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Pulmonary Quiz

CardioPulm Dr. Elkington/Novak

Western med defines asthma as a disease of the tracheobrochial tree
what symptoms occur with asthma (3) smooth muscle contraction , inflammation&hyperirritability, Increased Mucus production
Bronchoconstriction is smooth muscle contraction
What medical treatment is used for all asthma patients? "rescue" and "controller" meds
Asthma medical tmt for acute attacks rescue meds
Disorders caused by hyperactive immune response to harmless substances that touch or enter the body is the definition of allergies
Asthma medical tmt to reduce airway inflammation and prevent attacks controller meds
What disorders are caused by hyperactive immune response Allergies & autoimmune
What disorders are caused by hypoactive immune response infections& cancer
Asthma, urticaria and anaphylaxis is caused by a __________ immune response hyperactive/allergic
Leading cause of disability in children asthma
how many individuals in the US have asthma ~22 million (and increasing)
Asthma is associated with a tremendous loss of _________ quality of life
Therories on why more people are getting asthma and allergies Hygiene hyp, Environmental changes, lifestyle changes
Who first proposed the hygiene hypothesis in 1989 Strachan in BMJ
What is the Hygiene hypothesis less exposure to infections--> allergies, asthma
T or F exposure of young kids to older siblings protects against development of asthma TRUE
Hygiene hypothesis states that lack of early exposure to dirt bugs, animals during childhood will increase the Tendency toward __________________ of lungs, gut, skin, nose to harmless substances Hyper-reactivity
Antibiotic use in infancy ________ risk of asthma increase
Breastfeeding for the first 6 months can reduce asthma and allergies
What are the 4 (out of the 8) food allergies that are frequently outgrown MEWS-> Milk, Eggs, Wheat, Soy
What are the 4 food allergies that are not outgrown PNuttyShell Fish-> tree nuts almonds pecans cashews hazelnuts, Peanuts, Fish, Shellfish
What is the eastern medicine definition of asthma variety of disorders of The Whole Body caused by disruptions of chi energy flow, leading to breathing dis-ease
How does chiropractic define asthma a disorder of the whole body, caused/eacerbated by subluxations which contribute to autonomic and immune imblanaces& breathing dis-ease
typical symptoms and triggers for asthma SOB&wheezing, Exercise&cold air
Lab findings of asthma & allergies High IgE and eosinophils, positive skin test
What does SABA stand for short-acting beta agonists
what is the action and intended effects of SABA relaxes bronchial smooth muscle by stimulating sympathetic receptors, fast &powerful last 4hrs
Tmt for asthma until 1990 quick bronchodilation, SABA
tmt for asthma after 1990 Anti-inflammatory drugs
SABA had been found to be _________ when used too often Deleterious
What type of meds is SABA rescue meds
What are controller meds ICS, LABA, LRTA
What does ICS stand for and what is their effect inhaled corticosteroids, reducing inflammation in airways
What does LABA stand for and what is their effect Long-acting beta agonists, relaxing smooth muscle in airways, effect lasting 12hrs
Are LABA usually effect for acute attacks no
What does LRTA stand for and what is their effect leukotriene receptor antagonists, one pill/day
Overuse of SABA leads to __________ of asthma control due to ______ regulation and increased airways _________ deterioration, down, inflammation
Albuterol, pirbuterol, salbutamol are generic names for SABA
asthma require drugs via "________care" and medical "________" stepwise care, action plan
PRN for SABA is as needed - for symptoms
SABA over use is harmful because it inhibits ______ cell degranulation, a natural anti-inflammatory mech. mast
T or F treating the symptoms early on is necessary F, could be allowing a self-limiting disease to become a chronic one
What meds showed in studies loss of bone at the hip in premenopausal women and increases the risk of glaucoma ICS inhaled corticosteroids
Discontinuation of ICS might be difficult because they only suppress inflammation ________ temporarily
serevent, foradil, advair are Long-acting beta agonists LABA
severe side effects of serevent reported problems occurred right after, several deaths
9 years after serevent FDA states that it is associated with increased risk of life-threatening asthma episodes or deaths
3 years after a research trial SMART of serevent by the makers, GlaxoSmithKline, Halted the study due to
Serevent is one of the most widely prescribed drugs w/ about ___________ in the US in 2004 3.5 million
LABA may be responsible for ______ of the 5000 asthma -related deaths each year 4000
As of december 2008 LABA… risks outweigh benefits and should no longer be used to treat asthma
What are the current FDA recommendations for LABA not the only drug used to treat pt, not be used if other tmt work, only be used in combo w/ ICS
Singulair is increasing used to treat kids w/ asthma, side effects are unpleasant mood changes, suicidal thinking, suicide
What are the 2 systemic tmt for asthma Traditional immunotherapy (allergy shots), monoclonal antibodies (omalizumab)
What are the 2 immunotherapies SCIT & SLIT
What is SCIT subcutaneous immunotherapy, "allergy shots" increasing concentrated injections of specific allergens, adminstered over several years
SCIT is given after skin tests or RAST tests
What is SLIT similar to SCIT but drops under tongue
Chiropractic believes that asthma is a __________ disease Systemic, local manifestation in airways
Normal airway reactivity is protective, lungs protect themselves from ? harmful air (cold, hot, smoky)
Resp. tract infections (esp. viral), sinusitis, GERD, smoke, fumes… are triggers of asthma attacks
For asthma, it is important to this of _ _ _ _ POEM patient-oriented evidence that matters
T or F what happens in the gut affects the lungs and nose and skin? True "everything is connected"
Goals for treating asthma include reduce frequency and severity of attack, reduce need for Rescue & controller med, increase function
What permanent "groove" is seen in pt w/ asthma and why? Harrison's groove, diaphragm action as bones ossify
What are signs of Acute attack Pec, SCM and Scalene tightness, Tripode position
What is the ACT Asthma control test, asking about the last 4 weeks
Ajustments for asthma Upper Cervicals, T1-5, T10-L2, first rib/anyrib
Most pt w/ chronic asthma also have chronic _________ sinusitis subacute
How do chronic subacute sinusitis affect asthma sinuses drain during the night into bronchi, irritating airways
T or F, acetaminophen may help kids with asthma False, cause more asthma
T or F frequent small meals is encouraged for pt w/ asthma TRUE
in a person w/ asthma, exercise can improve QOL and reduce ___________ airway hyper-reactivity
Antibiotics are to be avoided, unless necessary, what is recommended Pro&preboiotics
T or F, H-pylori can affect asthma True, inverse relationship
COPD chronic obstructive pulmonary disease
4th leading cause of death in the US and will be 3rd by 2020 COPD
COPD incidence and prevalenc increasing due to more old smoker, increase life expectancy
COPD is primarily caused by the body's healing reaction to inhaled airborne irritants
Causes of COPD smoking, aging, genetic deficiency of AAT, family HX, severe childhood resp. disease
What is a deficiency of AAT alpha 1-antitrypsin, RARE, leading to early onset COPD
Course of COPD is irreversible, chronic, progressive
How much longer can most people with COPD live 50 % die within 10 years of DX
MC cause of death in pt w/ COPD pneumonia, cor pulmonale, resp. failure
COPD pathological lung changes chronic bronchitis, emphysema, *asthma
Airflow obstruction is due to _______ and __________ in chronic bronchitis sucus and inflammation
What is the chief SX of chronic bronchitis chronic, productive cough along w/ SOF
chronic bronchitis is also refered to _____ _______ "blue bloater"
In emphysema WBCs secrete which proteinase trypsin
Excess trypsin overwhelms ability of ___________ to protect lung tissue Alpha 1-antitrypsin (produced in liver&circulates in blood)
In emphysema increase in proteinases will start to _____________ destroy lung tissue
Tissue destruction in emphysema leads to airflow obstruction--> bronchioles collaspse during expiration, alveoli arent very elastic
Emphysema is also refered to "____ _____" pink puffer
common sign seen in pt w/ emphysema pursed lips
Early onset (<50yrs) of emphysema can be de to congenital deficiency of AAT
Hypertonic&shortened SCMS, scalenes, pec major, elevated 1st rib, rigidity of chest, flattened diaphargm and barrel chest are all manifestations of COPD
Lower Resipratory Tract (LRT) = Lungs
LRI is infection of the lungs
LRI can be caused by bacteria, viruses, fungi, other organisms
Bronchiolitis is also called_______? Why? RSV because respiratory syncytial virus is the MCC
MCC serious infection of LRT in infancy & young kids RSV/bronchiolitis
RSV infection in older kids and adult are similar to ordinary cold
What are signs and symptoms for infants w/ RSV? Irritability, poor feeding, decrease in wet diapers, Low-grade fever, cold sx, croupy couch/wheeze/crackles and Dyspnea
RSV looks a little like (2) asthma and pneumonia
Exam findings in RSV audible wheexing&crackles, SOB, Hyperinflated chest
T or F, guidelines suggest that ddx of bronchiolitis should be based on history and physical exam findings True, imaging and lab tests are rarely helpful
Acute bronchitis is almost always caused by__________ viruses
What is the most troubling sx of acute bronchitis cough
acute bronchitis is often called chest cold
touble cough w/ _______ is seen in bronchitis sputum, usually white or yellow
Bronchitis vs pneumonia SX Bronchitis milder except for cough, Pneumonia more severe sx, Fever, Chills, Chest px, Cold Sweat, SG of consolidation
Acute viral infection of LRT = influenza
Inluenza is the ___ leading cause of death in the US 6th
Most at risk of getting flu is school-aged kids
Most at risk of Serious, life-thretening flu Elderly
Pandecmic of influenza in 1918-19 & how many deaths "Spanish flu" A(H1N1), 20 million world wide
Most pandemics of influenza are caused by which type Type A, which can mutate suddenly
Antigenic _____ is gradual and antigenic _____ can be sudden drift, shift
T or F, viruses that normally affects birds or animals can begin to affect humans TRUE
What are the 2 types of surface proteins on the flu virus Hemagglutinin (H), Neuraminidase (N)
The swine flu in 2009-10 = H1N1
Manifestations of the flu include sudden onset, Chills&fever up to 104, muscle aches, dry cough
Manifestations of the flu in elderly differ S&S are less acute, may apear as fatigue that persists 3-6wks w/ malaise and weight loss
DDX Inluenza from colds and acute bronchitis by more sudden Onset & more severe S&S
DDX Inluenza from pneumonia by dry cough, presence of muscle aches
Complications of the flu include Pneumonia, sinusitis and or MEI, impaired ADLs
Treatment for Inluenza for symptom relief analgesic, throat lozenges, nasal decongestants
Treatment to speed healing of influenza rest, hydrate, supplements & herbs: Vit C, echinacea, NAC..
Treatment for high risk patients of Influenza amantadine or rimantadine (antiviral drugs), Relenza or Tamiflu
How much N-Acetyl Cysteine (NAC) should be taken during flu season 5-600mg
Created by: kfrancis
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