Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/64

Click to flip

64 Cards in this Set

  • Front
  • Back
COPD conditions
bronchiolitis (small airways disease),
chronic bronchitis, pulmonary emphysema, chronic asthma
and bronchiectasis.
COPD is said to affect ___% of the adult
population.
10
COPD patients tend to trap air, retain C02 and develop respiratory ______.
acidosis
The two most common forms of COPD are _________
chronic bronchitis and
emphysema.
Bronchi
bronchioles
Respiratory bronchioles
Alveolar ducts
Alveoli

Which are in the respiratory zone?
Alveolar ducts
Alveoli
Bronchi
bronchioles
Respiratory bronchioles
Alveolar ducts
Alveoli

Which are in the transition zone?
Respiratory bronchioles
Bronchi
bronchioles
Respiratory bronchioles
Alveolar ducts
Alveoli

Which are in the conduction zone?
Bronchi
bronchioles
What's this?

-abnormal enlargement of air
spaces distal to the terminal bronchiole accompanied by
destruction of their walls
Emphysema
Classification of Emphysema
Centrilobular/Centriacinar

Familial/Panlobular/Panacinar
Centrilobular/Centriacinar-affects central portion of
acinus or lobule (area of ______ zone).
transition
Familial/Panlobular/Panacinar-involves all of _____
lobule
Centrilobular Emphysema -Is the most common
type and is strongly associated with smoking and
pollution. It is most prominent in the _____ lobes.
upper
Panlobular is associated with alpha-1-antitrypsin
deficiency and is most prominent in the _____ lobes.
lower
Familial/Panlobular Emphysema:

Associated with alpha-1-antitrypsin (an alpha-1-
globulin) deficiency.
Amount and type determined by at least 22 pairs of
codominant alleles. Normal is ______
PiMM
Familial/Panlobular Emphysema:

Emphysema is associated with the ____ codominant
phenotype (0.012% of pop).
PiZZ
Familial/Panlobular Emphysema:

PiMZ phenotype is common (3-5% of pop) and there
is controversy whether they are predisposed to ____.
CAO
Which is Worse in upper lobe?

SMOKERS EMPHYSEMA
FAMILIAL EMPHYSEMA
SMOKERS EMPHYSEMA
Which is Phenotype PiZZ?

SMOKERS EMPHYSEMA
FAMILIAL EMPHYSEMA
FAMILIAL EMPHYSEMA
Which is Panlobular distribution ?

SMOKERS EMPHYSEMA
FAMILIAL EMPHYSEMA
FAMILIAL EMPHYSEMA
Which has Increased macrophages?

SMOKERS EMPHYSEMA
FAMILIAL EMPHYSEMA
SMOKERS EMPHYSEMA
What's this?

-persistent cough with sputum
production for three months in two consecutive years.
Chronic Bronchitis
Chronic Bronchitis:
-intrabronchial mucous and plugging,
bronchial gland hypertrophy and activity, increased bronchial
smooth muscle, usually associated with ____
emphysema
When do you get Compensatory emphysema?
-following removal of lung or portion of lung
What is Senile emphysema?
-refers to radiolucency on X-ray with age
Septal / Bullous emphysema?
-Septal emphysema is along the septa or
pleura. It leads to bullae formation and outpouchings along
the pleura.
The underlying reason for airway collapse is thought
to be due to destruction of the surrounding alveolar
______ which in the normal lung exerts traction on the
periphery of the airway, holding it open.
septa
Serial _____ measurements can help predict which
smokers are at greatest risk for disability and premature
death
FEVl
With which do you see Cirrhosis/liver disease (any age)?

SMOKERS EMPHYSEMA
FAMILIAL EMPHYSEMA
FAMILIAL EMPHYSEMA
emphysema: clinical features
Severe emphysema (both types)
Over expanded large lungs
Barrel chest, often hunched over
Low diaphragms
Gas trapping, C02 retention, respiratory acidosis,
hypoxia, bronchitis.
Pulmonary hypertension (possible with any chronic lung disease)
Right heart failure (cor pulmonale)
Pink Puffers = compensated COPD - non hypoxic

Blue Bloaters = COPD with hypoxia and ___ sided failure -
tend to be seen with severe bronchitis and severe hypoxia
right
Respiratory bronchiolitis: lesion is found in peripheral airways less than __? mm in
diameter and not associated in its early stages with
emphysema, bronchitis, asthma or bronchiectasis.
2
Emphysema and its precursor, bronchiolitis, are presently thought
to be due to an imbalance in release of proteases versus levels of
______
antiproteases
SAD-bronchiolitis:
Clinical disease not apparent until ____ of lung destroyed.
1/3
severe bronchiolitis is seen in persons with ______
arthritis
rheumatoid
Permanent dilatation of bronchi.
Bronchiectasis
Bronchiectasis is more common in lower lobes. This disease
process appears to be decreasing perhaps due to the
introduction of ______.
antibiotics
Important causes of bronchiectasis
Tuberculosis
b. Infection including measles and whooping cough
c. Cystic fibrosis
d. Asthma
e. Kartagener's Syndrome and other ciliary defects
f. Bronchial obstruction
End stage of small airway disease
emphysema
COPD tratment:
_______ improves contractile properties of
the diaphragm and can partially relieve
diaphragmatic fatigue
Theophylline
Repeated episodes of vaso-_______ secondary to
hypoxemia are thought to underlie the development of fixed pulmonary hypertension and cor pulmonale.
vasoconstriction
It is generally recommended that patients with resting O2
arterial tensions of less than 55mm Hg as well as patients
with arterial desaturation during exercise receive ____
therapy.
oxygen
Disease in which filling of the lung (or total lung
capacity) is markedly decreased.
RESTRICTIVE LUNG DISEASE
Is there acidosis with restrictive lung disease?
no
RLD

Chest wall or space occupying processes
a. Kyphoscoliosis
b. Chest Injury
c. Post Surgery
d. Paralysis
e. Obesity -Pregnancy
f. Ascites
g. Pleural effusion
RLD:
There may be a respiratory _____ due to hyperventilation,
alkalosis
Adult Respiratory Distress Syndrome (ARDS) :
Clinically these patients have rapidly progressive ______
dyspnea, hypoxemia, cyanosis, and respiratory failure.
Adult Respiratory Distress Syndrome (ARDS) :

There is a ___% mortality, peaking at 1-2 months.
50
Causes of ARDS
Hypovolemic shock, e.g., post-trauma
Septic shock, especially gram negative
Virus -e.g. Hanta virus
Pneumocystis and CMV in AIDS
Toxic gases, near drowning, high altitude (all are diffuse toxic
exposures)
Pancreatitis (systemic release of digestive enzymes)
Cardiopulmonary bypass
Some immunological disorders and other severe, diffuse
conditions (uremia, DIC, etc).
three stages of ARDS
exudative
proliferative
organizing
ARDS: What stage?

There is an initial injury involving all
layers of the alveolar wall: epithelial, interstitial and
endothelial. Edema fluid collects within the interstitium
and the capillaries leak plasma proteins leading to
formation of hyaline membranes.
exudative
ARDS: what stage?

The type I pneumonocytes are
replaced by type II. Fibroblasts proliferate within the
edematous interstitium and fibrous tissue may be seen
within 10-15 days.
proliferative
ARDS: Wht stage?

More fibrous tissue is produced,
alveolar spaces enlarge, and with time may form
prominent cystic spaces (honeycomb lung).
organizing
Chronic Interstitial and infiltrative disorders:

Describe the lungs.
The lungs are small, stiff and fibrotic.
Chronic Interstitial and infiltrative disorders:

The patients exhibit reduced lung volumes, hypoxemia
and hypocapnia... what's that?
respiratory alkalosis

as a result of
hyperventilation perhaps secondary to scarring &
involvement of the stretch receptors.
FEV1,/ FVC in Chronic Interstitial and infiltrative disorders:
FEV1,/
FVC is often increased.
Chronic Interstitial and infiltrative disorders:

hypoxemia at rest in these patients is a disparity in ventilation/perfusion, with functional ______ shunting through fibrotic lung.
right to left
Interstitial lung disease can clearly be induced by a
what drugs?
alkylating agents, nitrosoureas,
antimetabolites and other drugs used in cancer
therapy.
Etiologies for chronic interstitial fibrosis
Environmental disease (pneumoconioses and chronic
hypersensitivity disorders, etc.) (25%)
Sarcoidosis (20%)
Idiopathic interstitial pneumonias e.g. UIP, (10-15%)
Connective tissue disorders (10%)
Infections (3%)
Drugs (amiodarone, cytotoxic agents)
Radiation
Other immunological disorders (Goodpasture's, Wegener's,
eosinophilic (allergic) pneumonia)
interstitial disease/ idiopathic
pulmonary fibrosis :

The disease begins as a chronic inflammatory disorder in
which inflammatory cells collect in the lower respiratory
tract, a process called "alveolitis" even though the
inflammation also involves the walls of _______.
bronchioles
interstitial disease/ idiopathic
pulmonary fibrosis

While neutrophils damage the lung parenchyma, the
__________ releases both a collagenase and a factor which
stimulates fibroblast activity (collagen synthesis).
macrophage
interstitial disease/
idiopathic pulmonary fibrosis:


Circulating immune complexes are present in some
of these patients, the patients which respond best to
what treatment?
steroids
ILD:

One form of these disorders you should know: Usual
______ ______ (UIP).
interstitial pneumonitis
Stages of UIP
"Alveolitis"
Release of fibrogenic mediators
Fibrosis
"Honeycomb" lung at end stage
Causes of UIP
The cause is unclear.
Both neutrophils and macrophage are thought to be
involved.