Path 404: Mechanisms Of Acute And Chronic Bronchopulmonary Injuries

Front 1

What does ARDS stand for?

Back 1

adult respiratory distress syndrome

Front 2

What is ARDS?

Back 2

Rapidly progressive respiratory failure with severe hypoxemia usually requiring mechanical ventilation.

Front 3

True or false: ARDS is typically seen in previously healthy patients who sustained severe injury or illness.

Back 3

true

Front 4

The pathologic counterpart to ARDS is known as _________.

Back 4

Diffuse alveolar damage (DAD).

Front 5

What is the main mechanism of DAD?

Back 5

lung injury of various types resulting in endothelial and epithelial damage.

Front 6

Endothelial damage results in a leakage of ______ rich fluid from the capillaries which in turn forms _______ membranes on the injured alveolar wall.

Back 6

protein, hyaline

Front 7

Name the three phases for diffuse alveolar damage.

Back 7

1) exudative phase 2) organizing phase 3) resolution

Front 8

Which DAD phase occurs within the first week of insult and is characterized by protein exudation, accumulation of inflammatory cells and formation of hyaline membranes?

Back 8

exudative phase

Front 9

Which DAD phase occurs in the second week following injury and is marked by proliferation of type II pneumocytes and fibroblasts?

Back 9

organizing phase

Front 10

Which DAD phase is seen when patients survive ARDS but may still be left with permanent pumonary fibrosis?

Back 10

resolution phase

Front 11

Most often patients with ARDS required _______ and ________.

Back 11

mechanical ventilation and high levels of oxygen

Front 12

Treatment of ARDS is targeted at _________, __________, and __________.

Back 12

reversing underlying cause, supportive care, and minimizing complications

Front 13

What does COPD stand for?

Back 13

chronic obstructive pulmonary disease

Front 14

Which two diseases fit under the category of COPD?

Back 14

chronic bronchitis and emphysema

Front 15

What is chronic bronchitis defined by?

Back 15

The presence of chronic productive cough for greater than three months per year over a period of two years.

Front 16

What is the main mechanism leading to chronic bronchitis?

Back 16

cigarette smoking

Front 17

Name the principle findings in chronic bronchitis.

Back 17

1) hyperplasia of mucus secreting cells 2) thickening of the bronchial wall 3) increase in the number of goblet cells 4) increase in smooth muscle and 5) excess mucus in the airways

Front 18

True or false: Patients with chronic bronchitis can progress to chronic respiratory failure.

Back 18

true

Front 19

What things can exacerbate chronic bronchitis?

Back 19

bacterial or viral infections

Front 20

Which COPD disorder is defined as enlargement of air spaces distal to terminal bronchioles with destruction of bronchial walls without significant fibrosis.

Back 20

emphysema

Front 21

What is the major cause of emphysema?

Back 21

cigarette smoking

Front 22

The mechanism in hereditary emphysema is deficiency in _________.

Back 22

alpha-1 anti-trypsin

Front 23

In emphysema, damage to _______ tissues in the lung leads to impaired __________ and ___________ of bronchioles.

Back 23

elastic, elastic recoil, dilation

Front 24

True or false: there is a strong relationship between the anatomic location of emphysema and its clinical manifestation.

Back 24

false

Front 25

What symptoms do emphysema patients present with?

Back 25

1) progressive dyspnea on exertion 2) weight loss 3) prolonged expiration 4) chest hyperinflation

Front 26

Treatment of emphysema consists of what three things?

Back 26

1) smoking cessastion 2) oxygen theapy 3) bronchodilators

Front 27

Which disease is defined as reversible airway obstruction with increased airway responsiveness to a variety of stimuli.

Back 27

asthma

Front 28

What is present in a majority of patients with asthma?

Back 28

airway inflammation

Front 29

In asthma, which active mediators contribute to airway edema?

Back 29

histamine, prostaglandins, and leukotrienes

Front 30

What is the most common cause for asthma exacerbation?

Back 30

viral upper respiratory tract infections

Front 31

What is the clinical term for respiratory failure caused by asthma?

Back 31

status asthmaticus

Front 32

Name two bronchiodilators used to treat asthma.

Back 32

beta-agonists and theophylline

Front 33

True or false: Corticosteroids are used to treat asthma.

Back 33

true

Front 34

What condition is defined as accumulation of air in the pleural space?

Back 34

pneumothorax

Front 35

What things can cause pneumothorax?

Back 35

trauma, complications of lung disease, complications of surgery, or spontaneous cause

Front 36

A large, symptomatic pneumothorax can be drained with a _________.

Back 36

chest tube

Front 37

Which conditions is defined as the accumulation of fluid in the pleural space?

Back 37

pleural effusion

Front 38

What are the three types of pleural effusion?

Back 38

1) simple (serous) 2) hemorrhagic (bloody) 3) empyema (pus-like)

Front 39

What things can cause pleural effusion?

Back 39

1) elevated hydrostatic pressure in capillaries 2) low plasma protein 3) pleural inflammation 4) trauma

Front 40

What types pleural effusion needs a chest tube to drain?

Back 40

large, symptomatic, hemorrhagic or infected effusions