Diseases Exam 1
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| How do obstructive diseases affect RV? | Increased
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| How do obstructive diseases affect TLC? | NL or Increased
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| How do obstructive diseases affect FEV1? | Decreased
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| How do obstructive diseases affect FEV1%? | Decreased
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| How do obstructive diseases affect PEFR? | Decreased
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| What is another name for COPD? | COLD (Chronic Obstructive Lung Disease)
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| What is COPD? | A disease state characterized by the presence of incompletely reversible airflow obstruction
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| What two diseases make up COPD? | Emphysema and Chronic Bronchitis
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| What is Emphysema? | Permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of the alveolar walls, without obvious fibrosis
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| What are the two types of Emphysema? | Panacinar (Panlobular) and Centriacinar (Centrilobular)
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| What causes Panacinar (Panlobular) Emphysema? | AAT deficiency, genetic emphysema (most severe)
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| What causes Centriacinar (Centrilobular) Emphysema? | Smoking
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| What are the clinical manifestations of Emphysema? | Thin body build, barrel chest, diminished breath sounds, decreased heart sounds, prolonged expiration 1:4, dyspnea, reddish skin, and hyperresonant percussion note
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| What are the CXR findings for Emphysema? | Hyperinflation, narrow mediastinum, normal or small vertical heart, low flat diaphragm, and presence of blebs or bullae
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| What is Chronic Bronchitis? | Chronic, productive cough for 3 months, for 2 consecutive years
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| What are the causes of Chronic Bronchitis? | Smoking (most common), pollution, long standing asthma, biomass or occupational exposure
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| What are the clinical manifestations of Chronic Bronchitis? | Increased HR, RR, and BP, normal percussion, BS: wheezing, crackles, rhonchi, stocky and overweight build, hypoxia and hypercapnia, cough with copious amounts of purulent sputum, cyanosis, peripheral edema, JVD, cor pulmonale, DLCO
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| What are the CXR findings for Chronic Bronchitis? | Congested lung fields, densities, increased opacity, enlarged horizontal heart, increased bronchial vascular markings
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| List the treatment modalities for COPD | Smoking cessation, bronchodilators, corticosteroids, oxygen therapy, bronchopulmonary hygiene
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| What is pink puffer another term for? | Emphysema
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| What is blue bloater another term for? | Chronic Bronchitis
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| How much does hemoglobin saturation have to reduce before a patient is considered cyanotic? | <5g/L saturation
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| What is it important not to give a CO2 retainer to much oxygen? | They could stop breathing since their brains rely solely on oxygen levels for their hypoxic drive
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| What is the term for increased RBCs? | Polycythemia
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| What is hemoptysis? | Blood streaked sputum
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| What is the breathing pattern for a patient with Emphysema? | Prolonged expiration, 1:4
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| What contributes to Cor Pulmonale? | Polycythemia caused by hypoxemia
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| What are the physical signs of cor pulmonale? | Distended neck veins, peripheral and pitting edema, and enlarged, tender liver
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| What ABG would you expect for a patient with mild to moderate obstructive disease? | Acute Alveolar Hyperventilation with hypoxemia (uncompensated respiratory alkalosis)
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| What ABG would you expect for a patient with severe obstructive disease? | Chronic Ventilatory Failure with hypoxemia (full compensated respiratory acidosis)
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| What is Asthma? | Reversible bronchial airway smooth muscle constriction, airway inflammation, and increased airway responsiveness to an assortment of stimuli
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| What is the cause of extrinsic asthma? | Allergens, environmental agents, house dust, dander, bugs, mold, fungi, family related
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| What is the cause of intrinsic asthma? | Non-allergic, occurs after age 40, typically with no family history
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| What are the clinical manifestations of Asthma? | Increased HR, RR, and BP, accessory muscle use, pursed lip breathing, retractions, increased AP diameter, cyanosis, cough with excessive white, thick, tenacious sputum, pulsus paradoxus
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| What are the chest assessment findings for Asthma? | Wheezing and rhonchi, diminished BS, hyperresonant percussion note, decreased tactile and vocal fremitus, prolonged expiration 1:3
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| List the CXR findings for Asthma | Increased AP diameter, translucent (dark) lung fields, and depressed diaphragms
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| List the treatment modalities for Asthma | O2 therapy, bronchial hygiene therapy, aerosolized medication therapy, mechanical ventilation (status asthmaticus)
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| What is status asthmaticus? | An acute exacerbation of asthma that remains unresponsive to initial treatment with bronchodilators
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| What test is used to assess the reversibility of bronchoconstriction in asthma patients? | Spirometry
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| What are the major pathological changes in the lungs during an asthmatic episode? | Bronchospasm, bronchial wall inflammation, excessive production of thick, white bronchial secretions, mucous plugging, hyperinflation
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| How is airway resistance affected during status asthmaticus? | Increased airway resistance (Raw)
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| What type of ABG would you expect in a patient with status asthmaticus who is rapidly deteriorating? | Acute Ventilatory Failure (acute respiratory acidosis)
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| What treatments/medications are used for status asthmaticus? | O2 therapy, adequate humidification, IV steroids, mechanical ventilation, aminophylline IV
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| What is bronchiectasis? | Characterized by chronic dilation and distortion of one of more bronchi as the result of extensive inflammation and destruction of the bronchial wall cartilage, blood vessels, elastic tissues and smooth muscle
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| What are the three forms of bronchiectasis? | Cylindrical (Tubular), Varicose (Fusiform), Cystic (Saccular)
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| What is the most severe form of bronchiectasis? | Cystic (Saccular)
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| What are the causes of acquired bronchiectasis? | Recurrent pulmonary infections, bronchial obstruction, and inhalation/aspiration
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| What are the causes of congenital bronchiectasis? | Cystic fibrosis (causes 50% of bronchiectasis), Kartagener's syndrome, and systemic disorders
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| List the clinical manifestations of Bronchiectasis | Increased HR, RR, and BP, accessory muscle use, pursed lip breathing, increased AP diameter, cyanosis, digital clubbing, polycythemia, cor pulmonale, JVD, edema, foul smelling sputum that forms three layers
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| List the CXR findings for primarily obstructive Bronchiectasis | Translucent lung fields, depressed diaphragms, long and narrow heart, enlarged heart, and may see areas of consolidation and/or atelectasis
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| List the CXR findings for primarily restrictive Bronchiectasis | Atelectasis or consolidation, infiltrates (suggestive pneumonia), and increased opacity
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| List the treatment modalities for Bronchiectasis | O2 therapy, bronchopulmonary hygiene, lung expansion, aerosolized medication therapy, mechanical ventilation, expectorants, antibiotics
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| What is Cystic Fibrosis? | Genetic disorder caused by mutation of genes located in chromosome 7. Characterized by dysfunction of the endocrine gland
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| What is the cause of Cystic Fibrosis? | Genetics
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| List the clinical manifestations of Cystic Fibrosis | Increased HR, RR, and BP, accessory muscle use, pursed lip breathing, cyanosis, digital clubbing, polycythemia, cor pulmonale, JVD, pitting edema, enlarged, tender liver, cough, sputum, hemoptysis, poor body development, foul smelling stool in infants
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| List the CXR findings for Cystic Fibrosis | Translucent lung fields, depressed diaphragms, right ventricular enlargement, atelectasis and fibrosis, densities, bronchiectasis, pneumothorax, occasionally abscess formation
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| List the treatment modalities for Cystic Fibrosis | Special diet, O2 therapy, bronchopulmonary hygiene, humidification, lung expansion, aerosolized meds, mechanical ventilation, xanthines, expectorants, antibiotics, transplant
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| What is the most reliable test for Cystic Fibrosis? | Sweat test (AKA swear chloride test)
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| What digestive organ is primarily involved in Cystic Fibrosis? | Pancreas
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