysema

44
Q

barrel chest manifestation of ______

A

emphysema

45
Q

Pulmonary function tests (PFTs) for emphysema include _____ functional residual capacity _______RV, TLC _______ FEV1, FVC

A

increased; increased; decreased

46
Q

When diagnosing ________ with a chest x ray, you are looking for Hyperventilation Low, flat diaphragm

A

emphysema

47
Q

When diagnosing ________ with a chest x ray, you are looking for Presence of blebs or bullae Narrow mediastinum

A

emphysema

48
Q

When diagnosing ________ with a chest x ray, you are looking for Normal or small “vertical” heart

A

emphysema

49
Q

When diagnosing emphysema, the ECG is usually normal and will show high _____ waves

A

P

50
Q

Sinus _____: first sign of decreased oxygenation Supraventricular arrhythmias Ventricular irregularities will all show up on an ECG for _______

A

TACHYCARDIA; emphysema

51
Q

____ decrease in PaO2 _____ PaCO2 (elevated in late stages) in emphysema

A

mild; normal

52
Q

Thin, wasted individual hunched forward Using accessory muscles symptoms of

A

emphysema

53
Q

Decreased breath sounds, lack of crackles and rhonchi Prolonged expiration symptoms of _______

A

emphysema

54
Q

Decreased heart sounds Hyperresonance signs of _______

A

emphysema

55
Q

Decreased diaphragmatic excursion Chronic morning cough signs of ______

A

emphysema

56
Q

O2 therapy, smoking cessation, and meds like Inhaled short-acting B2 agonists and Inhaled anticholinergic bronchodilators used to treat _______

A

emphysema

57
Q

Meds like Cough suppressants Antimicrobial agents (infections) Inhaled/oral corticosteroids used to treat _______

A

emphysema

58
Q

Meds like Theophylline products used to treat _______

A

emphysema

59
Q

Cystic fibrosis is an autosomal recessive disorder of ________ glands

A

exocrine

60
Q

Most common genetic lung disease in the U.S. Classified as airflow or suppurative (pus-forming)

A

Cystic Fibrosis

61
Q

Hypersecretion of abnormal, thick mucus that obstructs exocrine glands and ducts Median survival age: 31 years

A

Cystic Fibrosis

62
Q

Dysfunction of ______ gene in cystic fibrosis

A

CFTR

63
Q

Primarily affects the pancreas, intestinal tract, sweat glands, and lungs, and in males causes infertility

A

Cystic Fibrosis

64
Q

High concentrations of sodium and chloride in sweat, salivary, and lacrimal secretions

A

Cystic Fibrosis

65
Q

_____-producing glands in the ____tract enlarge in cystic fibrosis

A

mucus; GI

66
Q

Increased production of pancreatic enzymes, causing ______ fat and protein in the stool in _______

A

decreased; cystic fibrosis

67
Q

______ system is also affected by the thick, tenacious mucus in cystic fibrosis

A

bronchopulmonary

68
Q

Failure of chloride channels to function Decreased flow of ions and water results in viscid mucus

A

Cystic Fibrosis

69
Q

Causes airway obstruction, atelectasis, and hyperinflation and also decreases ciliary action Provides a medium for pulmonary infection

A

Cystic Fibrosis

70
Q

History of cough in young adult or child Thick, tenacious sputum

A

Cystic Fibrosis

71
Q

Recurrent pulmonary infections and bronchitis Dyspnea, tachypnea Sternal retractions

A

Cystic Fibrosis

72
Q

Unequal breath sounds Moist basilar crackles and rhonchi

A

Cystic Fibrosis

73
Q

Barrel chest hyperresonant to percussion Digital clubbing (late)

A

Cystic Fibrosis

74
Q

Pancreatic insufficiency, cirrhosis of the liver, diabetes mellitus, gallstones, nasal polyps, and failure of development of the vas deferens in males are just some manifestations of ________

A

Cystic Fibrosis

75
Q

Depleted fat stores Steatorrhea (fatty stools) signs of ________

A

Cystic Fibrosis

76
Q

Anorexia Decreased growth rate in children (wt, ht, head circ) signs of _______

A

Cystic Fibrosis

77
Q

_______ and hypercapnia are signs of cystic fibrosis

A

hypoxemia

78
Q

_____ VC, airflow, TV _____ airway resistance, functional residual capacity in cystic fibrosis

A

decreased; increased

79
Q

Patchy atelectasis, bronchiectasis, cystic lung fields seen through a chest X-ray with ______

A

cystic fibrosis

80
Q

Some typical ways to diagnose _________include sputum C&S

A

cystic fibrosis

81
Q

When diagnosing cystic fibrosis, the sweat test looks for elevated _______ levels

A

Na; Cl

82
Q

Used to determine fat absorption and fecal fat excretion when testing for cystic fibrosis

A

72 hour stool collection

83
Q

Genetic marker ______ confirms diagnosis for cystic fibrosis

A

AF-508

84
Q

Aggressive treatment of respiratory infections Postural drainage and chest physiotherapy (priority) Forced expiratory technique treatments for __________

A

cystic fibrosis

85
Q

Treatment includes bronchodilators, and Dornase alfa

A

cystic fibrosis

86
Q

Treatment includes high dose antibiotics (bacterial infections) and the influenza vaccine

A

cystic fibrosis

87
Q

Nutritional therapy: Unrestricted fat consumption: 30% of caloric intake High protein Vitamin supplements, esp., A, K, D, E used for _______

A

cystic fibrosis

88
Q

Nutritional therapy: Pancreatic enzymes Intake of 150% normal caloric intake May need enteral feedings or IV feedings used for ________

A

cystic fibrosis

89
Q

Heart-lung or lung transplant may be needed for _____

A

cystic fibrosis

90
Q

˜Demonstrates obstruction of airflow in lungs

A

Pulmonary Function Testing (PFT)

91
Q

ØDetermines severity and diagnosis of COPD

ØPatient inhales deeply and exhales as quickly as possible until maximal air is exhaled

Also a type of pumonary function testing

A

Spirometry

92
Q
  • Total volume of air exhaled
  • Time required for exhaling the air is also measured
A

ØForced vital capacity (FVC) in spirometry

93
Q

Forced ______volume in 1 second is another popular type of spirometry

A

expiratory

94
Q

FEV1/FVC ratio >75% spirometry measure

A

no significant obstruction

95
Q

Spriometry measure: FEV1/FVC ratio between 60% and 70%

A

Mild obstruction

96
Q

Spirometry measure: FEV1/FVC ratio 50% to 60%

A

moderate obstruction

97
Q

Spirometry measure: FEV1/FVC ratio <50%

A

Severe obstruction

98
Q

˜A type of spirometry test given is when inhaled bronchodilator (albuterol or metaproterenol) given, repeat test in ___ to ____minutes

A

15-20

99
Q

Positive bronchodilator response is when

  • FEV1 improves >_____
  • Indicative of partially reversible bronchospasm of smooth muscle (asthma, asthmatic bronchitis)
A

15%

100
Q

ØMeasures ability of alveolar gases to diffuse into capillary blood

ØValuable for determining fibrosis or destruction of membrane

A

Diffusion capacity

101
Q

ØDecreased FEV1

ØLow FEV1/FVC ratio (<70%)

diagnose ________

A

obstructive disorder

102
Q

Improvement in FEV1 after use of bronchodilator (asthma) diagnose ________

A

obstructive disorder

103
Q

ØIncreased residual volume (RV)

ØIncreased functional residual capacity (FRC)

diagnose _______

A

obstructive disorder

104
Q
A