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45 Cards in this Set

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What is pluerisy?
• aka pleuritis
• inflammation of the pleura
What are the 5 mechanisms linked to abnormal collection of fluid in the pleural cavity?
• increased capillary pressure (ex. CHF)

• increased capillary permeability (ex. inflammation)

• decreased colloidal osmotic pressure (ex. hypoalbuminemia occuring w/ liver disease & nephrosis)

• increased negative intrapleural pressure (ex. atelectasis)

• impaired lymphatic drainage of the pleural space (from obstructive processes like mediastinal carcinoma)
What is hydrothorax?
the accumulation of a serous transudate in the pleural cavity
What are causes of hydrothorax?
• CHF (most common)
• liver failure
• malignancy
• nephrosis
• renal failure
What are conditions that produce exudative pleural effusions?
• infections
• lupus erythematosus
• malignancies
• pulmonary infarction
• rheumatoid arthritis
What is empyema?
pus in the pleural cavity
What is Chylothorax?
the effusion of lymph in the thoracic cavity
What is the most common cause of pleural effusion in the fetus and neonate?
chylothorax, resulting from congenital malformation of the thoracic duct or lymph channels
An effusion may cause a mediastinal shift towards which side?
the contralateral side of the chest
What are signs and symptoms of a pleural effusion?
• dullness or flatness to percussion
• diminished breath sounds
• dypnea (most common symptom)
• pleuritic pain (only when inflammation is present)
What is a pneumothorax?
when air enters the pleural cavity, causing partial of complete collapse of the affected lung
What is the difference between primary spontaneous pneumothorax and secondary spontaneous pneumothorax?
• primary spontaneous pneumothorax occurs in otherwise healthy persons
• secondary spontaneous pneumothorax occurs in person with underlying lung disease
What is the most common cause of secondary spontaneous pneumothorax?
emphysema
What is atelectasis?
refers to incomplete expansion of a lung or portion of a lung
What are some causes of atelectasis?
1. airway obstruction

2. lung compression (as in pneumothorax or pleural effusion)

3. increased recoil of the lung due to loss of pulmonary surfactant
If the area of atelectasis is large enough, the mediasdtinum and trachea will shift in which direction?
• it will shift to the affected side
• in compression atelectasis, the mediastinum shifts away from the affected side
Parasympathetic stimulation of bronchial smooth muscle produces what response? Sympathetic stimulation?
• parasympathetic stimulation, through the vagus nerve and cholinergic receptors, produce bronchial constriction

• sympathetic stimulation, through beta-2 adrenergic receptors, increases bronchodilation
What is the definition of bronchial asthma?
a chronic disorder of the airways that causes episodes of airway obstruction, bronchial hyperresponsiveness, and airway inflammation that usually are reversible
What are some cells and cellular elements that play a role in asthma?
• mast cells
• eosinophils
• T lymphocytes
• epithelial cells
What are the 2 categories of triggers that cause asthma?
• bronchospastic
• inflammatory
What causes the early- or acute-phase response?
the release of chemical mediators from IgE-coated mast cells
What is the MOA of beta-2 agonists?
• relaxes airway smooth muscle by increasing cyclic AMP
• enhances mucociliary clearance
• decreases vascular permeability
What is the MOA of Theophylline?
• smooth muscle relaxation from phosphodiesterase inhibitition & possibly adenosine antagonism
• increases diaphargm contractility & mucociliary clearance
What is the MOA of Ipratropium (Atrovent)?
• competitive inhibition of muscarin cholinergic receptors
• reduces intrinsic vagal tone to airway
Give 2 examples of mast cell stabilizers
• Cromolyn Sodium (Intal)
• Nedocromil Sodium (Tilade)
List examples of leukotriene inhibitors
• Montelukast (Singular)
• Zafirlukast (Accolate)
• Zileuton (Zyflo)
What is the MOA of Zafirlukast (Accolate), Zileuton (Zyflo), and Monteleukast (Singulair)?
• Singular and Accolate are leukotriene receptor antagonists
• Zyflo inhibits 5-lipoxygenase activity
What is the most common cause of COPD?
smoking
What is the definition of emphysema?
a loss of lung elasticity and abnormal enlargement of the air spaces distal to the terminal bronchioles, with destruction of the alveolar walls and capillary beds
Emphysema in patients before the age of 40 is usually caused by what?
alpha1-antitrypsin deficiency
What is the definition of chronic bronchitis?
• airway obstruction caused by inflammation of the major and small airways
• edema and hyperplasia of submucosal glands
• excess mucus excretion into the bronchial tree
What are pink puffers?
• patients w/ pulmonary emphysema
• are able to overventilate and maintain normal blood gas levels
What are blue bloaters?
• patients with chronic bronchitis who are unable to compensate by increasing their ventilation
• develop hypoxemia and cyanosis
Explain how patients with chronic bronchitis develop corpulmonale
• patients are unable to maintain normal blood gases by increasing their breathing effort and develop hypoxia
• hypoxia stimulates RBC production, causing polycythemia
• as a result, patients develop pulmonary hypertension and eventually right-sided heart failure (corpulmonale)
What is a bullectomy?
a surgical procedure that involves the removal of large emphysematous bullae that compress adjacent lung tisse and cause dyspnea
What is bronchiectasis?
• an uncommon type of COPD characterized by a permanent dilation of the bronchi and bronchioles
• caused by destruction of the muscle and elastic supporting tissue resulting from a cycle of infection and inflammation
True/False: Intersitital lung disease are considered restrictive lung disease
The correct answer is: True
Generally, what are the causes of interstitial lung diseases?
• inflammatory conditions that affect the interalveolar structures of the lung and produce lung fibrosis and a stiff lung

• a stiff and noncompliant lung is difficult to inflate, increasing the work of breathing
What type of breaths do people with interstitial lung disease tend to take?
because of the increased effort needed for lung expansion, persons with interstitial lung disease tend to take small but more frequent breaths
What is the difference between obstructive lung disease and interstitial lung disease?
• Obstructive lung disease primarily involve the airways of the lung
• Interstitial lung disease exert their effects on the collagen and elastic connective tissue found between the airways and the blood vessels of the lung
What is the theory for the pathogenesis of most interstitial lung disease?
• disorders are initiated by some type of injury to the alveolar epithelium followed by an inflammatory process that involves the alveoli and interstitium of the lung

• an accumulation of inglammatory and immune cells causes continued damage to lung tissue and replacement of normal functioning lung tissue w/ fibrous scar tissue
What are some causes of interstitial lung disease?
• occupational and environment inhalents
• drugs and therapeutic agents
• immunologic lung disease
What are the 2 major groups of occupation lung disease?
• Pneumoconioses: caused by the inhalation of inorganic dusts and particulate matter
• Hypersensitivity diseases: result from the inhalation of organic dusts and related occupational antigents
Give examples of pneumoconioses
• asbestosis
• berylliosis
• silicosis
• talcosis
What are characteristics of sarcoidosis?
• a multisystem granulomatous disorder that primarily affects the lungs and lymphatic systems of the body
• can affect any organ system, but most commonly manifests in the lungs, skin, and eyes