Chronric Bronchitis & COPD
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show | Component diseases:
1.Chronic bronchitis
2.Asthma
3. Emphysema
4.Bronchectasis
5. CF
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What is the Effect on airflow in terms of COPD: | show 🗑
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show | •Chronic inflammatory responses, noxious particles, gases
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Discuss the progressive nature of COPD and relate it to the need for establishing a baseline and follow up: | show 🗑
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show | -Smoking
-Genes
-Age&gender
-Lung growth and development
-Exposure to particles
-Social status
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Describe the general pathophysiology of COPD: | show 🗑
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show | dyspnea, cough, sputum, fever, wheezing, chest tightness, fatigue
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Differentiate the major symptomatic difference between chronic bronchitis and emphysema: | show 🗑
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show | Clinical assessment/history, Spirometer•volumes•capacities•flow
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show | Lab values,EKG,ABG,CXR
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List the COPD severity staging guidelines: | show 🗑
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show | Remove irritant =smoking cessation, Pharmacology agents
Pulmonary rehabilitation
Surgical options
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show | Drugs don't change the progressive decline in lung function. They will only help dilate the bronchotrachael tree to help aide air movement and mucus movement
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show | Improve symptoms & improve quality of life
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show | Racemic epinephrine/micronefrin-vaponefrine, Albuterol/Proventil, ventilin, Levalbuterol/xopenex,Salmeterol/serevent, Formoterol/foradil, Arformoterol/brovana, Ipratropium/atrovent,Tiotropium/sprivia, Budesonide/pulimcort,
Mometasone/asmanex
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show | Mometasone/asmanex
Fluticasone/Flovent
Beclomethasone/QVAR,
Acetylcysteine/mucomyst,
Dornase alpha/rhDNAse
Cormide/intal
Nedocromil/tilade
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show | Inhaled because they don't have the side effects of systemic steroids
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Discuss when it is appropriate to use systemic steroids: | show 🗑
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List the criteria for home oxygen use: | show 🗑
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Definition of CB: | show 🗑
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Three causes Of CB: | show 🗑
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Pathophysiology of CB: | show 🗑
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show | Larger airways plug, V/Q mismatch, Pulmonary arteries constrict, Polycythemia
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show | CBC-RBC 4.6-6.2 million/UL for M, 4.2-5.4 for F, Hgb 13-18 gm/dl for M, 12-16 gm/dl for F., Cor Pulmonale (hypertrophy R. Ven), Respiratory Failure
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show | Frequent cough w/mucous expectorate,Slight ↑ RR, Slight ↑ HR, CO, BP, Dyspnea only with lung infection, Breathsounds: no significant changes, Xray – no significant changes, ABG’s slight Resp. Alkalosis with mild hypoxemia (↑PH, ↓PaCO2, ↓HCO3 ↓PaO2)
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show | Chronic cough with increased mucus,Increased RR, HR, CO, BP, Dyspnea esp. with exertion, Increased WOB – prolonged expiration, Diagnostic palpation/percussion, Decreased tactile & vocal fremitus
Hyperresonant percussion note
Breathsounds,Decreased, Cr
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show | CXR, Hyperinflation (air trapping), Translucent (very dark), Increased A-P diameter(barrel chest),Flattened Diaphragm-< or blunted costophrenic angle, Spider like projection in the bronchogram, Enlarged heart
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Pulmonary function testing of CB: | show 🗑
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show | Stop smoking–eliminate irritant, Avoid other lung infections, Avoid Dry, cold air, Bronchial hygiene, Humidified O2 – PRN,Dilate airway to help cough – Bronchodilator- sympathomimetic, Beta 2-Parasympatholytic, Xanthines (theophylline) –
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show | ,Dilate airway to help cough – Bronchodilator- sympathomimetic, Beta 2-Parasympatholytic, Xanthines (theophylline) – aid bronchial dilation,Thin the thick mucous
–Mucolytic–P & PD–USN–Heated Aerosol•Antibiotics – bacterial
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What are the Breath sounds in early CB | show 🗑
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show | ABG’s slight Resp. Alkalosis with mild hypoxemia (↑PH, ↓PaCO2, ↓HCO3 ↓PaO2)
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show | Crackles- wet secretions
wheezes- bronchoconstriction (mucus plug)
Rhonchi- inflammed airways
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show | pH normal,↓ PaO2 (cyanosis & clubbing),↑ PaCO2, ↑ HCO3
Compensated Respiratory Acidosis
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Why do the pulmonary vessel constrict during chronic bronchitis | show 🗑
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laney21882
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