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SPC Pulm Disease
SPC Pulmonary Disease Exam 2 Review
| Question | Answer |
|---|---|
| What is Chronic Bronchitis? | Cough > 3mths in 2 consecutive years |
| What is Emphysema? | A permanent enlargement of the air spaces distal to the terminal bronchioles w/ destruction of bronchiole walls |
| What is COPD? | Chronic Obstructive Pulmonary Disease. Can be one, two, or all of CB, Emphysema, or Asthma |
| Panlobular Emphysema | Genetic defect, effects lower lungs, Apha1-antitrypsin deficiency |
| Centriacinar Emphysema | The most common form of emphysema, strongly associated w/ cigarette smoking and w/ CB |
| Emphysema risk factors | Alpha1-antitrypsin deficiency, age, tobacco use, occupational exposure, indoor/outdoor air polution, socioeconomic status, respiratory infections |
| Main PFTs used to measure COPD airflow limitations: | FVC, FEV1, and FEV1/FVC |
| COPD chest radiographs show: | Flat diaphragms, long and distended heart shadow, widened intercostal spaces - all caused by hyperinflation |
| Emphysema is detected by: | Spirometry can tip off but CT scan needed - can determine centriacinar or panacinar |
| Pink Puffer: | Type A COPD - emphysema, red complexion, pursed-lip breathing |
| Blue Bloater: | Type B COPD- chronic bronchitis, bluish color (cyanosis) |
| Emphysema features: | Barrel chest, pursed-lip breathing, accessory muscle use, decreased breath sounds, decreased DLCO & DL/VA |
| Chronic Bronchitis features: | Sputum, cyanosis, peripheral edema, neck vein distention, wheezes & crackles, typically normal DLCO & DL/VA |
| COPD therapeutic options: | Smoking cessation/prevention, flu / pneumonia shots, occupational exposure, inhaled corticosteroids (first, continued), long-term oral corticosteroids (last, stopped), ALpha1-antitrypsin augmentation therapy, mucolytic agents, exercise rehab, surgery |
| What best identifies emphysema and CB? | Spirometry |
| What is asthma? | Reversible broncial smooth muscle constriction (bronchospasm), airway inflammation, increased airway responsiveness to an assortment of stimuli |
| What is remodeling? | Damaged cilia, basement membrane of the mucosa may become thicker than normal (fibrosis) |
| Asthmatic episode major pathologic & structural changes: | Bronchospasm, excessive prod of thick, whitish bronchial secretions, hyperinflation of alveoli (air trapping) |
| Extrinsic Asthma: | Childhood, increase in IGE, immediate (Type I) anaphylactic hypersensitivity reaction = allergies |
| Intrinsic Asthma: | Adults ,normal or decreased IGE, non-allergic |
| Asthma exacerbations: | NDSAIDs, food additives/preservatives, exercise-induced bronchoconstriction, GERD |
| Asthma monitoring tests: | FEV1, FEV1/FVC, PEFR |
| Bronchodilator is working in asthma pt when: | >12% increase in FEV1 or >60L/m increase in PEFR |
| What is FENO? | Fractional Expired Nitric Oxide, determines airway inflammation |
| What is Pulsus Paradoxus? | Systolic BP that is more than 10mmHg lower on inspiration than on expiration |
| Pulsus Paradoxis during an asthma attack: | Caused by the major intrapleural pressure swings that occur during inspiration and expiration |
| Asthma xray findings: | Barrel Chest - hyperinflation |
| Asthma management goals: | Attain & maintain control of the clinical manifestations, maintain normal activity levels and pulm func, prevent asthma exacerbations, avoid adverse effects from meds, prevent asthma mortality |
| Asthma controller meds: | Serevent Diskus, Flunisolide, Singulair, Xolair |
| Asthma rescue meds: | Albuterol (1hr continuous) |
| Acute asthma exacerbation signs: | Increase RR, accessory muscle use, end-expiratory wheeze, increased pulse, pulsus paradoxus |
| What is varicose (fusiform) bronchiectasis? | Bronchi are dilated and constricted in an irregular fashion similar resulting in a distorted, bulbous shape |
| What is cylindrical (tubular) bronchiectasis? | Bronchi are dilated and rigid and have regular outlines similar to a tube |
| What is cystic (saccular) bronchiectasis? | Bronchi progressively increase in diameter until they end in large, cystlike sacs in the lung parenchyma |
| Prevelance of noncystic fibrosis bronchiectasis: | Relatively low in developed nations |
| Most common cause of NCFB? | Obstruction or Infection |
| Bronchiectasis leads to: | Atelectasis, Varicose, Cylindrical or Cystic bronchiectasis |
| Bronchiectasis causes: | foreign body aspirations, hilar adenopathy, bronchial airway mucoid impaction, tracheobronchial/vascular/lymphatic abnormalities, advanced age, malnutrition, sociolymphatic disadv, alpha1-antirtypsin deficiency |
| Best way to diagnose NCFB? | High resolution computed tomography (HR-CT) scan |
| Often found in bronchiectasis secretions: | Haemophilus influenzae, Streptococcus, Pseudomonas aeruginosa, and various anaerobic organisms |
| Bronchiectasis care: | CPT, postural drainage, expectorants, antibiotics (7-10 days), immunizations |
| Cor Pulmonale tx: | O2 1-2 L/m = PaO2 > 50% & SaO2 > 80% |
| Emphysema: PFT Paramenters incr / dcr: | Decreased: FEF25-75%, FEV1, DLCO. Increased: RV, TLC |
| Asthma Tx: | Ipratropium Bromide (Atrovent) - Anticholinergic |
Created by:
vgflgirl
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