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Pulmonary Quiz
CardioPulm Dr. Elkington/Novak
| Question | Answer |
|---|---|
| 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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